TY - JOUR
T1 - Clustering of Multiple Energy Balance-Related Behaviors in School Children and its Association with Overweight and Obesity—WHO European Childhood Obesity Surveillance Initiative (COSI 2015–2017)
AU - Bel-Serrat, Silvia
AU - Ojeda-Rodríguez, Ana
AU - Heinen, Mirjam M.
AU - Buoncristiano, Marta
AU - Abdrakhmanova, Shynar
AU - Duleva, Vesselka
AU - Sant’Angelo, Victoria Farrugia
AU - Fijałkowska, Anna
AU - Hejgaard, Tatjana
AU - Huidumac, Constanta
AU - Hyska, Jolanda
AU - Kujundzic, Enisa
AU - Milanović, Sanja Musić
AU - Ovezmyradova, Guljemal
AU - Pérez-Farinós, Napoleón
AU - Petrauskiene, Ausra
AU - Rito, Ana Isabel
AU - Shengelia, Lela
AU - Braunerová, Radka Taxová
AU - Rutter, Harry
AU - Murrin, Celine M.
AU - Kelleher, Cecily C.
AU - Breda, João
PY - 2019/2/27
Y1 - 2019/2/27
N2 - It is unclear how dietary, physical activity and sedentary behaviors co-occur in school-aged children. We investigated the clustering of energy balance-related behaviors and whether the identified clusters were associated with weight status. Participants were 6- to 9-year-old children (n = 63,215, 49.9% girls) from 19 countries participating in the fourth round (2015/2017) of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Energy balance-related behaviors were parentally reported. Weight and height were objectively measured. We performed cluster analysis separately per group of countries (North Europe, East Europe, South Europe/Mediterranean countries and West-Central Asia). Seven clusters were identified in each group. Healthier clusters were common across groups. The pattern of distribution of healthy and unhealthy behaviors within each cluster was group specific. Associations between the clustering of energy balance-related behaviors and weight status varied per group. In South Europe/Mediterranean countries and East Europe, all or most of the cluster solutions were associated with higher risk of overweight/obesity when compared with the cluster ‘Physically active and healthy diet’. Few or no associations were observed in North Europe and West-Central Asia, respectively. These findings support the hypothesis that unfavorable weight status is associated with a particular combination of energy balance-related behavior patterns, but only in some groups of countries.
AB - It is unclear how dietary, physical activity and sedentary behaviors co-occur in school-aged children. We investigated the clustering of energy balance-related behaviors and whether the identified clusters were associated with weight status. Participants were 6- to 9-year-old children (n = 63,215, 49.9% girls) from 19 countries participating in the fourth round (2015/2017) of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative. Energy balance-related behaviors were parentally reported. Weight and height were objectively measured. We performed cluster analysis separately per group of countries (North Europe, East Europe, South Europe/Mediterranean countries and West-Central Asia). Seven clusters were identified in each group. Healthier clusters were common across groups. The pattern of distribution of healthy and unhealthy behaviors within each cluster was group specific. Associations between the clustering of energy balance-related behaviors and weight status varied per group. In South Europe/Mediterranean countries and East Europe, all or most of the cluster solutions were associated with higher risk of overweight/obesity when compared with the cluster ‘Physically active and healthy diet’. Few or no associations were observed in North Europe and West-Central Asia, respectively. These findings support the hypothesis that unfavorable weight status is associated with a particular combination of energy balance-related behavior patterns, but only in some groups of countries.
KW - Children
KW - Cluster analysis
KW - Dietary intake
KW - Energy balance-related behaviors
KW - Obesity
KW - Overweight
KW - Physical activity
KW - Screen time
KW - Sedentary behavior
UR - http://www.scopus.com/inward/record.url?scp=85062415891&partnerID=8YFLogxK
U2 - 10.3390/nu11030511
DO - 10.3390/nu11030511
M3 - Article
SN - 2072-6643
VL - 11
SP - 1
EP - 20
JO - Nutrients
JF - Nutrients
IS - 3
M1 - 511
ER -