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Jani R, Irwin C, Rigby R, Byrne R, Love P, Khan F, Larach C, Yang WY, Mandalika S, Knight-Agarwal CR, Naumovski N, Mallan K. Association Between Picky Eating, Weight Status, Vegetable, and Fruit Intake in Children and Adolescents: Systematic Review and Meta-Analysis. Child Obes 2024. [PMID: 38990706 DOI: 10.1089/chi.2023.0196] [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] [Indexed: 07/13/2024]
Abstract
Aim: Picky eating is a common appetitive trait reported among children and adolescents and may have detrimental effects on their weight, vegetable, and fruit intake, impacting health status. However, an updated systematic review of the literature and summary of effect estimates is required. This study aims to explore the association between picky eating with weight, vegetable and fruit intake, vegetable-only intake, and fruit-only intake. Methods: A systematic literature search of six electronic scientific databases and data extraction was performed between November 2022 and June 2023. Original articles that examined picky eating in association with weight, vegetable and/or fruit intake were included. PRISMA guidelines were followed and meta-analytical and meta-regression analyses were conducted to compute summary effect estimates and explore potential moderators. PROSPERO registration: CRD42022333043. Results: The systematic review included 59 studies of which 45 studies were included in the meta-analysis. Overall, the summarized effect estimates indicated that picky eating was inversely associated with weight [Cohen's dz: -0.27, 95% confidence interval (CI): -0.41 to -0.14, p < 0.0001]; vegetable and fruit intakes (Cohen's dz: -0.35, 95% CI: -0.45, -0.25, p < 0.0001); vegetable-only intake (Cohen's dz: -0.41, 95% CI: -0.56, -0.26, p < 0.0001), and fruit-only intake (Cohen's dz: -0.32, 95% CI: -0.45, -0.20, p < 0.0001). Picky eating was positively associated with underweight (Cohen's dz: 0.46, 95% CI: 0.20, 0.71 p = 0.0008). Conclusion: Although effect sizes were small, picky eating was inversely associated with weight, vegetable, and fruit intakes, and positively associated with underweight in children and adolescents aged birth to 17 years.
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Affiliation(s)
- Rati Jani
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Chris Irwin
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Roshan Rigby
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Penelope Love
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Farheen Khan
- College of Home Science, Nirmala Niketan, Mumbai, India
| | - Catalina Larach
- School of Health Sciences and Social Work, Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Wai Yew Yang
- Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | | | - Catherine R Knight-Agarwal
- Department of Nutrition and Dietetics, School of Health Sciences, University of Canberra, Canberra, New South Wales, Australia
| | - Nenad Naumovski
- Department of Nutrition and Dietetics, School of Health Sciences, University of Canberra, Canberra, New South Wales, Australia
| | - Kimberley Mallan
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
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Vaughan E, Spyreli E, McKinley M, Hennessy M, Woodside J, Kelly C. Exploring the world of food with families: perspectives of low-income families on factors influencing their food choices. Public Health Nutr 2024; 27:e53. [PMID: 38234109 PMCID: PMC10882528 DOI: 10.1017/s136898002400020x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE The aim of this study was to investigate the social and environmental factors involved in the food decision-making processes of families living on lower incomes on the Island of Ireland. DESIGN A qualitative design was employed for this study, using photovoice and creative mapping methods. Parents were requested to take photos and draw maps of their food environments. Interviews were then conducted with parents, using the materials produced by parents as a cue to discuss their food environments, influences and decision-making processes around food choices. SETTING The participants were interviewed online via Microsoft Teams. PARTICIPANTS The participants were parents or guardians of children between the ages of 2 and 18 who self-defined as 'living on a tight budget'. RESULTS Twenty-eight participants were recruited and interviewed for this study, including twelve parents in Northern Ireland and sixteen in the Republic of Ireland. The findings were mapped on to Bronfenbrenner's Ecological Systems Theory and showed that multiple, overlapping and intersecting factors at the individual, micro-, meso-, exo-, macro- and chrono-system were implicated in family food choices. Upstream factors in particular, including structural, policy and commercial determinants, appear to be significant drivers of behaviour. CONCLUSIONS While the findings suggest that a complex range of factors are involved in family food choices, it is clear that policy measures and regulations are needed to stave off the impacts of rising social inequality and food poverty. Health promoters should strive to find non-stigmatising interventions to bridge the nutritional divide experienced by lower-income families.
