Children aged two to three who spend more than three hours a day watching screens such as tablets and televisions (televisions) become less physically active by the age of 5.5, compared to children who use screens for an hour or less each day, a study published in The Lancet Child and Adolescent Health newspaper found.
The study, involving more than 500 children in Singapore, suggests that following World Health Organization (WHO) guidelines for limiting screen time to one hour a day or less in children aged two at age five can promote healthier behaviors later in life.
Screen-viewing is growing in popularity, but screen time as a child has been linked to a range of health issues, including an increased risk of obesity and reduced cognitive development.
One of the ways that screen viewing can influence health is by replacing time that would otherwise be spent on other things, such as physical activity and sleep. Efforts to investigate this point have had mixed results, with most studies focusing on school-aged children and adolescents.
The latest study is the first to examine the effects of screen use at an early age on the daily activity of preschoolers.
Associate Professor Falk Mu? Ller-Riemenschneider, of the Saw Swee Hock of Public Health, National University of Singapore, said; “We investigated whether screen viewing habits at ages two to three affected the way children spent their time at age five. In particular, we were interested in whether screen viewing screen affected sleep patterns and activity levels later in childhood. ” 
Parents were asked to report how much time children spent on average watching or playing video games on TV, using a computer, or using a portable device, such as a cell phone or tablet. These screen habits were recorded when the children were two years old and again at three years old. An average of the two records was used in the analysis. At age five, the children wore a continuous activity monitor for seven days to monitor their sleep, sedentary behavior, light physical activity, and moderate to vigorous physical activity.
Children in the study spent an average of 2.5 hours per day staring at screens by the age of two to three. Television was the most commonly used device and was associated with the longest viewing time. Only a small proportion of children in the study responded to WHO recommendations of one hour per day or less.
The results found that children who used screens for three or more hours per day by age two to three spent an average of 40 minutes more time sitting each day at age five than those who used screens. less than an hour a day. at the same ages. Such early childhood use of screens was associated with about 30 minutes less light physical activity per day and about 10 minutes less moderate to vigorous activity each day. Similar effects were observed regardless of the type of screen. However, screen time in infancy did not appear to affect sleep patterns by age five.
The authors note some limitations, including the fact that parents may be biased in their reporting of their child’s use of screens and that the study did not control for other health-related behaviors (diet, sleep , physical activity) or environmental factors (such as time spent in daycare) because there was little information available on this topic. The authors note that the results were still similar when they conducted additional analysis to see how well health behaviors were having an impact.
The authors recommended caution when generalizing their results, as the families involved in the study were not representative of the entire population of Singapore.
However, they argue that the negative impact of screen time early in life on movement behaviors later in childhood underscores the importance of strategies to limit screen use in the early years.
Miss Bozhi Chen, Saw Swee Hock School of Public Health, National University of Singapore, said: “This analysis fills an important research gap and strengthens the existing evidence linking screen viewing time to human health. children later. Our findings support public health efforts to reduce screen viewing time in young children and suggest that more research into the long-term effects of screen viewing on movement behaviors is needed. ” 
Writing in a related comment, Dr Dorothea Dumuid (who was not involved in the study), of the University of South Australia, warned that the results do not provide evidence of a causal link between screen time and reduced physical activity; and screen time may be a marker for other underlying causative factors not measured in this study.
She said: “In this rapidly changing digital age, the use of screens by children is a major concern for parents and medical organizations. Many governments and the WHO have issued guidelines to limit the time. past screens. However, screens provide digital and social connectivity and educational opportunities. Future research is needed to assess the influence of media content, to determine optimal screen time durations in the context of a using 24-hour time, and to explore causal pathways. ”
NOTES TO EDITORS
This study was funded by the National Research Foundation of Singapore, the Singapore Institute of Clinical Sciences and the Agency for Science, Technology and Research (A * STAR). It was conducted by researchers from the National University of Singapore, the University of Paris, the Singapore Agency for Science, Technology and Research (A * STAR), the Singapore Eye Research Institute, the KK Women’s and Children’s Hospital, Nanyang Technological University, National University Health System of Singapore, University of Southampton, University of Helsinki and Charite University Medical Center Berlin.
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The Lancet Child and Adolescent Health
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