Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.
RCSI Department of Epidemiology and Public Health Medicine, Beaux Lane House, Lower Mercer Street, Dublin 2, Ireland.
BMC Pediatr. 2021 Apr 17;21(1):180. doi: 10.1186/s12887-021-02640-0.
Diet, physical activity, sedentary behaviours, and sleep time are considered major contributory factors of the increased prevalence of childhood overweight and obesity. The aims of this study were to (1) identify behavioural clusters of 5 year old children based on lifestyle behaviours, (2) explore potential determinants of class membership, and (3) to determine if class membership was associated with body measure outcomes at 5 years of age.
Data on eating behaviour, engagement in active play, TV watching, and sleep duration in 1229 5 year old children from the Cork BASELINE birth cohort study was obtained through in-person interviews with parent. Latent class analysis was used to identify behavioural clusters. Potential determinants of cluster membership were investigated using multinomial logistic regression. Associations between the identified classes and cardio metabolic body measures were examined using multivariate logistic and linear regression, with cluster membership used as the independent variable.
51% of children belonged to a normative class, while 28% of children were in a class characterised by high scores on food avoidance scales in combination with low enjoyment of food, and 20% experienced high scores on the food approach scales. Children in both these classes had lower conditional probabilities of engaging in active play for at least 1 hour per day and sleeping for a minimum of 10 h, and higher probability of watching TV for 2 hours or more, compared to the normative class. Low socioeconomic index (SEI) and no breastfeeding at 2 months were found to be associated with membership of the class associated with high scores on the food avoidance scale, while lower maternal education was associated with the class defined by high food approach scores. Children in the class with high scores on the food approach scales had higher fat mass index (FMI), lean mass index (LMI), and waist-to-height ratio (WtHR) compared to the normative class, and were at greater risk of overweight and obesity.
Findings suggest that eating behaviour appeared to influence overweight and obesity risk to a greater degree than activity levels at 5 years old. Further research of how potentially obesogenic behaviours in early life track over time and influence adiposity and other cardio metabolic outcomes is crucial to inform the timing of interventions.
饮食、身体活动、久坐行为和睡眠时间被认为是导致儿童超重和肥胖患病率上升的主要因素。本研究的目的是：(1)根据生活方式行为确定 5 岁儿童的行为聚类；(2)探索类别的潜在决定因素；(3)确定类别的归属是否与 5 岁时的身体测量结果有关。
通过对科克基础队列研究的 1229 名 5 岁儿童的家长进行面对面访谈，获取了儿童饮食行为、积极玩耍、看电视和睡眠时间的数据。采用潜在类别分析来确定行为聚类。使用多项逻辑回归来研究聚类成员的潜在决定因素。使用多元逻辑回归和线性回归来检查已识别的类与心血管代谢身体指标之间的关联，使用聚类成员作为自变量。
51%的儿童属于正常类，28%的儿童属于高回避食物量表得分与低食物享受得分相结合的类，20%的儿童属于高食物接近量表得分的类。与正常类相比，这两个类别的儿童每天至少进行 1 小时积极玩耍和至少睡 10 小时的可能性较低，而看电视 2 小时或更长时间的可能性较高。低社会经济指数（SEI）和 2 个月时没有母乳喂养与高回避食物量表得分类别的成员有关，而母亲教育程度较低与高食物接近量表得分定义的类别有关。高食物接近量表得分类别的儿童的脂肪质量指数（FMI）、瘦质量指数（LMI）和腰高比（WtHR）较高，超重和肥胖的风险较大。
研究结果表明，与 5 岁时的活动水平相比，饮食行为似乎对超重和肥胖风险的影响更大。进一步研究生命早期潜在肥胖行为如何随时间推移而变化，并影响肥胖和其他心血管代谢结果，对于确定干预时机至关重要。
