Hicks Kristie, Pitts Stephanie Jilcott, Lazorick Suzanne, Fang Xiangming, Rafferty Ann
lifestyle coach, Minority Diabetes Prevention Program; nutrition graduate assistant, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
associate professor, Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
N C Med J. 2019 Mar-Apr;80(2):69-75. doi: 10.18043/ncm.80.2.69.
With the rise in technology use for the adolescent population, screen time may be related to unhealthy eating habits and contribute to adolescent obesity. Since 2007, an adolescent wellness program, Motivating Adolescents to Choose Health (MATCH), has been implemented in select North Carolina middle schools. Using MATCH study data from fall 2015 in 26 North Carolina middle schools, we examined the cross-sectional associations between screen time, unhealthy beverage and snack consumption, and BMI z-score with linear regression models controlling for physical activity, school, sex, weight category, and race. Of the 2,763 youth surveyed, half were female, 48% were white, 33% were black, and 19% were other racial groups; 2% were underweight, 51% were healthy weight, 21% were overweight, and 26% were obese. Mean BMI percentile was the 72nd percentile and mean BMI z-score was 0.81. The average of self-reported behaviors included: 1,312 hours of screen time per year, sugary beverages consumed 2,073 times per year, and unhealthy snacks consumed 3,485 times per year. There were positive associations between screen time per year and both sugary beverage (B = 0.4699; 95% Confidence Interval [CI], 0.3689-0.5709; < .001), and unhealthy snack consumption per year (B = 1.0085; 95% CI, 0.8413-1.1757; < .001), after controlling for significant covariates. This suggests that an extra hour of screen time a day is associated with approximately 172 extra servings of sugary beverages per year (3.3 extra servings per week, or 0.5 extra servings per day) and 368 extra servings of unhealthy snacks per year (7.1 extra servings per week, or 1 extra per day). No association was found with BMI z-score (B = -0.00001; 95% CI, -0.00007-0.00005; = .697). The baseline survey questions did not differentiate between types of screen time, and self-reported data may have impacted results. In North Carolina adolescents, increased screen time is associated with increases in both unhealthy beverage and snack consumption. Future research is needed to further elucidate how these factors and others impact BMI. MATCH may increase effectiveness by including program components that address the relationship between screen time and unhealthy dietary consumption.
随着青少年群体技术使用的增加，屏幕使用时间可能与不健康的饮食习惯相关，并导致青少年肥胖。自2007年以来，一项青少年健康计划“激励青少年选择健康”（MATCH）已在北卡罗来纳州的部分中学实施。利用2015年秋季北卡罗来纳州26所中学的MATCH研究数据，我们使用线性回归模型，在控制了体育活动、学校、性别、体重类别和种族等因素后，研究了屏幕使用时间、不健康饮料和零食消费与BMI z评分之间的横断面关联。在接受调查的2763名青少年中，一半为女性，48%为白人，33%为黑人，19%为其他种族群体；2%体重过轻，51%体重正常，21%超重，26%肥胖。平均BMI百分位数为第72百分位数，平均BMI z评分为0.81。自我报告行为的平均值包括：每年1312小时的屏幕使用时间、每年饮用含糖饮料2073次、每年食用不健康零食3485次。在控制了显著的协变量后，每年的屏幕使用时间与含糖饮料（B = 0.4699；95%置信区间[CI]，0.3689 - 0.5709；P <.001）和每年不健康零食消费（B = 1.0085；95% CI，0.8413 - 1.1757；P <.001）之间均存在正相关。这表明每天额外增加一小时的屏幕使用时间与每年大约额外增加172份含糖饮料（每周额外增加3.3份，或每天额外增加0.5份）和每年额外增加368份不健康零食（每周额外增加7.1份，或每天额外增加1份）相关。未发现与BMI z评分存在关联（B = -0.00001；95% CI，-0.00007 - 0.00005；P =.697）。基线调查问卷未区分屏幕使用时间的类型，且自我报告数据可能影响了结果。在北卡罗来纳州的青少年中，屏幕使用时间增加与不健康饮料和零食消费的增加有关。未来需要进一步研究以阐明这些因素及其他因素如何影响BMI。MATCH可能通过纳入解决屏幕使用时间与不健康饮食消费之间关系的项目组成部分来提高有效性。
