The relationships between body mass index and television viewing, internet use and cellular phone use: the moderating effects of socio-demographic characteristics and exercise

The Effectiveness of a Physical Literacy-Based Intervention for Increasing Physical Activity Levels and Improving Health Indicators in Overweight and Obese Adolescents (CAPACITES 64)

Recently, the concept of Physical Literacy (PL) has emerged as a key concept for promoting active behavior and improving health indicators in adolescents. Overweight and obese adolescents have a low level of Physical Activity (PA), low cardiorespiratory capacity, and high Body Fat percentage (%BF). However, the development of PL in the interest of health improvement has never been studied in overweight and obese adolescents. The objective of this study was to evaluate the impact of an intervention developing PL in overweight and obese adolescents in order to increase their (PA) and improve their health. The study was a prospective, single-arm, non-randomized interventional study. The intervention brings together different actions in PA and dietary education in different adolescent living environments. The study took place over a 9-month period with two data collection times (0; +9 months) and measured Body Mass Index (BMI) and BMI z score, %BF and Skeletal Muscle Mass (%SMM), Moderate-to-Vigorous intensity Physical Activity (MVPA) by accelerometry, CRF, as well as PL by the CAPL-2 tool. Thirteen adolescents (age 11.7 (±1.09) years old) improved their PL scores (+8.3 (±9.3) pts; p ≤ 0.01). BMI z score (-0.3 (±0.3), p ≤ 0.01), their %BF (-3.8 (±4.9); p ≤ 0.01), their CRF (+1.5 (±1.7) mL·min·kg^-1; p ≤ 0.01), and their MVPA (+4.6 (±13.7) min/day; p = 0.36). Initiating multidimensional interventions to develop PL in overweight and obese adolescents may be a promising prospect to enable an increase in their MVPA and improve their long-term health. Longer-term randomized controlled interventional studies are needed to confirm these findings.

Correlation of Socio-Economic Factors, Diet, and Ownership of Consumer Electronics with Body Mass Index in Women of Childbearing Age: Insights from the 2016 South African Demographic Health Survey

The available evidence indicates a correlation between owning consumer electronics, such as cellphones and televisions, and a higher risk of obesity and increased adiposity. However, such studies are sparse in South Africa. Thus, the aim of this study is to examine the dietary and sociodemographic factors associated with various BMI categories, including the possession of consumer electronics, among women of reproductive age in South Africa. This is a secondary study of a population registry that includes dietary, BMI, and digital use items among women of reproductive age. The data is from the South Africa Demographic Health Survey (SADHS, 2016). Of the 3363 participants included in the analysis, women of normal weight were (35.5%), pre-obese (34.5%), obese (27.1%) and underweight (2.9%). Age was found to be significantly associated with pre-obesity at a <0.05 confidence interval. Owning a cellphone was significantly associated with being underweight and had 55% increased odds (1–0.45) (OR = 0.45; 95% CI 0.26–0.77, p = 0.004). Using internet almost daily was statistically significant with being underweight and had 55% (1–0.45) increased odds of being underweight (OR = 0.45; 95% CI 0.20–1.01, p = 0.054). Owning a cellphone and internet use was found to be significantly associated with being underweight. More research is needed to understand why cellphone ownership and using internet almost daily are significantly associated with being underweight.

The degree of association between overweight and obesity with the use of electronic media among Bangladeshi adolescents

BACKGROUND

Electronic media usage is recently considered a modifiable risk factor for overweight and obesity among adolescents. The purpose of this present study was to evaluate the association of electronic media (EM) usage with overweight and obesity among school-going adolescents.

METHODS

This cross-sectional study was conducted from October to December 2019 among school-going adolescents (14-16 years old) residing in the Jashore Sadar Upazila, Jashore district of Bangladesh. A standardized questionnaire was used to collect information regarding the socio-economic status, time spent watching television, video games playing, computer, and smart mobile phone use through face-to-face interviews. Age- and sex-specific body mass index (BMI) cut-off values for overweight and obesity were determined for Asian adolescents by the International Obesity Task Force (IOTF). Multinomial logistic regression analysis was carried out to determine the association between electronic media use with overweight and obesity.

