Abstract

Identifying modifiable lifestyle behaviors linked to childhood obesity is necessary to develop preventive strategies. To estimate the association of five lifestyle behaviors in children aged 4years on obesity and cardiometabolic risk factors at age 4years and on obesity and blood pressure at age 7years. We used child lifestyle data from the INMA project at age 4years (n=1480). We constructed a child lifestyle score by summing five behaviors (physical activity, sleep time, television time, plant based foods and intake of ultra-processed foods) and we categorized it into tertiles. At ages 4 and 7 years, we calculated age- and sex-specific z-scores for BMI, waist circumference (WC), and blood pressure. At age 4, we also calculated age-, and sex-, specific z-scores for triglycerides and HDL. We used linear and logistic regression analyses. The lifestyle score was not associated with the outcomes at 4years, but it was negatively associated with BMI and WC z-scores at age 7 years. Children at age 4 years in the highest tertile of the score had lower risk of overweight or obesity at age 7 years (OR = 0.61; 95% CI 0.39; 0.96) and abdominal obesity (OR = 0.48; 95% CI 0.24; 0.96). Higher adherence to a healthy lifestyle at age 4years decreased risk of overweight, obesity and abdominal obesity at 7years.

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