O'Connor, GiselleJulvez, JordiFernández-Barrés, SílviaNavarrete-Muñoz, Eva-MaríaMurcia, MarioTardón, AdoninaRiaño, IsolinaAmiano, PilarIbarluzea, JesúsGarcía Esteban, RaquelVrijheid, MartineSunyer Deu, JordiRomaguera Bosch, Dora2021-02-042021-02-042020O'Connor G, Julvez J, Fernandez-Barrés S, Navarrete-Muñoz EM, Murcia M, Tardón A, Galán IR, Amiano P, Ibarluzea J, Garcia-Esteban R, Vrijheid M, Sunyer J, Romaguera D. Association of lifestyle factors and neuropsychological development of 4-year-old children. Int J Environ Res Public Health. 2020; 17(16):5668. DOI: 10.3390/ijerph171656681661-7827http://hdl.handle.net/10230/46328Background: We aimed to assess how lifestyle factors such as diet, sleep, screen viewing, and physical activity, individually, as well as in a combined score, were associated with neuropsychological development in pre-school age children. Methods: We conducted a cross-sectional study in 1650 children of 4 years of age, from the Environment and Childhood Project (INMA) population-based birth cohorts in four regions of Spain. Children were classified per a childhood healthy lifestyle score (CHLS) with a range of 0 to 4 that included eating in concordance with the Mediterranean diet (1 point); reaching recommended sleep time (1 point); watching a maximum recommended screen time (1 point); and being physically active (1 point). The McCarthy Scales of Children's Abilities (MSCA) were used to test neuropsychological development. Multi-adjusted linear regression models were created to assess the association with the lifestyle factors individually and as a combined score. Results: CHLS was not associated with MSCA general cognitive score (1-point increment = -0.5, 95% CI: -1.2, 0.2). Analyzed by separate lifestyle factors, physical activity had a significant negative association with MSCA score and less TV/screen time had a negative association with MSCA score. Conclusion: In this cross-sectional study, a combined score of lifestyle factors is not related to neuropsychological development at pre-school age.application/pdfeng© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).info:eu-repo/semantics/articlehttp://dx.doi.org/10.3390/ijerph17165668Child healthCohort studyLifestyle factorsNeuropsychological developmentinfo:eu-repo/semantics/openAccess