Association between problematic internet use, socio-demographic variables and obesity among European adolescents.
Overweight of children and adolescents continues to be an important and alarming global public health problem. As the adolescent's time spent online has increased, problematic internet use (PIU) potentially leads to negative health consequences. This study aimed to examine the relation between PIU and overweight/obesity among adolescents in seven European countries and assess the effect of demographic and lifestyle factors recorded in the European Network for Adolescent Addictive Behaviour (EU NET ADB) survey (www.eunetadb.eu).



A cross-sectional school-based survey of 14- to 17-year-old adolescents was conducted in seven European countries: Germany, Greece, Iceland, the Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included sociodemographic data, internet usage characteristics, school achievement, parental control and the Internet Addiction Test. Associations between overweight/obesity and potential risk factors were investigated by logistic regression analysis, allowing for the complex sample design.



The study sample consisted of 10 287 adolescents aged 14-17 years. 12.4% were overweight/obese, and 14.1% presented with dysfunctional internet behavior. Greece had the highest percentage of overweight/obese adolescents (19.8%) and the Netherlands the lowest (6.8%). Male sex [odds ratio (OR) = 2.89, 95%CI: 2.46-3.38], heavier use of social networking sites (OR = 1.26, 95%CI: 1.09-1.46) and residence in Greece (OR = 2.32, 95%CI: 1.79-2.99) or Germany (OR = 1.48, 95%CI: 1.12-1.96) were independently associated with higher risk of overweight/obesity. A greater number of siblings (OR = 0.79, 95%CI: 0.64-0.97), higher school grades (OR = 0.74, 95%CI: 0.63-0.88), higher parental education (OR = 0.89, 95%CI: 0.82-0.97) and residence in the Netherlands (OR = 0.49, 95%CI: 0.31-0.77) independently predicted lower risk of overweight/obesity.



The results indicate an association of overweight/obesity with PIU and suggest the importance of formulating preventive public health policies that target physical health, education and sedentary online lifestyle early in adolescence with special attention to boys.
1 Adolescent Health Unit, Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece info@youth-health.gr.
Artemis K
AK
Tsitsika
1 Adolescent Health Unit, Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece.
Elisabeth K
EK
Andrie
2 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece.
Theodora
T
Psaltopoulou
1 Adolescent Health Unit, Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece.
Chara K
CK
Tzavara
2 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece.
Theodoros N
TN
Sergentanis
2 Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Athens, Greece.
Ioannis
I
Ntanasis-Stathopoulos
3 Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, University of Athens, Athens, Greece.
Flora
F
Bacopoulou
4 Panteion University of Social and Political Sciences, Athens, Greece.
Clive
C
Richardson
3 Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, University of Athens, Athens, Greece.
George P
GP
Chrousos
5 Second Department of Pediatrics, P. and A. Kyriakou Children's Hospital, University of Athens, Athens, Greece.
Maria
M
Tsolia
D000293:Adolescent; D000294:Adolescent Behavior; D016739:Behavior, Addictive / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D063766:Pediatric Obesity / Q000453:epidemiology*; D012307:Risk Factors; D057185:Sedentary Behavior; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires