Longitudinal patterns of lifestyle behaviours in adolescence: a latent transition analysis

Assessing health lifestyles in contemporary China: Patterns, transitions, and socioeconomic antecedents

Health lifestyles in China reflect complex interplays of various structural forces, yielding intricate and evolving patterns. Leveraging data from the 2004-2015 China Health and Nutrition Survey (N = 9,986), this study discerns latent health lifestyles, tracks transitional dynamics, and probes socioeconomic disparities in these shifts. Three distinct lifestyle categories emerge: 'high risk', 'overall healthy but inactive', and 'modernized and active'. Notably, the prevalent trend favours the 'overall healthy but inactive' lifestyle, steadily expanding over time, followed by the 'high-risk' group. Conversely, the 'modernized and active' lifestyle, while being the least common, exhibits a modest decline. Individuals engaged in primary industries are more likely to sustain an overall healthy but inactive lifestyle. Socioeconomic advantages, particularly in education and income, were linked to maintaining or transitioning into a modernised and active lifestyle, while lower income and unemployment were more prone to maintaining high-risk behaviours. These findings illuminate the intricate dynamics of health lifestyles in China's rapidly evolving landscape, highlighting socioeconomic influences on lifestyle transitions.

Tracking and changes in the clustering of physical activity, sedentary behavior, diet, and sleep across childhood and adolescence: A systematic review

INTRODUCTION

Clusters of health behaviors (e.g. physical activity/sedentary behavior/diet/sleep) can exert synergistic influences on health outcomes, such as obesity. Understanding how clusters of health behaviors change throughout childhood and adolescence is essential for developing interventions aimed at uncoupling unhealthy behaviors. This review synthesizes prospective studies examining changes in clusters of physical activity, sedentary behavior, diet, and sleep through childhood and adolescence.

METHODS

Electronic searches (PubMed, Embase, Web of Science, Scopus) identified prospective studies, published in English up to/including January 2024, of children/adolescents (0-19 years) which used data-driven methods to identify clusters of 2/more behaviors (physical activity, sedentary behaviors, diet, sleep) at multiple timepoints. A narrative synthesis was conducted due to methodological heterogeneity.

RESULTS

Eighteen studies reporting data from 26,772 individual participants were included. Eleven studies determined clusters at each timepoint (i.e. identified clusters at T1 and T2, respectively), while seven determined clusters longitudinally using behavioral data across multiple timepoints. Among studies that identified clusters at each timepoint, participants commonly transitioned to similarly characterized clusters between timepoints. Where cluster tracking was examined, 64% of clusters had stable transition probabilities of 60-100%. The most prevalent longitudinal cluster trajectories were characterized by co-occurring healthy behaviors which remained stable. Remaining within unhealthy clusters at multiple timepoints was associated with higher markers of adiposity.

CONCLUSION

'Healthy' and 'unhealthy' clusters remained highly stable over time, suggesting behavioral patterns developed early can become entrenched and resistant to change. Interventions focused on instilling healthy behaviors early are required to provide a strong foundation for behavioral stability throughout life.

Typologies of activity-related behaviours during adolescence and their transitions: a longitudinal analysis of the ELSPAC cohort

OBJECTIVES

The objective of this study was to identify typologies of activity-related behaviours during adolescence and to explore transitions between the identified typologies. Additionally, we aimed to identify demographic indicators associated with the transitions and typology membership.

DESIGN

Prospective cohort study.

SETTING

Czech Republic.

PARTICIPANTS

Individuals involved in the Czech part of the European Longitudinal Study of Pregnancy and Childhood study, aged 11 to 18 years. The study involved over 563 individuals, of whom 380 provided complete data for the analysis.

PRIMARY OUTCOME MEASURES

Time spent outdoors, participation in organised physical activity (PA) and sport activities, time spent watching television and using a personal computer, and total sleep duration at ages 11, 15 and 18 years. Typologies were identified using Latent Transition Analysis.

RESULTS

Four typologies of activity-related behaviours were identified and labelled to reflect their behavioural profiles: (1) Actives (high outdoor time and organised PA and sport participation, low screen time and optimal sleep duration); (2) Active screeners (median outdoor time, high organised PA and sport participation, high screen time, and optimal sleep duration); (3) Poor sleepers (average outdoor time and organised PA and sport participation, low screen time and not meeting sleep guidelines) and (4) Averages (average duration of all behaviours and optimal sleep duration). A major shift in typology membership from 11 to 18 years was observed, with a decreasing proportion of individuals in typologies characterised by a high proportion of outdoor time and participation in organised PA and sport activities (ie, Actives; Active screeners). A high proportion of individuals also transitioned to the typology with poor sleeping habits (ie, Poor sleepers). Sex and maternal education were associated with the typology membership and transition probabilities (p<0.05).

CONCLUSIONS

Targeting lifestyle interventions to those with specific lifestyle patterns in early adolescence may be beneficial for reducing the risk of poor sleep and promoting healthy lifestyle patterns later in life.

