OBESITY risk factors; CHI-squared test; QUESTIONNAIRES; RESEARCH funding; T-test (Statistics); TELEVISION; VIDEO games; BODY mass index; SEDENTARY lifestyles; PHYSICAL activity; DATA analysis software; DIARY (Literary form); ADOLESCENCE

OBJECTIVES: This study investigates how characteristics of young adolescents' screen media use are associated with their BMI. By examining relationships between BMI and both time spent using each of 3 screen media and level of attention allocated to use, we sought to contribute to the understanding of mechanisms linking media use and obesity. METHODS: We measured heights and weights of 91 13-to 15-year-olds and calculated their BMIs. Over 1 week, participants completed a weekday and a Saturday 24-hour time-use diary in which they reported the amount of time they spent using TV, computers, and video games. Participants carried handheld computers and responded to 4 to 7 random signals per day by completing onscreen questionnaires reporting activities to which they were paying primary, secondary, and tertiary attention. RESULTS: Higher proportions of primary attention to TV were positively associated with higher BMI. The difference between 25th and 75th per- centiles of attention to TV corresponded to an estimated +2.4 BMI points. Time spent watching television was unrelated to BMI. Neither duration of use nor extent of attention paid to video games or computers was associated with BMI. CONCLUSIONS: These findings support the notion that attention to TV is a key element of the increased obesity risk associated with TV viewing. Mechanisms may include the influence of TV commercials on preferences for energy-dense, nutritionally questionable foods and/or eating while distracted by TV. Interventions that interrupt these processes may be effective in decreasing obesity among screen media users. Pediatrics 2013;131:935-941 [ABSTRACT FROM AUTHOR]