Screen Time is Related to Dietary Intake in Children at 24-Months-of-Age

Abstract

Objectives: Screen time throughout childhood is positively related to anthropometric measures, mediated partially through its impact on diet quality. Existing literature lacks specific data for 24 months (24MN) children and focuses primarily on television screen time rather than all sources of screen time (smart phones, tablets, and video streaming services). Thus, we explored the relationship between screen device usage and diet quality at this early age. Methods: Parents and 24MN children (N = 396) were recruited from the STRONGKids 2 cohort study. Data included parent and child anthropometric measurements, physical activity time (Sports, Play, and Active Recreation for Kids Survey), dietary intake (Block Food Frequency Questionnaires), and the types and duration of screen time usage by the child (Common Sense Media Survey). Calories from macronutrients, sweets, added sugar, dietary fiber, and fruit and vegetable consumption were used to assess diet quality. Results: 26% of children exceeded the Academy of Pediatrics Guidelines of <2 h screen time per day. TV, DVDs, and shows on cellphones accounted for 79% of child screen time. 26% of children were overweight or obese, although BMI z-score at 24 MN was not related to screen time, physical activity time, or diet factors. Parent and child diet quality were related.; However, independent of parent diet, education, ethnicity, gender, and BMI, total screen time were associated with kcal consumed through sweets (r = 0.147, P = 0.014), added sugar intake in grams (r = 0.137, P = 0.023), and fruit consumption (r = −0.235, P < 0.001). Passive screen use (TV, DVDs, shows on a cell phone or computer) was associated with total kcals (r = 0.127, P = 0.036), kcals from sweets (r = 0.137, P = 0.023) and added sugar intake (r = 0.138, P = 0.022), and fruit (r = −0.260, P < 0.001) and vegetable consumption (r = −0.119, P = 0.049). Active screen use (playing games on a console, computer, cell phone, or other handheld device) was related to % fat intake (r = −0.119, P = 0.048). Conclusions: Total and passive screen time at 24 MN are associated with factors indicative of poor diet quality, which could negatively impact child health.