Screen Time Is Associated With Cardiometabolic and Cardiovascular Disease Risk in Childhood and Adolescence

David Horner; Marie Jahn; Klaus Bønnelykke; Bo L. Chawes; Trine Flensborg-Madsen; Ann-Marie Malby Schoos; Jakob Stokholm; Morten Arendt Rasmussen

doi:10.1161/JAHA.125.041486

Screen Time Is Associated With Cardiometabolic and Cardiovascular Disease Risk in Childhood and Adolescence

David Horner^*
, Marie Jahn
, Klaus Bønnelykke
, Bo L. Chawes
, Trine Flensborg-Madsen
, Ann-Marie Malby Schoos
, Jakob Stokholm
, Morten Arendt Rasmussen

^*Corresponding author for this work

Paediatrics (NSR)

Research output: Contribution to journal › Article › Research › peer-review

Abstract

BACKGROUND: Screen time in children and adolescents may be linked to cardiometabolic and cardiovascular risk.

METHODS: We analyzed data from >1000 participants in the COPSAC2010 and COPSAC2000 (Copenhagen Prospective Studies on Asthma in Childhood) mother-child 2000 and 2010 cohorts. Discretionary screen time, reported by parents or self, was assessed in relation to a composite cardiometabolic risk score based on Z scores of waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose. Secondary outcomes included insulin resistance, inflammation, lipoproteins, and anthropometry. A predicted cardiovascular risk score, derived from Cox models trained on UK Biobank data, was also assessed as an outcome. We evaluated whether lifestyle factors (sleep, physical activity, diet, puberty) moderated these associations. Blood nuclear magnetic resonance metabolomics were modeled using supervised machine learning to identify a metabolic screen-time signature.

RESULTS: Each additional hour of screen time was associated with higher cardiometabolic risk in both children (β=0.08 [0.01-0.14], P=0.021) and adolescents (β=0.13 [0.07-0.20], P=0.001). Sleep duration significantly moderated this association in both cohorts (childhood: P=0.029; adolescence: P=0.012), with higher risk among those with shorter sleep. Screen time was also associated with higher predicted cardiovascular risk in adolescence (β=0.07 [0.01-0.13], P=0.017). A screen time-associated metabolomic signature identified in childhood was validated in adolescence (β=0.14 [0.03-0.26], P=0.014).

CONCLUSIONS: Screen time was positively associated with cardiometabolic and cardiovascular risk, and these associations were stronger among children and adolescents with shorter sleep duration. These findings highlight the importance of jointly considering screen time and sleep patterns in the assessment of early-life risk factors for cardiometabolic and cardiovascular health.

Original language	English
Article number	e041486
Number of pages	13
Journal	Journal of the American Heart Association
Volume	14
Issue number	16
Early online date	6 Aug 2025
DOIs	https://doi.org/10.1161/JAHA.125.041486
Publication status	Published - 19 Aug 2025

Funding

All funding received by COPSAC is listed on www.copsac.com. The Lundbeck Foundation (grant numbers R16-A1694 and R269-2017-5), the Ministry of Health (grant number 903516), Danish Council for Strategic Research (grant number 0603-00280B), and the Capital Region Research Foundation have provided core support to the COPSAC research center. This project has received funding from the European Research Council under the European Union's Horizon 2020 research and innovation program (grant agreement number 946228) (B.C.). M.A.R. is funded by the Novo Nordisk Foundation (grant number NNF21OC0068517).

