United States Adolescents' Television, Computer, Videogame, Smartphone, and Tablet Use: Associations with Sugary Drinks, Sleep, Physical Activity, and Obesity

Published:December 14, 2016DOI:


      To quantify the relationships between youth use of television (TV) and other screen devices, including smartphones and tablets, and obesity risk factors.

      Study design

      TV and other screen device use, including smartphones, tablets, computers, and/or videogames, was self-reported by a nationally representative, cross-sectional sample of 24 800 US high school students (2013-2015 Youth Risk Behavior Surveys). Students also reported on health behaviors including sugar-sweetened beverage (SSB) intake, physical activity, sleep, and weight and height. Sex-stratified logistic regression models, adjusting for the sampling design, estimated associations between TV and other screen device use and SSB intake, physical activity, sleep, and obesity.


      Approximately 20% of participants used other screen devices for ≥5 hours daily. Watching TV ≥5 hours daily was associated with daily SSB consumption (aOR = 2.72, 95% CI: 2.23, 3.32) and obesity (aOR = 1.78, 95% CI: 1.40, 2.27). Using other screen devices ≥5 hours daily was associated with daily SSB consumption (aOR = 1.98, 95% CI: 1.69, 2.32), inadequate physical activity (aOR = 1.94, 95% CI: 1.69, 2.25), and inadequate sleep (aOR = 1.79, 95% CI: 1.54, 2.08).


      Using smartphones, tablets, computers, and videogames is associated with several obesity risk factors. Although further study is needed, families should be encouraged to limit both TV viewing and newer screen devices.



