Media use trajectories and risk of metabolic syndrome in European children and adolescents: the IDEFICS/I.Family cohort

International Journal of Behavioral Nutrition and Physical Activity

Toomas Veidebaum¹  Lucia Reisch²  Dénes Molnar³  Valeria Pala⁴  Stefaan De Henauw⁵  Gabriele Eiben⁶  Luis A. Moreno⁷  Alfonso Siani⁸  Christoph Buck⁹  Hermann Pohlabeln⁹  Elida Sina⁹  Antje Hebestreit⁹  Wolfgang Ahrens^1,10  Yiannis Kourides^1,11  Lauren Lissner^1,12 

[1] Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia;Department of Management, Society and Communication, Copenhagen Business School, Copenhagen, Denmark;Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary;Department of Preventive and Predictive Medicine, Fondazione IRCCS, Istituto Nazionale Dei Tumori, Milan, Italy;Department of Public Health and Primary Care, Ghent University, Ghent, Belgium;Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden;GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de La Obesidad Y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain;Institute of Food Sciences, National Research Council, Avellino, Italy;Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, 28359, Bremen, Germany;Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstraße 30, 28359, Bremen, Germany;Institute of Statistics, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany;Research and Education Institute of Child Health, Strovolos, Cyprus;School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden;

关键词: Longitudinal study;    Digital media;    Screen-time;    Metabolic disorders;    Sedentary behavior;    Physical activity;    Diet quality;    Children;    Adolescents;   

DOI  :  10.1186/s12966-021-01186-9

来源: Springer

【 摘 要 】

BackgroundMedia 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.MethodsChildren 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.Results10,359 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.ConclusionsDigital 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.Trial registrationISRCTN, ISRCTN62310987. Registered 23 February 2018- retrospectively registered.

【 授权许可】

CC BY