Electronic Screen Time Research Articles

Genetic and non-genetic factors in prediction of early pubertal development in Chinese girls.

The objective of this study is to develop a combined predictive model for early pubertal development (EPD) in girls based on both non-genetic and genetic factors. The case-control study encompassed 147 girls diagnosed with EPD and 256 girls who exhibited normal pubertal development. The non-genetic risk score (NGRS) was calculated based on 6 independent biochemical predictors screened by multivariate logistic regressions, and the genetic risk score (GRS) was constructed using 28 EPD related single-nucleotide polymorphisms (SNPs). Area under receiver operator characteristic curve (AROC), net reclassification optimization index (NRI) and integration differentiation index (IDI) were used to evaluate the improvement of adding genetic variants to the non-genetic risk model. Overweight (OR=2.74), longer electronic screen time (OR=1.79) and higher ratio of plastic bottled water (OR=1.01) were potential risk factors, and longer exercise time (OR=0.51) and longer day sleeping time (OR=0.97) were protective factors for EPD, and the AROC of NGRS model was 83.6% (79.3-87.9%). The GRS showed a significant association with EPD (OR=1.90), and the AROC of GRS model was 65.3% (59.7-70.8%). After adding GRS to the NGRS model, the AROC significantly increased to 85.7% (81.7-89.6%) (P=0.020), and the reclassification significantly improved, with NRI of 8.19% (P= 0.023) and IDI of 4.22% (P <0.001). We established a combined prediction model of EPD in girls. Adding genetic variants to the non-genetic risk model brought modest improvement. However, the non-genetic factors such as overweight and living habits have higher predictive utility.

Joint association of overweight/obesity, high electronic screen time, and low physical activity time with early pubertal development in girls: a case–control study

To examine the joint association of electronic screen time (EST), moderate-to-vigorous physical activity time (MVPA) and overweight/obesity with early pubertal development (EPD) in girls. A case–control study of 177 EPD girls and 354 girls with normal pubertal development was conducted between October 2019 and August 2022. Overweight/obesity was defined as body mass index ≥ 85th percentiles for age and sex. We found a non-significant increase of EPD risk among girls with high EST alone [OR: 2.75 (0.65–11.58)] or low MVPA alone [OR: 2.54 (0.74–8.69)], but a significant increase of EPD risk among girls with overweight/obesity alone [OR: 4.91 (1.01–23.92)], compared to girls without any of the three risk factors (low MVPA, high EST and overweight/obesity). Girls with any two of the three risk factors faced increased risk of EPD, and girls with all three risk factors faced the highest risk of EPD [OR and 95% CI: 26.10 (6.40–106.45)]. Being overweight/obesity might be more important than having low MVPA or high EST as a correlate of EPD compared to girls without any of the three risk factors, but the co-presence of low MVPA, high EST and overweight/obesity would largely increase the risk of EPD in girls.

When and what: A longitudinal study on the role of screen time and activities in adolescent sleep

ObjectivesPrevious research has highlighted a link between electronic media use and sleep outcomes, but the nuanced impacts of screen use at different time of day and activities on adolescent sleep are underexplored. Methods831 participants underwent online assessment three times with interval of three months regarding their screen time and activities at specific times of the day, daytime sleepiness was assessed with the Epworth Sleepiness Scale, and sleep outcomes were assessed with the Pittsburgh Sleep Quality Index and Insomnia Severity Index. The associations between time spent on various screen activities, and sleep outcomes were examined respectively after controlling for inter-individual differences using the Random Intercept Cross-Lagged Panel Model models and LMMs. ResultsThe RI_CLPM model revealed that both electronic screen time during daytime and after lights off in the evening in Wave1 negatively predicted the sleep quality in Wave2; the nighttime screen time before lights off in Wave1 significantly negatively predicted the seventy of insomnia in Wave2. Whereas no cross-lag and predictive effects of sleep outcomes on screen time were revealed. Moreover, daytime screen exposure, including T.V. watching and social media use, and nighttime music listening were negatively associated with sleep quality. Conversely, nighttime screen time of shopping and working/studying positively influenced sleep quality. Additionally, daytime screen time of T.V. viewing was positively associated with increased insomnia severity, whereas nighttime work/study-related screen time negatively affected insomnia severity. Nighttime screen time of music listening negatively predicted daytime sleepiness. ConclusionsThe current findings contributed to the existing literature suggesting that the effects of electronic screen time on sleep depended on both the time of day and type of screen activities.

