Prudent-Active and Fast-Food-Sedentary Dietary-Lifestyle Patterns: The Association with Adiposity, Nutrition Knowledge and Sociodemographic Factors in Polish Teenagers—The ABC of Healthy Eating Project

Abstract

A holistic approach to understanding the relationship between diet, lifestyle and obesity is a better approach than studying single factors. This study presents the clustering of dietary and lifestyle behaviours to determine the association of these dietary-lifestyle patterns (DLPs) with adiposity, nutrition knowledge, gender and sociodemographic factors in teenagers. The research was designed as a cross-sectional study with convenience sampling. The sample consisted of 1549 Polish students aged 11–13 years. DLPs were identified with cluster analysis. Logistic regression modelling with adjustment for confounders was applied. Three dietary-lifestyle patterns were identified: Prudent-Active (29.3% of the sample), Fast-food-Sedentary (13.8%) and notPrudent-notFast-food-lowActive (56.9%). Adherence to Prudent-Active pattern (reference: notPrudent-notFast-food-lowActive) was 29% or 49% lower in 12-year-old or 13-year-old teenagers than in 11-year-old teenagers, respectively, and higher by 57% or 2.4 times in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score. To the contrary, adherence to Fast-food-Sedentary (reference: notPrudent-notFast-food-lowActive) was lower by 41% or 58% in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score, respectively. In Prudent-Active, the chance of central obesity (waist-to-height ratio ≥0.5) was lower by 47% and overweight/obesity was lower by 38% or 33% (depending on which standard was used: International Obesity Task Force, 2012: BMI (body mass index)-for-age ≥ 25 kg/m2 or Polish standards, 2010: BMI-for-age ≥ 85th percentile) when compared with the notPrudent-notFast-food-lowActive pattern. In Fast-food-Sedentary, the chance of central obesity was 2.22 times higher than the Prudent-Active pattern. The study identified a set of characteristics that decreased the risk of general and central adiposity in teenagers, which includes health-promoting behaviours related to food, meal consumption and lifestyle. Avoiding high-energy dense foods is insufficient to prevent obesity, if physical activity and the consumption frequency of health-promoting foods are low and breakfast and a school meal are frequently skipped. The results highlight the importance of the nutrition knowledge of teenagers in shaping their health-promoting dietary habits and active lifestyle to decrease adiposity risk and negative aspects of lower family affluence which promotes unhealthy behaviours, both related to diet and lifestyle.

The Impact of an Educational Institution on Development of Healthy Lifestyle Skills for Prevention of Obesity in Adolescents

“…Important indicators of level of development of healthy lifestyle skills are eating behavior and physical activity. For effective prevention of obesity, it is necessary to combine limited foodstuffs with high number of calories, sufficient physical activity and consumption of healthful foodstuffs [2,11,12].…”

Lifestyle Patterns Begin in Early Childhood, Persist and Are Socioeconomically Patterned, Confirming the Importance of Early Life Interventions

“…Proposed mechanisms include: watching TV or movies as a hand-free passive occupation enables snacking; exposure to advertising of junk food and fast food when watching TV may increase children's requests for those particular foods and products; and viewing screens while eating distracts from internal satiety cues potentially leading to overconsumption [37][38][39]. Notably, a lifestyle pattern characterized by consumption of discretionary foods and drinks, and elevated screen time, is the pattern most often associated with child overweight in the literature [8][9][10][11][12]35,36].…”

“…The two most commonly observed lifestyle patterns in children are a "Snacking and sedentary" pattern, characterized by high consumption of energy-dense or processed foods along with high screen time (mostly television); and a "Healthy diet and physically active" pattern, often characterized by high consumption of core foods such as fruit and vegetables, along with high levels of physical activity. These two socio-economically differentiated lifestyle patterns are important as they reflect inter-related behavioural combinations that contribute either positively or negatively to energy balance, and have been shown to be associated with higher vs. lower risk of obesity in children [8][9][10][11][12]. Analysing the socio-demographic characteristics of the population groups exposed to co-occurrence or clustering of unhealthy behaviours can also inform the targeting of obesity prevention interventions.…”

Empirically derived dietary-lifestyle patterns and cardiometabolic health in young men: a review

“…dietary patterns or dietary-lifestyle patterns) and health outcomes using modelling, e.g. regression analysis or survival analysis (35) . The exploratory nature of this technique means that initially the components (sets of variables) are not known to the researcher and no assumptions can bias the results.…”