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Sahlan RN, Serier KN, Smith JE. Using Exploratory Structural Equation Modeling (ESEM) To Examine the Factor Structure and Measurement Invariance of the Farsi Version of the Children's Eating Attitudes Test (F-ChEAT) among Iranian Preadolescents Across Gender and Age. Child Psychiatry Hum Dev 2024; 55:1092-1102. [PMID: 36459345 DOI: 10.1007/s10578-022-01466-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 12/05/2022]
Abstract
Despite considerable examination of the Children's Eating Attitudes Test (ChEAT) in Western societies, there is no study about the ChEAT in Iran. The purpose of the current study was to translate and examine the factor structure and measurement invariance of the Farsi version of the ChEAT (F-ChEAT) among Iranian preadolescents. Iranian preadolescents (N = 717) completed the F-ChEAT and demographic information. Exploratory structural equation modeling (ESEM) was used to examine the factor structure and measurement invariance across gender and age. A 5-factor, 15-item ESEM model showed an excellent fit of the data. Tests of measurement invariance suggested that scores on the latent means could be meaningfully compared across gender and age. Girls had higher latent means on the Food Preoccupation and Caloric Awareness and Control factors, and older preadolescents had higher latent means on all the F-ChEAT factors, except for the Dieting factor. Findings suggest that a 5-factor, 15-item ESEM model of the F-ChEAT was a useful assessment tool to understand disordered eating symptoms in Iranian preadolescents.
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Affiliation(s)
- Reza N Sahlan
- Department of Clinical Psychology, Iran University of Medical Sciences, Tehran, Iran
| | - Kelsey N Serier
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Jane Ellen Smith
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA.
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Coop A, Clark A, Morgan J, Reid F, Lacey JH. The use and misuse of the SCOFF screening measure over two decades: a systematic literature review. Eat Weight Disord 2024; 29:29. [PMID: 38652332 PMCID: PMC11039549 DOI: 10.1007/s40519-024-01656-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE The SCOFF questionnaire was designed as a simple, memorable screening tool to raise suspicion that a person might have an eating disorder. It is over 20 years since the creation of the SCOFF, during which time it has been widely used. Considering this, we wish to review the use of the SCOFF in peer-reviewed scientific journals, and to assess whether it is being used appropriately in the manner in which it was originally devised and tested. METHODS The Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines were followed, and all search strategies and methods were determined before the onset of the study. PubMed and Wiley Online Library were searched using the terms SCOFF and eating. Two reviewers were involved in the reviewing process. Criteria for appropriate use of the SCOFF were formalised with the tool's original authors. RESULTS 180 articles were included in the final review. 48 articles had used the SCOFF appropriately, 117 articles inappropriately and 15 articles had been mixed in the appropriateness of their use. CONCLUSION This systematic review highlights the inappropriate use of the SCOFF in diverse languages and settings. When used correctly the SCOFF has made a significant contribution to the understanding of eating disorders and its simplicity has been applauded and led to widespread use. However in over two-thirds of studies, the use of the SCOFF was inappropriate and the paper highlights how and in what way it was misused, Guidelines for the appropriate use of the SCOFF are stated. Future validation and avenues of research are suggested. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Amy Coop
- Schoen Clinic Newbridge, Birmingham, UK
| | | | - John Morgan
- St George's, University of London, London, UK
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Austin A, De Silva U, Ilesanmi C, Likitabhorn T, Miller I, Sousa Fialho MDL, Austin SB, Caldwell B, Chew CSE, Chua SN, Dooley-Hash S, Downs J, El Khazen Hadati C, Herpertz-Dahlmann B, Lampert J, Latzer Y, Machado PPP, Maguire S, Malik M, Moser CM, Myers E, Pastor IR, Russell J, Smolar L, Steiger H, Tan E, Trujillo-Chi Vacuán E, Tseng MCM, van Furth EF, Wildes JE, Peat C, Richmond TK. International consensus on patient-centred outcomes in eating disorders. Lancet Psychiatry 2023; 10:966-973. [PMID: 37769672 DOI: 10.1016/s2215-0366(23)00265-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 10/02/2023]
Abstract
