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World J Clin Pediatr. Dec 9, 2026; 15(4): 124664
Published online Dec 9, 2026. doi: 10.5409/wjcp.124664
Published online Dec 9, 2026. doi: 10.5409/wjcp.124664
Screen time exposure, sleep alterations, and their relationship with excess weight in children and adolescents
Ana Pilar Nso-Roca, Department of Pediatrics, Hospital Universitario San Juan de Alicante, Alicante 03550, Alicante, Spain
Ana Pilar Nso-Roca, María Teresa Pastor-Fajardo, Francisco Sánchez-Ferrer, Department of Pediatrics, Universidad Miguel Hernández de Elche, San Juan de Alicante 03550, Alicante, Spain
Àurea Cartanyà-Hueso, Juana María Delgado-Saborit, Department of Medicine, Universitat Jaume I, Castellón de la Plana 12071, Castellón, Spain
María Teresa Pastor-Fajardo, Department of Pediatrics, Hospital General Universitario de Elche, Elche 03203, Alicante, Spain
Juana María Delgado-Saborit, Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Universitat Jaume I-Universitat de València, Valencia 46020, Valencia, Spain
Co-corresponding authors: Ana Pilar Nso-Roca and Juana María Delgado-Saborit.
Author contributions: Nso-Roca AP contributed to conceptualization and design of the research, methodology by defining clinical and biomarker data to be collected as well as the KIDMED, Krece Plus short, investigation by screening patients and acquiring clinical data, resources, data curation, project administration, supervision, funding acquisition, writing - original draft, review and editing the manuscript; Cartanyà-Hueso À contributed to formal analysis, data curation, visualization and writing - review and editing the manuscript; Pastor-Fajardo MT and Sánchez-Ferrer F contributed to methodology providing clinical advice on the suitability of the clinical and biomarker data to be collected as well as the KIDMED, Krece Plus short, investigation by screening patients and acquiring clinical data, data curation, and writing - review and editing the manuscript; Delgado-Saborit JM contributed to conceptualization and design of the research by defining the type of epidemiological study and target population, methodology by defining the test that evaluates daily leisure screen time exposure, the environmental factors and sleep habits, and statistical analysis to be implemented, investigation by contributing to data analysis, resources, data curation, project administration, supervision, funding acquisition, writing - original draft, review and editing the manuscript. All the authors have read and approved the final manuscript. Both Nso-Roca AP and Delgado-Saborit JM have played essential and complementary roles in the conception, execution, supervision, and manuscript preparation of this study as co-corresponding authors and co-principal investigators of the project that funded this research. Together, they secured the funding for the project, jointly conceptualized and designed the study, and provided overall scientific leadership throughout its development. Nso-Roca AP led the clinical component of the project, supervising and coordinating participant recruitment, data collection, and clinical investigation across the two participating hospitals. She was responsible for defining the clinical and biomarker data to be collected, overseeing data curation, and playing a central role on the preparation, revision, and editing of the manuscript from the clinical perspective. Delgado-Saborit JM led the epidemiological and analytical component of the project, defining the study design, target population, environmental and lifestyle exposure assessments, and the statistical analysis strategy. She supervised the data analysis and interpretation, contributed to data curation, and contributed to the drafting, revising, and editing the manuscript with a focus on the epidemiological and analytical aspects of the research. The complementary expertise and close collaboration between Nso-Roca AP and Delgado-Saborit JM, spanning clinical investigation, epidemiology, data analysis, project administration, supervision, and scientific writing, have been fundamental to the successful completion and publication of this manuscript.
AI contribution statement: The authors declare that an artificial intelligence (AI) tool (Gemini) was used during the preparation of this manuscript solely as an assistive technology for language refinement, proofreading, and improving stylistic flow. The authors have carefully reviewed, verified, and validated all AI-assisted outputs, ensuring strict terminology consistency and accuracy. The AI tool was not used to generate original scientific data, perform independent statistical analyses, or draw scientific conclusions. The authors assume full responsibility and accountability for the integrity, accuracy, originality, and scientific validity of the entire manuscript.
Supported by the Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana and Universitat Jaume I through the UJISABIO 2021 Call (acronym of the Project PLAGUICOM), No. A06; and the 1st Research Project Award on “Relación de los trastornos del sueño con el sobrepeso/obesidad en la población infanto-juvenil. Influencia de las nuevas tecnologías”, Granted by the Fundación del Sueño Mónica Duart and the Fundación Valenciana de Pediatría (Valencia, Spain).
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Ethics Committee of Hospital Universitario San Juan de Alicante (Protocol code: 23/052, date of approval: 9/08/2023) and by the Deontological Commission of the Universitat Jaume I (Protocol code: CD/74/2022).
Informed consent statement: Informed consent was obtained from all subjects involved in the study. For participants under 18 years of age, written informed consent was obtained from their parents or legal guardians.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request. The data are not publicly available due to privacy or ethical restrictions regarding participant information.
Corresponding author: Ana Pilar Nso-Roca, PhD, Professor, Department of Pediatrics, Hospital Universitario San Juan de Alicante, Alicante 03550, Alicante, Spain. anso@umh.es
Received: June 23, 2026
Revised: July 14, 2026
Accepted: August 3, 2026
Published online: December 9, 2026
Processing time: 90 Days and 16 Hours
Revised: July 14, 2026
Accepted: August 3, 2026
Published online: December 9, 2026
Processing time: 90 Days and 16 Hours
Core Tip
Core Tip: Insights into the synergistic impact of screen time and sleep quality on pediatric body composition are limited. We quantified visceral fat area and body composition using advanced bioimpedance software and investigated lifestyle factors that affect childhood obesity. It was revealed that increased daily screen time and poor sleep quality are heavily associated with higher visceral adiposity, while a high KIDMED score in patients with obesity often reflects reactive dietary changes rather than historical habits. With this knowledge, pediatricians can design more effective, multi-behavioral intervention strategies targeting digital habits and sleep hygiene alongside traditional nutritional counseling.