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BACKGROUND: Dietary patterns, physical activity (PA) and sedentary behaviours are some of the main behavioural determinants of obesity; their combined influence in children has been addressed in a limited number of studies. SUBJECTS/METHODS: Children (16 228) aged 2-9 years old from eight European countries participated in the baseline survey of the IDEFICS study. A subsample of 11 674 children (50.8% males) were included in the present study. Children's food and beverage consumption (fruit and vegetables (F&V) and sugar-sweetened beverages (SSBs)), PA and sedentary behaviours were assessed via parental questionnaires. Sex-specific cluster analysis was applied to identify behavioural clusters. Analysis of covariance and logistic regression were applied to examine the association between behavioural clusters and body composition indicators (BCIs). RESULTS: Six behavioural clusters were identified (C1-C6) both in boys and girls. In both sexes, clusters characterised by high level of PA (C1 and C3) included a large proportion of older children, whereas clusters characterised by low SSB consumption (C5 and C6) included a large proportion of younger children. Significant associations between derived clusters and BCI were observed only in boys; those boys in the cluster with the highest time spent in sedentary activities and low PA had increased odds of having a body mass index z-score (odds ratio (OR) = 1.33;95% confidence interval (CI) = (1.01, 1.74)) and a waist circumference z- score (OR = 1.41; 95%CI = (1.06, 1.86)) greater than one. CONCLUSION: Clusters characterised by high sedentary behaviour, low F&V and SSB consumption and low PA turned out to be the most obesogenic factors in this sample of European children. European Journal of Clinical Nutrition (2015) 69, 811-816; doi:10.1038/ejcn.2015.76; published online 3 June 2015, INTRODUCTION Changes in multiple lifestyle behaviours contributing to energy imbalance are required in successful multi-factorial approaches of obesity prevention. (1) Dietary patterns, physical activity (PA) and sedentary behaviours are some [...]

BACKGROUND/OBJECTIVES: Children from lower socioeconomic status (SES) may be at higher risk of unhealthy eating. We described country-specific dietary patterns among children aged 2-9 years from eight European countries participating in the IDEFICS study and assessed the association of dietary patterns with an additive SES indicator. SUBJECTS/METHODS: Children aged 2-9 years from eight European countries were recruited in 2007-2008. Principal component analysis was applied to identify dietary country-specific patterns. Linear regression analyses were applied to assess their association with SES. RESULTS: Two to four dietary patterns were identified in the participating regions. The existence of a 'processed' pattern was found in the eight regions. Also, a 'healthy' pattern was identified in seven of the eight regions. In addition, region-specific patterns were identified, reflecting the existing gastronomic and cultural differences in Europe. The 'processed' pattern was significantly inversely associated with the SES additive indicator in all countries except Sweden, whereas the 'healthy' pattern was positively associated with SES in the Belgian, Estonian, German and Hungarian regions, but was not significant in the Italian, Spanish and Swedish regions. CONCLUSIONS: A 'processed' pattern and a 'healthy' pattern were found in most of the participating countries in the IDEFICS study, with comparable food item profiles. The results showed a strong inverse association of SES with the 'processed' pattern, suggesting that children of parents with lower SES may be at higher risk of unhealthy eating. Therefore, special focus should be given to parents and their children from lower SES levels when developing healthy eating promotion strategies. European Journal of Clinical Nutrition (2014) 68, 811-821;doi:10.1038/ejcn.2014.78; published online 14 May 2014, INTRODUCTION Social inequalities in health are present from childhood until adult life; socioeconomic status (SES) differences in the risk of morbidity and mortality have been well documented. (1) The burden [...]