FINDINGS

The findings suggest that the overall prevalence of overweight and obesity was 13.5% and 25.2%, respectively. Among the total adolescent students, about 49.1% highly (above 3 hours per day) spent their time on EM use whereas 30.6% moderately (≥121 to 180 min/day) use EM. The regression analysis showed that spending high time using total screen-based electronic devices, television viewing, video game playing, computer use, and smartphone use were significantly associated with overweight (RRR: 7.36, 95% CI: 3.64-11.54; RRR: 4.58, 95% CI: 1.46-7.95; RRR: 4.45, 95% CI: 2.75-6.12; RRR: 3.18, 95% CI: 1.87-4.70; RRR: 2.15, 95% CI: 1.23-3.51) and obesity (RRR: 8.72, 95% CI: 4.64-12.54; RRR: 2.89, 95% CI: 1.31-5.21; RRR: 3.88, 95% CI: 1.74-5.13; RRR: 3.08, 95% CI: 1.32-4.86; RRR: 1.19, 95% CI: 0.93-1.48) in adolescents, respectively.

CONCLUSION

The results support the total time spent using electronic media was associated with an increased risk of being overweight and obesity. Finally, this study strongly suggests the proper use of electronic media may be necessary to reduce the risk of being overweight and obesity in early adolescents.

Can internet use change sport participation behavior among residents? Evidence from the 2017 Chinese General Social Survey

Purpose

The popularization of the internet has promoted the implementation of China's national fitness strategy and created conditions for Chinese residents to participate in sports. The internet is an essential medium for disseminating sports knowledge, and the use of the internet can change sport participation behaviors. Therefore, the internet can be used to popularize sports knowledge and promote the participation of all people in sports and thus improve the health of the entire population. This study attempts to empirically analyse how the use of the internet changes sport participation behavior.

Method

Utilizing data from the 2017 China General Social Survey, a probit model, ivprobit model, and bias-corrected non-parametric percentile bootstrap test were used to analyse the impact of internet use on sport participation behavior.

Results

The empirical results show that internet use significantly increased the probability of participation in sports by Chinese residents. Heterogeneity test results showed that internet use was more effective in promoting sport participation in middle-aged groups, groups of older persons, unmarried groups, and groups with a high school education or above. The mediating effect test results showed that internet use influenced residents' participation in sports by promoting social interaction, leisure and entertainment, and learning and recharging.

Conclusions

The internet has changed participation in sports; specifically, the use of the internet promotes sport participation. Additionally, internet use has a more obvious impact on improving the sport participation behavior of middle-aged, older, unmarried, and middle- and higher-educated individuals. Internet social interaction, internet entertainment and internet learning are effective channels to encourage Chinese residents to participate in sports and improve their health.

Problematic Smartphone Use and Its Associations with Sexual Minority Stressors, Gender Nonconformity, and Mental Health Problems among Young Adult Lesbian, Gay, and Bisexual Individuals in Taiwan

Smartphones are a necessity for many people; however, problematic smartphone use (PSU) may negatively influence people’s mental health. Using multivariate linear regression analysis, the study examined the associations of sexual minority stressors [namely perceived sexual stigma from family members, sexual orientation microaggressions (SOMs), and internalized sexual stigma] and gender nonconformity with PSU severity as well as the associations of PSU with depression and anxiety in young adult lesbian, gay, and bisexual (LGB) individuals. This cross-sectional survey study recruited 1000 young adult LGB individuals (500 men and 500 women). PSU severity was assessed using the Smartphone Addiction Inventory. The experiences of perceived sexual stigma from family members, SOMs, and internalized sexual stigma and the levels of gender nonconformity, depression, and anxiety were assessed. The results indicated that perceived sexual stigma from family members, SOMs, internalized sexual stigma in the dimensions of social discomfort and identity and gender nonconformity were significantly associated with PSU severity in LGB individuals. Moreover, PSU was significantly associated with depression and anxiety in LGB individuals. The findings highlight the significance of developing strategies for the prevention and early detection of PSU and sexual minority stress in LGB individuals.

Identification of the minimum data set to design a mobile-based application on overweight and obesity management for children and adolescents

PURPOSE

Designing mobile-based applications is one of the tools to raise the awareness of patients and the care team. Aim of this study is to identify the data elements of a mobile-based application to overweight and obesity management for children and adolescents from the experts' point of view.

METHODS

In this descriptive-analytical article, data collection was conducted through library and Internet research. The research population comprised 30 nutritionists selected via simple sampling method. The research instrument was a questionnaire developed by the researcher in four sections: demographic data, assessment data, therapeutic recommendations and application capabilities. Validity and reliability were confirmed by Content Validity Ratio (CVR) and Delphi method respectively.

