Consumption of vegetables, cooked meals, and eating dinner is negatively associated with overweight status in children.

OBJECTIVE: To evaluate potential associations between diet- and physical activity-related lifestyle patterns and obesity indices in a cohort of children. STUDY DESIGN: Dietary and physical activity information and anthropometric indices were collected from 1138 children (53% girls; age, 11.2 ± 0.7 years). Dietary intake was evaluated with two 24-hour recalls, which were analyzed for nutrient and food intake, eating frequency, and meal quality. Principal component analysis was used to extract salient lifestyle patterns. RESULTS: Five lifestyle behavioral patterns were identified. The "dinner, cooked meals and vegetables pattern," a multidimensional lifestyle pattern including the consumption of vegetables, cooked meals, and eating dinner, was negatively associated with all obesity indices, even after adjustment for potential confounders and exclusion of low energy reporters. A "high fiber pattern," representing high consumption of whole-grain cereals, legumes, and low intake of sugar-sweetened beverages was negatively correlated with obesity indices; when the analysis included only acceptable energy reporters, these associations became non-significant, except for triceps skinfolds. CONCLUSIONS: Our findings are supportive of the synergistic or conditional effects of distinct lifestyle-related behaviors on obesity. Although these results are hypothesis-generating and need replication, they suggest potential preventive approaches, interventional approaches, or both to combat childhood obesity.

Associations between lifestyle patterns and body mass index in a sample of Greek children and adolescents.

BACKGROUND: Although eating and physical activity behaviors have been previously individually investigated with regard to overweight in children, multidimensional lifestyle patterns, based on these behaviors, have not been explored. OBJECTIVE: To assess lifestyle patterns in relation to body mass index (BMI), in a nationally representative sample of the Greek pediatric population DESIGN: Cross-sectional study. Data were collected from May through July 2007. SUBJECTS: The sample consisted of 1,305 children and adolescents (ages 3 to 18 years). MAIN OUTCOME MEASURES: Information on participants' dietary intake, eating behaviors, physical activity habits, and BMI were collected. Adherence to the Mediterranean diet guidelines was evaluated using the KIDMED Mediterranean diet quality index; the higher the score in this index the more favorable the dietary pattern. The Goldberg cut-off limits for the ratio of energy intake/basal metabolic rate were used to evaluate dietary low energy reporting and participants were accordingly classified as low-energy reporters. STATISTICAL ANALYSIS: Principal component analysis was performed to identify participants' lifestyle patterns. Associations between BMI and lifestyle patterns were further evaluated using multiple linear regression analyses, after controlling for potential confounders. RESULTS: Principal component analysis identified seven lifestyle patterns explaining 85% of the total variance of lifestyle habits. A lifestyle pattern characterized by higher eating frequency, breakfast consumption and higher KIDMED score was negatively associated with BMI (standardized beta=-.125, P<0.001), after controlling for age, sex, and parental education. The association remained significant even when low-energy reporters were excluded from the analysis. CONCLUSIONS: Results from the study suggest a potential intercorrelation and protective action of selected eating behaviors, namely eating frequency, breakfast consumption, and adherence to the Mediterranean diet, against overweight and obesity in children and adolescents.