A new study published today in the influential BMJ (British Medical Journal) has systematically reviewed the evidence to date on the effects of screentime on health and wellbeing in adolescents and children.
The study, authored by UCL researchers Dr Russell M Viner and Neza Stiglic, concludes that there is moderately strong evidence linking higher screentime with depression and obesity.
The study also found moderate evidence supporting the link between elevated screentime and reduced quality of life, unhealthy diet and increased calorie intake.
Additionally, the researchers found weaker evidence linking higher screentime with behaviour problems, anxiety, hyperactivity and inattention, poorer self-esteem, poorer well-being and poorer psychosocial health, metabolic syndrome, poorer cardiorespiratory fitness, poorer cognitive development and lower educational attainments and poor sleep outcomes.
On the other hand, the study found weak evidence that small amounts of daily screen use is not harmful.
Strength of Evidence Linking Screentime with Health and Wellbeing Outcomes
- Obesity – Moderately Strong Evidence
- Depressive Symptoms – Moderately Strong Evidence
- Reduced Quality of Life – Moderate Evidence
- Unhealthy Diet – Moderate Evidence
- Increased Calorie Intake – Moderate Evidence
- Behaviour Problems – Weak Evidence
- Anxiety – Weak Evidence
- Hyperactivity and Inattention – Weak Evidence
- Poorer Self-Esteem – Weak Evidence
- Poorer Wellbeing – Weak Evidence
- Poorer Psychosocial Health – Weak Evidence
- Metabolic syndrome – Weak Evidence
- Poorer Cardiorespiratory Fitness – Weak Evidence
- Poorer Cognitive Development – Weak Evidence
- Lower Educational Attainments – Weak Evidence
- Poor Sleep Outcomes – Weak Evidence
- Eating Disorders – Insufficient Evidence
- Suicidal Ideation – Insufficient Evidence
- Individual Cardiovascular Risk Factors – Insufficient Evidence
- Asthma Prevalence – Insufficient Evidence
- Physical Pain – Insufficient Evidence
What does this mean for business, innovation and marketing? First, this litany of nefarious screentime effects should be taken with a pinch of salt. The researchers note that there is a lack of quality research available to date, and so the findings are tentative. More research is needed to confirm the links between screentime and health and wellbeing – specifically to elucidate how exactly screentime affects us.
That said, this study adds credence to the idea that technology companies may have a duty of care to minimise the screentime that they encourage or impose on users. Whilst digital screens can help make products and experiences cheaper, more convenient, more reliable and more fun, these benefits should be weighed against the impact of increased screentime.
The full study, which involved a systematic review of prior research, including an assessment the quality of evidence, can be downloaded here.
Stiglic N, and Viner R. M. (2019) Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. BMJ Open, 9, e023191.
And if you want to dig deeper, here is a list of the individual research studies that the study used as data sources.
Carson, V., Hunter, S., Kuzik, N., Gray, C. E., Poitras, V. J., Chaput, J. P., … & Kho, M. E. (2016). Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Applied Physiology, Nutrition, and Metabolism, 41(6), S240-S265.
Costigan, S. A., Barnett, L., Plotnikoff, R. C., & Lubans, D. R. (2013). The health indicators associated with screen-based sedentary behavior among adolescent girls: a systematic review. Journal of Adolescent Health, 52(4), 382-392.
Duch, H., Fisher, E. M., Ensari, I., & Harrington, A. (2013). Screen time use in children under 3 years old: a systematic review of correlates. International Journal of Behavioral Nutrition and Physical Activity, 10(1), 102.
Hale, L., & Guan, S. (2015). Screen time and sleep among school-aged children and adolescents: a systematic literature review. Sleep Medicine Reviews, 21, 50-58.
Hoare, E., Milton, K., Foster, C., & Allender, S. (2016). The associations between sedentary behaviour and mental health among adolescents: a systematic review. International journal of Behavioral Nutrition and Physical Activity, 13(1), 108.
LeBlanc, A. G., Spence, J. C., Carson, V., Connor Gorber, S., Dillman, C., Janssen, I., … & Tremblay, M. S. (2012). Systematic review of sedentary behaviour and health indicators in the early years (aged 0–4 years). Applied Physiology, Nutrition, and Metabolism, 37(4), 753-772.
Marsh, S., Mhurchu, C. N., & Maddison, R. (2013). The non-advertising effects of screen-based sedentary activities on acute eating behaviours in children, adolescents, and young adults. A systematic review. Appetite, 71, 259-273.
Oliveira, R.Gd., Guedes. D. P. (2016) Physical Activity, Sedentary Behavior, Cardiorespiratory Fitness and Metabolic Syndrome in Adolescents: Systematic Review and Meta-Analysis of Observational Evidence. PLoS ONE 11(12): e0168503.
Pearson, N., & Biddle, S. J. (2011). Sedentary behavior and dietary intake in children, adolescents, and adults: a systematic review. American Journal of Preventive Medicine, 41(2), 178-188.
Suchert, V., Hanewinkel, R., & Isensee, B. (2015). Sedentary behavior and indicators of mental health in school-aged children and adolescents: A systematic review. Preventive Medicine, 76, 48-57.
Tremblay, M. S., LeBlanc, A. G., Kho, M. E., Saunders, T. J., Larouche, R., Colley, R. C., … & Gorber, S. C. (2011). Systematic review of sedentary behaviour and health indicators in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 98.
Van Ekris, E., Altenburg, T. M., Singh, A. S., Proper, K. I., Heymans, M. W., & Chinapaw, M. J. M. (2016). An evidence‐update on the prospective relationship between childhood sedentary behaviour and biomedical health indicators: a systematic review and meta‐analysis. Obesity Reviews, 17(9), 833-849.
Wu, X. Y., Han, L. H., Zhang, J. H., Luo, S., Hu, J. W., & Sun, K. (2017). The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review. PloS One, 12(11), e0187668.
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Like previous, smaller studies, the research found that children who spent more time in front of screens tended to sleep worse, get poorer grades and show more ‘externalizing’ behaviors (things like ADHD, Conduct Disorder and Oppositional Defiant Disorder).
But compared to other factors shaping their lives, the influence of screen time was minute.