Prevalence of Myopia and Its Related Factors Among University Students in Madinah, Saudi Arabia.

Myopia, a common refractive error, is a growing global health burden influenced by both genetic and environmental factors. Despite its high prevalence, studies on its prevalence and risk factors among university students are lacking. The objective of this study is to investigate the prevalence of myopia and its associated factors among college students in Saudi Arabia's Madinah region. A cross-sectional study was conducted in Al-Madinah, Saudi Arabia, from February to June 2023, utilizing a survey that was distributed to college students through a social media application. A total of 433 university students from Al-Madinah province were enrolled in this study; 66.3% were females and 33.7% were males. Participants' ages ranged from 18 to 33 years with a mean of 21.3 ± 2.0 years.The prevalence of myopia among college students in Al-Madinah and its provinces was 57.3%, and 87.9% of them had myopia in both eyes.Respondents with an electronic screen time of more than three hours and a reading distance of less than 15cm were at significant risk of myopia with p-values of 0.037 and 0.019, respectively. A significant prevalence of myopia has been observed among university students in Madinah. Studying in scientific and medical fields, having eye diseases, prolonged use of digital devices, limiting daily outdoor activities to one hour, and having a reading distance of less than 15 cm significantly increased the risk of myopia. Encouraging education and screening programs for myopia prevention and control is crucial.

Development and evaluation study of FLY-Kids: a new lifestyle screening tool for young children

Evaluating, discussing, and advising on young children’s lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences. We aimed to develop and evaluate a new lifestyle screening tool for children aged 1–3 years. The lifestyle screening tool “FLY-Kids” was developed using data from lifestyle behaviour patterns of Dutch toddlers, age-specific lifestyle recommendations, target group analyses, and a Delphi process. Through 10 items, FLY-Kids generates a dashboard with an overview of the child’s lifestyle that can be used as conversation aid. FLY-Kids was completed by parents of children aged 1–3 years attending a regular youth healthcare appointment. Youth healthcare professionals (YHCP) then used the FLY-Kids dashboard to discuss lifestyle with the parents and provided tailored advice. Parents as well as YHCP evaluated the tool after use. Descriptive and correlation statistics were used to determine the usability, feasibility, and preliminary effect of FLY-Kids. Parents (N = 201) scored an average of 3.2 (out of 9, SD 1.6) unfavourable lifestyle behaviours in their children, while 3.0% complied with all recommendations. Most unfavourable behaviours were reported in unhealthy food intake and electronic screen time behaviour. Parents and YHCP regarded FLY-Kids as usable and feasible. The number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment (r = 0.47, p < 0.001). Conclusion: FLY-Kids can be used to identify unhealthy lifestyle behaviour in young children and guide the conversation about lifestyle in preventive healthcare settings. End-users rated FLY-Kids as helpful and user-friendly.What is Known:• A healthy lifestyle is important for optimal growth, development and overall health of young children (1-3 years).• Evaluating, discussing and advising on young children’s lifestyles may contribute to timely modification of unhealthy behaviour and prevention of adverse health consequences.What is New:• The new lifestyle screening tool FLY-Kids generates a dashboard with an overview of young children’s lifestyle that can be used as conversation aid between parents and youth healthcare professionals.• As parents and youth healthcare professionals rated FLY-Kids as helpful and user-friendly, and the number of items identified by FLY-Kids as requiring attention was associated with the number of items discussed during the appointment, FLY-Kids can be considered guiding the lifestyle discussion in preventive healthcare settings.

