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Nagata JM, Weinstein S, Alsamman S, Lee CM, Dooley EE, Ganson KT, Testa A, Gooding HC, Kiss O, Baker FC, Pettee Gabriel K. Association of physical activity and screen time with cardiovascular disease risk in the Adolescent Brain Cognitive Development Study. BMC Public Health 2024; 24:1346. [PMID: 38762449 PMCID: PMC11102349 DOI: 10.1186/s12889-024-18790-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/08/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND According to the Physical Activity Guidelines Advisory Committee Scientific Report, limited evidence is available on sedentary behaviors (screen time) and their joint associations with physical activity (steps) for cardiovascular health in adolescence. The objective of this study was to identify joint associations of screen time and physical activity categories with cardiovascular disease (CVD) risk factors (blood pressure, hemoglobin A1c, cholesterol) in adolescence. METHODS This study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, comprising a diverse sample of 4,718 U.S. adolescents aged 10-15 years between 2018 and 2021. Steps were measured by a Fitbit wearable device and levels were categorized as low (1,000-6,000), medium (> 6,000-12,000), and high (> 12,000) averaged daily step counts. Self-reported recreational screen time hours per day were classified as low (0-4), medium (> 4-8), and high (> 8) hours per day. CVD risk factors including blood pressure, hemoglobin A1c, and cholesterol (total and HDL) were measured. RESULTS The analytical sample averaged 6.6 h of screen time per day and 9,722 steps per day. In models including both screen time and steps, the high screen time category was associated with a 4.27 higher diastolic blood pressure percentile (95% CI 1.83-6.73) and lower HDL cholesterol (B= -2.85, 95% CI -4.77 to -0.94 mg/dL) compared to the low screen time category. Medium (B = 3.68, 95% CI 1.24-6.11) and low (B = 7.64, 95% CI 4.07-11.20) step categories were associated with higher diastolic blood pressure percentile compared to the high step category. The medium step category was associated with lower HDL cholesterol (B= -1.99, 95% CI -3.80 to -0.19 mg/dL) compared to the high step category. Findings were similar when screen time and step counts were analyzed as continuous variables; higher continuous step count was additionally associated with lower total cholesterol (mg/dL). CONCLUSIONS Combinations of low screen time and high steps were generally associated with favorable cardiovascular health markers including lower diastolic blood pressure and higher HDL cholesterol, which can inform future adolescent health guidelines.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA.
| | - Shayna Weinstein
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA
| | - Sana Alsamman
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA
| | - Christopher M Lee
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard. Birmingham, Alabama, 35233, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, M5S 1V4, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Holly C Gooding
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, 2015 Uppergate Drive, Atlanta, GA, 30322, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA, 94025, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA, 94025, USA
- School of Physiology, University of the Witwatersrand, 1 Jan Smuts Ave, Braamfontein, Johannesburg, 2000, South Africa
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard. Birmingham, Alabama, 35233, USA
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Nagata JM, Lee CM, Lin F, Ganson KT, Pettee Gabriel K, Testa A, Jackson DB, Dooley EE, Gooding HC, Vittinghoff E. Screen Time from Adolescence to Adulthood and Cardiometabolic Disease: a Prospective Cohort Study. J Gen Intern Med 2023; 38:1821-1827. [PMID: 36627526 PMCID: PMC10272026 DOI: 10.1007/s11606-022-07984-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Previous studies have analyzed the relationship between screen time and cardiometabolic disease risk factors among adolescents, but few have examined the longitudinal effects of screen time on cardiometabolic health into adulthood using nationally representative data. OBJECTIVE To determine prospective associations between screen time and later cardiometabolic disease over a 24-year period using a nationally representative adolescent cohort. DESIGN Longitudinal prospective cohort data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) collected from 1994 to 2018. PARTICIPANTS Adolescents aged 11-18 years old at baseline (1994-1995) followed for 24 years. MAIN MEASURES Predictors: screen time (five repeated measures of self-reported television and video watching from adolescence to adulthood). OUTCOMES Five repeated measures of body mass index (BMI); two repeated measures of waist circumference, hypertension, hyperlipidemia, and diabetes collected at 15- and 24-year follow-up exams. KEY RESULTS For the 7105 adolescents in the sample (49.7% female, 35.0% non-white), the baseline adolescent average screen time per day was 2.86 ± 0.08 hours per day, which generally declined through 24-year follow-up. Average BMI at baseline was 22.57 ± 0.13 kg/m2, which increased to 30.27 ± 0.18 kg/m2 through follow-up. By 24-year follow-up, 43.4% of participants had obesity, 8.4% had diabetes, 31.8% had hypertension, and 14.9% had hyperlipidemia. In mixed-effects generalized linear models, each additional hour of screen time per day was associated with 0.06 (95% CI 0.04-0.09) within-person increase in BMI. Each additional hour of screen time per day was associated with higher within-person odds of high waist circumference (AOR 1.17, 95% CI 1.09-1.26), obesity (AOR 1.09, 95% CI 1.03-1.15), and diabetes (AOR 1.17, 95% CI 1.07-1.28). Screen time was not significantly associated with hypertension or hyperlipidemia. CONCLUSIONS In this prospective cohort study, higher screen time in adolescence was associated with higher odds of select indicators of cardiometabolic disease in adulthood.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA.
