Table 3.
The characteristics of studies that evaluated the association between overweight and obesity risk by increased screen time among adolescents
| Journal/ Year/ First author | Country | Setting/ num | Design | Age (y)/ gender | Overweight/ obesity status and definition | ST definition | Adjusted variables | Main findings |
|---|---|---|---|---|---|---|---|---|
| Revista Paulista de Pediatria/ 2021/ Dalamaria T [27] | Brazil | School/ 1387 | Cross-sectional | 14–18/ both | Obesity/ ≥85th percentile of age | Internet addiction | None | Increased odds of obesity in internet addicted adolescents [OR = 1.1; CI = 0.9–3.18]. Not adjusted |
| BMC Public Health/ 2020/ Zhang Y [39] | China | School/ 2264 | Cross-sectional | 12–15/ both | Obesity/ ≥85th percentile of age | TV, VG, PC | Age, sex, being the single child, ethnic minority, fruit and vegetable intake, sleep time, parents’ Education, fathers’ occupation. | Non-significant association between screen time and odds of obesity. |
| Nutrients/ 2020/ Lopez-Gonzalez D [28] | Mexico | School/309 girl; 340 boys | Cross-sectional | 12–17/ both | Overweight/ obesity defined as ≤95th and ≥ 85th and ≥ 95th percentile of age respectively | TV, electronic games | Stratified by age and sex | Non-significant association between obesity and screen time. |
| Rev Bras Cineantropometri Desempenho Hum/ 2020/ Franceschin MJ [22] | Brazil | School/ 1015 | Cross-sectional | 15.3/ both | Overweight/ obesity defined as 1 ≤ BMI Z-score < 2 | TV, Video game or PC | Sex, age, type of school attended and dietary energy intake | A significant increased odds of overweight/ obesity in those with more than 2 hours per day TV watching (1.73 (1.24–2.42). The OR for PC and video games was 1.01 (0.71–1.45). |
| Revista Paulista de Pediatria/ 2020/ De Lima TR [35] | Brazil | School/ 583 | Cross-sectional | 11–17/ both | Overweight defined as BMI Z-score ≥ 1 | TV, Video game or PC | Gender, maternal schooling, alcohol consumption, smoking, screen time-sedentary behavior | Non-significant reduced risk of excess weight by increased screen time of more than 4 hours/day (0.87 CI = 0.59–1.30) |
| Public Health Nutrition/ 2020/ Cheng L [26] | China | School/ 2201 | Cross-sectional | 10/ both | Obesity/ ≥95th percentile of age | TV/video games/ PC/iPad/ phone | Sex, age and school location (rural or urban) with school as a random effect | Increased odds of obesity for those with more than 2 hours/ d screen time (1.53; CI = 0.95–2.09) |
| J Immigrant Minor health/ 2019/ Zulfiqar T [33] | Australia | Community/ 2115 girls and 2000 boys | Cross-sectional | 10–11/ both | Overweight/ obesity +BMI ≥ 25 kg/m2 | TV, electronic games | Sleep issues, breastfeeding, birth weight, siblings, foreign language spoken at home, maternal work status, family SEP, maternal partnership status | TV watching of more than 3 hours/ day in weekends was associated with odds of obesity in boys (1.4 (1.0,1.9) and girls (1.5 (1.1,1.9) P < 0.05 |
| In J Environ Res Pub Health/ 2019/ Kerkadi A [30] | Qatar | Community/ 1161 | Cross-sectional | 14–18/ both | Overweight 25 ≤ BMI ≤ 30 kg/m2 and obesity BMI ≥ 30 kg/m2 | TV, Video game or PC | Age, nationality | No significant association between screen time of more than 2 hours/ day and risk of overweight/ obesity (OR = 1; CI = 0.7–1.4) |
| Plos One/ 2019/ Pabon et al. [41] | USA | Community/ 2358 + 546 | Cross-sectional | 13–17/ both | Overweight/ obesity defined as 1 ≤ BMI Z-score < 2 | TV, Video game | Age, sex, socioeconomic level, geographic area, ethnic group and exposure to television and / or video games. | No significant association between increased screen time and risk of overweight or obesity. |
