Amanda E Staiano

Pennington Biomedical Research Center · Pediatric Obesity and Health Behavior

This chapter summarizes the associations between children’s digital screen media use (DSMU) and their health, within the 24-h movement behavior framework (physical activities, sedentary behaviors, sleep), provides recommendations for healthy DSMU, and highlights future research directions. Key concepts include behavior displacement, combined associ...

This chapter provides an update on and the synthesis of the most current evidence on screen use, nutritional intake, and obesity in youth. The strongest evidence of a mechanism linking screen media use to obesity is through repeated exposures to unhealthy food marketing and excess eating while viewing screens. Evidence of the neurocognitive effects...

The study objectives were 1) to determine the feasibility and acceptability of indoor activities to achieve moderate-to-vigorous physical activity (MVPA) in preschoolers, and 2) compare MVPA estimates between direct observation (DO) and various accelerometry placements. In this cross-sectional study, 35 preschoolers (51% female, 54% 3-year-olds) pe...

Background: Social determinants of health (SDOHs) may affect children’s health and health behaviors. This study aimed to understand the relationship between health behaviors and SDOHs in a child population from under-resourced communities (i.e., Medicaid eligible or enrolled, overweight or with obesity [OWOB], predominantly Black or African America...

Background The actions required to achieve higher-quality and harmonised global surveillance of child and adolescent movement behaviours (physical activity, sedentary behaviour including screen time, sleep) are unclear. Objective To identify how to improve surveillance of movement behaviours, from the perspective of experts. Methods This Delphi S...

Importance The prevalence estimates of physical activity, sedentary behavior, and sleep (collectively known as movement behaviors) in 3- and 4-year-old children worldwide remains uncertain. Objective To report the proportion of 3- and 4-year-old children who met the World Health Organization guidelines for physical activity, sedentary behavior, an...

Background Toddler physical activity is critical for child health, but little is known about its applications in early childhood education (ECE) centers. The aims of this study were 1) to determine if pragmatic and nature-based modifications to an ECE center’s outdoor setting were feasible and acceptable, and 2) to identify barriers and facilitator...

Purpose: Summer day camp offers children opportunities to grow knowledge and skills, be physically active, and have fun. Compared to healthy children, at-risk children (i.e., overweight, or with obesity and chronic health conditions) typically display less optimal health behaviors and psychosocial well-being, especially during summer months. This s...

The aim of this meta-meta-analysis was to systematically review randomised controlled trial (RCT) evidence examining the effectiveness of e- and m-Health interventions designed to improve physical activity, sedentary behaviour, healthy eating and sleep. Nine electronic databases were searched for eligible studies published from inception to 1 June...

Background : There is limited evidence from globally diverse samples on the prevalence and correlates of meeting the global guideline of 180 minutes per day of total physical activity (TPA) among 3- to 4-year-olds. Methods : Cross-sectional study involving 797 (49.2% girls) 3- to 4-year-olds from 17 middle- and high-income countries who participate...

There is some, albeit inconsistent, evidence supporting sex differences in preschoolers' motor competence (MC), with these observations not uniform when analyzed by age, and cultural groups. Thus, this study examined sex differences across ages in 3‐ to 5‐year‐old children's MC. A cross‐country pooled sample of 6241 children aged 3–5 years (49.6% g...

Background/objective Previous studies found conflicting results on the association between maternal gestational diabetes mellitus (GDM) and childhood overweight/obesity. This study was to assess the association between maternal GDM and offspring’s adiposity risk from 6 to 8 years of age. Methods The present study longitudinally followed 1156 mothe...

Objective The aim of this substudy within the Treatment Efforts Addressing Child Weight Management by Unifying Patients, Parents, and Providers (TEAM UP) pragmatic clinical trial was to compare the validity of anthropometric measurements collected remotely versus in‐person (≤7 days apart) among youth with obesity who were 6 to 15 years of age. Met...

Background and Objective One in five preschool children are overweight/obese, and increased weight status over time increases the risks of poorer future health. Motor skill competence may be a protective factor, giving children the ability to participate in health-enhancing physical activity. Yet, we do not know when the relationship between motor...