The effectiveness of mental health care can be improved through coordinated and wide-scale outcome measurement. The International Consortium for Health Outcomes Measurement has produced collaborative sets of outcome measures for various mental health conditions, but no universal guideline exists for eating disorders. This Position Paper presents a set of outcomes and measures for eating disorders as determined by 24 international experts from professional and lived experience backgrounds. An adapted Delphi technique was used, and results were assessed through an open review survey. Final recommendations suggest outcomes should be tracked across four domains: eating disorder behaviours and cognitions, physical health, co-occurring mental health conditions, and quality of life and social functioning. Outcomes are collected using three to five patient-reported measures. For children aged between 6 years and 12 years, the measures include the Children's Eating Attitude Test (or, for those with avoidant restrictive food intake disorder, the Eating Disorder in Youth Questionnaire), the KIDSCREEN-10, and the Revised Children's Anxiety and Depression Screener-25. For adolescents aged between 13 years and 17 years, the measures include the Eating Disorder Examination Questionnaire (EDE-Q; or, for avoidant restrictive food intake disorder, the Nine-Item Avoidant Restrictive Food Intake Disorder Screener [NIAS]), the two-item Patient Health Questionnaire (PHQ-2), the nine-item Patient Health Questionnaire (PHQ-9), the two-item Generalised Anxiety Disorder (GAD-2), the seven-item Generalised Anxiety Disorder (GAD-7), and the KIDSCREEN-10. For adults older than 18 years, measures include the EDE-Q (or, for avoidant restrictive food intake disorder, the NIAS), the PHQ-2, the PHQ-9, the GAD-2, the GAD-7, the Clinical Impairment Assessment, and the 12-item WHO Disability Assessment Schedule 2.0. These questionnaires should be supplemented by information on patient characteristics and circumstances (ie, demographic, historical, and clinical factors). International adoption of these guidelines will allow comparison of research and clinical interventions to determine which settings and interventions work best, and for whom.
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Affiliation(s)
- Amelia Austin
- Department of Community Health Sciences, and O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Psychological Medicine, King's College London, London, UK.
| | - Umanga De Silva
- International Consortium for Health Outcomes Measurement, Boston, MA, USA
| | | | | | - Isabel Miller
- International Consortium for Health Outcomes Measurement, Boston, MA, USA
| | | | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA; Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | | | - Chu Shan Elaine Chew
- Adolescent Medicine Service, Department of Paediatrics, Kandang Kerbau Women's and Children's Hospital, Singapore
| | | | - Suzanne Dooley-Hash
- Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | | | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen, Aachen, Germany
| | - Jillian Lampert
- The Emily Program, St Paul, MN, USA; REDC Consortium, New York, NY, USA
| | - Yael Latzer
- Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel; Eating Disorders Institution, Psychiatric Division, Rambam Health Care Campus, Haifa, Israel
| | - Paulo P P Machado
- Psychotherapy and Psychopathology Research Lab, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, The University of Sydney, Sydney, NSW, Australia; Sydney School of Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Madeeha Malik
- Institute of Pharmaceutical Sciences, Hamdard University, Islamabad, Pakistan; Cyntax Health Projects, Islamabad, Pakistan
| | - Carolina Meira Moser
- Programa de Transtornos Alimentares em Adultos, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, UFRGS, Porto Alegre, Brazil
| | | | | | - Janice Russell
- Sydney School of Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; NSW Statewide Eating Disorder Service, Peter Beumont Unit, Professor Marie Bashir Centre, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Lauren Smolar
- National Eating Disorders Association, White Plains, NY, USA
| | - Howard Steiger
- Eating Disorder Continuum, Douglas Mental Health University Institute, Montreal, QC, Canada; Psychiatry Department, McGill University, Montreal, QC, Canada
| | - Elizabeth Tan
- InsideOut Institute for Eating Disorders, The University of Sydney, Sydney, NSW, Australia
| | - Eva Trujillo-Chi Vacuán
- Comenzar de Nuevo Eating Disorders Research and Treatment Center, Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico
| | - Mei-Chih Meg Tseng
- Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Eric F van Furth
- Rivierduinen Eating Disorders Ursula, Leiden, Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - Jennifer E Wildes
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Christine Peat
