{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T22:26:22Z","timestamp":1794522382338,"version":"4.9.1"},"reference-count":98,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Adolescence is a critical period in human life, associated with reduced physical activity and increased sedentary behaviors. In this systematic review and dose-response meta-analysis, we evaluated the association between screen time and risk of overweight\/obesity among adolescents.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A systematic search in electronic databases, including PubMed, Embase, and Scopus was performed up to September 2021. All published studies evaluating the association between screen time and risk of overweight\/obesity among adolescents were retrieved. Finally, a total of 44 eligible studies were included in the meta-analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The results of the two-class meta-analysis showed that adolescents at the highest category of screen time were 1.27 times more likely to develop overweight\/obesity (OR\u2009=\u20091.273; 95% CI\u2009=\u20091.166\u20131.390; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001; I-squared (variation in ES attributable to heterogeneity)\u2009=\u200982.1%). The results of subgrouping showed that continent and setting were the possible sources of heterogeneity. Moreover, no evidence of non-linear association between increased screen time and risk of overweight\/obesity among adolescents was observed (P-nonlinearity\u2009=\u20090.311).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>For the first time, the current systematic review and meta-analysis revealed a positive association between screen time and overweight\/obesity among adolescents without any dose-response evidence.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>The protocol of the current work has been registered in the PROSPERO system (Registration number: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=233899\">CRD42021233899<\/jats:ext-link>).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12875-022-01761-4","type":"journal-article","created":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T23:05:52Z","timestamp":1656371152000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":147,"title":["Screen time increases overweight and obesity risk among adolescents: a systematic review and dose-response meta-analysis"],"prefix":"10.1186","volume":"23","author":[{"given":"Purya","family":"Haghjoo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goli","family":"Siri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ensiye","family":"Soleimani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdieh Abbasalizad","family":"Farhangi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira","family":"Alesaeidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"1761_CR1","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.adolescence.2016.01.005","volume":"48","author":"V Suchert","year":"2016","unstructured":"Suchert V, Hanewinkel R, Isensee B. Screen time, weight status and the self-concept of physical attractiveness in adolescents. J Adolesc. 2016;48:11\u20137.","journal-title":"J Adolesc"},{"issue":"11","key":"1761_CR2","doi-asserted-by":"publisher","first-page":"906e913","DOI":"10.1136\/bjsports-2011-090192","volume":"45","author":"RR Pate","year":"2011","unstructured":"Pate RR, Mitchell J, Byun W, Dowda M. Sedentary behaviour in youth. Br J Sports Med. 2011;45(11):906e913.","journal-title":"Br J Sports Med"},{"issue":"6","key":"1761_CR3","first-page":"534e540","volume":"30","author":"LL Hardy","year":"2006","unstructured":"Hardy LL, Dobbins T, Booth ML, Denney-Wilson E, Okely AD. Sedentary behaviours among Australian adolescents. Aust New Zealand. J Public Health. 2006;30(6):534e540.","journal-title":"J Public Health"},{"key":"1761_CR4","doi-asserted-by":"crossref","unstructured":"Domoff SE, Sutherland E, Yokum S, Gearhardt AN. The association of adolescents\u2019 television viewing with body mass index percentile, food addiction, and addictive phone use. Appetite. 2021:157;104990.","DOI":"10.1016\/j.appet.2020.104990"},{"issue":"5","key":"1761_CR5","doi-asserted-by":"publisher","first-page":"933","DOI":"10.5993\/AJHB.45.5.13","volume":"45","author":"RT Fairman","year":"2021","unstructured":"Fairman RT, Weaver SR, Akani BC, Dixon K, Popova L. \u201cYou have to vape to make it through\u201d: E-cigarette outcome expectancies among youth and parents. Am J Health Behav. 2021;45(5):933\u201346.","journal-title":"Am J Health Behav"},{"key":"1761_CR6","first-page":"1","volume-title":"The common sense census: media use by tweens and teens","author":"V Rideout","year":"2021","unstructured":"Rideout V, Robb M. The common sense census: media use by tweens and teens: Common Sense; 2021. p. 1\u2013104."},{"key":"1761_CR7","doi-asserted-by":"crossref","unstructured":"Throuvala MA, Griffiths MD, Rennoldson M, Kuss DJ. The role of recreational online activities in school-based screen time sedentary behaviour interventions for adolescents: a systematic and critical literature review. Int J Ment Heal Addict. 