Interaction effect of mobile gaming addiction and excessive sugar-sweetened beverage consumption on overweight and obesity among schoolchildren: Evidence from a large population-based study in Guangzhou, China.

Objective: To explore the individual and interactive associations between mobile gaming addiction (MGA), excessive consumption of sugar-sweetened beverages (SSBs), and overweight/obesity among schoolchildren, and to investigate whether these interactions vary by gender or grade level. Methods: Data were drawn from the Children's Growth Environment, Lifestyle, and Physical and Mental Health Development project (COHERENCE) conducted in Guangzhou, China, during the 2019/20 academic year. 418,197 children aged 6-12 years were included in the study. All participants were asked to complete an eligible questionnaire to provide details of their MGA over the past three months and SSBs consumption over the past week. Multiplicative and additive interaction models were performed to evaluate the interaction effects of MGA and excessive SSBs consumption on overweight/obesity, and variations by gender and grade level were also examined. Results: Excessive SSBs consumption was identified as a risk factor for childhood overweight/obesity, but MGA was not. However, the combination of MGA and excessive SSBs consumption was associated with an increased risk of overweight/obesity. This multiplicative interaction was significantly stronger in girls than in boys, with no differences observed across grade levels. Additionally, the additive interaction effect between MGA and excessive SSBs consumption was present only in girls and children in the lower elementary grades. Conclusions: This cross-sectional study found that the combination of MGA and excessive SSBs consumption is linked to an increased risk of childhood overweight/obesity, particularly in girls and children in lower elementary grades. These findings highlight the importance of addressing these factors together in targeted interventions.