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. 2025 Apr 29;12(5):576.
doi: 10.3390/children12050576.

Influence of Screen Time on Physical Activity and Lifestyle Factors in German School Children: Interim Results from the Hand-on-Heart-Study ("Hand aufs Herz")

Jennifer Wieprecht  1 , Delphina Gomes  1 , Federico Morassutti Vitale  1 , Simone Katrin Manai  1 , Samar Shamas  2 , Marcel Müller  2 , Maren Baethmann  1 , Anja Tengler  1 , Roxana Riley  1 , Guido Mandilaras  1 , Nikolaus Alexander Haas  1 , Meike Schrader  1
Affiliations

Influence of Screen Time on Physical Activity and Lifestyle Factors in German School Children: Interim Results from the Hand-on-Heart-Study ("Hand aufs Herz")

Jennifer Wieprecht et al. Children (Basel). .

Abstract

Background/Objectives: Today, digital technologies are integral to children's lives; their increasing use, however, may raise health concerns. This study aims to examine the effect of screen time on physical activity and lifestyle factors in German school children. Methods: As part of the prospective hand-on-heart-study ("Hand-aufs-Herz"), a comprehensive cardiovascular system check-up examination was conducted on 922 German schoolchildren. The pupils were asked for a self-report on their daily physical activities and club sports. The examinations on-site contained measurements of the pupils' weight and height as well as their physical fitness, which was assessed by a stair-climbing test. Results: A large proportion of pupils had a screen time of more than 2 h daily, regardless of the day of the week (63-76%). In fact, pupils with a screen time ≥ 2 h were more likely to achieve poor grades in school (weekday ORs 3.23, 95% CI 1.76, 5.95; weekend ORs 3.28, 95% CI 1.53, 7.00) and not be members of a sports club (weekday ORs 2.35, 95% CI 1.68, 3.29; weekend ORs 2.13, 95% CI 1.44, 3.14). Pupils who did not meet both recommendations for physical activity and screen time walked <5000 steps daily (60%), had a high proportion of overweight/obesity (40%), were non-swimmers (38.5%), spent ≥7 h sitting (35.8%), and slept fewer hours than recommended (30%). It has also been shown that longer screen time has a negative impact on the lifestyle of children and young people. Conclusions: Our results show that excessive screen time in children is linked to higher weight and an unhealthy lifestyle, increasing long-term cardiovascular risks. Public health initiatives aimed at reducing screen time, promoting physical activity, and encouraging healthier habits are essential to improve children's overall health and prevent future chronic diseases.

Keywords: BMI; adolescents; hand-on-heart-study (“Hand aufs Herz”); physical activity; screen time; sports clubs.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Proportion of children adhering to screen time and physical activity recommendations. (A) shows the results of the physical fitness assessment on-site. (B) shows proportion of pupils within or exceeding screen time recommendations. (C) shows proportion of children who fulfill both, only 1, or none of the recommendations.
Figure 2
Figure 2
Lifestyle indicators according to adherence to screen time and physical activity recommendations. p-values are based on χ2 test.
See this image and copyright information in PMC

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