The relationship between appetite and food preferences in British and Australian children

Associations between child eating behaviors with eating patterns and diet quality in preschool-aged children

Childhood eating behaviors are associated with weight status and laboratory assessments of dietary intake. However, little is known about how eating behaviors relate to the eating patterns and diet quality of children from marginalized populations when assessed in their natural environments. Therefore, we examined the association of food avoidant (e.g., food fussiness and satiety responsiveness) and food approach (e.g., food responsiveness and enjoyment of food) eating behaviors with children's meal size, eating frequency, and diet quality. We analyzed data from 61 predominately low-income Hispanic/Latinx preschool-aged children. Caregivers completed the Childhood Eating Behavior Questionnaire and two 24-h dietary recalls. From the recalls, we calculated meal size, eating frequency, and modified Diet Quality Index Scores (DQIS), and evaluated associations with eating behaviors using multivariable linear models. We also explored the relationship between eating behaviors and DQIS components. Food-avoidant subscales were associated with smaller meals and satiety responsiveness were associated with decreased snack frequency. Food approach subscales were not associated with meal size or eating frequency. Both food-avoidant and food-approach behaviors were associated with components of diet quality and caloric beverages outside of meal and snacks. These findings can inform future research on the relationship between child eating behaviors and dietary intake so that we can develop more tailored and effective interventions to promote healthy eating habits for low-income, Hispanic/Latinx preschool-aged children.

The influence of early and current feeding practices, eating behaviors, and screen time on dietary patterns in Polish toddlers - A cross-sectional study

Early nutrition has an important influence on a child's proper health and development, and understanding factors that may be related to desirable dietary patterns is key to improving the diet of future generations. The aim of this study was to assess whether early and current feeding practices, eating behaviors, and screen time viewing are associated with toddlers' dietary patterns. A cross-sectional sample of 467 mothers of toddlers (aged 1 year to 3) was surveyed between 2020 and 2022. Food consumption was evaluated by the Food Frequency Questionnaire (FFQ). The k-means algorithm was used to define dietary patterns on the basis of data collected from the FFQ and mealtime environment patterns, based on the data about practices during meals consumption. The odds of following a prohealth dietary pattern among early feeding factors were lower when infants ate commercial complementary foods more often. Distracted mealtime environment pattern increased the odds of following a non-eaters pattern, and commercial complementary foods pattern increased the odds of following a processed pattern. Currently, the odds of following a processed dietary pattern were higher when children were not breastfed and had higher screen time. Toddlers who ate during distraction and were more fussy had lower odds of following a prohealth dietary pattern, whereas higher enjoyment of food and satiety responsiveness increased the odds. The results indicate the need to increase parents' awareness about the importance of early factors in establishing dietary patterns.

The association between appetite and eating behaviors among Chinese female university students

Background

Young females are at a higher risk of developing unhealthy eating behaviors. This study investigated the relationship between appetitive traits and eating behaviors among female university students.

Methods

The study participants were 520 female university students from a public university in Eastern China. Appetitive traits were assessed using the Chinese version of the Adult Eating Behavior Questionnaire (C-AEBQ). Data on eating behaviors, including food intake frequency, meal regularity, and dieting behavior, were collected using self-administered questionnaires. The body mass index (BMI) was calculated using self-reported data. Pearson's and Spearman's correlations were used to correlate appetitive traits with BMI and eating behaviors. Latent profile analysis (LPA) was used to identify different appetitive patterns, and logistic regression was used to analyze the relationship between different appetitive patterns and eating behaviors.

Results

Two food-approach traits (food enjoyment and emotional over-eating) were positively correlated with BMI, while two food-avoidance traits (slowness in eating and satiety responsiveness) showed negative correlations. Food responsiveness was linked to a higher intake of delivered food, spicy food, and sugar-sweetened beverages, whereas satiety responsiveness was correlated with more frequent meal skipping. The LPA identified four appetitive patterns: food approachers, food approachers with emotional under-eating, food avoiders, and food avoiders with emotional over-eating. Food avoiders had significantly lower BMI than the other groups. Compared to food approachers, food avoiders skipped breakfast more frequently, and food avoiders with emotional over-eating skipped both breakfast and lunch more often. After adjusting for BMI, appetitive patterns showed no significant relationship with dieting behavior.

