Table 2. Summary of characteristics of included studies showing relation between screen time (ST) and Metabolic syndrome (MetS).
| Author; publication year | Country | Study design; Sample size (N) | Mean age at baseline (SD); gender | Screen type | Exposure ST measure |
Outcome measures (MetS) | Association with MetS OR (95%CI) |
Comments |
|---|---|---|---|---|---|---|---|---|
| Schaan et al. (2019) [36] | Brazil | 33,900; cross-sectional | 14.6 year (SD not reported); 59.4% Female | TV view, computers, videogames | Self-reported hours per day | IDF guidelines (WC, SBP, DBP, Fasting blood glucose, Triglycerides; HDL) | ST ≥6 h/day; 1.68 (1.03–2.74). | Prevalence of MetS 2.6% (95%CI: 2.3–3.0), ST remained significantly associated with MetS after adjusting of covariates; age, sex, socioeconomic, PA. Association remained significant MetS remained significant only for adolescents who reported consumption of snacks in front of screens. |
| Khan M et al. (2019) [32] | UAE | 474; cross-sectional | 14.9 ±1.9 years; 47% Female | Computer, television, and video game | Self-reported hours per day | IDF guidelines (WC, SBP, DBP, Fasting blood glucose, Triglycerides; HDL) | ST ≥2 h/day: 2.20 (1.04–4.67) Each hour of increased ST (1.21; 1.08–1.35) |
Prevalence of MetS 8.5% in <2hr/d, 13.4% ≥2 hr/d) Association was adjusted for age, sex, physical education classes, smoking, parental education, daily intake of carbonated drink, fruits, vegetables, milk, fast food |
| Mark E and Janssen (2008) [37] | US | 1803; cross- sectional | 15.9 ± 2.2 years; 50.3% Female | TV, video, computer game | Self-reported hours per day home interview/ mobile exam centre | NCEP ATP II: ≥3 of the following: high triglycerides, high fasting glucose, high WC, high BP, low HDL. | ST ≥5 h/day: 2.90 (1.39–6.02) | Prevalence of MetS 3.7% in≤1 hr/d, 8.4% in ≥5 hr/day. Association was adjusted for age, smoking and PA. |
| Kang HT et al. (2010) [38] | Korea | 845, cross-sectional | 13.4 ± 2.5 years; 46.9% Female | TV time, computer game, internet | Self-reported hours per week | NCEP ATP II: ≥3 of the following: high triglycerides, high fasting glucose, high WC, high BP, low HDL. | ST (≥35 h/week: 2.23 (1.02–4.86) | Prevalence of MetS 7.3%. Association was adjusted for age, sex, household income, residence area. |
| de Oliveira RG et al. (2014) [31] | Brazil | 1,035, cross-sectional | Mean not reported; 56.6% of (12-15y), 43.4% of (16-20y), 54.6% Female | TV, computer, video game, tablet, smartphone | Self-reported hours per day | IDF guidelines (WC, SBP, DBP, Fasting blood glucose, Triglycerides; HDL) | ST> 2 h/day: 1.32 (1.07–1.94) | Prevalence of MetS 4.5% (95% CI: 3.8–5.4). Association was adjusted for demographic, anthropometric nutritional indicators and, lifestyle determinants. |
| Siwarom S et al. (2021) [39] | Thailand | 1934, cross-sectional | 13.40 ± 1.94; 49.7% Female | television watching, computer, smart phone, tablet use | Self-reported hours per week/screen media exposure during the first 2 years of life | IDF, Cook’s, and de Ferranti’s. | MetS by 1 out of 3 definitions: Exposure to screen media during the first 2 years of life: 1.30 (1.01–1.68). No association between total ST & MetS: 1.00 (0.99–1.00) |
Prevalence of MetS 17%, Association of ST and MetS was adjusted for age, sex, foot intake, fruits and vegetables, PA. |
| Hardy L et al. (2010) [40] | Australia | 496, cross-sectional | 15.4 ± 0.4 year; 42% Female | watching television/DVDs/videos and using a computer for recreation | Self-reported hours per day. Adolescent Sedentary Activity Questionnaire |
Metabolic risk factors: Insulin level Glucose level HOMA-IR, HDL-C, LDL-C, Triglyceride, hs-CRP, ALT, GGT l, SBP, DBP |
ST ≥2 h/day Boys: HOMA-IR (adjusted OR, 2.42 (1.11–5.28), insulin levels (adjusted OR, 2.73 (1.43–5.23) Girls: no association |
Prevalence of abnormal biomarker e.g., Insulin in ≥2h/d is 22.7% boys vs, 22.9% girls; HOMA-IR 41.5% boys vs. 46.5% girls. Association was adjusted for BMI, SES (IRDS score), EDNP food score, Tanner score, and CRE (number of laps) |
| Fadzlina A et al. (2014) [41] | Malaysia | 1014, cross-sectional | 12.88 ± 0.33 years; 61.8% Female | Not reported | Self-reported hours per day | IDF guidelines (WC, SBP, DBP, Fasting blood glucose, Triglycerides; HDL) | No association between ST and MetS | Prevalence of MetS 2.6%in total, 10% among overweight. Obese No adjusted model was utilized |
| Grøntved A et al. (2020) [42] | EYHS, Danish cohort | 435, cohort | 15.6 ± 0.4 year; 54.5% Female | TV, computer use | Self-reported hours per day | MetS z-score based on AHA/NHLBI; WC, SBP, DBP, triglycerides, HDL (inverted), fasting glucose, fasting insulin | Total ST > 2 h/day a/w MetS z-score. 0.35 (0.08–0.62) Each 1-hour increment in TV viewing time; syndrome z-score 0.45 (0.14–0.76) |
MetS Z-score for ≤1h (−0.2 ± 2.6), 1-3h (−0.1 ± 2.5) >3 h were (1.2 ± 3.5) Adjusted for age, gender, cohort, parental education level, current smoking status, (MVPA), intake of soft drinks, fruit- and vegetable intake, and family history of cardiovascular disease. |
| de Castro Silveira et al. (2020) [43] | Brazil | 1200, cross-sectional | Up to 17 years, no mean age reported; 56% Female | Not reported | Self-reported hours per day | Continuous metabolic score (CMetS) > 1 as metabolic risk factor Z-score of WC, SBP, glucose, triglyceride, total cholesterol, LDL, HDL |
ST ≥2 h/day; Prevalence Ratio (PR) = 0.99 (0.95–1.03), insignificant association | Prevalence of metabolic risk 14.7%. ST was adjusted for cardiorespiratory fitness measured at time of recruitment yielded significant association. |
Abbreviations: IDF, International Diabetes Federation, NCEP ATP II, National Cholesterol Education Program Adult Treatment Panel; SD, Standard deviation; WC, Waist circumference; SBP, systolic blood pressure, DBP, diastolic blood pressure, PA, physical activity, BMI, Body mass index; SES, socioeconomic status; IRDS, Australian Bureau of Statistics Index of Relative; EDNP, energy-dense nutrient-poor; CRE, cardiorespiratory endurance. EYHS, European Youth Heart Study; AHA, American Heart Association (AHA); NHLBI, and the National Heart, Lung, and Blood Institute. HDL-C, high density lipoprotein cholesterol, LDL-C, low density lipoprotein cholesterol; HOMA-IR, Homeostatic Model Assessment for Insulin Resistance; h-s CRP, high sensitivity C-reactive protein; ALT, Alanine Aminotransferase; GGT, Gamma-Glutamyl Transferase.