Abstract P281: Longitudinal Associations of Diet, Screen Time, and Physical Activity Behaviors With Cardiometabolic Risk Factors Among Chinese Children and Their Parents

Abstract

Background: Understanding intergenerational differences in associations of urbanization-related lifestyle behaviors with cardiometabolic disease (CMD) risk factors in children and their parents is important in rapidly urbanizing China. Objective: We tested the intergenerational differences in longitudinal associations of away-from-home eating, snacking, screen time, and leisure-time sports with high waist-to-height ratio (WHtR), elevated blood pressure (BP), elevated hemoglobin A1c (HbA1c), and elevated C-reactive protein (CRP) among Chinese children and their parents. Method: We studied 5,180 children (aged 7-17y) and their parents participated in China Health and Nutrition Survey (1991-2009) with measured WHtR, BP, HbA1c, and CRP. We used three-day 24-hour dietary recall to derive away-from-home eating (non-consumer, <1meal/day, and ≥1meals/day) and consumption of fruit/vegetable snacks (any/none) and other snacks (any/none). We used a seven-day physical activity recall to collect screen time (≤1hr/day, 1-2hrs/day, and >2hrs/day) and leisure-time sports (any/none). Random-effects logistic regression was used to examine the associations of lagged behaviors with CMD risk factors. Results: We detected intergenerational differences in associations between lagged behaviors and risk factors ( P interaction <0.1). Generation-specific models showed that lagged away-from-home eating ≥1 (versus no) meals/day was negatively associated with parents’ high WHtR (OR=0.68, 95% CI=0.53, 0.89) but positively associated with children’s high WHtR (OR=1.46, 95% CI=1.01, 2.12) at follow-up. Lagged fruit/vegetable snack consumption was negatively related to parents’ high WHtR, parents’ elevated BP, and children’s high WHtR at follow-up. Lagged screen time was positively associated with parents’ high WHtR and children’s high WHtR, elevated BP, and high CRP at follow-up. The behavior-risk factor associations did not differ across years. Conclusion: CMD risk factors were negatively associated with fruit/vegetable snack consumption and positively associated with screen time in both generations. Away-from-home eating was associated with higher WHtR in children but lower WHtR in parents. Generation-specific intervention strategies may be needed for behavioral changes to reduce CMD risk.