Lifestyle correlates of overweight in adults: A hierarchical approach (the SPOTLIGHT project)

Célina Roda, Hélène Charreire, Thierry Feuillet, Joreintje D. Mackenbach, Sofie Compernolle, Ketevan Glonti, Helga Bárdos, Harry Rutter, Martin McKee, Johannes Brug, Ilse Bourdeaudhuij, Jeroen Lakerveld, Jean Michel Oppert

Research output: Contribution to journalArticlepeer-review

18 Citations (SciVal)


Background: Obesity-related lifestyle behaviors usually co-exist but few studies have examined their simultaneous relation with body weight. This study aimed to identify the hierarchy of lifestyle-related behaviors associated with being overweight in adults, and to examine subgroups so identified. Methods: Data were obtained from a cross-sectional survey conducted across 60 urban neighborhoods in 5 European urban regions between February and September 2014. Data on socio-demographics, physical activity, sedentary behaviors, eating habits, smoking, alcohol consumption, and sleep duration were collected by questionnaire. Participants also reported their weight and height. A recursive partitioning tree approach (CART) was applied to identify both main correlates of overweight and lifestyle subgroups. Results: In 5295 adults, mean (SD) body mass index (BMI) was 25.2 (4.5) kg/m2, and 46.0 % were overweight (BMI ≥25 kg/m2). CART analysis showed that among all lifestyle-related behaviors examined, the first identified correlate was sitting time while watching television, followed by smoking status. Different combinations of lifestyle-related behaviors (prolonged daily television viewing, former smoking, short sleep, lower vegetable consumption, and lower physical activity) were associated with a higher likelihood of being overweight, revealing 10 subgroups. Members of four subgroups with overweight prevalence >50 % were mainly males, older adults, with lower education, and living in greener neighborhoods with low residential density. Conclusion: Sedentary behavior while watching television was identified as the most important correlate of being overweight. Delineating the hierarchy of correlates provides a better understanding of lifestyle-related behavior combinations which may assist in targeting preventative strategies aimed at tackling obesity.

Original languageEnglish
Article number114
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Issue number1
Publication statusPublished - 3 Nov 2016


  • CART
  • Eating habits
  • Lifestyle-related behaviors
  • Obesity
  • Physical activity
  • Sedentary behavior
  • Sleep
  • Smoking status
  • Television viewing

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Nutrition and Dietetics


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