Controversies over screen time and digital media exposure on the nutritional health outcomes of children aged less than 18 years: A scoping review

The nutritional implications of screen time and digital media exposure among children have become a global concern amid rapid technological expansion, yet evidence remains inconsistent. To map controversies surrounding screen time and digital media exposure in relation to nutritional health outcomes among children under 18 years. A scoping review following the Arksey and O’Malley framework and PRISMA-ScR synthesized observational, clinical/preclinical, systematic, and umbrella reviews published within five years before and after the COVID-19 pandemic. Searches across seven databases identified eligible studies. Four reviewers independently screened and extracted data, resolving disagreements through consensus or a fifth reviewer. Narrative synthesis was applied. Fifty-nine studies were included. Excessive screen time was frequently associated with poor dietary habits, reduced diet quality, lower physical activity, increased adiposity and cardio metabolic risk, and disrupted sleep. Pandemic-era evidence showed heightened screen exposure and unhealthy behaviors, especially in socioeconomically vulnerable populations. Findings were heterogeneous, with several null or inconsistent associations. Key moderators included age, screen type and content, parental monitoring, socioeconomic status, and baseline health. Sleep disruption driven by stimulating content and melatonin suppression was a consistent mechanism linking screen exposure to metabolic risk. Evidence gaps persist regarding virtual reality, algorithm-driven digital food environments, and non-obesity outcomes, particularly in low- and middle-income countries. Excessive screen time adversely affects children’s nutritional health. Age-specific limits, parental engagement, and early preventive interventions are essential. More longitudinal and interventional research, especially in low-resource settings, is urgently needed to inform policy and public health strategies.