RESULTS

The Minimum Data Set (MDS) required for overweight and obesity management in children and adolescents was designed based on the data from the guidelines of the United States, Canada, Australia, Britain, Iran, and experts' opinions. The importance of this MDS suggested was calculated based on the percentage points given by experts for the demographic data of 100%, the assessment data of 88.33%, the therapeutic recommendations of 97.67%, and the application capabilities of 88.94%.

CONCLUSION

Identifying prevention and control minimum data set of overweight and obesity in children and adolescents from the point of view of experts will be effective in improving the applications in this field. This MDS has two parts of data elements: the first for recognition of the framework of evaluating and applying therapeutic methods that can empower parents to manage the child's body mass and the second as a patient's personal record for storage a set of data that can be used by nutritionists in visits to healthcare centers.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40200-021-00807-1.

Meal-time Smartphone Use in an Obesogenic Environment: Two Longitudinal Observational Studies

Background

Despite a large volume of research on the impact of other digital screens (eg, televisions) on eating behavior, little is known about the nature and impact of mealtime smartphone use.

Objective

We investigated how smartphones are used in everyday meals, whether phone users differ according to mealtime phone use patterns, and whether specific phone functions (particularly food photography) would affect the amount and enjoyment of food eaten.

Methods

Across 2 studies, we used the experience sampling method to track 1780 meals in situ. In study 1, a total 137 young adults reported on their mealtime smartphone use 3 times per day over 7 consecutive days. This corresponded to each main meal, with participants recording whether they used their phones and what phone functions they engaged in while eating. In study 2, a total of 71 young adults were similarly tracked for 3 meals per day over 7 days. Across the week, participants’ meals were randomized to 1 of 3 smartphone conditions: food photography while eating, nonfood photography while eating, or no phone use. As the outcome measures, participants reported on the amount and enjoyment of food they ate.

Results

During the week-long tracking, most participants (110/129, 85.3%) recorded at least one instance of mealtime smartphone use, with an average frequency of 1 in 3 meals where phones were used (27.1%; 95% CI 23.6-30.6). Unlike traditional digital screens, mealtime phone use encompassed a wide range of social and nonsocial activities. Further, specific forms of phone use behaviors influenced food intake in different ways. Specifically, in study 2, participants showed the typical pattern of increased food intake across the day when they engaged in nonfood photography during a meal (P<.001); however, this pattern was disrupted when they engaged in food photography (P=.73).

Conclusions

Our findings underscore the prevalence and multifaceted nature of mealtime phone use, distinguishing mobile phones from traditional forms of digital screens.

Trial Registration

ClinicalTrials.gov NCT03299075; https://www.clinicaltrials.gov/ct2/show/NCT03299075 and ClinicalTrials.gov NCT03346785; https://clinicaltrials.gov/ct2/show/NCT03346785

Internet Use in Relation to Overweight and Obesity: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

Although several studies have investigated the association between Internet use and odds of overweight and obesity, results are inconsistent. This systematic review and meta-analysis was performed to summarize evidence on the association between Internet use and odds of overweight and obesity. A systematic literature search was conducted in PubMed/Medline, Web of Science, Scopus, and Google Scholar up to February 2019 to identify relevant publications. Finally, 9 cross-sectional studies were considered in this systematic review and meta-analysis. Combining 11 effect sizes from 9 studies, we found a significant, positive association between the highest Internet use, compared to the lowest (ranged from ≥5 h/d to no use among studies), and odds of overweight and obesity (OR: 1.47; 95% CI: 1.21-1.78; I2, 69.6%; P < 0.001), such that Internet users had 47% greater odds of being overweight or obese. We also observed a significant, positive association between the highest Internet use, compared to the lowest (ranged from ≥5 h/d to no use among studies), and overweight/obesity (OR: 1.15; 95% CI: 1.06-1.25; I2, 0.0%; P = 0.426), obesity (OR: 2.58; 95% CI: 1.88-3.54; I2, 0.0%; P = 0.637), and overweight (OR: 1.38; 95% CI: 1.16-1.64; I2, 13.1%; P = 0.330). A linear dose-response meta-analysis revealed that each additional 1 h/d of Internet use was associated with 8% increased odds of overweight and obesity (OR: 1.08; 95% CI: 1.05-1.11; I2, 3.8%; P = 0.403). Findings of this systematic review and meta-analysis indicated that Internet use was positively associated with increased odds of being overweight and obese.

