Current Assessment of Weight,Dietary and Physical Activity Behaviors among Middle and High School Students in Shanghai,China—A 2019 Cross-Sectional Study

Poor nutrition or insufficient physical activity (PA) are risk factors for obesity and chronic diseases. This 2019 cross-sectional study from the school health survey examined the dietary and PA behaviors of Chinese adolescents. A total of 12,860 adolescents aged 11–18 participated through multistage and stratified cluster random sampling. A questionnaire collected data on weight, PA, sedentary lifestyle, and eating habits. Unhealthy behaviors were identified and summed up for each behavior. Participants were then classified into high and low amounts of risk behaviors. Weight status was defined using Body Mass Index (BMI) cutoff points for Chinese individuals aged 6–18. Multinomial logistic regression was used to assess effects of lifestyle behaviors on weight status. The prevalence of overweight and obesity was 22.3% among all participants (30.6% in boys, 13.2% in girls). Females engaged in more risk physical activities (4.12 vs. 3.80, p < 0.05), while males engaged in more risk dietary activities (2.20 vs. 2.02, p < 0.05). Higher number of risk dietary, PA, and sedentary behaviors were all significantly correlated with higher BMI (dietary: r = 0.064; PA: r = 0.099; sedentary: r = 0.161; p < 0.001 for all) and body weight (dietary: r = 0.124; PA: r = 0.128; sedentary: r = 0.222; p < 0.001 for all). Risk sedentary behaviors was a significant risk factor for overweight/obesity (Adjusted Odds Ratio AOR = 1.30, 95% Confidence Interval CI 1.11–1.52). Obesity and unhealthy lifestyle behaviors remain a concern among Chinese adolescents. These results provide an update on the factors contributing to overweight/obesity among adolescents and call for efforts to address obesity among adolescents.     

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 β=−.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.     

Children’s Eating Habits,Physical Activity,Sleep, and Media Usage before and during COVID-19 Pandemic in Poland

The COVID-19 pandemic has caused huge changes in people’s lifestyle, health, and social relationships. This situation has had an impact on children and adolescents, affecting their health, intellectual, physical, and emotional development. The survey aimed to compare eating behaviors, level of physical activity (PA), hours of sleep, and screen time among Polish children and adolescents aged 6–15 years before and during the COVID-19 pandemic. We obtained self-reported data from 1016 participants at two measurement points before and during the COVID-19 lockdown in Poland to examine the influence of the lockdown and the distance learning on PA, dietary habits, sleep, and media usage of children and adolescents aged 6–15 years. The study identified dietary differences and changes in daily activity patterns (reduced sleep duration with higher sleep quality and reduced physical activity). Additionally, the increase in general media usage was observed during the pandemic alongside a reduction in smartphone usage. Together, the findings indicate increased sleep, physical activity, and reduced media usage and screen time among Polish children and adolescents during the COVID-19 pandemic.     

Determinants of Adherence to the Mediterranean Diet in Spanish Children and Adolescents: The PASOS Study

A progressive shift away from traditional healthy dietary patterns, such as the Mediterranean diet (MedDiet), has been observed in recent decades. The aim of this study was to assess determinants of optimal adherence to the MedDiet in Spanish children and adolescents. A cross-sectional analysis was included in the PASOS nationwide representative study in Spain. Participants were 3607 children and adolescents; 8–16 years old. Primary and secondary outcome measures of weight and height were measured. Adherence to the MedDiet, physical activity, and sedentary behavior in children and adolescents, as well as parental physical activity and dietary habits, were assessed. Optimal adherence to the MedDiet was observed in 45.5% of primary school students and 34.8% of secondary school students (OR: 0.65; 95%CI: 0.56–0.75). Optimal adherence to the MedDiet was higher in children/adolescents meeting daily recommended moderate and vigorous physical activity (OR: 2.39, 95%CI: 1.97–2.89) and in those meeting daily recommended screen time on weekdays (OR: 2.05, 95%CI: 1.77–2.38) and weekends (OR: 1.76, 95%CI: 1.48–2.10). Participants with optimal adherence to the MedDiet were more likely to have mothers with a high-level education and high-tercile of SDQS, mothers who never smoked or were former smokers, and mothers who met the recommended physical activity and screen time. It can be concluded that a low prevalence of optimal adherence to the MedDiet was found among current Spanish children and adolescents. Optimal adherence to the MedDiet was associated with reaching the recommendations on physical activity and screen time, with the highest maternal educational level, and healthier maternal lifestyles.     

