Comparison of television viewing between children with autism spectrum disorder and controls

Aim: To examine the pattern and extent of television viewing in children with autism spectrum disorder (ASD) compared with typically developing controls and those with delayed language development (DLD). Methods: Fifty‐four individuals with ASD (mean age 2.56 ± 0.66 years) and 84 controls (mean age 2.43 ± 0.81 years) were enrolled. Fifty‐six individuals with DLD, who had language developmental levels similar to those with ASD, were enrolled in our previous study. Main outcome measures included onset and frequency of television viewing, in addition to the type of programme and whether a caregiver cowatched television. Results: Those with ASD began to watch television significantly earlier than controls (6.44 ± 6.35 vs. 12.41 ± 6.00 months of age, p ≤ 0.0001*) and spent more time watching television than those with DLD (4.60 ± 1.91 vs. 3.05 ± 1.90 h/day, p ≤ 0.0001*) and controls (4.60 ± 1.91 vs. 2.06 ± 1.21 h/day, p ≤ 0.0001*). Those with ASD appeared to watch more adult programmes than normal controls, and they were less likely to watch television with caregivers than both control groups. Conclusion: There is an earlier onset and higher frequency of television viewing in autistic children compared with children with typical development.     

Television viewing, computer use and total screen time in Canadian youth

BACKGROUND

Research has linked excessive television viewing and computer use in children and adolescents to a variety of health and social problems. Current recommendations are that screen time in children and adolescents should be limited to no more than 2 h per day.

OBJECTIVE

To determine the percentage of Canadian youth meeting the screen time guideline recommendations.

METHODS

The representative study sample consisted of 6942 Canadian youth in grades 6 to 10 who participated in the 2001/2002 World Health Organization Health Behaviour in School-Aged Children survey.

RESULTS

Only 41% of girls and 34% of boys in grades 6 to 10 watched 2 h or less of television per day. Once the time of leisure computer use was included and total daily screen time was examined, only 18% of girls and 14% of boys met the guidelines. The prevalence of those meeting the screen time guidelines was higher in girls than boys.

CONCLUSION

Fewer than 20% of Canadian youth in grades 6 to 10 met the total screen time guidelines, suggesting that increased public health interventions are needed to reduce the number of leisure time hours that Canadian youth spend watching television and using the computer.     

Factors that affect television viewing time in preschool and primary schoolchildren

BACKGROUND: Excessive viewing of television (TV) has been linked to aggressive behavior, violence and childhood obesity. METHODS: A cross-sectional study was conducted among preschool children and primary schoolchildren in Ankara during March and April 1999 to detect the factors that affect TV viewing time and to evaluate their parents' knowledge, attitudes and practices with regard to TV. The parents were asked to fill out a questionnaire about TV habits of their family, the number and location of TVs in the household and the effect of TV on children. Of 400 questionnaires, 350 answered the questions appropriately for this study. Children were divided into two groups, preschool children and primary schoolchildren. Television viewing time was given daily, as a mean of weekday. RESULTS: The mean age for becoming a TV viewer was 2.7 +/- 1.6 years. Of all, 62% of children spent >/= 2h/day watching TV and 8.3% of children spent > 4 h. The TV viewing time of child was significantly and positively correlated with that of siblings, mother and father for both groups. Age and sleeping time of the child, age and the education level of mother, presence of TV in the child's room and the starting age watching TV did not affect the viewing time. One-half of parents reported that the TV programs watched included violence, and one-third thought TV depicts child abuse, especially emotional abuse. CONCLUSIONS: It was found that the TV watching habits of parents had an influence on those of their children. Therefore, pediatricians should take 'TV histories' of children and their parents and educate parents how to become good TV viewers.     

