The relationship between early childhood BMI and lifestyle trends.

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Researchers used multi-trajectory modelling to investigate the longitudinal association between parallel improvements in lifestyle habits and BMI z scores in early childhood in the first study of its kind.
The research presented online in Obesity, the flagship publication of The Obesity Society (TOS).

“The results will educate early childhood obesity prevention action and policy, and will be of great interest to paediatricians, academics, politicians, and the general public,” said Miaobing Zheng of Deakin University’s Institute for Physical Activity and Nutrition, in Geelong, Australia.
Zheng is the corresponding author of the study.

According to experts, longitudinal research on the relationship between lifestyle habits and childhood obesity are scarce.

However, a connection between a healthier lifestyle and a lower risk of Obesity has previously been identified in a few cross-sectional studies.

The co-occurrence of stable, healthy lifestyle behaviours with a concurrent typical BMI z score trajectory of one unit from 18 to 60 months in approximately half of the children. The current study offers new empirical evidence that children with healthy lifestyles were more likely to have normal BMI z score development concurrently.

The Melbourne Feeding Activity and Nutrition Trial (InFANT) programme provided data on 439 children.
This children’s longitudinal cohort began in 2008 as a 15-month parent-focused cluster randomised controlled trial to reduce obesity risk behaviours in children until the age of 18 months.

Children aged 42 and 60 months received further follow-ups without interventions.

Multi-trajectory modelling was used to identify groups of children who had identical lifestyle behaviours and BMI z score trajectories. Multi-nomial logistic regression was used to determine the determinants of the trajectory groups.

Three classes of child lifestyle habits and BMI z scores were established and distinguished, displaying a combination of safe and unhealthy lifestyle behaviours and BMI z scores.
Group 2, “Safe lifestyle pattern, Mid BMI z”, revealed the most distinct trajectories through lifestyle trends and BMI z scores as compared to Groups 1 “Unhealthy lifestyle pattern, Low BMI z” and 3 “Unhealthy lifestyle pattern, High BMI z.”

Group 2 included approximately 53% of children and had a stable and low trajectory for an unhealthy lifestyle pattern marked by energy-dense and nutrient-poor discretionary food consumption and television viewing time, as well as a strong and rising trajectory for a balanced lifestyle pattern of fruit and vegetable intakes and time outside, with a mean BMI z score of 1 unit over time.

Groups 1 and 3 shared similar high trajectories for an unhealthy lifestyle pattern of discretionary food consumption and television viewing time and low trajectories for a healthy lifestyle pattern of fruit and vegetable intakes and time outdoors. However, the two groups’ BMI z score trajectories varied, with stable trends but mean scores of 0 and 2 units.

The established trajectory groups were not correlated with child sex, breastfeeding length, or maternal physical activity.

The authors of the study point out that the co-occurrence of regular lifestyle habits and BMI z score trajectories in early childhood emphasises the importance of beginning lifestyle obesity prevention early in life and that such measures should target both children and the mother.
A multi-behaviour plan that targets balanced eating, physical activity, and sedentary behaviours at the same time may be adapted.

“Young children learn by imitating what they see every day. There is no question that children imitate the behaviours they experience in the presence of their parents, both safe and unhealthy.” Liliana Aguayo, PhD, MPH, a childhood obesity researcher, TOS participant, and research assistant professor at Emory University’s Hubert Department of Global Health in Atlanta, Georgia, agreed.

“This study’s findings emphasise the significance of early childhood as a crucial time for the development of Obesity. More study is required to identify appropriate approaches to addressing both parent and child health behaviours at the same time.”

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