NewsMakers
Excessive screen time among youth may pose heart health risks
Increased recreational screen time was significantly associated with higher cardiovascular risks and cardiometabolic risks among children and adolescents.
Children and young adults who spend excessive hours glued to screens and electronic devices may have higher risks for cardiometabolic diseases, such as high blood pressure, high cholesterol and insulin resistance, according to new research published in the Journal of the American Heart Association.
A 2023 scientific statement from the American Heart Association noted that “cardiometabolic risk is accruing at younger and younger ages,” and only 29% of American youth, ages 2 to 19 years, had favorable cardiometabolic health based on 2013-2018 data from the National Health and Nutrition Examination Survey.
This analysis of more than 1,000 participants in two studies in Denmark found that increased recreational screen time was significantly associated with higher cardiovascular risks and cardiometabolic risks among children and adolescents.
“Limiting discretionary screen time in childhood and adolescence may protect long-term heart and metabolic health,” said study lead author David Horner, M.D., PhD., a researcher at the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) at the University of Copenhagen in Denmark. “Our study provides evidence that this connection starts early and highlights the importance of having balanced daily routines.”
Using data from a group of 10-year-olds studied in 2010 and a group of 18-year-olds in 2000 that were part of the Copenhagen Prospective Studies on Asthma in Childhood cohorts, researchers examined the relationship between screen time and cardiometabolic risk factors. Screen time included time spent watching TV, movies, gaming or using phones, tablets or computers for leisure.
Researchers developed a composite score based on a cluster of metabolic syndrome components — waist size, blood pressure, high-density lipoprotein or HDL “good” cholesterol, triglycerides and blood sugar levels – and adjusted for sex and age. The cardiometabolic score reflected a participant’s overall risk relative to the study group average (measured in standard deviations): 0 means average risk, and 1 means one standard deviation above average.
The analysis found that each extra hour of screen time increased the cardiometabolic score by about 0.08 standard deviations in the 10-year-olds and 0.13 standard deviations in the 18-year-olds. “This means a child with three extra hours of screen time a day would have roughly a quarter to half a standard-deviation higher risk than their peers,” Horner said.
“It’s a small change per hour, but when screen time accumulates to three, five or even six hours a day, as we saw in many adolescents, that adds up,” he said. “Multiply that across a whole population of children, and you’re looking at a meaningful shift in early cardiometabolic risk that could carry into adulthood.”
The analysis also found that both sleep duration and sleep timing affected the relationship between screen time and cardiometabolic risk. Both shorter sleep duration and going to sleep later intensified the relationship between screen time and cardiometabolic risk. Children and adolescents who had less sleep showed significantly higher risk associated with the same amount of screen time.
“In childhood, sleep duration not only moderated this relationship but also partially explained it: about 12% of the association between screen time and cardiometabolic risk was mediated through shorter sleep duration,” Horner said. “These findings suggest that insufficient sleep may not only magnify the impact of screen time but could be a key pathway linking screen habits to early metabolic changes.”
In addition, a machine learning analysis identified a unique metabolic signature in the blood that appeared to be associated with screen time.
“We were able to detect a set of blood-metabolite changes, a ‘screen-time fingerprint,’ validating the potential biological impact of the screen time behavior,” he said. “Using the same metabolomics data, we also assessed whether screen time was linked to predicted cardiovascular risk in adulthood, finding a positive trend in childhood and a significant association in adolescence. This suggests that screen-related metabolic changes may carry early signals of long-term heart health risk.
“Recognizing and discussing screen habits during pediatric appointments could become part of broader lifestyle counseling, much like diet or physical activity,” he said. “These results also open the door to using metabolomic signatures as early objective markers of lifestyle risk.”
Amanda Marma Perak, M.D., M.S.CI., FAHA, chair of the American Heart Association’s Young Hearts Cardiovascular Disease Prevention Committee, who was not involved in this research, said focusing on sleep is a great starting point to change screen time patterns.
“If cutting back on screen time feels difficult, start by moving screentime earlier and focusing on getting into bed earlier and for longer,” said Perak, an assistant professor of pediatrics and preventive medicine at Northwestern University Feinberg School of Medicine in Chicago.
Adults can also set an example, she said. “All of us use screens, so it’s important to guide kids, teens and young adults to healthy screen use in a way that grows with them. As a parent, you can model healthy screen use – when to put it away, how to use it, how to avoid multitasking. And as kids get a little older, be more explicit, narrating why you put away your devices during dinner or other times together.
“Make sure they know how to entertain and soothe themselves without a screen and can handle being bored! Boredom breeds brilliance and creativity, so don’t be bothered when your kids complain they’re bored. Loneliness and discomfort will happen throughout life, so those are opportunities to support and mentor your kids in healthy ways to respond that don’t involve scrolling.”
As an observational study using prospectively collected data, the findings reflect associations rather than proving cause and effect. Moreover, parents of the 10-year-olds and the 18-year-olds reported screen time through questionnaires, which may not accurately reflect the actual time youth spent on screens.
