Associations of Sleep Duration and Screen Time with Incidence of Overweight in European Children: The IDEFICS/I.Family Cohort

Abstract

<b><i>Introduction:</i></b> Over the past decades, children have been increasingly using screen devices, while at the same time their sleep duration has decreased. Both behaviors have been associated with excess weight, and it is possible they act as mutually reinforcing behaviors for weight gain. The aim of the study was to explore independent, prospective associations of screen time and sleep duration with incident overweight in a sample of European children. <b><i>Methods:</i></b> Data from 4,285 children of the IDEFICS/I.Family cohort who were followed up from 2009/2010 to 2013/2014 were analyzed. Hours per day of screen time and of sleep duration were reported by parents at baseline. Logistic regression analyses were carried out in separate and mutually adjusted models controlled for sex, age, European country region, parental level of education, and baseline BMI <i>z</i>-scores. <b><i>Results:</i></b> Among normal weight children at baseline (<i>N</i> = 3,734), separate models suggest that every hour increase in screen time and every hour decrease in sleep duration were associated with higher odds of the child becoming overweight or obese at follow-up (OR = 1.16, 95% CI: 1.02–1.32 and OR = 1.23, 95% CI: 1.05–1.43, respectively). In the mutually adjusted model, both associations were attenuated slightly ( screen time OR = 1.13, 95% CI: 0.99–1.28; sleep duration OR = 1.20, 95% CI: 1.03–1.40), being consistently somewhat stronger for sleep duration. <b><i>Discussion/Conclusion:</i></b> Both screen time and sleep duration increased the incidence of overweight or obesity by 13–20%. Interventions that include an emphasis on adequate sleep and minimal screen time are needed to establish their causal role in the prevention of overweight and obesity among European children.

Pediatric Diabetes on the Rise: Trends in Incident Diabetes During the COVID-19 Pandemic

“…Around the world, children were enrolled in school virtually, extracurricular activities were limited, and daily routines were adjusted to decrease the potential exposure to COVID-19. Potential consequences include increased screen time, unhealthy eating habits, decreased physical activity, and worsened sleep hygiene, all of which have associations with increased BMI [ 15 , 16 ]. A recent meta-analysis showed an increase in BMI in school-age children and an increase in obesity prevalence from 10.5% to 12.6% in high school and college students during the pandemic [ 27 ].…”

“…Across the globe, children were enrolled in school virtually, extracurricular activities were limited, and daily routines were adjusted to decrease the potential exposure to COVID-19. Consequences of this included increased screen time, unhealthy eating habits, decreased physical activity, and worsened sleep hygiene, which all have associations with increased body mass index (BMI) [ 15 , 16 ].…”

Associations of excessive screen time and early screen exposure with health-related quality of life and behavioral problems among children attending preschools

“…A growing body of evidence suggests that excessive screen time and early screen exposure have detrimental impacts on children [5][6][7][8][9]. For example, a multi-country cohort study has revealed a link between excessive screen time and an increased risk of overweight or obesity in children aged between 2 and 11 years [5].…”

A longitudinal causal graph analysis investigating modifiable risk factors and obesity in a European cohort of children and adolescents

“…We found that sleep duration and AVM possibly causally affect insulin resistance (HOMA), which in turn causally affects BMI. Others also reported associations of media exposure [32][33][34][35] and sleep 36,37 with insulin resistance, although the direction of the relationship between sleep and HOMA was inconsistent 38 . Although we found no clear evidence for a causal impact of physical activity, healthy diet or well-being on obesity, associations were previously found in the IDEFICS/I.Family cohort e.g.…”