Modifiable lifestyle behavior patterns, sedentary time and physical activity contexts: A cluster analysis among middle school boys and girls in the SALTA study

Objective: To analyze how modifiable health-related variables are clustered and associated with children's participation in play, active travel and structured exercise and sport among boys and girls. Methods: Data were collected from 9 middle-schools in Porto (Portugal) area. A total of 636 children in the 6th grade (340 girls and 296 boys) with a mean age of 11.64. years old participated in the study. Cluster analyses were used to identify patterns of lifestyle and healthy/unhealthy behaviors. Multinomial logistic regression analysis was used to estimate associations between cluster allocation, sedentary time and participation in three different physical activity (PA) contexts: play, active travel, and structured exercise/sport. Results: Four distinct clusters were identified based on four lifestyle risk factors. The most disadvantaged cluster was characterized by high body mass index, low high-density lipoprotein cholesterol and cardiorespiratory fitness and a moderate level of moderate to vigorous PA. Everyday outdoor play (OR = 1.85, 95%CI 0.318-0.915) and structured exercise/sport (OR = 1.85, 95%CI 0.291-0.990) were associated with healthier lifestyle patterns. There were no significant associations between health patterns and sedentary time or travel mode. Conclusion: Outdoor play and sport/exercise participation seem more important than active travel from school in influencing children's healthy cluster profiles.