The relationship between screen time (ST) and the frequency of snack consumption in a national sample of Iranian children and adolescents was assessed. The present nationwide survey was conducted on 14,880 school students living in urban and rural areas of 30 provinces in Iran. Trained healthcare providers conducted the physical examination and completed the questionnaire of the World Health Organization – Global School-Based Student Health Survey (WHO-GSHS).
The association between ST (total time spent watching TV and using a computer in leisure time) and the frequency of snack consumption was determined using ordinal logistic regression analysis. The subjects were 13,486 students out of the 14,880 invited including 50.8% boys. The mean (SD) age of participants was 12.47 (3.36) years.
In multivariate models, for students who had prolonged ST (more than 4 h/day), the odds of daily consumption of sweets (odds ratio, OR 1.25; 95% CI 1.14–1.4), salty snacks (OR 1.6; 95% CI 1.5–1.76), soft drinks (OR 1.52; 95% CI 1.4–1.7), canned fruit juice (OR 1.3; 95% CI 1.2–1.4), and fast food (OR 1.53; 95% CI 1.4–1.7) were higher compared to those with low ST. Furthermore, the odds of daily consumption of milk in students who had prolonged ST (more than 4 h/day) were lower compared to those with low ST (OR 0.9; 95% CI 0.8–0.99).
Prolonged time spent watching TV and using a computer during leisure time might be associated with unhealthy dietary habits. Moreover, inactivity induced by prolonged ST may also lead to unhealthy dietary habits and in turn excess weight in children and adolescents.
This nationwide survey was conducted in Iran with the cooperation of the Ministry of Health and Medical Education, Ministry of Education and Training, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, and Endocrinology and Metabolism Research center of Tehran University of Medical Sciences.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
1. Lobstein T, Baur L, Uauy R. IASO International Obesity Task Force. Obesity in children and young people. Obes Rev 2004;5:4–104. Search in Google Scholar
2. Kelishadi R, Ardalan G, Gheiratmand R, Gouya MM, Razaghi EM, et al. Association of physical activity and dietary behaviours in relation to the body mass index in a national sample of Iranian children and adolescents: CASPIAN Study. Bull World Health Organ 2007;85:19–26. Search in Google Scholar
3. Hajian K, Sajadi P, Rezvani AR. Prevalence of overweight and underweight among primary school children aged 7–12 years (babol 2006). JBUMS 2008;10:83–91. Search in Google Scholar
4. Kelishadi R, Djalalinia S, Motlagh ME, Rahimi A, Bahreynian M, et al. Association of neck circumference with general and abdominal obesity in children and adolescents: the weight disorders survey of the CASPIAN-IV study. BMJ open 2016;6:e011794. Search in Google Scholar
5. Kelishadi R, Haghdoost AA, Sadeghirad B, Khajehkazemi R. Trend in the prevalence of obesity and overweight among Iranian children and adolescents: a systematic review and meta-analysis. Nutrition 2014;30:393–400. Search in Google Scholar
6. Williams CL, Strobino BA. Childhood diet, overweight, and CVD risk factors: the Healthy Start project. Prev Cardiol 2008;11:11–20. Search in Google Scholar
7. Grimes CA, Riddell LJ, Campbell KJ, Nowson CA. Dietary salt intake, sugar-sweetened beverage consumption, and obesity risk. Pediatrics 2013;131:14–21. Search in Google Scholar
8. Baygi F, Dorosty AR, Kelishadi R, Qorbani M, Asayesh H, et al. Determinants of childhood obesity in representative sample of children in north east of iran. Cholesterol 2012;2012:875163. Search in Google Scholar
9. Baygi F, Qorbani M, Dorosty A, Kelishadi R, Asayesh H, et al. Dietary predictors of childhood obesity in a representative sample of children in north east of Iran. Zhongguo Dang Dai Er Ke Za Zhi 2013;15:501–8. Search in Google Scholar
10. Matin N, Kelishadi R, Heshmat R, Motamed-Gorji N, Djalalinia S, et al. Joint association of screen time and physical activity on self-rated health and life satisfaction in children and adolescents: the CASPIAN-IV study. Int Health 2016 [Epub ahead of print]. Search in Google Scholar
