It’s no secret that some kids and teenagers get too much screen time in any given day. And that could mean health issues down the road.

According to a study published in the Journal of American Heart Association, kids and teens who spend time on screens and get less sleep have a greater risk for future heart and metabolic issues like high blood sugar, high blood pressure and cholesterol levels.

The study came from data collected from more than 1,000 kids and teenagers from Denmark. Teenagers with excess screen time were especially at risk. Screen time included either watching TV or using electronic devices for videogaming or socialization.

Natasha Noel, MD, a pediatric cardiologist with OSF HealthCare Cardiovascular Institute, says studies like this are invaluable.

“I liked the fact that they highlighted that everyday habits could have an effect on the cardiac health of kids and teens,” she says. “I also liked that they didn't focus on weight alone, but they looked at other metabolic measures like high blood pressure, cholesterol and blood glucose.”

When kids are up late at night, obviously it can impact sleep, which regulates hormones, metabolism and blood pressure.

“When you have lack of sleep for whatever reason, and in this case, maybe late, prolonged screen times, it could increase your insulin resistance,” says Dr. Noel. “It could increase your appetite, your weight, blood pressure levels.”

Dr. Noel adds that more information is probably needed. Since the study reviewed a Danish population, Dr. Noel says the medical community would benefit from a larger and more diverse group of children for future studies. Another study could analyze what types of screens are used, the purposes for which they are used, and the long-term effects on the kids.

“Of the many things they told us was that not only more screen time, but more screen time occurring with less sleep,” she says. “That kind of had an additive effect on cardiovascular risk factors.”

More physical activity 

The study indirectly illustrates the importance of kids and the need for physical activity. If they’re crashed in front of the TV watching movies or playing video games, it could be an indication they are not getting enough physical movement needed for cardiovascular health.

“Physical activity is one of the mainstays of treatment, especially when we do lifestyle management for high blood pressure and high cholesterol,” she says. But even with physical activity, that screen time and less sleep may be independent risk factors for cardiovascular health long term for kids.”

Dr. Noel emphasizes to her patients the importance of incorporating more movement into daily routines. She recommends walking or biking to school, playing outside with friends, or participating in sports or theater.

It’s a conversation Dr. Noel has with many of her patients and their parents. She stresses that she’s not against screen time. But it’s important to set some ground rules – limit the use of screens, no screens in the bedroom when it’s time for bed and keep a consistent bedtime.

“It's not about taking it out of the picture completely. It's about balance and limiting it,” she says. “Believe it or not, the habits children build today, how they eat, how they move, how they sleep and how they use technology, could affect their long-term cardiac health.”

For more information about pediatric cardiology services, visit OSF HealthCare Children’s Hospital of Illinois.

Interview Clips 

OSF HealthCare gastroenterologist Omar Khokhar, MD, says it’s a homemade drink that includes a few main ingredients.

“It’s oranges, coconut water and salt. It can be derivatives of each one of those ingredients but that’s sort of the nuts and bolts of it. The thought process is that each one of those ingredients helps with the electrolyte balance in your body once you ingest this mocktail.”

The drink is designed to promote development of cortisol, a stress hormone that influences several systems in the body.

“Cortisol is one of many chemicals produced by a small gland on top of your kidney called the adrenal gland. And so, cortisol plays a key role in metabolism, immune function, blood-sugar metabolism and so any disruption in your cortisol metabolism can have a downstream effect in other parts of your body leading to potential health issues.”

The drink claims to help with something influencers have labeled “adrenal fatigue” and weight loss by increasing cortisol. But here’s the catch — Dr. Khokhar says the science doesn’t back it up.

“Adrenal fatigue has been debunked in 2016 by a meta-analysis, and it is not a true condition. The other pertinent point that people should know is that taking a cortisol mocktail does not in any way shape or form alter your cortisol levels. It has no impact on producing more cortisol or reducing cortisol levels in any way.”

There is a condition known as adrenal insufficiency, which is a serious medical condition in which the adrenal glands fail to produce enough cortisol. Symptoms include nausea, vomiting, low blood pressure, low blood sugar and extreme fatigue. Dr. Khokhar says if you experience these symptoms, see a doctor right away.

If you want to improve cortisol levels in a meaningful way, Dr. Khokhar suggests other approaches.

“There are things that are much more data-driven that can help with that. That includes getting seven or eight hours of sleep. That includes reducing your stress through meditation or other practices.” He also suggests, “That includes eating a healthy diet. Those are things that are maybe more difficult to do but they’ve been shown to improve cortisol levels, whether they’re high or low.” (

Dr. Khokhar says a cortisol cocktail as its being touted likely won’t harm you if you don’t have an underlying condition such as diabetes or high blood pressure that could be impacted by a sugary, salty drink.

On its own, he says coconut water has health benefits because it has electrolytes and hydrating properties. So, it can help with rehydration, especially after exercise or illness, and could also support heart health, blood sugar management, and digestive health. 

Additionally, coconut water and orange juice are a good source of Vitamin C and other antioxidants so benefits worth sipping, even if cortisol isn’t part of the picture. 

Dr. Omar Khokhar

B-roll-Cortisol Cocktail