Conclusion

Among female university students, appetitive patterns correlated with eating behaviors, and students with food-avoidance patterns had a higher risk of meal irregularity. These findings emphasize the importance of implementing trait- and pattern-specific approaches to promote healthy eating behaviors among female university students.

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.

Repeated exposure to models' positive facial expressions whilst eating a raw vegetable increases children's consumption of the modelled vegetable

Exposing children to adults eating a raw vegetable with positive facial expressions ('positive modelling') increases children's consumption of the modelled vegetable. However, whether repeated versus a single exposure to positive modelling enhances this effect, and whether it generalises to a non-modelled vegetable, remains to be examined. Hence, this study examined the effect of a single exposure, versus repeated, exposure to positive modelling on children's acceptance and intake of a modelled and non-modelled vegetable. Children aged 5-6 years (N = 153; 81 males, 72 females) were randomised to one of three conditions in which they had i) a single or ii) repeated exposure to a video of adults eating raw broccoli with positive facial expressions or iii) were exposed to a no-food control video. Children's acceptance (measured as willingness to try and number of tastes), intake and liking of a modelled (raw broccoli) and non-modelled vegetable (raw mangetout) were measured. Children had greater raw broccoli consumption and liking if they had received repeated exposure to positive modelling, compared to children who had received a single exposure, but not compared to children in the control condition. Children's mangetout intake was greater in the single (versus repeated) positive condition, but this effect was not dependent on time. There was no effect on children's vegetable acceptance. Repeatedly exposing children to adults enjoying a vegetable encourages children's intake of the modelled vegetable in comparison to a single exposure. Thus, repeated exposure to others' food enjoyment may be a practical and useful strategy to encourage children's vegetable consumption.

[Adherence to the Mediterranean diet and eating behaviour in Spanish schoolchildren]

Introduction

Introduction: eating behaviors may modulate or influence diet quality and the degree of adherence to the Mediterranean diet in children and adolescents. Aims: to investigate the association between diet quality and eating behavior in a group of Spanish schoolchildren. Methods: descriptive cross-sectional study of 283 Spain schoolchildren aged six to 16. Each subject was assessed using the KIDMED questionnaire for adherence to the Mediterranean diet and the Children's Eating Behaviour Questionnaire (CEBQ) questionnaire to assess eating behavior. Results: of the sample, 12.80 % had low adherence to the Mediterranean diet, 59.80 % had poor adherence, 59.80 % could be improved, and 27.40 % had high adherence. When relating eating behavior to dietary quality, it was found that, generally, schoolchildren with greater enjoyment of food and less demand for food have double the adherence to the Mediterranean diet due to almost twice the consumption of vegetables, nuts, and fish, and a lower intake of low-quality processed foods (sweets). The response to satiety and the speed of ingestion also played an important role in food choices. Conclusions: eating behaviors may play an essential role in the quality of school children's diets highlighting the enjoyment and acceptance or rejection of food. Given the bidirectional nature of the effects between eating behaviors and diet quality, the joint analysis may be the basis for future research with the aim of a better nutritional approach from the earliest ages.

Food fussiness is associated with family environmental factors in 1-3-year-old children: A large-scale cross-sectional study

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.

An epigenome-wide association study of child appetitive traits and DNA methylation

