Emotional eating is related with temperament but not with stress biomarkers in preschool children

Sleep duration is associated with appetitive traits in school-age years - results from the Generation XXI birth cohort

Sleep may influence appetite regulation through physiological and neurocognitive pathways. However, the association between sleep and appetite in childhood has been scarcely reported, particularly using a prospective design. We aimed to test associations between sleep duration at 7 years of age (y) and appetitive traits at both 7 and 10 y. Participants are from the population-based birth cohort Generation XXI (Porto, Portugal), at 7 (n = 2437) and 10 y (n = 1938) follow-ups. Data on sleep was gathered at 7 y and, considering bedtime and get-up time, total mean sleep duration was calculated and further categorized according to the 10th and 90th percentiles. Appetitive traits were assessed at 7 and 10 y using the parent-reported Children's Eating Behaviour Questionnaire. Associations were tested through Generalized Linear Models (co-variates: child's sex; maternal age, education and pre-pregnancy body mass index at 7 y). At 10 y, associations were further adjusted for the respective appetitive trait at 7 y. Children slept a mean of 10.2 h/night, and 13% and 9% slept ≤9.5 and ≥ 11.0 h/night at 7 y, respectively. For each additional hour in sleep duration, children scored 0.078 (99%CI: -0.145; -0.011) lower on Food Responsiveness, 0.065 (99%CI: -0.129; -0.002) lower on Emotional Undereating and 0.096 (99%CI: -0.161; -0.032) lower on Food Fussiness. Lastly, children sleeping ≤9.5 h/night scored higher on Food Responsiveness (β = 0.145 99%CI: 0.020; 0.271); while those sleeping ≥11.0 h/night scored lower on Food Fussiness (β = -0.255 99%CI: -0.370; -0.079). No significant prospective associations were found. In conclusion, in 7 y children, sleep duration was cross-sectionally associated with lower scores on food approach (Food Responsiveness) and avoidant traits (Emotional Undereating and Food Fussiness). However, the magnitude of the associations was small and further studies are warranted.

Temperament and emotional overeating: the mediating role of caregiver response to children's negative emotions

Objective

This study aimed to investigate the mediating effects of caregiver responses to a child's negative emotions on the associations between infant temperament and emotional overeating in preschool children.

Method

A sample of 358 children and their caregivers enrolled in the STRONG Kids 2 (SK2) birth cohort study (N = 468) provided data for this analysis. Caregivers completed questionnaires assessing child temperament at 3 months, caregiver response to negative emotions at 18 months, and child emotional overeating at 36 months. Structural Equation Modeling was conducted using the lavaan package in RStudio to test hypothesized models examining whether the relations between early temperament and subsequent emotional eating were mediated by caregiver responses to a child's emotions.

Results

Findings revealed that infant temperamental orienting/regulation predicted the later development of emotional overeating through supportive caregiver responses to a child's negative emotions. Lower levels of orienting/regulation were associated with greater emotional overeating, explained by less supportive caregiver responses to the child's emotions. Moreover, infant surgency had a positive direct influence on emotional overeating at 36 months. Both supportive and non-supportive caregiver responses to a child's negative emotions had significant direct influences on emotional overeating.

Conclusion

The results highlight the importance of caregiver response to a child's negative emotions as a mediator between infant temperament and emotional overeating in preschool children. Intervention strategies can be implemented to support caregivers in adopting supportive responses to their child's negative emotions to promote healthy eating behaviors from early childhood. Future studies are needed to explore these pathways of influences throughout child development.