Dietary and physical activity patterns in French children are related to overweight and socioeconomic status

Sedentary behavior (SED) has already been identified as a risk factor of childhood overweight (OW) but less is known about the dietary patterns related to adiposity. Our objective was to investigate if lifestyle patterns combining overall diet and physical activity were associated with childhood OW and if they were involved in the reverse association between socioeconomic status (SES) and OW. Dietary intake was assessed using a 7-d food record in 748 French children aged 3-11 y from the 1998-1999 cross-sectional French Enquête Individuelle et Nationale sur les Consommations Alimentaires national food consumption survey. Weight and height, leisure time physical activity, SED (television viewing), and SES were reported by parents or children by answering questionnaires. Scores for lifestyle patterns were assessed with factor analysis and their relationship with OW was explored by logistic regression analysis. Two similar lifestyle patterns were identified in children aged 3-6 y and 7-11 y: "snacking and sedentary" and "varied food and physically active." The snacking and sedentary pattern was positively associated with OW in the youngest children (P-trend = 0.0161) and partly mediated the negative association of SES to OW. The varied food and physically active pattern was inversely correlated with OW in the eldest children only (P-trend = 0.0401). A third pattern called "big eaters at main meals" was derived in children aged 7-11 y and was positively correlated with OW (P-trend = 0.0165). From a public health perspective, the combinations of identifiable dietary and physical activity behaviors may be useful as a basis for recommendations on preventing OW.     

Obesity-related behaviors of Malaysian adolescents: a sample from Kajang district of Selangor state

This study aims to determine the association between obesity-related behaviors (dietary practices, physical activity and body image) and body weight status among adolescents. A total of 382 adolescents (187 males and 195 females) aged 13 to 15 years in Kajang, Selangor participated in this study. Majority of the respondents were Malays (56.0%), followed by Chinese (30.1%) and Indians (13.9%). Dietary practices, physical activity and body image of the adolescents were assessed through the eating behaviors questionnaire, two-day dietary record, two-day physical activity record and multi-dimensional body image scale (MBIS), respectively. Body weight and height were measured by trained researchers. The prevalence of overweight and obesity (19.5%) was about twice the prevalence of underweight (10.5%). About two-thirds of the respondents (72.3%) skipped at least one meal and half of them (56.2%) snacked between meals with a mean energy intake of 1,641 ± 452 kcal/day. More than half of the respondents (56.8%) were practicing sedentary lifestyle with a mean energy expenditure of 1,631 ± 573 kcal per day. Energy intake (r = 0.153, P < 0.05), physical activity (r = 0.463, P < 0.01) and body image (r = 0.424, P < 0.01) were correlated with BMI. However, meal skipping, snacking and energy expenditure per kg body weight were not associated with body weight status. Multiple linear regression analysis showed that body image, physical activity and energy intake contributed significantly in explaining body weight status of the adolescents. In short, overweight and obesity were likely to be associated not only with energy intake and physical activity, but also body image. Hence, promoting healthy eating, active lifestyle and positive body image should be incorporated in future obesity prevention programmes in adolescents.     

