Table 1

Characteristics of included studies

AuthorAgeOutcome measuresMeta-analysisStudies
(n, CS, LS, RCT, N of subjects)
% duplicate studiesNarrative findingsFindings of meta-analysis
Pearson and Biddle19 C< 11 y; A: 12–18 yDietary intake; assessed largely through food frequency questionnairesNon=53; 19 in C and 26 in Ad; largely CS; 5 LS in C and 5 LS in Ad. Total N not reported.14.6%C (<12 y): TVST – assoc. with fruit, vegetable consumption; + assoc. with energy-dense snack consumption, fast food consumption, energy-dense drinks, total energy intake, percentage energy from fat.
Ad: ST – assoc. with fruit, vegetable, FV, fibre consumption; + assoc. energy-dense snack, fast food, fried food consumption, energy dense drink, total energy intake, percentage energy from fat, total fat.
C: strengths of assoc. were mainly small to moderate (no exact values given);
Ad: strength of assoc. was small to moderate for energy-dense drinks and snacks (no exact values given).
LeBlanc et al 18 0–4 yAdiposity (n=11), psychosocial health (n=6), cognitive development (n=8 studies). No studies identified of bone mass, motor development or cardiometabolic healthNon=23.
N=22 417.
13.0%Infants: TVST elicited no benefits and may be harmful to cognitive development; increased TVST assoc. with unfavourable adiposity.
Toddlers: TVST has – impact on adiposity, cognitive development, – affected psychosocial health
Preschoolers: TVST – impact on adiposity; evidence between increased TV and decreases scores on measures of psychosocial health; – relationship between TVV and cognitive development
Costigan et al 8 12–18 yPhysical, psychosocial and/or behavioural health outcomesNon=33; 25 CS, 8 LS.21.2%ST + assoc. with weight status, neck/shoulder/lower back pain, backache/headache, sleep problems and depressive symptoms;
− assoc. with perceived health and healthy dietary behaviour.
Tremblay et al 10 5–17 yBody composition, physical fitness, metabolic syndrome (MetS), cardiovascular risk, self-esteem, prosocial behaviour, academic performanceYesn=232; 8 RCTs, 10 intervention studies, 37 LS and 177 CS.
N= 983 840.
2.2%+assoc. between adiposity and TVST; assoc. between ST and higher cholesterol and blood pressure, haemoglobin A1c and insulin insensitivity;
− relationship between ST and self-esteem;
>2 hours/day ST assoc. with lower cardiorespiratory fitness.
TVST and BMI was the only area where data allowed meta-analysis; 4 RCTs included in the meta-analysis: decreased TVST assoc. with decrease in BMI (−0.89 kg/m2 (95% CI −1.467 to −0.11, p=0.01).
Suchert et al 10 5–18 yDepressive symptoms, anxiety symptoms, internalising problems, self-esteem, eating disorder symptoms, hyperactivity and inattention problems, well-being and quality of life (QoL)Non=91; 73 CS, 16 LS, 2 RCT. N not reported.7.7%+ assoc. between ST and hyperactivity/inattention problems, internalising problems, poorer psychological well-being and perceived QoL. Indeterminate assoc. between SBB and depressive and anxiety symptoms, self-esteem and eating disorder symptoms.
van Ekris et al 11 <18 yAnthropometrics, cardiometabolic risk, blood pressure, fitness, other biomedical health indicatorsYesn=109; N=24 257 for MA of TVV and BMI from 9 prospective cohorts. N=6971 for MA of computer screen viewing and BMI from 5 prospective cohorts.5.2%+ relationship between TVST and overweight/obesity incidence and overweight/obesity incidence; NoE for relationship between computer use/game time with BMI/BMI z-score or WC/WC z-score; + relationship between ST and BMI/BMI z-score and overweight/obesity.
NoE for relationship between ST and triglycerides and glucose, low-density lipoprotein cholesterol, ratio of total cholesterol to high-density lipoprotein cholesterol and systolic and diastolic blood pressure; - relationship between TVST and cardiorespiratory fitness/VO2max; InE with strength and being unfit, cardiorespiratory fitness/VO2max and metabolic risk z-scores, asthma and bone mass indicators.