The etiology of childhood appetitive traits is poorly understood. Early-life epigenetic processes may be involved in the developmental programming of appetite regulation in childhood. One such process is DNA methylation (DNAm), whereby a methyl group is added to a specific part of DNA, where a cytosine base is next to a guanine base, a CpG site. We meta-analyzed epigenome-wide association studies (EWASs) of cord blood DNAm and early-childhood appetitive traits. Data were from two independent cohorts: the Generation R Study (n = 1,086, Rotterdam, the Netherlands) and the Healthy Start study (n = 236, Colorado, USA). DNAm at autosomal methylation sites in cord blood was measured using the Illumina Infinium HumanMethylation450 BeadChip. Parents reported on their child's food responsiveness, emotional undereating, satiety responsiveness and food fussiness using the Children's Eating Behaviour Questionnaire at age 4-5 years. Multiple regression models were used to examine the association of DNAm (predictor) at the individual site- and regional-level (using DMRff) with each appetitive trait (outcome), adjusting for covariates. Bonferroni-correction was applied to adjust for multiple testing. There were no associations of DNAm and any appetitive trait when examining individual CpG-sites. However, when examining multiple CpGs jointly in so-called differentially methylated regions, we identified 45 associations of DNAm with food responsiveness, 7 associations of DNAm with emotional undereating, 13 associations of DNAm with satiety responsiveness, and 9 associations of DNAm with food fussiness. This study shows that DNAm in the newborn may partially explain variation in appetitive traits expressed in early childhood and provides preliminary support for early programming of child appetitive traits through DNAm. Investigating differential DNAm associated with appetitive traits could be an important first step in identifying biological pathways underlying the development of these behaviors.

Biobehavioral susceptibility for obesity in childhood: Behavioral, genetic and neuroimaging studies of appetite

Modern food environments are conducive to overeating and weight gain, but not everyone develops obesity. One reason for this may be that individuals differ in appetitive characteristics, or traits, that manifest early in life and go on to influence their behavioral susceptibility to gain and maintain excess weight. Classic studies showing that eating behavior in children can be measured by behavioral paradigms such as tests of caloric compensation and eating in the absence of hunger inspired the development and validation of psychometric instruments to assess appetitive characteristics in children and infants. A large body of evidence now suggests that food approach traits increase obesity risk, while food avoidant traits, such as satiety responsiveness, decrease obesity risk. Twin studies and genetic association studies have demonstrated that appetitive characteristics are heritable, consistent with a biological etiology. However, family environment factors are also influential, with mounting evidence suggesting that genetic and environmental risk factors interact and correlate with consequences for child eating behavior and weight. Further, neuroimaging studies are revealing that individual differences in responses to visual food cues, as well as to small tastes and larger amounts of food, across a number of brain regions involved in reward/motivation, cognitive control and other functions, may contribute to individual variation in appetitive behavior. Growing evidence also suggests that variation on psychometric measures of appetite is associated with regional differences in brain structure, and differential patterns of resting state functional connectivity. Large prospective studies beginning in infancy promise to enrich our understanding of neural and other biological underpinnings of appetite and obesity development in early life, and how the interplay between genetic and environmental factors affects appetitive systems. The biobehavioral susceptibility model of obesity development and maintenance outlined in this narrative review has implications for prevention and treatment of obesity in childhood.

Weight trajectories from birth to 5 years and child appetitive traits at 7 years of age: a prospective birth cohort study

Rapid prenatal and postnatal weight gain seem to alter appetite regulation and hypothalamic functions through different pathways; however, little is known on how early life growth trajectories may influence appetitive traits in school-age. We aimed to explore the associations between weight trajectories from birth to 5 years and appetitive traits at 7. Participants were from the Generation XXI birth cohort (n 3855). Four weight trajectories were investigated: 'normal weight gain' (closely overlaps the 50th percentile in the weight-for-age curve), 'weight gain during infancy' (low birth weight and weight gain mainly during infancy), 'weight gain during childhood' (continuous weight gain since birth) and 'persistent weight gain' (always showing higher weight than the average). Appetitive traits were assessed through the Children's Eating Behaviour Questionnaire. Associations were tested using generalised linear models, adjusted for maternal and child characteristics. Compared with 'normal weight gain', those in the other growth trajectories showed greater enjoyment of food and eating in response to food stimuli (i.e. Food Responsiveness) but were less able to compensate for prior food intake and ate faster at 7 (i.e. less Satiety Responsiveness and Slowness in Eating). Also, those with 'weight gain during infancy' showed to have greater Emotional Overeating and less Emotional Undereating and were fussier. Associations were stronger if greater weight gain occurred during infancy. Early infancy seems to be a sensitive period in the development of later appetitive traits. The control of rapid growth during infancy, besides strategies focused on the overall environment where children are living, is necessary.