An intervention to reduce television viewing by preschool children

BACKGROUND: Television viewing has been associated with increased violence in play and higher rates of obesity. Although there are interventions to reduce television viewing by school-aged children, there are none for younger children. OBJECTIVE: To develop and evaluate an intervention to reduce television viewing by preschool children. DESIGN: Randomized controlled trial conducted in 16 preschool and/or day care centers in rural upstate New York. PATIENTS: Children aged 2.6 through 5.5 years. INTERVENTION: Children attending intervention centers received a 7-session program designed to reduce television viewing as part of a health promotion curriculum, whereas children attending the control centers received a safety and injury prevention program. OUTCOME MEASUREMENTS: Change in parent-reported child television/video viewing and measured growth variables. RESULTS: Before the intervention, the intervention and control groups viewed 11.9 and 14.0 h/wk of television/videos, respectively. Afterward, children in the intervention group decreased their television/video viewing 3.1 h/wk, whereas children in the control group increased their viewing by 1.6 h/wk, for an adjusted difference between the groups of -4.7 h/wk (95% confidence interval, -8.4 to -1.0 h/wk; P =.02). The percentage of children watching television/videos more than 2 h/d also decreased significantly from 33% to 18% among the intervention group, compared with an increase of 41% to 47% among the control group, for a difference of -21.5% (95% confidence interval, -42.5% to -0.5%; P =.046). There were no statistically significant differences in children's growth between groups. CONCLUSIONS: This study is the first to show that a preschool-based intervention can lead to reductions in young children's television/video viewing. Further research is needed to determine the long-term effects associated with reductions in young children's television viewing.     

The effects of television viewing in Greece,and the role of the paediatrician: a familiar triangle revisited

To investigate the effects of television (TV) viewing on children, 4876 questionnaires on viewing habits completed by Greek children with the assistance of their parents were analysed. The most important results are summarized below. The mean time spent watching TV ranged from 21–32 h per week. The age when children started watching TV correlated with their later educational achievement: good students started watching TV earlier. Bad students, however, watched more TV, as did children from urban areas, and from lower socioeconomic groups. Children from households with more than one TV (especially if it was in the child’s bedroom) also watched more. Children who watched more TV were less compliant with TV restrictions and more likely to imitate TV characters. Eating while watching TV was associated with obesity only in teenagers. Most children watched TV from appropriate distances, with the lights on, and with the sound at medium volume. Conclusion This study of TV viewing habits in Greek children shows that certain patterns of watching TV may contribute to poor educational achievement, and obesity, in paediatric patients and, therefore, supports the idea of taking „televiewing histories“ when treating these patients. Received: 20 June 1995 Accepted: 26 April 1996     

Television watching, energy intake, and obesity in US children: results from the third National Health and Nutrition Examination Survey, 1988-1994

OBJECTIVES: To examine the relationship between television watching, energy intake, physical activity, and obesity status in US boys and girls, aged 8 to 16 years. METHODS: We used a nationally representative cross-sectional survey with an in-person interview and a medical examination, which included measurements of height and weight, daily hours of television watching, weekly participation in physical activity, and a dietary interview. Between 1988 and 1994, the Third National Health and Nutrition Examination Survey collected data on 4069 children. Mexican Americans and non-Hispanic blacks were oversampled to produce reliable estimates for these groups. RESULTS: The prevalence of obesity is lowest among children watching 1 or fewer hours of television a day, and highest among those watching 4 or more hours of television a day. Girls engaged in less physical activity and consumed fewer joules per day than boys. A higher percentage of non-Hispanic white boys reported participating in physical activity 5 or more times per week than any other race/ethnic and sex group. Television watching was positively associated with obesity among girls, even after controlling for age, race/ethnicity, family income, weekly physical activity, and energy intake. CONCLUSIONS: As the prevalence of overweight increases, the need to reduce sedentary behaviors and to promote a more active lifestyle becomes essential. Clinicians and public health interventionists should encourage active lifestyles to balance the energy intake of children.     