Screen time among Chinese primary and middle school students from 2016 to 2017

To get a better knowledge of the current situation of screen time among primary and secondary school students in all provinces of China from 2016 to 2017. Data was from the China National Nutrition and Health Surveillance of Children and Lactating Women(2016-2017).275 monitoring points were selected from 31 provinces of China by multi-stage stratified cluster random sampling. A total of 280 primary and secondary school students from 2 primary schools, 2 junior middle schools and 1 senior high school were randomly selected from each monitoring point to complete the survey.73629 primary and secondary school students(except grade 9 and grade 12) were included in this study. From 2016 to 2017, the average daily screen time of Chinese primary and secondary school students was(1.65±1.54) hours, M(P25, P75) was 1.29(0.58, 2.21) h. In terms of provinces, the average daily electronic screen time of primary and secondary school students in Beijing, Tianjin, Jilin, Fujian, Guangdong and Hainan is more than 2 hours. In terms of rural and urban areas, the screen time of students in Beijing&apos;s rural and urban areas, Tianjin&apos;s rural areas, Hebei&apos;s urban areas, Liaoning&apos;s rural areas, Jilin&apos;s rural areas, Fujian&apos;s urban areas, Guangdong&apos;s urban areas, Guangxi&apos;s urban areas, Hainan&apos;s rural and urban areas, and Xinjiang&apos;s urban areas all exceeds 2 hours/day. Besides, screen times of rural primary and secondary school students in Beijing(Z=2.62, P&lt;0.01), Tianjin(Z=5.94, P&lt;0.01), Liaoning(Z=11.56, P&lt;0.01), Jilin(Z=-7.59, P&lt;0.01), Shanghai(Z=3.19, P&lt;0.01), Jiangsu(Z=12.00, P&lt;0.01), Zhejiang(Z=-4.80, P&lt;0.01), Anhui(Z=-4.67, P&lt;0.01), Jiangxi(Z=-3.29, P=0.01), and Sichuan(Z=-4.53, P&lt;0.01) are longer than that of urban students. There are urban-rural differences in the average daily electronic screen time and different types of electronic screen time of primary and secondary school students in China&apos;s provinces from 2016 to 2017.

Children's electronic screen time exposure and its relationship to dental anxiety and behavior

ObjectivesThe purpose of this study was to assess the association between electronic screen time and dental anxiety and behaviour among children aged six to twelve years during dental examination, prophylaxis, and topical fluoride application. Material and methodsThis was a cross-sectional study which included 402 paediatric dental patients aged six to twelve years who came to King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. The data was collected from September 2020 to December 2021. Self-constructed questionnaire was used to collect data from the patient and his/her guardian. It was comprised of eight demographic questions as well as 13 multiple-choice questions regarding the patients' screen time. Child dental anxiety was assessed by using Abeer Children Dental Anxiety Scale (ACDAS). Assessment of child's behaviour was done by using Frankl Behavioural Rating Scale. ResultsThis study had a response rate of 100%. Out of the 402 participants, 248 (61.7%) were found to have anxiety while 154 (38.3%) were not. Of all participants 274 (68.2%) were cooperative and 128 (31.8%) were not. A Significant relationship between anxiety and behavioural problems during a dental visit and the participant's total exposure hours to electronic devices was found (p < 0.001). Children exposed to electronics at the age of two years or before displayed more anxiety and uncooperative behaviour (p < 0.001). Conclusionsearly exposure to electronic screens, especially for entertainment purposes and longer exposure can be associated with increased dental anxiety and uncooperative behaviour in children age 6–12 years. RecommendationsParents should be educated about the risks of permitting their children to use electronic devices and encouraged to replace such devices with activities that incorporate physical activity.

Functional constipation in Bangladeshi school aged children: A hidden misty at community.

