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Mediating role of disordered eating in the relationship between screen time and BMI in adolescents: longitudinal findings from the Research on Eating and Adolescent Lifestyles (REAL) study

  • Fatima Mougharbel (a1) (a2), Darcie D Valois (a3), Megan Lamb (a4) (a5), Annick Buchholz (a5), Nicole Obeid (a6), Martine Flament (a7) and Gary S Goldfield (a2) (a8)...

Abstract

Objective:

This study investigated whether the duration and type of screen time (ST) (TV viewing, recreational computer use, video gaming) is longitudinally associated with z-BMI and if these relationships are mediated by disordered eating (emotional, restrained).

Design:

At baseline, participants were n 1197 (T1; 60 % female) adolescents (mean age = 13·51 years) who completed surveys over 2 years. ST was assessed by a self-reported measure created by the investigative team, while emotional and restrained eating was measured by the Dutch Eating Behaviour Questionnaire (DEB-Q). Height and weight were objectively measured to quantify z-BMI.

Setting:

Thirty-one public and two private schools from the region of Ottawa, Canada.

Participants:

Students in grades 7–12.

Results:

Parallel multiple mediation analyses revealed that more time spent watching TV at baseline is associated with higher z-BMI at T3 (total effect; B = 0·19, se = 0·07, P = 0·01, 95 % CI 0·05, 0·34), but no relationships were observed for total ST exposure or other types of ST and z-BMI. Disordered eating did not mediate the positive association between baseline TV viewing and z-BMI at T3.

Conclusions:

TV viewing was longitudinally associated with higher z-BMI in a community-based sample of adolescents, but disordered eating behaviours did not mediate this relationship. However, other non-pathological eating behaviours may mediate the association between ST and obesity and warrant further investigation. Finding suggests that targeting reduction in youth’s TV viewing may be an effective component in the prevention of childhood obesity.

