Clustering of energy balance-related behaviors and parental education in European children: the ENERGY-project

International Journal of Behavioral Nutrition and Physical Activity

Luis A Moreno⁸  Johannes Brug⁴  Natasa Jan⁶  Eva Kovacs⁵  Yannis Manios¹  Frøydis N Vik³  Amika S Singh²  Ilse De Bourdeaudhuij⁷  Juan M Fernández-Alvira⁸ 

[1] Department of Nutrition and Dietetics, Harokopio University, Athens, Greece;Department of Public and Occupational Health and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands;Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway;Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands;Department of Pediatrics, Pecs University, Pecs, Hungary;Slovenian Heart Foundation, Ljubljana, Slovenia;Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium;GENUD (Growth, Exercise, Nutrition and Development) Research Group. Faculty of Health Sciences, University of Zaragoza, Zaragoza 50009, Spain

关键词: Cluster analysis;    Parental education;    Children;    ENERGY;    Energy balance-related behaviors;   

Others  :  811001
DOI  :  10.1186/1479-5868-10-5

 received in 2012-03-07, accepted in 2013-01-08,  发布年份 2013

【 摘 要 】

Background

Recent research and literature reviews show that, among schoolchildren, some specific energy balance-related behaviors (EBRBs) are relevant for overweight and obesity prevention. It is also well known that the prevalence of overweight and obesity is considerably higher among schoolchildren from lower socio-economic backgrounds. This study examines whether sugared drinks intake, physical activity, screen time and usual sleep duration cluster in reliable and meaningful ways among European children, and whether the identified clusters could be characterized by parental education.

Methods

The cross-sectional study comprised a total of 5284 children (46% male), from seven European countries participating in the ENERGY-project (“EuropeaN Energy balance Research to prevent excessive weight Gain among Youth”). Information on sugared drinks intake, physical activity, screen time and usual sleep duration was obtained using validated self-report questionnaires. Based on these behaviors, gender-specific cluster analysis was performed. Associations with parental education were identified using chi-square tests and odds ratios.

Results

Five meaningful and stable clusters were found for both genders. The cluster with high physical activity level showed the highest proportion of participants with highly educated parents, while clusters with high sugared drinks consumption, high screen time and low sleep duration were more prevalent in the group with lower educated parents. Odds ratio showed that children with lower educated parents were less likely to be allocated in the active cluster and more likely to be allocated in the low activity/sedentary pattern cluster.

Conclusions

Children with lower educated parents seemed to be more likely to present unhealthier EBRBs clustering, mainly characterized by their self-reported time spent on physical activity and screen viewing. Therefore, special focus should be given to lower educated parents and their children in order to develop effective primary prevention strategies.

