Childhood Obesity in the Digital Era: Impact of Screen Time, Sedentary Behaviour, and Dietary Patterns—A Narrative Review

Abstract

Background: Childhood obesity has emerged as a major global public health challenge, with the rapid expansion of digital technology contributing to substantial changes in children's and adolescents' lifestyles. Increasing exposure to television, smartphones, computers, video games, and other digital media has been associated with sedentary behaviour, unhealthy dietary practices, sleep disruption, and increased adiposity. Understanding the interaction between these factors is essential for developing effective prevention strategies in the digital era.

Objective: This narrative review aimed to synthesize available evidence regarding the impact of screen time, sedentary behaviour, and dietary patterns on childhood obesity and to examine the behavioural, physiological, parental, and socio-environmental factors that influence this relationship.

Methods: A narrative synthesis of published literature was undertaken using evidence from systematic and narrative reviews, cross-sectional studies, longitudinal cohort studies, randomized controlled trials, and intervention studies conducted across diverse geographical settings. The reviewed literature included children and adolescents from infancy to late adolescence and examined screen exposure, sedentary behaviour, dietary intake, physical activity, sleep, anthropometric indicators, and parental influences.

Results: The reviewed evidence demonstrated a consistent association between excessive screen time and increased body mass index and adiposity among children and adolescents. Television viewing, digital gaming, and mobile-device use may contribute to obesity through displacement of physical activity, increased sedentary time, screen-related snacking, exposure to marketing of energy-dense and nutrient-poor foods, and sleep disruption. Screen use during meals may promote distracted or “mindless” eating and increased energy intake. Unhealthy dietary patterns, including frequent consumption of fast foods and sugar-sweetened beverages and skipping breakfast, were also associated with higher screen exposure. Parental education, household media practices, and the presence of televisions or digital devices in children's bedrooms further influenced these behaviours. However, heterogeneity in study designs and reliance on self-reported measures limit conclusions regarding causality.

Conclusion: Childhood obesity in the digital era is a multifactorial problem involving the interaction of screen exposure, sedentary behaviour, dietary patterns, sleep, and family environments. Prevention should adopt a holistic, family-centred approach incorporating healthy nutrition, active play, appropriate screen-time management, adequate sleep, parental health literacy, and healthier digital environments. Long-term studies using objective measures are needed to evaluate sustainable interventions.