Dyadic Predictors of Willing to Engage in Physical Activity and Emotional Eating in Children and Adolescents with Mild and Moderate Intellectual Disability

Intellectual disability is associated with increased risk for childhood obesity, and the factors most often associated with this risk are incorrect eating behavior and insufficient amount and intensity of physical activity. As is well known, there area whole range of factors determining lifestyle, but many currently available reports in this field refer to the functioning of children without a diagnosis of intellectual disability, and, as we know, due to numerous individual and environmental barriers, children with ID may function differently in this context than their peers. Therefore, we examined the relationships between the selected variables and divided them into two models: (1) first regression model: child's willingness to engage in physical activity (dependent variable), child's physical limitations related to disabilities and/or comorbidities, child's independence, parents' willingness to engage in physical activity, child's body dissatisfaction (independent variables/predictors); (2) second regression model: child's emotional eating (dependent variable), child's coping with emotions, parents' attitudes, beliefs, and practices about child feeding (restriction and pressure to eat), parents' emotional eating, parents' happiness (independent variables/predictors). A group of 503 parents (of children and adolescents with mild and moderate intellectual disability) completed: the Contour Drawing Rating Scale, the Child Feeding Questionnaire, the Emotional Overeating Questionnaire, the Scale of Experiencing Happiness, and the supplementary survey. Our results allow partial confirmation of the hypotheses related to both of these models: (1) model I: the relationships between the child's willingness to engage in physical activity and all predictors are significant, but the direction of the relationship between the dependent variable and one of the predictors-body dissatisfaction-is opposite to the assumed one (negative relationship); (2) model II: the relationships between the child's emotional eating and almost all predictors are significant, except for the relationship between the dependent variable and pressure to eat. In conclusion, (to the authors' knowledge) this study is the first to assess dyadic predictors of willingness to engage in physical activity and emotional eating in children and adolescents with mild and moderate intellectual disability. It allows for a better understanding of the attitudes, beliefs, and experiences of children with intellectual disabilities and their parents, which gives the opportunity (taking into account factors from both individuals from the child-parent dyad) to better design strategies to support pro-health behaviors in children and adolescents from this group (which may improve the effectiveness of overweight prevention and obesity). These findings emphasize how important it is to consider the dynamic of the child-parent dyad when considering how parenting contributes to a child's willingness to engage in physical activity, as well as thatchild's emotional eating.

Examining links between child temperament and feeding, eating, and weight outcomes: An updated systematic review of the literature

BACKGROUND

Weight outcomes have been associated with child temperament, defined as individual differences in reactivity and self-regulation. The current systematic review aims to provide an updated summary of the evidence linking temperamental negative reactivity, surgency, and regulation superfactors to early childhood feeding, eating, and weight outcomes.

METHODS

PubMed, PsycINFO and Embase databases, as well as scientific meeting programs, were searched using keywords and subject headings. Publication dates were limited to 2012-2019 as prior reviews were published in 2012 and 2014. Identified studies were eligible if they included children ages 0-5 years, a measure of child temperament, and a measure of parent/caregiver feeding, child eating, or child weight. 7113 studies were identified and 121 met inclusion criteria.

RESULTS

Feeding, eating, and weight outcomes were largely unrelated to overarching negative reactivity, surgency, and effortful control superfactors. Examination of individual temperament dimensions suggested difficult temperament was frequently linked to non-responsive feeding practices, whereas elevated emotionality and decreased self-regulation were linked to maladaptive eating behaviors, and lower inhibitory control to adiposity. Analyses with infants reported greater percentages of significant associations compared to children, and cross-sectional studies generally reported fewer significant associations than other study designs.

CONCLUSIONS

Difficult temperament, greater emotionality and lower self-regulation and inhibitory control were the aspects of temperament most consistently related to poorer early childhood feeding, eating, and weight outcomes. Associations tended to be stronger in infancy, and when examined within a non-cross-sectional study design. Findings can inform the development of tailored efforts to promote healthy eating and growth throughout childhood.

