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Table 3 The characteristics of studies that evaluated the association between overweight and obesity risk by increased screen time among adolescents

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

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)

  1. 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