| | - Christopher M Lee
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA, 94143, USA
| | - Feng Lin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Holly C Gooding
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Eric Vittinghoff
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Jahangiry L, Aune D, Farhangi MA. Screen time and the risk of metabolic syndrome among children and adolescents: A systematic review and dose-response meta-analysis. Nutr Metab Cardiovasc Dis 2022; 32:2483-2492. [PMID: 36155149 DOI: 10.1016/j.numecd.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/27/2022] [Accepted: 08/03/2022] [Indexed: 10/31/2022]
Abstract
AIMS The metabolic syndrome (MetS) and its consequences are one of the main public health challenges worldwide. We conducted a systematic review and dose-response meta-analysis of studies that examined the association between screen time and the MetS among children and adolescents. DATA SYNTHESIS A systematic search was conducted using electronic databases, including PubMed, Scopus, ProQuest, and Cochrane Library, for studies published from 1963 up to 2 May 2022. In this systematic review and meta-analysis, observational studies with cross-sectional, case-control, and cohort design evaluating the association between screen time and MetS were included. Random effects models and linear and nonlinear dose-response meta-analyses were used to pool study results. RESULTS Seven studies were included in the meta-analysis. The summary OR of MetS among children and adolescents for the highest vs. lowest time of screen time was 1.64 (95% CI: 1.32-2.03, with little evidence of heterogeneity, I2 = 9.3%, P-heterogeneity = 0.35, n = 7 studies) and 1.64 (95% CI: 1.27-2.12, I2 = 27.7%, n = 6) for cross-sectional studies. Results persisted across several additional subgroup analyses. There was a linear positive association between screen time and the risk of MetS (P dose-response <0.0001; P nonlinearity = 0.64) with an OR of 1.29 (95% CI: 1.12-1.46) per 2 h/day increment in screen time. CONCLUSION The current dose-response meta-analysis suggested that increased screen time is associated with an increased risk of MetS among children and adolescents. Public health strategies may target unhealthy screen-based related behaviors to halt the development of MetS among children and adolescents.
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Affiliation(s)
- L Jahangiry
- Tabriz Health Services Management Research Center, Health Education and Health Promotion Department, Tabriz University of Medical Sciences, Tabriz, Iran; Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz 5166/15731, Iran.
| | - D Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
| | - M A Farhangi
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
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Harvey DL, Milton K, Jones AP, Atkin AJ. International trends in screen-based behaviours from 2012 to 2019. Prev Med 2022; 154:106909. [PMID: 34871663 DOI: 10.1016/j.ypmed.2021.106909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022]
Abstract
Many adults accumulate considerable time in screen-based behaviours, some of which have been associated with negative physical and psychological health outcomes. The aims of this study were to characterise contemporary patterns of screen-based behaviours and describe their temporal trends by global region, age, sex and education. Data covering the period 2012-2019 were obtained in aggregated form from GWI (previously known as Global Web Index), a global market research company. Temporal trends in the duration of adults' (16-64 years) self-reported personal computer, laptop and tablet use, mobile phone use, broadcast television viewing, online television viewing and games console use were described using data from over 2 million participants from 46 countries. For each activity, participants selected from response options ranging from less than 30 min to more than 10 h. Internationally, daily screen time increased from approximately 9 h in 2012 to 11 h in 2019, with notable increases in mobile phone use (approx. 2 h), online television viewing (approx. 37 min) and games console use (approx. 26 min). Differences were seen in the duration of time spent engaging in screen-based behaviours across regions and between socio-demographic groups, with Latin America, the Middle East and Africa and younger age groups seeing greater increases in overall screen time. The findings have important implications for health behaviour surveillance and for research exploring the links between screen-based behaviours and health.
