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  • Population Study Article
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Lifestyle behaviors clusters in a nationwide sample of Spanish children and adolescents: PASOS study

Pediatric Research volume 94, pages 2077–2084 (2023)Cite this article

Abstract

Background

Youth is a vulnerable period. To classify lifestyle behaviors and its relationship with health-related outcomes of Spanish children and adolescents.

Methods

Cross-sectional study including 3261 children aged 7.5–17.5 y (52.8% females). Physical activity (PA), screen-time, sleep time, adherence to Mediterranean diet (MD), weight status (WS) by validated methods. Cluster analysis was run considering chronological age.

Results

Six clusters were identified: C1: high screen time, low adherence to MD and sleep time (n = 431,13.20%); C2: high WS, medium adherence to MD,high sleep time, and low screen time (n = 466,14.30%); C3: young group with low screen time and high PA, adherence to MD and sleep (n = 537,16.40%); C4: worst profile regarding adherence to MD, PA, WS and sleep time (n = 609,18.70%); C5: low screen time and PA, high sleep time (n = 804,24.70%); C6: high PA and screen time, low WS (n = 414,12.70%). Mean absolute values were statistically different among PA levels, screen and sleep time, adherence to MD, age, and WS (all p < 0.001).

Conclusions

The most prevalent pattern was low levels of PA, MD, and screen time, and high sleep time. The second most prevalent was characterized by very low levels of PA, sleep time, and adherence to MD, and high screen time, and WS in adolescents.

Impact statement

  • The main identified lifestyle behavior was poor physical activity, low adherence to Mediterranean Diet and high screen and sleep time.

  • Children should increase physical activity levels, adherence to Mediterranean diet, decrease screen and sleep the appropriate hours per day.

  • Families, schools, and medical communities must work together to gloss over present and future diseases.

  • Sleep time had not been previously included in cluster analysis with physical activity, sedentary behaviors, obesity, and nutritional status, thus the present data open a new perspective in Spanish population.

  • Health policies should focus on promoting physical activity, Mediterranean diet, adequate sleep and reducing screen time.

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Fig. 1: Variable distributions for each cluster.

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Data availability

Data available under request.

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Acknowledgements

We thank the staff, pupils, parents, schools and municipalities for their participation, enthusiasm, and support.

Funding

PASOS has the institutional support of Spain’s Ministry of Education and Vocational Training, the Ministry of Health, Consumption and Social Welfare through AESAN (Spanish Agency for Food Safety and Nutrition), the High Commission against Child Poverty, the High Sports Council, the General College of Professional Associations of Physical Education and Sports, and the Departments of Education and/or Health and/or Sports of Spain’s 17 autonomous regions. The CIBERESP, CIBEROBN, CIBERESP and CIBERFES are initiatives of the Institute of Health Carlos III (ICSIII), Madrid, Spain. The PASOS study has been funded mainly by the Gasol Foundation and Fundación PROBITAS. Barça Foundation, Banco Santander, Viena, Grupo IFA and Fundación Deporte Joven also contributed with funds. MGG, JAT and CB are funded by the official funding agency for biomedical research of the Spanish government, Institute of Health Carlos III (ISCIII), which is co-funded by the European Regional Development Fund (CIBEROBN CB12/03/30038). CB is funded by the Directorate General of R + D of the Balearic Islands Government (Margalida Comas Grant). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. ImFINE Research Group. Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain

    Augusto G. Zapico, Raquel Aparicio-Ugarriza, Carlos Quesada-González, Eva Gesteiro & Marcela González-Gross

  2. Department of Language, Arts and Physical Education, Universidad Complutense de Madrid, Madrid, Spain

    Augusto G. Zapico

  3. Biomedical Research Center on Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain

    Raquel Aparicio-Ugarriza, Julia Wärnberg, Lluís Serra-Majem, Josep A. Tur, Montserrat Fíto, Cristina Bouzas & Marcela González-Gross

  4. Departamento de Matemática Aplicada a las Tecnologías de la Información y la Comunicación, Universidad Politécnica de Madrid, 28031, Madrid, Spain

    Carlos Quesada-González

  5. Gasol Foundation, Sant Boi de Llobregat, Spain

    Santiago Felipe Gómez & Clara Homs

  6. Biomedical Research Networking Center on Epidemiology and Public Health studies (CIBERESP), Institute of Health Carlos III, Madrid, Spain

    Santiago Felipe Gómez & Helmut Schröder

  7. Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain

    Santiago Felipe Gómez, Montserrat Fíto & Helmut Schröder

  8. Nursing and Physiotherapy Department, University of Lleida, Lleida, Spain

    Santiago Felipe Gómez

  9. EpiPHAAN Research Group. Faculty of Health Sciences, University of Málaga-Institute of Biomedical Research of Malaga (IBIMA), Málaga, Spain

    Julia Wärnberg & Juan Carlos Benavente-Marín

  10. ELIKOS group, Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD). CIBEROBN, ISCIII Navarra, Public University of Navarra, Navarra, Spain

    María Medrano

  11. Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, Universidad de Extremadura, Cáceres, Spain

    Narcís Gusi & Jesús Sánchez-Gómez

  12. PAFS Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Toledo, Spain

    Susana Aznar & Fabio Jiménez-Zazo

  13. Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES). Institute of Health Carlos III, Madrid, Spain

    Susana Aznar

  14. Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain

    Elena Marín-Cascales & Pedro E. Alcaraz

  15. Faculty of Sport Sciences, UCAM, Catholic University of Murcia, Murcia, Spain

    Elena Marín-Cascales, Pedro E. Alcaraz & Marta Sevilla-Sánchez

  16. Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain

    Miguel A. González-Valeiro

  17. Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain

    Lluís Serra-Majem & Estefanía Herrera-Ramos

  18. Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain

    Lluís Serra-Majem

  19. Regional Unit of Sports Medicine, Municipal Sports Foundation of Avilés, Asturias, Spain

    Susana Pulgar

  20. Research Group of Community Nutrition & Oxidative Stress, University of the Balearic Islands-IUNICS & Health Research Institute of the Balearic Islands (IDISBA), Palma de Mallorca, Spain

    Josep A. Tur & Cristina Bouzas

  21. Fundació FC Barcelona, Barcelona, Spain

    Marta Segu & Clara Sistac

  22. GRoW, Global Research on Wellbeing, Blanquerna School of Life Sciences, University Ramon Llull, Barcelona, Spain

    Clara Homs

Authors
  1. Augusto G. Zapico
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  2. Raquel Aparicio-Ugarriza
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Contributions

A.G.Z. and M.G.G. conceptualized and designed the study, R.A.U. and C.Q.G. run statistical analyses, A.G.Z., R.A.U. and M.G.G. drafted the initial manuscript and incorporated the suggestions of all the consortium authors, A.G.Z., R.A.U., C.Q.G., E.G., and M.G.G. wrote the manuscript. S.G. and H.S. are the coordinators of the PASOS study. All authors contributed to the methodology and data acquisition and reviewed the final version of the manuscript.

Corresponding author

Correspondence to Augusto G. Zapico.

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Zapico, A.G., Aparicio-Ugarriza, R., Quesada-González, C. et al. Lifestyle behaviors clusters in a nationwide sample of Spanish children and adolescents: PASOS study. Pediatr Res 94, 2077–2084 (2023). https://doi.org/10.1038/s41390-023-02710-2

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