Background Preschool children are not meeting recommended levels of physical activity (PA) nor are they proficient in fundamental motor skills (FMS), which are the foundation for PA. As such, interventions are needed to increase PA and FMS in young children. This trial examined the effects of an environmental (“painted playgrounds”) and capacity-bu...

Background Health disparities faced by autistic youth are exacerbated by inadequate physical activity (PA) and sleep, whereas healthy PA and sleep may improve mood and function. Adaptive Game Squad (AGS) is an evidence-based telehealth coaching and exergaming intervention to improve PA and sleep for adolescents with diverse neurodevelopmental and p...

Background: Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 y...

In book 1 of this 3-part series, we are pleased to present an extensive collection of adolescent health articles that address the diverse needs of the adolescent and young adult population as it relates to preventative health. Through a wide variety of research, we have come to a greater, more informed understanding of the vast needs of this dynami...

Introduction Remotely delivered treatment and research procedures were rapidly adopted in response to the COVID-19 pandemic. However, it is unclear if these measures are valid. The purpose of this study was to compare the validity of anthropometry and motor skill proficiency measurements collected in a remote-setting to in-person setting among a sa...

This study aimed to examine the temporal changes in energy-balance behaviors and home factors in adolescents with normal weight and those with overweight or obesity (OWOB). Adolescents or parent proxies completed survey assessments two to four years before (T0; n = 82), ≤ six months before (T1; n = 68), and ≤ three months after the COVID-19 pandemi...

Background: More moderate to vigorous physical activity (MVPA) and less time in sedentary behavior (SB) may protect against poor mental health in adolescence. Depressive symptomatology may also influence adolescents' own MVPA and SB. The aim of this study was to examine the bidirectional relationship between adolescent MVPA, SB, and depressive sym...

The objective of this technical report is to provide clinicians with actionable evidence-based information upon which to make treatment decisions. In addition, this report will provide an evidence base on which to inform clinical practice guidelines for the management and treatment of overweight and obesity in children and adolescents. To this end,...

The objective of this technical report is to provide clinicians with evidence-based, actionable information upon which to make assessment and treatment decisions for children and adolescents with obesity. In addition, this report will provide an evidence base to inform clinical practice guidelines for the management and treatment of overweight and...

Background: Multiple state and local governments have legislated screen time policy regulations in early care and education (ECE) centers in the United States, though little is known about how and whether these are enacted within these settings. This study examined the implementation, communication, monitoring, enforcement, and evaluation strategi...

Purpose: To examine the effects of substituting sedentary time with sleep or physical activity on adiposity in a longitudinal sample of adolescents. Methods: Adolescents (10-16 y) were recruited for a prospective observational cohort. Parents and adolescents reported demographic characteristics and pubertal development. Accelerometry was used to...

This cross-sectional study assesses trends in the prevalence of obesity in children and adolescents in the US between 2011 and 2020.

Physical activity has many health benefits, yet a large portion of our population is not meeting recommendations. Using accelerometry and global positioning systems (GPS) to accurately measure where people are active and to identify barriers and facilitators of activity across various settings will inform evidence-based policies and interventions t...

Background Race and sex differences in adolescents’ body fat are demonstrated in cross-sectional cohorts, yet a longitudinal design would better identify patterns of fat distribution over time. Objective The aim was to examine race and sex differences in adiposity between Black and White adolescents over 2-years. Design A cohort of adolescents ag...

Children and adolescents with psychiatric and neurodevelopmental diagnoses such as anxiety, depression, autism, and attention-deficit/hyperactivity disorder (ADHD) face enormous health disparities, and the prevalence of these disorders is increasing. Social, emotional, and behavioral disabilities (SEBD) often co-occur with each other and are associ...

The prevalence of pediatric obesity has increased over the past 40 years and the rate in females 6 to 19 years old is currently over 19%. This profound increase in obesity is predicted to negatively impact health and result in multiple obesity-related comorbidities in adulthood. Obesity disproportionately affects ethnic minorities with a higher per...

Background and objectives: Children's motor skills are a critical foundation for physical activity. The objective was to determine the effectiveness and feasibility of a mobile app-based intervention delivered to parents to improve preschoolers' motor skills. Methods: This randomized controlled trial randomly assigned children to : (1) Motor Ski...

