An Increase in Screen Time May Raise Diabetes Risk Factors in Children

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We live in a tech-y world, where a great deal of time is spent using technology to shop for goods, connect with friends and stream movies. In addition to the benefits, however, technology can have its drawbacks, particularly for our children. Studies have shown that too much screen time has been linked to obesity, delayed speech, and psychological stress.

Screen Time and Diabetes

In addition, new research has emerged suggesting an association between an increase in screen time, (more than 1 hour daily) and the risk for type 2 diabetes risk factors, specifically insulin resistance and adiposity (belly fat).

Researchers found that those children who reported the most screen time, more than 3 hours, as compared to those who watched 1 hour or less, had higher skin fold thickness, fat mass index, and insulin resistance, to name a few. Insulin resistance is the body's inability to use insulin, a hormone that has many roles. One of insulin's most prominent roles is helping the body to use glucose or sugar as fuel. Insulin resistance has been shown to be a marker or risk factor for developing type 2 diabetes.

The study, published in Archives of Disease in Childhood, used a sample that was taken from 4495 children (2337 girls and 2158 boys), 9-10 years of age. Participants were recruited from three UK cities (London, Birmingham, and Leicester), which together account for two-thirds of South Asians and black African-Caribbeans in the UK. Less than one-third of the participants were white-Caucasian. Children self reported daily screen time use via survey.

At the time of the study, between 2004-2007, the children were asked about 'screen time' which was defined as time spent watching television as well as video or computer game playing.

This study did not take into account smart phone and tablet use, which are now more widely used by children and can contribute to sedentary behavior.

Participants were also measured—height, weight, skin fold thickness, etc., and had labs drawn to test glucose, cholesterol, insulin, hemoglobin A1c (three month average of blood sugar), and other cardiometabolic risk factors. While there was a significant association in insulin resistance, the researchers did not find an association between blood sugar (glucose) and hemoglobin A1c, which when elevated are also considered to be other risk factors for type 2 diabetes.

What Can We Take Away From This Study?

While this study found an association between an increase in screen time and type 2 diabetes risk factors in children, it is important to note that it did not prove that an increase in screen time causes insulin resistance and adiposity. Further research and different type of research designs would have to be conducted to deem if this is the case.

On the other hand, it is still significant to recognize this association, as it can help to facilitate proactive action. Perhaps this knowledge can foster awareness for parents and their children, encouraging them to increase physical activity and reduce sedentary behavior, such as watching television and video game playing. This knowledge can help to increase type 2 diabetes prevention in children.

Future studies would benefit from assessing diet behaviors in conjunction with screen time use as this can also play a role in increasing the risk of type 2 diabetes.

What Are the Screen Time Guidelines? 

The American Academy of Pediatrics encourages the use of media time limits that are consistent. Consistency is important as it can help to develop routines and create regimens that are easy to follow. They suggest that children older than 2 years old should limit screen time to no more than 1 hour per day, and, when possible, they encourage parents to co-view or co-play with children. This helps facilitate learning and encourages engaging activity.

In addition, the AAP discourages the use of screen time in children under 2 years of age, however, they do suggest that for those parents who want to introduce media to children between the ages of 18-24 months, to use high quality programming and applications with them and not alone. To find apps that are age appropriate, they recommend researching via Common Sense Media.

In addition, they recommend having screen free zones—areas in the home where any type of tech device is not permitted. For example, bedrooms could become a restricted area—a place where your child is not able to watch television, play video games, or use a smart phone.

Screen free times—time during the day when the use of screens is not allowed, such as dinner time and before bed—is encouraged. A media curfew is also a technique that can be implemented, especially for older children. For example, once the clock strikes 9 pm, devices are turned off, given to parents, and put away until the next day.

Making less time for the use of technology yields more time for more physical activity and creative play. If you are interested in revamping your families' media use, you can find guidelines on how to create a family media plan here: Family Media Plan.

How Can We Reduce the Risk of Type 2 Diabetes in Children?

According to the Centers for Disease Control, between the years of 2008-2009, there were 5,089 people diagnosed with type 2 diabetes who were 20 years old or younger. It appears that the most at-risk group are children ages 10-19, with higher rates in U.S. minority groups, as opposed to non-Hispanic whites.