Copyright

Corresponding author

*Corresponding author: Email ggoldfield@cheo.on.ca

References

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1.Reilly, JJ, Methven, E, McDowell, ZCet al. (2003) Health consequences of obesity. Arch Dis Child 88, 748752.
2.Pulgarón, ER (2013) Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clin Ther 35, A18A32.
3.Han, JC, Lawlor, DA & Kimm, SY (2010) Childhood obesity. Lancet 375, 17371748.
4.Finkelstein, EA, Graham, WCK & Malhotra, R (2014) Lifetime direct medical costs of childhood obesity. Pediatrics 133, 854862.
5.Duckett, SJ, Swerissen, H & Grattan Institute (2016) A Sugary Drinks Tax: Recovering the Community Costs of Obesity. Carlton, Victoria: Grattan Institue.
6.Field, AE, Cook, NR & Gillman, MW (2005) Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res 13, 163169.
7.Guo, SS, Wu, W, Chumlea, WCet al. (2002) Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence. Am J Clin Nutr 76, 653658.
8.Inge, TH, King, WC, Jenkins, TMet al. (2013) The effect of obesity in adolescence on adult health status. Pediatrics 132, 10981104.
9.Whitaker, RC, Wright, JA, Pepe, MSet al. (1997) Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 337, 869873.
10.Leatherdale, ST & Ahmed, RJ (2011) Screen-based sedentary behaviours among a nationally representative sample of youth: are Canadian kids couch potatoes? Chronic Dis Inj Can 31, 141146.
11.Strasburger, VC, Jordan, AB & Donnerstein, E (2010) Health effects of media on children and adolescents. Pediatrics 125, 756767.
12.Tremblay, MS, Carson, V, Chaput, J-Pet al. (2016) Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab 41, Suppl. 3, S311S27.
13.Government of Canada SC (2019) Physical activity and screen time among Canadian children and youth, 2016 and 2017. https://www150.statcan.gc.ca/n1/pub/82–625-x/2019001/article/00003-eng.htm (accessed May 2019).
14.Walsh, JJ, Barnes, JD, Cameron, JDet al. (2018) Associations between 24 hour movement behaviours and global cognition in US children: a cross-sectional observational study. Lancet Child Adolesc Health 2, 783791.
15.Chaput, J-P, Klingenberg, L, Astrup, Aet al. (2011) Modern sedentary activities promote overconsumption of food in our current obesogenic environment. Obes Rev 12, e12e20.
16.Mitchell, JA, Rodriguez, D, Schmitz, KHet al. (2013) Greater screen time is associated with adolescent obesity: a longitudinal study of the BMI distribution from Ages 14 to 18. Obesity 21, 572575.
17.Rosiek, A, Frąckowiak Maciejewska, N, Leksowski, Ket al. (2015) Effect of television on obesity and excess of weight and consequences of health. Int J Environ Res Public Health 12, 94089426.
18.Carson, V, Janssen, I (2011) Volume, patterns, and types of sedentary behavior and cardio-metabolic health in children and adolescents: a cross-sectional study. BMC Public Health 11, 274.
19.Goldfield, GS, Kenny, GP, Hadjiyannakis, Set al. (2011) Video game playing is independently associated with blood pressure and lipids in overweight and obese adolescents. PLOS ONE 6, e26643.
20.Henderson, M, Gray-Donald, K, Rabasa Lhoret, Ret al. (2014) Insulin secretion and its association with physical activity, fitness and screen time in children. Obesity 22, 504511.
21.Boone, JE, Gordon-Larsen, P, Adair, LSet al. (2007) Screen time and physical activity during adolescence: longitudinal effects on obesity in young adulthood. Int J Behav Nutr Phys Act 4, 26.
22.Devís-Devís, J, Lizandra, J, Valencia-Peris, Aet al. (2017) Longitudinal changes in physical activity, sedentary behavior and body mass index in adolescence: migrations towards different weight cluster. PLoS ONE 12(6), e0179502.
23.Doherty, M, Santiago-Torres, M, Cui, Yet al. (2015) The association between screen time and weight status in Hispanic children. BAOJ Obes Weight Loss Manag 1(1), 001.
24.Hands, BP, Chivers, PT, Parker, HEet al. (2011) The associations between physical activity, screen time and weight from 6 to 14 yrs: the Raine Study. J Sci Med Sport 14, 397403.
25.Heilmann, A, Rouxel, P, Fitzsimons, Eet al. (2017) Longitudinal associations between television in the bedroom and body fatness in a UK cohort study. Int J Obes 41, 15031509.
26.Mann, KD, Howe, LD, Basterfield, Let al. (2017) Longitudinal study of the associations between change in sedentary behavior and change in adiposity during childhood and adolescence: Gateshead Millennium Study. Int J Obes 41, 10421047.
