International Journal of Public Health

, Volume 60, Issue 2, pp 157–165 | Cite as

Metabolic risk and television time in adolescent females

  • Aristides M. Machado-RodriguesEmail author
  • Neiva Leite
  • Manuel J. Coelho-e-Silva
  • Fernando Enes
  • Rômulo Fernandes
  • Luís P. G. Mascarenhas
  • Margaret C. S. Boguszewski
  • Robert M. Malina
Original Article



A sedentary lifestyle is increasingly implicated in a negative metabolic health profile among youth. The present study examined relationships between clustered metabolic risk factors and TV viewing in female adolescents.


The sample comprised 262 girls 14–17 years. Height, weight, fasting glucose, insulin, HDL cholesterol, triglycerides, and blood pressure were measured. Body mass index (BMI) was calculated. TV viewing time and moderate-to-vigorous physical activity (MVPA) were estimated from a 3-day diary. Outcome variables were normalized and expressed as Z scores which were summed into a metabolic risk score. Multiple linear regression analysis was used.


TV viewing was independently associated with increased prevalence of clustered metabolic risk in girls after adjustment for several confounders (i.e., chronological age, BMI, MVPA, and parental education). The final model also indicated that lower levels of MVPA, higher BMI, and lower mother education were associated with higher metabolic risk.


Increased TV viewing had an adverse effect on metabolic health of adolescent girls. The findings highlight the potential importance of preventive actions to ameliorate metabolic risk in youth which target both sedentary and physically active behaviors.


Public health Sedentary behavior Youth Overweight Lifestyle 



The authors acknowledge the support provided by the CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior)—“Impacto do peso ao nascimento e do estilo de vida sobre fatores de risco metabólico, hiperandrogenismo e anovulação em meninas e adolescentes” Project.

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.