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Affiliation(s)
- Elena Vaughan
- Health Promotion Research Centre, College of Medicine, Nursing and Health Sciences, University of Galway, University Road, Galway, Republic of Ireland
| | - Eleni Spyreli
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, Northern Ireland
| | - Michelle McKinley
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, Northern Ireland
| | - Marita Hennessy
- INFANT Centre, University College Cork, Cork, Republic of Ireland
| | - Jayne Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, Northern Ireland
| | - Colette Kelly
- Health Promotion Research Centre, College of Medicine, Nursing and Health Sciences, University of Galway, University Road, Galway, Republic of Ireland
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Piloquet H, Berge B, Maigret P, Hospital V. Food fussiness is associated with family environmental factors in 1-3-year-old children: A large-scale cross-sectional study. Appetite 2024; 192:107043. [PMID: 37827198 DOI: 10.1016/j.appet.2023.107043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023]
Abstract
The effects of environmental factors on eating behavior and food intake are not well-known during toddlerhood. This is a cross-sectional study exploring the association between family environmental factors, food fussiness and poorly diversified diet. N = 1679 healthy children aged 1-3 years were recruited by general practitioners and pediatricians. Two validated questionnaires were used: the Children's Eating Behavior Questionnaire (CEBQ), which includes a food fussiness (FF) dimension, and the Infant and Child Feeding Index (ICFI) which assesses diet diversification. Factors associated with FF and diet diversification were identified by multivariate logistic regression. Of the 1356 analyzed children, 19.5% were fussy (CEBQ-FF subscore >3). Food fussiness was significantly more common in older children (25.1% of 2-3-year-olds, versus 15.2% of 1-2-year-olds; OR = 1.7) and those conceived with medical assistance (OR = 3.2). Food fussiness was also observed more often in children exposed to distractions during meals (OR = 1.8), rewarded by parents to finish meals (OR = 3.9), free to eat at will (OR = 3.7), or who ate only occasionally with the whole family (OR = 2.0). Unsatisfactory dietary diversification (ICFI≤13.8) was observed in 21.8% of children and was not significantly associated with any variable. No association was found between eating behavior and dietary diversification level. This study showed that food mistrust tends to increase with age in 1-3-year-old children. It highlighted the influence of environmental factors on FF, including family habits during meals. Assisting parents with child food fussiness may help reduce later unhealthy dietary patterns.
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Affiliation(s)
- Hugues Piloquet
- University Hospital of Nantes, Department of Pediatrics, 38 Boulevard Jean Monnet, 44093 Nantes, France.
