Unhealthy snack intake modifies the association between screen-based sedentary time and metabolic syndrome in Brazilian adolescents

Camila Wohlgemuth Schaan,Deborah Salvo,Beatriz D Schaan,Harold W Kohl,Felipe Vogt Cureau

doi:10.1186/s12966-019-0880-8

Abstract

BackgroundExcessive screen time has been associated with metabolic syndrome (MetS) among adolescents; however, snack intake in front of screens may play a role in this association. Therefore, our objective was to investigate the association between screen-based sedentary time with MetS and whether this association is modified by unhealthy snack intake in front of screens.MethodsThis study was a nationwide, cross-sectional, school-based survey in Brazil including adolescents aged 12 to 17 years. The frequency of snack consumption in front of screen and screen-based sedentary time (TV view, computers and videogames use) were self-reported. Thereafter, screen time was categorized (≤2, 3–5 and ≥ 6 h/day); snack consumption in front of screens was dichotomized. Metabolic syndrome diagnosis was defined based on the International Diabetes Federation criteria. Associations between screen time and MetS were investigated using logistic regression in overall sample and after stratification by snack intake in front of screens.ResultsA total of 33,900 adolescents were included in the analysis. The final adjusted model, which included sociodemographic data, physical activity, and energy intake, showed that adolescents who spent ≥6 h/day in front of screens had an increased odds ratio for MetS (OR = 1.68, 95%CI: 1.03–2.74). However, after stratifying the sample according to reported snack intake, the association between higher screen-based sedentary time and MetS remained significant only for adolescents who reported consumption of snacks in front of screens.ConclusionLonger screen-based sedentary times were directly associated with MetS. However, this association seems to be modified by reported snack intake in front of screens.

Highlights

Despite its decline in the past few years, cardiovascular disease remains the main cause of mortality in Brazil, accounting for 31% of all deaths [1]
Our results suggest that screen time is associated with metabolic syndrome (MetS) in Brazilian adolescents, even after controlling for potential confounding factors, including total energy intake and physical activity
The association between screen time and MetS in this population appeared to be modified by the unhealthy snacking behavior in front of screens, remaining significantly associated only among those adolescents who have reported habitual unhealthy snacking in front of screens

Summary

Introduction

Despite its decline in the past few years, cardiovascular disease remains the main cause of mortality in Brazil, accounting for 31% of all deaths [1]. The co-occurrence of these typical cardiovascular risk factors, defined as the metabolic syndrome (MetS), Previous studies have shown that certain unhealthy behaviors are associated with a higher prevalence of MetS. These behaviors include short sleep duration [5], physical inactivity [6], and unhealthy diet [7]. Excessive screen time has been associated with metabolic syndrome (MetS) among adolescents; snack intake in front of screens may play a role in this association. Our objective was to investigate the association between screen-based sedentary time with MetS and whether this association is modified by unhealthy snack intake in front of screens

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Discussion

Conclusion