Lifestyle patterns in European preschoolers: Associations with socio-demographic factors and body mass index

Alexandra Descarpentrie *, Lucinda Calas, Maxime Cornet, Barbara Heude, Marie-Aline Charles, Demetris Avraam, Sonia Brescianini, Tim Cadman, Ahmed Elhakeem, Silvia Fernández-Barrés, Jennifer R Harris, Hazel Inskip, Jordi Julvez, Sabrina Llop, Katerina Margetaki, Silvia Maritano, Johanna Lucia Thorbjørnsrud Nader, Theano Roumeliotaki, Theodosia Salika, Mikel Subiza-PérezMarina Vafeiadi, Martine Vrijheid, John Wright, Tiffany Yang, Patricia Dargent-Molina, Sandrine Lioret

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Summary
Background
Energy balance-related behaviours (EBRBs), that is, dietary intake, screen, outdoor play and sleep, tend to combine into ‘lifestyle patterns’, with potential synergistic influences on health. To date, studies addressing this theme mainly focused on school children and rarely accounted for sleep, with a cross-country perspective.

Objectives
We aimed at comparing lifestyle patterns among preschool-aged children across Europe, their associations with socio-demographic factors and their links with body mass index (BMI).

Methods
Harmonized data on 2–5-year-olds participating in nine European birth cohorts from the EU Child Cohort Network were used (EBRBs, socio-demographics and anthropometrics). Principal component analysis and multivariable linear and logistic regressions were performed.

Results
The most consistent pattern identified across cohorts was defined by at least three of the following EBRBs: discretionary consumption, high screen time, low outdoor play time and low sleep duration. Consistently, children from low-income households and born to mothers with low education level had higher scores on this pattern compared to their socioeconomically advantaged counterparts. Furthermore, it was associated with higher BMI z-scores in the Spanish and Italian cohorts (β = 0.06, 95% CI = [0.02; 0.10], both studies).

Conclusion
These findings may be valuable in informing early multi-behavioural interventions aimed at reducing social inequalities in health at a European scale
Original languageEnglish
Article numbere13079
JournalPediatric Obesity
Volume18
Issue number12
Early online date5 Oct 2023
DOIs
Publication statusPublished - 16 Nov 2023

Bibliographical note

Funding Information:
ALSPAC: We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. Note that the ALSPAC study website contains details of all available data available through a fully searchable data dictionary and variable search tool (http://www.bristol.ac.uk/alspac/researchers/our-data/). BiB: The Born in Bradford (BiB) cohort is only possible because of the enthusiasm and commitment of the children and parents in BiB. We are grateful to all the participants, health professionals and researchers who have made BiB happen. EDEN: The authors thank the cohort participants and the EDEN mother-child study group, whose members are I. Annesi-Maesano, J.Y. Bernard, J. Botton, M. A. Charles, P. Dargent-Molina, B. de Lauzon-Guillain, P. Ducimetière, M. de Agostini, B. Foliguet, A. Forhan, X. Fritel, A. Germa, V. Goua, R. Hankard, B. Heude, M. Kaminski, B. Larroque†, N. Lelong, J. Lepeule, G. Magnin, L. Marchand, C. Nabet, F Pierre, R. Slama, M. J. Saurel-Cubizolles, M. Schweitzer and O. Thiebaugeorges. ELFE: The authors would like to thank the participants of the ELFE study and their families for their continued participation. INMA: The authors want to express their gratitude to all the families for taking part in this cohort study. We also appreciate the generous contribution made to the study by all the members of INMA. A full roster of the INMA Project Investigators can be found at http://www.proyectoinma.org/presentacion-inma/listado-investigadores/en_listado-investigadores.html. MoBa: The authors are grateful to all the participating families in Norway who take part in this on-going cohort study. Piccolipiù: The authors thank all the families who took part in this study and the whole Piccolipiù research group. RHEA: The authors are grateful to all the participating families who took part in this cohort study. SWS: The authors are grateful to the women of Southampton who gave their time to take part in the Southampton Women's Survey and to the research nurses and other staff who collected and processed the data.

Funding Information:
ALSPAC: AE receives part of his salary from the EU Horizon 2020 Research and Innovation Program under Grant Agreement No. 874739 (LongITools project). BiB, EDEN, ELFE, INMA, MoBa, Piccolipiù, RHEA, SWS: The remaining authors declare no conflicts of interest.

