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

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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: >= 90(th) 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: beta = 0.54, 95%CI = 0.20-0.88; intercept: beta = 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.
Keywords
Nutrition and Dietetics, Physical Therapy, Sports Therapy and Rehabilitation, Medicine (miscellaneous), Longitudinal study, Digital media, Screen-time, Metabolic disorders, Sedentary behavior, Physical activity, Diet quality, Children, Adolescents

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MLA
Sina, Elida, et al. “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, vol. 18, no. 1, 2021, doi:10.1186/s12966-021-01186-9.
APA
Sina, E., Buck, C., Veidebaum, T., Siani, A., Reisch, L., Pohlabeln, H., … Hebestreit, A. (2021). 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, 18(1). https://doi.org/10.1186/s12966-021-01186-9
Chicago author-date
Sina, Elida, Christoph Buck, Toomas Veidebaum, Alfonso Siani, Lucia Reisch, Hermann Pohlabeln, Valeria Pala, et al. 2021. “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 18 (1). https://doi.org/10.1186/s12966-021-01186-9.
Chicago author-date (all authors)
Sina, Elida, Christoph Buck, Toomas Veidebaum, Alfonso Siani, Lucia Reisch, Hermann Pohlabeln, Valeria Pala, Luis A. Moreno, Dénes Molnar, Lauren Lissner, Yiannis Kourides, Stefaan De Henauw, Gabriele Eiben, Wolfgang Ahrens, and Antje Hebestreit. 2021. “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 18 (1). doi:10.1186/s12966-021-01186-9.
Vancouver
1.
Sina E, Buck C, Veidebaum T, Siani A, Reisch L, Pohlabeln H, et al. 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. 2021;18(1).
IEEE
[1]
E. Sina et al., “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, vol. 18, no. 1, 2021.
@article{8731250,
  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: >= 90(th) 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: beta = 0.54, 95%CI = 0.20-0.88; intercept: beta = 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.}},
  articleno    = {{134}},
  author       = {{Sina, Elida and Buck, Christoph and Veidebaum, Toomas and Siani, Alfonso and Reisch, Lucia and Pohlabeln, Hermann and Pala, Valeria and Moreno, Luis A. and Molnar, Dénes and Lissner, Lauren and Kourides, Yiannis and De Henauw, Stefaan and Eiben, Gabriele and Ahrens, Wolfgang and Hebestreit, Antje}},
  issn         = {{1479-5868}},
  journal      = {{INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY}},
  keywords     = {{Nutrition and Dietetics,Physical Therapy,Sports Therapy and Rehabilitation,Medicine (miscellaneous),Longitudinal study,Digital media,Screen-time,Metabolic disorders,Sedentary behavior,Physical activity,Diet quality,Children,Adolescents}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{14}},
  title        = {{Media use trajectories and risk of metabolic syndrome in European children and adolescents : the IDEFICS/I.Family cohort}},
  url          = {{http://dx.doi.org/10.1186/s12966-021-01186-9}},
  volume       = {{18}},
  year         = {{2021}},
}

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