Clustering and correlates of multiple health behaviours in 9-10 year old children.

BACKGROUND: Sleep, physical activity, screen time and dietary behaviours influence health during childhood, but few studies have looked at all of these behaviours simultaneously and previous research has relied predominantly on self- or proxy-reports of physical activity and food frequency questionnaires for the assessment of diet. PURPOSE: To assess the prevalence and clustering of health behaviours and examine the socio-demographic characteristics of children that fail to meet multiple health behaviour guidelines. METHODS: Data are from the Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people (SPEEDY) study. Participants (n = 1472, 42.9% male) were dichotomized based on whether or not they met public health guidelines for accelerometer-assessed physical activity, diet-diary assessed fruit/vegetable intake and fat/non-milk extrinsic sugar (NMES) intake, and self-reported screen time and sleep duration. Behavioural clustering was assessed using an observed over expected ratio (O/E). Socio-demographic characteristics of participants that failed to meet multiple health behaviour guidelines were examined using ordinal logistic regression. Data were analysed in 2013. RESULTS: 83.3% of children failed to meet guidelines for two or more health behaviours. The O/E ratio for two behavioural combinations significantly exceeded 1, both of which featured high screen time, insufficient fruit/vegetable consumption and excessive fat/NMES intake. Children who were older (Proportional odds ratio (95% confidence interval): 1.69 (1.21,2.37)) and those that attended a school with a physical activity or diet-related policy (1.28 (1.01,1.62)) were more likely to have a poor health behaviour profile. Girls (0.80 (0.64,0.99)), participants with siblings (0.76 (0.61,0.94)) and those with more highly educated parents (0.73 (0.56,0.94)) were less likely to have a poor health behaviour profile. CONCLUSIONS: A substantial proportion of children failed to meet guidelines for multiple health behaviours and there was evidence of clustering of screen viewing and unhealthy dietary behaviours. Sub-groups at greatest risk may be targeted for intervention.This is the final published version, which can also be found online at: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0099498#ac

The association among SES, screen time, and outdoor play in children at different ages:The GECKO Drenthe study

Introduction: This study examined the association among socioeconomic status (SES), screen time, and outdoor play in children at different ages in the GECKO Drenthe birth cohort study. Methods: Valid data were obtained from two surveys at ages 3–4 years and 10–11 years. Screen time (TV watching and computer use) and outdoor play were reported by parents. Childhood SES was derived by a synthetic “Equivalized Household Income Indicator,” an estimated disposable income. Quantile regression models (cross-sectional analysis) and linear regression models (change between 3–4 and 10–11 years) were used. Results: In general, screen time increased strongly from a median of 51 min/day at 3–4 years (n = 888) to 122 min/day at 10–11 years (n = 1023), whereas time spent on outdoor play remained stable over age (77 min/day at 3–4 years and 81 min/day at 10–11 years). More time spent on outdoor play (50th quantile) was found in children with low SES families at 3–4 years, while at 10–11 years, more outdoor play was found in the high SES group. At 10–11 years, in the higher ranges of screen time, children from high SES had relatively lower screen time [50th quantile: −10.7 (−20.8; −0.6); 75th quantile: −13.6 (−24.4; −2.8)]. In the longitudinal analysis (n = 536), high SES was associated with an increasing time spent on outdoor play [11.7 (2.7; 20.8)]. Conclusion: Socioeconomic disparities in children's outdoor play and screen behavior may be more obvious with increasing age. Low SES may facilitate both outdoor play (at 3–4 years) and screen time (at 10–11 years); however, children from high SES families develop slightly more favorable behavior patterns with age.</p

Relation Between Leisure Time, Commuting, and Occupational Physical Activity With Blood Pressure in 125 402 Adults:The Lifelines Cohort