2021;19:1065\u2013115.","DOI":"10.1007\/s11469-019-00213-y"},{"issue":"6","key":"1761_CR8","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1037\/emo0000403","volume":"18","author":"JM Twenge","year":"2018","unstructured":"Twenge JM, Martin GN, Campbell WK. Decreases in psychological well-being among American adolescents after 2012 and links to screen time during the rise of smartphone technology. Emotion. 2018;18(6):765\u201380.","journal-title":"Emotion"},{"issue":"4","key":"1761_CR9","doi-asserted-by":"publisher","first-page":"657","DOI":"10.5993\/AJHB.45.4.5","volume":"45","author":"J Zhou","year":"2021","unstructured":"Zhou J, Li Z, Meng H, Chang Y-C, Peng N-H, Wei B. Chinese parental awareness of Children's COVID-19 protective measures. Am J Health Behav. 2021;45(4):657\u201364.","journal-title":"Am J Health Behav"},{"issue":"6","key":"1761_CR10","doi-asserted-by":"publisher","first-page":"756","DOI":"10.5993\/AJHB.44.6.2","volume":"44","author":"K Schroeder","year":"2020","unstructured":"Schroeder K, Kubik MY, Sirard JR, Lee J, Fulkerson JA. Sleep is inversely associated with sedentary time among youth with obesity. Am J Health Behav. 2020;44(6):756\u201364.","journal-title":"Am J Health Behav"},{"issue":"5","key":"1761_CR11","doi-asserted-by":"publisher","first-page":"828","DOI":"10.5993\/AJHB.45.5.3","volume":"45","author":"R Kamolthip","year":"2021","unstructured":"Kamolthip R, Fung XC, Lin C-Y, Latner JD, O'Brien KS. Relationships among physical activity, health-related quality of life, and weight stigma in children in Hong Kong. Am J Health Behav. 2021;45(5):828\u201342.","journal-title":"Am J Health Behav"},{"key":"1761_CR12","first-page":"117","volume":"48","author":"M Lutz","year":"2021","unstructured":"Lutz M, Vargas C, Stojanova J, Arancibia M. Diet and depressive disorders. Arch Clin Psychiatry (S\u00e3o Paulo). 2021;48:117\u201322.","journal-title":"Arch Clin Psychiatry (S\u00e3o Paulo)"},{"issue":"1","key":"1761_CR13","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1139\/H11-012","volume":"36","author":"MS Tremblay","year":"2011","unstructured":"Tremblay MS, LeBlanc AG, Janssen I, Kho ME, Hicks A, Murumets K, et al. Canadian sedentary behaviour guidelines for children and youth. Appl Physiol Nutr Metab. 2011;36(1):59\u201364.","journal-title":"Appl Physiol Nutr Metab"},{"issue":"4","key":"1761_CR14","doi-asserted-by":"publisher","first-page":"353","DOI":"10.3109\/17477160902934777","volume":"4","author":"SB Sisson","year":"2009","unstructured":"Sisson SB, Church TS, Martin CK, Tudor-Locke C, Smith SR, Bouchard C, et al. Profiles of sedentary behavior in children and adolescents: the US National Health and nutrition examination survey, 20012006. Int J Pediatr Obes. 2009;4(4):353\u20139.","journal-title":"Int J Pediatr Obes"},{"key":"1761_CR15","first-page":"1","volume-title":"Health policy for children and adolescents","author":"C Currie","year":"2012","unstructured":"Currie C, Zanotti C, Morgan A. Social determinants of health and well-being among young people health behaviour in school-aged children (HBSC): international report from the 2009\/2010 survey. In:  Health policy for children and adolescents: WHO Regional Office for Europe; 2012. p. 1\u2013252."},{"issue":"6","key":"1761_CR16","doi-asserted-by":"publisher","first-page":"780","DOI":"10.5993\/AJHB.44.6.4","volume":"44","author":"D Tang","year":"2020","unstructured":"Tang D, Bu T, Feng Q, Liu Y, Dong X. Differences in overweight and obesity between the north and south of China. Am J Health Behav. 2020;44(6):780\u201393.","journal-title":"Am J Health Behav"},{"issue":"6","key":"1761_CR17","doi-asserted-by":"publisher","first-page":"e007172","DOI":"10.1136\/bmjopen-2014-007172","volume":"5","author":"NA Coombs","year":"2015","unstructured":"Coombs NA, Stamatakis E. Associations between objectively assessed and questionnaire-based sedentary behaviour with BMI-defined obesity among general population children and adolescents living in England. BMJ Open. 2015;5(6):e007172.","journal-title":"BMJ Open"},{"issue":"6","key":"1761_CR18","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1002\/j.1550-8528.1997.tb00576.x","volume":"5","author":"M Guillaume","year":"1997","unstructured":"Guillaume M, Lapidus L, Bj\u00f6rntorp P, Lambert A. Physical activity, obesity, and cardiovascular risk factors in children. The Belgian Luxembourg child study II. Obes Res. 1997;5(6):549\u201356.","journal-title":"Obes Res"},{"issue":"1","key":"1761_CR19","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/sj.ijo.0802750","volume":"29","author":"V Burke","year":"2005","unstructured":"Burke V, Beilin LJ, Simmer K, Oddy WH, Blake KV, Doherty D, et al. Predictors of body mass index and associations with cardiovascular risk factors in Australian children: a prospective cohort study. Int J Obes. 2005;29(1):15\u201323.","journal-title":"Int J Obes"},{"key":"1761_CR20","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1186\/1471-2458-10-274","volume":"10","author":"D Martinez-Gomez","year":"2010","unstructured":"Martinez-Gomez D, Rey-L\u00f3pez JP, Chill\u00f3n P, G\u00f3mez-Mart\u00ednez S, Vicente-Rodr\u00edguez G, Mart\u00edn-Matillas M, et al. Excessive TV viewing and cardiovascular disease risk factors in adolescents. The AVENA cross-sectional study. BMC Public Health. 