Marzelina Karim,1,* Sidrah Darma,2,* Andi-Millaty Lantara3,*

1Department of Microbiology, Faculty of Medicine, Universitas Muslim Indonesia, Makassar, Indonesia; 2Department of Pediatrics, Faculty of Medicine, Universitas Muslim Indonesia, Makassar, Indonesia; 3Department of Physiology, Faculty of Medicine, Universitas Muslim Indonesia, Makassar, Indonesia

*These authors contributed equally to this work

Correspondence: Marzelina Karim, Faculty of Medicine, Universitas Muslim Indonesia, Urip Sumoharjo Street KM 05, Makassar, South Sulawesi, Indonesia, Email [email protected]

View the original paper by Prof. Dr. Chang and colleagues

We have read the paper by Chang et al on the Risk of Obesity Among Children Aged 2–6 Years Who Had Prolonged Screen time in Taiwan: A Nationwide Cross-Sectional Study.1 We congratulate the authors for their invaluable findings in the world of health education. Therefore we would like to share our views about this research which can build on and further develop this research if it will be continued in the future by other researchers who are also interested in doing the same research.

The study conducted by Chang et al aims to review and assess the risk of obesity in preschool children with prolonged screen time in Taiwan. Chang et al in their research found that prolonged screen time was not significantly associated with the risk of obesity, and this relationship was mediated by socio-demographic and lifestyle factors. But besides screen time and obesity, there are also some things that we need to pay attention to in assessing the correlation of these obesity risk factors, namely how much was the birth weight of children? How was the child’s diet?2 And what is the daily intake for children?3 Therefore, we suggest to Chang et al to add this objective to their future research so that they can test more effectively and efficiently on the same sample of preschool-aged children.1

This study used a nationwide cross-sectional method with random sampling. The method used by Chang et al is suitable but we would like to give a suggestion to try to continue with the cohort method. This survey method can see as a whole how the correlation is between risk factors in children who have been exposed to prolonged screen time and those who are not exposed to screen time with risk factors for obesity. This has also been done by Reyna-Vargas et al in reviewing the burden of the problem, describing related factors and their correlations, assessing the impact of screen time on the health of all preschool-aged children, and interventions to reduce screen time.3

In conclusion, we agree with Chang et al that their study can be used as a reference to observe the high prevalence of obesity and prolonged screen time among preschool children. Preschoolers with prolonged screen time may be at increased risk of obesity.1 According to the American Academy of Pediatrics that children who had prolonged screen time tend to experience a decrease in satiety so they continue to feel hungry and will increase their consumption of snacks and soft drinks or we can call it snacking.4 This observation is to support the health of preschool-age children, and future high-quality studies, such as conducting randomized controlled trials, are needed to demonstrate causality. However, direct observations are still needed to determine the correlation between screen time and obesity in preschool children.3

The authors report no conflicts of interest in this communication.

1. Chang RY, Chen TL, Yeh CC, et al. Risk of obesity among children aged 2–6 years who had prolonged screen time in Taiwan: a nationwide cross-sectional study. Clin Epidemiol. 2023;15:165–176. doi:10.2147/CLEP.S382956

2. Kaur N, Gupta M, Malhi P, Grover S. Screen time in under-five children. Indian Pediatr. 2019;56(9):773–788. PMID: 31638012. doi:10.1007/s13312-019-1638-8

3. Reyna-Vargas ME, Parmar A, Lefebvre DL, et al. Longitudinal associations between sleep habits, screen time and overweight, obesity in preschool children. Nat Sci Sleep. 2022;14:1237–1247. doi:10.2147/NSS.S363211

4. Strasburger VC; Council on Communications and Media. Children, adolescents, obesity, and the media. Pediatrics. 2011;128(1):201–208. doi:10.1542/peds.2011-1066

© 2023 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.