Media Use Trajectories and Risk of Metabolic Syndrome in European Children and Adolescents: The IDEFICS/I.Family Cohort

Elida Sina, Christoph Buck, Toomas Veidebaum, Alfonso Siani, Lucia A. Reisch, Hermann Pohlabeln, Valeria Pala, Luis Alberto Moreno, Dénes Molnar, Lauren Lissner, Yiannis Kourides, Stefaan De Henauw, Gabriele Eiben, Wolfgang Ahrens, Antje Hebestreit*, On behalf of the IDEFICS consortium, I.Family Consortium

*Corresponding author for this work

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Abstract

Background
Media use may influence metabolic syndrome (MetS) in children. Yet, longitudinal studies are scarce. This study aims to evaluate the longitudinal association of childhood digital media (DM) use trajectories with MetS and its components.

Methods
Children from Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden participating in the IDEFICS/I.Family cohort were examined at baseline (W1: 2007/2008) and then followed-up at two examination waves (W2: 2009/2010 and W3: 2013/2014). DM use (hours/day) was calculated as sum of television viewing, computer/game console and internet use. MetS z-score was calculated as sum of age- and sex-specific z-scores of four components: waist circumference, blood pressure, dyslipidemia (mean of triglycerides and HDL-cholesterol−1) and homeostasis model assessment for insulin resistance (HOMA-IR). Unfavorable monitoring levels of MetS and its components were identified (cut-off: ≥ 90th percentile of each score). Children aged 2–16 years with ≥ 2 observations (W1/W2; W1/W3; W2/W3; W1/W2/W3) were eligible for the analysis. A two-step procedure was conducted: first, individual age-dependent DM trajectories were calculated using linear mixed regressions based on random intercept (hours/day) and linear slopes (hours/day/year) and used as exposure measures in association with MetS at a second step. Trajectories were further dichotomized if children increased their DM duration over time above or below the mean.

Results
10,359 children and adolescents (20,075 total observations, 50.3% females, mean age = 7.9, SD = 2.7) were included. DM exposure increased as children grew older (from 2.2 h/day at 2 years to 4.2 h/day at 16 years). Estonian children showed the steepest DM increase; Spanish children the lowest. The prevalence of MetS at last follow-up was 5.5%. Increasing media use trajectories were positively associated with z-scores of MetS (slope: β = 0.54, 95%CI = 0.20–0.88; intercept: β = 0.07, 95%CI = 0.02–0.13), and its components after adjustment for puberty, diet and other confounders. Children with increasing DM trajectories above mean had a 30% higher risk of developing MetS (slope: OR = 1.30, 95%CI = 1.04–1.62). Boys developed steeper DM use trajectories and higher risk for MetS compared to girls.

Conclusions
Digital media use appears to be a risk factor for the development of MetS in children and adolescents. These results are of utmost importance for pediatricians and the development of health policies to prevent cardio-metabolic disorders later in life.
Original languageEnglish
Article number134
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Volume18
Issue number1
Number of pages14
ISSN1479-5868
DOIs
Publication statusPublished - Dec 2021

Keywords

  • Longitudinal study
  • Digital media
  • Screen-time
  • Metabolic disorders
  • Sedentary behavior
  • Physical activity
  • Diet quality
  • Children
  • Adolescents

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