title: The adiposity of children is associated with their lifestyle behaviours: a cluster analysis of school-aged children from 12 nations.
abstract: The relationship between children's adiposity and lifestyle behaviour patterns is an area of growing interest.
  
  
  
  The objectives of this study are to identify clusters of children based on lifestyle behaviours and compare children's adiposity among clusters.
  
  
  
  Cross-sectional data from the International Study of Childhood Obesity, Lifestyle and the Environment were used.
  
  
  
  the participants were children (9-11 years) from 12 nations (n = 5710).
  
  
  
  24-h accelerometry and self-reported diet and screen time were clustering input variables. Objectively measured adiposity indicators were waist-to-height ratio, percent body fat and body mass index z-scores.
  
  
  
  sex-stratified analyses were performed on the global sample and repeated on a site-wise basis. Cluster analysis (using isometric log ratios for compositional data) was used to identify common lifestyle behaviour patterns. Site representation and adiposity were compared across clusters using linear models.
  
  
  
  Four clusters emerged: (1) Junk Food Screenies, (2) Actives, (3) Sitters and (4) All-Rounders. Countries were represented differently among clusters. Chinese children were over-represented in Sitters and Colombian children in Actives. Adiposity varied across clusters, being highest in Sitters and lowest in Actives.
  
  
  
  Children from different sites clustered into groups of similar lifestyle behaviours. Cluster membership was linked with differing adiposity. Findings support the implementation of activity interventions in all countries, targeting both physical activity and sedentary time.
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, Australia.
authors.forename: Dorothea
authors.identifier: 0000-0003-3057-0963
authors.initials: D
authors.lastname: Dumuid
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Olds
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, Australia.|School of Health Sciences, Flinders University, Adelaide, Australia.
authors.forename: L K
authors.initials: LK
authors.lastname: Lewis
authors.affiliation: Facultat de Ciencies, Universitat de Girona, Girona, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Martin-Fernández
authors.affiliation: Population Science, Pennington Biomedical Research Center, Baton Rouge, USA.|School of Education, Syracuse University, Syracuse, USA.
authors.forename: T
authors.initials: T
authors.lastname: Barreira
authors.affiliation: Population Science, Pennington Biomedical Research Center, Baton Rouge, USA.
authors.forename: S
authors.initials: S
authors.lastname: Broyles
authors.affiliation: Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
authors.forename: J-P
authors.initials: JP
authors.lastname: Chaput
authors.affiliation: Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Fogelholm
authors.affiliation: Population Science, Pennington Biomedical Research Center, Baton Rouge, USA.
authors.forename: G
authors.initials: G
authors.lastname: Hu
authors.affiliation: Department of Nutrition, St John's Research Institute, Bengaluru, India.
authors.forename: R
authors.initials: R
authors.lastname: Kuriyan
authors.affiliation: Department of Nutrition, St John's Research Institute, Bengaluru, India.
authors.forename: A
authors.initials: A
authors.lastname: Kurpad
authors.affiliation: Department of Human Biology, University of Cape Town, Cape Town, South Africa.
authors.forename: E V
authors.initials: EV
authors.lastname: Lambert
authors.affiliation: Faculty of Sport, University of Porto, Porto, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Maia
authors.affiliation: Center of Studies of the Physical Fitness Research Laboratory from Sao Caetano du Sul (CELAFISCS), Sao Caetano do Sul, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Matsudo
authors.affiliation: Department of Recreation Management and Exercise Science, Kenyatta University, Kenyatta, Kenya.
authors.forename: V O
authors.initials: VO
authors.lastname: Onywera
authors.affiliation: Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia.
authors.forename: O L
authors.initials: OL
authors.lastname: Sarmiento
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: M
authors.initials: M
authors.lastname: Standage
authors.affiliation: Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
authors.forename: M S
authors.initials: MS
authors.lastname: Tremblay
authors.affiliation: Department of Kinesiology, University of Massachusetts Amherst, Amherst, USA.
authors.forename: C
authors.initials: C
authors.lastname: Tudor-Locke
authors.affiliation: Tianjin Women's and Children's Health Center, Tianjin, China.
authors.forename: P
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Population Science, Pennington Biomedical Research Center, Baton Rouge, USA.
authors.forename: P
authors.initials: P
authors.lastname: Katzmarzyk
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: F
authors.initials: F
authors.lastname: Gillison
authors.affiliation: School of Health Sciences, University of South Australia, Adelaide, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Maher
mesh_terms: D061725:Accelerometry; D050154:Adiposity; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D063766:Pediatric Obesity / Q000453:epidemiology*; D057185:Sedentary Behavior; D057566:Self Report
keywords: Lifestyle behaviours; compositional analysis; diet; obesity