Television viewing and food habits in toddlers and preschoolers in Greece: the GENESIS study

The aim of the current study was to evaluate the association between television (TV) viewing time and dietary habits of preschoolers. A representative sample of 2,374 Greek children aged 1–5 years was examined (GENESIS study). The majority of participants (74.0%) spent less than 2 h/day watching TV. Children spending ≥2 h/day watching TV seem to have higher energy intake compared to children watching TV less than 2 h/day, even after adjustment for potential confounders (p < 0.001). Furthermore, it was detected that the former were more likely to consume more than 5, 2, and 1.5 exchanges of fat, meat, and other carbohydrates per day, respectively, compared to the latter. In conclusion, the current findings indicate that prolonged TV viewing time may be associated with increased consumption of high-fat and high-sugar foods resulting in increased daily energy intake. Therefore, interventions aiming to modify children’s TV viewing behaviour might need to be implemented.     

Associations of Passive and Mentally Active Screen Time With Perceived School Performance of 197,439 Adolescents Across 38 Countries

ObjectiveTo examine the associations of passive (ie, television) and active (ie, electronic games, computer use) screen time (ST) with perceived school performance of adolescents across gender.MethodsData were from the 2014 Health Behaviour in School-aged Children survey conducted across 38 European countries and Canada. Perceived school performance was assessed using an item and dichotomized as high (good/very good) versus the remainder (average/below-average as reference). Participants reported hours per day of time spent watching television, playing electronic games, and using a computer in their free time. Multilevel logistic regression was used to estimate the associations.ResultsA total of 197,439 adolescents (average age 13.6 [standard deviation 1.63] years; 51% girls) were analyzed. Multivariable modeling showed that engaging in >2 h/d of ST was progressively and adversely associated with high performance in both boys and girls. Adolescents reporting >4 h/d of television time (≤1 h/d as reference) had 32% lower odds in boys (odds ratio [OR] 0.68; 95% confidence interval [CI]: 0.65–0.71) and 39% lower odds in girls (OR 0.61; 95% CI, 0.58–0.65) of reporting high performance. Playing electronic games for >4 h/d was associated with high performance with odds being 38% lower in boys (OR 0.62; 95% CI, 0.59–0.66) and 45% lower in girls (OR 0.55; 95% CI, 0.52–0.57). Sex differences in the estimates were mixed.ConclusionsHigh screen use, whether active or passive, was adversely associated with perceived high school performance, with association estimates being slightly stronger in girls than boys, and for mentally active than passive screen use. Discouraging high levels of screen use of any type could be beneficial to school performance.     

Association between the family environment and television viewing in Australian children

AIM: To describe the time children spend watching television (TV) and to assess associations between TV viewing time, the family environment and weight status. METHODS: Parents reported the amount of time children watched TV/video both for 'the previous school day' and 'usually' and described aspects of the family environment influencing TV access as part of a large cross-sectional study in the Barwon South-western region of Victoria, Australia. Child weight status was based on measured height and weight. All data were collected in 2003/2004. RESULTS: A total of 1926 children aged 4-12 years participated. Parent-reported mean +/- SE TV time for the previous school day was 83 +/- 1.5 min. Children who lived in a family with tight rules governing TV viewing time (22%), or who never watched TV during dinner (33%), or had only one TV in the household (23%) or had no TV in their bedroom (81%) had significantly less TV time than their counterparts. Overweight or obese children had more TV time than healthy weight children 88 +/- 2.9 versus 82 +/- 1.7 min per day (P=0.04). They were also more likely to live in a household where children had a TV in their bedroom than healthy weight children (25% vs. 17%, P<0.001). CONCLUSION: Strategies to reduce TV time should be included as part of broader strategies to prevent childhood obesity. They should include messages to parents about not having a TV in children's bedrooms, encouraging family rules restricting TV viewing, and not having the TV on during dinner.     