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Bozkurt O, Kocaadam-Bozkurt B, Köksal E, Özalp Ateş FS. Children's eating attitudes test (ChEAT): validation and reliability in Turkish children. J Eat Disord 2023; 11:93. [PMID: 37649120 PMCID: PMC10469453 DOI: 10.1186/s40337-023-00811-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/16/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES This study aims to examine the validity and reliability of the children's eating attitudes test (ChEAT) in Turkish children. METHODS The participants were 331 children (137 boys and 194 girls, ages 8-15). Data was collected through face-to-face interviews using a questionnaire containing socio-demographic characteristics, the ChEAT, and the children's eating behaviour questionnaire (CEBQ). Exploratory factor analysis (EFA) was performed to determine the factor structure of the Turkish version of the ChEAT. Additionally, the reliability was examined in terms of internal consistency and test-retest reliability. All statistical analyses were performed using Mplus Trial Version and SPSS 11.5 (SPSS, Chicago, IL, USA). RESULTS According to the goodness-of-fit statistic, a three-factor solution was appropriate and compatible with clinical considerations. The three factors explained 50.1% of the variance. Cronbach's alpha coefficient was 0.75 for ChEAT-26, 0.67 for "Preoccupation with thinness and food", 0.63 for "Social pressure to eat", and 0.71 for "Dieting". Furthermore, the test-retest reliability was 0.72, 0.62, 0.59, and 0.59 respectively. Statistically significant correlations between the ChEAT and CEBQ were found (p < 0.05). "Preoccupation with thinness and food" was significantly higher in obese children (p < 0.05), while "Social pressure to eat" was lower (p < 0.001). Sex, grade, BMI, parental education in addition to working status affected the ChEAT-26 scores. CONCLUSIONS The present study has provided preliminary evidence for the validity and reliability of a Turkish version of the ChEAT.
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Affiliation(s)
- Osman Bozkurt
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Erzurum Technical University, Erzurum, Turkey
| | - Betul Kocaadam-Bozkurt
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Erzurum Technical University, Erzurum, Turkey
| | - Eda Köksal
- Department of Nutrition and Dietetics, Gazi University Faculty of Health Sciences, Ankara, Turkey
| | - Funda Seher Özalp Ateş
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Manisa Celal Bayar University, 45030 Manisa, Turkey
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López-Gil JF, García-Hermoso A, Smith L, Firth J, Trott M, Mesas AE, Jiménez-López E, Gutiérrez-Espinoza H, Tárraga-López PJ, Victoria-Montesinos D. Global Proportion of Disordered Eating in Children and Adolescents: A Systematic Review and Meta-analysis. JAMA Pediatr 2023; 177:363-372. [PMID: 36806880 PMCID: PMC9941974 DOI: 10.1001/jamapediatrics.2022.5848] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/30/2022] [Indexed: 02/22/2023]
Abstract
Importance The 5-item Sick, Control, One, Fat, Food (SCOFF) questionnaire is the most widely used screening measure for eating disorders. However, no previous systematic review and meta-analysis determined the proportion of disordered eating among children and adolescents. Objective To establish the proportion among children and adolescents of disordered eating as assessed with the SCOFF tool. Data Sources Four databases were systematically searched (PubMed, Scopus, Web of Science, and the Cochrane Library) with date limits from January 1999 to November 2022. Study Selection Studies were required to meet the following criteria: (1) participants: studies of community samples of children and adolescents aged 6 to 18 years and (2) outcome: disordered eating assessed by the SCOFF questionnaire. The exclusion criteria included (1) studies conducted with young people who had a diagnosis of physical or mental disorders; (2) studies that were published before 1999 because the SCOFF questionnaire was designed in that year; (3) studies in which data were collected during COVID-19 because they could introduce selection bias; (4) studies based on data from the same surveys/studies to avoid duplication; and (5) systematic reviews and/or meta-analyses and qualitative and case studies. Data Extraction and Synthesis A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Main Outcomes and Measures Proportion of disordered eating among children and adolescents assessed with the SCOFF tool. Results Thirty-two studies, including 63 181 participants, from 16 countries were included in this systematic review and meta-analysis. The overall proportion of children and adolescents with disordered eating was 22.36% (95% CI, 18.84%-26.09%; P < .001; n = 63 181) (I2 = 98.58%). Girls were significantly more likely to report disordered eating (30.03%; 95% CI, 25.61%-34.65%; n = 27 548) than boys (16.98%; 95% CI, 13.46%-20.81%; n = 26 170) (P < .001). Disordered eating became more elevated with increasing age (B, 0.03; 95% CI, 0-0.06; P = .049) and body mass index (B, 0.03; 95% CI, 0.01-0.05; P < .001). Conclusions and Relevance In this systematic review and meta-analysis, the available evidence from 32 studies comprising large samples from 16 countries showed that 22% of children and adolescents showed disordered eating according to the SCOFF tool. Proportion of disordered eating was further elevated among girls, as well as with increasing age and body mass index. These high figures are concerning from a public health perspective and highlight the need to implement strategies for preventing eating disorders.