Funders	Funder number
Lundbeck Foundation	R16-A1694, R269-2017-5
Ministry of Health	903516
Danish Council for Strategic Research	0603-00280B
European Research Council under the EU's Horizon 2020 research and innovation program	946228
Novo Nordisk Foundation	NNF21OC0068517

Keywords

Adolescent
Blood Glucose
Cardiometabolic Risk Factors
Cardiovascular Diseases/epidemiology
Child
Female
Humans
Male
Prospective Studies
Risk Assessment
Risk Factors
Screen Time
Sleep
Time Factors
Adolescence
Metabolomics
Screen time
Cardiometabolic risk

Access to Document

10.1161/JAHA.125.041486

Cite this

@article{b92734c132e540f591f3caaa33cfe2ae,

title = "Screen Time Is Associated With Cardiometabolic and Cardiovascular Disease Risk in Childhood and Adolescence",

abstract = "BACKGROUND: Screen time in children and adolescents may be linked to cardiometabolic and cardiovascular risk.METHODS: We analyzed data from >1000 participants in the COPSAC2010 and COPSAC2000 (Copenhagen Prospective Studies on Asthma in Childhood) mother-child 2000 and 2010 cohorts. Discretionary screen time, reported by parents or self, was assessed in relation to a composite cardiometabolic risk score based on Z scores of waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose. Secondary outcomes included insulin resistance, inflammation, lipoproteins, and anthropometry. A predicted cardiovascular risk score, derived from Cox models trained on UK Biobank data, was also assessed as an outcome. We evaluated whether lifestyle factors (sleep, physical activity, diet, puberty) moderated these associations. Blood nuclear magnetic resonance metabolomics were modeled using supervised machine learning to identify a metabolic screen-time signature.RESULTS: Each additional hour of screen time was associated with higher cardiometabolic risk in both children (β=0.08 [0.01-0.14], P=0.021) and adolescents (β=0.13 [0.07-0.20], P=0.001). Sleep duration significantly moderated this association in both cohorts (childhood: P=0.029; adolescence: P=0.012), with higher risk among those with shorter sleep. Screen time was also associated with higher predicted cardiovascular risk in adolescence (β=0.07 [0.01-0.13], P=0.017). A screen time-associated metabolomic signature identified in childhood was validated in adolescence (β=0.14 [0.03-0.26], P=0.014).CONCLUSIONS: Screen time was positively associated with cardiometabolic and cardiovascular risk, and these associations were stronger among children and adolescents with shorter sleep duration. These findings highlight the importance of jointly considering screen time and sleep patterns in the assessment of early-life risk factors for cardiometabolic and cardiovascular health.",

keywords = "Adolescent, Blood Glucose, Cardiometabolic Risk Factors, Cardiovascular Diseases/epidemiology, Child, Female, Humans, Male, Prospective Studies, Risk Assessment, Risk Factors, Screen Time, Sleep, Time Factors, Adolescence, Metabolomics, Screen time, Cardiometabolic risk",

author = "David Horner and Marie Jahn and Klaus B{\o}nnelykke and Chawes, \{Bo L.\} and Trine Flensborg-Madsen and Schoos, \{Ann-Marie Malby\} and Jakob Stokholm and Rasmussen, \{Morten Arendt\}",

year = "2025",

month = aug,

day = "19",

doi = "10.1161/JAHA.125.041486",

language = "English",

volume = "14",

journal = "Journal of the American Heart Association",

issn = "2047-9980",

publisher = "American Heart Association Inc.",

number = "16",

}

TY - JOUR

T1 - Screen Time Is Associated With Cardiometabolic and Cardiovascular Disease Risk in Childhood and Adolescence

AU - Horner, David

AU - Jahn, Marie

AU - Bønnelykke, Klaus

AU - Chawes, Bo L.