Reciprocal associations between parental feeding practices and child eating behaviours from toddlerhood to early childhood: bivariate latent change analysis in the Gemini cohort

BACKGROUND

Parental feeding practices (PFPs) are a key component of a child's food environment. Parent-child feeding relationships are hypothesised to be bidirectional; however, to date, few large prospective studies have examined this, instead focussing on unidirectional relationships. As such, the direction of relationships between PFPs and children's eating behaviours remains unclear.

METHODS

Data were from Gemini, a population-based sample of children born in England and Wales in 2007. Children's eating behaviours and PFPs were measured at 15/16 months and 5 years using validated psychometric measures (n = 1,858 children). Bivariate Latent Change Score Modelling was used to examine the nature of relationships between PFPs and children's eating behaviours at 15/16 months and 5 years. Models were adjusted to account for clustering of twins within families and for sex of the child, socioeconomic status, gestational age and age of the child at measurement time points.

RESULTS

A reciprocal relationship was observed between instrumental feeding and emotional overeating, with greater instrumental feeding predicting greater increases in emotional overeating (β = .09; 0.03-0.15; p = .004) and vice versa (β = .09; 0.03-0.15; p = .005). Reciprocity was also observed between encouragement to eat nutritious foods and children's enjoyment of food, with greater encouragement predicting greater increases in enjoyment of food (β = .08; 0.02-0.13; p = .006) and vice versa (β = .07; 0.02-0.11; p = .003). Parent-child associations and child-parent associations were also observed.

CONCLUSION

These findings are consistent with the hypothesis that certain feeding practices are used as a 'natural' response to a child expressing a greater interest in and enthusiasm for food, but at the same time, such practices impact the development of eating behaviours by nurturing and encouraging the expression of higher emotional overeating and greater enjoyment of food in preschool years. The findings provide important insights into the PFPs and eating behaviour traits that could be targeted as part of a tailored feeding intervention to support parents of children during the preschool formative years.

Associations of appetitive traits with growth velocities from infancy to childhood

Several studies have reported associations between appetitive traits and weight gain during infancy or childhood, but none have directly compared these associations across both age periods. Here, we tested the associations between appetitive traits and growth velocities from birth to childhood. Appetitive trait data were collected using the Children's Eating Behaviour Questionnaire (CEBQ) in 149 children from the Cambridge Baby Growth Study at age 9-17 years. These participants also provided anthropometric measurements during infancy (birth, 3, 12, 18, and 24 months) and childhood (5 to 11 years). Standardized growth velocities (in weight, length/height, BMI, and body fat percentage) for 0-3 months, 3-24 months, and 24 months to childhood were estimated using individual linear-spline models. Associations between each of the eight CEBQ traits and each growth velocity were tested in separate multilevel linear regression models, adjusted for sex, age at CEBQ completion, and the corresponding birth measurement (weight, length, BMI, or body fat percentage). The three food-approach traits (food responsiveness, enjoyment of food and emotional overeating) were positively associated with infancy and childhood growth velocities in weight, BMI, and body fat percentage. By contrast, only one of the food-avoidant traits, satiety responsiveness, was negatively associated with all growth velocities. Significant associations were mostly of similar magnitude across all age periods. These findings reveal a broadly consistent relationship between appetitive traits with gains in weight and adiposity throughout infancy and childhood. Future interventions and strategies to prevent obesity may benefit from measuring appetitive traits in infants and children and targeting these as part of their programs.

Appetitive traits and food groups consumption in school-aged children: prospective associations from the Generation XXI birth cohort

PURPOSE

Appetite can influence children's dietary choices; however, this relationship in school-aged children is still unclear. We aimed to explore the prospective associations between child appetitive traits at age 7 and food consumption at 10 years of age.

METHODS

The study included 3860 children from the Generation XXI birth cohort, recruited in 2005/2006 in Porto, Portugal. The Children's Eating Behaviour Questionnaire was used to evaluate children's appetitive traits at 7 years. Food consumption was measured at 10 years through a validated Food Frequency Questionnaire. Logistic regression models were performed and adjusted for possible confounders.

