Patterns of lifestyle-related behaviors and parents’ overweight are associated with increased body adiposity in schoolchildren: a cross-sectional study in Portugal

Background This study evaluated the association between lifestyle-related behavior patterns and weight status indicators in schoolchildren. Methods Cross-sectional study includes nationally representative sample of Portuguese schoolchildren (6–9 years old; n = 10,258). Weight status was assessed using the body mass index (BMI) and waist circumference (WC). Principal component analysis was used to identify lifestyle-related behavior patterns. Multiple linear regression models were used to estimate the association between behavior patterns, BMI, and WC. Results Six lifestyle-related behavior patterns were identified: pattern 1: consuming iced tea and soft drinks ≥2 times/week, having a television (TV) in the bedroom, watching TV ≥2 h/day, and consuming <2 portions of fruits/day; pattern 2: parents and children remaining physically inactive during leisure time; pattern 3: consuming ≤1 portion of vegetables and milk/day; pattern 4: having parents with excess weight; pattern 5: consuming ≤3 daily meals and skipping breakfast; and pattern 6: not participating in physical education classes. After the adjustment, all of the patterns were associated with increased BMI z -score ( P ≤ 0.02) and WC ( P ≤ 0.03). Conclusions Lifestyle-related behavior patterns were associated with an increased risk of excess weight and the central distribution of body fat. Taking a public health perspective toward preventing childhood obesity, special attention should be given to identify subgroups with simultaneous occurrence of multiple risk behaviors, which is useful for planning prevention programs.