title: Clustering of multiple lifestyle behaviours and its association to cardiovascular risk factors in children: the IDEFICS study.
abstract: OBJECTIVE
  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.
  
  
  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 (β=0.60; 95% CI: 0.20, 1.01), 3 (β=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.
authors: Growth, Exercise, Nutrition and Development (GENUD) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain. sbel@unizar.es
authors: S
authors: S
authors: Bel-Serrat
authors: T
authors: T
authors: Mouratidou
authors: A M
authors: AM
authors: Santaliestra-Pasías
authors: L
authors: L
authors: Iacoviello
authors: Y A
authors: YA
authors: Kourides
authors: S
authors: S
authors: Marild
authors: D
authors: D
authors: Molnár
authors: L
authors: L
authors: Reisch
authors: A
authors: A
authors: Siani
authors: S
authors: S
authors: Stomfai
authors: B
authors: B
authors: Vanaelst
authors: T
authors: T
authors: Veidebaum
authors: I
authors: I
authors: Pigeot
authors: W
authors: W
authors: Ahrens
authors: V
authors: V
authors: Krogh
authors: L A
authors: LA
authors: Moreno
mesh_terms: D000367:Age Factors; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004032:Diet / Q000592:standards; D019422:Dietary Sucrose; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D012307:Risk Factors; D057185:Sedentary Behavior; D012737:Sex Factors; D013690:Television
chemical_list: D019422:Dietary Sucrose