Horner suggested that future research could explore whether limiting screen use in the hours before sleep, when light from screen exposure may disrupt circadian rhythms and disrupt sleep onset, may be an avenue to help reduce cardiometabolic risk.
NewsMakers
Could your oral health be affecting fertility?
Chronic oral inflammation may impair female fertility by triggering a systemic immune response that affects the ovaries. A new study shows this leads to oxidative damage, reduced egg quality, disrupted follicle development and reduced live birth rate. These findings point to a potential biological link between oral health and unexplained infertility, opening new directions for future treatments.
A new study led by Prof. Michael Klutstein at the Hebrew University of Jerusalem and Prof. Asaf Wilensky at the Hebrew University-Hadassah Medical center and spearheaded by the students Dr. Paz Kles and Stephen Ameho has uncovered a striking biological link between chronic oral inflammation and female fertility, suggesting that conditions in the mouth may have far-reaching effects on reproductive health.
Published in the Journal of Dental Research, the study shows that persistent inflammation in the oral cavity can impair ovarian function, reduce egg quality, and ultimately lower fertility rates.
Researchers examined in a mouse model inflammation associated with dental implants, a common clinical scenario, and tracked how immune signals spread throughout the body. Their findings reveal that inflammation does not remain confined to the oral cavity but triggers a systemic immune response that reaches the ovaries.
The consequences were significant. Chronic oral inflammation in the animals was linked to increased levels of inflammatory cytokines in the ovaries, along with shifts in immune cell populations. This was accompanied by oxidative damage to ovarian tissue, impaired development of follicles, and reduced quality of oocytes.
These biological changes translated into measurable reproductive outcomes, with markedly reduced birth rates observed under inflammatory conditions in the animals.
The study also identified deeper cellular effects. Oocytes exhibited DNA damage and epigenetic alterations resembling those seen in reproductive aging, pointing to a possible mechanism by which inflammation accelerates the decline in fertility.
“Inflammation is often thought of as a localized response, but our findings show that it can have systemic consequences that extend as far as the reproductive system,” said Prof. Michael Klutstein. “This work suggests that chronic oral inflammation may be an underrecognized factor in female infertility, potentially contributing to cases that currently have no clear explanation.”
The findings add to growing evidence that oral health is closely linked to overall health. Chronic oral inflammatory conditions such as periodontitis are widespread and have already been associated with a range of systemic diseases.
The researchers note that further investigation in clinical settings will be essential to determine how these findings translate to patient care. If confirmed, the work could open new avenues for diagnosis and treatment, including the use of anti-inflammatory or antioxidant approaches to improve fertility outcomes.
NewsMakers
Maintaining a healthy heart may require regular doses of positivity
The findings of this study further point to the importance of attending to mental and behavioral health for cardiovascular disease prevention and cardiovascular health optimization.
Positive psychology interventions such as mindfulness, gratitude journaling and optimism training can consistently improve blood pressure, inflammation markers and other cardiovascular disease risk factors within a matter of weeks, a recent study found. However, since these benefits are associated with lifestyle changes such as eating healthier and greater physical activity, the researchers suggested that ongoing reinforcements may be needed to stay on course long term.
Rosalba (Rose) Hernandez, a professor of social work at the University of Illinois Urbana-Champaign, led a team that analyzed the findings of 18 randomized controlled trials that used positive psychological and mindfulness interventions to enhance mental or physical health.
The programs that the team reviewed included individual methods — such as structured telephone sessions, journaling with brief check-ins and digital platforms such as apps and text messaging — and interactive in-person group sessions, as well as hybrid formats that blended these with online tools and virtual meetings. Most of the programs consisted of weekly sessions and at-home activities that reinforced the skills taught, with the majority of programs lasting from six to 12 weeks, the team found.
In general, the programs included 50-200 adults with elevated cardiovascular risk factors such as uncontrolled hypertension, heart failure or other conditions. Typically, the participants were in their late 50s to mid-60s, and women comprised 35-55% of the samples across those studies that reported their participants’ gender, according to the researchers.
“In hypertension and postacute coronary syndrome cohorts, mindfulness-based programs delivered over an eight-week period reduced systolic blood pressure and lowered inflammatory markers such as high-sensitivity C-reactive protein and fibrinogen,” said Hernandez, who is a Fellow of the American Heart Association. “A 12-week spirituality-based digital intervention achieved one of the largest reductions — reducing systolic blood pressure measured with a standard cuff by 7.6 points, and central systolic pressure — which is measured in the aorta as it leaves the heart — by 4.1 points.”
In prior research on positive psychology interventions, scientists seldom defined the dose that was needed to obtain the beneficial effects, Hernandez said. She and the team members sought to clarify the frequency and duration that was most likely to improve individuals’ cardiovascular health.
Programs that had more frequent contact with their participants yielded the most consistent physiological benefits, underscoring the opportunity to embed positive psychological strategies into long-term cardiovascular care, Hernandez said.