The number one risk factor for childhood diabetes appears to be obesity. Excess body weight can inhibit insulin from doing its job, which is to take sugar from the blood to the cells to use for energy. As a result, sugar or glucose accumulates in the blood stream. When blood sugars exceed normal limits, a diagnosis of diabetes is made. Fear not, this is not something that just happens overnight. This can take years to develop.

If your child is at increased risk of type 2 diabetes—they have a family history, are African American, an Alaska native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American, obese, and inactive—making lifestyle changes could help to prevent or delay developing diabetes in childhood and later in life.

Make Simple Dietary Changes

Depending on where your child is on the growth chart, they may benefit from losing a small amount of weight or maintaining their weight so that they can grow into it. If you are unsure of your child's weight status, consult with your pediatrician to develop a plan of action. He or she may recommend that you meet with a registered dietitian to help you create a balanced, nutrient dense eating plan.

Restrictive dieting and excessive exercise is not necessary, and could be dangerous for your child's health and development. Instead, create a balanced eating plan that contains ample amounts of fruit, vegetables, whole grains and lean protein (chicken, fish, turkey, lean beef, low-fat cheese, low-fat milk or milk alternatives). This plan should limit processed snack foods like chips and cookies, refined grains like white pasta and white bread, fried foods—such as chicken nuggets and french fries—and high fat proteins such as hot dogs, ribs, and bacon.

One of the easiest and most effective ways to help kids get to a healthy weight is to encourage drinking only unsweetened beverages—try to rid the house of sugary beverages such as soda, juice, energy drinks, and sweetened coffee beverages. These types of beverages add excess calories and sugar and can cause weight gain and an increase in blood sugars.

A great way to establish a kid-friendly healthy eating plan is to teach your children about Go, Slow, and Whoa foods. These are foods that should be eaten all the time, less often, and as a treat. Here is a great table to illustrate this concept: Go, Slow, and Whoa.

Some other good dietary websites geared towards children and families include: Kids Eat Right, Super Kids Nutrition, and ChopChop: The Fun Cooking Magazine.

Increase Physical Activity

In addition to a healthy eating plan, children should be physically active and get adequate sleep (these are the sleep recommendations for children and kids). According to the Centers for Disease Control, children should be getting a minimum of 60 minutes of physical activity daily. This physical activity should include aerobic exercise, muscle training, and bone strengthening exercise. Looking for ways on how to get this done? Check out Let's Move, the campaign led by former First Lady Michelle Obama.

If your child is not particularly active and gives you a hard time about engaging in physical activity, try to make it fun for them. Invite friends over to play jump rope, basketball, an old school game of tag, meet up at the pool or a park, or on days when you can't get outside, try an interactive video game like Wii Fit Plus, which has been shown to help reduce blood sugars.

A Word From Verywell

Although type 2 diabetes in childhood is more prevalent than in the past, the good news is that there are lifestyle changes that can reduce your risk. Reducing screen time may be one of the solutions. Make it a point to set media time limits that are consistent and consider making a family media plan. Making some simple lifestyle changes, omitting sugary beverages, and increasing vegetable and fruit intake can yield a big impact. Lastly, encouraging physical activity is very important. In addition to free play, plan organized physical activity with your children and family. Go for a walk after dinner, play a round of mini-golf, ride bicycles, go for a hike, engage in a friendly catch, or crank up the music and have a dance party in your pajamas—remember that all activity counts. Not only will you be benefiting your health, you'll bond with one another.

Sources: 

American Academy of Pediatrics. Handheld screentime linked with speech delays in young children. https://www.healthychildren.org/English/news/Pages/Handheld-Screen-Time-Linked-with-Speech-Delays-in-Young-Children.aspx

American Academy of Pediatrics. More screen time and less activity can mean more distress. https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/More-Screen-Time-and-Less-Activity-Can-mean-More-Distress.aspx

American Academy of Pediatrics. Where we stand: screen time. https://healthychildren.org/English/family-life/Media/Pages/Where-We-Stand-TV-Viewing-Time.aspx

Centers for Disease Control. National Diabetes Statistics Report, 2014. https://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf

Nightingale CM, Rudnicka AR, Donin AS, et al. Screen time is associated with adiposity and insulin resistance in children. Archives of Disease in Childhood Published Online First: 13 March 2017. doi: 10.1136/archdischild-2016-312016

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