Heavy screen users are the heaviest among 10,000 children.

This cross-sectional study examined the associations of recreational screen time (viewing TV programs on any screen-based device and computer use, performed while sitting) with body mass index (BMI) categories and waist-to-height ratio (WHtR) tertiles in 10,228 children (mean age 11.1 years, SD 0.8). We categorized the children into Light, Medium and Heavy TV viewers and computer users, and into Low, Medium and High exercise groups. Compared with Light TV viewers, Medium (OR: 1.30, 95% CI: 1.11-1.52, when adjusted for age, sex, language, sleep duration and exercise) and Heavy (OR: 1.57, 95% CI: 1.34-1.83) TV viewers had a higher risk of being overweight. Similarly, Heavy computer users had a higher risk of being overweight (OR: 1.42, 95% CI: 1.21-1.67). We observed interactions between exercise and TV viewing (p = 0.012) or computer use (p = 0.010). However, Heavy TV viewers had a higher risk of being overweight in all exercise groups. The associations of TV viewing and computer use were similar with BMI and WHtR. To conclude, heavy sedentary screen time is associated with overweight and central adiposity in children. Moreover, heavy TV viewers have a higher risk for overweight and central adiposity, regardless of weekly exercise duration.