Behavioral correlates of television viewing in primary school children evaluated by the child behavior checklist

BACKGROUND: Television is a source from which children gain information about life and experience different types of behavior. The Child Behavior Checklist (CBCL) has not been used thoroughly to evaluate the behavioral effects of television viewing on children. OBJECTIVE: To examine the competency and problem behavior correlates of television viewing in school-aged children using the CBCL. DESIGN: Cross-sectional survey. SETTING: Two randomly selected grade schools, one from a high-income district and the other from a low-income district. PARTICIPANTS: Students in grades 2 and 3 and their parents. MAIN OUTCOME MEASURES: A questionnaire on children's time spent watching television and engaging in other daily activities and the CBCL were sent to the parents of 888 second- and third-grade students. RESULTS: Results of the questionnaire reported that the overall mean +/- SD daily television viewing time was 2.5 +/- 1.3 hours. Overall television viewing time had a negative correlation with social and school achievement (r = -0.17, P<.001 and r = 0.11, P =.03, respectively) subscale scores. Withdrawn (r = 0.11, P =.004), social problem (r = 0.14, P =.001), thought problem (r = 0.11, P =.03), attention problem (r = 0.20, P<.001), delinquent behavior (r = 0.12, P<.001), aggressive behavior (r = 0.22, P<.001), and externalization (r = 0.19, P<.001) subscales and total problem (r = 0.15, P<.001) scores were positively correlated with time spent watching television. Stepwise logistic regression analysis revealed that the only significant variables associated with a risk of watching television for more than 2 hours were age, gender, social subscale, and attention problem subscale scores of the CBCL. CONCLUSION: As evaluated by the CBCL, television viewing time is positively associated with social problems, delinquent behavior, aggressive behavior, externalization, and total problem scores. Older age, male gender, and decreasing social subscale and increasing attention problem subscale scores on the CBCL increases the risk of watching television for more than 2 hours.     

Use of an open-loop system to increase physical activity

This study evaluated the effectiveness of an open-loop system that reinforces physical activity with TV watching to increase children's physical activity. Nonoverweight, sedentary boys and girls (8-12 y) were randomized to a group that received feedback of activity counts + reinforcement for physical activity by providing access to television (F+R, n = 20); or to feedback, no reinforcement (Feedback, n = 20) or no feedback, no reinforcement control (Control, n = 21) groups. Children wore an accelerometer with a count display for 4-months with a 1-year follow-up. F+R reduced TV by 68 min/day and TV time was lower than the Feedback (p < .005) and Control (p < .002) groups. TV time of F+R remained 31 min lower (p < .02) than baseline at 1-year. F+R had a 44% increase in physical activity, which was greater than the feedback (p < .04) and control (p < .01) groups. An open-loop system decreases TV viewing and increases physical activity of children for 4-months. TV of the F+R group remained lower at 12 months, suggesting a reduction in screen-time habits.     

TV watching modifies obesity risk linked to the 27Glu polymorphism of the ADRB2 gene in girls.

OBJECTIVE: A matched case-control study was conducted in a population of Spanish children and adolescents (5-18 years old), to assess the interaction between the Gln27Glu polymorphism of the ADRB2 and television (TV) watching on obesity risk. PATIENTS: Obese (n=165) and control subjects (n=165) matched by sex and age were recruited and classified according to Spanish reference data. Results. Using conditional logistic regression, we calculated the obesity risk linked to the polymorphism. A statistically significant association was found for 27Glu carrier allele girls (OR = 1.95; 95% CI = 1.02-3.70), but no association was apparent among boys. In the fully adjusted model, the odds ratio for obesity linked to the genotype Glu27Glu in the female population rose to 4.84 (95% CI = 1.37-17.10). Moreover, we found a significant negative interaction between hours of TV watching and the Gln27Glu polymorphism for obesity risk in girls. Surprisingly, among 27Glu carrier subjects, even girls with a low level of TV watching ( < 12.5 h/week) had a high obesity risk (OR = 4.60; 95% CI = 1.01-20.02), which was not very different to the odds ratio values for sedentary girls carrying the 27 Glu allele watching TV more than 12.5 h/week (OR = 6.05; 95% CI = 1.31-27.71). Conclusion. A higher risk of obesity was found for girls carrying the 27Glu allele of the ADRB2 gene even when they spent less than 12.5 h/week watching TV. In addition, our results suggest that the effect of sedentary lifestyle on obesity risk may depend on the genotype of the subject.     

