Temporal patterns of energy intake and physical activity and cross-sectional associations with body weight status in children and adolescents: results from the Portuguese National Food, Nutrition and Physical Activity Survey 2015-2016

Abstract

Temporal energy intake (EI) and physical activity (PA) patterns may be associated with obesity. We aimed to derive and characterise temporal EI and PA patterns and assess their cross-sectional association with weight status in participants aged 6-14 years from the Portuguese National Food, Nutrition and Physical Activity Survey 2015-2016. We extracted times and EI of all eating occasions from two 1-day food diaries/24-hour recalls, while types and times of PA from 4-day PA diaries. We derived EI patterns (n=714) and PA patterns (n=595), using, respectively, a hierarchical and K-means cluster analysis, considering the average proportion of total daily EI (%TEI) and PA intensity (%TPA), within each 2-hour interval across the 24-hour day. We assessed the association between patterns and Overweight or obesity (Body Mass Index z-score ≥+1 Standard Deviation) using adjusted logistic regressions [Odds ratio (95% Confidence Interval)]. Three EI patterns were identified and labelled based on the 2-h interval of %TEI peaks: 1-"Early afternoon & Early evening"; 2-"Early afternoon & Late evening", and 3-"Late morning, Early and Mid-afternoon & Late evening". EI Pattern 3 vs. 1 was negatively associated with overweight or obesity [0.49 (0.26,0.92)]. PA pattern 1-"Late Morning, Mid-afternoon & Early evening" vs. Pattern 2-"Late afternoon", was not associated with weight status [0.95 (0.65,1.38)]. A daily EI pattern characterised by more and even %TEI peaks at earlier daytime periods, instead of less, may be negatively associated with overweight or obesity amongst Portuguese 6-to-14-year-olds, whereas the identified PA patterns might have no relationship.