BACKGROUNDConstipation is a common problem in children and a frequent cause of hospital visit in both primary & specialized care, which needs proper evaluation & management. Presentation of constipation is variable among children. In Bangladesh there has been no published data regarding constipation in community among school aged children.AIMTo determine the magnitude of functional constipation and its risk factors in community among Bangladeshi school children.METHODSThis descriptive cross sectional study was conducted in different schools of Dhaka division, Bangladesh. All school aged children between 5-16 years of age who attended school were included in this study. Samples were collected randomly. Proper clinical history & physical examinations (without digital rectal examination) & available investigations (if done previously) were recorded. Diagnosis of functional constipation was done by Rome IV criteria and was compared with children without constipation. Children with any red flag sign, known chronic disease or any findings suggestive of organic disease and on treatment of constipation were excluded. Statistical analysis of the results was done by using Windows based software device with Statistical Packages for Social Science 20. For all statistical tests, P value of less than 0.05 was considered as statistically significant.RESULTSTotal study populations were 707 and male was 443 and female 264. Among them, 134 (19%) children had constipation. In constipated children, 78 children fulfilled the Rome IV criteria for functional constipation and it was 11% of total population. Mean age of children having functional constipation was 11.24 ± 3.54 years and Male female ratio was 1:1.78. Anorexia, nausea, abdominal pain, hard stool, blood with hard stool, alternate hard and loose stool and fecal mass in left iliac fossa were analyzed between two group and all were significantly higher in children with functional constipation group. Children of school, where toilet numbers were inadequate had 2.5 times more constipation risk in comparison to children of school with adequate toilet number (OR = 2.493, 95%CI: 1.214-5.120). Children who feel embarrassed to use toilet at school, had 3.6 times higher risk of constipation (OR = 3.552, 95%CI: 1.435-8.794). Here children with H/O affected sibs and parents/grandparents had 4 and 2.6 times more chance of constipation respectively in comparison to children without H/O affected sibs (OR = 3.977, 95%CI: 1.884–8.397) and parents/grandparents (OR = 2.569, 95%CI: 1.172-5.629). Children with inadequate fluid intake had 2 times more risk of constipation in comparison to children with adequate fluid intake (OR = 1.972, 95%CI: 1.135-3.426). Children who passed electronic screen time of > 2 h/d had 2 times more chance of constipation in comparison to children who passed electronic screen time < 2 h (OR = 2.138, 95%CI: 1.063-4.301).CONCLUSIONConstipation is not uncommon in Bangladeshi school aged children. Inadequate toilet number, family history of constipation, inadequate fluid intake, feeling embarrassed to use toilet at school, and electronic screen time for > 2 h/d were found as risk factors in the present study for functional constipation.

Screen Time, Age and Sunshine Duration Rather Than Outdoor Activity Time Are Related to Nutritional Vitamin D Status in Children With ASD.

Objective: This study aimed to investigate the possible association among vitamin D, screen time and other factors that might affect the concentration of vitamin D in children with autism spectrum disorder (ASD).Methods: In total, 306 children with ASD were recruited, and data, including their age, sex, height, weight, screen time, time of outdoor activity, ASD symptoms [including Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS) and Autism Diagnostic Observation Schedule–Second Edition (ADOS-2)] and vitamin D concentrations, were collected. A multiple linear regression model was used to analyze the factors related to the vitamin D concentration.Results: A multiple linear regression analysis showed that screen time (β = −0.122, P = 0.032), age (β = −0.233, P < 0.001), and blood collection month (reflecting sunshine duration) (β = 0.177, P = 0.004) were statistically significant. The vitamin D concentration in the children with ASD was negatively correlated with screen time and age and positively correlated with sunshine duration.Conclusion: The vitamin D levels in children with ASD are related to electronic screen time, age and sunshine duration. Since age and season are uncontrollable, identifying the length of screen time in children with ASD could provide a basis for the clinical management of their vitamin D nutritional status.

