Impact of lifestyle behaviors in early childhood on obesity and cardiometabolic risk in children: Results from the Spanish INMA birth cohort study

Pediatr Obes. 2020 Mar;15(3):e12590. doi: 10.1111/ijpo.12590. Epub 2019 Dec 2.


Background: Identifying modifiable lifestyle behaviors linked to childhood obesity is necessary to develop preventive strategies.

Objective: To estimate the association of five lifestyle behaviors in children aged 4 years on obesity and cardiometabolic risk factors at age 4 years and on obesity and blood pressure at age 7 years.

Methods: We used child lifestyle data from the INMA project at age 4 years (n = 1480). We constructed a child lifestyle score by summing five behaviors (physical activity, sleep time, television time, plant based foods and intake of ultra-processed foods) and we categorized it into tertiles. At ages 4 and 7 years, we calculated age- and sex-specific z-scores for BMI, waist circumference (WC), and blood pressure. At age 4, we also calculated age-, and sex-, specific z-scores for triglycerides and HDL. We used linear and logistic regression analyses.

Results: The lifestyle score was not associated with the outcomes at 4 years, but it was negatively associated with BMI and WC z-scores at age 7 years. Children at age 4 years in the highest tertile of the score had lower risk of overweight or obesity at age 7 years (OR = 0.61; 95% CI 0.39; 0.96) and abdominal obesity (OR = 0.48; 95% CI 0.24; 0.96).

Conclusions: Higher adherence to a healthy lifestyle at age 4 years decreased risk of overweight, obesity and abdominal obesity at 7 years.

Keywords: cardiometabolic risk; childhood obesity; cohort study; lifestyle behaviors; overweight; ultra-processed food.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases / prevention & control*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Exercise
  • Female
  • Healthy Lifestyle*
  • Humans
  • Male
  • Obesity, Abdominal / prevention & control
  • Pediatric Obesity / prevention & control*
  • Television