Influence of screen time and sleep duration on obesity in early adolescents

Shafira Maharani Malik; Farid Agung Rahmadi; Wistiani Wistiani

doi:10.14238/pi60.3.2020.154-9

Shafira Maharani Malik Undergraduate, Universitas Diponegoro Medical School, Semarang, Central Java
Farid Agung Rahmadi Department of Child Health, Universitas Diponegoro Medical School, Semarang, Central Java
Wistiani Wistiani Department of Child Health, Universitas Diponegoro Medical School, Semarang, Central Java

DOI: https://doi.org/10.14238/pi60.3.2020.154-9

Keywords: screen time; sleep duration; obesity; early adolescents

Abstract

Background Behavioral and environmental factors increase the risk of obesity. Many Indonesian children have their own smartphones and engage in excessive screen time, which may negatively impact their nutritional status and sleep duration. However, to our knowledge no studies have explained the magnitude of the influence of screen time and sleep duration on obesity in early adolescents.

Objective To analyze the influence of screen time and sleep duration on obesity in children aged 10-13 years.

Methods This case-control study was done from April to June 2019 in Semarang, Central Java. Subjects comprised 70 obese and 70 non-obese children, based on CDC body mass index-for-age percentiles. Subjects were recruited from 7 primary schools. Childrenâ€™s screen time and sleep duration data were collected from the modified 3DPAR questionnaire. Statistical analysis was conducted using Chi-square and logistic regression tests.

Results Obesity had significant associations with short sleep duration (aOR=4.20; 95%CI 1.80 to 9.78) and long computer screen time (OR=4.13; 95%CI 1.28 to 13.25). Total screen time on other media or all media combined were not associated with obesity since both the obese and non-obese groups spent >2 hours/day on screens. Short sleep duration was the dominant risk factor for obesity (OR=4.08; 95%CI 1.78 to 9.35).

Conclusion Short sleep duration (<9 hours/day) is associated with and a dominant risk factor for obesity in children aged 10-13 years. However, screen time is not associated and not influential as a dominant risk factor for obesity, despite the high odds of obesity in children with long computer screen time (>2 hours/day).