11. Steinbeck KS. The importance of physical activity in the prevention of overweight and obesity in childhood: a review and an opinion. Obes Rev 2001;2:117–30. Search in Google Scholar
12. Craigie AM, Lake AA, Kelly SA, Adamson AJ, Mathers JC. Tracking of obesity-related behaviours from childhood to adulthood: a systematic review. Maturitas 2011;70:266–84. Search in Google Scholar
13. Story M, Neumark-Sztainer D, French S. Individual and environmental influences on adolescent eating behaviors. J Am Diet Assoc 2002;102:S40–51. Search in Google Scholar
14. Pate RR, O’Neill JR, Lobelo F. The evolving definition of “sedentary”. Exerc Sport Sci Rev 2008;36:173–8. Search in Google Scholar
15. Robinson TN. Television viewing and childhood obesity. Pediatr Clin North Am 2001;48:1017–25. Search in Google Scholar
16. Temple JL, Giacomelli AM, Kent KM, Roemmich JN, Epstein LH. Television watching increases motivated responding for food and energy intake in children. Am J Clin Nutr 2007;85:355–61. Search in Google Scholar
17. Ford C, Ward D, White M. Television viewing associated with adverse dietary outcomes in children ages 2–6. Obes Rev 2012;13:1139–47. Search in Google Scholar
18. Pearson N, Biddle SJ. Sedentary behavior and dietary intake in children, adolescents, and adults: a systematic review. Am J Prev Med 2011;41:178–88. Search in Google Scholar
19. Chaput JP, Klingenberg L, Astrup A, Sjödin A. Modern sedentary activities promote overconsumption of food in our current obesogenic environment. Obes Rev 2011;12:e12–20. Search in Google Scholar
20. Sleddens EF, Kroeze W, Kohl LF, Bolten LM, Velema E, et al. Determinants of dietary behavior among youth: an umbrella review. Int J Behav Nutr Phys Act 2015;12:7. Search in Google Scholar
21. Aktaş AY. The effects of television food advertisement on children’s food purchasing requests. Pediatr Int 2006;48: 138–45. Search in Google Scholar
22. Boyland EJ, Harrold JA, Kirkham TC, Corker C, Cuddy J, et al. Food commercials increase preference for energy-dense foods, particularly in children who watch more television. Pediatrics 2011;128:e93–100. Search in Google Scholar
23. Guran T, Bereket A. International epidemic of childhood obesity and television viewing. Minerva Pediatr 2011;63:483–90. Search in Google Scholar
24. Guran T, Turan S, Akcay T, Degirmenci F, Avci O, et al. Content analysis of food advertising in Turkish television. J Paediatr Child Health 2010;46:427–30. Search in Google Scholar
25. Boynton-Jarrett R, Thomas TN, Peterson KE, Wiecha J, Sobol AM, et al. Impact of television viewing patterns on fruit and vegetable consumption among adolescents. Pediatrics 2003;112:1321–6. Search in Google Scholar
26. Wiecha JL, Peterson KE, Ludwig DS, Kim J, Sobol A, et al. When children eat what they watch: impact of television viewing on dietary intake in youth. Arch Pediatr Adolesc Med 2006;160:436–42. Search in Google Scholar
27. Santaliestra-Pasías AM, Mouratidou T, Verbestel V, Huybrechts I, Gottrand F, et al. Food consumption and screen-based sedentary behaviors in European adolescents: the HELENA study. Arch Pediatr Adolesc Med 2012;166:1010–20. Search in Google Scholar
28. Miller SA, Taveras EM, Rifas-Shiman SL, Gillman MW. Association between television viewing and poor diet quality in young children. Int J Pediatr Obes 2008;3:168–76. Search in Google Scholar
29. Borghese MM, Tremblay MS, Leduc G, Boyer C, Bélanger P, et al. Independent and combined associations of total sedentary time and television viewing time with food intake patterns of 9-to 11-year-old Canadian children. Appl Physiol Nutr Metab 2014;39:937–43. Search in Google Scholar
30. French SA, Story M, Neumark-Sztainer D, Fulkerson JA, Hannan P. Fast food restaurant use among adolescents: associations with nutrient intake, food choices and behavioral and psychosocial variables. Int J Obes Relat Metab Disord 2001;25:1823–33. Search in Google Scholar
31. Lowry R, Michael S, Demissie Z, Kann L, Galuska DA. Associations of physical activity and sedentary behaviors with dietary behaviors among US high school students. J Obes 2015;2015:876524. Search in Google Scholar
