Use of screens and intake of unhealthy food among children and adolescents: association with physical activity in a cross-sectional study

Abstract

Abstract Background The intake of unhealthy food taken on very regular basis may bring even further negative impact on health if associated with excessive time using of screen-based electronic devices. Objective To estimate the association between the use of different types of screen-based devices and the intake of unhealthy foods amongst children and adolescents and to determine whether daily physical activity (DPA) has a moderating effect on the association. Methods Cross-sectional study carried out with a probabilistic sample of students from second to fifth grade of public elementary schools in Feira de Santana, Bahia (n = 2,477; girls: 53.2%; age: 9.1 ± 1.38 years; BMI z-score 0.37 ± 4.19 Kg/m²). Food intake, screen use, and physical activity were assessed using an online questionnaire based on previous day recall (Web-CAAFE). Prevalence Ratios (PR) and 95% Confidence Intervals (95%CI) were estimated via multiple zero-inflated negative binomial regression, with adjustments for sex, age, and weekly frequency of school meal intake. The moderating effect of DPA was verified by inserting interaction terms with each screen-based device individually and with the daily sum of screen-based device exposure (∑ Screens). Results The majority of students (72.2%) reported using screens. The intake of unhealthy foods was positively associated with the use of cell phones (PR = 1.21; 95%CI = 1.13–1.30), computers (PR = 1.33; 95%CI = 1.22–1.46), and video games (PR = 1.36; 95%CI = 1.22–1.52). TV use was inversely associated with intake of unhealthy foods (PR = 0.92; 95%CI = 0.87–0.99). DPA moderated the effect of video game use on intake of unhealthy foods, that is, among students with DPA ≥ 4 who used video games, the intake of unhealthy foods was 21% lower (PR = 0.79; 95%CI = 0. 65-0.97). Overall, ∑ Screen-based devices were associated with a 20% increase in intake of unhealthy foods. Conclusion The intake of unhealthy foods was positively associated with the use of cell phones, computers, and video games. In addition, a frequency of four or more DPA attenuated the effect of video game exposure on intake of unhealthy foods. Upcoming investigations on the use of screen-based devices and the intake of unhealthy foods among schoolchildren should consider the exposure to different types of screen-based devices, as well as the influence of DPA.

Keywords

• Sedentary behavior
• Eating Behavior
• Students