Problematic social media use and overweight/obesity: explanatory pathway analysis of 124 667 in-school adolescents in 39 high-income countries

Internet use, unhealthy diet, and obesity in rural school-aged youth: a cross-sectional study in Henan Province, China

BACKGROUND

In rural areas of China, the prevalence of obesity in children has grown continuously, becoming a major problem in the field of pediatrics. The purpose of this study is to investigate the relationship between Internet use and obesity in rural children and explore the mediating role of unhealthy dietary preferences.

METHODS

This study empirically tested the impact of Internet use on obesity in rural children and its mechanism by using the survey data of Chinese rural primary and secondary school students, the OLS model, the two-stage least squares method, and the mediation effect model.

RESULTS

This study provides new evidence that the prevalence of obesity is higher when more internet time is spent. When length of Internet use increased by one unit, the BMI-Z value of rural children increased by 11.2%. Analysis shows that Internet use has a significant impact on obesity through three types of unhealthy diets: "fast food preference", "snack food preference" and "soft drink and sugary fruit drink preference" (all at the 1% level). Heterogeneity analysis found that non-left behind (NLBC), male and depressed rural children's obesity was more significantly affected by Internet use (significant at 1%, 10% and 10%, respectively).

CONCLUSIONS

This study provides new evidence that the prevalence rate of obesity is higher when more internet time is spent, especially in NLBC, boys and depressed children.

Family affluence and bullying victimisation affect life satisfaction in large-bodied adolescents: Evidence from 37 high-income countries

BACKGROUND

Adolescents with large body sizes often experience bullying which likely affects their overall well-being. Yet, there is limited research on how bullying victimisation affects overall life satisfaction among this cohort of adolescents, and how family affluence moderates this relationship.

OBJECTIVE

This study investigates the moderation effects of family affluence in the association between bullying victimisation and life satisfaction among adolescents with large bodies.

SETTING AND PARTICIPANTS

This research involved 16,240 adolescents with large bodies based on the World Health Organization's Body Mass Index Chart/Classification for ages 13 to 15 years from 37 high-income countries in Europe and North America.

DESIGN

The study used data from the Health Behaviour in School-aged Children (HBSC) survey, a cross-national study of adolescent health and well-being. Hypotheses were assessed through mixed effects binary logit models with random intercepts, accounting for data clustering and variations across regions.

RESULTS

After controlling for covariates, both cyberbullying (AOR = 1.72; 95 % CI = 1.48-2.00) and traditional bullying (AOR = 1.74, 95 % CI: 1.53-1.99) were significantly associated with lower life satisfaction compared with no bullying experience among participants. Family affluence partly moderated these associations, wherein the highest level of affluence reduced the effects of cyberbullying (AOR = 1.57, 95 % CI: 1.09-2.27) and traditional bullying (AOR = 1.41, 95 % CI: 1.02-1.96) on life satisfaction compared to lower levels.

CONCLUSION

Both traditional and cyberbullying significantly reduced life satisfaction among adolescents with large body sizes. However, higher family affluence moderates (reduces) these negative effects, suggesting a protective role of socioeconomic status. These findings highlight the need for targeted interventions to support bullied adolescents, particularly those with large bodies and from lower socioeconomic backgrounds.

Navigating the Digital Divide: Exploring the Drivers, Drawbacks, and Prospects of Social Interaction Technologies' Adoption and Usage Among Older Adults During COVID-19

The COVID-19 pandemic underscored the critical role of social interaction technologies (SITs) in mitigating loneliness and social isolation, particularly among older adults. However, challenges such as the digital divide, physical and cognitive declines, and digital literacy gaps persist. This article seeks to explore the drivers, drawbacks, and prospects of SITs' adoption during the pandemic. The paper employs a narrative review approach, using targeted phrases and keywords, including "COVID-19 pandemic and digital engagement," "digital technologies usage among older adults/people during COVID-19," and "drivers of digital technologies adoption among older adults/people during COVID-19." Articles were retrieved through Google Scholar searches conducted between October 2023 and December 2024. In line with key findings, we propose evidence-based recommendations, including user-centered digital communication technology design, the need to balance digital engagement with healthy physical activity, and personalized digital literacy programs, to enhance SITs' accessibility and usability for older adults.