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Affiliation(s)
- José Francisco López-Gil
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Antonio García-Hermoso
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Mike Trott
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
- Centre for Public Health, Queen’s University, Belfast, United Kingdom
| | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
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Huang Y, Wang C, Tong L. The Reliability and Validation of the Children's Eating Attitude Test among Chinese Samples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:738. [PMID: 36613060 PMCID: PMC9819825 DOI: 10.3390/ijerph20010738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/26/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
The purpose of this study was to examine the psychometric properties of the Children's Eating Attitude Test (ChEAT) in a Chinese sample. A total of 906 children (mean age = 10.55, SD = 1.08) from three primary schools were evaluated by the ChEAT. Factor analysis was performed to examine the factor structure of the ChEAT. The children's body mass index (BMI) was applied to assess the concurrent validity of the ChEAT. The ChEAT showed good internal consistency (Cronbach's α = 0.819) and split-half reliability (0.816) in Chinese children. Exploratory factor analysis suggested a four-factor structure, consistent with previous studies, which explained 41.16% of the total variance. Confirmatory factor analysis indicated good construct validity for the Chinese sample. The Chinese version of the ChEAT showed evidence for reliability and validity to evaluate the eating attitudes and behaviors for Chinese children. The mean score of each factor of the ChEAT differed significantly among different genders and BMI groups. Overweight girls had more eating disorder problems than normal-weight girls, and boys with lower BMI showed higher social eating pressure.
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McGowan A, Barry MR, Sonneville KR, Leung CW. Greater social adversity is associated with more disordered eating attitudes and behaviors among children from Southeast Michigan. Int J Eat Disord 2022; 55:1670-1677. [PMID: 35833678 PMCID: PMC10084038 DOI: 10.1002/eat.23775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study is to examine the association between indicators of social adversity, including socioeconomic status and race/ethnicity, and children's disordered eating behaviors and attitudes. METHODS Children ages 8-10 years old (n = 183) were recruited from Michigan. Data were collected through in-home surveys. The Children's Eating Attitudes Test (ChEAT-24) measured disordered eating attitudes and behaviors in the sample. Cumulative social adversity was considered the sum of four binary variables: caregiver race/ethnicity, caregiver education, household income, and child-reported food security status. Linear mixed models examined the association between social adversity indicators and ChEAT-24 scores. RESULTS Children of primary caregivers of color had significantly higher ChEAT-24 scores than children of white caregivers (p = .03). Children who reported food insecurity had significantly higher ChEAT-24 scores compared to children who reported food security (p = .01). Compared to children with the lowest social adversity score, children with the highest score had a 4.8-unit higher ChEAT-24 score (95% CI .3-9.4), after adjusting for covariates. A significant trend was observed for greater social adversity and higher ChEAT-24 score (p-trend = .02). CONCLUSION A linear association was observed between greater social adversity and more disordered eating behaviors and attitudes among children in this sample. These findings emphasize the need for eating disorder research in children from racial/ethnic minorities and socioeconomically disadvantaged populations to support future prevention efforts. PUBLIC SIGNIFICANCE Greater exposure to social adversity was associated with more disordered eating behaviors among preadolescent children. Given that eating disorders are understudied in lower-income and minority racial/ethnic populations, this study highlights the need for additional research to better support prevention and treatment efforts among children from socioeconomically diverse backgrounds.