Parrish et al.‘s (2021) investigation of caregiver perceptions of preschoolers' physical activity (PA) within the home environment posits important opportunities for public policy to consider space and available opportunities for PA for preschoolers. This study uncovered qualitative themes on preschoolers' PA in the home, referencing the use of ind...

Background: Nearly all schools in the United States experienced shutdown followed by phased reopening during the COVID-19 pandemic, thereby limiting students' opportunities for physical activity (PA). This study aimed to examine adolescents' PA at school (PAS) and PA out-of-school (PAO), screen-based sedentary behaviors (SbSB), health-related fitn...

Purpose: There is a paucity of global data on sedentary behaviour during early childhood. The purpose of this study was to examine how device-measured sedentary behaviour in young children differed across geographically, economically, and socio-demographically diverse populations, in an international sample. Methods: This multinational, cross-se...

Night-time screen-viewing (SV) contributes to inadequate sleep and poor diet, and subsequently excess weight. Adolescents may use many devices at night, which can provide additional night-time SV. Purpose: To identify night-time SV patterns, and describe differences in diet, sleep, weight status, and adiposity between patterns in a cross-sectional...

Exercise may sensitize individuals with overweight and obesity to appetitive signals (e.g., hunger and fullness cues), overriding trait eating behaviors that contribute to overeating and obesity, such as uncontrolled eating. The objective of the current study was to measure predictors of objective ad libitum energy intake at a laboratory-based, pos...

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviour...

Childhood obesity is a public health concern. Electronic and mobile health (e-&mHealth) approaches can facilitate the delivery of interventions for obesity prevention and treatment. Synthesizing reviews of e-&mHealth interventions to improve weight and weight-related behaviors (physical activity, sedentary behavior, and diet) is useful to character...

Background: Significant gaps exist in access to evidence-based pediatric weight management interventions, especially for low-income families who are disproportionately affected by obesity. As a part of the Centers for Disease Control and Prevention's Childhood Obesity Research Demonstration project (CORD 3.0), the Missouri team (MO-CORD) aims to in...

Background: Significant gaps exist in access to evidence-based pediatric weight management interventions, especially for low-income families. As a part of the Centers for Disease Control and Prevention's Childhood Obesity Research Demonstration project 3.0 (CORD), the Missouri CORD (MO-CORD) team aims to increase access to and dissemination of an e...

Introduction The present study examined the relationships between bullying victimization experiences, body esteem (BE), and body dissatisfaction (BD) by obesity status. Methods Using a cross‐sectional design, adolescents (10‐16y) from the U.S. completed surveys. Weight and height were objectively assessed. Bullying was assessed using the Personal...

A vast body of evidence regarding eHealth interventions for nutrition, physical activity, sedentary behavior, and obesity exists. This scoping review of systematic reviews aimed to evaluate the current level of evidence in this growing field. Seven electronic databases were searched for systematic reviews published until October 27, 2019. The syste...

Background The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children’s daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children’s movement behaviours be...

Background The prevalence of neurodevelopmental and psychiatric diagnoses (NPDs) in youth is increasing, and unhealthy physical activity (PA), diet, screen time, and sleep habits contribute to the chronic disease disparities and behavioral challenges this population experiences. Objective This pilot study aims to adapt a proven exergaming and tele...

Background The home environment is an important facilitator of young child movement behaviors, including physical activity (PA), sleep, and screen-time. Household chaos, characterized by crowding, noise, and disorder in the home, may hinder efforts to obtain adequate amounts of movement behaviors. The COVID-19 outbreak impacted many families, and s...

Objectives: Household chaos, including disorder, noise, and crowding within the home, is a risk factor for poor mental and physical health. Household chaos may act upon maternal behaviors of physical activity and sleep, potentially via higher stress. The purpose of this study is to evaluate the relationships among household chaos, maternal stress,...

Abstract Background Few adolescents achieve sufficient levels of physical activity, and many are spending most of their time in sedentary behavior. Affective response following sedentary time may influence motivation to remain sedentary. Ecological Momentary Assessment (EMA) is a real-time data capture methodology that can be used to identify facto...

Background: Few studies have examined both parent and child preferences regarding family-based weight management programs (WMPs) delivered in primary care settings, especially among racial minority populations. The purpose of this study was to determine the perceptions that parents and their children/adolescents have about the components that shoul...

