Journal of Nutritional Sciences and Dietetics 2016. 2(5):.

Concurrent Associations between Sleep Duration and Screen Time with Childhood Obesity
Azimeh Izadi, Reza Daryabeygi-Khotbesara, Fereshteh Aliasghari, Kourosh Djafarian


Objectives: Obesity is a multifactorial condition facing rapid rise worldwide, especially in children and adolescents. The present study aims to investigate the impact of sleep duration, TV watching and dietary intakes on the risk of childhood obesity.

Design, Setting, Subjects: A cross-sectional study was undertaken among 270 primary school children in Tehran, Iran. Sleep duration was measured by ACTi Graph device worn on the wrist. Using a questionnaire completed by parents, screen viewing time (TV, video games, etc.) was estimated. Also, weight, height and body mass index (BMI) were obtained. Data were analyzed by SPSS software (version 18: IBM corporation).

Results: Findings revealed that lower body mass index (BMI) and longer sleep duration is associated with low screen time (p<0.01). Higher daily mean energy consumption (1673.4±405.3 Kcal), total fat (55.3±19.3 g), carbohydrate (238.5±67.1 g), sugars (114.3±34.9 g), snacks (37.4±19.3 g) and lower daily intakes of fiber (7.9±3.7 g) as well as vegetables and fruits (2.6±1.3 servings) was significantly related to screen time in children (p<0.05). Lower fiber (8.1±4.2 g) as well as fruits & vegetable (2.6±1.4 servings) consumption were related to more sleep duration (≥540 min/day) (p<0.01).

Conclusion:  Screen time was a more important factor associated with BMI, diet and sleep in Iranian school children. Further studies are required to elaborate these associations. 


Sleep; Diet; Sugar intake; Children; Overweight; Television


Karnik S, Kanekar A. Childhood obesity: a global public health crisis. Int J Prev Med, 2012 3 (1). 2015:1-7.

Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML, et al. The global obesity pandemic: shaped by global drivers and local environments. The Lancet. 2011;378(9793):804-14.

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2014;384(9945):766-81.

Mistry SK, Puthussery S. Risk factors of overweight and obesity in childhood and adolescence in South Asian countries: a systematic review of the evidence. Public Health. 2015;129(3):200-9.

Pulgarón ER. Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clinical therapeutics. 2013;35(1):A18-A32.

Han JC, Lawlor DA, Kimm SY. Childhood obesity. The Lancet. 2010;375(9727):1737-48.

Zhang G, Wu L, Zhou L, Lu W, Mao C. Television watching and risk of childhood obesity: a meta-analysis. The European Journal of Public Health. 2015:ckv213.

Borghese MM, Tremblay MS, Leduc G, Boyer C, Bélanger P, LeBlanc AG, et al. 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. Journal of nutritional science. 2015;4:e8.

Chaput JP, Klingenberg L, Astrup A, Sjödin AM. Modern sedentary activities promote overconsumption of food in our current obesogenic environment. Obesity Reviews. 2011;12(5):e12-e20.

Pearson N, Biddle SJ. Sedentary behavior and dietary intake in children, adolescents, and adults: a systematic review. American journal of preventive medicine. 2011;41(2):178-88.

Jackson DM, Djafarian K, Stewart J, Speakman JR. Increased television viewing is associated with elevated body fatness but not with lower total energy expenditure in children. The American journal of clinical nutrition. 2009;89(4):1031-6.

Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, et al. Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics. 2002;109(1):45-60.

Yosaee S, Ansari S, Zamani A, Gharamaleki AS, Mahmoudi M, Djafarian K. Relationship between the Times Spent Watching TV and Playing Games with Fat Mass in Primary School Children. Journal of Mazandaran University of Medical Sciences. 2013;23(98):222-31.

Meltzer LJ, Montgomery-Downs HE, Insana SP, Walsh CM. Use of actigraphy for assessment in pediatric sleep research. Sleep medicine reviews. 2012;16(5):463-75.