京津冀地区儿童青少年体力活动视屏和睡眠时间与超重肥胖的关系

  目的  了解京津冀地区儿童青少年体力活动、视屏和睡眠状况及其与超重肥胖的关系,为京津冀地区儿童青少年保持健康体型提供参考和借鉴。  方法  2019年11月借助全国学生体质健康调研工作,参考儿童青少年体力活动指南对京津冀地区4 262名中小学生进行体力活动、睡眠状况、视屏时间调查,并采用Logistic回归分析其与超重肥胖之间存在的关联。  结果  京津冀地区儿童青少年超重肥胖检出率为22.03%;其中超重检出率12.01%,肥胖检出率10.02%。男生(26.09%)超重肥胖检出率高于女生(17.88%),差异有统计学意义(χ2=41.77,P < 0.01);城市(24.09%)和汉族(22.74%)儿童青少年超重肥胖检出率高于乡村(21.05%)和少数民族(17.70%),差异均有统计学意义(χ2值分别为5.00,7.63,P值均 < 0.05)。体力活动时间合格率为24.85%,视屏时间合格率为38.69%,睡眠时间合格率为57.09%。体力活动时间、视屏时间、睡眠时间3项均不合格的比例为21.68%,1项合格和2项合格分别占42.80%和28.77%,3项均合格的仅占6.76%。Logistic回归分析显示,睡眠时间合格与超重肥胖发生的风险呈负相关(OR=0.72,95%CI=0.52~0.98);与睡眠时间和视屏时间均未合格者相比,2项合格与超重肥胖的发生风险呈负相关(OR=0.57,95%CI=0.36~0.87)。  结论  京津冀地区儿童青少年体力活动时间合格率较低,保障睡眠时间将对超重肥胖的发生起到保护作用。应注重睡眠时间和视屏时间对儿童青少年超重肥胖的影响,并在以后的防控和干预中得以应用。     

Profiling Physical Activity,Diet, Screen and Sleep Habits in Portuguese Children

Obesity in children is partly due to unhealthy lifestyle behaviours, e.g., sedentary activity and poor dietary choices. This trend has been seen globally. To determine the extent of these behaviours in a Portuguese population of children, 686 children 9.5 to 10.5 years of age were studied. Our aims were to: (1) describe profiles of children’s lifestyle behaviours; (2) identify behaviour pattern classes; and (3) estimate combined effects of individual/socio-demographic characteristics in predicting class membership. Physical activity and sleep time were estimated by 24-h accelerometry. Nutritional habits, screen time and socio-demographics were obtained. Latent Class Analysis was used to determine unhealthy lifestyle behaviours. Logistic regression analysis predicted class membership. About 78% of children had three or more unhealthy lifestyle behaviours, while 0.2% presented no risk. Two classes were identified: Class 1-Sedentary, poorer diet quality; and Class 2-Insufficiently active, better diet quality, 35% and 65% of the population, respectively. More mature children (Odds Ratio (OR) = 6.75; 95%CI = 4.74–10.41), and boys (OR = 3.06; 95% CI = 1.98–4.72) were more likely to be overweight/obese. However, those belonging to Class 2 were less likely to be overweight/obese (OR = 0.60; 95% CI = 0.43–0.84). Maternal education level and household income did not significantly predict weight status (p ≥ 0.05).     

Peer Reviewed: Association Between Sedentary Behavior, Physical Activity, and Obesity: Inactivity Among Active Kids

Introduction

Sedentary behavior and physical activity are not mutually exclusive behaviors. The relative risk of overweight for adolescents who are highly sedentary and highly physically active is unclear. A better understanding of the relationship between sedentary behaviors, physical activity, and body mass index (BMI) would provide insight for developing interventions to prevent or reduce overweight.

Methods

Using the physical activity module of the School Health Action, Planning and Evaluation System (SHAPES), we collected data from 25,060 students in grades 9 through 12 from 76 secondary schools in Ontario, Canada. Sex-specific logistic regression analyses were performed to examine how BMI, weight perceptions, social influences, team sports participation, and smoking behavior were associated with being 1) high active-high sedentary, 2) low active-low sedentary, and 3) low active-high sedentary.