Television viewing and its effect on physical health of schoolage children

Obesity is an increasing health problem all over the world. In addition to genetic and many environmental factors, television is also thought to be a risk factor. This study examined the effects of television viewing on obesity and other physical complaints among Turkish children. From two different socioeconomic class primary schools, 886 second- and third-grade children were visited at their schools, and their weight, height and triceps skin fold thickness (TST) were measured and body mass index (BMI) calculated. Television viewing behavior of the children, parental weight and height, and physical complaints of children were investigated by a questionnaire sent to parents. A subgroup of children was also called to the hospital, and their blood lipid profile and visual acuity were measured. According to the questionnaires, children were found to watch television 2.1 +/- 1.2 hours/day (hr/d) during the weekdays, 3.4 +/- 2.1 hr/d at the weekend and 2.5 +/- 1.3 hr/d generally. Children were also grouped according to the amount of time they watch television. Group 1 (n = 298) children watched television less than 2 hr/d, Group 2 (n = 323) watched 2-4 hr/d, and Group 3 (n = 68) more than 4 hr/d. The prevalence of obesity was 10.9% according to BMI, 11.8% according to TST and 6.4% according to both criteria. Obese girls were found to watch television longer than their peers (2.9 +/- 1.2 hr/d vs 2.3 +/- 1.3 hr/d, respectively, p = 0.034), but no other relation was found between television viewing and obesity. Headache, back pain, eye symptoms and sleep problems were found to be more often among children who watched television longer (p < 0.05). It was concluded that television viewing is related to many physical complaints, which may have lifelong consequences (obesity). Thus, pediatricians should give appropriate guidance to families about television habits and health consequences.     

Overweight/obesity and factors associated with body mass index during adolescence: the VYRONAS study

Aim: To describe overweight and obese adolescents and to determine any correlations between an adolescent's body mass index (BMI) with personal (age, gender), lifestyle (sedentary/sport activities, smoking status) and parental (smoking status, BMI, number of cars) characteristics.
Methods: Cross-sectional data on weight, height and various characteristics from 2008 Greek adolescents (12- to 17-year olds, 50.85% boys), measured in 2005–2007, were used.
Results: Almost 1 in 5 (19.2%) boys and 1 in 7 (13.2%) girls 12–17 years of age were overweight while 4.4% of the boys and 1.7% of the girls were obese. The adolescents' age, mother's smoking status, father's and mother's BMI predicted boys' and girls' BMI (b = 0.551, 0.203, 0.110, 0.495 for boys, b = 0.233, 0.187, 0.180, 0.531 for girls, respectively, p ≤ 0.05). Univariate analysis revealed that television watching/using personal computer/playing video games and playtime were not correlated with BMI, while an inverse association of exercising for ≥ 5 h/week and BMI was found in both boys and girls (b =−1.098, −0.528, p = 0.005, 0.004 respectively).
Conclusion: The results of our study underline the high prevalence of obesity during adolescence in Greece. Age and parental unhealthy behaviour (increased BMI and maternal smoking status) were positive predictors of increased BMI of adolescents in both genders.     

No evidence for leptin as an independent associate of blood pressure in childhood and juvenile obesity