2010;10:274.","journal-title":"BMC Public Health"},{"issue":"2","key":"1761_CR21","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1123\/pes.22.2.245","volume":"22","author":"J Mota","year":"2010","unstructured":"Mota J, Ribeiro JC, Carvalho J, Santos MP, Martins J. Television viewing and changes in body mass index and cardiorespiratory fitness over a two-year period in schoolchildren. Pediatr Exerc Sci. 2010;22(2):245\u201353.","journal-title":"Pediatr Exerc Sci"},{"key":"1761_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1590\/1980-0037.2020v22e60449","volume":"22","author":"MJ Franceschin","year":"2020","unstructured":"Franceschin MJ, da Veiga GV. Association of cardiorespiratory fitness, physical activity level, and sedentary behaviour with overweight in adolescents. Revista Brasileira de Cineantropometria e Desempenho Humano. 2020;22:1\u201312.","journal-title":"Revista Brasileira de Cineantropometria e Desempenho Humano."},{"issue":"1","key":"1761_CR23","first-page":"35","volume":"44","author":"S Safiri","year":"2015","unstructured":"Safiri S, Kelishadi R, Qorbani M, Abbasi-Ghah-Ramanloo A, Motlagh ME, Ardalan G, et al. Screen time and its relation to cardiometabolic risk among children and adolescents: the CASPIAN-III study. Iran J Public Health. 2015;44(1):35\u201344.","journal-title":"Iran J Public Health"},{"key":"1761_CR24","doi-asserted-by":"crossref","unstructured":"Ulaganathan V, Kandiah M, Shariff ZM. A case\u2013control study on the association of abdominal obesity and hypercholesterolemia with the risk of colorectal cancer. J Carcinogenesis. 2018;17.","DOI":"10.4103\/jcar.JCar_2_18"},{"issue":"1","key":"1761_CR25","first-page":"49","volume":"10","author":"HA Putrawan","year":"2019","unstructured":"Putrawan HA, Antariksa B, Yunus F, Basalamah MA, Nurwidya F. Prevalence of pulmonary hypertension in indonesian patients with stable chronic obstructive pulmonary disease. J Nat Sci Biol Med. 2019;10(1):49.","journal-title":"J Nat Sci Biol Med"},{"issue":"10","key":"1761_CR26","doi-asserted-by":"publisher","first-page":"1838","DOI":"10.1017\/S1368980019004592","volume":"23","author":"L Cheng","year":"2020","unstructured":"Cheng L, Li Q, Hebestreit A, Song Y, Wang D, Cheng Y, et al. The associations of specific school-and individual-level characteristics with obesity among primary school children in Beijing, China. Public Health Nutrition. 2020;23(10):1838\u201345.","journal-title":"Public Health Nutrition"},{"key":"1761_CR27","doi-asserted-by":"crossref","unstructured":"Dalamaria T, De Jesus Pinto W, Dos Santos Farias E, De Souza OF. Internet addiction among adolescents in a western brazilian amazonian city. Revista Paulista de. Pediatria. 2021;39.","DOI":"10.1590\/1984-0462\/2021\/39\/2019270"},{"key":"1761_CR28","doi-asserted-by":"crossref","unstructured":"Lopez-Gonzalez D, Partida-Gayt\u00e1n A, Wells JC, Reyes-Delpech P, Avila-Rosano F, Ortiz-Obregon M, et al. Obesogenic lifestyle and its influence on adiposity in children and adolescents, evidence from mexico. Nutrients. 2020;12(3).","DOI":"10.3390\/nu12030819"},{"key":"1761_CR29","doi-asserted-by":"crossref","unstructured":"Haidar A, Ranjit N, Archer N, Hoelscher DM. Parental and peer social support is associated with healthier physical activity behaviors in adolescents: a cross-sectional analysis of Texas school physical activity and nutrition (TX SPAN) data. BMC Public Health. 2019;19(1).","DOI":"10.1186\/s12889-019-7001-0"},{"key":"1761_CR30","doi-asserted-by":"crossref","unstructured":"Kerkadi A, Sadig AH, Bawadi H, Thani AAMA, Chetachi WA, Akram H, et al. The relationship between lifestyle factors and obesity indices among adolescents in Qatar. Int J Environ Res Public Health. 2019;16(22).","DOI":"10.3390\/ijerph16224428"},{"issue":"2","key":"1761_CR31","first-page":"205","volume":"16","author":"M Saha","year":"2018","unstructured":"Saha M, Adhikary DK, Parvin I, Sharma YR, Akhter F, Majumder M. Obesity and its risk factors of among school children in Sylhet, Bangladesh. J Nepal Health Res Counc. 2018;16(2):205\u20138.","journal-title":"J Nepal Health Res Counc"},{"issue":"6","key":"1761_CR32","doi-asserted-by":"publisher","first-page":"303","DOI":"10.2188\/jea.JE20080095","volume":"19","author":"Y Sun","year":"2009","unstructured":"Sun Y, Sekine M, Kagamimori S. Lifestyle and overweight among Japanese adolescents: the Toyama birth cohort study. J Epidemiol. 2009;19(6):303\u201310.","journal-title":"J Epidemiol"},{"issue":"4","key":"1761_CR33","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1007\/s10903-018-0841-3","volume":"21","author":"T Zulfiqar","year":"2019","unstructured":"Zulfiqar T, Strazdins L, Dinh H, Banwell C, D'Este C. Drivers of overweight\/obesity in 4-11 year old children of Australians and immigrants; evidence from growing up in Australia. J Immigr Minor Health. 