Influences of Child Temperament and Household Chaos on Preschoolers' Emotional Eating

Background: Emotional eating has been linked to child temperament and family environment factors, such as household chaos. However, few studies have examined how child and home characteristics independently and together influence children's overeating and undereating in response to negative emotions. Objective: The current study examined associations among child temperament, household chaos, and emotional eating in children 18-24 months of age, and interaction effects were also tested. Methods: The study included an analysis sample of 371 families participating in the larger STRONG Kids2 longitudinal birth cohort study (N = 468). The Early Childhood Behavior Questionnaire was used to assess child temperament at 18 months, and the Confusion, Hubbub, and Order Scale was used to assess disorganization in the household at 24 months. Child emotional eating at 24 months was assessed using parental reports of the Child Eating Behavior Questionnaire. Results: Negative affectivity and household chaos were independently associated with child emotional overeating. Negative affectivity, effortful control, and household chaos were significantly associated with emotional undereating. No significant interactions were found. Conclusions: Child temperament and household environment independently influence emotional eating in young children, highlighting the need to consider these factors in early prevention. Longitudinal studies are warranted to determine mechanisms that may be involved in these relations.

Characteristics of eating behavior profiles among preschoolers with low-income backgrounds: a person-centered analysis

BACKGROUND

Individual differences in eating behaviors among young children are well-established, but the extent to which behaviors aggregate within individuals to form distinct eating behavior profiles remains unknown. Our objectives were to identify eating behavior profiles among preschool-aged children and evaluate associations with temperament and weight.

METHODS

A secondary, cross-sectional analysis of baseline data from 2 cohort studies was conducted involving 1004 children aged 3-4 years and their parents with low-income backgrounds. Children's eating behaviors and temperament were assessed by parental report. Body mass index z-scores and weight status were calculated using measured heights and weights. Latent profile analysis (LPA) was used to generate profiles and bivariate analyses were used to evaluate associations with temperament and weight status.

RESULTS

LPA revealed the presence of 3 eating behavior profiles among children. Children with High Food Approach profiles (21.2%) had lower temperamental inhibitory control and the highest percent of children with obesity relative to the other profiles. Children with High Food Avoidant profiles (35.6%) had lower temperamental impulsivity and lower BMI z-scores relative to the other profiles, whereas children with Moderate Eating profiles (intermediary levels of all behaviors; 43.2%) had higher temperamental inhibitory control and lower anger/frustration, than other profiles.

CONCLUSIONS

Young children's eating behaviors appear to aggregate within individuals to form empirically distinct profiles reflecting food approach, food avoidance, and moderate approaches to eating that are differentiated by aspects of temperament and weight. Future work should seek to understand the extent to which health promotion and obesity prevention approaches should be tailored to take into account children's fundamental dispositions towards eating.

Predicting preschool children's emotional eating: The role of parents' emotional eating, feeding practices and child temperament

Emotional eating (EE; defined as overeating irrespective of satiety and in response to emotional states) develops within childhood, persists into adulthood, and is linked with obesity. The origins of EE remain unclear, but parental behaviours (e.g., controlling feeding practices and modelling) and child characteristics (e.g., temperament) are often implicated. To date, the interaction between these influences has not been well investigated. This study explores whether the relationship between parent and child EE is shaped by parental feeding practices, and if the magnitude of this relationship varies as a function of child temperament. Mothers (N = 244) of 3–5‐year‐olds completed questionnaires about their EE, feeding practices, their children's EE and temperament. Results showed that parental use of food to regulate children's emotions fully mediated the relationship between parent and child EE, and using food as a reward and restricting food for health reasons partially mediated this relationship. Analyses demonstrated that the mediated relationship between parent and child EE via use of food as a reward and restriction of food for health reasons varied as a function of child negative affect, where high child negative affect moderated these mediations. These findings suggest child EE may result from interrelationships between greater parent EE, use of food as a reward, restriction of food for health reasons and negative affective temperaments, but that greater use of food for emotion regulation may predict greater child EE irrespective of child temperament.

Child temperament moderates the significant mediating relationships between parent EE, certain parental feeding practices and child EE.

Parental use of food as a reward significantly mediates the relationship between parent and child EE only for children who are medium or high in negative affect.

Parental restriction of food for health reasons significantly mediates the relationship between parent and child EE only for children who are high in negative affect.

In children who are low in negative affect, parental rewarding and restrictive feeding practices do not mediate the relationships between parent and child EE.

Models of eating behaviour should consider how child characteristics can shape the expression and influence of behaviours that are known to place children at greater risk of obesogenic eating behaviours.