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Affiliation(s)
- Danielle L Harvey
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, United Kingdom.
| | - Karen Milton
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, United Kingdom
| | - Andy P Jones
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, United Kingdom
| | - Andrew J Atkin
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, United Kingdom; Norwich Epidemiology Centre, University of East Anglia, Norwich, Norfolk NR4 7TJ, United Kingdom
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Pankova NB, Alchinova IB, Kovaleva OI, Lebedeva MA, Khlebnikova NN, Cherepov AB, Noskin LA, Karganov MY. Effects of Screen Time and Season on Cardiovascular System Indicators in Primary Schoolchildren. HUMAN PHYSIOLOGY 2021; 47:628-638. [PMID: 34931106 PMCID: PMC8674520 DOI: 10.1134/s0362119721060086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 12/01/2022]
Abstract
Indicators of the cardiovascular system, including heart rate (HR) and blood pressure (BP) variability parameters, were analyzed in primary school students with different computer screen times. The study included 4084 students of grades 1–4 (age 7–12 years) from 66 Moscow schools. The screen time at school and out of school was assessed by teachers, based on the national Sanitary Rules and Regulations: 0, no screen time; 1, screen time matching hygienic standards; 2, screen time at least twice greater than recommended. Physiological examinations were carried out by spiroarteriocardiorhythmography with a face mask, the conditions corresponding to the functional stress test (mild hypercapnia/hypoxia). Testing took place in spring and autumn (independent samples). Statistical data processing was performed using nonparametric criteria. It was revealed that the introduction of computer technologies in school lessons within the limits of hygienic standards was accompanied by an increase, within the normal range, of systolic BP in girls at the end of grade 2 and 4 and in boys at the beginning and end of grade 4. Screen time at least twice higher than the hygienic standard did not have an additional effect on BP, but provoked shifts in the function of autonomic regulation. Boys were more sensitive to the influence of this environmental factor. Their pattern of seasonal variability in total power (TP) of the HR variability spectrum was reversed compared to that of children who did not use computers at school; i.e., higher TP values were observed in spring. In grade 4, the process was accompanied by an increase in spontaneous arterial baroreflex sensitivity and a decrease in the relative power of the LF range in the variability spectrum of systolic BP. The changes were assumed to reflect the adaptive response to changes in educational environment.
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Affiliation(s)
- N. B. Pankova
- Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - I. B. Alchinova
- Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - O. I. Kovaleva
- Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - M. A. Lebedeva
- Institute of General Pathology and Pathophysiology, Moscow, Russia
| | | | - A. B. Cherepov
- Institute of General Pathology and Pathophysiology, Moscow, Russia
| | - L. A. Noskin
- Konstantinov St. Petersburg Institute of Nuclear Physics, St. Petersburg, Russia
| | - M. Yu. Karganov
- Institute of General Pathology and Pathophysiology, Moscow, Russia
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Intervention Effects of the Health Promotion Programme "Join the Healthy Boat" on Objectively Assessed Sedentary Time in Primary School Children in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239029. [PMID: 33287418 PMCID: PMC7730991 DOI: 10.3390/ijerph17239029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/16/2020] [Accepted: 11/26/2020] [Indexed: 12/11/2022]
Abstract
Sedentary behaviour (SB) in children is related to negative health consequences that can track into adulthood. The programme "Join the Healthy Boat" promotes reduced screen time and a less sedentary lifestyle in schoolchildren. This study investigated the effects of the programme on children's SB. For one year, teachers delivered the programme. A total of 231 children (7.0 ± 0.6 years) participated in the cluster-randomised study; there were 154 one year later at follow-up. Children's SB was assessed using multi-sensor accelerometery, screen time via parental questionnaire. Effects were analysed using (linear) mixed effects regression models. At baseline, children spent 211 (±89) min daily in SB, at follow-up 259 (±109) min/day with no significant difference between the intervention (IG) and control group (CG). SB was higher during weekends (p < 0.01, for CG and IG). However, at follow-up, daily screen time decreased in IG (screen time of >1 h/day: baseline: 33.3% vs. 27.4%; follow-up: 41.2% vs. 27.5%, for CG and IG, respectively). This multi-dimensional, low-threshold intervention for one year does not seem to achieve a significant reduction in children's SB, although screen time decreased in IG. Therefore, it should be considered that screen time cannot be the key contributor to SB and should not solely be used for changing children's SB. However, if screen time is targeted, interventions should promote the replacement of screen time with active alternatives.
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