We studied whether leptin is an independent associate of blood pressure in obese children and adolescence. 102 obese children (48 girls, age: 11.6 +/- 2.22 yr; body mass index [BMI]: 27.45 +/- 4.4; blood pressure: 122.5 +/- 11.1/64.7 +/- 10.6 mm Hg and 54 boys, age: 11.5 +/- 2.4 yr; BMI: 27.6 +/- 4.4; blood pressure: 122.5 +/- 13.2/60.9 +/- 8.1 mm Hg [mean +/- SD]) were investigated. Serum leptin and insulin were measured by RIA; glucose was determined enzymatically. Fat mass (FM) was calculated by bioelectrical impedance. Leptin was higher in girls than in boys (p=0.018) but no significant gender differences were found with respect to indices of adiposity and systolic blood pressure (SBP). Children were divided into three groups, according to pubertal stage (Group 1: prepubertal, 32 boys/13 girls; Group 2: pubertal, 17 boys/25 girls; Group 3: late/postpubertal, 5 boys/10 girls). SBP and DBP correlated with body weight in the whole group (r=0.49, p<0.0001, and r=0.27, p=0.004). In Group 1, BMI showed the highest correlation to SBP; in Group 3 no indices of adiposity were related to SBP. In no case was leptin significantly associated with SBP after adjustment for adiposity. In Group 2, glucose was significantly associated with SBP after adjustment for body weight. In Group 3, however, no correlations were found between SBP, DBP and metabolic characteristics, perhaps due to small sample size. Stepwise multiple regression revealed that body weight and glucose contributed to the variation in SBP in the whole group (R2=0.31, p<0.0001). Insulin accounted for almost 8% of the variation in DBP (R2=0.08, p=0.0034). Body weight contributed significantly to SBP in boys (R2=0.39, p<0.0001) and girls (R2=0.24, p< 0.001). The results imply that body weight contributes independently to the variation in blood pressure. Glucose and insulin contribute to mean blood pressure to some extent, but our data do not support the assumption that leptin per se serves as an independent predictor of blood pressure in obese children and adolescents.     

Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health

OBJECTIVE: To evaluate the impact of a school-based health behavior intervention known as Planet Health on obesity among boys and girls in grades 6 to 8. DESIGN: Randomized, controlled field trial with 5 intervention and 5 control schools. Outcomes were assessed using preintervention (fall 1995) and follow-up measures (spring 1997), including prevalence, incidence, and remission of obesity. PARTICIPANTS: A group of 1295 ethnically diverse grade 6 and 7 students from public schools in 4 Massachusetts communities. INTERVENTION: Students participated in a school-based interdisciplinary intervention over 2 school years. Planet Health sessions were included within existing curricula using classroom teachers in 4 major subjects and physical education. Sessions focused on decreasing television viewing, decreasing consumption of high-fat foods, increasing fruit and vegetable intake, and increasing moderate and vigorous physical activity. MAIN OUTCOME MEASURES: Obesity was defined as a composite indicator based on both a body mass index and a triceps skinfold value greater than or equal to age- and sex-specific 85th percentiles. Because schools were randomized, rather than students, the generalized estimating equation method was used to adjust for individual-level covariates under cluster randomization. RESULTS: The prevalence of obesity among girls in intervention schools was reduced compared with controls, controlling for baseline obesity (odds ratio, 0.47; 95% confidence interval, 0.24-0.93; P = .03), with no differences found among boys. There was greater remission of obesity among intervention girls vs. control girls (odds ratio, 2.16; 95% confidence interval, 1.07-4.35; P = .04). The intervention reduced television hours among both girls and boys, and increased fruit and vegetable consumption and resulted in a smaller increment in total energy intake among girls. Reductions in television viewing predicted obesity change and mediated the intervention effect. Among girls, each hour of reduction in television viewing predicted reduced obesity prevalence (odds ratio, 0.85; 95% confidence interval, 0.75-0.97; P = .02). CONCLUSION: Planet Health decreased obesity among female students, indicating a promising school-based approach to reducing obesity among youth.     

Sex-specific differences in free, inorganic sulfate excretion in 24 hours urine of healthy children (author's transl)

Free, inorganic sulfate was determined quantitatively in the 24 h urine of 65 boys and 53 girls (age 6--14 years). The determination of sulfate was carried out by the aid of the spectrophotometric method with barium chloranilate. Results: The following values were obtained for the boys and girls: Boys (ages 6--10 years) 17,66 +/- 11,70 mmol/24 h, girls (6--10 years) 10,70 +/- 10,26 mmol/24 h, boys (10--14 years) 17,40 +/- 12,32 mmol/24 h, girls (10-14 years) 7,26 +/- 8,90 mmol/24 h. No statistical age-specific differences were observed, but the sex-specific investigation revealed that the younger and older boys had a statistical higher excretion of sulfate in 24 h urine as compared to the younger and older girls.     

