How energy balance-related behaviors, temperament, stress, and overweight associate: A cross-sectional study of Finnish preschoolers.

OBJECTIVE:This study aimed to 1) examine the clustering of energy balance-related behaviors (EBRBs) and 2) investigate whether EBRB clusters, temperament, and hair cortisol concentration (HCC) associate with overweight. DESIGN:We assessed food consumption using food records, screen time using sedentary behavior diaries, sleep consistency and temperament (negative affectivity, surgency, effortful control) using questionnaires, and HCC using hair samples. Accelerometers were used to assess physical activity (PA) intensities, sleep duration, and sleep efficiency. Researchers measured each child's weight and height. We used finite mixture models to identify EBRB clusters and multilevel logistic regression models to examine the associations between EBRB clusters, temperament, HCC, and overweight. SETTING:The cross-sectional DAGIS survey, data collected in 2015-2016. PARTICIPANTS:Finnish 3-6-year-olds (n=864) recruited through preschools. RESULTS:One-third of the participants were categorized into the cluster labeled "Unhealthy diet, excessive screen time", characterized by unhealthy dietary choices (e.g., greater consumption of high-fat, high-sugar dairy products) and longer screen time. Two-thirds were categorized into the second cluster, labeled "Healthy diet, moderate screen time". PA and sleep were irrelevant for clustering. Higher negative affectivity and lower effortful control associated with the "Unhealthy diet, excessive screen time" cluster. EBRB clusters and HCC did not associate with overweight, but surgency was positively associated with overweight (OR=1.63, 95% CI 1.17-2.25). CONCLUSIONS:Of the EBRBs, food consumption and screen time seem to associate. As temperament associates with EBRB clusters and overweight, tailored support acknowledging the child's temperament could be profitable in maintaining a healthy weight.