Elsevier

Appetite

Volume 171, 1 April 2022, 105928
Appetite

Screen use during food consumption: Does it cause increased food intake? A systematic review

https://doi.org/10.1016/j.appet.2022.105928Get rights and content

Abstract

Nowadays people use screens, such as mobile phones, television, or tablets, more often during mealtimes, which may have an effect on intake. This review aims to analyze the effect of screen use, during food consumption, on intake. A systematic review was carried out, based on those protocols established by PRISMA. The Cochrane Library, PubMed, Web of Science and Scopus databases were consulted. Experimental studies, published between 2010 and 2021, that recorded individual intake while using screens such as television, cell phones, or tablets, were selected. A total of 7181 relevant articles were obtained, which were then assessed in accordance with predetermined inclusion and exclusion criteria. Finally, 35 studies were included in the complete review: 22 compared different kinds of television content (e.g., adverts), five which compared television versus the absence of screens, four which compared television versus video games, two which compared the use of simultaneous screens, and two studies which included cell phones. A total of 27 studies reported consumption increases related to the presence of advertisements and food signals on screens. No significant differences in intake were reported in the eight studies that reported design or sample size limitations, or lack of control of certain variables. It is thus concluded that screen use during food consumption may increase intake. Education is necessary to regulate the habit of consuming food in the presence of screens. Also, the creation of policies that regulate advertising and food cues on screens are justified and must be accompanied by strategies to monitor compliance. As a limitation, further evidence is necessary in order to determine the effect of mobile phone and tablet use while eating. This protocol was registered via PROSPERO, ID: CRD42020211797.

Introduction

Food consumption behavior is multidimensional, and food intake is one of its various dimensions. While the environment can encourage food intake through food availability and exposure to food advertisements (Boswell & Kober, 2016; Swinburn et al., 2011), experimental evidence has shown that environmental factors not related to food may also influence variations in food intake, including auditory or audiovisual distractors (Long, Meyer, Leung, & Wallis, 2011). For example, some studies have shown that technology use, such as music, television, and video games, is associated with increased food intake (Bellisle, Dalix, & Slama, 2004; Blass et al., 2006; Cessna, Raudenbush, Reed, & Hunker, 2007; Hetherington, Anderson, Norton, & Newson, 2006; Stroebele & de Castro, 2006).

For the above-mentioned reasons, studying the effect of devices, such as mobile phones, televisions, or tablets, during food consumption, is important, as their use has increased to include mealtimes (de-Sola, Talledo, Rodríguez de Fonseca, & y Rubio, 2017). Therefore, their effect on food intake must be characterized. Certain studies have determined that eating while using screens increases food intake, as the deployment of attentional resources towards food is altered, so that individuals focus their attention on the screen and not on their meal (Bellieni et al., 2006; Braude and Stevenson, 2014a, Braude and Stevenson, 2014b; Ogden et al., 2013; Wijndaele et al., 2010). Likewise, Braude and Stevenson (2014) have mentioned that the use of screens, such as television, disrupts cognitive control of food consumption, and primarily reduces one's opportunity to assess cues that would normally regulate food intake. For example, these may include interoceptive signals, which refer to those stimuli or sensations that come from internal organs, which provide information about their state, for example gastric distension. Television viewing has also been proposed to reduce memory for what has been eaten, due to attention being directed towards the television rather than the eating process, this condition has been pointed out as a risk factor for excessive consumption following recent consumption amnesia (Higgs & Woodward, 2009).

To summarize, the distraction caused by screen use can divert attention from hunger and satiety, thus breaking the link between the amount consumed and urge to eat, which implies increased intake (Bellissimo, Pencharz, Thomas, & Anderson, 2007; Ogden et al., 2013). Additionally, another factor that may influence food consumption behavior is the screen advertising effect (Coates, Hardman, Halford, Christiansen, & Boyland, 2019). Cancer Research UK (2018) reported significant associations between junk food marketing amount of TV exposure and higher snack and sugary drink consumption. Youth with high exposure to televised junk food marketing were 1.9 times more likely to consume two or more sugary drinks per week, were 1.8 times more likely to consume one or more takeout foods, and 1.7 times more likely to consume fried potato foods once or more per week. Boyland et al. (2016) pointed out that acute exposure to food advertising increases food intake, in children. Other authors have highlighted that the food consumption process often begins with motivation from external signals that respond to sociocultural and structural contexts, beyond physical hunger, and in many cases, these responses occur automatically (Stanszus, Frank, & Geiger, 2019; van'tRiet, Sijtsema, Dagevos, & DeBruijn, 2011).