Positive mother‐child interactions and parenting styles were associated with lower screen time in early childhood

This study examined long-term associations between mother-child interactions and parenting styles and electronic screen time. We studied 280 healthy children (53.2% girls) enrolled at a mean age of 36±0.4months from February 2015 to September 2016. The study included retrospective data on 267 children who had been recruited from medical facilities in Thailand at 6months of age. Mother-child interaction, parenting styles and screen time were assessed at various ages and path analyses were performed to elucidate the directionality and relationships between the variables. Increased mother-child interaction at 18months of age was positively associated with less screen time at 2 and 3years of age. Likewise, nurturing authoritative parenting at 3years of age was directly related to lower media exposure at 4years. The total screen time at younger ages had positive direct relationships with relaxed permissive and strict authoritarian parenting styles, but negative direct relationships with nurturing authoritative parenting in subsequent years. Early mother-child interaction and nurturing authoritative parenting were associated with subsequent decreased screen time, while media exposure at the age of two was related to relaxed permissive and strict authoritarian parenting at 3years of age.

A randomised controlled trial of performance review and facilitated feedback to increase implementation of healthy eating and physical activity-promoting policies and practices in centre-based childcare

BackgroundWhile it is recommended that childcare services implement policies and practices to support obesity prevention, there remains limited evidence to inform policy and practice. The aim of this study is to examine the effectiveness of performance review and facilitated feedback in increasing the implementation of healthy eating and physical activity-promoting policies and practices in childcare services.MethodsThe study was conducted with childcare services in the Hunter New England region of New South Wales, Australia. Eligible services were randomised to a wait-list control group or to receive the implementation strategy. The strategy targeted the implementation of written nutrition, physical activity, and small screen recreation policies; providing information to families regarding healthy eating, physical activity, and small screen time; providing twice weekly healthy eating learning experiences to children; providing water and plain milk only to children; providing fundamental movement skills activities for children every day; and limiting the use of electronic screen time for educational purposes and learning experiences. Intervention services received a performance review and facilitated feedback process five times over the 10 months that included an assessment of current practices, goal setting, identification of barriers to implementation, problem-solving, and resource provision. The primary outcome was the proportion of services implementing all six policies and practices, assessed by nominated supervisor completion of a computer-assisted telephone interview at baseline and 12-month follow-up.ResultsOne hundred and eight services took part. There were no significant differences in the proportion of services implementing all six practices at 12 months (mean difference 0.51; 95% CI 0.16 to 1.58; p = 0.24). There were also no differences between groups in the mean number of policies and practices implemented (mean difference 0.1; 95% CI − 0.4 to 0.6; p = 0.71), or the proportion implementing each of the six individual policies and practices at 12 months (OR range 0.57 to 1.85; p > 0.05).ConclusionsFurther support may be required to assist childcare services to make recommended changes to their policies and practices.Trial registrationThe trial was registered retrospectively on 10 September 2014 with the Australian New Zealand Clinical Trials Registry ACTRN12614000972628.

Rationale and design of GENEiUS: a prospective observational study on the genetic and environmental determinants of body mass index evolution in Canadian undergraduate students

IntroductionObesity is a global epidemic and is a risk factor for developing other comorbidities. Young adulthood is a critical period for body weight change and establishing healthy lifestyle behaviours. The...

Screen Time Engagement Is Increased in Urban Children With Asthma.

Physical activity in children has been shown to play a role in its relationship to asthma, both in terms of prevalence and incidence. One measure of physical activity in children is sedentary behavior, which might be measured by the degree of engagement with media electronic screens. We found that children with asthma, as compared with children without asthma, engage in significantly more hours of screen time (median 35 vs 26 h/wk, P = .004). In this birth cohort, those who developed a diagnosis of asthma at 8 years of age were significantly more engaged in electronic screen time than their peers. No other clinical or lifestyle behaviors were significantly associated with a diagnosis of asthma. Further study will be needed to determine directionality of this finding.

