Departament de Bioquímica i Biotecnologia. Unitat de Nutrició Humana, Universitat Rovira i Virgili, Reus, Spain.
Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.
Eur J Pediatr. 2024 Apr;183(4):1819-1830. doi: 10.1007/s00431-023-05389-z. Epub 2024 Jan 23.
To assess the associations between the adherence to a composite score comprised of 6 healthy lifestyle behaviors and its individual components with several cardiometabolic risk factors in Spanish preschool children. Cross-sectional analyses were conducted in 938 participants included in the CORALS cohort aged 3-6 years. Six recognized healthy lifestyle behaviors (breastfeeding, sleep duration, physical activity, screentime, adherence to the Mediterranean diet, and eating speed) were assessed in a composite score. Multiple linear and logistic regression models were fitted to assess the associations with cardiometabolic risk factors (weight status, waist circumference, fat mass index, blood pressure, fasting plasma glucose, and lipid profile). In the adjusted multiple linear and logistic regression models, compared with the reference category of adherence to the healthy lifestyle behavior composite score, those participants in the category of the highest adherence showed significant decreased prevalence risk of overweight or obesity [OR (95% CI), 0.4 (0.2, 0.6)] as well as significant lower waist circumference, fat mass index (FMI), systolic blood pressure and fasting plasma glucose concentration [β (95% CI), - 1.4 cm (- 2.5, - 0.4); - 0.3 kg/m (- 0.5, - 0.1); and - 3.0 mmHg (- 5.2, - 0.9); - 1.9 mg/dL (- 3.5, - 0.4), respectively]. Slow eating speed was individually associated with most of the cardiometabolic risk factors. Conclusions: Higher adherence to the healthy lifestyle behavior composite score was associated with lower waist circumference, FMI, other cardiometabolic risk factors, and risk of overweight or obesity in Spanish preschool children. Further studies are required to confirm these associations. What is Known: • Lifestyle is a well-recognized etiologic factor of obesity and its comorbidities. • Certain healthy behaviors such as adhering to a healthy diet, increasing physical activity, and decreasing screentime are strategies for prevention and treatment of childhood obesity. What is New: • Higher adherence to the healthy lifestyle behavior composite score to 6 healthy behaviors (breastfeeding, sleep duration, physical activity, screentime, eating speed, and adherence to the Mediterranean diet) was associated with decreased adiposity, including prevalence risk of overweight or obesity, and cardiometabolic risk in preschool children. • Slow eating and greater adherence to the Mediterranean diet were mainly associated to lower fasting plasma and serum triglycerides concentration, respectively.
评估西班牙学龄前儿童中由 6 种健康生活方式行为组成的综合得分及其各个组成部分与多种心血管代谢危险因素之间的关联。在 CORALS 队列中，对 938 名 3-6 岁的参与者进行了横断面分析。在综合评分中评估了 6 种公认的健康生活方式行为（母乳喂养、睡眠时间、身体活动、屏幕时间、遵循地中海饮食和进食速度）。采用多元线性和逻辑回归模型评估与心血管代谢危险因素（体重状况、腰围、脂肪质量指数、血压、空腹血糖和血脂谱）的相关性。在调整后的多元线性和逻辑回归模型中，与健康生活方式行为综合得分的参考类别相比，最高得分类别的参与者超重或肥胖的患病率风险显著降低[比值比（95%可信区间），0.4（0.2，0.6）]，腰围、脂肪质量指数（FMI）、收缩压和空腹血糖浓度也显著降低[β（95%可信区间），-1.4cm（-2.5，-0.4）；-0.3kg/m（-0.5，-0.1）；-3.0mmHg（-5.2，-0.9）；-1.9mg/dL（-3.5，-0.4）]。进食速度较慢与大多数心血管代谢危险因素有关。结论：西班牙学龄前儿童健康生活方式行为综合得分越高，腰围、FMI、其他心血管代谢危险因素和超重或肥胖的风险越低。需要进一步的研究来证实这些关联。已知：•生活方式是肥胖及其合并症的公认病因。•某些健康行为，如坚持健康饮食、增加身体活动和减少屏幕时间，是预防和治疗儿童肥胖的策略。新发现：•对包括母乳喂养、睡眠时间、身体活动、屏幕时间、进食速度和地中海饮食在内的 6 种健康行为的健康生活方式行为综合得分的较高依从性与较低的肥胖程度相关，包括超重或肥胖的患病率风险以及学龄前儿童的心血管代谢风险。•进食速度较慢和更遵循地中海饮食主要与空腹血浆和血清甘油三酯浓度降低有关。