  1. Abrantes MM, Lamounier JA, Colosimo EA (2002) Overweight and obesity prevalence among children and adolescents from Northeast and Southeast regions of Brazil. J Pediatr (Rio J) 78(4):335–340Google Scholar
  2. American Academy of Pediatrics (2001) Children, adolescents, and television. Pediatrics 107(2):423–426CrossRefGoogle Scholar
  3. Andersen LB, Harro M, Sardinha LB, Froberg K, Ekelund U, Brage S, Anderssen SA (2006) Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study). Lancet 368(9532):299–304. doi: 10.1016/S0140-6736(06)69075-2 CrossRefPubMedGoogle Scholar
  4. Biddle SJ, Gorely T, Marshall SJ (2009) Is television viewing a suitable marker of sedentary behavior in young people? Ann Behav Med 38(2):147–153. doi: 10.1007/s12160-009-9136-1 CrossRefPubMedGoogle Scholar
  5. Boone JE, Gordon-Larsen P, Adair LS, Popkin BM (2007) Screen time and physical activity during adolescence: longitudinal effects on obesity in young adulthood. Int J Behav Nutr Phys Act 4:26. doi: 10.1186/1479-5868-4-26 CrossRefPubMedCentralPubMedGoogle Scholar
  6. Bouchard C, Tremblay A, Leblanc C, Lortie G, Savard R, Theriault G (1983) A method to assess energy expenditure in children and adults. Am J Clin Nutr 37(3):461–467PubMedGoogle Scholar
  7. Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB, Froberg K, European Youth Heart Study (EYHS) (2004) Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European Youth Heart Study (EYHS). Diabetes Care 27(9):2141–2148CrossRefPubMedGoogle Scholar
  8. Cavali ME, Brasileiro R, Taddei J (2010) Síndrome metabólica: comparação de critérios diagnósticos. Jornal de Pediatria 86(4):325–330Google Scholar
  9. Desai S, Alva S (1998) Maternal education and child health: is there a strong causal relationship? Demography 35(1):71–81CrossRefPubMedGoogle Scholar
  10. Eisenmann JC (2008) On the use of a continuous metabolic syndrome score in pediatric research. Cardiovasc Diabetol 7:17. doi: 10.1186/1475-2840-7-17 CrossRefPubMedCentralPubMedGoogle Scholar
  11. Eisenmann JC, Laurson KR, DuBose KD, Smith BK, Donnelly JE (2010) Construct validity of a continuous metabolic syndrome score in children. Diabetol Metab Syndr 2:8. doi: 10.1186/1758-5996-2-8 CrossRefPubMedCentralPubMedGoogle Scholar
  12. Ekelund U, Brage S, Froberg K, Harro M, Anderssen SA, Sardinha LB, Riddoch C, Andersen LB (2006) TV viewing and physical activity are independently associated with metabolic risk in children: the European Youth Heart Study. PLoS Med 3(12):e488. doi: 10.1371/journal.pmed.0030488 CrossRefPubMedCentralPubMedGoogle Scholar
  13. Ekelund U, Anderssen S, Andersen LB, Riddoch CJ, Sardinha LB, Luan J, Froberg K, Brage S (2009) Prevalence and correlates of the metabolic syndrome in a population-based sample of European youth. Am J Clin Nutr 89(1):90–96. doi: 10.3945/ajcn.2008.26649 CrossRefPubMedGoogle Scholar
  14. Gupta N, Shah P, Nayyar S, Misra A (2013) Childhood obesity and the metabolic syndrome in developing countries. Indian J Pediatr 80(Suppl 1):S28–S37. doi: 10.1007/s12098-012-0923-5 CrossRefPubMedGoogle Scholar
  15. Hsu YW, Belcher BR, Ventura EE, Byrd-Williams CE, Weigensberg MJ, Davis JN, McClain AD, Goran MI, Spruijt-Metz D (2011) Physical activity, sedentary behavior, and the metabolic syndrome in minority youth. Med Sci Sports Exerc 43(12):2307–2313. doi: 10.1249/MSS.0b013e318222020f CrossRefPubMedGoogle Scholar
  16. Huang YC, Malina RM (2002) Physical activity and health-related physical fitness in Taiwanese adolescents. J Physiol Anthropol Appl Human Sci 21(1):11–19CrossRefPubMedGoogle Scholar
  17. Hume C, van der Horst K, Brug J, Salmon J, Oenema A (2010) Understanding the correlates of adolescents’ TV viewing: a social ecological approach. Int J Pediatr Obes 5(2):161–168. doi: 10.3109/17477160903242550 CrossRefPubMedGoogle Scholar
  18. Iannotti RJ, Janssen I, Haug E, Kololo H, Annaheim B, Borraccino A, H.P.A.F. Group (2009) Interrelationships of adolescent physical activity, screen-based sedentary behaviour, and social and psychological health. Int J Public Health 54(Suppl 2):191–198. doi: 10.1007/s00038-009-5410-z CrossRefPubMedCentralPubMedGoogle Scholar
  19. Katzmarzyk PT, Malina RM, Song TM, Bouchard C (1998) Physical activity and health-related fitness in youth: a multivariate analysis. Med Sci Sports Exerc 30(5):709–714CrossRefPubMedGoogle Scholar