A pragmatic randomised controlled trial of an implementation intervention to increase healthy eating and physical activity-promoting policies, and practices in centre-based childcare services: study protocol

BackgroundPromotion of healthy eating and physical activity in early childhood is recommended as a global chronic disease prevention strategy. Centre-based childcare services represent a promising setting to provide children with...

Associations between sports participation, adiposity and obesity-related health behaviors in Australian adolescents

BackgroundThe purpose of this study was to examine the relationship between organized sports participation, weight status, physical activity, screen time, and important food habits in a large nationally representative sample of Australian adolescents.MethodsNationally representative cross-sectional study of 12,188 adolescents from 238 secondary schools aged between 12 and 17 years (14.47 ± 1.25 y, 53% male, 23% overweight/obese). Participation in organized sports, compliance with national physical activity, screen time, and fruit and vegetable consumption guidelines, and consumption of sugar-sweetened beverages and high-fat foods were self-reported. Weight status and adiposity (BMI, waist circumference) were measured.ResultsOrganized sports participation was higher among males and those residing in rural/remote areas. Underweight adolescents reported the lowest levels of participation. Higher levels of participation were associated with an increased likelihood of complying with national physical activity (OR = 2.07 [1.67-2.58]), screen time (OR = 1.48 [1.19-1.84]), and fruit and vegetable consumption guidelines (OR = 1.32 [1.05-1.67]). There was no association between organized sport participation and weight status, adiposity, consumption of sugar-sweetened beverages or high-fat foods.ConclusionsParticipation in organized sports was associated with a greater likelihood to engage in a cluster of health behaviors, including meeting physical activity guidelines, electronic screen time recommendations, and fruit and vegetable consumption guidelines. However, participation in organized sports was not associated with unhealthy dietary behaviors including the consumption of sugar-sweetened beverages and high-fat foods. There is no association between participation in organized sports and likelihood to be overweight or obese. The role of sports in promoting healthy weight and energy balance is unclear.

Electronic screen use and mental well-being of 10-12-year-old children

Today's children spend a great deal of time viewing electronic screen material, but the consequences of such behaviors, if any, are unknown. This study sought to identify (i) the magnitude of total daily electronic screen time and (ii) the relations between electronic screen use and mental well-being indicators, in a sample of 10-12-year-old children. We analysed cross-sectional, population-based data of 10-12-year-old children from the 2007 Youth in Iceland school survey (n = 10,829, response rate: 81.7%, boys: 50.5%). Logistic regression models with odds ratios and 95% confidence intervals were conducted to assess the odds of each selected mental well-being indicator, depending on the number of daily hours spent on each electronic screen-based activity. All analyses were conducted separately for boys and girls and adjusted for family structure. The prevalence of self-reported screen use of 4 hours per day or more ranges from 2.8% to 6.6% among boys and from 1.0% to 3.8% among girls. All five screen-based activities were significantly associated with all seven well-being indicators (P < 0.001) with symptoms being more common with increased time spent on screen use. This study is the first of its kind to demonstrate a dose-response relationship between electronic screen use and mental well-being in 10-12-year-old children. Further research is needed to assess the validity and potential implications of these findings.

Caffeine and Screen Time in Adolescence: Associations with Short Sleep and Obesity

To investigate the associations between sleep duration and obesity incidence and risk factors among pre-adolescents and adolescents. Cross-sectional study of a community based cohort The Tucson Children's Assessment of Sleep Apnea follow-up study (TuCASA) cohort. 319 Caucasian and Hispanics between 10-17 years. Parent-reported sleep duration and BMI z-score. Surveys of electronic screen time, dietary and caffeine intake, exercise and sleep habits by parents, and anthropometric measures. Parent-reported total sleep time (TST) was inversely associated with BMI z-score, but not significantly correlated with any of the examined nutritional variables or exercise components. Hispanic ethnicity was associated with significantly lower parent-reported TST and higher BMI z-score. Parent-reported TST was inversely related to electronic screen time and caffeine use, but these findings were differentially related to age. Caffeine consumption was associated with decreasing parent-reported TST primarily in older adolescents. Electronic screen time was associated with lower parent-reported TST in younger adolescents. Hispanic ethnicity and parental reports of TST were found to be the most closely associated with BMI z-score. Decreased TST and increased caffeine intake and screen time may result in higher obesity risk in the adolescent population.

