Systematic Reviews and Meta-analyses| Volume 32, ISSUE 11, P2483-2492, November 2022

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Screen time and the risk of metabolic syndrome among children and adolescents: A systematic review and dose-response meta-analysis

  • L. Jahangiry
    Tabriz Health Services Management Research Center, Health Education and Health Promotion Department, Tabriz University of Medical Sciences, Tabriz, Iran

    Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz 5166/15731, Iran
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  • D. Aune
    Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom

    Department of Nutrition, Bjørknes University College, Oslo, Norway

    Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
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  • M.A. Farhangi
    Corresponding author.
    Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
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      • Increased screen time is associated with an increased risk of MetS among children and adolescents.
      • High-level screen time was associated with a statistically significant 58% increase in odds of MetS among children and adolescents.
      • There was a 29% increase in odds of MetS per 2 h of screen time per day.
      • More research is needed considering the type of screen time and study design.



      The metabolic syndrome (MetS) and its consequences are one of the main public health challenges worldwide. We conducted a systematic review and dose-response meta-analysis of studies that examined the association between screen time and the MetS among children and adolescents.

      Data synthesis

      A systematic search was conducted using electronic databases, including PubMed, Scopus, ProQuest, and Cochrane Library, for studies published from 1963 up to 2 May 2022. In this systematic review and meta-analysis, observational studies with cross-sectional, case-control, and cohort design evaluating the association between screen time and MetS were included. Random effects models and linear and nonlinear dose-response meta-analyses were used to pool study results.


      Seven studies were included in the meta-analysis. The summary OR of MetS among children and adolescents for the highest vs. lowest time of screen time was 1.64 (95% CI: 1.32–2.03, with little evidence of heterogeneity, I2 = 9.3%, P-heterogeneity = 0.35, n = 7 studies) and 1.64 (95% CI: 1.27–2.12, I2 = 27.7%, n = 6) for cross-sectional studies. Results persisted across several additional subgroup analyses. There was a linear positive association between screen time and the risk of MetS (P dose-response < 0.0001; P nonlinearity = 0.64) with an OR of 1.29 (95% CI: 1.12–1.46) per 2 h/day increment in screen time.


      The current dose-response meta-analysis suggested that increased screen time is associated with an increased risk of MetS among children and adolescents. Public health strategies may target unhealthy screen-based related behaviors to halt the development of MetS among children and adolescents.



      MetS (metabolic syndrome), BMI (body mass index), PA (physical activity), TV (television), AHRQ (Healthcare Research and Quality), OR (odds ratio), CI (confidence interval), MESH (Medical Subject Heading), ATP (III) (National Cholesterol Education Program Adult Treatment Panel), CVD (cardiovascular diseases)
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