Applied nutritional investigationTelevision watching, videogames, and excess of body fat in Spanish adolescents: The AVENA study
Introduction
Obesity in childhood and adolescence is becoming an increasing concern in America [1] and, more recently, in Europe [2], [3], [4]. For instance, the prevalence of overweight and obesity in Spanish adolescents has doubled in the past decennium and currently amounts to some 25% of males and 20% of females [4]. In this regard, obesity has been associated with sedentary lifestyle patterns in adolescent populations [5].
Although several environmental factors have been associated with childhood obesity [5], [6], such as low physical activity and eating disorders, the time spent watching television (TV) is the sedentary behavior most commonly studied [7]. It has been shown that the odds risk of being overweight is nearly five times greater in those subjects usually watching TV more than 5 h/d compared with those watching less than 1 h [8]. In addition, TV watching has been recently described as a predictor for childhood obesity in a Spanish case–control study [6]. This is of great concern because it has been reported that the number of children watching TV for more than 4 h/d is also increasing [9].
Recent data on the Spanish adolescent population suggest a greater risk of obesity with longer periods of TV watching [10] and data from Switzerland suggest that other sedentary activities, such as the use of electronic games, are also associated with obesity in children of that country [11]. It is not clear whether other sedentary activities are independently associated with obesity and it is not known if greater physical activity linked with usual activities such as active commuting to school could counterbalance the negative effect of TV and electronic device use. The aim of this study was to assess the individual risk for overweight and excess body fat of different sedentary behaviors (such as time spent watching TV or playing videogames), and whether physical activities such as active commuting to school could have a protective effect.
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Population
The complete methodology of the study has been described elsewhere [12]. Briefly, this multicenter study on eating habits and evaluation of the nutritional condition of adolescents, Alimentación y Valoración del Estado Nutricional de los Adolescentes (AVENA), was performed in Spanish adolescents 13–18.5 y of age. The population was selected by means of a multiple-step, simple random sampling, taking into account first the location (Granada, Madrid, Santander, Zaragoza, and Murcia) and then by
Results
Table 1 summarizes the subjects' weight, height, BMI, %BF, and socioeconomic status. Significant differences were found between male and female subjects in weight and height (P < 0.05). BMI was similar for males and females, whereas %BF was significantly higher in females than in males (P < 0.05). No differences were found in socioeconomic status between age or sex groups.
Descriptive data for sedentary-related variables are presented in Table 2, Table 3. Data regarding the prevalence of
Discussion
The present study of Spanish adolescents contains important results: overweight and obesity were independently associated with time spent watching TV, whereas increased age, higher socioeconomic status, and being female were revealed as protective factors. Similarly, the excess in body fat was independently associated with the time spent watching TV and playing videogames, especially during the weekend. In addition, this study suggests that 3 h/wk of general physical activity and active
Conclusion
Time spent watching TV increased the risk of overweight and obesity in Spanish adolescents, but the effect was also influenced by age, sex, and socioeconomic status. An excess of body fat as assessed by anthropometry was more directly explained by time spent watching TV, and playing videogames during the weekend, especially in male adolescents. The latter could be an interesting indicator of individual sedentary behavior and a potential target for future adolescent health promotion actions.
Acknowledgments
The authors thank Anselmo López Cabañas and the Methodological Support Department of the Instituto Aragonés de Ciencias de la Salud for its support on statistical analysis.
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The AVENA study was supported by the Spanish Ministry of Health (FIS 00/0015) and grants from Panrico S.A., Madaus S.A., Procter and Gamble S.A., and the Fundación Cuenca Villoro.