      BMI (Body mass index), CDC (Centers for Disease Control and Prevention), SSBs (Sugar-sweetened beverages), TV (Television), YRBSS (Youth Risk Behavior Surveillance System)
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        • Common Sense Media
        The Common Sense Census: Media Use by Tweens and Teens.
        • Strasburger V.C.
        • Hogan M.J.
        • Mulligan D.A.
        • Ameenuddin N.
        • Christakis D.A.
        • Cross C.
        • et al.
        Children, adolescents, and the media.
        Pediatrics. 2013; 132: 958-961
        • Kabali H.K.
        • Irigoyen M.M.
        • Nunez-Davis R.
        • Budacki J.G.
        • Mohanty S.H.
        • Leister K.P.
        • et al.
        Exposure and use of mobile media devices by young children.
        Pediatrics. 2015; 136: 1044-1050
        • Robinson T.N.
        Reducing children's television viewing to prevent obesity: a randomized controlled trial.
        JAMA. 1999; 282: 1561-1567
        • Gortmaker S.L.
        • Must A.
        • Sobol A.M.
        • Peterson K.
        • Colditz G.A.
        • Dietz W.H.
        Television viewing as a cause of increasing obesity among children in the United States, 1986-1990.
        Arch Pediatr Adolesc Med. 1996; 150: 356-362
        • Falbe J.
        • Rosner B.
        • Willett W.C.
        • Sonneville K.R.
        • Hu F.B.
        • Field A.E.
        Adiposity and different types of screen time.
        Pediatrics. 2013; 132: e1497-505
        • Hancox R.J.
        • Milne B.J.
        • Poulton R.
        Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study.
        Lancet. 2004; 364: 257-262
        • Community Preventive Services Task Force
        Reducing children's recreational sedentary screen time: recommendation of the community preventive services task force.
        Am J Prev Med. 2016; 50: 416-418
        • Wiecha J.L.
        • Peterson K.E.
        • Ludwig D.S.
        • Kim J.
        • Sobol A.
        • Gortmaker S.L.
        When children eat what they watch: impact of television viewing on dietary intake in youth.
        Arch Pediatr Adolesc Med. 2006; 160: 436-442
        • Andreyeva T.
        • Kelly I.R.
        • Harris J.L.
        Exposure to food advertising on television: associations with children's fast food and soft drink consumption and obesity.
        Econ Hum Biol. 2011; 9: 221-233
        • Powell L.M.
        • Szczypka G.
        • Chaloupka F.J.
        • Braunschweig C.L.
        Nutritional content of television food advertisements seen by children and adolescents in the United States.
        Pediatrics. 2007; 120: 576-583
        • Speers S.E.
        • Harris J.L.
        • Schwartz M.B.
        Child and adolescent exposure to food and beverage brand appearances during prime-time television programming.
        Am J Prev Med. 2011; 41: 291-296
        • Sonneville K.R.
        • Gortmaker S.L.
        Total energy intake, adolescent discretionary behaviors and the energy gap.
        Int J Obes (Lond). 2008; 32: S19-27
        • Falbe J.
        • Willett W.C.
        • Rosner B.
        • Gortmaker S.L.
        • Sonneville K.R.
        • Field A.E.
        Longitudinal relations of television, electronic games, and digital versatile discs with changes in diet in adolescents.
        Am J Clin Nutr. 2014; 100: 1173-1181
        • Marinelli M.
        • Sunyer J.
        • Alvarez-Pedrerol M.
        • Iniguez C.
        • Torrent M.
        • Vioque J.
        • et al.
        Hours of television viewing and sleep duration in children: a multicenter birth cohort study.
        JAMA Pediatr. 2014; 168: 458-464
        • Nuutinen T.
        • Ray C.
        • Roos E.
        Do computer use, TV viewing, and the presence of the media in the bedroom predict school-aged children's sleep habits in a longitudinal study?.
        BMC Public Health. 2013; 13: 684
        • Hart C.N.
        • Carskadon M.A.
        • Considine R.V.
        • Fava J.L.
        • Lawton J.
        • Raynor H.A.
        • et al.
        Changes in children's sleep duration on food intake, weight, and leptin.
        Pediatrics. 2013; 132: e1473-80
        • Cappuccio F.P.
        • Taggart F.M.
        • Kandala N.B.
        • Currie A.
        • Peile E.
        • Stranges S.
        • et al.
        Meta-analysis of short sleep duration and obesity in children and adults.
        Sleep. 2008; 31: 619-626
        • Falbe J.
        • Davison K.K.
        • Franckle R.L.
        • Ganter C.
        • Gortmaker S.L.
        • Smith L.
        • et al.
        Sleep duration, restfulness, and screens in the sleep environment.
        Pediatrics. 2015; 135: e367-75
        • Thomee S.
        • Harenstam A.
        • Hagberg M.
        Mobile phone use and stress, sleep disturbances, and symptoms of depression among young adults—a prospective cohort study.
        BMC Public Health. 2011; 11: 66
        • Freeman B.
        • Kelly B.
        • Baur L.
        • Chapman K.
        • Chapman S.
        • Gill T.
        • et al.
        Digital junk: food and beverage marketing on Facebook.
        Am J Public Health. 2014; 104: e56-64
        • Montgomery K.C.
        • Chester J.
        Interactive food and beverage marketing: targeting adolescents in the digital age.
        J Adolesc Health. 2009; 45: S18-29
        • Centers for Disease Control and Prevention
        Adolescent and school health: Youth Risk Behavior Surveillance System (YRBSS).
        (Accessed November 23, 2016)
        • Kuczmarski R.J.
        • Ogden C.L.
        • Guo S.S.
        • Grummer-Strawn L.M.
        • Flegal K.M.
        • Mei Z.
        • et al.
        2000 CDC Growth Charts for the United States: methods and development.
        Vital Health Stat 11. 2002; : 1-190
        • Thomée S.
        • Lissner L.
        • Hagberg M.
        • Grimby-Ekman A.
        Leisure time computer use and overweight development in young adults—a prospective study.
        BMC Public Health. 2015; 15: 839
        • Christakis D.A.
        Interactive media use at younger than the age of 2 years: time to rethink the American Academy of Pediatrics guideline?.
        JAMA Pediatr. 2014; 168: 399-400
        • Strasburger V.
        • Shifrin D.
        • Fuld G.
        Infants and interactive media use.
        JAMA Pediatr. 2014; 168: 969
        • Brown A.
        • Shifrin D.
        • Hill D.L.
        Beyond ‘turn it off’: how to advise families on media use.
        AAP News. 2015; 36
        • Powell L.M.
        • Harris J.L.
        • Fox T.
        Food marketing expenditures aimed at youth: putting the numbers in context.
        Am J Prev Med. 2013; 45: 453-461
        • Gringras P.
        • Middleton B.
        • Skene D.J.
        • Revell V.L.
        Bigger, Brighter, bluer-better? current light-emitting devices — adverse sleep properties and preventative strategies.
        Front Public Health. 2015; 3: 233
        • Bickham D.S.
        • Hswen Y.
        • Rich M.
        Media use and depression: exposure, household rules, and symptoms among young adolescents in the USA.
        Int J Public Health. 2015; 60: 147-155
        • Long M.W.
        • Ward Z.J.
        • Resch S.C.
        • Cradock A.L.
        • Wang Y.C.
        • Giles C.M.
        • et al.
        State-level estimates of childhood obesity prevalence in the United States corrected for report bias.
        Int J Obes (Lond). 2016; 40: 1523-1528
        • Te Velde S.J.
        • van der Horst K.
        • Oenema A.
        • Timperio A.
        • Crawford D.
        • Brug J.
        Parental and home influences on adolescents' TV viewing: a mediation analysis.
        Int J Pediatr Obes. 2011; 6: e364-72