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

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 (beta = 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 ( beta = - 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.