Evidence map›Paper›PMID 41772512›Full record

ArticleBMC public health2026

Higher recreational screen time and lower step count are associated with higher cardiovascular disease risk in early adolescence.

Jason M Nagata, Nathan D Nguyen, Isaac Frimpong, Alexander Heuer, Christiane K Helmer, Abubakr A Al-Shoaibi, Kyle T Ganson, Alexander Testa, Erin E Dooley, Thomas P Le and 3 more

Abstract read
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In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jason M NagataDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, Box 0503, 550 16th Street, San Francisco, CA, 94143, USA. jason.nagata@ucsf.edu.
Nathan D NguyenDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, Box 0503, 550 16th Street, San Francisco, CA, 94143, USA.
Isaac FrimpongDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, Box 0503, 550 16th Street, San Francisco, CA, 94143, USA.
Alexander HeuerDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, Box 0503, 550 16th Street, San Francisco, CA, 94143, USA.
Christiane K HelmerDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, Box 0503, 550 16th Street, San Francisco, CA, 94143, USA.
Abubakr A Al-ShoaibiDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, Box 0503, 550 16th Street, San Francisco, CA, 94143, USA.
Kyle T GansonFactor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor St W, Toronto, ON, M5S 1V4, Canada.
Alexander TestaDepartment of Management, Policy and Community Health, University of Texas Health Science Center at Houston, 7000 Fannin St, Houston, TX, 77030, USA.
Erin E DooleyDepartment of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35233, USA.
Thomas P LeDepartment of Psychology, Bryn Mawr College, 151 N Merion Ave, Bryn Mawr, PA, 19010, USA.
Kelley Pettee GabrielDepartment of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35233, USA.
Fiona C BakerCenter for Health Sciences, SRI International, Menlo Park, 333 Ravenswood Ave, Menlo Park, CA, 94025, USA.
Holly C GoodingDivision of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Emory University School of Medicine, James B. Williams Medical Education Building, 100 Woodruff Circle, Atlanta, GA, 30322, USA.

Funding

Investigating relationships between problematic social media use and binge-eating disorder to inform precision guidance for adolescentsRF1MH135492 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI NAGATA, JASON M · 2025 to 2025
$1.9M
Longitudinal pathways between adolescent social media use and substance use: Informing evidence-based guidanceR01DA064134 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Jason M Nagata · 2025 to 2026
$1.5M
Informing national guidelines on adolescent and young adult physical activity and sedentary behavior to prevent cardiovascular diseaseK08HL159350 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI NAGATA, JASON M · 2021 to 2025
$869k
Doris Duke Charitable Foundation 2022056NHLBI NIH HHS K08 HL159350NHLBI NIH HHS K08HL159350NIDA NIH HHS R01 DA064134NIH HHS R01DA064134NIMH NIH HHS RF1 MH135492
6 · The paper itself

Abstract

backgroundAdolescence is a critical period for developing behaviors that affect lifelong cardiovascular health. While physical activity improves cardiovascular outcomes, excessive recreational screen time is linked to negative cardiovascular indicators. This study examined associations between screen time and physical activity with cardiovascular risk factors in a large, diverse sample of early adolescents.

methodsThis study included 4,443 adolescents from the Adolescent Brain Cognitive Development (ABCD) Study collected at Year 2 (2018–2020) and Year 4 (2020–2022). Screen time was self-reported and categorized as low (0–4), medium (> 4–8), or high (> 8) hours/day. Physical activity was measured via Fitbit step count over 3 weeks and categorized as low (1,000–6,000), medium (> 6,000–12,000), and high (> 12,000) steps/day. Outcomes included blood pressure percentile and hypertensive-range blood pressure, which were available for the full sample, while total cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL cholesterol, hemoglobin A1c, and testing consistent with diabetes were available in a subset (one-third) at Year 4. Adjusted linear and Poisson regression models examined joint associations of screen time and step count with cardiovascular health outcomes.

resultsAdolescents averaged 6.1 (± 5.1) hours/day of screen use and 9,280 (± 3,279) steps/day. Higher screen time and lower step count showed dose-response associations with higher diastolic blood pressure percentile (all p < 0.01). Compared to reference categories, high screen time (> 8 h/day) was associated with a 4.25-point increase in diastolic blood pressure percentile (95% confidence interval [CI] 1.85 to 6.65) and low step count (1,000–6,000 steps/day) was associated with a 7.15-point increase (95% CI 4.82 to 9.48). Both high screen time (adjusted risk ratio [ARR] 1.88, 95% CI 1.42 to 2.56) and low step count (ARR 2.35, 95% CI 1.88 to 2.94) were associated with increased risk of hypertensive-range blood pressure. Low step count was associated with -3.72 mg/dL lower HDL cholesterol (95% CI -6.52 to -2.92) and increased risk of low HDL cholesterol (ARR 2.05, 95% CI 1.79 to 2.36).

conclusionsHigher screen time and lower physical activity were associated with poorer cardiovascular health, supporting guidelines and early interventions promoting increased physical activity and reduced screen time.

Indexed as

Cardiovascular DiseasesExerciseHeart Disease Risk FactorsScreen TimeAdolescentFemaleHumansMaleBlood lipidsDigital mediaExerciseMetabolic healthPreventionTeenVascular healthYouth

Identifiers

PMID41772512
PMCPMC13059598

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.