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      Digital Technology Use and BMI: Evidence From a Cross-sectional Analysis of an Adolescent Cohort Study


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          The use of digital technology such as mobile phones is ubiquitous in adolescents. However, excessive use may have adverse health effects, possibly partially mediated by disruptions to sleep.


          This study aims to assess the social predictors of digital technology use and their cross-sectional association with BMI z scores and being overweight in a large sample of adolescents.


          We used baseline data from a subset of a large adolescent cohort from 39 schools across Greater London who participated in the Study of Cognition, Adolescents and Mobile Phones (n=1473). Digital technology use included phone calls, internet use on mobile phones, and video gaming on any device. Multilevel regression was used to assess the associations between digital technology use and age-specific and sex-specific BMI z scores and being overweight (including obesity). Measurements were derived from height and weight, obtained by the Tanita BC-418 Body Composition Analyzer. We examined whether these associations were mediated by insufficient sleep.


          Generally, participants with lower socioeconomic status reported more use of digital technology. Controlling for socioeconomic status, internet use on mobile phones for more than 3 hours per day was associated with higher BMI z scores (adjusted β=.30, 95% CI 0.11-0.48) and greater odds of being overweight (adjusted odds ratio 1.60, 95% CI 1.09-2.34), compared with low use (≤30 minutes). Similar associations were found between video gaming and BMI z scores and being overweight. The BMI z score was more strongly related to weekday digital technology use (internet use on mobile phones and video gaming) than weekend use. Insufficient sleep partly mediated the associations between digital technology use and BMI z scores (proportion of mediation from 8.6% to 17.8%) by an indirect effect.


          We found an association between digital technology use and BMI in adolescents, partly mediated by insufficient sleep, suggesting that the underlying mechanisms may be multifactorial. Further research with longitudinal data is essential to explore the direction of the relationships.

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          Most cited references 49

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                Author and article information

                J Med Internet Res
                J Med Internet Res
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                July 2021
                5 July 2021
                : 23
                : 7
                [1 ] MRC Centre for Environment and Health Department of Epidemiology and Biostatistics Imperial College London London United Kingdom
                [2 ] National Institute for Health Research Health Protection Research Unit in Chemical and Radiation Threats and Hazards Imperial College London London United Kingdom
                [3 ] Department of Psychological Sciences Birkbeck, University of London London United Kingdom
                [4 ] Department of Epidemiology and Public Health Swiss Tropical and Public Health Institute Basel Switzerland
                [5 ] University of Basel Basel Switzerland
                [6 ] NIHR Biomedical Research Centre Imperial College London London United Kingdom
                [7 ] Mohn Centre for Children’s Health and Wellbeing School of Public Health Imperial College London London United Kingdom
                Author notes
                Corresponding Author: Mireille Toledano m.toledano@ 123456imperial.ac.uk
                ©Chen Shen, Iroise Dumontheil, Michael Thomas, Martin Röösli, Paul Elliott, Mireille Toledano. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 05.07.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                Original Paper
                Original Paper


                adolescent, digital technology, obesity, insufficient sleep, mediation analysis, mobile phone


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