MA: BMI at follow-up was not significantly associated with each additional hour of TV viewing (β=0.01, 95% CI (−0.002 to 0.02)) or computer use (β=0.00, 95% CI (-0.004 to 0.01)) per day, with high heterogeneity in each analysis. Adjustment for physical activity or diet did not change findings.
Carson et al 17 5–17 yBody composition, MetS/cardiovascular disease risk factors, academic achievement, fitness, self-esteemNon=235; 1 RCT, 1 cross-over trial, 49 LS, 5 CC and 179 CS. 35 used accelerometer measures of SB.
N not stated.
3.5%Higher ST assoc. with unfavourable body composition, overweight/obese and with clustered risk factor score and lower cardiorespiratory fitness, unfavourable measures of behaviour, lower self-esteem (TVST); inconsistent findings for assoc. with lower academic attainment.
Hoare et al 20 10–19 yDepressive symptomatology, anxiety symptomatology, self-esteem, suicide ideation, other mental health indicatorsNon=32;
1 RCT, 6 LS, 24 CS.
21.9%+ Relationship between ST and depressive symptomatology, psychological distress and ST duration and severity of anxiety symptoms. + Relationship between low self-esteem and screen time. InE for relationship between ST and suicidal ideation.
Duch et al 9 <3 yBiological and demographic factors, family biological and demographic factors, family structure factors, behavioural factors, structural environmental factorsNon=29;
18 CS, 10 LS, 1 RCT.
N not stated.
3.5%+ Assoc. between ST and age and BMI. InE on ST and sleep duration and crying duration.
Marsh et al 1 5–24 yEnergy intake measured objectively in experimental studies using an experimental meal during two exposure scenariosNon=10;
8 RCT and 2 quasi-experimental studies.
0ST (in the absence of food advertising) assoc. with increased dietary intake; TVST increases intake of very palpable energy-dense foods; stimulatory effects of TVST on intake were stronger in overweight/obese C than those of normal weight
Hale and Guan24 5–17 ySleep outcomesNon=67; 3 RCT.0Assoc. with at least one of the sleep outcomes (delayed bedtime, shortened total sleep time, daytime tiredness, sleep onset latency) was found for computer use, video gaming, mobile device, unspecified ST.
Goncalves de Oliveira et al 23 10–19 yMetSYes. ST dichotomised as ≤2 h vs >2 h for analysesn=21; 9 examined ST, 8 CS, 1 CC.
N=8680.
0Inconclusive evidence for the assoc. of ST or TVST with presence of the MetS.Significant assoc. was not identified between ST and MetS; OR for MetS in relation to >2 h ST=1.20 (95% CI 0.91 to 1.59), p=0.20, n=3881, studies =6, I2=37%).
Subgroup analysis: no significant assoc. between ST and MetS through the whole week (OR=1.03 (95% CI 0.75 to 1.42), p=0.84, n=2261, studies=4, I2=24%); however, there was a significant assoc. between weekend ST and MetS (OR=2.05 (95% CI 1.13 to 3.73), p=0.02, n=1620 studies=2, I2=0%).
Wu et al 22 3–18 yHealth-related quality of life (HRQOL)Yes. ST dichotomised as <2–2.4 h vs ≥2–2.5 hn=31, 17 examined ST. 13 CS, 1 LS. Total N not reported.Assoc. of ST with with HRQOL, consistent across television, computer and video screentime and across CSS and LS. 1 IS reported a dose-response relationship between screentime and HRQOL. HRQOL was lower across physical, mental and psychosocial health, school functioning, and general health domains.Significant assoc. between higher screentime and lower HRQOL: >2–2.5 h/day ST associated with fall in HRQOL by 2.71 (1.59, 3.38; studies=2).
  • + or – used for direction of association of screentime (ST) with health outcomes. n refers to studies while N refers to total number of participants across the reviews. Per cent duplicate studies refers to the proportion of studies within a review that were included in any other included review.

  • assoc., associated with; Ad, adolescent; BMI, body mass index; C, child; CC, case-control study; CS, cross-sectional study; FV, fruit and vegetable; MA, meta-analysis; NoE, no evidence; RCT, randomised controlled trial; LS, longitudinal study; QOL, quality of life; ST, screentime; TST, total sleep time; TVST, television screentime; y, year.