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Sanders T, Noetel M, Parker P, Del Pozo Cruz B, Biddle S, Ronto R, Hulteen R, Parker R, Thomas G, De Cocker K, Salmon J, Hesketh K, Weeks N, Arnott H, Devine E, Vasconcellos R, Pagano R, Sherson J, Conigrave J, Lonsdale C. An umbrella review of the benefits and risks associated with youths' interactions with electronic screens. Nat Hum Behav 2024; 8:82-99. [PMID: 37957284 DOI: 10.1038/s41562-023-01712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/01/2023] [Indexed: 11/15/2023]
Abstract
The influence of electronic screens on the health of children and adolescents and their education is not well understood. In this prospectively registered umbrella review (PROSPERO identifier CRD42017076051 ), we harmonized effects from 102 meta-analyses (2,451 primary studies; 1,937,501 participants) of screen time and outcomes. In total, 43 effects from 32 meta-analyses met our criteria for statistical certainty. Meta-analyses of associations between screen use and outcomes showed small-to-moderate effects (range: r = -0.14 to 0.33). In education, results were mixed; for example, screen use was negatively associated with literacy (r = -0.14, 95% confidence interval (CI) = -0.20 to -0.09, P ≤ 0.001, k = 38, N = 18,318), but this effect was positive when parents watched with their children (r = 0.15, 95% CI = 0.02 to 0.28, P = 0.028, k = 12, N = 6,083). In health, we found evidence for several small negative associations; for example, social media was associated with depression (r = 0.12, 95% CI = 0.05 to 0.19, P ≤ 0.001, k = 12, N = 93,740). Limitations of our review include the limited number of studies for each outcome, medium-to-high risk of bias in 95 out of 102 included meta-analyses and high heterogeneity (17 out of 22 in education and 20 out of 21 in health with I2 > 50%). We recommend that caregivers and policymakers carefully weigh the evidence for potential harms and benefits of specific types of screen use.
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Affiliation(s)
- Taren Sanders
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia.
| | - Michael Noetel
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Philip Parker
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Borja Del Pozo Cruz
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physical Education, Faculty of Education, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | - Stuart Biddle
- Centre for Health Research, University of Southern Queensland, Springfield, Queensland, Australia
- Faculty of Sport and Health Scienchresholds for statistical credibilites, University of Jyväskylä, Jyväskylä, Finland
| | - Rimante Ronto
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Ryan Hulteen
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, USA
| | - Rhiannon Parker
- The Centre for Social Impact, University of New South Wales, Sydney, New South Wales, Australia
| | - George Thomas
- The Health and Wellbeing Centre for Research Innovation, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Katrien De Cocker
- Department of Movement and Sport Science, Ghent University, Ghent, Belgium
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Kylie Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia
| | - Nicole Weeks
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Hugh Arnott
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Emma Devine
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, New South Wales, Australia
| | - Roberta Vasconcellos
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Rebecca Pagano
- School of Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Jamie Sherson
- School of Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - James Conigrave
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
| | - Chris Lonsdale
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, New South Wales, Australia
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Liu Y, Sun X, Zhang E, Li H, Ge X, Hu F, Cai Y, Xiang M. Association between Types of Screen Time and Weight Status during the COVID-19 Pandemic: A Longitudinal Study in Children and Adolescents. Nutrients 2023; 15:2055. [PMID: 37432199 DOI: 10.3390/nu15092055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 07/12/2023] Open
Abstract
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.