| | - Benoit Berge
- Euraxi Pharma, 10 Rue Gutenberg, 37300 Joué-lès-Tours, France
| | - Pascal Maigret
- NHS-Menarini, Medical Department, 1 Rue Du Jura, 94630 Rungis, France
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Mudholkar A, Korostenski L, Blackwell D, Lane AE. Factors associated with the early emergence of atypical feeding behaviours in infants and young children: A scoping review. Child Care Health Dev 2023; 49:1-19. [PMID: 35301737 PMCID: PMC10084441 DOI: 10.1111/cch.13005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 03/03/2022] [Accepted: 03/12/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Atypical feeding behaviours such as significantly limited food preferences, hypersensitivity to food textures or temperatures and pocketing food without swallowing are common concerns in child health. Current reports indicate an inter-relationship between early growth, feeding problems and developmental disorders, yet little is known about how these behaviours develop in early childhood. There is also a lack of consensus about clinical definitions for atypical feeding behaviours, diagnostic thresholds and the associated precursors. To date, there has been no synthesis of the extant literature about factors associated with the early onset of atypical feeding behaviours in young children. OBJECTIVE This scoping review aimed to characterize the factors associated with the early emergence of atypical feeding behaviours in typically developing young children. METHODS CINAHL, MEDLINE, PsycINFO and Scopus databases were searched. Studies published in the last 5 years were included if they examined factors associated with the development of atypical eating behaviours in infants and young children. Of the 2137 records obtained after the search strategy was applied, 202 full-text articles were retrieved for a more detailed examination and to ensure they met the inclusion criteria. This resulted in 54 studies being included in this scoping review. RESULTS Of the 54 studies, three studies analysed precursors responsible for atypical feeding behaviours, and 51 studies discussed the factors associated with the early emergence of feeding difficulties. Multiple factors, including genetic factors, breastfeeding, late introduction of solids and lumpy foods, complementary feeding techniques, parental mental health, prematurity and child factors including temperament, were identified. There is inconsistent evidence for the associations between breastfeeding exposure and feeding difficulties. CONCLUSIONS This study identified multiple factors potentially associated with the early onset of atypical feeding behaviours in young children; however, there is insufficient evidence at this time to support specific recommendations for early feeding practices in young children. More methodologically rigorous studies are needed to extend these findings.
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Affiliation(s)
- Asmita Mudholkar
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne.,School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs
| | - Larissa Korostenski
- Department of Neonatology, John Hunter Children's Hospital, Newcastle, Australia
| | - Dianne Blackwell
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne.,School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Alison E Lane
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne
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Kerem L, Van De Water AL, Kuhnle MC, Harshman S, Hauser K, Eddy KT, Becker KR, Misra M, Micali N, Thomas JJ, Holsen L, Lawson EA. Neurobiology of Avoidant/Restrictive Food Intake Disorder in Youth with Overweight/Obesity Versus Healthy Weight. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:701-714. [PMID: 33769133 PMCID: PMC8464625 DOI: 10.1080/15374416.2021.1894944] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Avoidant/restrictive food intake disorder (ARFID) occurs across the weight spectrum, however research addressing the coexistesnce of ARFID with overweight/obesity (OV/OB) is lacking. We aimed to establish co-occurrence of OV/OB and ARFID and to characterize divergent neurobiological features of ARFID by weight. METHOD Youth with full/subthreshold ARFID (12 with healthy weight [HW], 11 with OV/OB) underwent fasting brain fMRI scan while viewing food/non-food images (M age = 16.92 years, 65% female, 87% white). We compared groups on BOLD response to high-calorie foods (HCF) (vs. objects) in food cue processing regions of interest. Following fMRI scanning, we evaluated subjective hunger pre- vs. post-meal. We used a mediation model to explore the association between BMI, brain activation, and hunger. RESULTS Participants with ARFID and OV/OB demonstrated significant hyperactivation in response to HCF (vs. objects) in the orbitofrontal cortex (OFC) and anterior insula compared with HW participants with ARFID. Mediation analysis yielded a significant indirect effect of group (HW vs. OV/OB) on hunger via OFC activation (effect = 18.39, SE = 11.27, 95% CI [-45.09, -3.00]), suggesting that OFC activation mediates differences in hunger between ARFID participants with HW and OV/OB. CONCLUSIONS Compared to youth with ARFID and HW, those with OV/OB demonstrate hyperactivation of brain areas critical for the reward value of food cues. Postprandial changes in subjective hunger depend on BMI and are mediated by OFC activation to food cues. Whether these neurobiological differences contribute to selective hyperphagia in ARFID presenting with OV/OB and represent potential treatment targets is an important area for future investigation.