Results

Low active-high sedentary boys were more likely to be overweight than high active-low sedentary boys (adjusted odds ratio [AOR], 1.60; 95% confidence interval [CI], 1.01-2.58). When compared with high active-low sedentary girls, girls who were low active-high sedentary (OR, 2.24; 95% CI, 1.23-4.09) or high active-high sedentary (OR, 1.91; 95% CI, 1.01-3.61) were more likely to be overweight.

Conclusion

Sedentary behavior may moderate the relationship between physical activity and overweight. Developing a better understanding of sedentary behavior in relation to physical activity and overweight is critical for preventing and reducing overweight among youth.     

Patterns in sedentary and exercise behaviors and associations with overweight in 9–14-year-old boys and girls - a cross-sectional study.

Background  

Before starting interventions addressing energy-balance related behaviors, knowledge is needed about the prevalence of sedentary behaviors and low physical exercise, their interrelationships, possible gender differences. Therefore this study aimed to describe gender differences in sedentary and physical exercise behaviors and their association with overweight status in children from nine European countries. Additionally, to identify clusters of children sharing the same pattern regarding sedentary and physical exercise behavior and compare these groups regarding overweight status.     

Associations of Physical Activity and Dietary Behaviors With Children's Health and Academic Problems*

BACKGROUND: We examined the associations of physical activities and dietary behaviors with children's health and academic‐behavioral problems. METHODS: We employed a Community‐wide Children's Health Assessment and Planning Survey to examine physical activity, healthy meals, health status, and academic‐behavioral problems in 3708 children 7 to 14 years of age. Statistical associations were examined with chi‐square test and logistic regression analysis; we calculated odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Among these children, 30.2% were overweight‐obese, 11.0% had academic problems, and 7.9% had behavioral problems. Children classified as healthy eaters were more likely to exercise ≥4 days/week (79.1% vs 64.6%, OR: 2.08, 95% CI: 1.14 to 2.49), less likely to be overweight‐obese (27.7% vs 44.6%, OR: 0.48, CI: 0.31 to 0.73), less likely to have academic problems (9.1% vs 16.1%, OR: 0.57, 95% CI: 0.41 to 0.79) and behavioral problems (6.9% vs 13.9%, OR: 0.46, 95% CI: 0.32 to 0.66) compared with their less healthy eating peers. Physical activity and healthy meals were associated with an improved health status (p < .001). However, the proportions of children taking unhealthy meals or choosing sedentary lifestyle increased as the cohorts progressed (p < .05) from childhood (7 to 8 years) to adolescence (13 to 14 years). CONCLUSIONS: Healthy (or unhealthy) lifestyle behaviors are significantly interrelated. Children who take healthy meals and exercise often are associated with better health and fewer academic and behavioral problems. Unfortunately, taking unhealthy meals and sedentary lifestyle characterize a growing proportion of young adolescents. Thus, curbing unhealthy lifestyle behaviors should start in early childhood.     

Body Weight,Weight Self-Perception,Weight Teasing and Their Association with Health Behaviors among Chinese Adolescents—The Shanghai Youth Health Behavior Survey

Weight-related status has been associated with the physical and psychological health of adolescents. This cross-sectional study evaluated three different kinds of weight-related statuses (Body Mass Index (BMI), weight self-perception and weight teasing from others) among Chinese adolescents and identified their associations with health risk behaviors (lack of healthy dietary behavior, unhealthy dietary behavior, binge eating behavior, lack of physical activity (PA), sedentary behaviors (SB) and sleep disturbance). A stratified random cluster sampling method was used to select 10,070 students aged 11–18 years old from schools in Shanghai. Self-reported questionnaires were collected, weight-related statuses were divided into three categories and six specific health risk behaviors were classified into two groups: positive or negative. Overall, 27.82% of the adolescents were classified as being overweight and obese (35.61% of boys and 18.21% of girls), 43.45% perceived themselves as too heavy and 30.46% experienced weight teasing in the past. Among overweight or obese participants, 50.55% have been teased about their weight, and 77.48% perceived themselves as too heavy. Weight perception and weight teasing were significantly associated with health risk behaviors rather than the actual body weight status based on BMI, especially regarding binge eating behavior (body weight status (BMI): p > 0.05, underweight perception: OR = 1.18, 95%CI 1.03–1.34; weight teasing for more than once a year: OR = 2.00, 95%CI 1.76–2.27). In addition, weight perception and weight teasing were significantly associated with health risk behaviors, mainly in normal and overweight/obese groups but not in underweight groups. Weight teasing and weight self-perception play an independent and stronger role than actual body weight in the health behaviors of adolescents. This calls for more attention and intervention to reduce peer bullying and stigmas on weight among adolescents.     