RESULTS

Children with greater Enjoyment of Food at 7 years were 36% more likely to eat fruits ≥ 2 times/day and 54% more likely to eat vegetables > 2.5 times/day at 10 years compared to those with less frequent consumption. Children who ate more in response to negative emotions had higher odds of consuming energy-dense foods (OR = 1.33; 99% CI 1.13-1.58) and salty snacks (OR = 1.28; 99% CI 1.08-1.51) 3 years later. Those with less ability to adjust intake (higher Satiety Responsiveness) and more selective about foods (higher Food Fussiness) at 7 years were less likely to consume vegetables frequently, and were more likely to consume energy-dense foods and sugar-sweetened beverages.

CONCLUSIONS

Children's appetitive traits at 7 years were associated with the consumption of several food groups at 10 years of age. Eating more in response to negative emotions (Emotional Eating), with less ability to adjust intake (Satiety Responsiveness) and more food selectivity (Food Fussiness) were associated with worse dietary choices (in general, lower fruit and vegetables, and higher energy-dense foods and sugar-sweetened beverages consumption).

LEVEL OF EVIDENCE

Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

Change in preference for vegetables and their perceptual attributes as a function of age and pickiness

Preference for vegetables is influenced by various factors, including demographic, psychological, socio-environmental, and genetic factors. This study confirmed that age, pickiness, and perceptual attributes were predictors of preference for vegetables and examined how preference for vegetables and their perceptual attributes varies with age and pickiness. Children (8-14 years, n = 420), youth (15-34 years, n = 569), middle-aged adults (35-64 years, n = 726), and older adults (65-85 years, n = 270) were asked which vegetables they liked (or disliked) and which perceptual attributes of each vegetable they liked (or disliked). On the basis of their responses, an overall preference score and a preference sub-score for each perceptual attribute were calculated. Participants in each age group were classified into four statuses (non-, mild, moderate, and severe) according to their pickiness scores. Multiple regression analysis revealed that age and preference sub-scores for eight perceptual attributes (sweetness, sourness, bitterness, umami, pungency, orthonasal aroma, texture, and appearance) were positive predictors of overall preference score and that pickiness score and four perceptual attributes (saltiness, astringency, retronasal aroma, and aftertaste) were negative predictors. In addition, overall preference score and preference sub-scores for perceptual attributes other than saltiness increased with increasing age group and decreasing picker status; however, preference sub-scores for at least one of the six perceptual attributes (bitterness, astringency, pungency, orthonasal aroma, retronasal aroma, and aftertaste) exhibited negative values in children, youth, and pickers (mild, moderate, and severe). The increase in preference for these perceptual attributes might be an indicator of the adultization of food perception and the expansion of food acceptance.

An epigenome-wide association study of child appetitive traits and DNA methylation

Childhood appetitive traits are consistently associated with obesity risk, and yet their etiology is poorly understood. Appetitive traits are complex phenotypes which are hypothesized to be influenced by both genetic and environmental factors, as well as their interactions. Early-life epigenetic processes, such as DNA methylation (DNAm), may be involved in the developmental programming of appetite regulation in childhood. In the current study, we meta-analyzed epigenome-wide association studies (EWASs) of cord blood DNAm and early-childhood appetitive traits. Data were from two independent cohorts: the Generation R Study (n=1,086, Rotterdam, the Netherlands) and the Healthy Start study (n=236, Colorado, USA). DNAm at autosomal methylation sites in cord blood was measured using the Illumina Infinium HumanMethylation450 BeadChip. Parents reported on their child's food responsiveness, emotional undereating, satiety responsiveness and food fussiness using the Children's Eating Behaviour Questionnaire at age 4-5 years. Multiple regression models were used to examine the association of DNAm (predictor) at the individual site- and regional-level (using DMRff) with each appetitive trait (outcome), adjusting for covariates. Bonferroni-correction was applied to adjust for multiple testing. There were no associations of DNAm and any appetitive trait at the individual site-level. However, at the regional level, we identified 45 associations of DNAm with food responsiveness, 7 associations of DNAm with emotional undereating, 13 associations of DNAm with satiety responsiveness, and 9 associations of DNAm with food fussiness. This study shows that DNAm in the newborn may partially explain variation in appetitive traits expressed in early childhood and provides preliminary support for early programming of child appetitive traits through DNAm. Investigating differential DNAm associated with appetitive traits could be an important first step in identifying biological pathways underlying the development of these behaviors.