The effect of Internet use on body weight in Chinese adolescents: Evidence from a nationally longitudinal survey

The prevalence of overweight and obesity among adolescents has been increasing steadily. This study aims to investigates the causal effect and underlying mechanisms between Internet use and body weight among Chinese adolescents. Using data from China Health and Nutrition Survey (CHNS) spanning from 2004 to 2015, the analytical sample includes 3054 participants (aged 11-19, 48% females). We exploit ordinary least squares (OLS) and two-stage least squares (2SLS) models, obtained causal effect of Internet use on body mass index (BMI), overweight and obesity among adolescents. We find a significant positive effect of Internet use on BMI (β = 0.499, p < 0.05) and probability of overweight (β = 0.061, p < 0.05). Specifically, Internet use increases BMI by 2.56%, and increases the probability of being overweight by 6.1%. But no evidence shows that Internet use significantly increases the probability of obesity (p > 0.1). The mechanism is that Internet use increases sedentary activities (mainly screen time) and food consumption behavior, which results in an imbalance between energy intake and expenditure that in turn increases BMI and overweight. Furthermore, the longer the time spent playing games online, the greater the probability of adolescents being overweight (β = 0.012, p < 0.1), whereas time spent watching movies online, surfing online, and chatting online is not significantly associated with body weight. Heterogeneity analyses show that the adverse effects of Internet use on adolescents' body weight is more pronounced in rural areas and among the male group. This study suggests that reducing time spent playing games online, and increasing physical activity and cultivating healthy eating behaviour can reduce the risk of overweight and obesity in adolescents.

The Association Between Longitudinal Changes in Body Mass Index and Longitudinal Changes in Hours of Screen Time, and Hours of Physical Activity in German Children

INTRODUCTION

The association of screen time and physical activity with body weight in children has been investigated in cross-sectional and prospective studies, as well as randomized controlled trials. The present study extends previous research by examining how longitudinal within-person changes in screen time and physical activity relate to changes in Body Mass Index (BMI) in children, and how changes in screen time and physical activity relate to each other.

METHODS

The data for the present study came from the PIER Youth Study. Data were collected from 971 children and their parents at two time points approximately 1 year apart. A multilevel modeling approach with measurement occasions nested within children was used to model changes in BMI across age.

RESULTS

Within a child, a change in daily hours of TV viewing was associated with a corresponding change in BMI, whereas a change in daily hours of physical activity was associated with an opposite change in BMI. Within-person correlations between changes in screen time and physical activity were small but positive.

CONCLUSION

The present findings have important implications for interventions to reduce and prevent childhood overweight and obesity. Specifically, interventions should focus on both reducing daily TV viewing and promoting physical activity.

Determinants of childhood obesity in China

Over the past four decades, China has witnessed an important nutritional transition, characterised by a heightened overnutrition burden among children. The country now has the largest population of children with obesity globally. In this paper, we review the epidemiology of childhood obesity in China, its determinants, and risk factors, with a particular focus on school-aged children. Evidence unveils substantial variations across age, gender, and region. We describe multilevel obesogenic determinants, including macro-level social, cultural, and environmental factors; meso-level factors related to schools and communities; and micro-level factors tied to families and individuals from the perinatal-infant stage to childhood and adolescence. The primary drivers of childhood obesity appear to be rooted in the broader macro-level social, economic, and technological environment; obesogenic factors, which have affected school, community, and family environments; and accelerated unhealthy behaviour uptake. Identifying and characterising the catalysts behind the rise in childhood obesity in China is imperative for the development of scalable, effective, and tailored prevention, control, and intervention strategies.

Longitudinal associations of screen time, physical activity, and sleep duration with body mass index in U.S. youth

BACKGROUND

Youth use different forms of screen time (e.g., streaming, gaming) that may be related to body mass index (BMI). Screen time is non-independent from other behaviors, including physical activity and sleep duration. Statistical approaches such as isotemporal substitution or compositional data analysis (CoDA) can model associations between these non-independent behaviors and health outcomes. Few studies have examined different types of screen time, physical activity, and sleep duration simultaneously in relation to BMI.