Acebo C, Sadeh A, Seifer R, Tzischinsky O, Wolfson AR, Hafer A, et al. Estimating sleep patterns with activity monitoring in children and adolescents: how many nights are necessary for reliable measures? Sleep. 1999;22(1):95-103.

Laurson KR, Lee JA, Gentile DA, Walsh DA, Eisenmann JC. Concurrent associations between physical activity, screen time, and sleep duration with childhood obesity. ISRN obesity. 2014;2014.

National Sleep Foundation: Children and Sleep 2017 [Available from:

Paruthi S, Brooks LJ, D’Ambrosio C, Hall WA, Kotagal S, Lloyd RM, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016;12(6):785-6.

Azadbakht L, Kelishadi R, Khodarahmi M, Qorbani M, Heshmat R, Motlagh ME, et al. The association of sleep duration and cardiometabolic risk factors in a national sample of children and adolescents: the CASPIAN III study. Nutrition. 2013;29(9):1133-41.

Hovsepian S, Kelishadi R, Motlagh ME, Kasaeian A, Shafiee G, Arefirad T, et al. Level of physical activity and screen time among Iranian children and adolescents at the national and provincial level: The CASPIAN-IV study. Medical Journal of The Islamic Republic of Iran (MJIRI). 2016;30(1):880-90.

Heshmat R, Qorbani M, Babaki AES, Djalalinia S, Ataei-Jafari A, Motlagh ME, et al. Joint association of screen time and physical activity with cardiometabolic risk factors in a national sample of Iranian adolescents: the CASPIANIII study. PloS one. 2016;11(5):e0154502.

Hale L, Guan S. Screen time and sleep among school-aged children and adolescents: a systematic literature review. Sleep medicine reviews. 2015;21:50-8.

Boyland EJ, Halford JC. Television advertising and branding. Effects on eating behaviour and food preferences in children. Appetite. 2013;62:236-41.

Halford JC, Boyland EJ, Cooper GD, Dovey TM, Smith CJ, Williams N, et al. Children's food preferences: effects of weight status, food type, branding and television food advertisements (commercials). International Journal of Pediatric Obesity. 2008;3(1):31-8.

Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC, et al. Systematic review of sedentary behaviour and health indicators in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity. 2011;8(1):98.

Chaput J-P, Visby T, Nyby S, Klingenberg L, Gregersen NT, Tremblay A, et al. Video game playing increases food intake in adolescents: a randomized crossover study. The American journal of clinical nutrition. 2011;93(6):1196-203.

Van den Bulck J, Van Mierlo J. Energy intake associated with television viewing in adolescents, a cross sectional study. Appetite. 2004;43(2):181-4.

Kjeldsen JS, Hjorth MF, Andersen R, Michaelsen KF, Tetens I, Astrup A, et al. Short sleep duration and large variability in sleep duration are independently associated with dietary risk factors for obesity in Danish school children. International journal of obesity. 2014;38(1):32-9.

Westerlund L, Ray C, Roos E. Associations between sleeping habits and food consumption patterns among 10–11-year-old children in Finland. British Journal of Nutrition. 2009;102(10):1531-7.

Beebe DW, Simon S, Summer S, Hemmer S, Strotman D, Dolan LM. Dietary intake following experimentally restricted sleep in adolescents. Sleep. 2013;36(6):827-34.

Mullins EN, Miller AL, Cherian SS, Lumeng JC, Wright KP, Kurth S, et al. Acute sleep restriction increases dietary intake in preschool‐age children. Journal of Sleep Research. 2016.

Birbilis M, Moschonis G, Mougios V, Manios Y. Obesity in adolescence is associated with perinatal risk factors, parental BMI and sociodemographic characteristics. European journal of clinical nutrition. 2013;67(1):115-21.

Gluckman PD, Hanson MA, Beedle AS. Non‐genomic transgenerational inheritance of disease risk. Bioessays. 2007;29(2):145-54.

Yang W, Kelly T, He J. Genetic epidemiology of obesity. Epidemiologic reviews. 2007;29(1):49-61.

Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics. 2004;114(1):e29-e36.


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