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Affiliation(s)
- Liya Kerem
- Neuroendocrine Unit, Department of Medicine, Massachusetts
General Hospital and Harvard Medical School
- Division of Pediatric Endocrinology, Mass General Hospital
for Children
| | - Avery L. Van De Water
- Neuroendocrine Unit, Department of Medicine, Massachusetts
General Hospital and Harvard Medical School
- Division of Women’s Health, Department of Medicine
and Department of Psychiatry, Brigham and Women’s Hospital and Harvard
Medical School
| | - Megan C. Kuhnle
- Neuroendocrine Unit, Department of Medicine, Massachusetts
General Hospital and Harvard Medical School
| | - Stephanie Harshman
- Neuroendocrine Unit, Department of Medicine, Massachusetts
General Hospital and Harvard Medical School
| | - Kristine Hauser
- Neuroendocrine Unit, Department of Medicine, Massachusetts
General Hospital and Harvard Medical School
| | - Kamryn T. Eddy
- Eating Disorders Clinical and Research Program,
Massachusetts General Hospital, Department of Psychiatry and Harvard Medical
School
| | - Kendra R. Becker
- Eating Disorders Clinical and Research Program,
Massachusetts General Hospital, Department of Psychiatry and Harvard Medical
School
| | - Madhusmita Misra
- Neuroendocrine Unit, Department of Medicine, Massachusetts
General Hospital and Harvard Medical School
- Division of Pediatric Endocrinology, Mass General Hospital
for Children
| | - Nadia Micali
- Department of Psychiatry, Great Ormond Street Institute of
Child Health, University College London
- Department of Psychiatry, Faculty of Medicine and Child and
Adolescent Psychiatry Division, Department of Child and Adolescent Health,
University of Geneva
| | - Jennifer J. Thomas
- Eating Disorders Clinical and Research Program,
Massachusetts General Hospital, Department of Psychiatry and Harvard Medical
School
| | - Laura Holsen
- Division of Women’s Health, Department of Medicine
and Department of Psychiatry, Brigham and Women’s Hospital and Harvard
Medical School
| | - Elizabeth A. Lawson
- Neuroendocrine Unit, Department of Medicine, Massachusetts
General Hospital and Harvard Medical School
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6
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Delahunt A, Conway MC, Callaghan SL, Brien EC, Geraghty AA, Reilly SL, McDonnell CM, Mehegan J, McAuliffe FM. Maternal dietary quality during pregnancy and child appetitive traits at 5-years-old: Findings from the ROLO longitudinal birth cohort study. Appetite 2022; 179:106291. [DOI: 10.1016/j.appet.2022.106291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/16/2022] [Accepted: 08/26/2022] [Indexed: 11/02/2022]
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Early Feeding Factors and Eating Behaviors among Children Aged 1–3: A Cross-Sectional Study. Nutrients 2022; 14:nu14112279. [PMID: 35684080 PMCID: PMC9183102 DOI: 10.3390/nu14112279] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
Early nutrition plays a crucial role not only in providing essential nutrients for proper child development, but may also be an important step in creating desirable eating behaviors, which can be transmitted into adulthood. The aim of this study was to assess possible links between early feeding factors, such as breastfeeding, complementary feeding (timing and method) as well as types of complementary foods and mealtime environment during the first three months of complementary feeding and eating behaviors in children aged 1–3 years old. This cross-sectional, online survey involved 467 mothers of toddlers aged 1–3 years old from the whole of Poland. The questionnaire consisted of questions about early feeding and the Children’s Eating Behavior Questionnaire (CEBQ). The adjusted linear regression model revealed that longer duration of any breastfeeding was negatively related to enjoyment of food (EF), desire to drink (DD) and positively related to satiety responsiveness (SR) and slowness in eating (SE) subscales. Moreover, offering homemade complementary foods more often than commercial may be related to higher SR. Eating meals during distraction seems to be negatively associated with EF, and positively with DD and SE subscales. Our study highlights possible links between early feeding factors and toddlers’ eating behaviors, so further investigation, also including dietary factors, is needed.