| BMC Public Health/ 2019/ Haidar A [29] | USA | School/ 6716 | Cross-sectional | 14.88/ both | Overweight/ obesity defined as ≤95th and ≥ 85th and ≥ 95th percentile of age respectively | TV, DVD, movies | Grade, gender, ethnicity, weight, SES, parents’ education level | No significant association between increased screen time and risk of overweight or obesity. |
| J Nepal Health Res Counc/ 2018/ Saha M [31] | Bangladesh | School/ 288 | Cross-sectional | 10–14/ both | Obesity defined as ≥95th percentile of age | TV, Video game, PC | None | No significant association between increased screen time and risk of overweight or obesity. |
| Tropical Doctor/ 2018/ Mansouri N [42] | Pakistan | School/ 887 | Cross-sectional | 11–15/ both | Overweight defined as ≤95th and ≥ 85th percentile of age | TV | Age, sex, type of school, sleeping soft drink consumption | Watching TV more than 2 hours/ day was associated with increased risk of overweight (6.42 (4.32–9.54) P < 0.0001) |
| Prev Chronic Dis/ 2018/ Hu EY [74] | USA | School/ 15,624 | Cross-sectional | 14–18/ both | Obesity defined as ≥95th percentile of age | TV, Video or computer game, PC use | Age, sex, and race/ethnicity | Increased risk of obesity for those with more than 3 hours/ day TV watching (1.38 (1.09–1.76) and more than 3 hours video game or PC use (1.19 (0.98–1.43) |
| BMC Res Notes/ 2018/ Godakanda I [43] | USA | School/ 880 | Cross-sectional | 14–15/ both | Overweight defined as BMI Z-score ≥ 1 | TV, Video/ DVD | Age, sex, ethnicity, schooling years | Television watching time ≥ 2 h/day (2.6 (1.7–3.8) and Video/DVD watching ≥2 h/day (3.1 (1.8–5.3) were associated with increased risk of overweight. |
| Egypt Ped Assoc Gazette/ 2016/ Talat MA [44] | Egypt | School/ 900 | Cross-sectional | 12–15/both | Overweight/ obesity defined as ≤95th and ≥ 85th and ≥ 95th percentile of age respectively | TV | Age, gender, SES | More than 2 hours TV watching was associated with increased risk of obesity (1.36 CI = 0.45–6.8; P = 0.048) |
| BMJ Open/ 2016/ Piryani S [75] | Nepal | School/ 360 | Cross-sectional | 16–19/ both | Overweight defined as BMI Z-score ≥ 1 | TV | Age, sex, ethnicity, type of school, mother’s educational and occupation, family type, number of siblings, SES, watching TV and fruit consumption | Watching TV more than 2 hours/ day was associated with increased risk of obesity (OR = 8.86 (3.90 to 20.11) < 0.001 |
| Med J Islamic Rep Iran/ 2016/ Moradi G [45] | Iran | School/ 2506 | Cross-sectional | 10–12/ both | Overweight/ obesity defined as ≤95th and ≥ 85th and ≥ 95th percentile of age respectively | TV, VG | Age, sex, SES | Screen time was associated with increased risk of overweight and obesity (1.41 (1.17–1.69) |
| Indian J Comm Health/ 2015/ Watharkar A [46] | India | School/ 806 | Cross-sectional | 12–15/ both | Overweight/ obesity defined as ≤95th and ≥ 85th and ≥ 95th percentile of age respectively | TV, PC, cell phone | None | Increased risk of overweight obesity for those with more than 2 hours TV watching (OR = 3.72; CI = 2.38–5.83) or more than 2 hours computer or mobile phone use (OR = 1.68; CI = 1.09–2.57) |
| Revista Paulista de Pediatria/ 2015/ De Lucena JMS [47] | Brazil | School/ 2874 | Cross-sectional | 14–19/ both | Overweight 25 ≤ BMI ≤ 30 kg/m2 and obesity BMI ≥ 30 kg/m2 | TV, PC, VG | None | Excessive screen time was associated with increased risk of overweight/ obesity (1.25 (0.93–1.67) |