Meeting 24-Hour Movement and Dietary Guidelines: Prevalence,Correlates and Association with Weight Status among Children and Adolescents: A National Cross-Sectional Study in China

China is confronted with a “double burden” of underweight and overweight/obesity in children and adolescents. This study aimed to investigate the prevalence and correlates of meeting 24 h movement and dietary guidelines among Chinese children and adolescents. Further, the study aimed to examine the association of meeting 24 h movement and dietary guidelines with weight status in Chinese children and adolescents. A total of 34,887 Chinese children and adolescents were involved. Only 2.1% of participants met the 24 h movement guidelines. Compared to those who met all three 24 h movement guidelines, those who only met the sleep duration guideline was significantly associated with a higher risk of underweight (p < 0.05), and those who only met the moderate-to-vigorous physical activity, or screen time guidelines were significantly associated with a higher risk of overweight/obesity (p < 0.05). Compared with those meeting the dietary guidelines, those who did not meet the soft drink intake guideline had a significantly lower risk of underweight (p < 0.05), those who did not meet the fruit intake guideline had a significantly lower risk of overweight/obesity (p < 0.05), and those who did not meet the milk intake guideline showed a significantly higher risk of overweight/obesity (p < 0.001). These findings indicate a significant association between meeting the 24 h movement and dietary guidelines and weight status among Chinese children and adolescents.     

Associations between dietary patterns, physical activity (leisure-time and occupational) and television viewing in middle-aged French adults

Diet and physical activity are considered to be major components of a healthy lifestyle. However, few studies have examined in detail the relationships between specific types of physical activity, sedentary behaviour and diet in adults. The objective of the present study was to assess differential relationships between dietary patterns, leisure-time and occupational physical activities and time spent watching television (TV), as an indicator of sedentary behaviour, in middle-aged French subjects. We performed a cross-sectional analysis using data from 1359 participants in the SUpplémentation en VItamines et Minéraux AntioXydants study, who completed a detailed physical activity questionnaire and at least six 24 h dietary records. Sex-specific dietary patterns were derived using factor analysis; their relationships with leisure-time and occupational physical activities and TV viewing were assessed using ANCOVA, after adjustment for age, educational level and smoking status. Three dietary patterns were identified in each sex. After adjustment for potential confounders, leisure-time physical activity was positively associated with a 'healthy' food pattern in both men (P for trend < 0·01) and women (P for trend < 0·03) and negatively associated with an 'alcohol/meat' pattern in men (P for trend < 0·01). TV viewing was positively associated with a 'convenience' pattern in men and with a 'alcohol-appetiser' pattern in women. In conclusion, identification of relationships between dietary patterns, physical activity and sedentary behaviour can enable identification of different types of lifestyle and should help to target at-risk groups in nutrition prevention programmes.     