Measurement is the foundation of research and theory on children's eating behaviours: Current issues and directions for progress

Eating behaviours affect food intakes and are involved in the aetiology of obesity. There has been impetus to translate findings about children's eating behaviour into intervention and policy programs. However, measurement limitations have hindered our capacity to understand and influence children's eating behaviours. In the present paper we provide an overview of some of the key methodological and measurement issues facing the field of children's eating behaviours and highlight implications for research and health promotion. Drawing on insight from parallel issues that occur in the measurement of early social and emotional development, we examine two overlapping themes in children's (aged 0-∼12 years) eating behaviours (Somaraki et al., 2021) measurement issues related to validity and reliability, and (Steinsbekk & Wichstrøm, 2015) associated methodological challenges, such as contextual influences and the importance of designing studies that use multiple informants and multiple methods. We then suggest insights and strategies aimed at advancing approaches to measurement of children's eating behaviours. To progress our understanding of children's eating behaviours, we conclude that a range of psychometrically sound, fit-for-purpose measurement instruments and procedures are needed for use in multi-trait, multi-method, multi-informant studies in a range of populations and contexts.

Examining the associations between mothers' motivation to regulate their own eating behaviors, food parenting practices and perceptions of their child's food responsiveness

Based on the Self-Determination Theory, this study examined: 1) how mothers' autonomous and controlled motivation to regulate their own eating behaviors relate to their food parenting practices, and 2) whether and how child food responsiveness (i.e., reactivity and attraction to food) interact with mothers' motivation to predict maternal food parenting practices. Participants were 296 French Canadian mothers of at least one child aged between 2 and 8 years old. Results of partial correlation analyses (controlling for demographics and controlled motivation) showed that maternal autonomous motivation to regulate their own eating behaviors was positively related to autonomy-promoting (i.e., child involvement) and structure-based (i.e., modeling, creating a healthy environment, monitoring) food parenting practices. In contrast, controlling for demographics and autonomous motivation, maternal controlled motivation was positively associated with food-related practices based on coercive control (i.e., the use of food to regulate the child's emotions, the use of food as a reward, pressure to eat, restriction for weight reasons, and restriction for health reasons). Furthermore, the child's food responsiveness was found to interact with mothers' motivation to regulate their own eating behaviors in the prediction of maternal food parenting practices such that mothers with high autonomous motivation or low controlled motivation were found to react with more structure-based (i.e., creating a healthy environment) and autonomy-based (i.e., child involvement) practices, as well as less controlling practices (i.e., the use of food to regulate the child's emotions), to a child who is highly responsive to food. In conclusion, findings suggest that guiding mothers toward developing a more autonomous and less controlled motivation to regulate their own eating behaviors might help them adopt more autonomy-promoting and structure-based and less controlling feeding practices, especially with children who are highly responsive to food.

Eating behaviors, dietary patterns and weight status in emerging adulthood and longitudinal associations with eating behaviors in early childhood

Background

Eating behaviors may contribute to differences in body weight and diet over time. Our study aims to examine how eating behaviors of young adults relate to their current weight status and dietary patterns and to explore longitudinal associations with eating behaviors in early childhood.

Methods

Study participants are young adults (n = 698) taking part in the Quebec Longitudinal Study of Child Development. At age 22, eating behaviors were assessed using the Adult Eating Behavior Questionnaire. Dietary patterns were derived from information collected by food frequency questions. Weight status was based on self-reported data. Information on eating behaviors in childhood had been collected when participants were 2.5 to 6 years old. Pearson’s correlations were used to determine associations between adult eating behaviors and body mass index. Simple and multivariate linear regression analyses were used to examine associations between eating behaviors and dietary patterns at age 22, and longitudinal associations with behaviors in early childhood. Ordinal logistic regression analyses were used to assess associations between overeating and fussy eating in childhood and weight status at age 22.

