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. 2006 Dec;3(12):e488.
doi: 10.1371/journal.pmed.0030488.

TV viewing and physical activity are independently associated with metabolic risk in children: the European Youth Heart Study

Ulf Ekelund  1 , Søren Brage, Karsten Froberg, Maarike Harro, Sigmund A Anderssen, Luis B Sardinha, Chris Riddoch, Lars Bo Andersen
Affiliations

TV viewing and physical activity are independently associated with metabolic risk in children: the European Youth Heart Study

Ulf Ekelund et al. PLoS Med. 2006 Dec.

Abstract

Background: TV viewing has been linked to metabolic-risk factors in youth. However, it is unclear whether this association is independent of physical activity (PA) and obesity.

Methods and findings: We did a population-based, cross-sectional study in 9- to 10-y-old and 15- to 16-y-old boys and girls from three regions in Europe (n = 1,921). We examined the independent associations between TV viewing, PA measured by accelerometry, and metabolic-risk factors (body fatness, blood pressure, fasting triglycerides, inverted high-density lipoprotein (HDL) cholesterol, glucose, and insulin levels). Clustered metabolic risk was expressed as a continuously distributed score calculated as the average of the standardized values of the six subcomponents. There was a positive association between TV viewing and adiposity (p = 0.021). However, after adjustment for PA, gender, age group, study location, sexual maturity, smoking status, birth weight, and parental socio-economic status, the association of TV viewing with clustered metabolic risk was no longer significant (p = 0.053). PA was independently and inversely associated with systolic and diastolic blood pressure, fasting glucose, insulin (all p < 0.01), and triglycerides (p = 0.02). PA was also significantly and inversely associated with the clustered risk score (p < 0.0001), independently of obesity and other confounding factors.

Conclusions: TV viewing and PA may be separate entities and differently associated with adiposity and metabolic risk. The association between TV viewing and clustered metabolic risk is mediated by adiposity, whereas PA is associated with individual and clustered metabolic-risk indicators independently of obesity. Thus, preventive action against metabolic risk in children may need to target TV viewing and PA separately.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Objectively Measured PA (Mean 95% Confidence Interval [CI]) Stratified by Quartiles of TV Viewing (n = 1,702)
Data are adjusted for gender, study location, age group, sexual maturity, smoking status, and parental SES.
Figure 2
Figure 2. The Clustered Metabolic-Risk Score (Mean 95% CI) Stratified by Quartiles of TV Viewing (n = 1,485)
Data on TV viewing are adjusted for PA, gender, study location, age group, sexual maturity, smoking status, birth weight, and parental SES (p = 0.053 in continuous analysis).
Figure 3
Figure 3. The Clustered Metabolic-Risk Score (Mean 95% CI) Stratified by Quartiles of PA (n = 1,485)
Data on PA are adjusted for TV viewing, gender, study location, age group, sexual maturity, smoking status, birth weight, and parental SES (p < 0.0001 in continuous analysis).
See this image and copyright information in PMC

Comment in

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