Too Much Screen time Raises Risk of Pre-Diabetes in Children

MedicalResearch.com Interview with:

Mélanie Henderson, MD, FRCPC, PhD

Mélanie Henderson

Mélanie Henderson, MD, FRCPC, PhD
Pediatric Endocrinologist and Assistant Clinical Professor
Division of Endocrinology and Diabetes
University of Montreal/Centre Hospitalier Universitaire Ste-Justine
Montréal, Québec

Medical Research: What is the background for this study? What are the main findings?

Dr. Henderson: Dysregulation in insulin sensitivity and insulin secretion are the basic elements in the pathophysiology of type 2 diabetes. There is extensive data suggesting that better lifestyle habits are associated with the prevention or the delay in onset of type 2 diabetes in adults, with improved lifestyle habits having been more effective than pharmacologic agents at diabetes prevention in one study. Little work however has been done to determine whether this holds true in children. Cross-sectional studies in youth have found conflicting results and no study has considered the combined effect of physical activity, fitness and sedentary behavior on insulin dynamics in children.

Understanding the impact of lifestyle habits on insulin dynamics in childhood has become paramount, given that less than 7% of Canadian children are currently meeting physical activity guidelines and that 1/3 of school-aged Canadian children and 2/3 of Canadian teenagers are exceeding the current guidelines in terms of screen time, which advocate for a maximum of 2 hours daily.

Our study shows that adiposity is the central predictor of insulin dynamics in children, and that physical activity and screen time play an important role, in part through their effect on adiposity. Thus, establishing and maintaining a highly physically active lifestyle early on in life, while minimizing sedentary behaviour (specifically screen time) appear to be important strategies to consider to prevent type 2 diabetes in youth.

Medical Research: What should clinicians and patients take away from your report?

Dr. Henderson: I think that our findings suggest that we should promote the adoption of physical activity and reduce screen time early in life, even in pre-pubertal otherwise healthy youth. Physical activity tends to decrease with age: this is well established even across childhood and adolescence. Our findings suggest that we should be encouraging children early on to be physically active, and that we should reduce their screen time, in order to favour a healthy body weight and better cardiometabolic health later on in life. Our findings are the first to confirm that physical activity and screen time have independent effects on insulin dynamics even in pre-puberty, and that these strategies are potentially effective strategies to prevent the development of type 2 diabetes in children.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Henderson: Our team will be examining how nutrition influences insulin dynamics across time. More research is needed to understand the different types of screen time (active video games versus television, etc) and how these impact cardiometabolic health. The children from the QUALITY cohort are now 15-17 year of age, and we are in the process of re-assessing their health status.  With this next wave of evaluations, we will be interested in looking at trajectories across childhood and late adolescence of lifestyle habits and how they relate to pre-diabetes and overt type 2 diabetes. Long-term longitudinal studies will provide the important clues to better understand the pathophysiology of type 2 diabetes in childhood, and thus to the development of effective preventive measures. Ultimately, we will need to evaluate the effectiveness of preventive strategies using trials in groups of youth with pre-diabetes and examine how these apply across children of different ethnic groups given the ethnic differences in the prevalence of type 2 diabetes. 

Medical Research: Is there anything else you would like to add?

Dr. Henderson: Our findings suggest that we should be encouraging children early on to be physically active, and that we should reduce their screen time, in order to favour a healthy body weight and better cardiometabolic health later on in life. This being said, I do think that it is never too late to start improving our lifestyle habits, and adult data certainly confirm that improving lifestyle habits can reduce or even prevent the transition from pre-diabetes to overt type 2 diabetes, so we should send the message to readers that it is never too late to become physically active and decrease our screen time, but our findings suggest that we would be wise to start in childhood!

Citation:

Henderson M, Benedetti A, Barnett TA, Mathieu M, Deladoëy J, Gray-Donald K. Influence of Adiposity, Physical Activity, Fitness, and Screen Time on Insulin Dynamics Over 2 Years in Children. JAMA Pediatr. Published online February 08, 2016. doi:10.1001/jamapediatrics.2015.3909.

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Mélanie Henderson, MD, FRCPC, PhD (2016). Too Much Screen time Raises Risk of Pre-Diabetes in Children MedicalResearch.com