Change in clusters of lifestyle behaviours from childhood to adolescence: a longitudinal analysis

This study aimed to identify changes in clusters of lifestyle behaviours (physical activity, screen time and diet) between the ages of 7 and 14 years, and to examine socio-demographic determinants of changes. Longitudinal analyses were performed on a sample of 9339 children from the UK Millennium Cohort Study (MCS) who had complete data on behaviours of interest at age 7 (wave 4) and 14 years (wave 6). Joint Correspondence Analysis (JCA) and k-means cluster analysis were used to identify clusters of lifestyle behaviours at both time waves. Multinomial logistic regressions were used to examine the associations between socio-economic variables and changes in cluster membership. Analyses were conducted separately for boys and girls. Clusters of behaviours at age 7 and 14 years were identified as healthy, mixed or unhealthy respectively. Compared to girls, a higher proportion of boys remained in the healthier cluster over time (19.1% vs. 13.1%) or became healthier (26.4% vs. 9.36%). A higher proportion of girls changed to an unhealthier cluster (57.2% vs. 33.9%). Indicators of lower socio-economic status, such as low family income, low parental education, and not living with both parents at age 7 were associated with unhealthier changes in cluster membership. Conclusion Lifestyle behaviours cluster in children and are susceptible to change over a 7-year period, with a high proportion of boys becoming healthier and a higher proportion of girls became unhealthier. Indicators of socio-economic status appear to be important in determining changes in clusters. What is Known: • Poor lifestyle behaviours (i.e. unhealthy dietary habits, low physical activity, and sedentary behaviours) tend to cluster in children and adolescents. What is New: • Lifestyle behaviours cluster in children and are susceptible to changes between childhood and adolescence. Changes occur differently in boys and girls. Indicators of low socio-economic status are associated with unhealthier changes in behavioural clusters.

Environment profiles, social participation patterns, depressive symptoms and quality of life of disabled older adults: a longitudinal investigation

OBJECTIVES

This study used the World Health Organization's healthy ageing framework to explore longitudinal influences of environment profiles and social participation (SP) patterns on depressive symptoms (DSs) and on quality of life (QOL).

METHODS

Data were collected from a sample of community-dwelling older adults in Taiwan in 2018 (T1; N = 1,314) and a follow-up survey in 2020 (T2; N = 831). Latent class analysis was conducted to obtain environment and SP profiles. Multilevel modeling was carried out to explicate the hypothesized associations.

RESULTS

Three unique environment profiles, labeled as Highly- (Highly-FE), Moderately- (Moderately-FE) and Weakly-Facilitative Environment (Weakly-FE), were identified from T1 data. The three SP classes that were obtained from T1 and T2 data denoted High-, Moderate- and Low-SP. Participants in the 'Highly-FE' class were more likely to belong to the 'High-SP' and 'Moderate-SP' subgroups and exhibited significantly fewer DSs and better QOL. The associations were confirmed both cross-sectionally and longitudinally.

CONCLUSION

Interventions should be developed to promote or maintain preferred SP to maximize the current and future mental health and subjective well-being of disabled older adults.

Physical Activity and Eating Behavior Inequalities Mediating the Effects of Socioeconomic Status and Sex on Adolescent Quality of Life: Insights of the PRALIMAP Trial

BACKGROUND

This study aimed to quantify the 2-year mediating effects of physical activity (PA) and eating behavior (EB) on socioeconomic and sex inequalities in quality of life (QoL) among French adolescents.

METHODS

Adolescents from a 2-year school-based trial were included. PA and EB were assessed at baseline, 1 year, and 2 years using the International Physical Activity Questionnaire and an eating habits questionnaire, respectively. QoL was measured at 2 years using the Duke Health Profile questionnaire. The mediating effect of adherence to PA and EB guidelines in the associations between socioeconomic status or sex and QoL was analyzed with a counterfactual method.

RESULTS

Among the 3562 included adolescents (mean age, 15.2 [0.6] y), being a boy and having a high socioeconomic status was associated with high QoL. Differences in QoL by socioeconomic status were mediated by adherence to guidelines for PA (up to 10.2%) and EB (up to 8.8%), and differences in QoL by sex were predominantly mediated by adherence to guidelines for PA (up to 163.8%).

CONCLUSIONS

Policies, programs, and interventions designed to reduce socioeconomic and sex inequalities in QoL among adolescents could use PA and EB as leverage.

A latent transition analysis of physical activity and screen-based sedentary behavior from adolescence to young adulthood

BACKGROUND

Distinct typologies of physical activity and screen-based sedentary behaviors are common during adolescence, but it is unknown how these change over time. This longitudinal study examined the stability of activity-related behavioral typologies over the transition out of secondary school.

METHODS

Year 11 students (penultimate school year) completed a self-report survey (baseline), which was repeated 2 years later (follow-up) (75% female, mean baseline age: 16.9 ± 0.4 years). Latent transition analysis identified typologies of physical activity and screen time behaviors and explored changes in typology membership between baseline and follow-up among those with complete data and who were not attending secondary school at follow-up (n = 803).

RESULTS

Three unique typologies were identified and labelled as: 1) Sedentary gamers (baseline: 17%; follow-up: 15%: high levels of screen behaviors, particularly video gaming); 2) Inactives (baseline: 46%; follow-up: 48%: low physical activities, average levels of screen behaviors); and 3) Actives (baseline: 37%; follow-up: 37%: high physical activities, low screen behaviors). Most participants remained in the same typology (83.2%), 8.5% transitioned to a typology with a more health-enhancing profile and 8.3% transitioned to a typology with a more detrimental behavioral profile.

CONCLUSIONS

The high proportion within the 'inactive' typology and the stability of typologies over the transition period suggests that public health interventions are required to improve activity-related behavior typologies before adolescents leave secondary school.