Impacts of Dietary Patterns and Screen Time on the Risk of Developing Type 2 Diabetes Mellitus Among Children in Saudi Arabia: A Cross-Sectional Study

Background Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by the progressive loss of adequate beta-cell insulin secretion, often occurring in the context of insulin resistance. It is increasingly recognized among children due to changes in lifestyle behaviors. Children’s dietary patterns and prolonged screen time are key modifiable risk factors that may contribute to early metabolic disturbances. In Saudi Arabia, rapid urbanization has led to shifts in eating habits and increased sedentary behaviors among children, warranting further investigation to better understand these risk factors. This study aims to examine the association between dietary patterns, screen time, and early markers of T2DM among children in Saudi Arabia. Methods A cross-sectional study was conducted among children using a structured, guardian-reported questionnaire administered electronically in Arabic and English. The questionnaire assessed dietary behaviors, screen time, and early markers of T2DM. Dietary intake was evaluated using a five-point frequency scale (never = 0, always = 5), covering eight food groups. Early markers of T2DM were assessed using a composite score based on five guardian-reported binary items: overweight/obesity diagnosis, rapid weight gain, elevated glucose/insulin levels, diabetes-related symptoms, and family history of T2DM. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, NY, USA), after data cleaning in Microsoft Excel (Microsoft Corp., Redmond, WA, USA). Results A total of 292 participants were included in the study. Frequent consumption of unhealthy foods was reported, with 40.8% consuming fast food sometimes and 33.6% often consuming sugar-sweetened beverages. Screen exposure of 30 minutes to 2 hours per day was reported by 29.8% of participants, while 23.6% reported 2-4 hours daily. Overweight or obesity was present in 13.4% of participants, and 15.4% reported recent weight gain. A significant negative correlation was found between dietary behavior scores and T2DM markers (r = -0.257, p < 0.001). Higher screen time was significantly associated with increased T2DM markers (p = 0.001), with the highest scores observed in children who exceeded six hours of screen time daily (1.42 ± 1.06). The combined effect of high screen time and sugary intake was also associated with a higher risk (1.24 ± 1.23 vs. 0.57 ± 0.75, p < 0.001). Conclusion This study shows that unhealthy dietary habits and prolonged screen time are significantly associated with early markers of T2DM among children. The combined effect of these behaviors further increases the risk of metabolic syndrome. Promoting healthier eating habits and reducing screen exposure are essential strategies to prevent the early onset of diabetes and improve long-term health outcomes in children.