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Associations between early-life screen viewing and 24 hour movement behaviours: findings from a longitudinal birth cohort study

Associations between early-life screen viewing and 24 hour movement behaviours: findings from a longitudinal birth cohort study
Associations between early-life screen viewing and 24 hour movement behaviours: findings from a longitudinal birth cohort study

Background: Screen viewing is a sedentary behaviour reported to interfere with sleep and physical activity. However, few longitudinal studies have assessed such associations in children of preschool age (0–6 years) and none have accounted for the compositional nature of these behaviours. We aimed to investigate the associations between total and device-specific screen viewing time at age 2–3 years and accelerometer-measured 24 h movement behaviours, including sleep, sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity (MVPA) at age 5·5 years. Methods: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study is an ongoing longitudinal birth cohort study in Singapore, which began in June 2009. We recruited pregnant women during their first ultrasound scan visit at two major public maternity units in Singapore. At clinic visits done at age 2–3 years, we collected parent-reported information about children's daily total and device-specific screen viewing time (television, handheld devices, and computers). At 5·5 years, children's movement behaviours for 7 consecutive days were measured using wrist-worn accelerometers. We assessed the associations between screen viewing time and movement behaviours (sedentary behaviour, light physical activity, MVPA, and sleep) using Dirichlet regression, which accounts for the compositional nature of such behaviours. This study is active but not recruiting and is registered with ClinicalTrials.gov, NCT01174875. Findings: Between June 1, 2009, and Oct 12, 2010, 1247 pregnant women enrolled and 1171 singleton births were enrolled. 987 children had parent-reported screen data at either 2 or 3 years, of whom 840 attended the clinic visit at age 5·5 years, and 577 wore an accelerometer. 552 children had at least 3 days of accelerometer data and were included in the analysis. Total screen viewing time at age 2–3 years had a significant negative association with sleep (p=0·008), light physical activity (p<0·0001), and MVPA (p<0·0001) in relation to sedentary behaviour at age 5·5 years. Compared with children who spent 1 h or less per day screen viewing at age 2–3 years, children who screen viewed for 3 h or more per day at 2–3 years engaged in more sedentary behaviour (439·8 mins per day [≤1 h screen viewing time] vs 480·0 mins per day [≥3 h screen viewing time]), and less light physical activity (384·6 vs 356·2 mins per day), and MVPA (76·2 vs 63·4 mins per day) at age 5·5 years. No significant differences in time spent sleeping were observed between the groups (539·5 vs 540·4 mins per day). Similar trends were observed for television viewing and handheld device viewing. Interpretation: Longer screen viewing time in children aged 2–3 years was associated with more time spent engaged in sedentary behaviour and shorter time engaged in light physical activity and MVPA in later childhood. Our findings indicate that screen viewing might displace physical activity during early childhood, and suggest that reducing screen viewing time in early childhood might promote healthier behaviours and associated outcomes later in life. Funding: Singapore National Research Foundation, and Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR).

2352-4650
201-209
Chen, Bozhi
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Bernard, Jonathan Y.
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Natarajan, Padmapriya
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Ning, Yilin
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Cai, Shirong
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Lanca, Carla
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Tan, K.H.
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Yap, F.
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Chong, Yap-Seng
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Shek, Lynette
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Godfrey, Keith
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Saw, S-M.
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Chan, Shiao-Yng
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Eriksson, Johan G.
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Tan, C.S.
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Müller-Riemenschneider, Falk
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Chen, Bozhi
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Bernard, Jonathan Y.
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Natarajan, Padmapriya
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Ning, Yilin
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Cai, Shirong
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Lanca, Carla
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Tan, K.H.
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Yap, F.
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Chong, Yap-Seng
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Shek, Lynette
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Godfrey, Keith
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Saw, S-M.
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Chan, Shiao-Yng
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Eriksson, Johan G.
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Tan, C.S.
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Müller-Riemenschneider, Falk
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Chen, Bozhi, Bernard, Jonathan Y., Natarajan, Padmapriya, Ning, Yilin, Cai, Shirong, Lanca, Carla, Tan, K.H., Yap, F., Chong, Yap-Seng, Shek, Lynette, Godfrey, Keith, Saw, S-M., Chan, Shiao-Yng, Eriksson, Johan G., Tan, C.S. and Müller-Riemenschneider, Falk (2020) Associations between early-life screen viewing and 24 hour movement behaviours: findings from a longitudinal birth cohort study. The Lancet Child & Adolescent Health, 4 (3), 201-209. (doi:10.1016/S2352-4642(19)30424-9).

