Clustering of dietary intake and sedentary behavior in 2-year-old children.
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.
Gubbels
Jessica S
JS
Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands. Jessica.Gubbels@GVO.unimaas.nl
Kremers
Stef P J
SP
Stafleu
Annette
A
Dagnelie
Pieter C
PC
de Vries
Sanne I
SI
de Vries
Nanne K
NK
Thijs
Carel
C
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