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Nutritional Epidemiology

Dietary and Physical Activity Patterns in French Children Are Related to Overweight and Socioeconomic Status^1,2

³ French Food Safety Agency, Dietary Survey Unit-Nutritional Epidemiology, F-94700 Maisons-Alfort, France; ⁴ Doctoral School ABIES-AgroParisTech, F-75231 Paris, France; and ⁵ Institut de Recherche pour le Développement, UR106 Nutrition, Food, Societies (WHO Collaborating Center for Nutrition), F-34394 Montpellier, France

^* To whom correspondence should be addressed. E-mail: maire{at}mpl.ird.fr.

Sedentary behavior (SED) has already been identified as a risk factor of childhood overweight (OW) but less is known about the dietary patterns related to adiposity. Our objective was to investigate if lifestyle patterns combining overall diet and physical activity were associated with childhood OW and if they were involved in the reverse association between socioeconomic status (SES) and OW. Dietary intake was assessed using a 7-d food record in 748 French children aged 3–11 y from the 1998–1999 cross-sectional French Enquête Individuelle et Nationale sur les Consommations Alimentaires national food consumption survey. Weight and height, leisure time physical activity, SED (television viewing), and SES were reported by parents or children by answering questionnaires. Scores for lifestyle patterns were assessed with factor analysis and their relationship with OW was explored by logistic regression analysis. Two similar lifestyle patterns were identified in children aged 3–6 y and 7–11 y: "snacking and sedentary" and "varied food and physically active." The snacking and sedentary pattern was positively associated with OW in the youngest children (P-trend = 0.0161) and partly mediated the negative association of SES to OW. The varied food and physically active pattern was inversely correlated with OW in the eldest children only (P-trend = 0.0401). A third pattern called "big eaters at main meals" was derived in children aged 7–11 y and was positively correlated with OW (P-trend = 0.0165). From a public health perspective, the combinations of identifiable dietary and physical activity behaviors may be useful as a basis for recommendations on preventing OW.