Clustering of Lifestyle and Health Behaviours in Australian Children and Their Relationship with Obesity, Self-Rated Health and Quality of Life

Abstract

Objective This study identifies the clustering of lifestyle and health behaviours in a nationally representative sample of Australian children and adolescents and explores the association of the clusters with obesity, self-rated health and quality of life. Methods The study participants were 3127 children aged 14/15 years who participated in the 8th Wave of the birth cohort of the Longitudinal Study of Australian Children (LSAC). A latent class analysis (LCA) was conducted to identify clusters on the basis of the following health behaviours: physical activity, sedentary behaviour, alcohol consumption, smoking, diet, eating disorders, sleep problems, and weight-gain consciousness. Obesity, self-rated general health, and pediatric health related to quality of life were used in this study to compare the latent groups. Multinomial logistic regression was used to investigate the association among LCA clusters and health outcome variables. Results Based on the lifestyle and health behaviour characteristics, latent class analysis found better model fits for identifying distinct clusters among male and female children separately, rather than all children. The study identified five clusters for male children: healthy lifestyle cluster (n = 624, 38.9%), temperate cluster (n = 440, 27.4%), physically inactive cluster (n = 73, 4.6%), mixed lifestyle cluster (n = 347, 21.6%) and multiple risk factor cluster (n = 122, 7.6%). For female children, this study found following four clusters: healthy lifestyle cluster (n = 659, 43.3%), temperate cluster (n = 558, 36.7%), mixed lifestyle cluster (n = 63, 4.2%) and multiple risk factor cluster (n = 241, 15.8%). Children from the healthy lifestyle and temperate clusters reported low and moderately active health risk behaviours, respectively; mixed lifestyle or multiple risk factor clusters showed higher negative association on health-related quality of life score compared to healthy lifestyle clusters for both male and female children. Conclusion This current study identifies sex-segregated discernible patterns of lifestyle and health behaviours in Australian adolescents. The study findings lead to an improved classification strategy for children with different lifestyles and health related behaviours to identify characteristics of the vulnerable groups in relation to obesity, general health status and quality of life.

The clustering of multiple health and lifestyle behaviours among Swedish adolescents: A person-oriented analysis

“…However, tests of measurement invariance indicated that the clusters may be meaningfully compared [45]. These results echo the findings from earlier studies [20,22,23,25,[43][44][45], which suggests that the frequency, intensity and overall HLB patterns are not the same for all groups.…”

“…This suggests that the effects of HLBs may be multiplicative and/or cumulative rather than additive [21]. Previous studies from high income countries demonstrated that HLBs tend to cluster among people with similar socioeconomic and demographic circumstances [20][21][22][23][24], with those in lower socioeconomic circumstances being associated with less healthy behaviours [20,[22][23][24][25].…”

“…NCDs are known contributors to the burden of disease and premature death among adults in Sweden [13], resulting in significant costs to the health and care systems [18]. Moreover, research has shown that EBH, PA, TU, AC and SHP tend to co-occur in complex ways [19, 20], and that the combination of these behaviours may have more conducive or detrimental effects on an individual’s health, than the effects of single HLBs [21]. This suggests that the effects of HLBs may be multiplicative and/or cumulative rather than additive [21].…”