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Juton C, Berruezo P, Torres S, Castañer O, Según G, Fitó M, Homs C, Gómez SF, Schröder H. Association between Meal Frequency and Weight Status in Spanish Children: A Prospective Cohort Study. Nutrients 2023; 15:nu15040870. [PMID: 36839228 PMCID: PMC9960333 DOI: 10.3390/nu15040870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/13/2023] [Accepted: 02/02/2023] [Indexed: 02/11/2023] Open
Abstract
Childhood obesity is a major international problem, and unhealthy eating habits remain widespread. Increasing the frequency of meals of nutritious food can help children to regulate their appetite and maintain a healthy weight. However, there is scarce prospective evidence on the relationship between the meal frequency and weight outcomes. Therefore, the objective of the present study was to determine the prospective association between the meal frequency, body mass index, and waist circumference in Spanish children. Additionally, we analyzed the impact of the meal frequency on the incidence of excessive weight and abdominal obesity. The study included 1400 children with a mean (SD) age of 10.1 (0.6) and an average follow-up of 15 months. Anthropometric measurements, including the body weight, height, and waist circumference, were measured by trained personnel, and children were asked about whether they usually had the following meals: breakfast, a mid-morning snack, lunch, an afternoon snack, and dinner. Multiple linear regression models revealed a significant (p < 0.05) inverse association between the meal frequency with a standardized BMI (zBMI) and the waist-to-height ratio (WHtR) after adjusting for sex, age, allocation to an intervention group, school, maternal education, physical activity, diet quality, and for the corresponding outcome variable at the baseline. Furthermore, the odds of developing abdominal obesity or excessive weight during the follow-up significantly decreased with an increase in the meal frequency after controlling for the same confounders. In conclusion, a higher meal frequency at the baseline was predictive for a lower zBMI, WHtR, and odds of the incidence of excessive weight and abdominal obesity.
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Affiliation(s)
- Charlotte Juton
- Endocrinology Department, Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
| | - Paula Berruezo
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
| | - Silvia Torres
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Faculty of Health Science and Wellbeing, University of Vic-University Central of Catalonia, 08500 Barcelona, Spain
| | - Olga Castañer
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Genís Según
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
- University of Lleida, 25003 Lleida, Spain
| | - Montserrat Fitó
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Clara Homs
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Sciences, University Ramon Llull, 08025 Barcelona, Spain
| | - Santiago F. Gómez
- Gasol Foundation Europe, Sant Boi de Llobregat, 08830 Barcelona, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- GREpS, Health Education Research Group, Nursing and Physiotherapy Department, University of Lleida, 25008 Lleida, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029 Madrid, Spain
- Correspondence: (S.F.G.); (H.S.)
| | - Helmut Schröder
- Cardiovascular Risk and Nutrition Research Group (CARIN), IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029 Madrid, Spain
- Correspondence: (S.F.G.); (H.S.)
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Wiersma R, Rijnks RH, Bocca G, Boezen HM, Hartman E, Corpeleijn E. Regional variation in lifestyle patterns and BMI in young children: the GECKO Drenthe cohort. Int J Health Geogr 2022; 21:7. [PMID: 35778749 PMCID: PMC9250228 DOI: 10.1186/s12942-022-00302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A better understanding of lifestyle behaviours of children < 7 years and the relation with childhood overweight is needed. The aim of our prospective study was to examine how lifestyle patterns in young children are associated with the development of childhood overweight. As ecological models suggest focusing on not only the child as an individual, but also their environment, we also considered the role of socio-economic status (SES) and spatial clustering of lifestyle and body mass index (BMI). METHODS In 1792 children (aged 3-6 years) participating in the GECKO Drenthe cohort, diet, screen time, outdoor play and sleep were assessed by questionnaires and moderate-to-vigorous physical activity and sedentary time by accelerometry (Actigraph GT3X). At 10-11 years, height and weight were measured to calculate age- and sex-specific standardized BMI z-scores (zBMI). Lifestyle patterns were identified using principal component analysis. To assess spatial clustering for the lifestyle patterns and zBMI, we calculated the Global Moran's I statistic. Linear- and logistic regression models, taking into account SES, were performed to examine the association between the lifestyle patterns and the development of overweight. For the spatial analyses, we added spatial terms for the determinants, the outcome, and the error term. RESULTS Three lifestyle patterns were identified: (1) 'high activity', (2) 'low screen time, high sleep and healthy diet', and (3) 'high outdoor play'. No associations were observed between the 'high activity' or 'high outdoor play' patterns at young age with the development of childhood overweight (all p > 0.05). In contrast, children who adhered to the 'low screen time, high sleep and healthy diet' pattern had lower odds to become overweight and a lower zBMI at 10-11 years (odds ratio [95% CI] = 0.766 [0.65; 0.90]). These findings remained similar after taking SES into account. Regarding the spatial analyses, we found spatial clustering of zBMI, but no spatial clustering of the lifestyle patterns. CONCLUSIONS Low screen time, high sleep duration and a healthy diet cluster into a pattern that seems favourable in the prevention of childhood overweight, independent of individual SES. The spatial analyses suggest that there are likely other neighbourhood factors that contribute to the spatial clustering of childhood overweight.
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Affiliation(s)
- Rikstje Wiersma
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Richard H Rijnks
- Department of Planning, Faculty of Spatial Sciences, Urban & Regional Studies Institute, University of Groningen, Groningen, The Netherlands
| | - Gianni Bocca
- Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - H Marike Boezen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Esther Hartman
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Section F, PO Box 196, 9700 AD, Groningen, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
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