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Affiliation(s)
- Andrea McGowan
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Mikayla R Barry
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Cindy W Leung
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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Barry MR, Sonneville KR, McGowan AR, Needham BL, Kobayashi LC, Leung CW. Caregiver-reported household food insecurity and child-reported food insecurity in relation to eating disorder risk factors and symptoms among preadolescent children. Int J Eat Disord 2022; 55:1331-1341. [PMID: 35869930 PMCID: PMC9551508 DOI: 10.1002/eat.23784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/01/2022] [Accepted: 07/08/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the relation of caregiver-reported household food insecurity (FI) and child-reported FI with eating disorder (ED) risk factors and symptoms, including effect modification by gender, in preadolescent children. METHOD Data were from the Family Food Study, a cross-sectional study of households with incomes ≤200% of the federal poverty line in southeastern Michigan. Children aged 8-10 years (n = 194) and their female primary caregivers reported separately on FI status. Children reported ED risk factors/symptoms via the 24-item Children's Eating Attitudes Test (ChEAT-24), with higher scores indicating more ED risk factors/symptoms. Linear mixed models were used to examine associations between FI measures with the ChEAT-24 total score, plus subscale scores for dieting, food preoccupation, weight preoccupation, vomiting, and social pressure to eat/gain weight. Models were adjusted for child age, child gender, caregiver race/ethnicity, caregiver education, and household income. RESULTS Among all children, child-reported FI, but not caregiver-reported household FI, was associated with more ED risk factors/symptoms. Child-reported FI (vs. no FI) was associated with higher average ChEAT-24 total score (β = 2.41, 95% CI: 0.57, 4.25). Child-reported FI was also associated with more food preoccupation, more weight preoccupation, and more social pressure to eat. Caregiver-reported household FI was marginally associated with less dieting in girls, and child-reported FI was associated with more dieting in boys. DISCUSSION Child-reported FI may be more salient than caregiver-reported household FI as a risk factor for ED-related outcomes in preadolescent children. Gender may modify the association between FI and dieting behavior. PUBLIC SIGNIFICANCE STATEMENT More child-reported food insecurity, but not parent-reported household food insecurity, was associated with more eating disorder risk factors and symptoms among preadolescent boys and girls. These findings emphasize the need for future studies that investigate the role of food insecurity in the development of eating disorders, especially studies that measure child-reported experience of food insecurity.
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Affiliation(s)
- Mikayla R. Barry
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMichiganUSA,Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Kendrin R. Sonneville
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Andrea R. McGowan
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Belinda L. Needham
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Lindsay C. Kobayashi
- Department of EpidemiologyUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
| | - Cindy W. Leung
- Department of Nutritional SciencesUniversity of Michigan School of Public HealthAnn ArborMichiganUSA
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Legendre M, Côté M, Aimé A, Brault MC, Dion J, Bégin C. The children's eating attitudes test: French validation of a short version. Eat Weight Disord 2021; 26:2749-2756. [PMID: 33646517 DOI: 10.1007/s40519-021-01158-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/18/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Disordered eating attitudes and behaviors (DEAB) in childhood have been prospectively associated with eating disorders and obesity in adolescence. Therefore, evaluating DEAB in children with a reliable, sensitive and well-adapted scale is very important. The Children's Eating Attitudes Test (ChEAT) is one of the most popular measuring tools for DEAB in children, but no French version is available. Moreover, while completion time is an important factor to be considered when working with children, only one recent study proposed a shorter version of the ChEAT. Taking the previous works of Murphy and colleagues (2019) as a starting point, the current study aimed to provide the first French-speaking validated 14-item short version of the ChEAT. METHODS A sample of 1092 boys and girls aged between 8 and 12 years old were recruited in two urban areas in the province of Quebec, Canada. They completed the ChEAT, and their height and weight were measured at school. Factorial structure and internal consistency were assessed. RESULTS After the initial factorial analysis, two "vomiting (or purging)" items were yielded as problematic and were thus removed from the analysis. The remaining 12 items provided a good fit to the data and a good internal consistency. Moreover, the factorial structure was proved to be invariant across sexes. CONCLUSION This study is the first to provide a French assessment of DEAB in elementary school children. The French short version of the ChEAT provided a quick and reliable assessment for DEAB with non-clinical children population and could be used as a screening tool, even though no cut-off was established yet. LEVEL OF EVIDENCE Cross-sectional, descriptive study, Level V.