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Hazley D, Stack M, Walton J, McNulty BA, Kearney JM. Food neophobia across the life course: Pooling data from five national cross-sectional surveys in Ireland. Appetite 2022; 171:105941. [DOI: 10.1016/j.appet.2022.105941] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 12/12/2022]
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‘Fussy eating’ and feeding dynamics: School children's perceptions, experiences, and strategies. Appetite 2022; 173:106000. [DOI: 10.1016/j.appet.2022.106000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/30/2022] [Accepted: 03/04/2022] [Indexed: 11/02/2022]
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Chilman L, Kennedy-Behr A, Frakking T, Swanepoel L, Verdonck M. Picky Eating in Children: A Scoping Review to Examine Its Intrinsic and Extrinsic Features and How They Relate to Identification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9067. [PMID: 34501656 PMCID: PMC8431657 DOI: 10.3390/ijerph18179067] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
The health benefits and importance of family mealtimes have been extensively documented. Picky eating can impact this complex activity and has numerous extrinsic (or external) and intrinsic (or internal) features. Occupational therapists work with children and their families by looking at both intrinsic and extrinsic influences and are therefore well-placed to work within this context. This scoping review comprises a comprehensive search of key health industry databases using pre-determined search terms. A robust screening process took place using the authors pre-agreed inclusion and exclusion criteria. There were 80 studies that met the inclusion criteria, which were then mapped using content analysis. The most common assessments used to identify picky eating relied on parental reports and recall. Often additional assessments were included in studies to identify both the intrinsic and extrinsic features and presentation. The most common reported intrinsic features of the child who is a picky eater included increased sensitivity particularly to taste and smell and the child's personality. Extrinsic features which appear to increase the likelihood of picky eating are authoritarian parenting, rewards for eating, and pressuring the child to eat. Most commonly reported extrinsic features that decrease the likelihood of picky eating are family meals, responsive parents, and involving the child in the preparation of food. In conclusion, there is a lack of published papers addressing the role of occupational therapists in the assessment and identification of picky eating in children. There appears to be a complex interplay between intrinsic and extrinsic features which impact caregiver responses and therefore on the picky eater.
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Affiliation(s)
- Laine Chilman
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Locked Bag 4 Maroochydore, Maroochydore DC, Sunshine Coast, QLD 4558, Australia ; (A.K.-B.); (L.S.); (M.V.)
| | - Ann Kennedy-Behr
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Locked Bag 4 Maroochydore, Maroochydore DC, Sunshine Coast, QLD 4558, Australia ; (A.K.-B.); (L.S.); (M.V.)
- School of Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia
| | - Thuy Frakking
- Research Development Unit, Caboolture Hospital, Metro North Hospital & Health Service, Herston, QLD 4510, Australia;
- Centre for Clinical Research, School of Medicine, The University of Queensland, Herston, QLD 4029, Australia
| | - Libby Swanepoel
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Locked Bag 4 Maroochydore, Maroochydore DC, Sunshine Coast, QLD 4558, Australia ; (A.K.-B.); (L.S.); (M.V.)
| | - Michele Verdonck
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Locked Bag 4 Maroochydore, Maroochydore DC, Sunshine Coast, QLD 4558, Australia ; (A.K.-B.); (L.S.); (M.V.)
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Coskun O, Kipoglu O, Karacabey BN, Kilic MA, Simsek Ceran D, Yildiz EP, Aydınlı N, Caliskan M. Evaluation of eating behaviors in childhood epilepsy with centrotemporal spikes: Case-control study. Epilepsy Behav 2021; 120:108029. [PMID: 33992962 DOI: 10.1016/j.yebeh.2021.108029] [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: 02/10/2021] [Revised: 04/14/2021] [Accepted: 04/25/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Psychosocial and behavioral disorders have been reported in childhood epilepsy with centrotemporal spikes (CECTS). We aimed to identify the symptoms of eating disorders in CECTS. METHODS Patients with CECTS were recruited from the pediatric neurology outpatient clinic between September 2019 and July 2020. The Children's Eating Behaviour Questionnaire (CEBQ) was administered to 39 patients and 31 controls. Patients' scores were compared with those of healthy subjects. RESULTS There was no significant difference between the CEBQ of patients with CECTS and the control group (p > 0.05). There was no significant difference between the BMI of the patients with CECTS and the control group. In the patient group with CECTS, no significant difference was found in terms of CEBQ according to the antiepileptic drug used and EEG findings (p > 0.05). CONCLUSION No difference was found in the eating habits of patients with CECTS compared with the healthy control group.
