CitationDong, Fei; Howard, Annie Green; Herring, Amy H.; Thompson, Amanda L.; Adair, Linda S.; Popkin, Barry M.; Aiello, Allison E.; Zhang, Bing; & Gordon-Larsen, Penny (2017). Longitudinal Associations of away-from-Home Eating, Snacking, Screen Time, and Physical Activity Behaviors with Cardiometabolic Risk Factors among Chinese Children and Their Parents. American Journal of Clinical Nutrition, 106(1), 168-178. PMCID: PMC5486196
AbstractBackground: Little is known about intergenerational differences in associations of urbanization-related lifestyle behaviors with cardiometabolic risk factors in children and their parents in rapidly urbanizing China.
Objective: We tested the intergenerational differences in longitudinal associations of away-from-home eating, snacking, screen time, and leisure-time sports with high waist-to-height ratio (WHtR), elevated blood pressure (BP), elevated glycated hemoglobin (HbA1c), and elevated C-reactive protein (CRP) among Chinese children and their parents.
Design: We studied children enrolled in the longitudinal China Health and Nutrition Survey (1991-2009, 7 surveys) aged 7-17 y in ≥2 surveys (average follow-up: 2.3 surveys out of a possible 4 surveys with the age restriction; n = 3875, including 1175 siblings) and their parents (2947 mothers, 2632 fathers) living in the same household. We used 3 consecutive interviewer-administered 24-h dietary recalls to derive a 3-d average for away-from-home eating (nonconsumer, >0 and <1 meal/d, or ≥1 meals/d) and consumption of fruit or vegetable snacks (any or none) and other snacks (any or none) and a self-reported 7-d physical activity recall for screen time (≤1, >1 and ≤2, or >2 h/d) and leisure-time sports (any or none). Random-effects logistic regression was used to examine the associations of lagged (average: 3 y) behaviors with cardiometabolic risk factors (WHtR, BP, HbA1c, and CRP).
Results: We detected intergenerational differences in associations between lagged behaviors and risk factors (P-interaction < 0.1). Generation-specific models showed that lagged away-from-home eating of ≥1 meal/d (compared with none) was negatively associated with parents' high WHtR (OR: 0.68; 95% CI: 0.53, 0.88) but positively associated with children's high WHtR (OR: 1.46; 95% CI: 1.01, 2.12). Lagged fruit and vegetable snack consumption was negatively related to parents' (OR: 0.76; 95% CI: 0.59, 0.97) and children's (OR: 0.58; 95% CI: 0.33, 1.00) high WHtR. Lagged screen time (>2 compared with ≤1 h/d) was positively associated with parents' (OR: 2.58; 95% CI: 1.56, 4.28) and children's high WHtR (OR: 2.26; 95% CI: 1.06, 4.83).
Conclusion: Parent-offspring differences in associations between lifestyle behaviors and cardiometabolic risk factors provide insight into intergenerational differences in cardiometabolic risk with urbanization.
Reference TypeJournal Article
Journal TitleAmerican Journal of Clinical Nutrition
Howard, Annie Green
Herring, Amy H.
Thompson, Amanda L.
Adair, Linda S.
Popkin, Barry M.
Aiello, Allison E.