Université de Paris, CRESS, INSERM, INRA, F-75004, Paris, France.
Paris-Saclay University, Faculty of Medicine, F-94276, Kremlin-Bicêtre, France.
Int J Behav Nutr Phys Act. 2020 Feb 12;17(1):20. doi: 10.1186/s12966-020-00927-6.
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.
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.
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.
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.
尽管人们对儿童肥胖与不同生活方式群体之间的关系越来越感兴趣，但很少有研究采用纵向设计来检查各种环境下的大量行为，特别是与饮食和睡眠相关的日常习惯，也很少有研究检查这些因素在幼儿中的作用。本研究的目的是基于 2 岁和 5 岁时的饮食、睡眠和活动相关行为及其家庭环境，识别男孩和女孩的聚类，并评估在不同母亲教育水平下确定的聚类是否存在差异，以及是否与 5 岁时的体脂肪有关。
在 EDEN 母婴队列中，分别在 2 岁和 5 岁时，有 1436 名和 1195 名父母完成了一份包含行为数据的问卷。一项潜在类别分析旨在揭示性别特异性的行为聚类。体脂肪百分比通过人体测量和生物电阻抗测量来估计。使用多变量线性回归模型评估聚类成员与体脂肪之间的关联。
在 2 岁时，出现了两个主要以相反的饮食习惯为特征的聚类。在 5 岁时，电视暴露是最具区别性的特征，但性别不同，聚类的数量和类型也不同。只有在女孩中发现聚类成员与体脂肪之间存在关联，在 5 岁时，暴露于高电视的聚类中女孩的体脂肪最高，尽管户外玩耍和散步时间较长，但进餐习惯不佳。母亲教育程度较低的女孩更有可能处于这种高风险聚类中。在从 2 岁到 5 岁期间，电视观看时间最高、进餐习惯最差的女孩在聚类演变路径上的女孩，在 5 岁时体脂肪更高。
减少电视时间和改善进餐习惯可能是预防幼儿超重的有效方法，特别是在处于不利家庭环境中的女孩。这些预防措施应尽早开始，理想情况下在 2 岁之前，并应在学龄前持续进行。