2019;21(4):737\u201350.","journal-title":"J Immigr Minor Health"},{"issue":"1","key":"1761_CR34","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1080\/17477160701520132","volume":"3","author":"AE Collins","year":"2008","unstructured":"Collins AE, Pakiz B, Rock CL. Factors associated with obesity in Indonesian adolescents. Int J Pediatr Obes. 2008;3(1):58\u201364.","journal-title":"Int J Pediatr Obes"},{"key":"1761_CR35","doi-asserted-by":"crossref","unstructured":"De Lima TR, Moraes MS, Andrade JHC, De Farias JM, Silva DAS. Associated factors with the isolated and simultaneous presence of overweight and abdominal obesity in adolescents. Revista Paulista de Pediatria. 2020;38.","DOI":"10.1590\/1984-0462\/2020\/38\/2018332"},{"issue":"4","key":"1761_CR36","first-page":"81","volume":"9","author":"RA Alyoubi","year":"2020","unstructured":"Alyoubi RA, Kobeisy SA, Souror HN, Alkhaldi FA, Aldajam MA, Allebdi KS, et al. Active screen time habits and headache features among adolescents and young adults in Saudi Arabia. Int J Pharm Res Allied Sci. 2020;9(4):81\u20136.","journal-title":"Int J Pharm Res Allied Sci"},{"issue":"7","key":"1761_CR37","doi-asserted-by":"publisher","first-page":"1472","DOI":"10.1177\/1359105314556161","volume":"21","author":"I Amigo","year":"2016","unstructured":"Amigo I, Pe\u00f1a E, Errasti JM, Busto R. Sedentary versus active leisure activities and their relationship with sleeping habits and body mass index in children of 9 and 10\u2009years of age. J Health Psychol. 2016;21(7):1472\u201380.","journal-title":"J Health Psychol"},{"issue":"4","key":"1761_CR38","doi-asserted-by":"publisher","first-page":"264","DOI":"10.7326\/0003-4819-151-4-200908180-00135","volume":"151","author":"D Moher","year":"2009","unstructured":"Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264\u20139.","journal-title":"Ann Intern Med"},{"key":"1761_CR39","doi-asserted-by":"crossref","unstructured":"Zhang Y, Zhang X, Li J, Zhong H, Pan CW. Associations of outdoor activity and screen time with adiposity: findings from rural Chinese adolescents with relatively low adiposity risks. BMC Public Health. 2020;20(1).","DOI":"10.1186\/s12889-020-09897-7"},{"issue":"1","key":"1761_CR40","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/ijo.2011.244","volume":"37","author":"E De Jong","year":"2013","unstructured":"De Jong E, Visscher TLS, Hirasing RA, Heymans MW, Seidell JC, Renders CM. Association between TV viewing, computer use and overweight, determinants and competing activities of screen time in 4- to 13-year-old children. Int J Obes. 2013;37(1):47\u201353.","journal-title":"Int J Obes"},{"issue":"5","key":"1761_CR41","doi-asserted-by":"publisher","first-page":"e0216455","DOI":"10.1371\/journal.pone.0216455","volume":"14","author":"D Rinc\u00f3n-Pab\u00f3n","year":"2019","unstructured":"Rinc\u00f3n-Pab\u00f3n D, Uraz\u00e1n-Hern\u00e1ndez Y, Gonz\u00e1lez-Santamar\u00eda J. Association between the time spent watching television and the sociodemographic characteristics with the presence of overweight and obesity in Colombian adolescents (secondary analysis of the ENSIN 2010). Plos One. 2019;14(5):e0216455.","journal-title":"Plos One"},{"issue":"4","key":"1761_CR42","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1177\/0049475518786664","volume":"48","author":"N Mansoori","year":"2018","unstructured":"Mansoori N, Nisar N, Shahid N, Mubeen SM, Ahsan S. Prevalence of obesity and its risk factors among school children in Karachi, Pakistan. Trop Doct. 2018;48(4):266\u20139.","journal-title":"Trop Doct"},{"issue":"1","key":"1761_CR43","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1186\/s13104-018-3292-y","volume":"11","author":"I Godakanda","year":"2018","unstructured":"Godakanda I, Abeysena C, Lokubalasooriya A. Sedentary behavior during leisure time, physical activity and dietary habits as risk factors of overweight among school children aged 14-15 years: case control study. BMC Res Notes. 2018;11(1):186.","journal-title":"BMC Res Notes"},{"issue":"1","key":"1761_CR44","first-page":"20","volume":"64","author":"MA Talat","year":"2016","unstructured":"Talat MA, El Shahat E. Prevalence of overweight and obesity among preparatory school adolescents in urban Sharkia governorate, Egypt. Egypt Pediatr Assoc Gaz. 2016;64(1):20\u20135.","journal-title":"Egypt Pediatr Assoc Gaz"},{"key":"1761_CR45","unstructured":"Moradi G, Mostafavi F, Azadi N, Esmaeilnasab N, Nouri B. Evaluation of screen time activities and their relationship with physical activity, overweight and socioeconomic status in children 10-12 years of age in Sanandaj, Iran: a cross-sectional study in 2015. Med J Islam Repub Iran. 2016;30(1)."},{"issue":"2","key":"1761_CR46","first-page":"216","volume":"27","author":"A Watharkar","year":"2015","unstructured":"Watharkar A, Nigam S, Martolia DS, Varma P, Barman SK, Sharma RP. Assessment of risk factors for overweight and obesity among school going children in Kanpur, Uttar Pradesh. Indian J Community Health. 2015;27(2):216\u201322.","journal-title":"Indian J Community Health"},{"issue":"4","key":"1761_CR47","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.rpped.2015.04.001","volume":"33","author":"JMS De Lucena","year":"2015","unstructured":"De Lucena JMS, Cheng LA, Cavalcante TLM, Da Silva VA, De Farias JC. Prevalence of excessive screen time and associated factors in adolescents. Revista Paulista de Pediatria. 