Cumulative Effect of Obesogenic Behaviours on Adiposity in Spanish Children and Adolescents

• Published in: Obesity facts Vol. 10; no. 6; pp. 584 - 596
• Main Authors: Schröder, Helmut, Bawaked, Rowaedh Ahmed, Ribas-Barba, Lourdes, Izquierdo-Pulido, Maria, Roman-Viñas, Blanca, Fíto, Montserrat, Serra-Majem, Lluis
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01-01-2017; S. Karger; S. Karger GmbH; Karger Publishers
• Subjects: Abdomen; Age; Behavior; Cardiovascular disease; Childhood obesity; Diet; Education; Energy; Estimates; Exercici; Exercise; Health risk assessment; Metabolism; Obesitat en els adolescents; Obesitat en els infants; Obesity; Obesity in adolescence; Obesity in children; Obesogenic behaviours; Original; Original Article; Overweight; Physical activity; Population; Questionnaires; Screen time; Socioeconomic factors; Standard scores; Statistical analysis; Teenagers; Spain; Obesogenic behaviours; Childhood obesity; Physical activity; Diet
• ISSN: 1662-4025; 1662-4033
• DOI: 10.1159/000480403

Objective: Little is known about the cumulative effect of obesogenic behaviours on childhood obesity risk. We determined the cumulative effect on BMI z-score, waist-to-height ratio (WHtR), overweight and abdominal obesity of four lifestyle behaviours that have been linked to obesity. Methods: In this cross-sectional analysis, data were obtained from the EnKid sudy, a representative sample of Spanish youth. The study included 1,614 boys and girls aged 5-18 years. Weight, height and waist circumference were measured. Physical activity (PA), screen time, breakfast consumption and meal frequency were self-reported on structured questionnaires. Obesogenic behaviours were defined as <1 h PA/day, ≥2 h/day screen time, skipping breakfast and <3 meals/day. BMI z-score was computed using age- and sex-specific reference values from the World Health Organization (WHO). Overweight including obesity was defined as a BMI > 1 SD from the mean of the WHO reference population. Abdominal obesity was defined as a WHtR ≥ 0.5. Results: High screen time was the most prominent obesogenic behaviour (49.7%), followed by low physical activity (22.4%), low meal frequency (14.4%), and skipping breakfast (12.5%). Although 33% of participants were free of all 4 obesogenic behaviours, 1, 2, and 3 or 4 behaviours were reported by 44.5%, 19.3%, and 5.0%, respectively. BMI z-score and WHtR were positively associated (p < 0.001) with increasing numbers of concurrent obesogenic behaviours. The odds of presenting with obesogenic behaviours were significantly higher in children who were overweight (OR 2.68; 95% CI 1.50; 4.80) or had abdominal obesity (OR 2.12; 95% CI 1.28; 3.52); they reported more than 2 obesogenic behaviours. High maternal and parental education was inversely associated (p = 0.004 and p < 0.001, respectively) with increasing presence of obesogenic behaviours. Surrogate markers of adiposity increased with numbers of concurrent presence of obesogenic behaviours. The opposite was true for high maternal and paternal education.