Joint associations between weekday and weekend physical activity or sedentary time and childhood obesity

OBJECTIVE

To evaluate the single and joint associations of objectively measured moderate-to-vigorous physical activity (MVPA) and sedentary time on week and weekend days with obesity in children from 12 countries across all inhabited continents.

METHODS

A multinational, 12-country cross-sectional study of 5779 children aged 9-11 years was conducted. Time spent in MVPA and sedentary behaviors was assessed by waist-worn accelerometry. Logistic regression was used to examine the independent and joint associations of MVPA and sedentary time on weekdays and weekend with the odds of obesity.

RESULTS

After adjustment for all confounding factors, the odds ratios (ORs) of childhood obesity were the highest among children with a low level of MVPA on both weekdays and weekend (OR 4.67), high among children with a high level of MVPA on weekdays and a low level of MVPA on weekend (OR 1.99) and high among children with a low level of MVPA on weekdays and a high levels of MVPA on weekend (OR 2.20), compared to those with a high level of MVPA on both weekdays and weekend. Similarly, the ORs of childhood obesity were significantly higher among children with a high level of sedentary time on both weekdays and weekend (OR 1.87) compared with those with low levels of sedentary time on both weekdays and weekend.

CONCLUSIONS

Lower levels of MVPA or higher levels of sedentary time on either weekdays or weekend were associated with increased odds of obesity in 9-11 year old children in 12 countries.

Prevention of Obesity and Metabolic Syndrome in Children

In recent decades, the prevalence of overweight and obesity has become increasingly common such that it is now the major nutritional problem worldwide. Obesity occurs when dietary energy intake exceeds energy expenditure and has arisen in many societies due to an increasingly "obesogenic" environment in which physical activity has declined and yet children continue to be exposed to unhealthy, energy-dense diets. Additional risks for the development of obesity also include psychological issues and genetic factors. Obesity has many adverse health consequences including development of insulin resistance, Type 2 diabetes, and the metabolic syndrome. There are also important genetic influences on the likelihood of developing insulin resistance. Given the limited success of therapeutic interventions to treat obesity and the metabolic syndrome, there has been an increased interest in preventative strategies. These are likely to be most successful when targeting the young and will require a combination of approaches which will need inter-disciplinary collaborations across health and local government to target families, schools, and local environments to facilitate behavior changes which influence young people's eating behaviors and habitual levels of physical activity.

Epidemic obesity in children and adolescents: risk factors and prevention

The prevalence of obesity among children and adolescents (aged 2-18 years) has increased rapidly, with more than 100 million affected in 2015. Moreover, the epidemic of obesity in this population has been an important public health problem in developed and developing countries for the following reasons. Childhood and adolescent obesity tracks adulthood obesity and has been implicated in many chronic diseases, including type 2 diabetes, hypertension, and cardiovascular disease. Furthermore, childhood and adolescent obesity is linked to adulthood mortality and premature death. Although an imbalance between caloric intake and physical activity is a principal cause of childhood and adolescent obesity, environmental factors are exclusively important for development of obesity among children and adolescents. In addition to genetic and biological factors, socioenvironmental factors, including family, school, community, and national policies, can play a crucial role. The complexity of risk factors for developing obesity among children and adolescents leads to difficulty in treatment for this population. Many interventional trials for childhood and adolescent obesity have been proven ineffective. Therefore, early identification and prevention is the key to control the global epidemic of obesity. Given that the proportion of overweight children and adolescents is far greater than that of obesity, an effective prevention strategy is to focus on overweight youth, who are at high risk for developing obesity. Multifaceted, comprehensive strategies involving behavioral, psychological, and environmental risk factors must also be developed to prevent obesity among children and adolescents.

Internet use patterns and Internet addiction in children and adolescents with obesity

BACKGROUND

There are no data regarding the Internet addiction (IA) rates and patterns in youth with obesity.

OBJECTIVE

This study aimed to explore the prevalence and patterns of IA in children and adolescents with obesity. The relationship between IA and body mass index (BMI) was also investigated.

METHODS

Study includes 437 children and adolescents with age ranging from 8 to 17 years: 268 with obesity and 169 with healthy controls. The Internet addiction scale (IAS) form was administered to all participants. The obesity group also completed a personal information form including Internet usage habits and goals. Linear regression analysis was utilized to assess the contributions of Internet use habits and goals to BMI in the obesity group and IAS scores to BMI in both groups.

