Screen time is associated with depressive symptomatology among obese adolescents: a HEARTY study.

UNLABELLED: Obese adolescents spend a disproportionate time in screen-based activities and are at higher risk for clinical depression compared to their normal-weight peers. While screen time is associated with obesity and cardiometabolic risk factors, little is known about the relationship between screen time and mental health. This cross-sectional study examines the association between duration and types of screen time and depressive symptomatology (subclinical symptoms) in a sample of 358 (261 female; 97 male) overweight and obese adolescents aged 14-18 years. Self-report measures assessed depressive symptoms and time spent in different types of screen behavior (TV, recreational computer use, and video games). After controlling for age, ethnicity, sex, parental education, body mass index (BMI), physical activity, caloric intake, carbohydrate intake, and intake of sugar-sweetened beverages, total screen time was significantly associated with more severe depressive symptomatology (ß = 0.21, p = 0.001). After adjustment, time spent playing video games (ß = 0.13, p = 0.05) and recreational computer time (ß = 0.18, p = 0.006) was associated with depressive symptoms, but TV viewing was not. CONCLUSIONS: Screen time may represent a risk factor or marker of depressive symptomatology in obese adolescents. Future intervention research should evaluate whether reducing screen exposure reduces depressive symptoms in obese youth, a population at increased risk for psychological disorders. WHAT IS KNOWN: • Screen time is associated with an increased risk of obesity in youth. • Screen time is associated with an adverse cardio-metabolic profile in youth. What is New: • Screen time is associated with more severe depressive symptoms in overweight and obese adolescents. • Time spent in recreational computer use and playing video games, but not TV viewing, was associated with more severe depressive symptoms in overweight and obese adolescents.

Screen time is independently associated with health-related quality of life in overweight and obese adolescents.

AIM: Excessive screen time and diminished health-related quality of life (HRQoL) are greater problems for obese than nonobese adolescents, but no research has examined the relationship between these two variables. This study examined the association between screen time and HRQoL in overweight and obese adolescents. METHODS: A sample of 358 overweight and obese adolescents aged 14-18 years were assessed at baseline between 2005 and 2010 as part of the Canadian Healthy Eating, Aerobic and Resistance Training in Youth (HEARTY) trial. We used the Pediatric Quality of Life (PEDS-QL) and other self-report measures to assess HRQoL and screen time, defined as how long the 261 females and 97 males spent viewing TV, using the computer and playing video games. RESULTS: After adjusting for socio-demographic variables, adiposity, physical activity and diet, screen time duration was associated with reduced overall HRQoL (adjusted r = -0.16, ß = -0.16, p = 0.009) and psychosocial HRQoL (adjusted r = -0.16, ß = -0.18, p = 0.004), but not physical HRQoL. No differences were found between males and females. CONCLUSION: Screen time was associated with reduced overall and psychosocial HRQoL in overweight and obese adolescents. Future research should determine whether reducing screen time improves overall and psychosocial HRQoL in obese adolescents.

Can nurses rise to the public health challenge? How a novel solution in nurse education can address this contemporary question.

This paper raises the problem of how improvements in health outcomes, a key component in many governments' strategies, can be achieved. The work highlights a novel undergraduate educational approach which offers solutions to public health challenges within nursing. Against the backdrop of one UK university institution it discusses approaches that can guide nursing students towards a deeper understanding and engagement within the principles of public health. It then proposes how nurses can use their learning to become leaders of health improvement.

Sex steroid hormone pathway genes and health-related measures in women of 4 races/ethnicities: the Study of Women's Health Across the Nation (SWAN).