Preventing Childhood Obesity: Wake Up, It's Time for Sleep!

The obesity epidemic continues to be a major public health concern in the United States, with the prevalence of childhood obesity tripling since 1980.1 Obesity in childhood is associated with both short- and long-term adverse outcomes.2 Children who are obese tend to become obese adults,3 and, once present, obesity is notoriously hard to treat.4 The obesity epidemic has been paralleled by a similar epidemic of sleep deprivation. Across infancy, childhood, and adolescence, evidence suggests a decrease in sleep duration ranging from 30 to 60 minutes over the last 20 years, due largely in part to later bedtimes.5,6 Sleep duration has been implicated as a potential risk factor for obesity. Several experimental and epidemiological studies in adults and children have reported an association between short sleep duration and increased body mass index (BMI). The study by Drescher et al.7 adds to this literature by showing a relationship between parent-reported total sleep time (TST) and BMI z-score among children 10-17 years of age. In this cross-sectional study, Drescher et al. found that decreased parent-reported TST was associated with higher standardized BMI. Although the cross-sectional design limits the ability to examine causality, the study had several strengths, including a diverse sample of children participating in a community-based cohort study, research-level measures of height and weight, use of both questionnaires and polysomnography to measure sleep, and careful measurement of physical activity and screen time. Prevention and treatment of childhood obesity are national priorities, and potentially effective intervention strategies are critically needed to address the alarming increase of obesity prevalence in today's youth. The consistent association across adult and childhood studies of short sleep duration and high BMI suggests that modifying sleep duration may aid in decreasing the risk of obesity. The high prevalence of sleep insufficiency in adolescence and the inverse association between parent-reported total sleep time and BMI z-score reported by Drescher et al. also lend support to the importance of sleep as a key component of a healthy lifestyle and weight maintenance throughout the lifecourse. Despite the increasing evidence relating sleep duration and obesity, few interventions have reported attempts to improve childhood sleep duration and quality to prevent obesity, and more information is needed about potential intervention strategies to improve sleep. Drescher et al. identify two potential age-specific targets for sleep interventions, i.e., caffeine consumption and electronic screen time. Today's youth spends more time using media devices than ever before, and 71% of 8- to 18-year-old children have televisions in their bedrooms.8 Results reported by Drescher et al. suggest that lessening the amount of screen time to increase sleep duration may be an effective strategy for pre-adolescents less than 13 years old. Caffeine intake provides another interesting possible means to modify sleep duration. Due to caffeine's ubiquitous presence in everyday life and its inverse relationship with parent-reported total sleep time in children 13 years of age and older as reported by Drescher et al., decreasing caffeine use provides an additional way to address sleep insufficiency in older adolescents. Targeting caffeine and screen media could be potential intervention strategies for improving sleep duration among school age children and possibly also preventing obesity. Identifying determinants of short sleep and obesity can also inform the design of interventions for high-risk populations. The disproportionate prevalence of obesity among racial/ethnic minorities of all ages has been widely documented, and studies have found racial/ethnic differences in many related risk factors in children including short sleep duration.9 Drescher et al. found that Hispanic adolescents had significantly higher BMI z-scores compared to their white counterparts and had significantly shorter parent-reported total sleep time. Thus, it is possible that targeting sleep duration may be a particularly effective strategy for obesity prevention among minority populations. In summary, the study by Drescher et al. suggests it is time for obesity prevention efforts to “wake up” and consider the important role of sleep, which has largely been overlooked in traditional childhood obesity prevention discussions.