Meta-Analysis: The Effect of Screen Time and Fast-Food Intake on Obesity in Children and Adolescents

Salwa Annisaa, Yulia Lanti Retno Dewi, Eti Poncorini Pamungkasari


Background: Obesity has reached epidemic proportions worldwide, making obesity a serious global public health challenge. Obesity is not only found in adults but also in children and adoles­cents which can lead to various physical and mental health problems that are detrimental to the quality of life and are very risky into adulthood. Obesity in children and adolescents today is caused by a lifestyle that makes a person increase in consuming fast food, lack of sleep and the longer duration of screen time. This study aims to analyze the effect of screen time and fast food on obesity in children and adolescents.

Subjects and Method: This was a systematic review and meta-analysis. Population= children and adolescents, Intervention= screen time and fast food, Comparison= no screen time and no fast food, Outcome= obesity. Article searches through journal databases include: PubMed, Science Direct, Google Scholar and Springerlink. The articles used in this study are articles that have been published from 2011-2021. The keywords used are obesity OR obese OR overweight AND “fast foods” OR snacks OR “fried foods” AND “social media” OR “screen time” OR television AND child OR adolescent. Articles were selected with the help of PRISMA flow diagrams. The inclusion criteria included full-text articles with a cross-sectional study design. The analysis used logistic regression with adjusted odds ratio and published in English. Articles that have met the requirements are analyzed using the Revman 5.3 application.

Results: Fifteen articles came from Nepal, China, Pakistan, Canada, Darussalam, Ethiopia, Italy, Australia, Indonesia. Meta-analysis of 8 cross-sectional studies showed that screen time 3 hours/ day can affect obesity in children and adolescents 2.4 times compared to screen time < 3 hours/ day. The results of the meta-analysis in 8 cross-sectional studies showed that fast food 3 times/ week had an effect on obesity in children and adolescents by 2.74 times compared to fast food < 3 times/week.

Conclusion: The long duration of screen time and the frequency of consuming fast food often increase the risk of obesity in children and adolescents.

Keywords: obesity, screen time, fast foods, meta-analysis


Salwa Annisaa. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: Mobile: 0815411­80488.

Journal of Health Promotion and Behavior (2021), 06(02): 164-175




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Aggarwal B and Jain V (2017). Obesity in Children: Definition, Etiology and App-roach. Indian J Pediatr 2017 85:6, 85(6): 463–471. doi: 10.1007/S12098-017-2531-X.

Andegiorgish AK, Wang J, Zhang X, Liu X and Zhu H (2011). Prevalence of over-weight, obesity, and associated risk fac¬tors among school children and adolescents in Tianjin, China. Eur J Pediatr 2011 171:4, 171(4): 697–703. doi: 10.1007/S00431-011-1636-X.

Anuradha B (2019). Screen time. J Trop Pediatr. Oxford Academic, 105–106. doi: 10.1093/tropej/fmz014.

Ardeshirlarijani E, Namazi N, Jabbari M, Zeinali M, Gerami H, Jalili RB, Larijani B and Azadbakht L (2019). The link between breakfast skipping and overweigh/obesity in children and adolescents: a meta-analysis of observational studies. J Diabetes

Metab Disord, 18(2): 657–664. doi: 10.1007/S40200-019-00446-7.

Ardic C and Omar E (2019). Obesity frequency and related risk factors in primary school children. Eur Res Jl, 5(3): 467–472. doi: 10.18621/EURJ.-395207.

Ashakiran S and Deepthi R (2012). Fast foods and their impact on health. JKIMSU, 7–15.

Bharati S, Pal M, Shome S, Roy P, Dhara P and Bharati P (2017). Influence of socio-economic status and television watching on childhood obesity in Kol-kata. Homo : internationale Zeits¬chrift fur die vergleichende Forschung am Menschen, 68(6): 487–494.

doi: 10.1016/J.JCHB.2017.08.005.

Biswas T, Islam A, Islam MS, Pervin S and Rawal LB (2017). Overweight and obesity among children and adoles-cents in Bangladesh: a systematic re¬vi-ew and meta-analysis. Public health, 142: 94–101. doi: 10.1016/J.PUHE.-2016.¬10.010.

Borghese MM, Tremblay MS, Leduc G, Boyer C, Bélanger P, LeBlanc AG, Francis C and Chaput J-P (2015). Television viewing and food intake during television viewing in normal-weight, overweight and obese 9- to 11-year-old Canadian children: a cross-sectional

analysis. J nutr sci, 4. doi: 10.1017/JNS.2014.72.

CASP (2018). Critical Appraisal Skills Prog-ram¬me (CASP) for Cross Sectional Study. CASP.