References

1. WHO. Obesity and overweight [Internet]. 2018 [cited 2019 Feb 13]. Available from: https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
2. OECD/EU. Obesity Update 2017. Vol. 13, OECD update report. 2017.
3. WHO. Tenfold increase in childhood and adolescent obesity in four decades: new study by Imperial College London and WHO [Internet]. 2017 [cited 2019 Apr 3]. Available from: https://www.who.int/news-room/detail/11-10-2017-tenfold-increase-in-childhood-and-adolescent-obesity-in-four-decades-new-study-by-imperial-college-london-and-who.
4. Kementerian Kesehatan Republik Indonesia. Riset Kesehatan Dasar 2013. Jakarta: KEMENKES RI; 2013. p 218.
5. Kementerian Kesehatan Republik Indonesia. Pedoman Pencegahan dan Penanggulangan Kegemukan dan Obesitas pada Anak Sekolah. Jakarta: KEMENKES RI; 2012. p 1-2.
6. Putri PA, Noer ER. Perbedaan asupan energi, lemak, serat dan aktivitas fisik pada anak obesitas dan non-obesitas usia 3 – 5 tahun. J Nutr Coll. 2014;3:150–7.
7. Rochmawati W. Perilaku pemanfaatan internet (Internet Utilization Of Behavior) (Studi Deskriptif tentang Pemanfaatan Internet Untuk Kepentingan Hiburan dan Akademik di Kalangan Anak-Anak di Kota Surabaya). Libri-Net. 2012;1:1–5.
8. GSMA and NTT DOCOMO. Children’s use of mobile phones An international comparison 2011. 2012 [cited 2019 Feb 15]. Available from https://www.gsma.com/publicpolicy/wp-content/uploads/2012/03/Childrensuseofmobilephones2011.pdf.
9. Uttari DA, Sidiartha IG. Hubungan Antara Screen Time dengan Obesitas Pada Anak. E-Journal Med. 2017;6(5).
10. Hale L, Kirschen GW, LeBourgeois MK, Gradisar M, Garrison MM, Montgomery-Downs H, et al. Youth screen media habits and sleep: sleep-friendly screen behavior recommendations for clinicians, educators, and parents. Child Adolesc Psychiatr Clin N Am. 2018;27:229–45. DOI: 10.1016/j.chc.2017.11.014
11. IDAI - Kurva Pertumbuhan CDC-2000 Lengkap [Internet]. [cited 2019 Mar 14]. Available from: http://www.idai.or.id/professional-resources/growth-chart/cdc-modified-21-april-2001
12. Rachmi CN, Li M, Alison Baur L. Overweight and obesity in Indonesia: prevalence and risk factors—a literature review. Public Health. 2017;147:20–9.
13. Putra AR, Pangestuti DR, Rahayuning D, Kartasurya MI. Hubungan Aktivitas Fisik Dan Waktu Di Depan Layar Elektronik Dengan Indeks Massa Tubuh Siswa SD Islam Hidayatullah Semarang. J Kesehat Masy. 2017;5:255–65.
14. Suraya R. Pengaruh Konsumsi Makanan Jajanan , Aktivitas Fisik , Screen Time , dan Durasi Tidur terhadap Obesitas pada Remaja Pengguna Smartphone di Madrasah Aliyah Negeri Binjai Tahun 2018. Universitas Sumatera Utara; 2018.
15. American Academy of Pediatrics. Children, Adolescents, Obesity, and the Media. Pediatrics. 2011;128(1):201–8.
16. Centers for Disease Control. CDC - How Much Sleep Do I Need? - Sleep and Sleep Disorders [Internet]. 2017 [cited 2019 Feb 25]. Available from: https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html
17. Marfuah D, Hadi H, Huriyati E. Durasi dan Kualitas Tidur Hubungannya dengan Obesitas pada Anak Sekolah Dasar di Kota Yogyakarta dan Kabupaten Bantul. J Gizi dan Diet Indones (Indonesian J Nutr Diet. 2013;1:93–101.
18. Taheri S. The link between short sleep duration and obesity: we should recommend more sleep to prevent obesity. Arch Dis Child. 2006 Nov;91(11):881–4. DOI:10.1136/adc.2005.093013
19. Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004 ;1:e62. DOI:10.1371/journal.pmed.0010062
20. Leibel RL. The Role of Leptin in the Control of Body Weight. Nutr Rev. 2002;60:S15–9. DOI: 10.1301/002966402320634788
21. Wistiani, Ratih D, Mulyono, Bakri S. The Effects of Zinc Supplementation on Immune Response of Obese Children With Family History of Atopy. J Biomed Transl Res. 2018;4:27-32.
22. Sherwood L. Fisiologi Manusia: dari sel ke sistem. 6th ed. Yesdelita N, editor. Jakarta: EGC; 2011.
23. Thomas M, Sing H, Belenky G, Holcomb H, Mayberg H, Dannals R, et al. Neural basis of alertness and cognitive performance impairments during sleepiness. I. Effects of 24 h of sleep deprivation on waking human regional brain activity. J Sleep Res. 2000 Dec 18;9:335–52. DOI: 10.1046/j.1365-2869.2000.00225.x
24. Nedeltcheva A V, Kilkus JM, Imperial J, Kasza K, Schoeller DA, Penev PD. Sleep curtailment is accompanied by increased intake of calories from snacks. Am J Clin Nutr. 2009;89:126–33. DOI: 10.3945/ajcn.2008.26574
25. Spiegel K, Leproult R, L’Hermite-Balériaux M, Copinschi G, Penev PD, Van Cauter E. Leptin Levels Are Dependent on Sleep Duration: Relationships with Sympathovagal Balance, Carbohydrate Regulation, Cortisol, and Thyrotropin. J Clin Endocrinol Metab. 2004 ;89:5762–71. DOI: 10.1210/jc.2004-1003
26. Knutson KL. Sleep duration and cardiometabolic risk: a review of the epidemiologic evidence. Best Pract Res Clin Endocrinol Metab. 2010;24:731–43. DOI: 10.1016/j.beem.2010.07.001
27. Patel SR, Hu FB. Short sleep duration and weight gain: a systematic review. Obesity (Silver Spring). 2008;16:643–53. DOI: 10.1038/oby.2007.118
28. Lowe B. Assessing the nature and extent of children ’ s screen time. [thesis] University of Otago, Wellington; 2016.
29. Robinson TN, Banda JA, Hale L, Lu AS, Fleming-Milici F, Calvert SL, et al. Screen Media Exposure and Obesity in Children and Adolescents. Pediatrics. 2017;140(Suppl 2):S97–101. DOI: 10.1542/peds.2016-1758K
30. Ramsey Buchanan L, Rooks-Peck CR, Finnie RKC, Wethington HR, Jacob V, Fulton JE, et al. Reducing Recreational Sedentary Screen Time. Am J Prev Med. 2016 ;50:402–15. DOI: 10.1016/j.amepre.2015.09.030
31. Ayu R, Sartika D. FAKTOR RISIKO OBESITAS PADA ANAK 5-15 TAHUN DI INDONESIA. Makara Kesehat. 2011;15:37–43.
32. He F, Guan P, Liu Q, Crabtree D, Peng L, Wang H. The relationship between obesity and body compositions with respect to the timing of puberty in Chongqing adolescents: a cross-sectional study. BMC Public Health. 2017;17:664. DOI: 10.1186/s12889-017-4681-1.