RESULTS

A total of 24.6% of the obese children and adolescents were diagnosed with IA according to IAS, while 11.2% of healthy peers had IA (p < 0.05). The mean IAS scores for the obesity group and the control group were 53.71 ± 25.04 and 43.42 ± 17.36, respectively (p < 0.05). The IAS scores (t = 3.105) and spending time more than 21 h week^-1 on the Internet (t = 3.262) were significantly associated with increased BMI in the obesity group (p < 0.05). Other Internet habits and goals were not associated with BMI (p > 0.05). The IAS scores (t = 8.719) were also found to be associated with increased BMI in the control group (p < 0.05).

CONCLUSIONS

The present study suggests that obese children and adolescents were found to have higher IA rates than their healthy peers, and the results indicate an association between IA and BMI.

Socio-demographic determinants of body mass index among school children in Ebonyi State, Nigeria

BACKGROUND

African specific studies on the factors associated with the growth pattern of children are needed to guide evidence and develop effective population-based interventions that can be tailored to the unique African context.

PURPOSE

The purpose of this study was to determine the socio-economic correlates of body mass index (BMI) of primary and secondary school children in Ebonyi State, which is situated in south-eastern Nigeria.

METHODOLOGY

This was a quantitative, cross-sectional study that utilised clustering and stratified sampling techniques to select 1000 learners from primary and secondary schools located in Abakaliki local government area. Apart from a questionnaire, a Mettler weighing scale was also used for data collection. A generalised linear model was used to test the association between the participants' socio-demographic characteristics and their BMI.

RESULT

BMI was positively related to female gender but negatively related to age and level of education. The mode of cooking, who the participants live with and how they get to school also predicted changes in BMI. Other variables like mother's occupation and family's mode of transport were also associated with BMI changes while father's level of education, mother's level of education, father's occupation and the type of residence did not have any statistical relationship with BMI.

CONCLUSION

The present study shows that the BMI of school children is influenced by the socio-demographic characteristics surrounding them. Therefore, efforts should be made to improve the socio-economic standing of families in this community.

Lack of sleep is associated with internet use for leisure

OBJECTIVE

Previous studies have suggested that excessive internet use may cause lack of sleep. However, recent studies have hypothesized that lack of sleep may instigate internet use for leisure. To elucidate the potential effects of sleep time on internet use, we explored the different associations between sleep time and internet use according to its purpose.

METHODS

The population-based, cross-sectional study group from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) collected data from 57,425 middle school students in 2014 and 2015. Sleep time over the past 7 days was classified into the following groups: < 7 h (6 h); ≥ 7 h, < 8 h (7 h); ≥ 8 h, < 9 h (8 h); and ≥ 9 h (9+ h). Internet use time per day was separately surveyed for leisure and for study and categorized as follows: 0 h; > 0 h, ≤ 1 h (1 h); > 1 h, ≤ 2 h (2 h); and > 2 h (2+ h) per day. Information on age, sex, region of residence, body mass index (BMI), economic level, parental education level, stress level, school performance level, and sleep satisfaction were retrieved. The relationships between sleep time and internet use time for leisure/study were analyzed using multinomial logistic regression with complex sampling. In the subgroup analysis according to sleep satisfaction (good, normal, and poor), the associations of sleep time with internet use for leisure were analyzed using the same methods.

RESULTS

Compared to 9+ h of sleep, less sleep was related to a long internet use time (2+ h) for leisure (adjusted odds ratio, AOR [95% confidence interval, CI] of sleep: 8 h = 1.23 [1.14-1.32]; 7 h = 1.42 [1.31-1.54]; and 6 h = 1.56 [1.44-1.70]; P < 0.001). Conversely, a relationship between less sleep and a long internet use time (2+ h) for study was evident only for 6 h of sleep (AOR of sleep: 8 h = 0.84 [0.84-1.04]; 7 h = 1.05 [0.94-1.17]; and 6 h = 1.32 [1.27-1.59]; P < 0.001). In the subgroup analysis according to sleep satisfaction, less sleep was associated with a long internet use time for leisure in all sleep satisfaction groups, although the relationship was more significant in the lower sleep satisfaction group.

CONCLUSION

Less sleep was significantly related to long-term use of the internet for leisure, whereas this association was not definite for internet use for study. Furthermore, poor sleep quality potentiated the relationship between less sleep time and internet use for leisure.

The association between body mass index and duration spent on electronic devices in children and adolescents in Western Saudi Arabia

Objectives:

To evaluate the relationship between body mass index (BMI) and the duration spent on electronic devices, and to assess the factors that can cause obesity among children.