We synthesized findings relating health outcomes and genetic variants of the sex steroid hormone pathway in women from the Study of Women's Health Across the Nation (SWAN) Genetics Study. The SWAN Genetics Study, a component of the longitudinal SWAN study, describes selected genetics characteristics of health-related attributes during the menopausal transition in African American, Caucasian, Chinese, and Japanese women. At baseline, SWAN recruited menstruating women aged 42 to 52 years, who were not using exogenous hormones. Immortalized cell lines were developed and genotyped in 1,538 specimens from 1,757 participants in the genetics study. Genotypes and haplotypes from 6 genes (27 single nucleotide polymorphisms [SNPs]) in the sex steroid hormone pathway were related to circulating hormone concentrations, menstrual cycle profiles, and health-related outcomes, including lipids, diabetes mellitus, depressive symptoms, measures of cognition, bone mineral density (BMD), and vasomotor symptoms. Allele frequencies and distances differed substantially in the 4 race/ethnicity-specific groups evaluated, leading to variable patterns of association with health-related measures. For example, 17HSD genotypes were highly associated with diabetes risk in Caucasian women, whereas its haplotypes were associated with diabetes risk in both African American and Caucasian women. Several SNPs were associated with multiple outcomes. ESR1 rs3798577 was significantly associated with circulating estradiol concentrations, indicators of ovarian aging, high-density lipoprotein (HDL) cholesterol, apolipoprotein A-1, insulin sensitivity, and lumbar spine BMD. CYP1A1 rs2606345 was related to estrogen metabolite concentrations, vasomotor symptoms, and depressive symptoms. Some associations were much more prominent in specific races/ethnicities; Chinese women had statistically significant relations between ESR2 rs1256030 and HDL cholesterol, lumbar spine BMD, hip BMD, and metabolic syndrome. Importantly, women in the SWAN Genetics Study were typical of women in the community-based SWAN sample. This community-based sample of women from the SWAN Genetics Study identified important genetic sex steroid hormone pathway variants in relation to measures of health status. The magnitude and breadth of these relationships should motivate further research to verify and extend the findings.

Aromatase gene (CYP 19) polymorphisms and endogenous androgen concentrations in a multiracial/multiethnic, multisite study of women at midlife.

A limited number of studies have focused on androgens in women's health, particularly at the genetic level. We evaluated testosterone and estradiol (E2) levels among women in relation to 5 single nucleotide polymorphisms (SNPs) of the aromatase (CYP 19) gene, the cytochrome P450 enzyme that converts androgens to estrogens. We related 5 aromatase SNPs (CYP 19 rs2414096, CYP 19 rs936306, CYP 19 rs2446405, CYP 19 rs1008805, and CYP 19 rs749292) to serum androgen and E2 markers in 1,538 participants of the Study of Women's Health Across the Nation (SWAN), including 412 African American, 807 Caucasian, 151 Chinese, and 168 Japanese women. Aromatase allele and genotype frequencies differed significantly among racial/ethnic groups. Compared with other genotypes of the CYP 19 rs936306 polymorphism, the TT genotype was associated with a significant difference in the testosterone to E2 (T:E2) ratio--lower testosterone and higher E2 levels--especially in African American women. Japanese women with the AA genotype of the CYP 19 rs749292 polymorphism had lower testosterone and E2 levels but higher levels of sex hormone-binding globulin (SHBG) compared with Japanese women with the AG and GG genotypes. Among Caucasian women, there was markedly lower SHBG levels among those with the AA genotype of the CYP 19 rs2414096 polymorphism compared with other genotypes, after adjusting for age and body mass index. Three of 5 aromatase gene SNPs were associated with variation in serum androgen concentrations among women, both within and between racial/ethnic groups. Aromatase genetic markers may be important in understanding the emerging associations reported between endogenous androgens and women's health status.

CYP1A1 and CYP1B1 polymorphisms and their association with estradiol and estrogen metabolites in women who are premenopausal and perimenopausal.

The purpose of this study was to relate measured concentrations of estradiol (E2) and the urinary estrogen metabolites 2-hydroxyestrone (2-OHE1) and 16alpha-hydroxyestrone (16alpha-OHE1) to single nucleotide polymorphisms (SNPs) from CYP1A1 and CYP1B1, the primary genes involved in estrogen catabolism. We investigated the association of 4 CYP1A1 SNPs (CYP1A1 rs4646903, CYP1A1 rs1531163, CYP1A1 rs2606345, and CYP1A1 rs1048943) and 2 CYP1B1 SNPs (CYP1B1 rs162555 and CYP1B1 rs1056836) to circulating serum E2 concentrations and the urinary estrogen metabolites 2-OHE1 and 16alpha-OHE1. The associations were evaluated in 1,340 participants of 4 racial/ethnic groups from the Study of Women's Health Across the Nation (SWAN) who were premenopausal and perimenopausal. There was substantial variation in the allele frequencies of the SNPs for African American and Caucasian women. There was, however, remarkable comparability between Chinese and Japanese women; their CYP1A1 and CYP1B1 allele frequencies differed by only < or =11%. There was significant variation in E2 concentrations by genotype within racial/ethnic group for CYP1A1 rs2606345. In particular, Japanese women with the CC genotype had lower E2 concentrations than did Japanese women with the AC genotype. Chinese women with the CC genotype had higher 2-OHE1 concentrations than did Chinese women with the AC genotype. Further, African American women with the CC genotype had higher 16alpha-OHE1 concentrations than did those with other genotypes. CYP1A1 rs2606345 may play an important role in estrogen metabolism in women who are premenopausal and perimenopausal.