METHODS

Data were baseline (2017-2018) and one-year follow-up (2018-2019) from the Adolescent Brain Cognitive Development Study, a multi-site study of a nationally representative sample of U.S. youth (N = 10,544, mean [SE] baseline age = 9.9 [0.03] years, 48.9% female, 45.4% non-White). Participants reported daily minutes of screen time (streaming, gaming, socializing), physical activity, and sleep. Sex-stratified models estimated the association between baseline behaviors and follow-up BMI z-score, controlling for demographic characteristics, internalizing symptoms, and BMI z-score at baseline.

RESULTS

In females, isotemporal substitution models estimated that replacing 30 min of socializing (β [95% CI] = -0.03 [-0.05, -0.002]), streaming (-0.03 [-0.05, -0.01]), or gaming (-0.03 [-0.06, -0.01]) with 30 min of physical activity was associated with a lower follow-up BMI z-score. In males, replacing 30 min of socializing (-0.03 [-0.05, -0.01]), streaming (-0.02 [-0.03, -0.01]), or gaming (-0.02 [-0.03, -0.01]) with 30 min of sleep was associated with a lower follow-up BMI z-score. In males, replacing 30 min of socializing with 30 min of gaming was associated with a lower follow-up BMI z-score (-0.01 [-0.03, -0.0001]). CoDA estimated that in males, a greater proportion of time spent in baseline socializing, relative to the remaining behaviors, was associated with a higher follow-up BMI z-score (0.05 [0.02, 0.08]). In females, no associations between screen time and BMI were observed using CoDA.

CONCLUSIONS

One-year longitudinal associations between screen time and BMI may depend on form of screen time, what behavior it replaces (physical activity or sleep), and participant sex. The alternative statistical approaches yielded somewhat different results. Experimental manipulation of screen time and investigation of biopsychosocial mechanisms underlying the observed sex differences will allow for causal inference and can inform interventions.

Association between breakfast skipping and psychosomatic symptoms among Canadian adolescents

This cross-sectional study aimed to examine the mediating roles of gender and substance use in the influence of breakfast skipping on psychosomatic symptoms. The study used data among a nationally-representative sample of 2855 Canadian adolescents who participated in the 2018 Health Behavior in School-aged Children (HBSC) survey. Sequential logistic regressions were used to estimate the associations between breakfast skipping and psychosomatic symptoms. Path analysis using a non-parametric bootstrapping technique tested the hypothesized mediating roles. Results showed that adolescents who skipped breakfast were 2.55 times more likely to report higher psychosomatic symptoms compared to non-breakfast skippers (AOR = 2.55; 95% CI = 1.75-3.82). The bootstrapping mediation models showed that breakfast skipping indirectly influenced psychosomatic symptoms through substance use and gender, accounting for 18.47% ( β = 0.0052, Boots 95% CI = 0.0025, 0.00730) and 10.70% ( β = 0.0091, Boots 95% CI = 0.0052, 0.0125), respectively, of the total effect. Our findings have important implications for targeted public and mental health interventions to address both breakfast skipping and psychosomatic symptoms among adolescents.  Conclusion: The study compellingly underscores the significance of incorporating gender-specific factors and substance use in understanding the correlation between breakfast skipping and psychosomatic symptoms. These insights hold importance for tailoring public health interventions to alleviate the prevalence of psychosomatic symptoms among adolescents by actively addressing breakfast skipping. What is Known: • Breakfast is considered the most important meal of the day due to its role in providing the brain with the energy necessary to enhance cognitive functions. • Adolescents commonly exhibit a prevalent lifestyle behaviour of skipping breakfast. What is New: • This study provides robust evidence supporting the association between breakfast skipping and elevated psychosomatic symptoms in adolescents. • Gender and substance use mediate this association, offering novel insights into the complex interplay that contributes to psychosomatic symptoms among this demographic group. • Longitudinal research is needed to unravel causal relationships and illuminate the underlying mechanisms of this intricate connection.