Methods:

A cross-sectional study including 541 participants. Data was collected from March to June 2015 via ambulatory pediatric clinics in Jeddah, Kingdom of Saudi Arabia. The BMI standard deviation was calculated based on Center of Disease Control and Prevention (CDC) standards.

Results:

The mean age of the participants was 10.1 years. Children who spent ≥2 hours daily on electronic devices showed an increased BMI, and made up 68.4% of the sample.

Conclusion:

An increased BMI was more common among children who spent ≥2 hours daily on electronic devices. The relationship between BMI, reduced physical activity, and eating during television viewing was determined.

Internet addiction, sleep and health-related life quality among obese individuals: a comparison study of the growing problems in adolescent health

BACKGROUND

The rapid rise in the global prevalence of obesity suggests that environmental factors may be responsible. The increased use of technology is associated with increased rates of obesity due to declines in physical activity and significant sedentary life style. Internet addiction is also a growing health issue associated with diminished physical activity and poor sleep quality as well as various health problems. The purpose of this study was to determine associations between Internet addiction and adolescent obesity-related problems.

DESIGN AND METHODS

In this case-control study, 71 adolescents with obesity were recruited from the outpatient clinic at Tepecik Teaching Hospital and Katip Celebi University Hospital, Department of Pediatric Endocrinology in Izmir, Turkey. The control group consisted of 64 non-obese adolescents that were matched with patients in the study group by age and gender. All subjects completed socio-demographic forms, an Internet addiction scale, the Pediatric Quality of Life Inventory, the Pittsburgh Sleep Quality Index, and the Epworth Sleepiness Scale.

RESULTS

Adolescents with obesity were significantly more likely to have Internet addiction (p = 0.002), lower quality of life (p < 0.001), and higher daytime sleepiness (p = 0.008). Moreover, binary regression analysis showed that Internet addiction and less physical activity were associated with increased odds of obesity.

CONCLUSION

The results indicated a significant association between Internet addiction and obesity. Health practitioners should take possible Internet addiction, online activities, and physical activities into consideration in follow-up of obese adolescents. In addition to pharmacologic therapies and dietary interventions, providing behavioral therapy targeting healthy Internet use may be promising to reduce the effects of obesity in adolescence.

Ownership of consumer electronics is associated with measures of adiposity during health transition in Vanuatu

OBJECTIVE

The Republic of Vanuatu, like many developing nations, is undergoing a rapid health transition. Our previous study identified several behavioral risk factors for the rising prevalence of obesity. Unexpectedly, daily time spent using television and radio was revealed as a protective factor for obesity in 2007. In this study, we sought to explore associations between ownership of consumer electronics (CE) and measures of adiposity in Vanuatu in 2011.

METHODS

We surveyed 873 adults from five islands varying in level of economic development. Height, weight, and waist circumferences; triceps, subscapular, and suprailiac skinfolds; and percent body fat by bioelectrical impedance were measured. Ownership of eight types of CE, diet through 24-h dietary recall and leisure-time activity patterns were assessed using a questionnaire.

RESULTS

Participants from more developed islands owned more types of CE, and revealed higher measures of adiposity on average as well as higher prevalence of obesity/central obesity. When controlling for demographic factors, and dietary and activity patterns, increased measures of adiposity and risk for obesity/central obesity were associated with ownership of cellphones, music players, televisions, video players, microwaves, and/or refrigerators. Positive correlations between CE ownership and measures of adiposity were mainly observed among men on the two most developed islands.

CONCLUSIONS

The results of this study indicate a possible role of CE use in the rising prevalence of obesity and the shift to a sedentary lifestyle in Vanuatu and many other modernizing regions, where prevention efforts including education on healthy use of CE are imperative.

Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update

This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5–17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth, mean age: 5–17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.

Impulsivity as a precedent factor for problematic Internet use: How can we be sure?

Previous research has suggested that problematic Internet use (PIU) is associated with impulse control disorder. Although researchers have suggested that impulsivity is a risk factor for PIU, the literature lacks longitudinal evidence on the relationship between impulsivity and PIU. We aimed to use a cross-lagged analytic framework to identify temporal order effects and hypothesised that impulsivity was the precedent factor for PIU. In a panel sample of college students (N = 367), trait impulsivity and PIU were measured in the spring of freshman year and in their junior year. The measures included a self-developed PIU Scale and the revised Impulsiveness Scale based on Barratt's concept. We found that "non-planning impulsivity" was not associated with PIU. The "motor impulsivity" subfactor was thus adopted in the cross-lagged model. The results suggest that motor impulsivity and PIU were stable across time. Motor impulsivity at Time 1 positively predicted PIU at Time 2, but PIU at Time 1 did not predict motor impulsivity at Time 2. A further investigation using gender as a moderator found a gender difference in the temporal relationship. Because motor impulsivity is a risk factor for PIU, potential prevention strategies based on this result are suggested.

