Smartphone addiction and metabolic health risk in pediatrics

Smartphone ownership among children and adolescents has risen sharply over the past decade, coinciding with a parallel rise in pediatric metabolic disorders, including obesity, hypertension, insulin resistance, and early markers of metabolic syndrome. Whether these two trends are mechanistically related has become a question of growing clinical and public health relevance. This study synthesizes evidence on the association between problematic smartphone use in children and adolescents and metabolic health outcomes, with attention to the behavioral, neurobiological, and psychiatric pathways that may connect the two. Peer-reviewed studies published between 2019 and 2026 were identified through structured searches of PubMed, Scopus, Web of Science, Google Scholar, and IEEE Xplore, using combinations of terms related to smartphone addiction, problematic smartphone use, screen time, and pediatric metabolic outcomes. Fourteen studies meeting predefined eligibility criteria (original research; participants aged 5-18 years; a quantitatively examined association between smartphone use and a metabolic or closely related outcome) constituted the primary evidence base. This base was supplemented with additional targeted literature on diagnostic classification, neurobiology, psychiatric comorbidity, and intervention, cited separately, to address conceptual and clinical gaps identified during peer review. Across the included studies, the prevalence of problematic smartphone use ranged from approximately 22% to 53%, varying by instrument, cutoff score, and cultural context. Problematic use was consistently associated with obesity, hypertension, unfavorable dietary patterns, sleep disruption, and reduced physical activity; evidence for a direct association with insulin resistance was more limited and inconsistent. The COVID-19 pandemic was associated with a marked, temporary increase in both screen time and addiction prevalence. Proposed mechanisms include displacement of physical activity, altered dietary behavior, circadian disruption via melatonin suppression, and dysregulation of reward and stress-response circuitry, occurring within an apparently bidirectional relationship with psychiatric symptoms such as anxiety, depression, and attention-deficit/hyperactivity disorder.

Problematic smartphone use appears to be a plausible, modifiable contributor to pediatric metabolic risk, operating through overlapping behavioral, neurobiological, and psychosocial pathways. Because most available evidence is cross-sectional and drawn from a limited number of heterogeneous studies, causal inference is not currently possible, and the associations reported here should be interpreted as correlational rather than confirmed pathogenic relationships. Longitudinal and mechanistic research, alongside coordinated clinical screening and family-centered intervention, is needed to clarify and act on this relationship.

• Previous studies have investigated the role of how excessive use of smartphones has progressively become common among children and adolescents worldwide. • The researches also demonstrated how excessive smartphone use may negatively affect overall well-being in pediatric populations.

• In this review, all the recent studies on smartphone addiction and metabolic health risk in pediatrics are highlighted. • Unlike previous studies that have focused on individual outcomes, this review combines evidence on sleep disturbances, sedentary behavior, psychological factors, dietary pattern, obesity, hypertension, diabetes, and other health consequences within a single framework. • The review highlights the diverse impact of smartphone addiction and identifies important gaps for future research.