22 Mealtime Media Use And Non-High-Density Lipoprotein Cholesterol in Children

Abstract

Background Television viewing during mealtime has been associated with elevated BMI in children. Recently, there has been an increase in the use of mobile media devices; however, the association between overall media use during mealtime and markers of cardiometabolic risk (CMR) remains unknown. Objectives To examine mealtime media use in children and its association with non-HDL cholesterol levels and other CMR outcomes, including BMI z-score (zBMI), total cholesterol, HDL cholesterol, triglycerides, glucose and insulin. Design/Methods A cross-sectional analysis using repeated measures was conducted on n=2,117 (total observations=2,911) healthy children age 1–13 years participating in a practice-based research network from 2013–2018. To account for repeated measures, multivariable linear regression with generalized estimating equations was used to examine the association between weekly mealtime media use and non-HDL cholesterol as well as secondary CMR outcomes. Individual age groups (<5y and ≥5y) were analyzed separately when age group interaction terms were significant (p<0.05). Results After adjusting for child age, sex, birthweight, fasting time, physical activity, total screen time, maternal education, maternal ethnicity, family income, parental history of cardiometabolic disease, breastfeeding duration and family meals, total media use during mealtime was not associated with non-HDL cholesterol (p=0.51). In children ≥5y, each increase of one meal with media per week was associated with a decrease in HDL cholesterol by -0.006 mmol/L (95% CI -0.009, -0.002; p=0.003), and this was driven by media use during breakfast (-0.012 mmol/L; 95% CI -0.02, -0.004; p=0.002). In children ≥5y, there was marginal evidence of increased zBMI for each dinner consumed with media per week (0.034 units; 95% CI -0.0003, 0.069; p=0.05). In children <5y, each snack consumed with media per week was associated with a decrease in zBMI by -0.022 units (95% CI -0.041, -0.003; p=0.02). Total mealtime media use was also inversely associated with log-triglycerides in children <5y (beta=-0.004; 95% CI -0.008, -0.00009; p=0.04). Total mealtime media use was not associated with total cholesterol, glucose or insulin (p>0.05). Conclusion While mealtime media use was not associated with non-HDL cholesterol, it may be associated with unfavourable lipid profiles through effects on HDL cholesterol in children ≥5y. Motivations for mealtime media use may differ among pre-school and school-aged children, which may therefore contribute to the differing direction of associations observed in our study. Further research examining the context in which mealtime media is used is warranted.