27.Bogaert, N, Steinbeck, KS, Baur, LAet al. (2003) Food, activity and family – environmental vs biochemical predictors of weight gain in children. Eur J Clin Nutr 57, 12421249.
28.Basterfield, L, Pearce, MS, Adamson, AJet al. (2012) Physical activity, sedentary behavior, and adiposity in English children. Am J Prev Med 42, 445451.
29.Chaput, JP, Lambert, M, Mathieu, MEet al. (2012) Physical activity vs. sedentary time: independent associations with adiposity in children. Pediatr Obes 7, 251258.
30.Biddle, SJH, García Bengoechea, E & Wiesner, G (2017) Sedentary behaviour and adiposity in youth: a systematic review of reviews and analysis of causality. Int J Behav Nutr Phys Act 14, 43.
31.van Ekris, E, Altenburg, TM, Singh, ASet al. (2016) An evidence-update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta-analysis. Obes Rev 17, 833849.
32.Carson, V, Hunter, S, Kuzik, Net al. (2016) Systematic review of physical activity and cognitive development in early childhood. J Sci Med Sport 19, 573578.
33.Prince, SA, Saunders, TJ, Gresty, Ket al. (2014) A comparison of the effectiveness of physical activity and sedentary behaviour interventions in reducing sedentary time in adults: a systematic review and meta-analysis of controlled trials. Obes Rev 15, 905919.
34.Cameron, JD, Maras, D, Sigal, RJet al. (2016) The mediating role of energy intake on the relationship between screen time behaviour and body mass index in adolescents with obesity: the HEARTY study. Appetite 107, 437444.
35.Pearson, N, Ball, K & Crawford, D (2011) Mediators of longitudinal associations between television viewing and eating behaviours in adolescents. Int J Behav Nutr Phys Act 8, 23.
36.Bellisle, F, Dalix, AM & Slama, G (2004) Non food-related environmental stimuli induce increased meal intake in healthy women: comparison of television viewing versus listening to a recorded story in laboratory settings. Appetite 43, 175180.
37.Berthoud, H-R (2006) Homeostatic and non-homeostatic pathways involved in the control of food intake and energy balance. Obesity 5, 197S200S.
38.Temple, JL, Giacomelli, AM, Kent, KMet al. (2007) Television watching increases motivated responding for food and energy intake in children. Am J Clin Nutr 85, 355361.
39.Stice, E, Presnell, K, Shaw, Het al. (2005) Psychological and behavioral risk factors for obesity onset in adolescent girls: a prospective study. J Consult Clin Psychol 73, 195202.
40.Keles, B, McCrae, N & Grealish, A (2019) A systematic review: the influence of social media on depression, anxiety and psychological distress in adolescents. Int J Adolesc Youth 0, 115.
41.Carter, A, Forrest, JI & Kaida, A (2017) Association between internet use and body dissatisfaction among young females: cross-sectional analysis of the Canadian community health survey. J Med Internet Res 19(2), e39.
42.Stiglic, N & Viner, RM (2019) Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. BMJ Open 9, e023191.
43.Chaput, J-P, Visby, T, Nyby, Set al. (2011) Video game playing increases food intake in adolescents: a randomized crossover study. Am J Clin Nutr 93, 11961203.
44.Snoek, HM, Engels, RCME, van Strien, Tet al. (2013) Emotional, external and restrained eating behaviour and BMI trajectories in adolescence. Appetite 67, 8187.
45.Field, AE, Austin, SB, Taylor, CBet al. (2003) Relation between dieting and weight change among preadolescents and adolescents. Pediatrics 112, 900906.
46.Lowe, MR, Doshi, SD, Katterman, SNet al. (2013) Dieting and restrained eating as prospective predictors of weight gain. Front Psychol 4, 577.
47.Neumark-Sztainer, D, Wall, M, Story, Met al. (2012) Dieting and unhealthy weight control behaviors during adolescence: associations with 10-year changes in body mass index. J Adolesc Health 50, 8086.
48.Stice, E, Cameron, RP, Killen, JDet al. (1999) Naturalistic weight-reduction efforts prospectively predict growth in relative weight and onset of obesity among female adolescents. J Consult Clin Psychol 67, 967974.
49.Goldfield, GS, Moore, C, Henderson, Ket al. (2010) Body dissatisfaction, dietary restraint, depression, and weight status in adolescents. J Sch Health 80, 186192.
50.Maras, D, Flament, MF, Murray, Met al. (2015) Screen time is associated with depression and anxiety in Canadian youth. Prev Med 73, 133138.
51.de Onis, M, Onyango, AW, Borghi, Eet al. (2007) Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 85, 660667.
