Relationship between the use of multimedia devices, BMI, and sleep in 0–6-year-old children during the first phase of the COVID-19 health emergency in Italy

Background: In today's technological society, children are exposed to electronic devices from an early age. During the Italian national lockdown from 8th March to 3rd May 2020 (56 days) in response to Covid-19, screen time increased significantly due to people’s confinement at home and their consequent inability to physically interact with others. Virtual communication has provided some compensation to the problem of social distancing but at the same time, it has increased the amount of daily time both adults and children spend in sedentary activities, in contradiction to the daily movement and physical activity targets prescribed in the WHO guidelines. This preliminary research has investigated whether the highly sedentary lifestyle induced by the Covid-19 lockdown, combined with an increase in screen time, affected the sleep and Body Mass Index (BMI) of children aged 0-6 years. Methods: An anonymous questionnaire containing 32 questions was sent by e-mail to parents of children aged 0-6 years. Where parents had more than one child, they were asked to fill in a form for each child. Results: Considering all the study subjects (n=125), there was no significant relationship between screen time and BMI in children aged 0-6 years (r=0.09) and between screen time and hours of sleep (r=-0.03). Conclusions: Despite the fact that during the period of health emergency the lockdown reduced the opportunities for movement and the physical activity prescribed by the WHO guidelines, no significant changes were found in the relationships between screen time and hours of sleep and between screen time and BMI. The high percentage of children with habits that conflict with those suggested by the WHO guidelines, both in terms of sleep and screen time, suggests that there is a need to increase parental awareness of the importance of the WHO health recommendations. It is important to attempt to subvert the constant demands of children to spend many hours sitting in front of a screen, by daily encouraging more dynamic play activities that involve greater expenditure of physical energy.