Purpose: Lifestyle patterns emerge early in life but the extent to which these patterns are stable from toddlerhood to preschool age is poorly known. In a multi-ethnic Asian cohort, we aim to derive multi-time point lifestyle patterns from ages 2-5 years and examine early life predictors of these patterns.

Methods: Child’s diet, outdoor play, and screen time were collected using questionnaires at age 2 and 5 years. Prospective principal component analysis was used to derive lifestyle patterns. We categorized 30 predictors into four groups — sociodemographic, pre-conception, pregnancy, and postnatal —and examined their associations with lifestyle patterns by four-stage hierarchical linear regression analyses.

Results: Of 406 children, two patterns emerged consistently over time: “healthy” (fruits, vegetables, outdoor, and low screen time) and “less healthy” (discretionary consumption and high screen time). The significant predictors for “healthy” pattern were Chinese and Indian ethnicity, higher maternal education, higher pre-pregnancy physical activity, lower pre-pregnancy screen time, non-working mothers during pregnancy, and longer breastfeeding duration. The significant predictors for “less healthy” pattern were Malay ethnicity, poor sleep quality during pregnancy, less healthy maternal diet during pregnancy, mothers who were generally more concerned about their child hunger, and mothers who were less likely to feed their child on schedule in the first 2 years of life.

Conclusion: Two lifestyle patterns were characterized over toddlerhood and preschool age. Multiple predictors from pre-conception and throughout the first 1000 days of life were identified, suggesting potential targets for early intervention and health promotion activities.

Purposes: The overall impact of interventions targeting multiple behaviors remains largely unexplored. This study adapted an integrative lifestyle pattern analysis approach to assess the overall effectiveness of an early childhood intervention on change across multiple behaviors.

Methods: The Melbourne INFANT program was a 15-month cluster-randomized controlled trial involving 4-month-old infants and their parents at baseline in 2008 (n=542). The intervention included six education sessions helping parents to promote a healthy diet, physical activity, and limit sedentary behavior in their infants. Participants were followed-up twice post-intervention, at ages 3.6 in 2011and 5 years in 2013, to assess sustained effects of the intervention. Previous principal component analyses identified two lifestyle patterns from dietary intake, outdoor time and television viewing time. Random effect linear regression models were conducted to assess the impact of the intervention on lifestyle patterns.

Results: The intervention group had a lower “Discretionary consumption and TV” lifestyle pattern score than the control group at all time points with adjusted mean difference: -0.29, 95%CI -0.49, -0.09 P=0.004 post-intervention at age 1.5 years; -0.29, 95%CI -0.54, -0.04 P=0.02 at the first follow-up (age 3.6 years); and -0.21, 95%CI -0.43, 0.01 P=0.06 at the second follow-up (age 5.0 years). No evidence of between-group differences was found for the “Fruit, vegetables and outdoor” lifestyle pattern score.

Conclusion: This early childhood intervention designed to promote change in more than one obesity related behavior was effective in improving correlated unhealthy lifestyle behaviors. Lifestyle pattern analysis is a useful and interpretable approach for evaluating multi-behavioral interventions.

Purposes: This study aimed at examining prospective associations between lifestyle patterns in early childhood and not only weight status but also socio-emotional development.

Methods: The sample consisted of 876 children from the French EDEN mother-child cohort. Three different lifestyle patterns were considered at 5 years: “Discretionary Consumption, Low Vegetables, High Screen” in girls and “Discretionary Consumption, High Screen, Low Sleep” in boys (unhealthy); “Fish, Dairy products, Fruits & Vegetables, Low Screen” in both sexes (healthy); “Sugar Sweetened Beverages, High Screen, Outdoor Play, Walking, Low Sleep” in girls and “Dairy products, High Screen, Outdoor Play, Walking, High Sleep” in boys (mixed). At 8 years, socioemotional development was parent-assessed by The Strengths and Difficulties Questionnaire. Height and weight reported by parents from children’s health booklets or measured, were used to generate BMI z-scores (WHO standards). Using an outcome-wide approach, for each outcome and sex, associations were investigated controlling for a wide array of factors including: sociodemographic characteristics, early life factors, and prior values of exposures and outcomes.

Results: In boys, the 5-year healthy pattern was positively associated with prosocial behaviors (β=0.25, 95% CI:0.06 to 0.46) and inversely related to symptoms of hyperactivity-inattention (β=-0.32, 95% CI: -0.62 to -0.02) three years later. However, there was no evidence of associations between any of the lifestyle patterns studied and BMI z-scores. We found no significant associations in girls.

Conclusions:  Independently of previous health status and background variables, the combination of a diverse and nutrient-rich diet with less screen time in 5-years-olds was prospectively associated with better socio-emotional and behavioral development.  This study thus complements the existing literature on lifestyle patterns and physical health and suggests that promoting optimal EBRBs through multi-behavioral interventions, beyond obesity prevention, could be valuable to support holistic wellness.