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Abstract
Clinical manifestations of cardiometabolic risk (CMR) may be set early in childhood due to unfavorable behaviors or lifestyle patterns related to diet and physical activity. Several factors may determine the adoption of such lifestyle-related behaviors, which researchers have tried to cluster under certain frameworks or models. In this context, the framework developed and proposed by this review gathers all the present knowledge regarding these determining factors to date and groups them into three main categories related to personal characteristics and the social and physical environment. Based on the proposed framework, a large variety of personal, social and physical environmental factors can positively or negatively influence CMR-related behaviors (either directly or indirectly via their interrelations), thus leading to decreased or increased risk, respectively. This framework could be of great value to public health policy makers and legislators for designing and implementing interventional programs tailored to the needs of susceptible population groups who are most in need for such initiatives. Targeting the correlates as potential determinants of CMR-related behaviors, and not just on the behaviors themselves, has been shown previously to be the most effective approach for tackling health issues related to CMR starting from early life stages.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
The first line of defense against cardiometabolic risk (CMR) is the modification of related risk behaviors, such as diet and physical activity (PA).
Clinical manifestations of CMR, as well as certain behaviors or lifestyle patterns, may be set early in childhood.
Low consumption of fruits and vegetables, breakfast skipping and increased consumption of fruit juices, soft/fizzy drinks, confectionary and fast food have previously been reported as unfavorable dietary behaviors that increase CMR in children.
Reduced PA levels, combined with increased sedentary behaviors, exert a significant negative effect on CMR.
CMR behaviors (i.e., diet, PA) are influenced by children’s internal personal characteristics, as well as their social and physical environment either directly or indirectly through their interactions.
Attitudes, subjective norms and emotions are very strong personal determinants of dietary behavior, while self-efficacy positively affects both dietary and PA behaviors.
Modeling of the dietary behaviors of parents, peers and teachers is a strong social environmental determinant of children’s dietary behavior, while parenting styles and practices (i.e., encouragement, support, rule setting and rewarding), parental perceptions of their children’s weight status and peer’s teasing or bullying affect both children’s dietary and PA behavior.
Availability of and accessibility to food, sports’ infrastructures and equipment at home, neighborhood and school, as well as aesthetics and safety of the surroundings are strong physical environmental determinants of children’s dietary and PA behaviors, respectively.