Screen time, dietary patterns and intake of potentially cariogenic food in children: A systematic review

To investigate the association between screen-time behavior and diet, including a potentially cariogenic diet, in children younger than 12 years old. Four electronic databases were searched, from their earliest records up to April 2018. Observational studies were included, assessing time spent in sedentary behavior (viewing of TV, DVDs, computer and electronic games) and dietary intake in preschoolers and school-aged children. The quality of the studies was assessed using the Newcastle-Ottawa Scale. The strength of the evidence was evaluated by the GRADE system. Nineteen articles were included, all providing cross-sectional analysis. Sedentary behavior was assessed by parent-reported or self-reported questionnaires. In 10 studies, food frequency questionnaires were the method of dietary assessment. Most studies only assessed television viewing time (13). A significant relationship was found in all the studies, between television and/or total screen-time viewing and adverse dietary outcomes, including fewer fruits and vegetables, and greater consumption of unhealthy foods. In 15 studies, higher TV viewing and/or screen-time rates were associated with higher intake of cariogenic foods, like energy-dense snacks and sugar-sweetened beverages. There may be an association between sedentary behavior, particularly television viewing, and an unhealthy diet in young people involving increased intake of cariogenic foods. However, the strength of the evidence studies was limited. Further efforts are needed to limit television viewing in young children, aimed at promoting health and preventing lifestyle-associated diseases, such as dental caries.