Synergistic associations between dietary patterns, lifestyle behaviors and childhood obesity

To analyze the relationships between diet, lifestyle behaviors and obesity among preschool children aged 3-7 in Wuxi City, providing a scientific basis for implementing a healthy diet and lifestyle.

A stratified cluster random sampling method was used to select study participants. Self-administered questionnaires were used to collect demographic data. The dietary diversity score (DDS), dietary behaviors, and current lifestyle were analyzed. Children's growth and development were assessed using BMI-Z scores. Variance analysis and logistic regression were employed to explore the relationships.

A total of 3,727 preschool children were included. The average DDS was 5.07 ± 1.94, with 36.79% of children showing low dietary diversity (DDS ≤ 4). The largest proportion of children (53.13%) had normal BMI-Z score (-1 ≤ BMI-Z ≤ 1). The children were divided into four groups based on BMI-Z scores, and statistically significant differences were observed across age, current height, current weight, birth weight, DDS, parental BMI, and maternal pre-pregnancy weight (p < 0.05). Low dietary diversity, nighttime snacking, and prolonged daily screen time (1-2 h or ≥2 h) were positively associated with childhood obesity (p < 0.05). After adjusting for factors including children's age, gender, birth weight, parental BMI, family income, number of family members dining together, family type, and primary caregiver, low dietary diversity remained significantly associated with obesity.

To prevent childhood obesity, more attention should be paid to preschool children with low dietary diversity, frequent nighttime snacking and excessive screen use. Targeted interventions addressing these factors should be considered.