  20. Katzmarzyk PT, Shen W, Baxter-Jones A, Bell JD, Butte NF, Demerath EW, Gilsanz V, Goran MI, Hirschler V, Hu HH, Maffeis C, Malina RM, Muller MJ, Pietrobelli A, Wells JC (2012) Adiposity in children and adolescents: correlates and clinical consequences of fat stored in specific body depots. Pediatr Obes 7(5):e42–e61. doi: 10.1111/j.2047-6310.2012.00073.x CrossRefPubMedGoogle Scholar
  21. Leech RM, McNaughton SA, Timperio A (2014) The clustering of diet, physical activity and sedentary behavior in children and adolescents: a review. Int J Behav Nutr Phys Act 11:4. doi: 10.1186/1479-5868-11-4 CrossRefPubMedCentralPubMedGoogle Scholar
  22. Lobstein T (2010) Global prevalence of childhood obesity physical activity and obesity. Human Kinetics, Champaign, pp 57–60Google Scholar
  23. Ma GS, Li YP, Hu XQ, Ma WJ, Wu J (2002) Effect of television viewing on pediatric obesity. Biomed Environ Sci 15(4):291–297PubMedGoogle Scholar
  24. Machado-Rodrigues AM, Coelho ESMJ, Mota J, Cyrino E, Cumming SP, Riddoch C, Beunen G, Malina RM (2011) Agreement in activity energy expenditure assessed by accelerometer and self-report in adolescents: variation by sex, age, and weight status. J Sports Sci 29(14):1503–1514. doi: 10.1080/02640414.2011.593185 CrossRefPubMedGoogle Scholar
  25. Machado-Rodrigues AM, Coelho e Silva MJ, Mota J, Santos RM, Cumming SP, Malina RM (2012a) Physical activity and energy expenditure in adolescent male sport participants and nonparticipants aged 13–16 years. J Phys Act Health 9(5):626–633PubMedGoogle Scholar
  26. Machado-Rodrigues AM, Figueiredo AJ, Mota J, Cumming SP, Eisenmann JC, Malina RM, Coelho ESMJ (2012b) Concurrent validation of estimated activity energy expenditure using a 3-day diary and accelerometry in adolescents. Scand J Med Sci Sports 22(2):259–264. doi: 10.1111/j.1600-0838.2010.01155.x CrossRefPubMedGoogle Scholar
  27. Machado-Rodrigues AM, Leite N, Coelho-e-Silva MJ, Martins RA, Valente-dos-Santos J, Mascarenhas LP, Boguszewski MC, Padez C, Malina RM (2014a) Independent association of clustered metabolic risk factors with cardiorespiratory fitness in youth aged 11–17 years. Ann Hum Biol 41(3):271–276. doi: 10.3109/03014460.2013.856471 CrossRefPubMedGoogle Scholar
  28. Machado-Rodrigues AM, Leite N, Coelho ESMJ, Valente-Dos-Santos J, Martins RA, Mascarenhas LP, Boguszewski MC, Padez C, Malina RM (2014b) Relationship between metabolic syndrome and moderate-to-vigorous physical activity in youth. J Phys Act Health. doi: 10.1123/jpah.2013-0053 PubMedGoogle Scholar
  29. Malina RM (2013) Youth, sport, and physical activity. In: Coelho-e-Silva MJ, Cupido-dos-Santos A, Figueiredo AJ, Pereira JP, Armstrong N (eds) Children and exercise XXVIII. Routledge, Great Britain, pp 5–30Google Scholar
  30. Malina RM, Bouchard C, Bar-Or O (2004) Growth, maturation, and physical activity, 2nd edn. Human Kinetics, Champaign, ILGoogle Scholar
  31. Mark AE, Janssen I (2008) Relationship between screen time and metabolic syndrome in adolescents. J Public Health (Oxf) 30(2):153–160. doi: 10.1093/pubmed/fdn022 CrossRefGoogle Scholar
  32. Marshall SJ, Gorely T, Biddle SJ (2006) A descriptive epidemiology of screen-based media use in youth: a review and critique. J Adolesc 29(3):333–349. doi: 10.1016/j.adolescence.2005.08.016 CrossRefPubMedGoogle Scholar
  33. Mota J, Ribeiro JC, Santos MP (2009) Obese girls differences in neighbourhood perceptions, screen time and socioeconomic status according to level of physical activity. Health Educ Res 24(1):98–104. doi: 10.1093/her/cyn001 CrossRefPubMedGoogle Scholar
  34. Mueller WH, Martorell R (1988) Reliability and accuracy of measurement. In: Martorell R (ed) Lohman TG, AFR. Anthropometric standardization reference manual. Human Kinetics, Champaign, pp 83–86Google Scholar
  35. National High Blood Pressure Education Program (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114(2 Suppl 4th Report):555–576Google Scholar
  36. Olds TS, Maher CA, Ridley K, Kittel DM (2010) Descriptive epidemiology of screen and non-screen sedentary time in adolescents: a cross sectional study. Int J Behav Nutr Phys Act 7:92. doi: 10.1186/1479-5868-7-92 CrossRefPubMedCentralPubMedGoogle Scholar
  37. Pitel L, Madarasova Geckova A, Reijneveld SA, van Dijk JP (2013) Socioeconomic gradient shifts in health-related behaviour among Slovak adolescents between 1998 and 2006. Int J Public Health 58(2):171–176. doi: 10.1007/s00038-012-0382-9 CrossRefPubMedCentralPubMedGoogle Scholar
