Evidence map›Paper›PMID 41639908›Full record

ArticleThe international journal of behavioral nutrition and physical activity2026

Bidirectional associations between smart device use and body mass index among children aged 3 to 5 years: a longitudinal study.

Pairote Chakranon, Jian-Pei Huang, Heng-Kien Au, Hawjeng Chiou, Chen-Li Lin, Yi-Yung Chen, Shih-Peng Mao, Pilyoung Kim, Hsueh-Wen Hsu, Yi-Hua Chen

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Article in The international journal of behavioral nutrition and physical activity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Pairote ChakranonSchool of Public Health, College of Public Health, Taipei Medical University, New Taipei, Taiwan.
Jian-Pei HuangDepartment of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Heng-Kien AuDepartment of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan.
Hawjeng ChiouDepartment of Business Administration, College of Management, National Taiwan Normal University, Taipei, Taiwan.
Chen-Li LinDepartment of Obstetrics & Gynecology, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan.
Yi-Yung ChenDepartment of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Shih-Peng MaoDepartment of Obstetrics and Gynecology, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei, Taiwan.
Pilyoung KimDepartment of Psychology, College of Arts, Humanities and Social Sciences, University of Denver, Denver, CO, USA.
Hsueh-Wen HsuMaster Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Yi-Hua ChenSchool of Public Health, College of Public Health, Taipei Medical University, New Taipei, Taiwan. yichen.tmu@gmail.com.

Funding

Ministry of Education the Higher Education Sprout Project; DP2-TMU-112-O-10, DP2-TMU-113-O-04, DP2-TMU-114-O-03National Science and Technology Council NSTC 114-2314-B-038 -039 -MY3, NSTC 114-2621-M-038-001, NSTC 113-2621-M-038-003, NSTC 112-2621-M-038-003, MOST 111-2314-B-038-043-MY3, MOST 108-2314-B-038-083-MY3, MOST 105-2314-B-038-031-MY3, NSC 102-2314-B-038-038-MY3, and NSC 99-2628-B-038-015-MY3
6 · The paper itself

Abstract

backgroundThe increase in smart device use, including smartphones and tablets, among young children has raised concerns about its impact on health, particularly on body mass index (BMI). However, the bidirectional associations between smart device use and BMI in preschoolers remain unclear. This study examined the longitudinal associations, considering the moderating effects of mother-child interactions and child sex.

methodsData were obtained from the Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan, a cohort study conducted in Taipei, Taiwan. In total, 590 preschoolers were assessed at ages 3, 4, and 5 years. Smart device use, BMI z-scores, and mother-child interaction quality were evaluated using validated parent-reported questionnaires. The random-intercept cross-lagged panel model was used to investigate bidirectional associations, adjusting for stable confounders. Multiple-group models examined the moderating effects of mother-child interactions and child sex. Model estimates were reported as standardized coefficients.

resultsHigher BMI z-scores at age 4 years were linked to increased device use at age 5 years (β = 0.36; 95% CI, 0.05-0.67). Multiple-group models revealed that among dyads with lower mother-child interactions, higher device use at age 3 years was associated with higher BMI at age 4 years (β = 0.40; 95% CI, 0.07 to 0.72), which was subsequently linked to greater device use at age 5 years (β = 0.50; 95% CI, 0.10 to 0.90). Additionally, higher device use at age 4 years was associated with higher BMI at age 5 years (β = 0.65; 95% CI, 0.31 to 1.00). A similar bidirectional pattern was observed among boys, while no significant cross-lagged associations were found among girls. In contrast, high-quality mother-child interactions revealed higher device use at age 4 years was associated with lower BMI at age 5 years, suggesting a protective role against prolonged device use and subsequent BMI increases.

conclusionsOur study indicates bidirectional associations between smart device use and BMI among preschoolers, emphasizing the protective role of high-quality mother-child interactions. Interventions should focus on enhancing parent-child relationships, limiting device use, and promoting active engagement. Future studies should investigate the effect of media content and children's self-regulation on these associations.

Indexed as

Body Mass IndexComputers, HandheldMother-Child RelationsSmartphoneChild, PreschoolFemaleHumansLongitudinal StudiesMaleSurveys and QuestionnairesTaiwanBody mass indexMother-child interactionsPreschoolerSmart device use

Identifiers

PMID41639908
PMCPMC12958733

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.