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Summary: Background: The relationship between children's adiposity and lifestyle behaviour patterns is an area of growing interest. Objectives: The objectives of this study are to identify clusters of children based on lifestyle behaviours and compare children's adiposity among clusters. Methods: Cross‐sectional data from the International Study of Childhood Obesity, Lifestyle and the Environment were used. Participants: the participants were children (9–11 years) from 12 nations (n = 5710). Measures: 24‐h accelerometry and self‐reported diet and screen time were clustering input variables. Objectively measured adiposity indicators were waist‐to‐height ratio, percent body fat and body mass index z‐scores. Analysis: sex‐stratified analyses were performed on the global sample and repeated on a site‐wise basis. Cluster analysis (using isometric log ratios for compositional data) was used to identify common lifestyle behaviour patterns. Site representation and adiposity were compared across clusters using linear models. Results: Four clusters emerged: (1) Junk Food Screenies, (2) Actives, (3) Sitters and (4) All‐Rounders. Countries were represented differently among clusters. Chinese children were over‐represented in Sitters and Colombian children in Actives. Adiposity varied across clusters, being highest in Sitters and lowest in Actives. Conclusions: Children from different sites clustered into groups of similar lifestyle behaviours. Cluster membership was linked with differing adiposity. Findings support the implementation of activity interventions in all countries, targeting both physical activity and sedentary time. [ABSTRACT FROM AUTHOR]

Background No studies have examined if mid-upper arm circumference (MUAC) can be an alternative screening tool for obesity in an international sample of children differing widely in levels of human development. Objective Our aim is to determine whether MUAC could be used to identify obesity in children from 12 countries in five major geographic regions of the world. Methods This observational, multinational cross-sectional study included 7337 children aged 9-11 years. Anthropometric measurements were objectively assessed, and obesity was defined according to the World Health Organization reference data. Results In the total sample, MUAC was strongly correlated with adiposity indicators in both boys and girls ( r > 0.86, p < 0.001). The accuracy level of MUAC for identifying obesity was high in both sexes and across study sites (overall area under the curve of 0.97, sensitivity of 95% and specificity of 90%). The MUAC cut-off value to identify obesity was ~25 cm for both boys and girls. In country-specific analyses, the cut-off value to identify obesity ranged from 23.2 cm (boys in South Africa) to 26.2 cm (girls in the UK). Conclusions Results from this 12-country study suggest that MUAC is a simple and accurate measurement that may be used to identify obesity in children aged 9-11 years. MUAC may be a promising screening tool for obesity in resource-limited settings. [ABSTRACT FROM AUTHOR]