Dietary,Lifestyle and Socio-Economic Correlates of Overweight,Obesity and Central Adiposity in Lebanese Children and Adolescents

The Eastern Mediterranean region is characterized by one of the highest burdens of paediatric obesity worldwide. This study aims at examining dietary, lifestyle, and socio-economic correlates of overweight, obesity, and abdominal adiposity amongst children and adolescents in Lebanon, a country of the Eastern Mediterranean basin. A nationally representative cross-sectional survey was conducted on 6–19-year-old subjects (n = 868). Socio-demographic, lifestyle, dietary, and anthropometric data (weight, height, waist circumference) were collected. Overweight and obesity were defined based on BMI z-scores. Elevated waist circumference (WC) and elevated waist to height ratio (WHtR) were used as indices of abdominal obesity. Of the study sample, 34.8% were overweight, 13.2% were obese, 14.0% had elevated WC, and 21.3% had elevated WHtR. Multivariate logistic regression analyses showed that male gender, maternal employment, residence in the capital Beirut, sedentarity, and higher consumption of fast food and sugar sweetened beverages were associated with increased risk of obesity, overweight, and abdominal adiposity, while regular breakfast consumption, higher intakes of milk/dairies and added fats/oils were amongst the factors associated with decreased risk. The study’s findings call for culture-specific intervention strategies for the promotion of physical activity, healthy lifestyle, and dietary practices amongst Lebanese children and adolescents.     

Greater bed- and wake-time variability is associated with less healthy lifestyle behaviors: a cross-sectional study

Aim

This study examines associations between the variability in bed/rise times, usual bed/rise time and dietary quality, physical activity, alcohol consumption, sitting time, sleep insufficiency and a composite index of behaviors.

Subject and methods

A random sample of Australian adults drawn from an online Panel cohort in 2013 completed a cross-sectional online survey. A total of 1,317 participants, median age 57 (IQR?=?20) completed the survey. Bed- and wake times, variability in bed- and wake-times, dietary quality, physical activity, alcohol consumption, sitting time, sleep insufficiency and socio-demographics were assessed using a questionnaire. Associations were examined with generalized linear models.

Results

Having bed - times that varied by >30 min were associated with lower dietary quality, higher alcohol consumption, higher sitting time, more frequent insufficient sleep and poorer overall pattern of lifestyle behaviors. Greater variability in wake times, usual bed times and usual wake times were inconsistently associated with lifestyle behaviours.

Conclusions

Greater bed-time variability is associated with a less healthy pattern of lifestyle behaviors. Greater consistency in sleep timing may contribute to, or be reflective of, a healthier lifestyle.

     

Risk factors for overweight and obesity in French adolescents: Physical activity,sedentary behavior and parental characteristics

ObjectiveWe determined the prevalence by age and sex and associated factors of overweight and obesity in French adolescents.MethodsWe conducted a cross-sectional study of 2385 adolescents aged 11–18 y (1213 boys and 1172 girls) from middle and high schools in the Aquitaine region (southwest France) in 2004–2005. Weight and height were measured, and adolescents filled in a questionnaire about their characteristics and those of their parents. Overweight and obesity were defined according to the age- and sex-specific body mass index cutoff points of the International Obesity Task force.ResultsPrevalence of overweight (obesity included) was greater in boys and younger children. The odds ratio (OR) for an adolescent being overweight increased with parents' being overweight (at least one parent overweight, OR 1.97, 1.48–2.62, P < 0.0001), low paternal socioeconomic status (OR 1.78, 1.22–2.60, P < 0.01) and sedentary behavior (22 h/wk, OR 1.33, 1.02–1.74, P < 0.05), and decreased with physical activity of parents (at least one parent active, OR 0.67, 0.51–0.89, P = 0.01).ConclusionOur data support the hypothesis that parental overweight and low socioeconomic status and adolescents' sedentary behavior are strong risk factors for adolescent overweight and obesity, and that parents active lifestyle is associated with a lower risk of overweight in their adolescents.     