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Affiliation(s)
- Yujie Liu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Xiaomin Sun
- Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Erliang Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Huilun Li
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Xin Ge
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Fan Hu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
| | - Mi Xiang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, South Chongqing Road No. 227, Shanghai 200025, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
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Sun Y, Liu Y, Yin X, Li M, Zhang T, Zhang F, Guo Y, Sun P. Proportion of Chinese Children and Adolescents Meeting 24-Hour Movement Guidelines and Associations with Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1408. [PMID: 36674163 PMCID: PMC9859181 DOI: 10.3390/ijerph20021408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Background: Since there is little knowledge about the 24-hour movement behaviors of Chinese children and adolescents, the purposes of this study were to investigate the proportion of Chinese children and adolescents meeting the 24-Hour Movement Guidelines and to further evaluate its relationship with overweight and obesity. Methods: A total of 440 children and adolescents aged 7−18 years from 7 cities in China were selected to measure physical activity using accelerometers, and sleep (SLP) and screen time (ST) using questionnaires. The data were analyzed with the independent T-test, Mann−Whitney U test, Cox−Stuart test, chi-square test, and logistic regression. Results: The proportion of Chinese children and adolescents meeting the overall 24-Hour Movement Guidelines was 7.3%. Boys (11.8%) were higher than girls (3.4%) (p < 0.001) and showed a downward trend with age (Ptrend = 0.03). The rates of overweight and obesity among children and adolescents who met the ST, MVPA + ST, ST + SLP, and MVPA + SLP + ST guidelines were 39%, 15%, and 36%, and 25% did not meet any guidelines. The rates of overweight and obesity among those who met 1, 2, and 3 guidelines were lower than the rate among those who did not meet any guidelines (odds ratio (OR) = 0.51, 95% confidence interval (CI): 0.22−1.17; OR = 0.32, 95% CI: 0.13−0.77; OR = 0.23, 95% CI: 0.07−0.81) and showed a decreasing trend (Ptrend = 0.006). Conclusions: The proportion of Chinese children and adolescents meeting the overall 24-Hour Movement Guidelines was low. The rate of overweight and obesity among children and adolescents who met the overall 24-Hour Movement Guidelines was the lowest compared with the rates among those who met any one or two. There was a dose−response relationship between the number of guidelines met and the overweight and obesity rate.
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Affiliation(s)
- Yi Sun
- College of Physical Education, Ludong University, Yantai 264025, China
| | - Yuan Liu
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Xiaojian Yin
- College of Economics and Management, Shanghai Institute of Technology, Shanghai 201418, China
| | - Ming Li
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Ting Zhang
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Feng Zhang
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Yaru Guo
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
| | - Pengwei Sun
- College of Physical Education & Health, East China Normal University, Shanghai 200241, China
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Yue C, Wenyao G, Xudong Y, Shuang S, Zhuying S, Yizheng Z, Linlin Z, Jinxin C, Xingqi W, Yujia L. Dose-response relationship between daily screen time and the risk of low back pain among children and adolescents: a meta-analysis of 57831 participants. Environ Health Prev Med 2023; 28:64. [PMID: 37899211 PMCID: PMC10613558 DOI: 10.1265/ehpm.23-00177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/30/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND The risk of low back pain (LBP) increases steeply during adolescence, and adolescents with LBP are more likely to have low back pain in their adult years. This study aimed to investigate the dose-response relationship between daily screen time and the risk of low back pain among children and adolescents. METHODS PubMed, the Cochrane Library, Embase, and Web of Science were searched to collect relevant studies on daily screen time and the risk of low back pain from the establishment of the database up to December 2022. Two investigators independently screened the literature, extracted data, and evaluated the risk of bias in the included studies. Stata16.0 was used to perform a dose-response meta-analysis and the methodological quality evaluation of the included studies. RESULTS The results of the meta-analysis showed that there is a positive correlation between daily computer time (OR = 1.32, 1.05-1.60), daily mobile phone time (OR = 1.32, 1.00-1.64), daily TV watching (OR = 1.07, 1.04-1.09) and the risk of low back pain, separately. The dose-response meta-analysis showed that there is a linear relationship between daily computer use and low back pain. The risk of low back pain increased by 8.2% for each 1-hour of daily computer use. CONCLUSIONS Screen time is related to the risk of low back pain, and there is a linear relationship between daily computer use and the risk of low back pain. A number of strategic measures should be taken to prevent adolescents from developing severe low back pain.
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Affiliation(s)
- Cheng Yue
- Department of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu Province, 221116, China
| | - Guo Wenyao
- Department of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu Province, 221116, China
| | - Ya Xudong
- Department of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu Province, 221116, China
| | - Shao Shuang
- Department of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu Province, 221116, China
| | - Shao Zhuying
- Department of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu Province, 221116, China
| | - Zhu Yizheng
- Department of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu Province, 221116, China
| | - Zhou Linlin
- Department of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu Province, 221116, China
| | - Chen Jinxin
- Yancheng Xinyang Youth Development Service Center, Yancheng, Jiangsu Province, 224000, China
| | - Wang Xingqi
- Biomedical R&d Center, School of Life Science, Jiangsu Normal University, Xuzhou, Jiangsu Province, 221116, China
| | - Liu Yujia
- Department of Physical Education, Jiangsu Normal University, Xuzhou, Jiangsu Province, 221116, China
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