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. 2023 Dec;94(6):2077-2084.
doi: 10.1038/s41390-023-02710-2. Epub 2023 Jul 15.

Lifestyle behaviors clusters in a nationwide sample of Spanish children and adolescents: PASOS study

Augusto G Zapico  1   2 , Raquel Aparicio-Ugarriza  3   4 , Carlos Quesada-González  3   5 , Santiago Felipe Gómez  6   7   8   9 , Julia Wärnberg  4   10 , María Medrano  11 , Narcís Gusi  12 , Susana Aznar  13   14 , Elena Marín-Cascales  15   16 , Miguel A González-Valeiro  17 , Lluís Serra-Majem  4   18   19 , Susana Pulgar  20 , Josep A Tur  4   21 , Marta Segu  22 , Montserrat Fíto  4   8 , Clara Homs  6   23 , Juan Carlos Benavente-Marín  10 , Jesús Sánchez-Gómez  12 , Fabio Jiménez-Zazo  13 , Pedro E Alcaraz  15   16 , Marta Sevilla-Sánchez  16 , Estefanía Herrera-Ramos  18 , Cristina Bouzas  4   21 , Clara Sistac  22 , Helmut Schröder  7   8 , Eva Gesteiro  3 , Marcela González-Gross  3   4
Affiliations

Lifestyle behaviors clusters in a nationwide sample of Spanish children and adolescents: PASOS study

Augusto G Zapico et al. Pediatr Res. 2023 Dec.

Abstract

Background: Youth is a vulnerable period. To classify lifestyle behaviors and its relationship with health-related outcomes of Spanish children and adolescents.

Methods: Cross-sectional study including 3261 children aged 7.5-17.5 y (52.8% females). Physical activity (PA), screen-time, sleep time, adherence to Mediterranean diet (MD), weight status (WS) by validated methods. Cluster analysis was run considering chronological age.

Results: Six clusters were identified: C1: high screen time, low adherence to MD and sleep time (n = 431,13.20%); C2: high WS, medium adherence to MD,high sleep time, and low screen time (n = 466,14.30%); C3: young group with low screen time and high PA, adherence to MD and sleep (n = 537,16.40%); C4: worst profile regarding adherence to MD, PA, WS and sleep time (n = 609,18.70%); C5: low screen time and PA, high sleep time (n = 804,24.70%); C6: high PA and screen time, low WS (n = 414,12.70%). Mean absolute values were statistically different among PA levels, screen and sleep time, adherence to MD, age, and WS (all p < 0.001).

Conclusions: The most prevalent pattern was low levels of PA, MD, and screen time, and high sleep time. The second most prevalent was characterized by very low levels of PA, sleep time, and adherence to MD, and high screen time, and WS in adolescents.

Impact statement: The main identified lifestyle behavior was poor physical activity, low adherence to Mediterranean Diet and high screen and sleep time. Children should increase physical activity levels, adherence to Mediterranean diet, decrease screen and sleep the appropriate hours per day. Families, schools, and medical communities must work together to gloss over present and future diseases. Sleep time had not been previously included in cluster analysis with physical activity, sedentary behaviors, obesity, and nutritional status, thus the present data open a new perspective in Spanish population. Health policies should focus on promoting physical activity, Mediterranean diet, adequate sleep and reducing screen time.

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