# Association between TV/DVD screen exposure time at age 1 and risk of chronic constipation at age 3: the Japan Environment and Children’s Study

## TL;DR

Exposure to TV/DVD screens at age 1 is linked to a higher risk of chronic constipation in children by age 3.

## Contribution

This study identifies a dose-response relationship between early screen time and later constipation risk in children.

## Key findings

- Longer TV/DVD exposure at age 1 correlates with increased constipation risk at age 3.
- Adjusted odds ratios show a progressive rise in risk with increasing screen time.
- The association was consistent across both sexes with no significant interaction.

## Abstract

Chronic constipation is a long-term problem that decreases children’s quality of life. Information and communication technology devices have developed rapidly in recent decades and have had various impacts on children. This prospective cohort study examined the association between television/digital versatile disc (TV/DVD) screen exposure time at age 1 and the risk of chronic constipation at age 3.

Data from 63,697 infants in the Japan Environment and Children’s Study (JECS) were analyzed. We divided participants into five groups according to TV/DVD exposure time per day: no exposure (0 h), short exposure (<1 h), middle exposure (1.0–<2.0 h), long exposure (2.0–<4.0 h), and very long exposure (≥4 h). Logistic regression analysis was performed to assess the association between TV/DVD exposure time and the risk of constipation. For logistic regression analysis, odds ratios (ORs) were adjusted for sex, parents’ education, household income, nursery school, feeding contents, and obesity. The interaction between the sexes was also examined.

The prevalence of constipation for males, females, and all participants at age 3 was 9.3, 11.0, and 10.1%, respectively. The TV/DVD screen time distribution per day at age 1 was 10.6% for none, 34.1% for short, 29.9% for middle, 19.2% for long, and 6.2% for the very long exposure group. After adjusting for confounding factors, a dose-response pattern was identified between TV/DVD exposure time and constipation in all participants (p for trend < 0.001). The adjusted ORs increased progressively in the short (OR 1.15, 95% confidence interval [CI] 1.04–1.27), middle (OR 1.22, 95% CI 1.11–1.35), long (OR 1.37, 95% CI 1.24–1.52), and very long exposure groups (OR 1.53, 95% CI 1.35–1.74). This association was not significantly different between the sexes (p for interaction = 0.36).

Longer TV/DVD exposure time at age 1 was associated with the risk of chronic constipation at age 3. Excessive screen exposure may need to be avoided from infancy to decrease the risk of chronic constipation in later years.

The online version contains supplementary material available at https://doi.org/10.1265/ehpm.25-00109.