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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., (© 2016 World Obesity Federation.)

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., (© 2016 World Obesity Federation.)

Summary: Background: It is unknown whether moderate‐to‐vigorous physical activity (MVPA) thresholds for obesity should be adapted depending on level of sedentary behaviour in children. Objective: The objective of the study is to determine the MVPA thresholds that best discriminate between obese and non‐obese children, by level of screen time and total sedentary time in 12 countries. Methods: This multinational, cross‐sectional study included 6522 children 9–11 years of age. MVPA and sedentary time were assessed using waist‐worn accelerometry, while screen time was self‐reported. Obesity was defined according to the World Health Organization reference data. Results: Receiver operating characteristic curve analyses showed that the best thresholds of MVPA to predict obesity ranged from 53.8 to 73.9 min d−1 in boys and from 41.7 to 58.7 min d−1 in girls, depending on the level of screen time. The MVPA cut‐offs to predict obesity ranged from 37.9 to 75.9 min d−1 in boys and from 32.5 to 62.7 min d−1 in girls, depending on the level of sedentary behaviour. The areas under the curve ranged from 0.57 to 0.73 (‘fail’ to ‘fair’ accuracy), and most sensitivity and specificity values were below 85%, similar to MVPA alone. Country‐specific analyses provided similar findings. Conclusions: The addition of sedentary behaviour levels to MVPA did not result in a better predictive ability to classify children as obese/non‐obese compared with MVPA alone. [ABSTRACT FROM AUTHOR]