Assessment of glycemic control by continuous glucose monitoring system in 50 children with type 1 diabetes starting on insulin pump therapy

OBJECTIVE: To report experience with a continuous glucose monitoring system (CGMS) and to identify factors influencing glycemic control in a large cohort of children and adolescents with type 1 diabetes and change to insulin pump therapy via continuous subcutaneous insulin infusion (CSII). RESEARCH DESIGN and METHODS: In 50 patients [21 boys, 29 girls; median age 12.6 yr (range: 1.3-16.4 yr); diabetes duration 5.0 yr (0.2-13.3)], hemoglobin A1c (HbA1c) and ambulatory CGMS were performed before and 6 wk after starting CSII. Average glucose concentration per 24 h, during day and night time as well as number of excursions, duration, and area under the curve (AUC) of glucose values above 180 mg/dL and below 60 mg/dL were calculated from CGMS data. Simultaneously, metabolic control was documented by standardized self-monitoring of blood glucose (SMBG). RESULTS: In the total cohort, HbA1c improved from 8.1 +/- 1.2% at baseline to 7.7 +/- 0.9% after 6 wk of CSII (p <0.001). This effect was more distinct in boys (8.0 +/- 1.4 vs. 7.5 +/- 1.1%, p=0.007) than in girls (8.1 +/- 1.1 vs. 7.8 +/- 0.7%, p=0.039) as well as in patients with poor glycemic control (HbA1c >8.0%) at baseline (8.9 +/- 0.6 vs. 8.1 +/- 0.8%, p <0.001) and in those older than 12 yr (8.2 +/- 1.2 vs. 7.7 +/- 1.0%, p <0.001). At 6 wk of CSII, the values of glucose average per 24 h, AUC and time above 180 mg/dL, particularly during the day, improved. HbA1c was correlated with AUC above 180 mg/dL (r=0.742, p <0.001) and CGMS average glucose per 24 h (r=0.628, p=0.002), but to a lesser extent with SMBG values (r=0.418, p=0.054). CONCLUSION: With the change to CSII, HbA1c improved significantly after 6 wk of therapy. CGMS usage provided additional information about glycemic control in these patients.     

Can neighborhoods explain racial/ethnic differences in adolescent inactivity?

OBJECTIVE: To determine if neighborhoods and their attributes contribute to racial/ethnic disparities in adolescent inactivity. METHODS: We undertook a cross-sectional analysis of the National Longitudinal Study of Adolescent Health (n = 17,007), a nationally representative school-based study in the United States. Stratifying by gender, we used multivariate linear regression and multi-level modeling to determine whether neighborhood of residence may partially explain racial/ethnic disparities in adolescent physical inactivity, defined as hours viewing television or videos/DVDs and/or playing computer/video games each week. RESULTS: Participants lived in largely segregated communities. Black and Hispanic adolescent girls reported higher levels of inactivity than White adolescent girls (21 vs. 15 vs. 13 hours/week, respectively, p <0.001). Similar patterns were seen in adolescent boys, with Black adolescent males reporting a mean of 26 hours/week; Hispanic boys a mean of 20 hours/week; and White boys a mean of 17 hours/week of inactivity (p <0.001). After accounting for between-neighborhood variation, there were no residual within-neighborhood differences in inactivity between Hispanic and White adolescent girls (gamma = -0.06, p =0.93); when living in the same neighborhood Hispanic and White girls had similar levels of inactivity. Black adolescent girls and boys were found to have higher levels of inactivity no matter where they lived (gamma =7.00, p <0.001 for girls; gamma = 6.96, p <0.001 for boys). Hispanic boys had similar patterns of inactivity to White boys (gamma =-1.57, p = 0.12). In both males and females, the reported rate of violent crime in the neighborhood was associated with inactivity, despite the individual's perception of his/her neighborhood as safe not being predictive. CONCLUSIONS: Although inactivity varies by race/ethnicity and gender, only in Hispanic adolescent girls does neighborhood fully explain the differential use. Our findings suggest that approaches other than changing neighborhood characteristics are needed to eliminate racial/ethnic disparities in adolescent inactivity.