Abstract

ObjectivesWhile studies exist on the association between screen time and cardiometabolic risk among adolescents, research examining the effect of screen time on cardiometabolic risk in young children is lacking. The primary objective of this study was to examine the association between daily screen time and cardiometabolic risk (CMR) [sum of age- and sex-standardized z-scores of systolic blood pressure (SBP), glucose, log-triglycerides, waist circumference (WC), and negative high-density lipoprotein (HDL) cholesterol divided by the square root of five] in young children. Secondary objectives included examining individual CMR risk factors, including waist-to-height ratio and non high-density lipoprotein (non-HDL) cholesterol, as well as the individual cut-offs of these risk factors. Additional analyses include examining the association between screen time and CMR by handheld/non-handheld devices.MethodsA study was conducted among young children 3 to 6 years from the TARGet Kids! practice-based research network in Toronto and Montreal, Canada. Children with one or more measures of screen time and CMR were included in this study. Generalized estimating equation (GEE) multivariable linear regressions and multivariable logistic regressions, using published cut-offs, were conducted to evaluate these associations.ResultsData from 1317 children [mean age 52 months (SD = 13.36), 44.34% female] were included for analyses. There was no evidence of associations between screen time and total CMR score or individual risk factors (p > 0.05) after adjusting for confounders. A statistically significant, but small association between daily screen time and non-HDL cholesterol was found (B = 0.046; CI = [0.017 to 0.075]; p = 0.002.ConclusionsThough no relationship was reported between daily screen time and the majority of CMR factors in early childhood, there was an association between daily screen time and non-HDL cholesterol. As the relationship between daily screen time and CMR factors may not be apparent in early childhood, studies to evaluate longer-term cardiometabolic effects of screen time are needed. Although there is an evidence-based rationale to reduce screen time in early childhood, prevention of cardiometabolic risk may not be the primary driver.

Highlights

  • Young children, adolescents, and adults are spending a substantial amount of time in sedentary behavior, including screen time, which may increase the risk of cardiometabolic disease [1, 2]

  • There was no evidence of associations between screen time and total cardiometabolic risk (CMR) score or individual risk factors (p > 0.05) after adjusting for confounders

  • Though no relationship was reported between daily screen time and the majority of CMR factors in early childhood, there was an association between daily screen time and non-high-density lipoprotein (HDL) cholesterol

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Summary

Introduction

Adolescents, and adults are spending a substantial amount of time in sedentary behavior, including screen time, which may increase the risk of cardiometabolic disease [1, 2]. The World Health Organization (WHO) guidelines for screen time suggests that children under 1 year of age are not recommended to engage in any screen time, children 1 to 4 years are recommended to engage in no more than 1 h per day [5]. These align with guidelines from other countries, such as in Australia and New Zealand [6, 7].

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