Sleep duration and screen time in children and adolescents: Simultaneous moderation role in the relationship between waist circumference and cardiometabolic risk according to physical activity

Abstract To evaluate the simultaneous moderating role of sleep duration and screen time in the relationship between waist circumference (WC) and clustered cardiometabolic risk score (cMetS) according to children and adolescents' physical activity. A cross‐sectional study was conducted on 3072 children and adolescents (aged 6–17 years, 57.5% girls). Physical activity, sleep duration, and screen time were assessed through a self‐report questionnaire. The cMetS was determined by averaging the z‐scores of risk factors and dividing it by four. Moderation analyses were tested through multiple linear regression models. Among physically active individuals, sleep duration ( p = 0.85) and screen time ( p = 0.96) had no influence on the relationship between WC and cMetS. However, a positive interaction between WC x screen time and cMetS ( p = 0.04) was observed for physically inactive participants. Concerning sleep duration, there was no interaction with WC. Participants who spent 60 min of screen time presented lower cMetS, even presenting high WC, compared to the higher tertiles of screen time (180 and 360 min). However, although the interaction between sleep duration and WC was not significant, it was observed that the lowest tertile of sleep duration (482 min) combined with 60 min of screen time presented lower cMetS even with the presence of high WC. Our findings encourage compliance with physical activity guidelines associated with the adoption of adequate screen time to minimize the influence of waist circumference on cMetS.