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      Screen time increases overweight and obesity risk among adolescents: a systematic review and dose-response meta-analysis

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          Abstract

          Background

          Adolescence is a critical period in human life, associated with reduced physical activity and increased sedentary behaviors. In this systematic review and dose-response meta-analysis, we evaluated the association between screen time and risk of overweight/obesity among adolescents.

          Methods

          A systematic search in electronic databases, including PubMed, Embase, and Scopus was performed up to September 2021. All published studies evaluating the association between screen time and risk of overweight/obesity among adolescents were retrieved. Finally, a total of 44 eligible studies were included in the meta-analysis.

          Results

          The results of the two-class meta-analysis showed that adolescents at the highest category of screen time were 1.27 times more likely to develop overweight/obesity (OR = 1.273; 95% CI = 1.166–1.390; P < 0.001; I-squared (variation in ES attributable to heterogeneity) = 82.1%). The results of subgrouping showed that continent and setting were the possible sources of heterogeneity. Moreover, no evidence of non-linear association between increased screen time and risk of overweight/obesity among adolescents was observed (P-nonlinearity = 0.311).

          Conclusion

          For the first time, the current systematic review and meta-analysis revealed a positive association between screen time and overweight/obesity among adolescents without any dose-response evidence.

          Trial registration

          The protocol of the current work has been registered in the PROSPERO system (Registration number: CRD42021233899).

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12875-022-01761-4.

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          Most cited references84

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

          David Moher, Alessandro Liberati, Jennifer Tetzlaff … (2009)
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            Establishing a standard definition for child overweight and obesity worldwide: international survey.

            T. J. Cole, M Bellizzi, K Flegal … (2000)
            To develop an internationally acceptable definition of child overweight and obesity, specifying the measurement, the reference population, and the age and sex specific cut off points. International survey of six large nationally representative cross sectional growth studies. Brazil, Great Britain, Hong Kong, the Netherlands, Singapore, and the United States. 97 876 males and 94 851 females from birth to 25 years of age. Body mass index (weight/height(2)). For each of the surveys, centile curves were drawn that at age 18 years passed through the widely used cut off points of 25 and 30 kg/m(2) for adult overweight and obesity. The resulting curves were averaged to provide age and sex specific cut off points from 2-18 years. The proposed cut off points, which are less arbitrary and more internationally based than current alternatives, should help to provide internationally comparable prevalence rates of overweight and obesity in children.
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              Canadian sedentary behaviour guidelines for children and youth.

              Mark S. Tremblay, Allana G. LeBlanc, Ian Janssen … (2011)
              The Canadian Society for Exercise Physiology (CSEP), in partnership with the Healthy Active Living and Obesity Research Group (HALO) at the Children's Hospital of Eastern Ontario Research Institute, and in collaboration with ParticipACTION, and others, has developed the Canadian Sedentary Behaviour Guidelines for Children (aged 5-11 years) and Youth (aged 12-17 years). The guidelines include a preamble to provide context, followed by the specific recommendations for sedentary behaviour. The entire development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which is the international standard for clinical practice guideline development. Thus, the guidelines have gone through a rigorous and transparent developmental process and the recommendations are based on evidence from a systematic review and interpretation of the research evidence. The final guidelines benefitted from an extensive online consultation process with 230 domestic and international stakeholders and key informants. The final guideline recommendations state that for health benefits, children (aged 5-11 years) and youth (aged 12-17 years) should minimize the time that they spend being sedentary each day. This may be achieved by (i) limiting recreational screen time to no more than 2 h per day - lower levels are associated with additional health benefits; and (ii) limiting sedentary (motorized) transport, extended sitting time, and time spent indoors throughout the day. These are the first evidence-based Canadian Sedentary Behaviour Guidelines for Children and Youth and provide important and timely recommendations for the advancement of public health based on a systematic synthesis, interpretation, and application of the current scientific evidence.
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                Author and article information

                Contributors
                Mahdieh Abbasalizad Farhangi: abbasalizadm@tbzmed.ac.ir , abbasalizad_m@yahoo.com
                Journal
                Journal ID (nlm-ta): BMC Prim Care
                Journal ID (iso-abbrev): BMC Prim Care
                Title: BMC Primary Care
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2731-4553
                Publication date (Electronic): 28 June 2022
                Publication date PMC-release: 28 June 2022
                Publication date Collection: 2022
                Volume: 23
                Electronic Location Identifier: 161
                Affiliations
                [1 ]GRID grid.411874.f, ISNI 0000 0004 0571 1549, Urology Research Center, Razi Hospital, School of Medicine, , Guilan University of Medical Sciences, ; Rasht, Iran
                [2 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Department of Internal Medicine, Amir Alam Hospital, , Tehran University of Medical Sciences, ; Tehran, Iran
                [3 ]GRID grid.412888.f, ISNI 0000 0001 2174 8913, Student Research Committee, , Tabriz University of Medical Sciences, ; Tabriz, Iran
                [4 ]GRID grid.412888.f, ISNI 0000 0001 2174 8913, Department of Community Nutrition, Faculty of Nutrition, , Tabriz University of Medical Sciences, ; Tabriz, Iran
                [5 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Rheumatology Research Center, , Tehran University of Medical Sciences, ; Tehran, Iran
                Article
                Publisher ID: 1761
                DOI: 10.1186/s12875-022-01761-4
                PMC ID: 9238177
                PubMed ID: 35761176
                SO-VID: 07068bb1-c37e-48e2-ac21-378dce09f5ea
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 13 January 2022
                Date accepted : 3 June 2022
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2022

                Keywords: screen time,overweight,obesity,dose-response,adiposity,meta-analysis
                Data availability:
                Keywords: screen time, overweight, obesity, dose-response, adiposity, meta-analysis

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