| BMC Pediatr/ 2014/ Velásquez-Rodríguez CM [48] | Finland | Community/ 120 | Cross-sectional | 10–18/ both | Overweight defined as ≤95th and ≥ 85th percentile of age | TV | None | Increased risk of overweight in excessive TV watchers among adolescents with insulin resistance (OR = 2.39; CI = 0.94–6.05) but not among healthy adolescents. |
| Int J Obes/ 2013/ De Jong E [40] | Netherland | School/ 2004 + 2068 | Cross-sectional | 10–13/ both | Overweight 25 ≤ BMI ≤ 30 kg/m2 and obesity BMI ≥ 30 kg/m2 | TV, PC | Family characteristics and lifestyle nutrition behaviours | No significant association between TV watching more than 1.5 hours or PC use of more than 30 minutes and overweight/ obesity. |
| JCRPE/ 2012/ Ercan S [49] | Turkey | School/ 8848 | Cross- sectional | 11–18/ both | Overweight 25 ≤ BMI ≤ 30 kg/m2 and obesity BMI ≥ 30 kg/m2 | TV, PC | None | Increased risk of overweight and obesity for those with more than 2 hours TV watching or PC use. |
| Pediatrics/ 2012/ Drake KM [50] | England | School/ 1718 | Cross-sectional | 12–18/ both | Overweight/ obesity defined as ≤95th and ≥ 85th and ≥ 95th percentile of age respectively | TV, DVD, video game | Adolescent demographics (gender, grade in school, race [white/nonwhite]);screen time; academic performance; employment status; diet quality (fast food, fruit and vegetable consumption over the past week) | Screen time of 7.1–14 and > 14 hours/week was associated with increased obesity risk of OR = 1.28 CI = 1.06, 1.55; P < 0.05 and OR = 1.37 CI = 1.09, 1.71; P < 0.01 respectively. |
| J Korean Med Sci/ 2012/ Byun W [53] | Korea | Community/ 1033 | Cross-sectional | 12–18/ both | Overweight/ obesity defined as ≥95th percentile of age | TV, PC, video game | Age, sex, annual household income, and moderate-to-vigorous physical activity | Increased risk of overweight and obesity was observed by increased screen time |
| Ital J Pediatr / 2012/ Adesina AF [51] | Nigeria | School/ 690 | Cross-sectional | 10–19/ both | Overweight/ obesity defined as ≤95th and ≥ 85th and ≥ 95th percentile of age respectively | TV | None | Increased risk of overweight and obesity was observed by increased screen time |
| Childhood Obesity/ 2011/ El-Gilany AH [52] | Egypt | School/ 953 | Cross-sectional | 14–19/ both | Overweight defined as ≤95th and ≥ 85th percentile of age | TV, PC | Age, sex, socioeconomic level, geographic area, ethnicity | Increased risk of overweight/ obesity for those with more than 2 hours TV watching (2.6 (1.7–3.9) or more than 2 hours computer use (1.8 (1.3–2.5) |
| J Epidemiol/ 2009/ Sun Y [32] | Japan | School/ 2842 | Cross-sectional data of an original cohort | 12–13/ both | Overweight 25 ≤ BMI ≤ 30 kg/m2 | TV, VG | Age, parental overweight, and other lifestyle variables | Watching TV more than 3 hours/ d was associated with increased risk of overweight in boys (OR = 1.79; CI = 1.21–2.67 and girls OR = 2.37; CI = 1.55–3.62; P < 0.001 |
| Int J Pediatr Obes/ 2008/ Collins AE [34] | Indonesia | School/ 1758 | Cross-sectional | 12–15/ both | Obesity defined as BMI ≥ 25 kg/m2 | PC, PS | None | Increased risk of obesity in those with more than 3 hours/ d PC use (OR = 1.85; CI = 1.04–3.29) or play station use (OR = 1.94; CI = 1.23–3.05) |
Abbreviations: BMI Body mass index, TV Television, ST Screen time, SBP Systolic blood pressure, DBP Diastolic blood pressure, PC Personal computer, DVD Digital video discs, VCDs Video compact disc digital, SEP Socioeconomic position, SES Socioeconomic status, ST Measurement in all of the studies was performed by questionnaire. All of the included participants were apparently healthy