Yan Zhao, Wen Zheng, Yufei Ni, Aiping Wu, Kan Ye, Yelin Bao, Xinye Jiang, Guoqin Liu, Guoqiang Yang, Li Zhang, Hongxia Qi, Heyun Lv, Lihua Li, Rui Qin, Hong Cao
There was a non-linear association between obesity and sleep duration. Lack of outdoor activity was an independent associated factor for obesity. In nominal analyses, excessive intake of milk, fish/shrimp, meat, and eggs was associated with higher odds of obesity in children during the first 6 years of life, whereas an inverse association was observed, with obesity risk decreasing among individuals who preferred vegetarian foods. After false discovery rate correction, sleep duration >14 h, outdoor activity <1 h/day, preference for vegetarian foods, and meat intake >150 g/day remained statistically significant.
OBJECTIVE: To identify lifestyle and dietary factors associated with obesity in children during the first 6 years of life.
METHODS: Children aged 0-6 years were recruited from 12 Children's Health Care Centers in Jiangsu, China, by a multistage stratified cluster random-sampling method. Diet, sleep, supplementation and outdoor activity were collected by questionnaire/interview. Obesity was defined as Body mass index Z-score >2 (World Health Organization standards). Logistic regression was used to examine the associations between lifestyle/dietary factors and obesity, adjusting for sex, age, delivery mode, birth weight, region, and season, with additional stratified and restricted cubic spline dose-response analyses.
RESULTS: A survey of 5,243 children were enrolled in the present study. Prevalence varied by characteristics: sleep <10 h (8.5%), >14 h (9.9%), outdoor activity <1 h (10.7%), complementary feeding before 4 months (9.8%), daily calcium ≥300 mg (10.4%), preference for meat (10.0%), fish/shrimp ≥ 2 times/week (7.1%), daily milk ≥600 mL (6.3%), daily meat >150 g (11.2%), and daily egg >60 g (11.1%). Adjusted analyses identified higher obesity odds for sleep <10 h [odds ratio (OR) 1.327, 95% Confidence Interval (95% CI) 1.024-1.719] or >14 h (2.503, 1.640-3.820), outdoor activity <1 h (2.018, 1.465-2.779), vitamin D supplementation <15 days (1.686, 1.063-2.673), complementary feeding <4 months (1.665, 1.114-2.487), preference for meat (1.369, 1.049-1.859), fish/shrimp ≥ 2 times/week (1.354, 1.026-1.788), daily meat >150 g (2.060, 1.207-3.514), daily egg >60 g (2.937, 1.075-8.024), and daily milk ≥600 mL (1.830, 1.083-3.094 vs. ≤100 mL). A vegetarian preference was inversely associated with obesity.
CONCLUSION: There was a non-linear association between obesity and sleep duration. Lack of outdoor activity was an independent associated factor for obesity. In nominal analyses, excessive intake of milk, fish/shrimp, meat, and eggs was associated with higher odds of obesity in children during the first 6 years of life, whereas an inverse association was observed, with obesity risk decreasing among individuals who preferred vegetarian foods. After false discovery rate correction, sleep duration >14 h, outdoor activity <1 h/day, preference for vegetarian foods, and meat intake >150 g/day remained statistically significant.