Screen time and the risk of metabolic syndrome among children and adolescents: A systematic review and dose-response meta-analysis

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.

Keywords: Adolescents; Cardio-metabolic risk factors; Children; Metabolic syndrome; Screen time.