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Abstract
Objectives The purpose of this study is (1) to identify obesity-related lifestyle behaviour patterns of diet, physical activity, sedentary and sleep behaviours in preschool children, (2) to examine the association between identified behaviour clusters and overweight/obesity and (3) to investigate differences in children's family environments according to clusters.
Design setting and participants A cross-sectional study on 2114 preschool children aged 3–6 years who attended childcare facilities (24 nursery schools and 10 kindergartens) in Tsuruoka city, Japan in April 2003 was conducted.
Main outcome measures Children's principal caregivers completed a questionnaire on children's lifestyle behaviours (dinner timing, outside playtime, screen time and night-time sleep duration), family environment (family members, maternal employment, mealtime regularity and parents' habitual exercise and screen time) and measurements of weight and height. Cluster analysis was performed using children's 4 lifestyle behaviours based on those non-missing values (n=1545). The χ2 tests and analysis of variance (ANOVA) estimated cluster differences in overweight/obesity and family environments.
Results 6 clusters were identified. Children's overweight/obesity varied across clusters (p=0.007). The cluster with the most screen time, shorter night-time sleep duration, average dinner timing and outside playtime had the highest overweight/obesity prevalence (15.1%), while the cluster with the least screen time, the longest sleep duration, the earliest dinner timing and average outside playtime had the lowest prevalence (4.0%). Family environments regarding mealtime regularity and both parents' screen time also significantly varied across clusters. The cluster having the highest overweight/obesity prevalence had the highest proportion of irregular mealtimes and the most screen time for both parents.
Conclusions This study suggests that public health approaches to prevent children's overweight/obesity should focus on decreasing screen time and increasing night-time sleep duration. To shape those behaviours, regular mealtimes and decreasing parents' screen time within family environments need to be targeted among family members.
- EPIDEMIOLOGY
- PUBLIC HEALTH
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Footnotes
Contributors All authors contributed to the writing and revising of the manuscript. EW, JSL, KM and KK conducted data collection. EW, JSL and KM conceived and designed this analysis and interpreted the findings. EW and KM performed the analyses. EW drafted the manuscript. The manuscript was critically reviewed by JSL, KM and KK.
Funding This study was supported by a grant from the Japan Ministry of Education, Culture, Sports, Science and Technology (JSPS KAKENHI grant number 25242063).
Competing interests None declared.
Patient consent Obtained.
Ethics approval Ethics Review Committee of the University of Tokyo.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All available data can be obtained by contacting the corresponding author.