【 授权许可】

   
2013 Fernández-Alvira et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Rokholm B, Baker JL, Sorensen TI: The levelling off of the obesity epidemic since the year 1999–a review of evidence and perspectives. Obesity reviews: an official journal of the International Association for the Study of Obesity 2010, 11:835-846.
• [2]Reilly JJ: Tackling the obesity epidemic: new approaches. Arch Dis Child 2006, 91:724-726.
• [3]Singh AS, Mulder C, Twisk JW, van Mechelen W, Chinapaw MJ: Tracking of childhood overweight into adulthood: a systematic review of the literature. Obesity reviews: an official journal of the International Association for the Study of Obesity 2008, 9:474-488.
• [4]Nader PR, O'Brien M, Houts R, Bradley R, Belsky J, Crosnoe R, Friedman S, Mei Z, Susman EJ: Identifying risk for obesity in early childhood. Pediatrics 2006, 118:e594-e601.
• [5]Kumanyika S, Jeffery RW, Morabia A, Ritenbaugh C, Antipatis VJ: Obesity prevention: the case for action. International journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity 2002, 26:425-436.
• [6]Hill JO, Wyatt HR, Reed GW, Peters JC: Obesity and the environment: where do we go from here? Science 2003, 299:853-855.
• [7]Summerbell CD, Douthwaite W, Whittaker V, Ells LJ, Hillier F, Smith S, Kelly S, Edmunds LD, Macdonald I: The association between diet and physical activity and subsequent excess weight gain and obesity assessed at 5 years of age or older: a systematic review of the epidemiological evidence. Int J Obes 2009, 33(Suppl 3):S1-S92.
• [8]Jimenez-Pavon D, Kelly J, Reilly JJ: Associations between objectively measured habitual physical activity and adiposity in children and adolescents: systematic review. International journal of pediatric obesity: IJPO: an official journal of the International Association for the Study of Obesity 2010, 5:3-18.
• [9]Moreno LA, Rodriguez G: Dietary risk factors for development of childhood obesity. Curr Opin Clin Nutr Metab Care 2007, 10:336-341.
• [10]Rey-Lopez JP, Vicente-Rodriguez G, Biosca M, Moreno LA: Sedentary behaviour and obesity development in children and adolescents. Nutrition, metabolism, and cardiovascular diseases: NMCD 2008, 18:242-251.
• [11]Must A, Barish EE, Bandini LG: Modifiable risk factors in relation to changes in BMI and fatness: what have we learned from prospective studies of school-aged children? Int J Obes 2009, 33:705-715.
• [12]Must A, Parisi SM: Sedentary behavior and sleep: paradoxical effects in association with childhood obesity. Int J Obes 2009, 33(Suppl 1):S82-S86.
• [13]Hense S, Pohlabeln H, De Henauw S, Eiben G, Molnar D, Moreno LA, Barba G, Hadjigeorgiou C, Veidebaum T, Ahrens W: Sleep duration and overweight in European children: is the association modified by geographic region? Sleep 2011, 34:885-890.
• [14]Lobstein T, Frelut ML: Prevalence of overweight among children in Europe. Obesity reviews: an official journal of the International Association for the Study of Obesity 2003, 4:195-200.
• [15]Gordon-Larsen P, Adair LS, Popkin BM: The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents. Obes Res 2003, 11:121-129.
• [16]Brug J, Lien N, Klepp KI, van Lenthe FJ: Exploring overweight, obesity and their behavioural correlates among children and adolescents: results from the health-promotion through obesity prevention across Europe project. Public Health Nutr 2010, 13:1676-1679.
• [17]te Velde SJ, De Bourdeaudhuij I, Thorsdottir I, Rasmussen M, Hagstromer M, Klepp KI, Brug J: Patterns in sedentary and exercise behaviors and associations with overweight in 9–14-year-old boys and girls–a cross-sectional study. BMC Publ Health 2007, 7:16. BioMed Central Full Text
• [18]Johnson F, Pratt M, Wardle J: Socio-Economic Status and Obesity in Childhood. In Epidemiology of Obesity in Children and Adolescents Prevalence and Etiology. 1st edition. Edited by Moreno LA, Pigeot I, Ahrens W. New York: Springer; 2010. [Springer (Series Editor): Series on Epidemiology and Public Health]
• [19]Hafekost K, Mitrou F, Lawrence D, Zubrick SR: Sugar sweetened beverage consumption by Australian children: implications for public health strategy. BMC Publ Health 2011, 11:950. BioMed Central Full Text
• [20]van der Horst K, Oenema A, Ferreira I, Wendel-Vos W, Giskes K, van Lenthe F, Brug J: A systematic review of environmental correlates of obesity-related dietary behaviors in youth. Health Educ Res 2007, 22:203-226.
• [21]Zecevic CA, Tremblay L, Lovsin T, Michel L: Parental influence on young Children's physical activity. Int J Pediatr 2010, 2010:468526.
• [22]Van Der Horst K, Paw MJ, Twisk JW, Van Mechelen W: A brief review on correlates of physical activity and sedentariness in youth. Medicine and science in sports and exercise 2007, 39:1241-1250.
• [23]Spilsbury JC, Storfer-Isser A, Drotar D, Rosen CL, Kirchner LH, Benham H, Redline S: Sleep behavior in an urban US sample of school-aged children. Arch Pediatr Adolesc Med 2004, 158:988-994.