32. Vereecken CA, Todd J, Roberts C, Mulvihill C, Maes L. Television viewing behaviour and associations with food habits in different countries. Public Health Nutr 2006;9:244. Search in Google Scholar
33. Gebremariam MK, Bergh IH, Andersen LF, Ommundsen Y, Totland TH, et al. Are screen-based sedentary behaviors longitudinally associated with dietary behaviors and leisure-time physical activity in the transition into adolescence. Int J Behav Nutr Phys Act 2013;10:9. Search in Google Scholar
34. Ng C, Young TK, Corey PN. Associations of television viewing, physical activity and dietary behaviours with obesity in aboriginal and non-aboriginal Canadian youth. Public Health Nutr 2010;13:1430–7. Search in Google Scholar
35. Campbell KJ, Crawford DA, Ball K. Family food environment and dietary behaviors likely to promote fatness in 5–6 year-old children. Int J Obes (Lond) 2006;30:1272–80. Search in Google Scholar
36. Coon KA, Goldberg J, Rogers BL, Tucker KL. Relationships between use of television during meals and children’s food consumption patterns. Pediatrics 2001;107:E7. Search in Google Scholar
37. Shang L, Wang J, O’Loughlin J, Tremblay A, Mathieu MÈ, et al. Screen time is associated with dietary intake in overweight Canadian children. Prev Med Rep 2015;2:265–9. Search in Google Scholar
38. Al‐Hazzaa H, Al‐Sobayel H, Abahussain N, Qahwaji D, Alahmadi M, et al. Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia. J Hum Nutr Diet 2014;27:204–13. Search in Google Scholar
39. Kelishadi R, Ardalan G, Qorbani M, Ataie-Jafari A, Bahreynian M, et al. Methodology and early findings of the fourth survey of childhood and adolescence surveillance and prevention of adult non-communicable disease in Iran: The CASPIAN-IV study. Int J Prev Med 2013;4:1451. Search in Google Scholar
40. Kelishadi R, Majdzadeh R, Motlagh ME, Heshmat R, Aminaee T, et al. Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents: the Caspian-IV study. Int J Prev Med 2012;3:699. Search in Google Scholar
41. Ahadi Z, Qorbani M, Kelishadi R, Ardalan G, Motlagh M, et al. Association between breakfast intake with anthropometric measurements, blood pressure and food consumption behaviors among Iranian children and adolescents: the CASPIAN-IV study. Public Health 2015;129:740–7. Search in Google Scholar
43. Rideout VJ, Foehr UG, Roberts DF. Generation M [superscript 2]: media in the lives of 8-to 18-year-olds. Henry J Kaiser Family Foundation, 2010. Search in Google Scholar
44. Vereecken CA, Maes L. Television viewing and food consumption in Flemish adolescents in Belgium. Soz Praventivmed 2006;51:311–17. Search in Google Scholar
45. Adams J, Tyrrell R, Adamson AJ, White M. Effect of restrictions on television food advertising to children on exposure to advertisements for ‘less healthy’ foods: repeat cross-sectional study. PLoS One 2012;7:e31578. Search in Google Scholar
46. Scully P, Macken A, Leddin D, Cullen W, Dunne C, et al. Food and beverage advertising during children’s television programming. Ir J Med Sci 2015;184:207–12. Search in Google Scholar
47. Halford JC, Gillespie J, Brown V, Pontin EE, Dovey TM. Effect of television advertisements for foods on food consumption in children. Appetite 2004;42:221–5. Search in Google Scholar
48. Nelson MC, Neumark-Stzainer D, Hannan PJ, Sirard JR, Story M. Longitudinal and secular trends in physical activity and sedentary behavior during adolescence. Pediatrics 2006;118:e1627–e1634. Search in Google Scholar
49. Biddle SJ, Gorely T, Marshall SJ, Cameron N. The prevalence of sedentary behavior and physical activity in leisure time: a study of Scottish adolescents using ecological momentary assessment. Prev Med 2009;48:151–5. Search in Google Scholar
50. Safiri S, Kelishadi R, Qorbani M, Abbasi-Ghahramanloo A, Motlagh M, et al. Screen time and its relation to cardiometabolic risk among children and adolescents: the CASPIAN-III study. Ir J Pub Health 2015;44:35–44. Search in Google Scholar
©2017 Walter de Gruyter GmbH, Berlin/Boston