Fear of COVID-19 mediates the relationship between negative emotional reactivity and emotional eating

Recent studies have highlighted high levels of emotional eating during the coronavirus (COVID‐19) pandemic, but have not satisfactorily explained these changing eating patterns. Here, we tested one potential explanatory model broadly based on a biosocial model of emotional eating. Specifically, we examined the extent to which negative emotional reactivity was associated with emotional eating, as well as the mediating role of fear of COVID‐19. A total of 474 women from Romania were asked to complete measures of emotional eating, negative emotional reactivity, and fear of COVID‐19. Mediation analysis showed that higher negative emotional reactivity was significantly and directly associated with greater emotional eating. This direct relationship was also mediated by fear of COVID‐19. These results highlight one possible route through which the ongoing COVID‐19 pandemic may have resulted in elevated rates of emotional eating, though further research is needed.

Eating Behavior, Physical Activity and Exercise Training: A Randomized Controlled Trial in Young Healthy Adults

Regular physical activity (PA) is an important part of the treatment of several medical conditions, including overweight and obesity, in which there may be a weakened appetite control. Eating behaviour traits influence weight control and may be different in active and sedentary subjects. This paper reports the relationships between the time spent in sedentary behaviour and physical activity (PA) of different intensity, and eating behaviour traits in young, healthy adults. Additionally, it reports the results of a six-month-long, randomized, controlled trial to examine the effect of an exercise intervention on eating behaviour traits. A total of 139 young (22.06 ± 2.26 years) healthy adults (68.35% women) with a Body Mass Index (BMI) of 24.95 ± 4.57 kg/m² were enrolled. Baseline assessments of habitual PA were made using wrist-worn triaxial accelerometers; eating behaviour traits were examined via the self-reported questionnaires: Binge Eating, Three-Factor Eating Questionnaire-R18 and Control of Eating Questionnaire. The subjects were then randomly assigned to one of three groups: control (usual lifestyle), moderate-intensity exercise (aerobic and resistance training 3¨C4 days/week at a heart rate equivalent to 60% of the heart rate reserve (HRres) for the aerobic component, and at 50% of the 1 repetition maximum (RM) for the resistance component), or vigorous-intensity exercise (the same training but at 80% HRres for half of the aerobic training, and 70% RM for the resistance training). At baseline, sedentary behaviour was inversely associated with binge eating (r = −0.181, p < 0.05) and with uncontrolled eating (r = −0.286, p = 0.001). Moderate PA (MPA) was inversely associated with craving control (r = −0.188, p < 0.05). Moderate-to-vigorous PA (MVPA) was directly associated with binge eating (r = 0.302, p < 0.001) and uncontrolled eating (r = 0.346, p < 0.001), and inversely associated with craving control (r = −0.170, p < 0.015). Overall, PA was directly associated with binge eating (r = 0.275, p = 0.001), uncontrolled eating (r = 0.321, p < 0.001) and emotional eating (r = 0.204, p < 0.05). Additionally, only emotional eating was modified by the intervention, increasing in the vigorous-intensity exercise group (p < 0.05). In summary, we observed that time spent in sedentary behaviour/PA of different intensity is associated with eating behaviour traits, especially binge eating in young adults. In contrast, the six-month exercise intervention did not lead to appreciable changes in eating behaviour traits.

Emotion regulation mediates relationships between perceived childhood invalidation, emotional reactivity, and emotional eating

Dialectical Behavior Therapy (DBT) is informed by the biosocial model which suggests that emotional sensitivity and childhood invalidation interact to influence emotion dysregulation, leading to behavioral disorders. Although adapted DBT interventions have resulted in improved emotional eating, little research has been conducted to examine whether key aspects of the biosocial model apply to emotional eating. Adults ( N = 258) were enrolled via Amazon’s Mechanical Turk. Three separate mediation analyses were performed using Hayes’ SPSS macro. Results showed that emotion regulation difficulties mediated the relationships between biosocial variables (i.e. perceived maternal and paternal invalidation and emotional reactivity) and emotional eating.

