Identification of lifestyle patterns associated with obesity and fat mass in children: the Healthy Growth Study

Abstract

Objective: To investigate possible associations of lifestyle patterns with obesity and fat mass in children. Design: Cross-sectional epidemiological study. Principal component analysis was used to identify lifestyle patterns. Setting: Primary schools from four regions in Greece. Subjects: A total of 2073 schoolchildren (aged 9-13 years). Results: Children in the fourth quartile of the lifestyle pattern combining higher dairy foods with more adequate breakfast consumption were 39?4 %, 45?2 % and 32?2 % less likely to be overweight/obese and in the highest quartile of sum of skinfold thicknesses and fat mass, respectively, than children in the first quartile of this pattern. Similarly, children in the fourth quartile of a lifestyle pattern comprising consumption of high-fibre foods, such as fruits, vegetables and wholegrain products, were 27?4 % less likely to be in the highest quartile of sum of skinfold thicknesses than children in the first lifestyle pattern quartile. Finally, children in the fourth quartile of a lifestyle pattern characterized by more time spent on moderate-tovigorous physical activity and more frequent meals were 38?0 %, 26?3 % and 29?5 % less likely to be overweight, centrally obese and in the highest quartile of fat mass, respectively, than their peers in the first quartile of this lifestyle pattern (all P , 0?05). Conclusions: The current study identified three lifestyle patterns (i.e. one pattern comprising higher dairy consumption with a more adequate breakfast; a second pattern characterized by increased consumption of high-fibre foods; and a third pattern combining higher physical activity levels with more frequent meals), which were all related with lower odds of obesity and/or increased fat mass levels. From a public health perspective, promotion of these patterns among children and their families should be considered as one of the components of any childhood obesity preventive initiative.

Patterns of lifestyle-related behaviors and parents’ overweight are associated with increased body adiposity in schoolchildren: a cross-sectional study in Portugal

“…According to this theory, one way to reduce the currently observed high prevalence of obesity, involving lifestyle-related behaviors, is the reduction in the consumption of high energy-dense and nutrientpoor foods [31]. The lifestyle patterns of the Portuguese children were similar to those observed among Greek children and adolescents [19,22,23]. Yannakoulia et al [19] found that the pattern characterized by consumption of vegetables, cooked meals, and eating dinner was inversely associated with BMI, WC, and the triceps skinfold, and the pattern characterized by consumption of whole-grain, legumes, and low consumption of sugar-sweetened drinks was inversely associated with the triceps skinfold.…”

“…Vartanian et al [15] performed a meta-analysis of 88 articles and found significant associations between soft drink consumption and increased caloric intake and body weight. Milk and dairy products serve as one of the best sources of dietary calcium with high bioavailability [23], and they have consistently been associated with reduced body fat [35,36]. Skinner et al [35] monitored children beginning when they were 2 months old and found that the intake of dairy products was associated with a lower body fat percentage at 8 years old.…”

“…However, they are highly interrelated [19,20], being necessary to identify multidimensional patterns to better understand the complexity of the relationship between these behaviors and weight status [21]. The principal component analysis (PCA) has become a common approach because it considers the possible synergy of these factors by grouping strongly related behaviors in different patterns [19,[21][22][23].…”

Risk Behaviour Patterns for Chronic Diseases and Associated Factors Among Adolescents

“…Other studies have aimed to identify the occurrence of behavior patterns using PCA (6)(7)(8). Among them, Busch et al (6) identified four patterns among adolescents in the Netherlands: "behavior prone to risk" (alcohol consumption, smoking, drug use, and early sexual activity), "bully behavior" (bullying and compulsive use of the Internet), "problematic screen time" (excessive time using video games and internet), and "sedentary behavior, unhealthy eating habits, and insufficient physical activity" (excessive weekly time watching TV and using the internet, unhealthy eating habits, and insufficient physical activity).…”

“…Moreover, it has been shown that certain risk behaviors increase the risk of involvement in others, forming clusters of behaviors (6)(7)(8), that is, the occurrence of concurrent risk behaviors in adolescents (9,10). Simultaneity of different risk behaviors may have a synergistic effect on the deterioration of individual health; in other words, it may result in a multiplicative deleterious effect, rather than an additive effect of each behavior (11).…”