Diet, Activity and Sleep Clusters Associated With Obesity Markers of Children in the US‐Affiliated Pacific

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AIM: Among children in the US-Affiliated Pacific, we aimed to identify lifestyle clusters and associations with obesity. METHODS: Movement behaviours, diet and anthropometrics were from the Children's Healthy Living Program (n = 1780; 2012-2015). Partitioning-around-medoids identified clusters; regression examined differences in anthropometrics. RESULTS: Among 2-5-year-olds, boys' clusters were: (1) high %energy from (E%) fat and sedentary behaviour; (2) high screen time and energy intake and (3) long sleep. Body mass index z-score (zBMI) was lower in Cluster 3 versus 1 (-0.28 [-0.50; -0.07], p = 0.01). Girls' clusters were: (1) high energy intake; (2) low E% fat and (3) high physical activity and sleep. zBMI was lower in Cluster 3 versus 1 (-0.34 [-0.55; -0.13], p = 0.002). Among 6-8-year-olds, boys' clusters were: (1) high screen time; (2) high energy intake; (3) high E% protein; (4) long sleep and (5) high sedentary time and low E% saturated fat. Compared with Cluster 1, zBMI was lower in Clusters 3 (-0.43 [-0.84; -0.02], p = 0.04), 4 (-0.64 [-1.08; -0.20], p = 0.004) and 5 (-0.93 [-1.35; -0.51], p < 0.001). Girls' clusters were: (1) high E% fat and protein; (2) high screen time and energy intake; (3) short sleep and high physical activity (4) long sleep and (5) low sedentary time. Compared with Cluster 1, zBMI was lower in Clusters 2 (-0.57 [-0.98; -0.17], p = 0.006), 3 (-0.48 [-0.81; -0.14], p = 0.005) and 5 (-0.50 [-0.83; -0.18], p = 0.003). CONCLUSION: Various lifestyle patterns support healthy body weight. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01881373.