Association between recreational screen time and excess weight and obesity assessed with three sets of criteria in Spanish residents aged 2-14 years.

Introduction And Objective: Studies that assess the association between excess weight and screen time in childhood and adolescence are methodologically heterogeneous, and few studies have analysed the exposure to smartphones and tablets. Our study aimed to assess the association between daily recreational screen time and excess weight (overweight+obesity) and obesity in children aged 2-14 years residing in Spain using different sets of standards.

Methods: We conducted a cross-sectional study using data from the 2017 Spanish National Health Survey (N=4528). We assessed the prevalence of overweight and obesity applying the criteria of the World Health Organization (WHO), International Obesity Task Force (IOTF), and Orbegozo 2011 study. We categorised daily recreational screen time in minutes as 0-59, 60-119, 120-179, and ≥180. We calculated crude and adjusted prevalence ratios (aPR) of excess weight and obesity based on the daily minutes of recreational screen time with the corresponding 95% confidence intervals (95%CI). Moreover, we calculated crude and adjusted change (aΔ) in the expected number of fulfilled excess weight/obesity criteria based on the minutes of daily recreational screen time with the corresponding 95% CI. We adjusted the association analyses for potential confounders.

Results: We found that spending 180min or more a day of recreational screen time was associated with an increase in the adjusted prevalence of excess weight (e.g. Orbegozo 2011 aPR, 1.20; 95% CI, 1.02-1.42) and of obesity (e.g. IOTF aPR, 1.41; 95% CI, 1.06-1.86) as well as an increase in the adjusted number of fulfilled criteria for excess weight (aΔ, 1.18; 95% CI, 1.06-1.31).

Conclusions: Longer periods of recreational screen time were associated with excess weight and obesity in children aged 2-14 years. Cohort studies are required to confirm these findings, as this may be a determinant of health in children.