Effect of Lifestyle Interventions in Obese Pregnant Women on the Neurocognitive Development and Anthropometrics of Preschool Children

INTRODUCTION

Maternal obesity and excessive gestational weight gain are related to adverse outcomes in women and children. Lifestyle interventions during pregnancy showed positive effects on decreasing weight gain during pregnancy, but effects on offspring's health and wellbeing are unclear. We aimed to assess the effect of lifestyle intervention programmes on offspring mental health, temperament, eating habits and anthropometric and cardiovascular measures.

METHODS

Ninety-six offspring of pregnant women with a body mass index (BMI) ≥29 kg/m2 who were randomly assigned to 3 intervention groups during pregnancy (routine antenatal care, a brochure group or a prenatal session group) and 77 offspring of pregnant women with a normal BMI (between 18.5 and 24.9 kg/m2) were used as an additional control group in this analysis. When the children were between 3 and 7 years old, anthropometric and cardiovascular measurements were conducted and various questionnaires about offspring mental health, temperament and eating habits were filled out.

RESULTS

Children of mothers who received a brochure-based lifestyle intervention programme showed significantly less surgency/extraversion compared to children of mothers who received routine antenatal care (contrast estimate = -0.36, SE = 0.15, p = 0.02, 95% CI [-6.66, -0.06]) and prenatal lifestyle intervention sessions (contrast estimate = -0.46, SE = 0.14, p < 0.01, 95% CI [-0.74, -0.18]) after adjusting for child's age, sex, offspring birth weight and mother's educational level. The lifestyle intervention could not be associated with any significant differences in offspring mental health, eating habits and anthropometric and cardiovascular characteristics. Children of mothers with a normal BMI showed less emotional problems (F(1, 156) = 5.42, p = 0.02) and internalizing (F(1, 156) = 3.04, p = 0.08) and externalizing problems (F(1, 156) = 6.10, p = 0.02) when compared to children of mothers in the obese group.

DISCUSSION/CONCLUSION

The results suggest that a brochure-based lifestyle intervention programme can affect the offspring temperament. Future follow-up studies need to investigate how these temperament-related effects may influence obesity development later in life.

Different types of parental stress and childhood obesity: A systematic review of observational studies

Different types of parental stress may influence children's health behaviors and weight. The aim of this review was to systematically examine the relationships between parental stress and child obesity. We reviewed 27 studies published through December 2018 and classified parental stress as parents' general stress, parenting role stress, and life event stress. There were positive relationships of parents' general stress and parenting role stress with child obesity among families with younger children and in longitudinal studies. The relationship between life event stress and child obesity differed by measures. We found that parenting role stress may be associated with unhealthy parenting practices. Contextual factors such as children's and parents' sex, race or ethnicity, socioeconomic status, and family structure appeared to play a moderating role in the relationship between parents' stress and child obesity, which warrant cautious interpretation. Our recommendations for future research include clarifying further the types of parental stress that influence child obesity, evaluating long-term relationship between parental stress and child obesity, and identifying possible mediating factors to support the relationship between parents' stress and child obesity. Researchers may also consider developing stress management programs for parents to address child obesity.

The influence of preschoolers' emotional and behavioural problems on obesity treatment outcomes: Secondary findings from a randomized controlled trial

BACKGROUND

Few studies have explored the influence of preschoolers' behavioural problems on obesity treatment.

OBJECTIVES

To assess emotional and behavioural problems before and after an obesity intervention and examine relationships between changes in child behaviour and changes in weight status.

METHOD

The study included 77 children (4-6 years old, 53% girls, mean body mass index [BMI] z-score of 3.0 [SD 0.6]) who participated in the More and Less Study, a randomized controlled trial. Families were randomized to a parenting program or to standard treatment. The children's heights and weights (BMI z-score, primary outcome) were measured at baseline and 12 months post baseline. Parents rated their children's behaviours (secondary outcome) on the Child Behavior Checklist (CBCL) for ages 1.5 to 5 years, a questionnaire that measures psychosocial health and functioning, encompassing emotional and behavioural problems. Changes in child behaviour during treatment were examined through paired samples t tests; the influence of child behaviour on treatment effects was examined through linear regressions.