• [24]McLaughlin Crabtree V, Williams NA: Normal sleep in children and adolescents. Child Adolesc Psychiatr Clin N Am 2009, 18:799-811.
• [25]Hense S, Barba G, Pohlabeln H, De Henauw S, Marild S, Molnar D, Moreno LA, Hadjigeorgiou C, Veidebaum T, Ahrens W: Factors that influence weekday sleep duration in European children. Sleep 2011, 34:633-639.
• [26]Brug J, Van Stralen M, Te Velde S, Chinapaw M, De Bourdeaudhuij I, Lien N, Bere E, Maskini V, Singh A, Maes L: Differences in weight status and energy-balance related behaviors among schoolchildren across europe: the ENERGY-project. PLoS One 2012. In press
• [27]Rasmussen M, Krolner R, Klepp KI, Lytle L, Brug J, Bere E, Due P: Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part I: quantitative studies. Int J Behav Nutr Phys Act 2006, 3:22. BioMed Central Full Text
• [28]Rey-Lopez JP, Tomas C, Vicente-Rodriguez G, Gracia-Marco L, Jimenez-Pavon D, Perez-Llamas F, Redondo C, Bourdeaudhuij ID, Sjostrom M, Marcos A: Sedentary behaviours and socio-economic status in Spanish adolescents: the AVENA study. Eur J Public Health 2011, 21:151-157.
• [29]Schuit AJ, van Loon AJ, Tijhuis M, Ocke M: Clustering of lifestyle risk factors in a general adult population. Prev Med 2002, 35:219-224.
• [30]Klepp KI, Perez-Rodrigo C, De Bourdeaudhuij I, Due PP, Elmadfa I, Haraldsdottir J, Konig J, Sjostrom M, Thorsdottir I, de Almeida MD V: Promoting fruit and vegetable consumption among european schoolchildren: rationale, conceptualization and design of the pro children project. Ann Nutr Metab 2005, 49:212-220.
• [31]van Stralen MM, te Velde SJ, Singh AS, De Bourdeaudhuij I, Martens MK, van der Sluis M, Manios Y, Grammatikaki E, Chinapaw MJ, Maes L: EuropeaN energy balance research to prevent excessive weight gain among youth (ENERGY) project: design and methodology of the ENERGY cross-sectional survey. BMC Publ Health 2011, 11:65. BioMed Central Full Text
• [32]Brug J, te Velde SJ, Chinapaw MJ, Bere E, de Bourdeaudhuij I, Moore H, Maes L, Jensen J, Manios Y, Lien N: Evidence-based development of school-based and family-involved prevention of overweight across europe: the ENERGY-project's design and conceptual framework. BMC Publ Health 2010, 10:276. BioMed Central Full Text
• [33]Singh AS, Vik FN, Chinapaw J, Uijtdewiligen L, Verloigne M, Fernández-Alvira JM, Stomfai S, Manios Y, Martens M, Brug J: Test-retest reliability and construct validity of the ENERGY-child questionnaire on energy balance-related behaviours and their potential determinants: the ENERGY-project. Int J Behav Nutr Phys Act 2011, 8:136. BioMed Central Full Text
• [34]Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000, 320:1240-1243.
• [35]Haerens L, Kirk D, Cardon G, de Bourdeaudhuij I, Vansteenkiste M: Motivational profiles for secondary school physical education and its relationship to the adoption of a physically active lifestyle among university students. Eur Phys Educ Rev 2010, 16:117-139.
• [36]Everitt BS, Landau S, Leese M: Cluster Analysis. 4th edition. New York: Oxford University Press, Inc; 2001.
• [37]Ottevaere C, Huybrechts I, Benser J, De Bourdeaudhuij I, Cuenca-Garcia M, Dallongeville J, Zaccaria M, Gottrand F, Kersting M, Rey-Lopez JP: Clustering patterns of physical activity, sedentary and dietary behavior among European adolescents: The HELENA study. BMC Publ Health 2011, 11:328. BioMed Central Full Text
• [38]de Bourdeaudhuij I, van Oost P: A cluster-analytical approach toward physical activity and other health related behaviors. Medicine and science in sports and exercise 1999, 31:605-612.
• [39]Wang Y, Tussing L, Odoms-Young A, Braunschweig C, Flay B, Hedeker D, Hellison D: Obesity prevention in low socioeconomic status urban African-american adolescents: study design and preliminary findings of the HEALTH-KIDS Study. Eur J Clin Nutr 2006, 60:92-103.
• [40]Lioret S, Maire B, Volatier JL, Charles MA: Child overweight in France and its relationship with physical activity, sedentary behaviour and socioeconomic status. Eur J Clin Nutr 2007, 61:509-516.
• [41]Melkevik O, Torsheim T, Iannotti RJ, Wold B: Is spending time in screen-based sedentary behaviors associated with less physical activity: a cross national investigation. Int J Behav Nutr Phys Act 2010, 7:46. BioMed Central Full Text
• [42]Marshall SJ, Biddle SJ, Gorely T, Cameron N, Murdey I: Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis. International journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity 2004, 28:1238-1246.
• [43]Grimm GC, Harnack L, Story M: Factors associated with soft drink consumption in school-aged children. J Am Diet Assoc 2004, 104:1244-1249.
• [44]Vereecken CA, Inchley J, Subramanian SV, Hublet A, Maes L: The relative influence of individual and contextual socio-economic status on consumption of fruit and soft drinks among adolescents in Europe. Eur J Public Health 2005, 15:224-232.
• [45]Chen X, Beydoun MA, Wang Y: Is sleep duration associated with childhood obesity? a systematic review and meta-analysis. Obesity 2008, 16:265-274.