2015;33(4):407\u201314.","journal-title":"Revista Paulista de Pediatria"},{"key":"1761_CR48","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/1471-2431-14-258","volume":"14","author":"CM Vel\u00e1squez-Rodr\u00edguez","year":"2014","unstructured":"Vel\u00e1squez-Rodr\u00edguez CM, Vel\u00e1squez-Villa M, G\u00f3mez-Ocampo L, Berm\u00fadez-Cardona J. Abdominal obesity and low physical activity are associated with insulin resistance in overweight adolescents: a cross-sectional study. BMC Pediatr. 2014;14:258.","journal-title":"BMC Pediatr"},{"issue":"4","key":"1761_CR49","first-page":"204","volume":"4","author":"S Ercan","year":"2012","unstructured":"Ercan S, Dallar YB, \u00d6nen S, Engiz O. Prevalence of obesity and associated risk factors among adolescents in Ankara, Turkey. J Clin Res Pediatr Endocrinol. 2012;4(4):204\u20137.","journal-title":"J Clin Res Pediatr Endocrinol"},{"issue":"2","key":"1761_CR50","doi-asserted-by":"publisher","first-page":"e296","DOI":"10.1542\/peds.2011-2898","volume":"130","author":"KM Drake","year":"2012","unstructured":"Drake KM, Beach ML, Longacre MR, MacKenzie T, Titus LJ, Rundle AG, et al. Influence of sports, physical education, and active commuting to school on adolescent weight status. Pediatrics. 2012;130(2):e296\u2013304.","journal-title":"Pediatrics"},{"key":"1761_CR51","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/1824-7288-38-31","volume":"38","author":"AF Adesina","year":"2012","unstructured":"Adesina AF, Peterside O, Anochie I, Akani NA. Weight status of adolescents in secondary schools in port Harcourt using body mass index (BMI). Ital J Pediatr. 2012;38:31.","journal-title":"Ital J Pediatr"},{"issue":"3","key":"1761_CR52","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1089\/chi.2011.0008","volume":"7","author":"AH El-Gilany","year":"2011","unstructured":"El-Gilany AH, El-Masry R. Overweight and obesity among adolescent school students in Mansoura, Egypt. Child Obes. 2011;7(3):215\u201322.","journal-title":"Child Obes"},{"issue":"4","key":"1761_CR53","doi-asserted-by":"publisher","first-page":"388","DOI":"10.3346\/jkms.2012.27.4.388","volume":"27","author":"W Byun","year":"2012","unstructured":"Byun W, Dowda M, Pate RR. Associations between screen-based sedentary behavior and cardiovascular disease risk factors in Korean youth. J Korean Med Sci. 2012;27(4):388\u201394.","journal-title":"J Korean Med Sci"},{"key":"1761_CR54","doi-asserted-by":"publisher","first-page":"1600324","DOI":"10.1002\/mnfr.201600324","volume":"61","author":"CE Cho","year":"2017","unstructured":"Cho CE, Taesuwan S, Malysheva OV, Bender E, Tulchinsky NF, Yan J. Trimethylamine-N-oxide (TMAO) response to animal source foods varies among healthy young men and is influenced by their gut microbiota composition: a randomized controlled trial. Mol Nutr Food Res. 2017;61:1600324.","journal-title":"Mol Nutr Food Res"},{"key":"1761_CR55","volume-title":"Oxford English Dictionary","author":"Oxford University Press","year":"2020","unstructured":"Oxford University Press. Oxford English Dictionary. Oxford: Oxford University Press; 2020."},{"key":"1761_CR56","volume-title":"Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age","author":"World Health Organization","year":"2020","unstructured":"World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age. 2020; Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/311664."},{"key":"1761_CR57","volume-title":"Adolescent health in the South-East Asia region","author":"Organization, W.H","year":"2020","unstructured":"Organization, W.H. Adolescent health in the South-East Asia region. 2020; Available from: https:\/\/www.who.int\/southeastasia\/health-topics\/adolescent-health."},{"issue":"SUPP.1","key":"1761_CR58","first-page":"13","volume":"52","author":"DO., M","year":"2008","unstructured":"DO., M. The new WHO child growth standards. Paediatr Croat Suppl. 2008;52(SUPP.1):13\u20137.","journal-title":"Paediatr Croat Suppl"},{"key":"1761_CR59","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1136\/bmj.320.7244.1240","volume":"320","author":"TJ Cole","year":"2000","unstructured":"Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240\u20133.","journal-title":"BMJ"},{"key":"1761_CR60","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s11325-012-0677-3","volume":"17","author":"A Anandam","year":"2013","unstructured":"Anandam A, Akinnusi M, Kufel T, Porhomayon J, El-Solh AA. Effects of dietary weight loss on obstructive sleep apnea: a meta-analysis. Sleep Breath. 2013;17:227\u201334.","journal-title":"Sleep Breath"},{"key":"1761_CR61","doi-asserted-by":"crossref","unstructured":"Li L, Shen T, Wen LM, Wu M, He P, Wang Y, et al. Lifestyle factors associated with childhood obesity: a cross-sectional study in Shanghai, China. BMC Res Notes. 2015;8(1).","DOI":"10.1186\/s13104-014-0958-y"},{"key":"1761_CR62","unstructured":"Bhadoria AS, Kapil U, Kaur S. Association of duration of time spent on television, computer and video games with obesity amongst children in national capital territory of Delhi. Int J Prev Med. 2015."