52.van Strien, T, Frijters, JER, Bergers, GPAet al. (1986) The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Int J Eat Disord 5, 295315.
53.Wardle, J (1987) Eating style: a validation study of the Dutch eating behaviour questionnaire in normal subjects and women with eating disorders. J Psychosom Res 31, 161169.
54.Strien, T van & Oosterveld, P (2008) The children’s DEBQ for assessment of restrained, emotional, and external eating in 7- to 12-year-old children. Int J Eat Disord 41, 7281.
55.Herman, CP & Polivy, J (1975) Anxiety, restraint, and eating behavior. J Abnorm Psychol 84, 666672.
56.Kaplan, HI, Kaplan, HS (1957) The psychosomatic concept of obesity. J Nerv Ment Dis 125, 181201.
57.Stroebe, W (2008) Dieting, Overweight, and Obesity: Self-Regulation in a Food-rich Environment. Washington, DC: American Psychological Association.
58.Gustavson, K, von Soest, T, Karevold, Eet al. (2012) Attrition and generalizability in longitudinal studies: findings from a 15-year population-based study and a Monte Carlo simulation study. BMC Public Health 12, 918.
59.Schafer, JL & Graham, JW (2002) Missing data: our view of the state of the art. Psychol Methods 7, 147177.
60.Tambs, K, Rønning, T, Prescott, CAet al. (2009) The Norwegian Institute of Public Health twin study of mental health: examining recruitment and attrition bias. Twin Res Hum Genet 12, 158168.
61.Goodman, JS & Blum, TC (1996) Assessing the non-random sampling effects of subject attrition in longitudinal research. J Manag 22, 627652.
62.Fischer, EH, Dornelas, EA & Goethe, JW (2001) Characteristics of people lost to attrition in psychiatric follow-up studies. J Nerv Ment Dis 189, 4955.
63.Cole, TJ & Lobstein, T (2012) Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes 7, 284294.
64.Halvarsson, K & Sjödén, P-O (1998) Psychometric properties of the Dutch Eating Behaviour Questionnaire (DEBQ) among 9–10-year-old Swedish girls. Eur Eat Disord Rev 6, 115125.
65.Shang, L, Wang, J, O’Loughlin, Jet al. (2015) Screen time is associated with dietary intake in overweight Canadian children. Prev Med Rep 2, 265269.
66.Goldfield, GS, Mallory, R, Parker, Tet al. (2007) Effects of modifying physical activity and sedentary behavior on psychosocial adjustment in overweight/obese children. J Pediatr Psychol 32, 783793.
67.Epstein, LH, Roemmich, JN, Paluch, RAet al. (2005) Influence of changes in sedentary behavior on energy and macronutrient intake in youth. Am J Clin Nutr 81, 361366.
68.Boulos, R, Vikre, EK, Oppenheimer, Set al. (2012) ObesiTV: how television is influencing the obesity epidemic. Physiol Behav 107, 146153.
69.American Academy of Pediatrics Council on Communications and Media (2016) Media and young minds. Pediatrics 138, e20162591.
70.Murray, M, Maras, D & Goldfield, GS (2016) Excessive time on social networking sites and disordered eating behaviors among undergraduate students: appearance and weight esteem as mediating pathways. Cyberpsychology Behav Soc Netw 19, 709715.
71.Sampasa-Kanyinga, H, Chaput, J-P & Hamilton, HA (2015) Associations between the use of social networking sites and unhealthy eating behaviours and excess body weight in adolescents. Br J Nutr 114, 19411947.
72.Must, A & Anderson, SE (2006) Body mass index in children and adolescents: considerations for population-based applications. Int J Obes 30, 590594.
73.Inokuchi, M, Matsuo, N, Takayama, JIet al. (2011) BMI z-score is the optimal measure of annual adiposity change in elementary school children. Ann Hum Biol 38, 747751.
74.Cole, TJ, Faith, MS, Pietrobelli, Aet al. (2005) What is the best measure of adiposity change in growing children: BMI, BMI %, BMI z-score or BMI centile? Eur J Clin Nutr 59, 419425.
75.Freedman, DS & Sherry, B (2009) The validity of BMI as an indicator of body fatness and risk among children. Pediatrics 124, Suppl. 1, S23S34.
76.Leatherdale, ST & Harvey, A (2015) Examining communication- and media-based recreational sedentary behaviors among Canadian youth: results from the COMPASS study. Prev Med 74, 7480.

Keywords

Mediating role of disordered eating in the relationship between screen time and BMI in adolescents: longitudinal findings from the Research on Eating and Adolescent Lifestyles (REAL) study

  • Fatima Mougharbel (a1) (a2), Darcie D Valois (a3), Megan Lamb (a4) (a5), Annick Buchholz (a5), Nicole Obeid (a6), Martine Flament (a7) and Gary S Goldfield (a2) (a8)...

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