Time Spent on the Internet and Adolescent Blood Pressure

Internet use is nearly ubiquitous among adolescents. Growing evidence suggests heavy Internet use negatively impacts health, yet the relationship between time spent on the Internet and adolescent blood pressure (BP) is unknown. We examined the association between Internet use and elevated BP in a racially diverse cross-sectional sample of 331 healthy adolescents (ages 14–17 years). Heavy Internet use was defined as ≥2 hr/day, moderate use as <2 hr/day and ≥5 days/week, and light use as <2 hr/day and ≤4 days/week. Elevated BP was defined as systolic or diastolic BP ≥90th percentile. Heavy Internet users had statistically significantly higher odds of elevated BP compared to light Internet users. School nurses can play an important role in preventing high BP through assessment of BP and other health behaviors including Internet use, and health teaching to individuals, student groups, faculty, and parents to increase awareness of the relationship between Internet use and health.

Computer Game Use and Television Viewing Increased Risk for Overweight among Low Activity Girls: Fourth Thai National Health Examination Survey 2008-2009

Studies of the relationship between sedentary behaviors and overweight among children and adolescents show mixed results. The fourth Thai National Health Examination Survey data collected between 2008 and 2009 were used to explore this association in 5,999 children aged 6 to 14 years. The prevalence of overweight defined by the age- and gender-specific body mass index cut-points of the International Obesity Task Force was 16%. Using multiple logistic regression, computer game use for more than 1 hour a day was found to be associated with an increased risk of overweight (adjusted odds ratio (AOR) = 1.4; 95% confidence interval: 1.02-1.93). The effect of computer game use and TV viewing on the risk for overweight was significantly pronounced among girls who spent ≤3 days/week in 60 minutes of moderate-intensity physical activity (AOR = 1.99 and 1.72, resp.). On the contrary, these sedentary behaviors did not exert significant risk for overweight among boys. The moderating effect on risk of overweight by physical inactivity and media use should be taken into consideration in designing the interventions for overweight control in children and adolescents. Tracking societal changes is essential for identification of potential areas for targeted interventions.

The relationship between internet addiction and body mass index in Turkish adolescents

The purpose of this study was to investigate Internet use patterns and Internet addiction among adolescents and to examine the correlation between Internet addiction and eating attitudes and body mass index (BMI). The study was conducted among 1,938 students, aged between 14 and 18 years. The Internet Addiction Test (IAT), the Eating Attitudes Test (EAT), and a sociodemographic query form were used to collect data. According to the IAT, 12.4% of the study sample met the criteria for Internet addiction. A significant positive correlation between BMI and the IAT (r=0.307; p<0.01) and weekly Internet use (r=0.215; p<0.01) was found. Nine students with Internet addiction (3.8%) and 90 with average Internet use (5.3%) were found to have a possible eating disorder (p>0.05). No relationship was found between the EAT and the IAT and duration of weekly Internet use. Linear regression analysis revealed a significant independent association of the IAT with BMI (r=0.235; p<0.001). These results indicate an association between Internet addiction and BMI. Further studies are needed to describe the causality of this association.

Sedentary Behavior and Health Outcomes in Children and Adolescents

The purpose of this review was to summarize findings from epidemiological studies that determined if sedentary behavior was associated with obesity, metabolic risk factors, and cardiorespiratory fitness in children and adolescents. We noted if studies adjusted for moderate-to-vigorous physical activity (MVPA), dietary intakes, and/or sleep duration. Articles were identified through PubMed using the search terms: (sedentary OR sitting OR television) AND (adiposity OR blood pressure OR body mass index OR cardiometabolic OR metabolic risk OR waist circumference). The search was limited to ages 6 to 18 years, humans, and published between January 1, 2008 and September 26, 2012. Cross-sectional and longitudinal studies observed associations between more sedentary behavior, especially screen-based sedentary behavior, and measures of obesity; and most associations were independent of MVPA and dietary intake. Cross-sectional and longitudinal studies reported associations between screen-based sedentary behavior and lower cardiorespiratory fitness, and most associations were independent of MVPA and obesity. Cross-sectional studies observed associations between more screen-based and objectively measured sedentary behavior and lower insulin sensitivity; and most associations were independent of MVPA and obesity. There was little-to-no evidence that sedentary behavior was associated with increased blood pressure and increased blood lipids.

