Clusters of diet, physical activity, television exposure and sleep habits and their association with adiposity in preschool children: the EDEN mother-child cohort

Abstract

Background: Despite the growing interest in the relation between adiposity in children and different lifestyle clusters, few studies used a longitudinal design to examine a large range of behaviors in various contexts, in particular eating-and sleep-related routines, and few studies have examined these factors in young children. The objectives of this study were to identify clusters of boys and girls based on diet, sleep and activity-related behaviors and their family environment at 2 and 5 years of age, and to assess whether the clusters identified varied across maternal education levels and were associated with body fat at age 5. Methods: At 2 and 5 years, respectively, 1436 and 1195 parents from the EDEN mother-child cohort completed a questionnaire including behavioral data. A latent class analysis aimed to uncover gender-specific behavioral clusters. Body fat percentage was estimated by anthropometric and bioelectrical impedance measurements. Association between cluster membership and body fat was assessed with mutivariable linear regression models. Results: At 2 years, two clusters emerged that were essentially characterized by opposite eating habits. At 5 years, TV exposure was the most distinguishing feature, but the numbers and types of clusters differed by gender. An association between cluster membership and body fat was found only in girls at 5 years of age, with girls in the cluster defined by very high TV exposure and unfavorable mealtime habits (despite high outdoor playing and walking time) having the highest body fat. Girls whose mother had low educational attainment were more likely to be in this high-risk cluster. Girls who were on a cluster evolution path corresponding to the highest TV viewing time and the least favorable mealtime habits from 2 to 5 years of age had higher body fat at 5 years. Conclusions: Efforts to decrease TV time and improve mealtime routines may hold promise for preventing overweight in young children, especially girls growing up in disadvantaged families. These preventive efforts should start as early in life as possible, ideally before the age of two, and should be sustained over the preschool years.

Household chaos, family routines, and young child movement behaviors in the U.S. during the COVID-19 outbreak: a cross-sectional study

“…Older children’s sleep may have increased from a lack of formal school start times, akin to delaying school start times [ 30 ], which is not as rigid in preschools. This imbalance of movement behaviors is particularly concerning given evidence that preschoolers who do not meet movement guidelines over the long-term experience negative consequences of higher adiposity [ 42 ], lower educational outcomes [ 5 ], and compromised physiological development [ 5 ], and the COVID-19 outbreak is creating a long-term challenge to household routines.…”

“…Creation of a valid and reliable questionnaire to thoroughly assess 24-h movement guideline adherence in this age range is needed. Another limitations is that other health behaviors may play a role in screen-time and sleep patterns, including sleep arrangement and mealtime habits [ 42 ], and these behaviors may also differ among levels of household chaos. Examination of household chaos with device-based measures of physical activity, sedentary behavior, and sleep, such as accelerometry, may better assess the potential mechanisms.…”

Eating Behaviour, Physical Activity, TV Exposure and Sleeping Habits in Five Year Olds: A Latent Class Analysis

“…years, and only one previous study considered diet, physical activity, sedentary behaviour, and sleep concurrently 12 . In addition to including variables on all these lifestyle behaviour in young children, this is also to our knowledge the rst study to include eating behaviour, as opposed to dietary quality.…”

“…Reviews of studies using CA or LCA to identify patterns of lifestyle behaviours in children and adolescents have found that these behaviours often cluster in complex ways and that group membership differs by gender, age and socio economic status 8,11 . Most previous studies have been conducted in older children, while evidence in young children (< 6 years) is more limited 12,13 . Moreover, few studies have studied diet, physical activity, sedentary behaviour, and sleep simultaneously, with sleep in particular often not included 14,15 .…”

Eating behaviour, physical activity, TV exposure and sleeping habits in five year olds: a latent class analysis

“…One recent study analysed behavioural patterns at 2 and 5 years of age, and identified two clusters characterised by opposite eating habits at 2 years, while TV was the most distinguishing cluster feature at 5 years. Girls in the cluster defined by high TV exposure were found to have significantly higher body fat at 5 years [ 13 ]. Another study investigating behavioural patterns in 2–9 year olds found that clusters characterised by high sedentary behaviour, low fruit and vegetable intake, sugar-sweetened beverage consumption and low PA were associated with body mass index (BMI) and waist circumference z-scores greater than 1 [ 14 ].…”