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Affiliation(s)
- Orhan Coskun
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey
| | - Osman Kipoglu
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey
| | | | | | | | - Edibe Pembegul Yildiz
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey; Istanbul University Institute of Child Health, Istanbul, Turkey.
| | - Nur Aydınlı
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey
| | - Mine Caliskan
- Department of Pediatric Neurology, Istanbul Medical Faculty, Turkey; Istanbul University Institute of Child Health, Istanbul, Turkey
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Loochi SA, Demol S, Nagelberg N, Lebenthal Y, Phillip M, Yackobovitch-Gavan M. Gonadotropin releasing hormone analogue therapy in girls with idiopathic precocious puberty/early-fast puberty: dynamics in adiposity indices, eating habits and quality of life. J Pediatr Endocrinol Metab 2021; 34:373-383. [PMID: 33609438 DOI: 10.1515/jpem-2020-0471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/02/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND The impact of gonadotropin-releasing-hormone-analogue (GnRHa) treatment on weight and body composition is controversial. Exploring the nutritional, psychological patterns of this population may aid to clarify this propensity to gain weight. This prospective observational study aimed to evaluate longitudinal changes in adiposity, nutrition and quality of life in girls with central precocious/early-fast puberty (CPP/EFP) during GnRHa treatment. METHODS Thirty-two GnRHa-treated girls with CPP/EFP and 27 prepubertal girls (7-10 years) were included in the analysis. Outcome measures assessed at baseline for CPP/EFP and the control groups and during up to two years of GnRHa treatment for the CPP/EFP group, included anthropometrics, body-composition, basal-metabolic-rate (BMR), 3-day food-diaries, child eating-behavior questionnaire, and pediatric quality-of-life questionnaire (PedsQL). RESULTS Girls with CPP/EFP had higher pretreatment BMI-SDS, fat percentages, waist circumference and waist-per-height (p<0.01 for all), and lower psychosocial functioning than controls (p<0.05). Changes in anthropometric and body composition measurements indicated a gradual increase in adiposity and a decrease in muscle mass (p<0.001 for all). Dynamics in body composition could not be explained by the participants' self-reported dietary patterns and physical activity levels or by the measured BMR, which revealed an adequate and relatively low energy intake as compared to energy requirements. A gradual decline in physical functioning (PedsQL) after one and two years of GnRHa treatment was observed (p<0.001). CONCLUSIONS Our findings highlight the need for comprehensive surveillance in girls with CPP/EFP. Dynamics in weight status and body composition during GnRHa treatment indicate the need for tailored nutritional and physical activity counseling aimed at preventing obesity.