RESULTS

Child emotional and behavioural problems significantly improved after obesity treatment. Lower scores were found for Emotional Reactivity, Sleep Problems, Affective Problems, Aggressive Behaviour, Externalizing Behaviours, Oppositional Defiant Problems, and Total Problems. Child behaviour significantly affected obesity treatment results: Attention Problems and attention deficit hyperactivity disorder (ADHD) at baseline contributed to increasing BMI z-scores, whereas Oppositional Defiant Problems, Externalizing Behaviours, and a higher number of behavioural problems predicted decreasing BMI z-scores.

CONCLUSIONS

Child behaviours at baseline influenced treatment results. Child emotional and behavioural problems improved post treatment. The results suggest that obesity treatment may help in reducing emotional distress among preschoolers.

Temperament in obesity-related research: Concepts, challenges, and considerations for future research

Temperament, defined as individual differences in reactivity and regulation, has important implications for the development of childhood obesity. Indeed, numerous studies have demonstrated associations between temperament and children's eating behavior, parent feeding practices, and children's weight outcomes. Together, these findings have significantly improved our understanding of the developmental pathways to obesity-related outcomes. However, to better our understanding of the role of temperament in children's health, greater attention to how temperament is conceptualized and measured is needed. The purpose of this paper is to review the concept and principles of temperament, describe challenges in the measurement of temperament, and provide considerations for future research aimed at understanding the relationship between temperament, food intake, and childhood obesity. Moving forward, a fuller appreciation of the complexity of the temperament concept and thoughtful selection of temperament measures may help improve predictions and identify targets for interventions aimed at decreasing the risk for obesity in childhood.

A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research

Childhood obesity has reached alarming proportions in many countries. There is consensus that both biological (especially genetic) and environmental (including psychosocial) factors contribute to weight gain and obesity in childhood. Research has identified extensive risk or predictive factors for childhood obesity from both of these domains. There is less consensus about the developmental processes or pathways showing how these risk factors lead to overweigh/obesity (OW/OB) in childhood. We outline a biopsychosocial process model of the development of OW/OB in childhood. The model and associated scholarship from developmental theory and research guide an analysis of research on OW/OB in childhood. The model incorporates biological factors such as genetic predispositions or susceptibility genes, temperament, and homeostatic and allostatic processes with the psychosocial and behavioral factors of parenting, parental feeding practices, child appetitive traits, food liking, food intakes, and energy expenditure. There is an emphasis on bidirectional and transactional processes linking child biology and behavior with psychosocial processes and environment. Insights from developmental theory and research include implications for conceptualization, measurement, research design, and possible multiple pathways to OW/OB. Understanding the developmental processes and pathways involved in childhood OW/OB should contribute to more targeted prevention and intervention strategies in childhood.

Biological and Psychosocial Processes in the Development of Children's Appetitive Traits: Insights from Developmental Theory and Research

There has been increasing concern expressed about children's food intakes and dietary patterns. These are closely linked to children's appetitive traits (such as disinhibited eating and food fussiness/neophobia). Research has examined both biological and psychosocial correlates or predictors of these traits. There has been less focus on possible processes or mechanisms associated with children's development of these traits and research that links biological and psychosocial factors. There is an absence of research that links biological and psychosocial factors. In the present article, we outline a model intended to facilitate theory and research on the development of appetitive traits. It is based on scholarship from developmental theory and research and incorporates biological factors such as genetic predispositions and temperament as well as psychosocial factors in terms of parent cognitions, feeding styles and feeding practices. Particular attention is directed to aspects such as emotional eating and feeding, self-regulation of energy intake, and non-shared family environments. We highlight the opportunity for longitudinal research that examines bidirectional, transactional and cascade processes and uses a developmental framework. The model provides a basis for connecting the biological foundations of appetitive traits to system-level analysis in the family. Knowledge generated through the application of the model should lead to more effective prevention and intervention initiatives.