Association of early childhood lifestyle patterns with overweight in preschoolers and timing of adiposity rebound
Abstract
Background: An unhealthy diet, excessive screen time, low levels of physical activity and suboptimal sleep are known risk factors for childhood overweight and obesity (OW/OB). These energy balance–related behaviors tend to co-occur and combine into “lifestyle patterns” (LPs) that may have a synergistic effect on OW/OB. However, few studies have examined these LPs before preschool age, and none investigated the possible involvement of parental feeding practices (e.g., breastfeeding and timing of complementary feeding), non-screen leisure activities and sleep quality. We aimed to identify such LPs during the first 2 years of life and assess their associations with OW/OB at age 5 years and age at adiposity rebound (AR). Methods: Participants were children from the French nationwide ELFE ( Etude Longitudinale Française depuis l’Enfance ) birth cohort. We used principal component analysis of 18 items characterizing parental feeding practices and children’s energy balance-related behaviors ( n = 13,121) to derive LPs. We analyzed the associations of LPs with OW/OB at age 5 years (International Obesity Task Force definition; n = 8,388) and age at AR (in days; n = 7,845) using multivariable logistic and linear regression models, respectively. Results: We identified three LPs: “Early complementary feeding, discretionary consumption, high screen time”, “Balanced diet, non-screen leisure activities”, and “Healthy feeding practices, low dairy consumption, suboptimal sleep” patterns. The first pattern was positively associated with OW/OB at age 5 years (OR [95% CI] = 1.09 [1.03, 1.16] per 1-SD increase) and inversely associated with age at AR (β [95% CI] = − 12.1 days [− 19.1; −5.0] per 1-SD increase). No association was observed for the second LP. For the third pattern, no clear evidence of associations was found, although the effect sizes were comparable to those of the first LP (OR = 1.07 [0.99; 1.15]; β = −7.6 days [− 15.5; 0.3] per 1-SD increase). Conclusion: These results emphasize the perinatal period as a critical window for the emergence of interrelated lifestyle behaviors associated with OW/OB. They highlight the need for interventional studies to evaluate the effectiveness of early, integrated, multi-behavioral strategies to prevent childhood obesity.
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BibTeX
@article{baietto2026association,
title = {{Association of early childhood lifestyle patterns with overweight in preschoolers and timing of adiposity rebound}},
author = {Mélissa Baietto and Camille Le Gal and Alexandra Descarpentrie and Marion Lecorguillé and Aminata H Cissé and Jonathan Y Bernard and Muriel Tafflet and Jade Pilato and Judith van der Waerden and Blandine de Lauzon-Guillain and Marie-Aline Charles and Barbara Heude and Sandrine Lioret},
journal = {International Journal of Behavioral Nutrition and Physical Activity},
year = {2026},
month = jun,
doi = {10.1186/s12966-026-01941-w},
url = {https://hal.science/hal-05764130v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of early childhood lifestyle patterns with overweight in preschoolers and timing of adiposity rebound
AU - Mélissa Baietto
AU - Camille Le Gal
AU - Alexandra Descarpentrie
AU - Marion Lecorguillé
AU - Aminata H Cissé
AU - Jonathan Y Bernard
AU - Muriel Tafflet
AU - Jade Pilato
AU - Judith van der Waerden
AU - Blandine de Lauzon-Guillain
AU - Marie-Aline Charles
AU - Barbara Heude
AU - Sandrine Lioret
PY - 2026
DA - 2026/06/25
JO - International Journal of Behavioral Nutrition and Physical Activity
DO - 10.1186/s12966-026-01941-w
UR - https://hal.science/hal-05764130v1
AB - Background: An unhealthy diet, excessive screen time, low levels of physical activity and suboptimal sleep are known risk factors for childhood overweight and obesity (OW/OB). These energy balance–related behaviors tend to co-occur and combine into “lifestyle patterns” (LPs) that may have a synergistic effect on OW/OB. However, few studies have examined these LPs before preschool age, and none investigated the possible involvement of parental feeding practices (e.g., breastfeeding and timing of complementary feeding), non-screen leisure activities and sleep quality. We aimed to identify such LPs during the first 2 years of life and assess their associations with OW/OB at age 5 years and age at adiposity rebound (AR). Methods: Participants were children from the French nationwide ELFE ( Etude Longitudinale Française depuis l’Enfance ) birth cohort. We used principal component analysis of 18 items characterizing parental feeding practices and children’s energy balance-related behaviors ( n = 13,121) to derive LPs. We analyzed the associations of LPs with OW/OB at age 5 years (International Obesity Task Force definition; n = 8,388) and age at AR (in days; n = 7,845) using multivariable logistic and linear regression models, respectively. Results: We identified three LPs: “Early complementary feeding, discretionary consumption, high screen time”, “Balanced diet, non-screen leisure activities”, and “Healthy feeding practices, low dairy consumption, suboptimal sleep” patterns. The first pattern was positively associated with OW/OB at age 5 years (OR [95% CI] = 1.09 [1.03, 1.16] per 1-SD increase) and inversely associated with age at AR (β [95% CI] = − 12.1 days [− 19.1; −5.0] per 1-SD increase). No association was observed for the second LP. For the third pattern, no clear evidence of associations was found, although the effect sizes were comparable to those of the first LP (OR = 1.07 [0.99; 1.15]; β = −7.6 days [− 15.5; 0.3] per 1-SD increase). Conclusion: These results emphasize the perinatal period as a critical window for the emergence of interrelated lifestyle behaviors associated with OW/OB. They highlight the need for interventional studies to evaluate the effectiveness of early, integrated, multi-behavioral strategies to prevent childhood obesity.
SN - 1479-5868
ER -