},{"issue":"6","key":"1761_CR63","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1002\/ajhb.22440","volume":"25","author":"DD Bingham","year":"2013","unstructured":"Bingham DD, Varela-Silva MI, Ferr\u00e3o MM, Augusta G, Mour\u00e3o MI, Nogueira H, et al. Socio-demographic and behavioral risk factors associated with the high prevalence of overweight and obesity in portuguese children. Am J Hum Biol. 2013;25(6):733\u201342.","journal-title":"Am J Hum Biol"},{"issue":"3","key":"1761_CR64","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1007\/s10995-011-0774-0","volume":"16","author":"M Koleilat","year":"2012","unstructured":"Koleilat M, Harrison GG, Whaley S, McGregor S, Jenks E, Afifi A. Preschool enrollment is associated with lower odds of childhood obesity among WIC participants in LA County. Matern Child Health J. 2012;16(3):706\u201312.","journal-title":"Matern Child Health J"},{"issue":"3","key":"1761_CR65","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1007\/s10995-011-0792-y","volume":"16","author":"AW Taylor","year":"2012","unstructured":"Taylor AW, Winefield H, Kettler L, Roberts R, Gill TK. A population study of 5 to 15 year olds: full time maternal employment not associated with high BMI. The importance of screen-based activity, reading for pleasure and sleep duration in children's BMI. Matern Child Health J. 2012;16(3):587\u201399.","journal-title":"Matern Child Health J"},{"issue":"2","key":"1761_CR66","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1590\/S1807-59322010000200010","volume":"65","author":"G Balaban","year":"2010","unstructured":"Balaban G, Motta ME, Silva GA. Early weaning and other potential risk factors for overweight among preschool children. Clinics (Sao Paulo). 2010;65(2):181\u20137.","journal-title":"Clinics (Sao Paulo)"},{"issue":"Suppl 1","key":"1761_CR67","doi-asserted-by":"publisher","first-page":"S28","DOI":"10.1123\/jpah.6.s1.s28","volume":"6","author":"JE Fulton","year":"2009","unstructured":"Fulton JE, Wang X, Yore MM, Carlson SA, Galuska DA, Caspersen CJ. Television viewing, computer use, and BMI among U.S. children and adolescents. J Phys Act Health. 2009;6(Suppl 1):S28\u201335.","journal-title":"J Phys Act Health"},{"issue":"3","key":"1761_CR68","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1007\/s10995-008-0362-0","volume":"13","author":"Y Khader","year":"2009","unstructured":"Khader Y, Irshaidat O, Khasawneh M, Amarin Z, Alomari M, Batieha A. Overweight and obesity among school children in Jordan: prevalence and associated factors. Matern Child Health J. 2009;13(3):424\u201331.","journal-title":"Matern Child Health J"},{"issue":"5","key":"1761_CR69","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.3945\/ajcn.2009.28153","volume":"90","author":"RM Steele","year":"2009","unstructured":"Steele RM, Van Sluijs EMF, Cassidy A, Griffin SJ, Ekelund U. Targeting sedentary time or moderate- and vigorous-intensity activity: independent relations with adiposity in a population-based sample of 10-y-old British children. Am J Clin Nutr. 2009;90(5):1185\u201392.","journal-title":"Am J Clin Nutr"},{"issue":"7","key":"1761_CR70","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1079\/PHN2003473","volume":"6","author":"I Da Costa Ribeiro","year":"2003","unstructured":"Da Costa Ribeiro I, Taddei JAAC, Colugnatti F. Obesity among children attending elementary public schools in Sao Paulo, Brazil: a case-control study. Public Health Nutr. 2003;6(7):659\u201363.","journal-title":"Public Health Nutr"},{"issue":"9","key":"1761_CR71","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1017\/S1368980008002462","volume":"11","author":"A Lagiou","year":"2008","unstructured":"Lagiou A, Parava M. Correlates of childhood obesity in Athens, Greece. Public Health Nutr. 2008;11(9):940\u20135.","journal-title":"Public Health Nutr"},{"issue":"6","key":"1761_CR72","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1038\/oby.2004.109","volume":"12","author":"N Stettler","year":"2004","unstructured":"Stettler N, Signer TM, Suter PM. Electronic games and environmental factors associated with childhood obesity in Switzerland. Obes Res. 2004;12(6):896\u2013903.","journal-title":"Obes Res"},{"issue":"5","key":"1761_CR73","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1079\/PHN2005899","volume":"9","author":"J Utter","year":"2006","unstructured":"Utter J, Scragg R, Schaaf D. Associations between television viewing and consumption of commonly advertised foods among New Zealand children and young adolescents. Public Health Nutr. 2006;9(5):606\u201312.","journal-title":"Public Health Nutr"},{"key":"1761_CR74","doi-asserted-by":"publisher","first-page":"E137","DOI":"10.5888\/pcd15.180122","volume":"15","author":"EY Hu","year":"2018","unstructured":"Hu EY, Ramachandran S, Bhattacharya K, Nunna S. Obesity among high school students in the United States: risk factors and their population attributable fraction. Prev Chronic Dis. 2018;15:E137.","journal-title":"Prev Chronic Dis"},{"issue":"5","key":"1761_CR75","doi-asserted-by":"publisher","first-page":"e010335","DOI":"10.1136\/bmjopen-2015-010335","volume":"6","author":"S Piryani","year":"2016","unstructured":"Piryani S, Baral KP, Pradhan B, Poudyal AK, Piryani RM. Overweight and its associated risk factors among urban school adolescents in Nepal: a cross-sectional study. BMJ Open. 2016;6(5):e010335.","journal-title":"BMJ Open"},{"key":"1761_CR76","doi-asserted-by":"crossref","unstructured":"Strahan BE, Elder JH. Video game playing effects on obesity in an adolescent with autism spectrum disorder: a case study. Autism Res Treat. 