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Screen Time and Bone Status in Children and Adolescents: A Systematic Review.

ABSTRACT: Introduction: Technological advances over the last 2 decades have led to an increase in the time spent by children and youth engaged in screen-based activities, and growing recognition of deleterious effects on health. In this systematic review of cohort and cross-sectional studies, we assess current data on the relationship between screen time and bone status in children and teenagers. Methods: We searched PUBMED and SCOPUS databases for studies of children and adolescents that assessed screen time and bone status, determined by measuring bone mineral content or density, bone stiffness index, bone speed of sound, bone broadband ultrasound attenuation, or frame index. Searches were limited to studies published between 1900 and 2020, and performed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The studies included were evaluated using the Newcastle-Ottawa quality assessment scale. Results: Ten cohort and cross-sectional studies including pediatric population were selected. The combined study population was 20,420 children/adolescents, of whom 18,444 participated in cross-sectional studies. Four studies assessed the effects of total screen time, seven the consequences of TV viewing time, and six the effects of recreational computer use on bone health. Our findings indicate an inverse association between total and weekly screen time and bone health in children and adolescents. In 57% of the studies included also a negative correlation between television viewing time and bone status was observed, while recreational computer time did not have a significant impact on bone health. According to the only four studies that included dietetic factors, no relevant differences were found between calcium intake and screen time or bone broadband ultrasound attenuation and bone speed of sound. Conclusions: Review of the literature of the past three decades provides strong support for comprehensive education of screen time on bone status. The findings of this systematic review support a negative association between screen time and bone status in children and adolescents, with a different impact when considering the different technological devices. As peak bone mass in adolescents is the strongest predictor of osteoporosis risk, strategies aimed at improving bone health should incorporate conscious use of digital technology.

SUBMITTER: de Lamas C

PROVIDER: S-EPMC8672244 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Technological developments in recent decades have increased young people's engagement with screen-based technologies (screen time), and a reduction in young people's contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. The aim of this systematic scoping review was to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for young children (<5 years), schoolchildren (5-11 years), early adolescents (12-14 years), and older adolescents (15-18 years). Original quantitative studies were identified in four databases (PubMed, PsycInfo, Scopus, Embase), resulting in 186 eligible studies. A third of included studies were undertaken in Europe and almost as many in the United States. The majority of studies were cross-sectional (62%). In general, high levels of screen time appeared to be associated with unfavourable psychological outcomes while green time appeared to be associated with favourable psychological outcomes. The ways screen time and green time were conceptualised and measured were highly heterogeneous, limiting the ability to synthesise the literature. The preponderance of cross-sectional studies with broadly similar findings, despite heterogeneous exposure measures, suggested results were not artefacts. However, additional high-quality longitudinal studies and randomised controlled trials are needed to make a compelling case for causal relationships. Different developmental stages appeared to shape which exposures and outcomes were salient. Young people from low socioeconomic backgrounds may be disproportionately affected by high screen time and low green time. Future research should distinguish between passive and interactive screen activities, and incidental versus purposive exposure to nature. Few studies considered screen time and green time together, and possible reciprocal psychological effects. However, there is preliminary evidence that green time could buffer consequences of high screen time, therefore nature may be an under-utilised public health resource for youth psychological well-being in a high-tech era.

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Screen Time and Bone Status in Children and Adolescents: A Systematic Review.

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