Deprivation Index and Lifestyle: Baseline Cross-Sectional Analysis of the PREDIMED-Plus Catalonia Study

This baseline cross-sectional analysis from data acquired in a sub-sample of the PREDIMED-Plus study participants aimed to evaluate the relation between the Composite Socioeconomic Index (CSI) and lifestyle (diet and physical activity). This study involved 1512 participants (759 (52.2%) women) between 55 and 80 years with overweight/obesity and metabolic syndrome assigned to 137 primary healthcare centers in Catalonia, Spain. CSI and lifestyle (diet and physical activity) were assessed. Multiple linear regression or multinomial regression were applied to the data. Cluster analysis was performed to identify dietary patterns. The multiple linear regression model showed that a high deprivation index was related to a higher consumption of refined cereals (11.98 g/d, p-value = 0.001) and potatoes (6.68 g/d, p-value = 0.001), and to a lower consumption of fruits (−17.52 g/d, p-value = 0.036), and coffee and tea (−8.03 g/d, p-value = 0.013). Two a posteriori dietary patterns were identified by cluster analysis and labeled as “healthy” and “unhealthy”. In addition, the multinomial regression model showed that a high deprivation index was related to an unhealthy dietary pattern and low physical activity (OR 1.42 [95% CI 1.06–1.89]; p-value < 0.05). In conclusion, a high deprivation index was related to an unhealthy lifestyle (diet and physical activity) in PREDIMED-Plus study participants.     

成都市学龄儿童膳食模式与超重肥胖的关系研究

目的 探讨成都市学龄儿童膳食模式与其超重肥胖的关系。方法 采用分层整群抽样选取1 010例成都市7～12岁儿童作为研究对象,通过问卷调查收集儿童的基本信息、膳食数据及生活方式信息。通过因子分析法建立儿童的膳食模式。同时对儿童进行体格测量,计算儿童的体重指数（BMI）并判断其超重肥胖情况。采用多元Logistic回归模型分析儿童膳食模式与超重肥胖的关系。结果 本研究提取了成都市儿童的3种膳食模式:模式1与饮料、冰淇淋、西式快餐等的高摄入量相关;模式2以豆类、薯类、全谷物、乳类及其制品等为主要食物;模式3与蔬菜、水果的高摄入量相关。在调整相关混杂因素后,模式2得分越高,儿童超重肥胖的发生风险越低（OR值: 0.59, 95%CI: 0.39～0.90, P = 0.04）;模式1和模式3与儿童超重肥胖无关。结论 儿童的膳食模式会对其超重肥胖产生影响,应加强对儿童青少年的营养教育,指导其选择健康的膳食。     

Patterns and correlates of multiple risk behaviors in overweight women

BACKGROUND: Knowledge about the prevalence, co-occurrence, and correlates of lifestyle related behaviors of overweight women is needed to inform the design of health promotion interventions for weight loss. METHODS: Cross-sectional study involves 394 overweight and obese women, aged 18 to 55 (mean age=41.26), 39% from minority backgrounds, recruited through primary care clinics for a weight loss trial. Dependent variables were the proportion meeting recommended levels of physical activity (measured with an Actigraph), percent calories from fat, and servings of fruits and vegetables (assessed with a Food Frequency Questionnaire, FFQ) and accumulating less than 8 h/day of sedentary time for sedentary behavior (Actigraph). Covariates included socio-demographics, psychosocial variables, diet behaviors, and depression. RESULTS: Seventy-five percent of the sample did not engage in at least 30 min/day of physical activity, and 56% spent less than 8 h/day in sedentary activities. About 76% and 79% of the sample did not meet the dietary fat, and fruits and vegetable consumption guidelines, respectively. Two-thirds of the sample had three or more risk factors. Being employed full-time, lower education level, less use of physical activity change strategies, and low levels of social support were associated with higher likelihood of having a greater total number of health risk behaviors. CONCLUSION: Nearly 80% of the sample had multiple lifestyle risk behaviors. Poor dietary behaviors were present in all of the most prevalent risk behavior combinations. Lower socioeconomic and educational status and family and employment obligations characterize overweight and obese women with unhealthy activity and dietary behaviors in need of health promotion interventions.