Chooi YC, Ding C and Magkos F (2019). The epidemiology of obesity. Metabo¬lism - Clinical and Experimental, 92: 6–10. doi: 10.1016/J.METABOL.20¬18.-09.005.

Cochrane (2014). RevMan 5.3 User Guide. New York. The Cochrane Collabo-ration.

Damayanti S, Gultom L, Herdanto A, Lestari E, Sidiartha IG and Maxitalia M (2014). Diagnosis tata laksana dan pencegahan obesitas pada anak dan remaja (Diagnosis, management and prevention of obesity in children and adolescents). I. Jakarta: IDAI.

Desalew A, Mandesh A and Semahegn A (2017). Childhood overweight, obesity and associated factors among primary school children in dire dawa, eastern Ethiopia; a cross-sectional study. BMC Obesity, 4(1): 1–10. doi: 10.¬1186/-S40608-017-0156 2/TABLES/5.

Emond JA, Longacre MR, Titus LJ, Hen-dricks K, Drake KM, Carroll JE, Cleve-land LP and Dalton MA (2020). Fast food intake and excess weight gain over a 1-year period among pre¬school-age children. Pediatric obesity, 15(4). doi: 10.1111/IJPO.12602.

Febriani D and Sudiarti T (2019). Fast food as drivers for overweight and obesity among urban school children at Jakarta, Indonesia. J Gizi Pangan, 14(2): 99–106. doi: 10.25182/JGP.-2019.¬14.¬2.99-106.

Frayon S, Wattelez G, Paufique E, Nedjar-Guerre A, Serra-Mallol C and Galy O (2020). Overweight in the pluri-ethnic adolescent population of New Caledonia: Dietary patterns, sleep duration and screen time. The Lancet Regional Health - Western Pacific,

: 100025. doi: 10.1016/j.lanwpc.2020.-100025.

Gali N, Tamiru D and Tamrat M (2017). The Emerging Nutritional Problems of School Adolescents: Overweight or Obesity and Associated Factors in Jimma Town, Ethiopia. J Pediatr Nurs, 35: 98–104. doi: 10.1016/-J.PEDN.2017.03.002.

Galpin A and Taylor G (2018). The British Psychological Society Promoting excellence in psychology Children, adolescents and screen use. Available at: Accessed: 9 November 2021.

Gebremichael B and Chere A (2015). Preva-lence of Childhood Overweight and Obe¬sity and its Determinant Factors Among Elementary School Children in Addis Ababa, Ethiopia: A Cross Sectional Study. J Nutr Disorders Ther, 05(04). doi: 10.4172/2161-05-09.¬S1-002.

Gibney M, Margets B, Kearney JM and Arab L (2009). Gizi kesehatan masya¬rakat (Public health nutrition). Jakar¬ta: EGC.

Hadi H, Nurwanti E, Gittelsohn J, Arun-dhana AI, Astiti D, West KP and Dibley MJ (2020). Improved Under¬standing of Interactions between Risk Factors for Child Obesity May Lead to Better Designed Prevention Policies and Programs in Indonesia. Nutri¬ents,

(1). doi: 10.3390/NU120101¬75.

Hannon TS, Rao G and Arslanian SA (2005). Childhood obesity and type 2 diabetes mellitus. Pediatrics, 473–480. doi: 10.1542/peds.2004-2536.

Harris JL, Bargh JA and Brownell KD (2009). Priming Effects of Television Food Advertising on Eating Behavior. Health Psychology, 28(4): 404–413. doi: 10.1037/a0014399.

Hayyat MU, Munir A, Shahzad L and Farhan M (2019). Assessing the nexus of fast food consumption and childhood obesity in Lahore Metropolitan City of Pakistan. Int J Biosci(IJB), 14(04): 95–102. doi: 10.12692/ijb/14.4.95-102.

Hill D, Ameenuddin N, Chassiakos YR, Cross C, Radesky J, Hutchinson J, Boyd R, Mendelson R, Moreno MA, Smith J and Swanson WS (2016). Media use in school aged children and adolescents. Pediatrics, 138(5). doi: 10.1542/PEDS.2016-2592/60321.

Hu J, Ding N, Yang L, Ma Y, Gao M and Wen D (2019). Association between television viewing and early childhood overweight and obesity: A pairmatched case control study in China. BMC Pediatrics, 19(1): 1–8. doi: 10.1186/S12887-019-15579/TABLES/3.

Islam N and Ullah GMS (2010). Factors affecting consumers’ preferences on fast food items in Bangladesh. JABR, 26(4): 131–146. doi: 10.19030/jabr.v26i4.313.

James PT, Leach R, Kalamara E and Shayeghi M (2001). The worldwide obesity epidemic. Obesity research, 9 Suppl 4. doi: 10.1038/OBY.2001.123.