The team found that the strongest behavioral improvements were achieved by an eight-week program delivered over WhatsApp that combined weekly sessions with daily microtasks, motivating participants to engage in greater physical activity, eat a healthier diet and take their medication as prescribed. A program that included motivational interviewing succeeded in increasing cardiac patients’ levels of physical activity by 1,800 steps a day and their medication adherence, while the mindfulness programs improved participants’ activity levels and diets only, according to the study.
“The therapeutic dose that was most consistently linked with improvements in blood pressure, inflammation and endothelial function was daily practice reinforced by weekly sessions over eight to 12-week periods,” Hernandez said. “Therapeutic dosing typically involved high-frequency dosing over this time period to obtain short-term physiologic benefits, while ongoing less-intensive contact may be needed to sustain behavioral change.”
Published in the journal Cardiology Clinics, the study was co-written by University of South Florida social work professor Soonhyung Kwon; Alyssa M. Vela, a professor of surgery and of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine; and Katharine S. Edwards, a professor of cardiovascular medicine and of psychiatry and behavioral medicine at Stanford Medicine.
“The findings of this study further point to the importance of attending to mental and behavioral health for cardiovascular disease prevention and cardiovascular health optimization,” Vela said. “This speaks to the need for routine screening and integration of cardiac behavioral medicine to allow for access to important interventions.”
The current study adds to a growing body of research linking psychological well-being — including traits such as optimism, positive affect and gratitude — with cardioprotective benefits.
NewsMakers
Heart disease risk may start in the womb, study finds
Young adults whose mothers had high blood pressure during pregnancy — either pregnancy-associated hypertension, pre-eclampsia or eclampsia — had more signs of early arterial injury, higher blood pressure, higher body mass index and higher blood sugar than peers.
A child’s future heart health may be partially shaped before they are born, reports a new Northwestern Medicine study that found pregnancy complications are linked to poorer cardiovascular health in offspring more than 20 years later.
The study found that young adults whose mothers had high blood pressure during pregnancy — either pregnancy-associated hypertension, pre-eclampsia or eclampsia — had more signs of early arterial injury, higher blood pressure, higher body mass index and higher blood sugar than peers.
The authors said the study adds to growing evidence that cardiovascular risk may be transmitted across generations through a combination of biological, environmental and behavioral factors.
“That means we must make sure people maintain good health from childhood into young adulthood, so that if or when someone becomes a parent, they pass on the best opportunity for good health to their children,” said study senior author Dr. Nilay Shah, assistant professor of medicine in the division of cardiology at Northwestern University Feinberg School of Medicine.
How the study was conducted
Shah and colleagues evaluated nearly 1,350 mother-child pairs from the Future of Families and Child Well-Being Study, which enrolled mothers and children at birth between 1998 and 2000 across 20 U.S. cities. The children were then followed into adulthood.
Using delivery hospitalization records, the Northwestern scientists first identified whether mothers experienced pregnancy complications, including high blood pressure during pregnancy, gestational diabetes (high blood sugar during pregnancy) or preterm birth (before 37 weeks of pregnancy).
The three pregnancy complications are on the rise, and affect almost one in four pregnancies in the U.S.
The research team then analyzed cardiovascular health of offspring at age 22, using blood pressure measurements, blood testing, body mass index assessments and carotid artery ultrasounds to look for signs of artery injury.
Finally, the scientists compared participants with and without exposure to each pregnancy complication and adjusted for factors like income, education, difference in birth weight and smoking during pregnancy.
Key findings
At around age 22, participants whose mothers had high blood pressure during pregnancy had:
- Higher body mass index (+2.8 BMI points)
- Higher diastolic blood pressure (+2.3 mm Hg)
- Higher blood sugar levels (+0.2% HbA1c)
- Thicker artery walls (~0.02 mm)
While the difference in artery wall thickness may seem small, the study authors said it corresponds to roughly three to five years of additional vascular aging. That means arteries looked older and less healthy than expected, which raises the risk of future heart disease.
Other pregnancy complications also showed some long-term effect:
- Exposure to gestational diabetes was linked to worse blood pressure and some evidence of artery thickening
- Being born preterm was associated with higher blood sugar levels
‘Most heart disease is preventable’
With pregnancy complications on the rise in the U.S., Shah said the study provides compelling evidence that improving health before and during pregnancy could help reduce heart disease risk in the next generation.
“There is evidence that both parents’ health at the time of conception and during pregnancy influences a child’s health,” he said. “So, promoting health from an early age, like exercising regularly, eating healthfully, never smoking and getting enough sleep, is not just meant for an individual, but doing so may help future generations be healthier, too.”
Shah also emphasizes that risk is not destiny.
“The good news is that most heart disease is preventable,” he said. “If you experienced high blood pressure or high blood sugar during pregnancy, or your child was born early, it does not absolutely mean that your child will have worse health as adults. But I would encourage you to pay attention now to your child’s health behaviors.
“What children learn in childhood sets the stage for their health across their lives. If you are wondering whether your children’s behaviors are healthy, or are considering making a change, please speak with your child’s pediatrician for advice and guidance.”
Other Northwestern co-authors include Emily Lam, Abigail Gauen, Dr. Sadiya Khan, Alexa Freedman and Norrina Allen.
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