Record type: Article

Abstract

Background: Screen viewing is a sedentary behaviour reported to interfere with sleep and physical activity. However, few longitudinal studies have assessed such associations in children of preschool age (0–6 years) and none have accounted for the compositional nature of these behaviours. We aimed to investigate the associations between total and device-specific screen viewing time at age 2–3 years and accelerometer-measured 24 h movement behaviours, including sleep, sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity (MVPA) at age 5·5 years. Methods: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study is an ongoing longitudinal birth cohort study in Singapore, which began in June 2009. We recruited pregnant women during their first ultrasound scan visit at two major public maternity units in Singapore. At clinic visits done at age 2–3 years, we collected parent-reported information about children's daily total and device-specific screen viewing time (television, handheld devices, and computers). At 5·5 years, children's movement behaviours for 7 consecutive days were measured using wrist-worn accelerometers. We assessed the associations between screen viewing time and movement behaviours (sedentary behaviour, light physical activity, MVPA, and sleep) using Dirichlet regression, which accounts for the compositional nature of such behaviours. This study is active but not recruiting and is registered with ClinicalTrials.gov, NCT01174875. Findings: Between June 1, 2009, and Oct 12, 2010, 1247 pregnant women enrolled and 1171 singleton births were enrolled. 987 children had parent-reported screen data at either 2 or 3 years, of whom 840 attended the clinic visit at age 5·5 years, and 577 wore an accelerometer. 552 children had at least 3 days of accelerometer data and were included in the analysis. Total screen viewing time at age 2–3 years had a significant negative association with sleep (p=0·008), light physical activity (p<0·0001), and MVPA (p<0·0001) in relation to sedentary behaviour at age 5·5 years. Compared with children who spent 1 h or less per day screen viewing at age 2–3 years, children who screen viewed for 3 h or more per day at 2–3 years engaged in more sedentary behaviour (439·8 mins per day [≤1 h screen viewing time] vs 480·0 mins per day [≥3 h screen viewing time]), and less light physical activity (384·6 vs 356·2 mins per day), and MVPA (76·2 vs 63·4 mins per day) at age 5·5 years. No significant differences in time spent sleeping were observed between the groups (539·5 vs 540·4 mins per day). Similar trends were observed for television viewing and handheld device viewing. Interpretation: Longer screen viewing time in children aged 2–3 years was associated with more time spent engaged in sedentary behaviour and shorter time engaged in light physical activity and MVPA in later childhood. Our findings indicate that screen viewing might displace physical activity during early childhood, and suggest that reducing screen viewing time in early childhood might promote healthier behaviours and associated outcomes later in life. Funding: Singapore National Research Foundation, and Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR).

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Accepted/In Press date: 11 December 2019
e-pub ahead of print date: 28 January 2020
Published date: March 2020
Additional Information: Funding Information: This research was supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Programme and administered by the Singapore Ministry of Health's National Medical Research Council (NMRC), Singapore- NMRC/TCR/004-NUS/2008 ; NMRC/TCR/012-NUHS/2014 . Additional funding was provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. KMG is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union's Erasmus+ Capacity-Building ENeA SEA Project and Seventh Framework Programme (FP7/2007–2013), projects EarlyNutrition and ODIN under grant agreement numbers 289346 and 613977. All participating pregnant women signed written informed consent for themselves and on behalf of their offspring at enrolment. The study received ethical approval from the National Healthcare Group Domain Specific Review Board and the SingHealth Centralised Institutional Review Board. Funding Information: KMG and Y-SC report reimbursement for speaking at conferences sponsored by Nestle Nutrition Institute and are part of an academic consortium that has received research funding from Abbott Nutrition, Nestle, and Danone. Y-SC also reports grants from Singapore Ministry of Health's National Medical Research Council; research support from Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, during the conduct of the study; has a patent Vitamin B12 and its use for gestational diabetes pending; has a patent Myo-inositol and one or more probiotics for use in type 2 diabetes pending; has a patent Vitamin B12 and for use in type 2 diabetes pending; and owns a patent for Myo-inositol and one or more probiotics for gestational diabetes. All other authors declare no competing interests. Funding Information: This study was supported by the Translational and Clinical Research Flagship Programme of the Singapore National Research Foundation through the Ministry of Health's National Medical Research Council (NMRC) of Singapore ( NMRC/TCR/004-NUS/2008 , NMRC/TCR/012-NUHS/2014 ). Additional funding was provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR). KMG is supported by the National Institute for Health Research (NIHR) through the NIHR Southampton Biomedical Research Centre and by the EU Erasmus+ Capacity Building Project and Seventh Framework Programme (FP7/2007–2013; EarlyNutrition and ODIN projects, grant numbers 289346 and 613977). We thank the GUSTO study group, operational managers, research fellows, study coordinators, and data management team. We greatly appreciate voluntary participation of all participants, and cooperation of KK Women's and Children's Hospital and National University Hospital. Publisher Copyright: © 2020 Elsevier Ltd

Identifiers

Local EPrints ID: 437210
URI: http://eprints.soton.ac.uk/id/eprint/437210
ISSN: 2352-4650
PURE UUID: f875cc1b-c7d9-4464-a59f-09944e7995d3
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

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Date deposited: 21 Jan 2020 17:37
Last modified: 24 Nov 2022 05:01

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Contributors

Author: Bozhi Chen
Author: Jonathan Y. Bernard
Author: Padmapriya Natarajan
Author: Yilin Ning
Author: Shirong Cai
Author: Carla Lanca
Author: K.H. Tan
Author: F. Yap
Author: Yap-Seng Chong
Author: Lynette Shek
Author: Keith Godfrey ORCID iD
Author: S-M. Saw
Author: Shiao-Yng Chan
Author: Johan G. Eriksson
Author: C.S. Tan
Author: Falk Müller-Riemenschneider

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