Background Whether all domains of daily-life moderate-to-vigorous physical activity (MVPA) are associated with lower blood pressure (BP) and how this association depends on age and body mass index remains unclear. Methods and Results In the population-based Lifelines cohort (N=125 402), MVPA was assessed by the Short Questionnaire to Assess Health-Enhancing Physical Activity, a validated questionnaire in different domains such as commuting, leisure-time, and occupational PA. BP was assessed using the last 3 of 10 measurements after 10 minutes' rest in the supine position. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or use of antihypertensives. In regression analysis, higher commuting and leisure-time but not occupational MVPA related to lower BP and lower hypertension risk. Commuting-and-leisure-time MVPA was associated with BP in a dose-dependent manner. β Coefficients (95% CI) from linear regression analyses were -1.64 (-2.03 to -1.24), -2.29 (-2.68 to -1.90), and finally -2.90 (-3.29 to -2.50) mm Hg systolic BP for the low, middle, and highest tertile of MVPA compared with "No MVPA" as the reference group after adjusting for age, sex, education, smoking and alcohol use. Further adjustment for body mass index attenuated the associations by 30% to 50%, but more MVPA remained significantly associated with lower BP and lower risk of hypertension. This association was age dependent. β Coefficients (95% CI) for the highest tertiles of commuting-and-leisure-time MVPA were -1.67 (-2.20 to -1.15), -3.39 (-3.94 to -2.82) and -4.64 (-6.15 to -3.14) mm Hg systolic BP in adults 60 years, respectively. Conclusions Higher commuting and leisure-time but not occupational MVPA were significantly associated with lower BP and lower hypertension risk at all ages, but these associations were stronger in older adults

Effect of a multidisciplinary treatment program on eating behavior in overweight and obese preschool children

Background: The effects of multidisciplinary treatment programs on eating behavior in overweight preschoolaged children are largely unknown. We evaluated a multidisciplinary intervention program on eating behavior in 3- to 5-year-old overweight children, comparing them with children given standard treatment. We also assessed the parental eating behavior changes and investigated associations between parents and children. Methods: We randomized 75 children to a multidisciplinary intervention or to a standard care program. During a 16-week period, children and parents in the multidisciplinary group were given dietary advice, physical activity sessions and, for parents only, psychological counseling. Children and parents in the standard group visited a pediatrician 3 times and were given information on a healthy lifestyle. At baseline, after 16 weeks, and after 12 months, children were measured and parents completed the Dutch Child Eating Behavior Questionnaire (DEBQ-C) for their children and the DEBQ for themselves. Results: At the three time points, 70 (93.3%), 57 (91.9%), and 42 (73.7%) DEBQ-Cs were analyzed. We found no differences in the changes in eating behavior between the two groups over time. In both groups, there was a significant increase in restrained eating behavior present at 16 weeks, however, this was no longer present at 12 months. We found no associations between changes in eating behavior between the children and their parents. Conclusions: A multidisciplinary obesity intervention program in preschool-aged children induced more restrained eating behavior between baseline and 16 weeks. However, there was no difference with the children in the standard care group

The association among SES, screen time, and outdoor play in children at different ages:The GECKO Drenthe study

Introduction: This study examined the association among socioeconomic status (SES), screen time, and outdoor play in children at different ages in the GECKO Drenthe birth cohort study. Methods: Valid data were obtained from two surveys at ages 3–4 years and 10–11 years. Screen time (TV watching and computer use) and outdoor play were reported by parents. Childhood SES was derived by a synthetic “Equivalized Household Income Indicator,” an estimated disposable income. Quantile regression models (cross-sectional analysis) and linear regression models (change between 3–4 and 10–11 years) were used. Results: In general, screen time increased strongly from a median of 51 min/day at 3–4 years (n = 888) to 122 min/day at 10–11 years (n = 1023), whereas time spent on outdoor play remained stable over age (77 min/day at 3–4 years and 81 min/day at 10–11 years). More time spent on outdoor play (50th quantile) was found in children with low SES families at 3–4 years, while at 10–11 years, more outdoor play was found in the high SES group. At 10–11 years, in the higher ranges of screen time, children from high SES had relatively lower screen time [50th quantile: −10.7 (−20.8; −0.6); 75th quantile: −13.6 (−24.4; −2.8)]. In the longitudinal analysis (n = 536), high SES was associated with an increasing time spent on outdoor play [11.7 (2.7; 20.8)]. Conclusion: Socioeconomic disparities in children's outdoor play and screen behavior may be more obvious with increasing age. Low SES may facilitate both outdoor play (at 3–4 years) and screen time (at 10–11 years); however, children from high SES families develop slightly more favorable behavior patterns with age.</p