BACKGROUND/OBJECTIVES: This longitudinal study describes the relationship between young children's screen time, dietary habits and anthropometric measures. The hypothesis was that television viewing and other screen activities at baseline result in increased consumption of sugar-sweetened beverages (SSB) and increased BMI, BMI z-score and waist to height ratio (WHtR) two years later. A second hypothesis was that SSB consumption mediates the association between the screen activities and changes in the anthropometric measures. SUBJECTS/METHODS: The study is a part of the prospective cohort study IDEFICS ('Identification and prevention of dietary and lifestyle-induced health effects in children and infants'), investigating diet, lifestyle and social determinants of obesity in 2 to 9-year-olds in eight European countries (baseline n = 16 225, two-year follow- up; n = 11 038). Anthropometry was objectively measured, and behaviours were parent-reported. RESULTS: The main hypothesis was supported, but the second hypothesis was not confirmed. The odds ratio of being in the highest quintile of % change in WHtR was 1.26 (95% CI: 1.17-1.36) and in BMI 1.22 (95% CI: 1.13-1.31), for each hour per day watching television. The odds ratio of having increased SSB consumption was 1.19 (95% CI: 1.09-1.29) for each hour per day watching TV. The associations for total screen time were slightly weaker. CONCLUSIONS: The results indicate substantial effects of TV viewing and other screen activities for young children, both on their consumption of sugary drinks and on an increase in BMI and central obesity. Our findings suggest that television viewing seems to have a stronger effect on food habits and anthropometry than other screen activities in this age group. European Journal of Clinical Nutrition (2014) 68, 223-228; doi: 10.1038/ejcn.2013.234; published online 20 November 2013 Keywords: Children; screen time; television; soft drinks; overweight, INTRODUCTION Childhood obesity has a complex etiology and, according to a recent review, has long-term effects into adulthood, including premature mortality and morbidity. (1) Systematic reviews (2,3) and pooled analysis [...]

BACKGROUND/OBJECTIVES: Individual lifestyle behaviours have independently been associated with cardiovascular diseases (CVD) risk factors in children. This study aimed to identify clustered lifestyle behaviours (dietary, physical activity (PA) and sedentary indicators) and to examine their association with CVD risk factors in children aged 2-9 years. SUBJECTS/METHODS: Participants included 4619 children (51.6% boys) from eight European countries participating in the IDEFICS cross-sectional baseline survey (2007-2008). Insulin resistance, total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, sum of two skinfolds and systolic blood pressure (SBP) z-scores were summed to compute a CVD risk score. Cluster analyses stratified by sex and age groups (2 to < 6 years; 6-9 years) were performed using parental-reported data on fruit, vegetables and sugar-sweetened beverages (SSB) consumption, PA performance and television video/DVD viewing. RESULTS: Five clusters were identified. Associations between CVD risk factors and score, and clusters were obtained by multiple linear regression using cluster 5 ('low beverages consumption and low sedentary') as the reference cluster. SBP was positively associated with clusters 1 ('physically active'; β = 1.34;95% confidence interval (CI): 0.02, 2.67), 2 ('sedentary'; β = 1.84; 95% CI: 0.57, 3.11), 3 ('physically active and sedentary'; β = 1.45;95% CI: 0.15, 2.75) and 4 ('healthy diet'; β = 1.83;95% CI: 0.50, 3.17) in older boys. A positive association was observed between CVD risk score and clusters 2 (b = 0.60;95% CI: 0.20, 1.01), 3 (b = 0.55;95% CI: 0.14, 0.97) and 4 (β = 0.60, 95% CI: 0.18, 1.02) in older boys. CONCLUSIONS: Low television/video/DVD viewing levels and low SSB consumption may result in a healthier CVD profile rather than having a diet rich in fruits and vegetables or being physically active in (pre-)school children. European Journal of Clinical Nutrition (2013) 67, 848-854; doi:10.1038/ejcn.2013.84; published online 1 May 2013 Keywords: cardiovascular diseases; lifestyle; diet; exercise; sedentary lifestyle; child, INTRODUCTION Increased risk of CVD is characterized by a cluster of metabolic abnormalities, such as abdominal obesity, atherogenic dyslipemia, hypertension, insulin resistance and glucose intolerance. (1) CVD remains the leading [...]