AU - Flensborg-Madsen, Trine

AU - Schoos, Ann-Marie Malby

AU - Stokholm, Jakob

AU - Rasmussen, Morten Arendt

PY - 2025/8/19

Y1 - 2025/8/19

N2 - BACKGROUND: Screen time in children and adolescents may be linked to cardiometabolic and cardiovascular risk.METHODS: We analyzed data from >1000 participants in the COPSAC2010 and COPSAC2000 (Copenhagen Prospective Studies on Asthma in Childhood) mother-child 2000 and 2010 cohorts. Discretionary screen time, reported by parents or self, was assessed in relation to a composite cardiometabolic risk score based on Z scores of waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose. Secondary outcomes included insulin resistance, inflammation, lipoproteins, and anthropometry. A predicted cardiovascular risk score, derived from Cox models trained on UK Biobank data, was also assessed as an outcome. We evaluated whether lifestyle factors (sleep, physical activity, diet, puberty) moderated these associations. Blood nuclear magnetic resonance metabolomics were modeled using supervised machine learning to identify a metabolic screen-time signature.RESULTS: Each additional hour of screen time was associated with higher cardiometabolic risk in both children (β=0.08 [0.01-0.14], P=0.021) and adolescents (β=0.13 [0.07-0.20], P=0.001). Sleep duration significantly moderated this association in both cohorts (childhood: P=0.029; adolescence: P=0.012), with higher risk among those with shorter sleep. Screen time was also associated with higher predicted cardiovascular risk in adolescence (β=0.07 [0.01-0.13], P=0.017). A screen time-associated metabolomic signature identified in childhood was validated in adolescence (β=0.14 [0.03-0.26], P=0.014).CONCLUSIONS: Screen time was positively associated with cardiometabolic and cardiovascular risk, and these associations were stronger among children and adolescents with shorter sleep duration. These findings highlight the importance of jointly considering screen time and sleep patterns in the assessment of early-life risk factors for cardiometabolic and cardiovascular health.

AB - BACKGROUND: Screen time in children and adolescents may be linked to cardiometabolic and cardiovascular risk.METHODS: We analyzed data from >1000 participants in the COPSAC2010 and COPSAC2000 (Copenhagen Prospective Studies on Asthma in Childhood) mother-child 2000 and 2010 cohorts. Discretionary screen time, reported by parents or self, was assessed in relation to a composite cardiometabolic risk score based on Z scores of waist circumference, systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, and glucose. Secondary outcomes included insulin resistance, inflammation, lipoproteins, and anthropometry. A predicted cardiovascular risk score, derived from Cox models trained on UK Biobank data, was also assessed as an outcome. We evaluated whether lifestyle factors (sleep, physical activity, diet, puberty) moderated these associations. Blood nuclear magnetic resonance metabolomics were modeled using supervised machine learning to identify a metabolic screen-time signature.RESULTS: Each additional hour of screen time was associated with higher cardiometabolic risk in both children (β=0.08 [0.01-0.14], P=0.021) and adolescents (β=0.13 [0.07-0.20], P=0.001). Sleep duration significantly moderated this association in both cohorts (childhood: P=0.029; adolescence: P=0.012), with higher risk among those with shorter sleep. Screen time was also associated with higher predicted cardiovascular risk in adolescence (β=0.07 [0.01-0.13], P=0.017). A screen time-associated metabolomic signature identified in childhood was validated in adolescence (β=0.14 [0.03-0.26], P=0.014).CONCLUSIONS: Screen time was positively associated with cardiometabolic and cardiovascular risk, and these associations were stronger among children and adolescents with shorter sleep duration. These findings highlight the importance of jointly considering screen time and sleep patterns in the assessment of early-life risk factors for cardiometabolic and cardiovascular health.

KW - Adolescent

KW - Blood Glucose

KW - Cardiometabolic Risk Factors

KW - Cardiovascular Diseases/epidemiology

KW - Child

KW - Female

KW - Humans

KW - Male

KW - Prospective Studies

KW - Risk Assessment

KW - Risk Factors

KW - Screen Time

KW - Sleep

KW - Time Factors

KW - Adolescence

KW - Metabolomics

KW - Screen time

KW - Cardiometabolic risk

U2 - 10.1161/JAHA.125.041486

DO - 10.1161/JAHA.125.041486

M3 - Article

C2 - 40767283

SN - 2047-9980

VL - 14

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

IS - 16

M1 - e041486

ER -

Screen Time Is Associated With Cardiometabolic and Cardiovascular Disease Risk in Childhood and Adolescence

Abstract

Funding

Keywords

Access to Document

Fingerprint

Cite this