2015;2015.","DOI":"10.1155\/2015\/128365"},{"issue":"6","key":"1761_CR77","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1016\/j.amepre.2012.02.023","volume":"42","author":"BA Primack","year":"2012","unstructured":"Primack BA, Carroll MV, McNamara M, Klem ML, King B, Rich M, et al. Role of video games in improving health-related outcomes: a systematic review. Am J Prev Med. 2012;42(6):630\u20138.","journal-title":"Am J Prev Med"},{"issue":"2","key":"1761_CR78","doi-asserted-by":"publisher","first-page":"669","DOI":"10.3390\/ijerph17020669","volume":"17","author":"WM Williams","year":"2020","unstructured":"Williams WM, Ayres CG. Can active video games improve physical activity in adolescents? A review of RCT. Int J Environ Res Public Health. 2020;17(2):669.","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"1761_CR79","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1590\/S0066-782X2010005000065","volume":"95","author":"IR Rivera","year":"2010","unstructured":"Rivera IR, Silva MA, Silva RD, Oliveira BA, Carvalho AC. Physical inactivity, TV-watching hours and body composition in children and adolescents. Arq Bras Cardiol. 2010;95(2):159\u201365.","journal-title":"Arq Bras Cardiol"},{"issue":"4","key":"1761_CR80","doi-asserted-by":"publisher","first-page":"296","DOI":"10.4103\/0970-0218.91418","volume":"36","author":"JP Goyal","year":"2011","unstructured":"Goyal JP, Kumar N, Parmar I, Shah VB, Patel B. Determinants of overweight and obesity in affluent adolescent in Surat city, South Gujarat region, India. Indian J Commun Med. 2011;36(4):296\u2013300.","journal-title":"Indian J Commun Med"},{"issue":"5","key":"1761_CR81","doi-asserted-by":"publisher","first-page":"539","DOI":"10.5007\/1980-0037.2016v18n5p539","volume":"18","author":"FJG Pitanga","year":"2016","unstructured":"Pitanga FJG, Alves CFA, Pamponet ML, Medina MG, Aquino R. Screen time as discriminator for overweight, obesity and abdominal obesity in adolescents. Revista Brasileira de Cineantropometria e Desempenho Humano. 2016;18(5):539\u201347.","journal-title":"Revista Brasileira de Cineantropometria e Desempenho Humano"},{"issue":"4","key":"1761_CR82","doi-asserted-by":"publisher","first-page":"e34916","DOI":"10.1371\/journal.pone.0034916","volume":"7","author":"CL Edwardson","year":"2012","unstructured":"Edwardson CL, Gorely T, Davies MJ, Gray LJ, Khunti K, Wilmot EG. Association of sedentary behaviour with metabolic syndrome: a meta-analysis. Plos One. 2012;7(4):e34916.","journal-title":"Plos One"},{"issue":"SP2","key":"1761_CR83","doi-asserted-by":"publisher","first-page":"e22","DOI":"10.15586\/jptcp.v27iSP2.744","volume":"27","author":"MA Storz","year":"2020","unstructured":"Storz MA. The role of vegan diets in lipotoxicity-induced beta-cell dysfunction in type-2-diabetes. J Popul Ther Clin Pharmacol. 2020;27(SP2):e22\u201338.","journal-title":"J Popul Ther Clin Pharmacol"},{"issue":"2","key":"1761_CR84","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1093\/ajcn\/85.2.355","volume":"85","author":"JL Temple","year":"2007","unstructured":"Temple JL, Giacomelli AM, Kent KM, Roemmich JN, Epstein LH. Television watching increases motivated responding for food and energy intake in children. Am J Clin Nutr. 2007;85(2):355\u201361.","journal-title":"Am J Clin Nutr"},{"key":"1761_CR85","first-page":"232","volume":"15","author":"M Borghese","year":"2014","unstructured":"Borghese M, Tremblay M, Leduc G, Boyer C, Belanger P, LeBlanc A, et al. Television viewing and food intake pattern of normal weight, overweight, and obese 9-11 year-old Canadian children. Obes Rev. 2014;15:232.","journal-title":"Obes Rev"},{"issue":"11","key":"1761_CR86","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1038\/oby.2006.238","volume":"14","author":"EM Taveras","year":"2006","unstructured":"Taveras EM, Sandora TJ, Shih MC, Ross-Degnan D, Goldmann DA, Gillman MW. The association of television and video viewing with fast food intake by preschool-age children. Obesity (Silver Spring). 2006;14(11):2034\u201341.","journal-title":"Obesity (Silver Spring)"},{"issue":"5","key":"1761_CR87","first-page":"93","volume":"11","author":"P Mariona","year":"2021","unstructured":"Mariona P, Roy A. Survey on lifestyle and food habits of patients with PCOS and obesity. J Complement Med Res. 2021;11(5):93.","journal-title":"J Complement Med Res"},{"issue":"6","key":"1761_CR88","doi-asserted-by":"publisher","first-page":"1196","DOI":"10.3945\/ajcn.110.008680","volume":"93","author":"JP Chaput","year":"2011","unstructured":"Chaput JP, Visby T, Nyby S, Klingenberg L, Gregersen NT, Tremblay A, et al. Video game playing increases food intake in adolescents: a randomized crossover study. Am J Clin Nutr. 2011;93(6):1196\u2013203.","journal-title":"Am J Clin Nutr"},{"issue":"1","key":"1761_CR89","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1016\/j.appet.2007.03.044","volume":"49","author":"T Cessna","year":"2007","unstructured":"Cessna T, Raudenbush B, Reed A, Hunker R. Effects of video game play on snacking behavior. Appetite. 