  38. Prado CV, Lima AV, Fermino RC, Anez CR, Reis RS (2014) Social support and physical activity in adolescents from public schools: the importance of family and friends. Cad Saude Publica 30(4):827–838CrossRefPubMedGoogle Scholar
  39. Ramirez ER, Norman GJ, Rosenberg DE, Kerr J, Saelens BE, Durant N, Sallis JF (2011) Adolescent screen time and rules to limit screen time in the home. J Adolesc Health 48(4):379–385. doi: 10.1016/j.jadohealth.2010.07.013 CrossRefPubMedCentralPubMedGoogle Scholar
  40. Rey-Lopez JP, Vicente-Rodriguez G, Biosca M, Moreno LA (2008) Sedentary behaviour and obesity development in children and adolescents. Nutr Metab Cardiovasc Dis 18(3):242–251. doi: 10.1016/j.numecd.2007.07.008 CrossRefPubMedGoogle Scholar
  41. Rideout VJ, Foehr UG, Roberts DF (2010) Generation M2: media in the lives of 8-to-18 years olds. Henry J Kaiser Family Foundation, Menlo ParkGoogle Scholar
  42. Rodrigues AN, Perez AJ, Pires JG, Carletti L, Araújo MT, Moyses MR, Bissoli NS, Abreu GR (2009) Cardiovascular risk factors, their associations and presence of metabolic syndrome in adolescents. Jornal de Pediatria 85:55–60CrossRefPubMedGoogle Scholar
  43. Ruiz JR, Ortega FB, Martinez-Gomez D, Labayen I, Moreno LA, De Bourdeaudhuij I, Manios Y, Gonzalez-Gross M, Mauro B, Molnar D, Widhalm K, Marcos A, Beghin L, Castillo MJ, Sjostrom M, H.S. Group (2011) Objectively measured physical activity and sedentary time in European adolescents: the HELENA study. Am J Epidemiol 174(2):173–184. doi: 10.1093/aje/kwr068 CrossRefPubMedGoogle Scholar
  44. Scuteri A, Vuga M, Najjar SS, Mehta V, Everson-Rose SA, Sutton-Tyrrell K, Matthews K, Lakatta EG (2008) Education eclipses ethnicity in predicting the development of the metabolic syndrome in different ethnic groups in midlife: the Study of Women’s Health Across the Nation (SWAN). Diabet Med 25(12):1390–1399. doi: 10.1111/j.1464-5491.2008.02596.x CrossRefPubMedCentralPubMedGoogle Scholar
  45. Silva KS, da Silva Lopes A, Dumith SC, Garcia LM, Bezerra J, Nahas MV (2014) Changes in television viewing and computers/videogames use among high school students in Southern Brazil between 2001 and 2011. Int J Public Health 59(1):77–86. doi: 10.1007/s00038-013-0464-3 CrossRefPubMedGoogle Scholar
  46. Staiano AE, Harrington DM, Broyles ST, Gupta AK, Katzmarzyk PT (2013) Television, adiposity, and cardiometabolic risk in children and adolescents. Am J Prev Med 44(1):40–47. doi: 10.1016/j.amepre.2012.09.049 CrossRefPubMedCentralPubMedGoogle Scholar
  47. Tremblay MS, Colley RC, Saunders TJ, Healy GN, Owen N (2010a) Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab 35(6):725–740. doi: 10.1139/H10-079 CrossRefPubMedGoogle Scholar
  48. Tremblay MS, Colley RC, Saunders TJ, Healy GN, Owen N (2010b) Physiological and health implications of a sedentary lifestyle. Appl Physiol Nutr Metab Physiologie appliquee, nutrition et metabolisme 35(6):725–740. doi: 10.1139/H10-079 CrossRefGoogle Scholar
  49. Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, Goldfield G, Connor Gorber S (2011) Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act 8:98. doi: 10.1186/1479-5868-8-98 CrossRefPubMedCentralPubMedGoogle Scholar
  50. Vernay M, Salanave B, de Peretti C, Druet C, Malon A, Deschamps V, Hercberg S, Castetbon K (2013) Metabolic syndrome and socioeconomic status in France: The French Nutrition and Health Survey (ENNS, 2006–2007). Int J Public Health 58(6):855–864. doi: 10.1007/s00038-013-0501-2 CrossRefPubMedGoogle Scholar
  51. WHO (2005) The European health report 2005: public health action for healthier children and populations, summary. World Health Organization, Copenhagen, p 12Google Scholar

Copyright information

© Swiss School of Public Health 2014

Authors and Affiliations

  • Aristides M. Machado-Rodrigues
    • 1
    Email author
  • Neiva Leite
    • 2
  • Manuel J. Coelho-e-Silva
    • 1
  • Fernando Enes
    • 1
  • Rômulo Fernandes
    • 3
  • Luís P. G. Mascarenhas
    • 2
  • Margaret C. S. Boguszewski
    • 2
  • Robert M. Malina
    • 4
    • 5
  1. 1.Faculdade de Ciências do Desporto e Educação FísicaUniversidade de CoimbraCoimbraPortugal
  2. 2.Department of PediatricsFederal University of ParanáCuritibaBrazil
  3. 3.Center of Science and TechnologyPaulista State University, UNESPSão PauloBrazil
  4. 4.Department of Kinesiology and Health EducationUniversity of Texas at AustinAustinUSA
  5. 5.Department of KinesiologyTarleton State UniversityStephenvilleUSA

Personalised recommendations