Problematic Internet use and associated risks in a college sample

OBJECTIVE

The Internet is commonly used among young adults; however, Internet use may become a problematic behavior. Past research has examined Internet behavior in young adults and its relationship to other behaviors and health issues, yet further research is needed to gain a more comprehensive understanding of this relationship.

METHOD

A sample (n=2108) of college students (56.9% female) was examined using a self-report Internet survey concerning demographic characteristics, Internet use, health behaviors, psychosocial functioning, and psychiatric comorbidities. The IAT was used to determine levels of problematic Internet use (limited use (none or almost no use), mild use (typical user), moderate use (occasional problems) and severe use (frequent, serious problems)) and the MINI for testing for psychiatric problems.

RESULTS

We found that 237 students (12.9%) met criteria for limited Internet use, 1502 (81.8%) for mild Internet use and 98 (5.3%) for moderate to severe Internet use. Variables significantly associated with greater frequency of Internet use included lower Grade Point Average (p=.006), less frequent exercise (p=.018), higher PHQ-9 scores (p<.0001) (indicative of greater depression symptoms) and higher Perceived Stress Scores (p<.0001).

CONCLUSIONS

These data indicate that moderate to severe Internet use is associated with a range of psychosocial problems in young adults. More research is needed to better understand the relationship between Internet use and physical and mental health, as well as academic variables.

College students' alcohol displays on Facebook: intervention considerations

OBJECTIVE

The purpose of this study was to investigate college freshmen's views towards potential social networking site (SNS) screening or intervention efforts regarding alcohol.

PARTICIPANTS

Freshmen college students between February 2010 and May 2011.

METHODS

Participants were interviewed; all interviews were audio-recorded and transcribed. Qualitative analysis was conducted using an iterative approach.

RESULTS

A total of 132 participants completed the interview (70% response rate), the average age was 18.4 years (SD 0.49), and 64 were males (48.5%). Three themes emerged from our data. First, most participants stated they viewed displayed alcohol content as indicative of alcohol use. Second, they explained they would prefer to be approached in a direct manner by someone they knew. Third, the style of approach was considered critical.

CONCLUSIONS

When approaching college students regarding alcohol messages on SNSs, both the relationship and the approach are key factors.

The fault, dear viewer, lies not in the screens, but in ourselves: relationships between screen media and childhood overweight/obesity

This article summarizes recent findings about associations between electronic screen media and childhood overweight/obesity, hypothesized mechanisms, and mediators. Recommendations are made for parents and clinicians.

Associations between displayed alcohol references on Facebook and problem drinking among college students

OBJECTIVE

To examine the associations between displayed alcohol use and intoxication/problem drinking (I/PD) references on Facebook and self-reported problem drinking using a clinical scale.

DESIGN

Content analysis and cross-sectional survey.

SETTING

Facebook Web site (http://www.facebook.com/).

PARTICIPANTS

The study included undergraduate students (age range, 18-20 years) at 2 state universities with public Facebook profiles.

MAIN EXPOSURES

The profiles were categorized into 1 of 3 distinct categories: Nondisplayers, Alcohol Displayers, and I/PD Displayers.

OUTCOME MEASURES

An online survey measured problem drinking using the Alcohol Use Disorders Identification Test (AUDIT) scale. Analyses examined associations between alcohol display category and (1) AUDIT problem drinking category using logistic regression, (2) AUDIT score using negative binomial regression, and (3) alcohol-related injury using the Fisher exact test.

RESULTS

Among 307 profiles identified, 224 participants completed the survey (73% response rate). The average age was 18.8 years; 122 (54%) were female; 152 (68%) were white; and approximately 50% were from each university. Profile owners who displayed I/PD were more likely (odds ratio, 4.4; 95% CI, 2.0-9.4) to score in the problem drinking category of the AUDIT scale, had 64.0% (incidence rate ratio, 1.64; 95% CI, 1.27-11.0) higher AUDIT scores overall, and were more likely to report an alcohol-related injury in the past year (P = .002).

CONCLUSIONS

Displayed references to I/PD were positively associated with AUDIT scores suggesting problem drinking as well as alcohol-related injury. Results suggest that clinical criteria for problem drinking can be applied to Facebook alcohol references.