Funding Information:
The LifeCycle project received funding from the European Union's (EU's) Horizon 2020 Research and Innovation Program (Grant No. 733206 LifeCycle) and was supported by the EUCAN‐Connect project under the EU's Horizon 2020 Research and Innovation Program (Grant No. 824989). This study was funded by a grant from the French National Research Agency (ANR‐19‐CE36–0006). All study‐specific funding are presented as follows: ALSPAC: The UK Medical Research Council and Wellcome (Grant No. 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. BiB: BiB receives core infrastructure funding from the Wellcome Trust (WT101597MA) and a joint grant from the UK Medical Research Council (MRC) and Economic and Social Science Research Council (ESRC) (MR/N024397/1). This study received support from the European Union's Horizon 2020 Research and Innovation Program (LifeCycle, Grant Agreement No. 733206; ATHLETE, Grant Agreement No. 874583) and the National Institute for Health Research Applied Research Collaboration Yorkshire and Humber (NIHR200166). The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. EDEN: The EDEN study was supported by the Foundation for Medical Research (FRM), French National Agency for Research (ANR), National Institute for Research in Public Health (IRESP: TGIR cohorte santé 2008 program), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO‐A) and Human Nutrition National Research Programs, Paris‐Sud University, Nestlé, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union FP7 programmes (FP7/2007‐2013, HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle Générale de l'Education Nationale a complementary health insurance (MGEN), French National Agency for Food Security and French Speaking Association for the Study of Diabetes and Metabolism (ALFEDIAM). ELFE: The ELFE cohort is a joint project between the French Institute for Demographic Studies (INED) and the National Institute of Health and Medical Research (INSERM), in partnership with the French blood transfusion service (Etablissement français du sang, EFS), Santé publique France, the National Institute for Statistics and Economic Studies (INSEE), the Direction générale de la santé (DGS, part of the Ministry of Health and Social Affairs), the Direction générale de la prévention des risques (DGPR, Ministry for the Environment), the Direction de la recherche, des études, de l'évaluation et des statistiques (DREES, Ministry of Health and Social Affairs), the Département des études, de la prospective et des statistiques (DEPS, Ministry of Culture) and the Caisse nationale des allocations familiales (CNAF), with the support of the Ministry of Higher Education and Research and the Institut national de la jeunesse et de l'éducation populaire (INJEP). It receives a government grant managed by the National Research Agency under the ‘Investissements d'avenir’ programme (ANR‐11‐EQPX‐0038, ANR‐19‐COHO‐0001). INMA: The INfancia y Medio Ambiente cohort study was funded as described below. The Gipuzkoa cohort received funding from Instituto de Salud Carlos III (PI06/0867 FIS‐PI18/01142, FIS‐PI09/00090 and FIS‐PI18/01142 incl. FEDER funds), Department of Health of the Basque Government (2005111093, 2009111069 and 2013111089), Provincial Government of Gipuzkoa (DFG06/002, DFG08/001) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain). The Sabadell cohort was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041; PI041436, PI081151, incl. FEDER funds), Generalitat de Catalunya‐CIRIT 1999SGR 00241 and Fundació La marató de TV3 (090430). We acknowledge support from the Spanish Ministry of Science and Innovation and the State Research Agency through the ‘Centro de Excelencia Severo Ochoa 2019‐2023’ Program (CEX2018‐000806‐S) and support from the Generalitat de Catalunya through the CERCA Program. Finally, Valencia cohort received support from grants from UE (FP7‐ENV‐2011 cod 282957, HEALTH.2010.2.4.5‐1 and ATHLETE cod 874583), Spain: ISCIII (Red INMA G03/176, CB06/02/0041; FIS‐FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/1213, PI07/0314, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, PI17/00663 and PI19/1338; Miguel Servet‐FEDER CP11/00178, CP15/00025 and CPII16/00051), Generalitat Valenciana (AICO/2021/132), FISABIO (UGP 15‐230, UGP‐15‐244, and UGP‐15‐249) and Alicia Koplowitz Foundation 2017. JJ holds a Miguel Servet‐II contract (Grant No. CPII19/00015) awarded by the Instituto de Salud Carlos III (co‐funded by European Social Fund ‘Investing in your future’). MoBa: The Norwegian Mother, Father and Child Cohort Study was supported by the Norwegian Ministry of Health and Care Services and the Ministry of Education and Research. Work by JRH was supported, in part, through the Research Council of Norway, Centres of Excellence funding scheme (Project No. 262700). Piccolipiù: The study was funded by the Italian National Centre for Disease Prevention and Control (CCM grant 2010 and 2014), through the Italian Ministry of Health (art 12 and 12bis Dl .gs. vo 502/92). RHEA: The Rhea project was financially supported by European projects (EU FP6‐2003‐Food‐3‐NewGeneris, EU FP6. STREP Hiwate, EU FP7 ENV.2007.1.2.2.2. Project No. 211,250 Escape, EU FP7‐2008‐ENV‐1.2.1.4 Envirogenomarkers, EU FP7‐HEALTH‐2009 single stage CHICOS, EU FP7 ENV.2008.1.2.1.6. Proposal No. 226,285 ENRIECO, EU‐FP7 HEALTH‐2012 Proposal No. 308,333 HELIX, H2020 LIFECYCLE, Grant Agreement No. 733206, H2020 ATHLETE, Grant Agreement No. 874583) and the Greek Ministry of Health (Program of Prevention of obesity and neurodevelopmental disorders in preschool children, in Heraklion district, Crete, Greece: 2011–2014; ‘Rhea Plus’: Primary Prevention Program of Environmental Risk Factors for Reproductive Health and Child Health: 2012–15). Additional funding from NIEHS supported Dr Chatzi (R01ES030691, R01ES029944, R01ES030364, R21ES029681, R21ES028903 and P30ES007048). SWS: The SWS was supported by grants from the Medical Research Council, National Institute for Health Research Southampton Biomedical Research Centre, British Heart Foundation, University of Southampton and University Hospital Southampton National Health Service Foundation Trust and the European Union's Seventh Framework Program (FP7/2007‐2013), project EarlyNutrition (Grant No. 289346) and from the European Union's Horizon 2020 Research and Innovation Program (LifeCycle, Grant Agreement No. 733206). Study participants were drawn from a cohort study funded by the Medical Research Council and the Dunhill Medical Trust.

Publisher Copyright:
© 2023 World Obesity Federation.

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