title: Clustering of dietary intake and sedentary behavior in 2-year-old children.
abstract: OBJECTIVE
  To examine clustering of energy balance-related behaviors (EBRBs) in young children. This is crucial because lifestyle habits are formed at an early age and track in later life. This study is the first to examine EBRB clustering in children as young as 2 years.
  
  
  METHODS
  Cross-sectional data originated from the Child, Parent and Health: Lifestyle and Genetic Constitution (KOALA) Birth Cohort Study. Parents of 2578 2-year-old children completed a questionnaire. Correlation analyses, principal component analyses, and linear regression analyses were performed to examine clustering of EBRBs.
  
  
  RESULTS
  We found modest but consistent correlations in EBRBs. Two clusters emerged: a "sedentary-snacking cluster" and a "fiber cluster." Television viewing clustered with computer use and unhealthy dietary behaviors. Children who frequently consumed vegetables also consumed fruit and brown bread more often and white bread less often. Lower maternal education and maternal obesity were associated with high scores on the sedentary-snacking cluster, whereas higher educational level was associated with high fiber cluster scores.
  
  
  CONCLUSIONS
  Obesity-prone behavioral clusters are already visible in 2-year-old children and are related to maternal characteristics. The findings suggest that obesity prevention should apply an integrated approach to physical activity and dietary intake in early childhood.
authors.affiliation: Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands. Jessica.Gubbels@GVO.unimaas.nl
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Gubbels
authors.forename: Stef P J
authors.initials: SP
authors.lastname: Kremers
authors.forename: Annette
authors.initials: A
authors.lastname: Stafleu
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
authors.forename: Sanne I
authors.initials: SI
authors.lastname: de Vries
authors.forename: Nanne K
authors.initials: NK
authors.lastname: de Vries
authors.forename: Carel
authors.initials: C
authors.lastname: Thijs
mesh_terms: D001628:Beverages; D001939:Bread; D002675:Child, Preschool; D016000:Cluster Analysis; D003201:Computers / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004032:Diet; D004522:Educational Status; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D008297:Male; D009035:Mothers; D009043:Motor Activity; D009426:Netherlands; D009765:Obesity / Q000453:epidemiology; D011446:Prospective Studies; D012737:Sex Factors; D013690:Television / Q000706:statistics & numerical data; D014675:Vegetables