Eating while distracted: a systematic review and meta-analysis of the effect of distraction on concurrent and later energy intake in adults

BACKGROUND: Eating while distracted e.g., television (TV) watching, phone use is believed to increase food intake. A previous small meta-analysis of experimental studies (published in American Journal of Clinical Nutrition) supported this. Many studies have since been published, which call for an updated analysis. OBJECTIVES: This study aimed to conduct an updated systematic review and meta-analysis to examine the effect of distraction on concurrent and later intake. METHODS: Eligible articles (searching up to December 2024) were identified from: a previously conducted meta-analysis which included studies up until 2012; database searches from 2012 to 2024 (PsycINFO, Medline, and PubMed); and both forward and backward citation searching. We followed PRISMA guidelines and conducted generic variance inverse meta-analyses with intake as the outcome variable for both concurrent and later intake. RESULTS: A total of 50 eligible studies were included (40 measuring concurrent intake, 10 measuring later intake). Random effects meta-analyses revealed that the overall effect of distraction on concurrent intake was nonsignificant standardized mean difference (SMD) = 0.123, 95% confidence interval (CI): <-0.01, 0.25; P = 0.051. Moderator analyses revealed that type of distractor moderated the effect of distraction on eating, with passive distractor tasks (e.g., TV watching) resulting in greater food intake when distracted SMD = 0.272 (95% CI: 0.128, 0.417), whereas physically demanding distractors SMD = -0.139 (95% CI: -0.334, 0.057) and cognitively demanding distractors SMD = 0.202 (95% CI: -0.028, 0.432) did not. The effect of distraction on later intake was statistically significant, such that eating while distracted led to greater intake at a subsequent eating episode SMD = 0.419 (95% CI: 0.195, 0.642). CONCLUSIONS: Distracted eating increases later intake; however, the effect of distracted eating on concurrent intake is less consistent, and only relatively passive distractors may increase energy intake. Collectively, these findings highlight the impact of distracted eating on food intake as a potential contributor to overeating. This systematic review and meta-analysis was registered at PROSPERO as CRD42024518245.