Effects such as those mentioned above, regarding TV viewing, may be caused by the use of screens such as cell phones or tablets, as well, as these are similar types of distraction, are more portable and widely-used than televisions, and provide advertising exposure. However, the effects of cell phone or tablet use on food consumption behavior have been studied less than those of television. It has been shown that mobile phone use can modify individuals' behavior, and problematic mobile phone use has been classified as a behavioral addiction (Tossell et al. al. 2015). Cell phones’ wide range of applications and uses tend to induce overuse, and with this, alterations which promote their use even during food consumption (De-Sola, Rodríguez, & Rubio, 2016; Vilas, Pont-Sunyer, & Tolosa, 2012).

A variety of actions may be performed with screen use: for example, watching a movie or playing video games. The variation between these actions may imply modifications to distraction levels. Likewise, the type of content to which the individual is exposed on each screen may generate distraction variations: for example, content on the screen that generates emotions, such as sadness or joy, tends to generate greater distractions, and has been related to increased food intake (Lyons, Tate, & Ward, 2013). With this in mind, a synthesis and analysis of studies that have assessed the aforementioned variables is necessary. Thus, the present systematic review aimed to analyze the effect of screen use, including television, cell phones, and tablets, on intake during meals.

Section snippets

Protocol and register

The protocol employed herein was registered, on December 15, 2020, via the International Prospective Register of Systematic Reviews (PROSPERO), ID: CRD42020211797.

Eligibility criteria

The inclusion criteria encompassed experimental studies, published between 2010 and 2020. This period was selected because, from this date forward, there was increased technology use, which included mobile phones, television, and tablets (Tossell, Kortum, Shepard, Rahmati, & Zhong, 2015). Exclusion criteria involved studies with

Results

The search criteria for the aforementioned articles yielded 7181 results. After removing duplicates and applying the inclusion and exclusion criteria, 35 articles were selected and included in the present analysis (Fig. 1).

The quality of those articles included in the review was assessed, using the Effective Public Health Practice Project Tool (EPHPP). Both researchers assigned the same initial rating to all articles, except one. In this case, the researchers compared their ratings and then

Discussion

The objective of this review was to analyze the effect of the use of screens, such as television, cell phones, and tablets; 35 studies were included in the complete review: 22 compared different kinds of television content (e.g., adverts), five which compared television versus the absence of screens, four which compared television versus video games, two which compared the use of simultaneous screens, and two studies which included cell phones. A total of 27 studies reported consumption

Conclusions

Overall, the evidence suggests that screen use, and in particular, the use of televisions during food consumption, can increase food intake. Three mechanisms related to this increase in consumption stand out: firstly, exposure to advertisements and food signals that mostly correspond to unhealthy food marketing, secondly, the distraction generated by screens that interrupts the signal processing that would normally regulate intake, such as the perception of gastric distention, and thirdly,

Ethical statement

Ethics approval was not required for this research, as it is a review of existing literature, therefore original studies would have to have sought ethical approval.

Author contributions

MTT and ELL defined the search terms and conducted the literature search. MTT and VGAC screened the articles identified by the search. MTT and ELL extracted and analyzed the data from the identified articles and drafted the manuscript. LAMA and ALE critically revised the paper. All authors reviewed and approved the final version of the review.

Funding/support

The study was carried out with the support of CONACYT grant number 761800. The funding source had no involvement in the study design, the collection, analysis and interpretation of data, in the writing of the report and in the decision to submit the article for publication.

Declaration of competing interest

All researchers state that they have no conflicts of interest with the research.

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