Kakinami L, Barnett TA, Séguin L and Paradis G (2015). Parenting style and obesity risk in children. Preventive Medicine, 75: 18–22. doi:10.1016/J.YPMED.2015.03.005.

Kane S, Conus S, Haltom D, Hirshorn K, Pak Y and Vigdorchik J (2010). A shoulder health survey: correlating behaviors and comorbidities with shoulder problems. Sports health, 2(2): 119–34. doi: 10.1177/194173810-9338358.

Karki A, Shrestha A and Subedi N (2019). Prevalence and associated factors of childhood overweight/obesity among primary school children in urban Nepal. BMC public health, 19(1). doi: 10.1186/S12889-019-7406-9.

Kaye LK, Orben A, Ellis DA, Hunter SC and Houghton S (2020). The Conceptual and Methodological Mayhem of ‘Screen Time’. Int J Environ 2020, Vol. 17, Page 3661, 17(10): 3661. doi: 10.3390/IJERPH17103661.

Kelly T, Yang W, Chen CS, Reynolds K and He J (2008). Global burden of obesity in 2005 and projections to 2030. Int J obes (2005), 32(9): 1431–1437. doi: 10.1038/IJO.2008.102.

Krebs NF, Himes JH, Jacobson D, Nicklas TA, Guilday P and Styne D (2007). Assessment of Child and Adolescent Overweight and Obesity. Pediatrics, 120(Supplement_4): S193–S228. doi: 10.1542/PEDS.2007-2329D.

Kumar S and Kelly AS (2017). Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment. Mayo Clinic proceedings, 92(2): 251–265. doi: 10.1016/J.MAYOCP.2016.09.017

Kurdanti W, Suryani I, Syamsiatun NH, Siwi LP, Adityanti MM, Mustikaningsih D and Sholihah KI (2015). Faktor-faktor yang mempengaruhi kejadian obesitas pada remaja (Factors that influence the incidence of obesity in adolescents). JGKI, 11(4): 179–190.

Available at: (Accessed: 9 November 2021).

Kurniawan F (2018). Program sehat cegah obesitas pada anak (Healthy program to prevent obesity in children). UGM.

Lamboglia CMGF, Silva VTBL Da, Vascon-celos Filho JE De, Pinheiro MHNP, Munguba MCDS, Silva Júnior FVI, Paula FAR De and Silva CAB Da (2013). Exergaming as a strategic tool in the fight against childhood obesity: a systematic review. J obes, 2013.

doi: 10.1155/2013/438364.

Martens L, De Smet S, Yusof MYPM and Rajasekharan S (2017). Association between overweight/obesity and periodontal disease in children and adole-scents: a systematic review and meta-analysis. Eur Arch Paediatr Denty, 18(2): 69–82. doi: 10.1007/S40368-017-0272-1.

Md M and Islam S (2020). The Impact of Fast Food on Our Life: A Study on Food Habits of Bangladeshi People. GJMR, 20(8).

Mekonnen T, Tariku A and Abebe SM (2018). Overweight/obesity among school aged children in Bahir Dar City: cross sectional study. Ital J Pediatr, 44(1). doi: 10.1186/S13052-018-0452-6.

Mihrshahi S, Drayton BA, Bauman AE and Hardy LL (2017). Associations between childhood overweight, obesity, abdominal obesity and obesogenic behaviors and practices in Australian homes. BMC public health, 18(1). doi: 10.1186/S12889-017-4595-Y.

Moher D, Liberati A, Tetzlaff and D Altman (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement.

Murti B (2018). Prinsip Dan Metode Riset Epidemiologi (V). UNS.

Nittari G, Scuri S, Sagaro GG, Petrelli F and Grappasonni I (2020). Epidemiology of Obesity in Children and Adolescents. Teamwork in Healthcare. doi: 10.5772/INTECHOPEN.93604.

Paduano S, Borsari L, Salvia C, Arletti S, Tripodi A, Pinca J and Borella P (2020). Risk Factors for Overweight and Obesity in Children Attending the First Year of Primary Schools in Modena, Italy. J Community Health, 45(2): 301–309. doi: 10.1007/S10-900-019-00741-7.

Paduano S, Greco A, Borsari L, Salvia C, Tancredi S, Pinca J, Midili S, Tripodi A, Borella P and Marchesi I (2021). Physical and Sedentary Activities and Childhood Overweight/Obesity: A Cross-Sectional Study among First Year Children of Primary Schools in Modena, Italy. IJRPH 2021, Vol. 18, Page 3221, 18(6): 3221. doi: 10.3390/IJERPH18063221.


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