2007;49(1):282.","journal-title":"Appetite"},{"issue":"3","key":"1761_CR90","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1017\/S0007114515004602","volume":"115","author":"JP Chaput","year":"2015","unstructured":"Chaput JP, Tremblay A, Pereira B, Boirie Y, Duclos M, Thivel D. Food intake response to exercise and active video gaming in adolescents: effect of weight status. Br J Nutr. 2015;115(3):547\u201353.","journal-title":"Br J Nutr"},{"issue":"1","key":"1761_CR91","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1824-7288-36-52","volume":"36","author":"L Shi","year":"2010","unstructured":"Shi L, Mao Y. Excessive recreational computer use and food consumption behaviour among adolescents. Ital J Pediatr. 2010;36(1):1\u20134.","journal-title":"Ital J Pediatr"},{"issue":"s1","key":"1761_CR92","doi-asserted-by":"publisher","first-page":"S28","DOI":"10.1123\/jpah.6.s1.s28","volume":"6","author":"JE Fulton","year":"2009","unstructured":"Fulton JE, Wang X, Yore MM, Carlson SA, Galuska DA, Caspersen CJ. Television viewing, computer use, and BMI among US children and adolescents. J Phys Act Health. 2009;6(s1):S28\u201335.","journal-title":"J Phys Act Health"},{"issue":"1","key":"1761_CR93","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1038\/ijo.2016.163","volume":"41","author":"D Gilbert-Diamond","year":"2017","unstructured":"Gilbert-Diamond D, Emond JA, Lansigan RK, Rapuano KM, Kelley WM, Heatherton TF, et al. Television food advertisement exposure and FTO rs9939609 genotype in relation to excess consumption in children. Int J Obes. 2017;41(1):23\u20139.","journal-title":"Int J Obes"},{"issue":"5","key":"1761_CR94","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1111\/j.2047-6310.2013.00185.x","volume":"9","author":"AE Ustjanauskas","year":"2014","unstructured":"Ustjanauskas AE, Harris JL, Schwartz MB. Food and beverage advertising on children's web sites. Pediatr Obes. 2014;9(5):362\u201372.","journal-title":"Pediatr Obes"},{"key":"1761_CR95","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/j.appet.2014.06.103","volume":"81","author":"B Lee","year":"2014","unstructured":"Lee B, Kim H, Lee SK, Yoon J, Chung SJ. Effects of exposure to television advertising for energy-dense\/nutrient-poor food on children's food intake and obesity in South Korea. Appetite. 2014;81:305\u201311.","journal-title":"Appetite"},{"issue":"Suppl 2","key":"1761_CR96","first-page":"s162","volume":"56","author":"J Dibildox","year":"2014","unstructured":"Dibildox J. Analysis of TV, advertising and other behavioral determinants of overweight and obesity in childhood. Salud Publica Mex. 2014;56(Suppl 2):s162\u20136.","journal-title":"Salud Publica Mex"},{"issue":"2","key":"1761_CR97","doi-asserted-by":"publisher","first-page":"356","DOI":"10.4103\/0976-9668.160004","volume":"6","author":"S Kar","year":"2015","unstructured":"Kar S, Khandelwal B. Fast foods and physical inactivity are risk factors for obesity and hypertension among adolescent school children in east district of Sikkim, India. J Nat Sci Biol Med. 2015;6(2):356.","journal-title":"J Nat Sci Biol Med"},{"issue":"2","key":"1761_CR98","doi-asserted-by":"publisher","first-page":"268","DOI":"10.5993\/AJHB.45.2.7","volume":"45","author":"MA Leman","year":"2021","unstructured":"Leman MA, Claramita M, Rahayu GR. Predicting factors on modeling health behavior: a systematic review. Am J Health Behav. 2021;45(2):268\u201378.","journal-title":"Am J Health Behav"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-022-01761-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-022-01761-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-022-01761-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,15]],"date-time":"2022-11-15T01:04:45Z","timestamp":1668474285000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcfampract.biomedcentral.com\/articles\/10.1186\/s12875-022-01761-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,28]]},"references-count":98,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1761"],"URL":"https:\/\/doi.org\/10.1186\/s12875-022-01761-4","relation":{},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,28]]},"assertion":[{"value":"13 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 June 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The protocol of the current work has been registered in the PROSPERO system (Registration number: ). Also, the research has been approved by the ethics committee of Tabriz University of Medical Sciences (Code:\u00a0IR.TBZMED.VCR.REC.1400.374;\u00a0\u00a0Grant number: \u00a068712).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there is no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"161"}}