title: Clustering of lifestyle behaviours and relation to body composition in European children. The IDEFICS study.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1] GENUD (Growth, Exercise, Nutrition and Development) Research Group, Department of Physiatry and Nursing, School of Health Sciences, University of Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Spain [2] Red SAMID, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: A M
authors.initials: AM
authors.lastname: Santaliestra-Pasías
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, Department of Physiatry and Nursing, School of Health Sciences, University of Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Mouratidou
authors.affiliation: Department of Intercultural Communication and Management, Copenhagen Business School, Frederiksberg, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Reisch
authors.affiliation: 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Department of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Pigeot
authors.affiliation: 1] Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany [2] Department of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Ahrens
authors.affiliation: Department of Paediatrics, The Queen Silvia Children's Hospital, University of Gothenburg, Smörslottsgatan, Gothenburg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Mårild
authors.affiliation: Department of Pediatrics, Medical Faculty, University of Pécs, József A. u. 7., Pécs, Hungary.
authors.forename: D
authors.initials: D
authors.lastname: Molnár
authors.affiliation: Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Siani
authors.affiliation: Department of Preventive and Predictive Medicine, Nutritional Epidemiology Unit, Fondazione IRCCS IstitutoNazionaledeiTumori, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Sieri
authors.affiliation: Research and Education Institute of Child Health, StrovolosNicosia, Cyprus.
authors.forename: M
authors.initials: M
authors.lastname: Tornatiris
authors.affiliation: National Institute for Health Development, Center of Health and Behavioral Sciences, Tallinn, Estonia.
authors.forename: T
authors.initials: T
authors.lastname: Veidebaum
authors.affiliation: Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: Verbestel
authors.affiliation: Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
authors.forename: I
authors.initials: I
authors.lastname: De Bourdeaudhuij
authors.affiliation: 1] GENUD (Growth, Exercise, Nutrition and Development) Research Group, Department of Physiatry and Nursing, School of Health Sciences, University of Zaragoza, Facultad de Ciencias de la Salud, Zaragoza, Spain [2] Red SAMID, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: L A
authors.initials: LA
authors.lastname: Moreno
mesh_terms: D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior / Q000208:ethnology; D002664:Child Nutritional Physiological Phenomena / Q000208:ethnology; D002675:Child, Preschool; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D008019:Life Style / Q000208:ethnology; D008297:Male; D009043:Motor Activity; D009749:Nutrition Surveys; D050177:Overweight / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D010290:Parents; D063766:Pediatric Obesity / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D012307:Risk Factors; D057185:Sedentary Behavior / Q000208:ethnology; D055105:Waist Circumference