Aim To describe concurrent screen use and any relationships with lifestyle behaviours and psychosocial health. Methods Participants wore an accelerometer for seven days to calculate physical activity sleep and sedentary time. Screen ownership and use and psychosocial variables were self‐reported. Body mass index (BMI) was measured. Relationships w...

A systematic review was performed to synthesize the latest evidence of health information technology (HIT) used by healthcare professionals to address overweight/obesity among children and adolescents. This literature has not been summarized since 2012 despite the rapidly changing nature of HIT, the millions of federal healthcare dollars invested i...

Technology holds promise for delivery of accessible, individualized, and destigmatized obesity prevention and treatment to youth. This review examined the efficacy of recent technology-based interventions on weight outcomes. Seven databases were searched in April 2020 following PRISMA guidelines. Inclusion criteria were: participants aged 1–18 y, u...

BACKGROUND: Family-based behavioral therapy is an efficacious approach to deliver weight management counseling to children and their parents. However, most families do not have access to in-person, evidence-based treatment. We previously developed and tested DRIVE (Developing Relationships that Include Values of Eating and Exercise), a home-based p...

Excess abdominal visceral adipose tissue (VAT) is associated with cardiometabolic risk factors in adolescents. VAT is mainly measured using Magnetic Resonance Imaging (MRI), yet dual-energy x-ray absorptiometry (DXA) is more affordable and available. The purpose was to compare adolescent VAT values obtained by MRI and DXA. A sample of 330 adolescen...

Fundamental motor skills (FMSs) are building blocks for future movements and may vary according to cultural context. Moreover, network analysis can identify which skills contribute most to an overall set of skills. This study identified the most influential FMS in samples of U.S. and Brazil preschoolers that may contribute to a pattern of adequate...

Approximately 17% of children in the United States have obesity, and the U.S. Preventive Services Task Force recommends comprehensive behavioral family-based weight management programs to treat childhood obesity. Family-based programs are efficacious, though families must present to treatment centers, many of which are in centers of excellence, to...

Background: The 2020 COVID-19 pandemic has placed unprecedented restrictions on children’s ability to participate in adequate movement behaviours. This international longitudinal study compared young children’s physical activity, sedentary behaviour and sleep behaviours before and during the COVID-19 pandemic. Methods: Parents of children aged 3-5...

Background Preschool age is an important time to master fundamental motor skills (FMS) through structured physical activity, yet many young children lag behind in motor skill development. Objective The Promoting Lifelong Activity in Youth (PLAY) study is a pilot comparative effectiveness trial to test the acceptability, feasibility, and preliminar...

BACKGROUND Family-based behavioral therapy is an efficacious approach to deliver weight management counseling to children and their parents. However, most families do not have access to in-person, evidence-based treatment. We previously developed and tested DRIVE (Developing Relationships that Include Values of Eating and Exercise), a home-based pa...

BACKGROUND The prevalence of neurodevelopmental and psychiatric diagnoses (NPDs) in youth is increasing, and unhealthy physical activity (PA), diet, screen time, and sleep habits contribute to the chronic disease disparities and behavioral challenges this population experiences. OBJECTIVE This pilot study aims to adapt a proven exergaming and tele...

Exergames are digital games that require the player to engage in physical activity including upper or lower body movement. Traditionally played on a video game console via peripherals and/or infrared cameras, exergames are now being played on smartphones and attached to exercise equipment like stationary cycling. Numerous studies have demonstrated...

Objective: The Action for Health in Diabetes (Look AHEAD) trial was a randomized trial comparing effects of intensive lifestyle intervention (ILI) and diabetes support and education (DSE) on cardiovascular disease (CVD) among individuals with overweight/obesity and type 2 diabetes. A secondary analysis was conducted to evaluate the association bet...

Background: High levels of sedentary behavior and low physical activity are associated with poor health, and the cognitive determinants of these behaviors in children and adolescents are not well understood. To address this gap, we developed a novel, non-verbal, computer-based assessment to quantify the degree to which youth prefer to be sedentary...

OBJECTIVE To examine the association among 24 -h movement guidelines and fundamental motor skills (FMS) in preschoolers. DESIGN Prospective cohort study with one-year follow-up. METHODS Parents of 3-4-year-old children reported child age, sex, race, and time spent viewing screens (hours/day). Accelerometers measured preschooler physical activity...