Association between Types of Screen Time and Weight Status during the COVID-19 Pandemic: A Longitudinal Study in Children and Adolescents

Background: This study aimed to investigate the changes in distinct types of screen time and explore their longitudinal association with children and adolescents’ weight status. Methods: A two-wave longitudinal study was conducted among 2228 children and adolescents (6–19 years) in Shanghai, China, before and during the pandemic. Recreational screen time (watching TV/videos, online gaming, using social media, and browsing webpages), educational screen time (online homework and online class), and BMI were measured using a self-reported questionnaire. Mixed-effects models were constructed to assess the associations between screen time and weight status. Results: The prevalence of overweight and obesity was 20.5% and 10.2% at baseline, respectively. Both recreational and educational screen time increased significantly over two months. While recreational screen time was found to be a risk factor for obesity, it was not the case for educational screen use. Specifically, adolescents who spent more time watching TV/videos had a higher obesity risk (OR = 1.576). No significant associations were found in children. Conclusions: Overweight and obesity were prevalent among children and adolescents in China. Reducing screen-based activities is a promising strategy to prevent unhealthy weight gain in Chinese children and adolescents, while it is necessary to consider the content and distinguish between educational and recreational screen use.

[1]  Kuai Yu,et al.  Reliability and Validity of Common Subjective Instruments in Assessing Physical Activity and Sedentary Behaviour in Chinese College Students , 2022, International journal of environmental research and public health.

[2]  P. A. van den Brandt,et al.  Prevalence and Correlates of Overweight, Obesity and Physical Activity in Italian Children and Adolescents from Lombardy, Italy , 2022, Nutrients.

[3]  L. Jahangiry,et al.  Screen Time and Body Mass Index Among Children and Adolescents: A Systematic Review and Meta-Analysis , 2022, Frontiers in Pediatrics.

[4]  M. Tremblay,et al.  School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review , 2022, International Journal of Behavioral Nutrition and Physical Activity.

[5]  M. Tremblay,et al.  International school-related sedentary behaviour recommendations for children and youth , 2022, International Journal of Behavioral Nutrition and Physical Activity.

[6]  L. Baur,et al.  Obesity in children and adolescents: epidemiology, causes, assessment, and management , 2022, The lancet. Diabetes & endocrinology.

[7]  Ailing Liu,et al.  Association between Physical Activity, Sedentary Behaviors, Sleep, Diet, and Adiposity among Children and Adolescents in China , 2021, Obesity Facts.

[8]  T. Hesketh,et al.  Educational Aspirations and Expectations of Adolescents in Rural China: Determinants, Mental Health, and Academic Outcomes , 2021, International journal of environmental research and public health.

[9]  S. Pavičić Žeželj,et al.  The Outcome of COVID-19 Lockdown on Changes in Body Mass Index and Lifestyle among Croatian Schoolchildren: A Cross-Sectional Study , 2021, Nutrients.

[10]  A. Pakpour,et al.  Internet addiction and psychological distress among Chinese schoolchildren before and during the COVID-19 outbreak: A latent class analysis , 2021, Journal of behavioral addictions.

[11]  A. Pan,et al.  Epidemiology and determinants of obesity in China. , 2021, The lancet. Diabetes & endocrinology.

[12]  S. Walitza,et al.  Stress and Mental Health among Children/Adolescents, Their Parents, and Young Adults during the First COVID-19 Lockdown in Switzerland , 2021, International journal of environmental research and public health.

[13]  P. Jia,et al.  Impact of COVID-19 lockdown on activity patterns and weight status among youths in China: the COVID-19 Impact on Lifestyle Change Survey (COINLICS) , 2020, International Journal of Obesity.

[14]  C. Pan,et al.  Associations of outdoor activity and screen time with adiposity: findings from rural Chinese adolescents with relatively low adiposity risks , 2020, BMC Public Health.

[15]  Youfa Wang,et al.  A 3‐year longitudinal study of the association of physical activity and sedentary behaviours with childhood obesity in China: The childhood obesity study in China mega‐cities , 2020, Pediatric obesity.

[16]  Lukáš Jakubec,et al.  Is adherence to the 24-hour movement guidelines associated with a reduced risk of adiposity among children and adolescents? , 2020, BMC Public Health.

[17]  Tara-Leigh F. McHugh,et al.  Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth , 2020, International Journal of Behavioral Nutrition and Physical Activity.

[18]  T. Saunders,et al.  Combinations of physical activity and screen time recommendations and their association with overweight/obesity in adolescents , 2020, Canadian Journal of Public Health.

[19]  Ross Arena,et al.  A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another? , 2020, Progress in Cardiovascular Diseases.

[20]  A. Rundle,et al.  COVID‐19–Related School Closings and Risk of Weight Gain Among Children , 2020, Obesity.

[21]  H. Naito,et al.  The associations between meeting 24‐hour movement guidelines and adiposity in Asian Adolescents: The Asia‐Fit Study , 2020, Scandinavian journal of medicine & science in sports.

[22]  P. Parker,et al.  Type of screen time moderates effects on outcomes in 4013 children: evidence from the Longitudinal Study of Australian Children , 2019, International Journal of Behavioral Nutrition and Physical Activity.

[23]  G. Patton,et al.  Economic development and the nutritional status of Chinese school-aged children and adolescents from 1995 to 2014: an analysis of five successive national surveys. , 2019, The lancet. Diabetes & endocrinology.

[24]  A. Timperio,et al.  The Relationship between Objectively Measured and Self-Reported Sedentary Behaviours and Social Connectedness among Adolescents , 2019, International journal of environmental research and public health.

[25]  Gadi Lissak,et al.  Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study , 2018, Environmental research.

[26]  A. Must,et al.  The State of the Summer: a Review of Child Summer Weight Gain and Efforts to Prevent It , 2018, Current Obesity Reports.

[27]  K. Schmitt,et al.  Education, school type and screen time were associated with overweight and obesity in 2930 adolescents , 2018, Acta paediatrica.

[28]  Gretchen A. Stevens,et al.  Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults , 2017, Lancet.

[29]  Sandra L. Calvert,et al.  Screen Media Exposure and Obesity in Children and Adolescents , 2017, Pediatrics.

[30]  Youfa Wang,et al.  Parental Expectations and Child Screen and Academic Sedentary Behaviors in China. , 2017, American journal of preventive medicine.

[31]  S. Biddle,et al.  Sedentary behaviour and adiposity in youth: a systematic review of reviews and analysis of causality , 2017, International Journal of Behavioral Nutrition and Physical Activity.

[32]  Terry K Koo,et al.  A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. , 2016, Journal Chiropractic Medicine.

[33]  Goutham Rao,et al.  Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches A Scientific Statement From the American Heart Association , 2013, Circulation.

[34]  N. Vogeltanz-Holm,et al.  Relationships between health behaviors and weight status in American Indian and white rural children. , 2013, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[35]  Kathryn H. Schmitz,et al.  Greater screen time is associated with adolescent obesity: a longitudinal study of the BMI distribution from ages 14 to 18 , 2012, Obesity.

[36]  G. Cardon,et al.  Energy balance‐related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies , 2012, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[37]  K. Eagle,et al.  Health status and behavior among middle-school children in a midwest community: what are the underpinnings of childhood obesity? , 2010, American heart journal.

[38]  T. Robinson,et al.  Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. , 2005, Circulation.

[39]  조남욱.  전자/제조업의 Collaboration 전략 , 2003 .

[40]  C. Dolea,et al.  World Health Organization , 1949, International Organization.