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Affiliation(s)
- Shiran Abargil Loochi
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Demol
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Nessia Nagelberg
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Yael Lebenthal
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Phillip
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Yackobovitch-Gavan
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Jesse Z and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
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13
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Warkentin S, Carnell S, Oliveira A. Leptin at birth and at age 7 in relation to appetitive behaviors at age 7 and age 10. Horm Behav 2020; 126:104842. [PMID: 32841621 DOI: 10.1016/j.yhbeh.2020.104842] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 08/05/2020] [Accepted: 08/14/2020] [Indexed: 12/31/2022]
Abstract
Leptin contributes to the control of food intake and energy balance. However, its association with appetitive behaviors during childhood is not well understood. We aimed to investigate the association between leptin, assessed at birth and at 7 years of age (y), and appetitive behaviors assessed at 7 and 10 y. Children from a Portuguese cohort with assessment of leptin levels at birth from umbilical cord blood (n = 645) and at 7 y from venous blood samples (n = 587), were included. The Children's Eating Behavior Questionnaire assessed appetitive behaviors at 7 and 10 y. Weight and height were measured at 7 and 10 y to derive BMI z-scores (BMIz). A series of Generalized Linear Models tested relationships between leptin and appetitive behaviors, adjusting for potential confounders (maternal age, education, pre-pregnancy BMI, smoking during pregnancy, child physical activity and child BMIz), and interaction terms for child sex and child BMIz. At 7 y, 116 boys and 118 girls were classified as having overweight/obesity, and these children had higher leptin levels. Cross-sectional analyses using the 7 y data produced the strongest results. Higher leptin at 7 y was significantly associated with lower scores on Satiety Responsiveness, Food Fussiness and Slowness in Eating, and higher scores on Food Responsiveness, Enjoyment of Food and Emotional Overeating at 7 y. Only the association with Emotional Overeating remained when adjusting for child BMIz. Significant interaction effects between child sex and leptin were found for appetite at 7 y, such that higher leptin was associated with higher Food Responsiveness (p < 0.001) and lower Slowness in Eating (p < 0.001) to a greater extent among boys. Umbilical cord blood leptin was not associated with appetitive behaviors at 7 or 10 y. Our results show that leptin levels are positively associated with food approach and negatively with food avoidant behaviors. Associations were more consistent in cross-sectional analyses (at 7 y), were largely dependent on child weight, and tended to be stronger among boys. Our findings support a role for leptin in affecting appetite, with potential consequences for current weight status and future weight gain.
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Affiliation(s)
- Sarah Warkentin
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal.
| | - Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Warkentin S, Santos AC, Oliveira A. Associations of appetitive behaviors in 7-year-old children with their cardiometabolic health at 10 years of age. Nutr Metab Cardiovasc Dis 2020; 30:810-821. [PMID: 32143895 DOI: 10.1016/j.numecd.2020.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Atherosclerosis begins early in life, thus optimal cardiovascular health needs to be promoted early. We investigated whether appetitive behaviors among 7 year olds are associated with their cardiometabolic health years later. METHODS AND RESULTS A sample of 2951 children from a Portuguese birth cohort was analyzed. The Children's Eating Behavior Questionnaire assessed eating behaviors, and a measure of cardiometabolic risk (higher risk group: those in the upper quartile of triglycerides, homeostatic model assessment-insulin resistance, waist circumference and systolic blood pressure and in the lower quartile of high-density lipoprotein cholesterol z-scores) was created. Linear and logistic regressions were run. Children with more food avoidant behaviors had lower cardiometabolic risk (Satiety Responsiveness - boys: OR = 0.39, 95% CI 0.16; 0.93, girls: OR=0.37, 95% CI 0.17; 0.82 and Slowness in eating - boys: OR = 0.49, 95% CI 0.25; 0.95, girls: OR = 0.49, 95% CI 0.27; 0.91). Food approach behaviors (Food responsiveness (CEBQ-FR), Enjoyment of food (CEBQ-EF) and Emotional overeating (CEBQ-EOE)) increased cardiometabolic risks (e.g. CEBQ-FR: boys: OR = 2.50, 95% CI 1.45; 4.32, girls: OR = 2.33, 95% CI 1.46; 3.71). CEBQ-EF had stronger effects in boys, while CEBQ-EOE was positively associated with cardiometabolic risk among girls. When adjusting for BMIz at 7y, associations did not remain significant. Appetitive behaviors were also associated with isolated cardiometabolic parameters; the strongest association being with waist circumference. CONCLUSIONS Appetitive behaviors at 7-years are associated with cardiometabolic risk at age 10. While 'food avoidant' behaviors protect against cardiometabolic risk and 'food approach' behaviors increase cardiometabolic risk, these associations are largely dependent of child's adiposity.
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Affiliation(s)
- Sarah Warkentin
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal.
| | - Ana Cristina Santos
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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15
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Challenges in child and adolescent nutrition. Public Health Nutr 2019; 22:1-2. [PMID: 30595139 DOI: 10.1017/s1368980018003646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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