title: Screen time is associated with adiposity and insulin resistance in children.
abstract: Higher screen time is associated with type 2 diabetes (T2D) risk in adults, but the association with T2D risk markers in children is unclear. We examined associations between self-reported screen time and T2D risk markers in children.
  
  
  
  Survey of 4495 children aged 9-10 years who had fasting cardiometabolic risk marker assessments, anthropometry measurements and reported daily screen time; objective physical activity was measured in a subset of 2031 children.
  
  
  
  Compared with an hour or less screen time daily, those reporting screen time over 3 hours had higher ponderal index (1.9%, 95% CI 0.5% to 3.4%), skinfold thickness (4.5%, 0.2% to 8.8%), fat mass index (3.3%, 0.0% to 6.7%), leptin (9.2%, 1.1% to 18.0%) and insulin resistance (10.5%, 4.9% to 16.4%); associations with glucose, HbA1c, physical activity and cardiovascular risk markers were weak or absent. Associations with insulin resistance remained after adjustment for adiposity, socioeconomic markers and physical activity.
  
  
  
  Strong graded associations between screen time, adiposity and insulin resistance suggest that reducing screen time could facilitate early T2D prevention. While these observations are of considerable public health interest, evidence from randomised controlled trials is needed to suggest causality.
authors.affiliation: Population Health Research Institute, St George's, University of London, London, UK.
authors.forename: Claire M
authors.initials: CM
authors.lastname: Nightingale
authors.affiliation: Population Health Research Institute, St George's, University of London, London, UK.
authors.forename: Alicja R
authors.initials: AR
authors.lastname: Rudnicka
authors.affiliation: Population Health Research Institute, St George's, University of London, London, UK.
authors.forename: Angela S
authors.initials: AS
authors.lastname: Donin
authors.affiliation: Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Naveed
authors.initials: N
authors.lastname: Sattar
authors.affiliation: Population Health Research Institute, St George's, University of London, London, UK.
authors.forename: Derek G
authors.initials: DG
authors.lastname: Cook
authors.affiliation: Population Health Research Institute, St George's, University of London, London, UK.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
authors.affiliation: Population Health Research Institute, St George's, University of London, London, UK.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Owen
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D009765:Obesity / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D057185:Sedentary Behavior; D057566:Self Report; D013690:Television / Q000706:statistics & numerical data*
keywords: Adiposity; Childhood; Type 2 diabetes