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Affiliation(s)
- Maxime Legendre
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada
| | - Marilou Côté
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada
| | - Annie Aimé
- Psychology and Psychoeducation Department, Pavillon Campus de Saint-Jérôme, Université du Québec en Outaouais, 5, rue St-Joseph, St-Jérôme, QC, J7Z 0B7, Canada
| | - Marie-Christine Brault
- Department of Human and Social Sciences, Université du Québec À Chicoutimi, 555, boul. de l'université, Chicoutimi, QC, G7H 2BI, Canada
| | - Jacinthe Dion
- Department of Health Sciences, Université du Québec À Chicoutimi, 555, boul. de l'université, Chicoutimi, QC, G7H 2BI, Canada
| | - Catherine Bégin
- School of Psychology, Pavillon Félix-Antoine-Savard, Laval University, 2325, rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
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Yeargin S, Torres-McGehee TM, Emerson D, Koller J, Dickinson J. Hydration, Eating Attitudes and Behaviors in Age and Weight-Restricted Youth American Football Players. Nutrients 2021; 13:nu13082565. [PMID: 34444723 PMCID: PMC8401195 DOI: 10.3390/nu13082565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 01/17/2023] Open
Abstract
There is a paucity of research examining hydration and nutrition behaviors in youth American football players. A potentially unique risk factor are league restrictions based on weight (WR) or age (AR). The purpose of this study was to examine hydration status between WR and AR leagues. The secondary purpose was to describe eating patterns in players. An observational cohort design with 63 youth football players (10 ± 1 yrs, 148.2 ± 9.4 cm, 44.9 ± 15.3 kg) was utilized. Independent variables were league (AR (n = 36); WR (n = 27)) and activity type (practice (PX = 8); game (GM = 3)). Dependent variables were hydration status (urine osmolality; percent change in body mass (%BM)), eating attitudes (Children’s Eating Attitude Test (ChEAT-26)) and self-reported frequency of meals. On average, players arrived activity mildly hypohydrated (830 ± 296 mOsm/kg) and %BM was minimal (−0.1 ± 0.7%) during events. Players consumed 2 ± 1 meals and 1 ± 1 snack before events. The ChEAT-26 survey reported 21.6% (n = 8) of players were at risk for abnormal eating attitudes. Among these players, eating binges, vomiting, excessive exercise and drastic weight loss were reported. Youth American football players arrived activity mildly hypohydrated and consumed enough fluid during activity to maintain euhydration. Abnormal eating attitudes and the use of unhealthy weight loss methods were reported by some youth American football players.
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Affiliation(s)
- Susan Yeargin
- Exercise Science Department, Arnold School of Public Health University of South Carolina, Columbia, SC 29208, USA;
- Correspondence:
| | - Toni M. Torres-McGehee
- Exercise Science Department, Arnold School of Public Health University of South Carolina, Columbia, SC 29208, USA;
| | - Dawn Emerson
- Department of Physical Therapy, Rehabilitation Sciences, and Athletic Training, School of Health Professions University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | | | - John Dickinson
- Palmetto Health/USC Orthopedic Center, Columbia, SC 29203, USA;
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