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Prospective associations between energy balance-related behaviors at 2 years of age and subsequent adiposity: the EDEN mother–child cohort

Abstract

Background/Objectives:

Sedentary behavior, physical activity and dietary behavior are formed early during childhood and tend to remain relatively stable into later life. No longitudinal studies have assessed the independent influence of these three energy balance-related behaviors during toddlerhood on later adiposity. We aimed to analyze the associations between TV/DVD watching time, outdoor play time and dietary patterns at the age of 2 years and child adiposity at the age of 5 years, in boys and girls separately.

Subjects/Methods:

This study included 883 children from the French EDEN mother–child cohort. TV/DVD watching time, outdoor play time and dietary intakes were reported by parents in questionnaires when the child was aged 2 years. Two dietary patterns, labeled 'Guidelines' and 'Processed, fast foods', were identified in a previous study. The percentage of body fat (%BF) based on bioelectrical impedance analysis and body mass index were measured at the age of 5 years.

Results:

In boys, TV/DVD watching time at the age of 2 years was positively associated with %BF at the age of 5 years (β=0.50 (95% confidence interval: 0.001, 1.00) for those boys with 60 min per day of TV/DVD watching time vs those with 15 min per day, P-value for trend 0.05). In girls, outdoor play was inversely associated with %BF (β=−0.96 (95% confidence interval: −1.60, −0.32) for those in the highest tertile of outdoor play time vs those in the lowest tertile, P=0.001). Overall, at the age of 2 years, dietary patterns were associated with both TV/DVD watching time and outdoor play time, but no significant and independent association was observed between dietary patterns and later adiposity.

Conclusion:

This study shows longitudinal and gender-differentiated relations between both TV/DVD watching time and outdoor play time in toddlerhood and later adiposity, whereas evidence for a relation between dietary patterns and subsequent fat development was less conclusive. Early childhood—by the age of 2 years—should be targeted as a critical time for promoting healthy energy balance-related behaviors.

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Acknowledgements

We are extremely grateful to all the families who took part in this study, the midwives and psychologists who recruited and followed them, and the whole EDEN team, including research scientists, engineers, technicians and managers and especially Josiane Sahuquillo and Edith Lesieux for their commitment and their role in the success of the study. We also acknowledge the commitment of the members of the EDEN mother–child cohort study group: I Annesi-Maesano, JY Bernard, J Botton, MA Charles, P Dargent-Molina, B de Lauzon-Guillain, P Ducimetière, M de Agostini, B Foliguet, A Forhan, X Fritel, A Germa, V Goua, R Hankard, B Heude, M Kaminski, B Larroque†, N Lelong, J Lepeule, G Magnin, L Marchand, C Nabet, F Pierre, R Slama, MJ Saurel-Cubizolles, M Schweitzer, O Thiebaugeorges. We thank Jo Ann Cahn for her help in preparing the manuscript. We acknowledge all funding sources for the EDEN study: Foundation for Medical Research (FRM), National Agency for Research (ANR), National Institute for Research in Public Health (IRESP: TGIR cohorte santé 2008 program), French Ministry of Health (DGS), French Ministry of Research, INSERM Bone and Joint Diseases National Research (PRO-A) and Human Nutrition National Research Programs, Paris-Sud University, Nestlé, French National Institute for Population Health Surveillance (InVS), French National Institute for Health Education (INPES), the European Union FP7 programmes (FP7/2007-2013, HELIX, ESCAPE, ENRIECO, Medall projects), Diabetes National Research Program (through a collaboration with the French Association of Diabetic Patients (AFD)), French Agency for Environmental Health Safety (now ANSES), Mutuelle Générale de l’Education Nationale (a complementary health insurance fund) (MGEN), French national agency for food security, French-language association for the study of diabetes and metabolism (ALFEDIAM). The funders had no influence of any kind on the analyses or the interpretation of the results.

Author contributions

CSG, PDM and SL conceived and designed the work, with advice from BH and MAC. CSG analyzed the data with advice from BH, JB, PDM and SL. CSG, PDM and SL drafted and revised the manuscript. All authors interpreted the data and criticized the manuscript for important intellectual content. MAC and BH designed and led the EDEN mother–child cohort. AF is responsible for the EDEN data management. JB and SC have fitted weight and height growth trajectories using the Jenss–Bayley nonlinear model and provided the relevant data. All authors have read and approved the final version of the manuscript. This article is the work of the authors. SL serves as guarantor for the contents of this article. All authors had full access to all of the data (including statistical reports and tables) in the study and take the responsibility for the integrity of the data and the accuracy of the data analysis. All researchers are independent of the funding bodies. All members in the EDEN mother–child cohort study group designed the study and revised the draft manuscript.

Members of the EDEN mother–child cohort study group

The members of the EDEN mother–child cohort study group are as follows: I Annesi-Maesano, JY Bernard, J Botton, MA Charles, P Dargent-Molina, B de Lauzon-Guillain, P Ducimetière, M de Agostini, B Foliguet, A Forhan, X Fritel, A Germa, V Goua, R Hankard, B Heude, M Kaminski, B Larroque, N Lelong, J Lepeule, G Magnin, L Marchand, C Nabet, F Pierre, R Slama, MJ Saurel-Cubizolles, M Schweitzer and O Thiebaugeorges.

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Saldanha-Gomes, C., Heude, B., Charles, MA. et al. Prospective associations between energy balance-related behaviors at 2 years of age and subsequent adiposity: the EDEN mother–child cohort. Int J Obes 41, 38–45 (2017). https://doi.org/10.1038/ijo.2016.138

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