Accepted Article Preview: Published ahead of advance online publication Clustering of diet, physical activity and sedentary behaviour among Australian children: cross-sectional and longitudinal associations with overweight and obesity R M Leech, S A McNaughton, Anna Timperio

Cite this article as: R M Leech, S A McNaughton, Anna Timperio, Clustering of diet, physical activity and sedentary behaviour among Australian children: crosssectional and longitudinal associations with overweight and obesity, International Journal of Obesity accepted article preview 24 April 2015; doi: 10.1038/ijo.2015.66. This is a PDF file of an unedited peer-reviewed manuscript that has been accepted for publication. NPG are providing this early version of the manuscript as a service to our customers. The manuscript will undergo copyediting, typesetting and a proof review before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers apply.

Received 26 September 2014; revised 22 January 2015; accepted 8 February 2015; Accepted article preview online 24 April 2015

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2015 Macmillan Publishers Limited. All rights reserved.

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Title Page Title: Clustering of diet, physical activity and sedentary behaviour among Australian children: cross-sectional and longitudinal associations with overweight and obesity. Running title: Clustering of obesogenic behaviours and obesity Authors: Rebecca M Leech, M.Clin.Epid.;1 Sarah A McNaughton, Ph.D.;1 Anna Timperio , Ph.D.1 Affiliations: 1Centre for Physical Activity and Nutrition Research (C-PAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia. Fax: +61-3- 9244 6017. Author for correspondence: Rebecca Leech, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, 3125, Australia. Phone: +61-3-5341 2791. Fax: +61-3-9244 6017, Email: [email protected]. Conflict of interest: Sarah A McNaughton is supported by an Australian Research Council (ARC) Future Fellowship (FT100100581). Anna Timperio is supported by a National Heart Foundation of Australia Future Leader Fellowship (ID: 100046). All authors declare no potential conflict of interest.

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2015 Macmillan Publishers Limited. All rights reserved.

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Abstract Background/Objectives: Evidence suggests diet, physical activity (PA) and sedentary behaviour cluster together in children, but research supporting an association with overweight/obesity is equivocal. Furthermore, the stability of clusters over time is unknown. The aim of this study was to examine the clustering of diet, PA and sedentary behaviour in Australian children and cross-sectional and longitudinal associations with overweight/obesity. Stability of obesityrelated clusters over 3-years was also examined. Subjects/Methods: Data were drawn from the baseline (T1: 2002/03) and follow-up waves (T2: 2005/06) of the Health Eating and Play Study. Parents of Australian children aged 5-6 (n=87) and 10-12 years (n=123) completed questionnaires. Children wore accelerometers and height and weight were measured. Obesity-related clusters were determined using Kmedians cluster analysis. Multivariate regression models assessed cross-sectional and longitudinal associations between cluster membership, and BMI z-score and weight status. Kappa statistics assessed cluster stability over time. Results: Three clusters, labelled ‘most Healthy’, ‘Energy-dense (ED) consumers who watch TV’ and ‘high sedentary behaviour/low moderate-to-vigorous physical activity’ were identified at baseline and at follow-up. No cross-sectional

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2015 Macmillan Publishers Limited. All rights reserved.

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associations were found between cluster membership, and BMI z-score or weight status at baseline. Longitudinally, children in the ‘ED consumers who watch TV’ cluster had a higher odds of being overweight/obese at follow-up (OR=2.8; 95% CI: 1.1, 6.9; P

Clustering of diet, physical activity and sedentary behaviour among Australian children: cross-sectional and longitudinal associations with overweight and obesity.

Evidence suggests diet, physical activity (PA) and sedentary behaviour cluster together in children, but research supporting an association with overw...
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