Results

Body mass index was positively correlated with Emotional overeating, Enjoyment of food, and Food responsiveness and negatively correlated with Satiety responsiveness, Emotional undereating, Slowness in eating and Hunger. A Healthy dietary pattern was positively associated with both Enjoyment of food and Hunger, and negatively associated with Food fussiness. Inversely, a Beverage-rich dietary pattern was negatively associated with Enjoyment of food and positively associated with Food fussiness. A Protein-rich pattern was positively associated with Enjoyment of food, while a High energy density pattern was positively associated with Food fussiness. Young adults with higher scores for fussy eating in early childhood were more likely to manifest Food fussiness and Emotional undereating, and less likely to adopt a Healthy dietary pattern. Young adults with higher scores for overeating in early childhood were less likely to show traits such as Slowness in eating and more likely to be overweight.

Conclusions

Our findings suggest that eating behaviors in childhood have long-term influence on diet and weight status, thereby reinforcing the importance of early interventions that promote healthy eating.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01376-z.

Child ADHD and autistic traits, eating behaviours and weight: A population-based study

BACKGROUND

Children with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) have an increased obesity risk. Although these conditions commonly co-occur, shared factors relating to obesity risk are unknown.

OBJECTIVES

To examine the shared and unique associations of ADHD and autistic traits with eating behaviours and BMI.

METHODS

Children (N = 4134) from the population-based Generation R Study were categorized into subgroups based on parent-reported ADHD and autistic traits scores at 6 years: ADHD_High , ASD_High , ADHD+ASD_High and REF (reference group: ADHD+ASD_Low ). Multiple linear regressions examined the associations between subgroups and eating behaviours (at 10 years) and BMIz (at 14 years), relative to REF. Mediation analyses tested the indirect effect of subgroup and BMIz through eating behaviours.

RESULTS

ADHD + ASD_High children expressed both food approach (increased food responsiveness and emotional overeating) and avoidant eating behaviours (increased emotional undereating, satiety responsiveness/ slowness in eating and picky eating, and decreased enjoyment in food). ASD_High children were more food avoidant, while ADHD_High children had more food approach behaviours and greater BMIz. ADHD_High and BMIz were indirectly associated with food responsiveness and emotional overeating.

CONCLUSIONS

ADHD and autistic trait phenotypes show distinct associations with potential obesity risk factors, and further research is needed to improve targeted early intervention.

Ecological factors and childhood eating behaviours at 5 years of age: findings from the ROLO longitudinal birth cohort study

Background

Individual differences in children eating behaviours have been linked with childhood overweight and obesity. The determinants of childhood eating behaviours are influenced by a complex combination of hereditary and ecological factors. This study examines if key ecological predictors of childhood overweight; maternal socio-economic status (SES), children’s screen time, and childcare arrangements, are associated with eating behaviours in children aged 5-years-old.

Methods

This is secondary, cross-sectional analysis of the ROLO (Randomized COntrol Trial of LOw glycemic diet in pregnancy) study, using data from the 5-year follow-up (n = 306). Weight, height, and body mass index (BMI) were obtained from mothers and children at the 5-year follow-up. Children’s BMI z-scores were calculated. SES was determined using maternal education level and neighborhood deprivation score. Information on children’s screen time and childcare arrangements were collected using lifestyle questionnaires. Children’s eating behaviours were measured using the Children’s Eating Behaviour Questionnaire (CEBQ). Multiple linear regression, adjusted for potential confounders, assessed associations between maternal SES, screen time and children’s eating behaviours. One-way ANOVA, independent sample t-tests and Spearman’s correlation examined childcare exposure and children’s eating behaviour.

Results

Mothers in the lowest SES group had higher BMI and were younger than those in the highest SES group (p =  < 0.001, p = 0.03 respectively). In adjusted analysis, the lowest SES group was associated with a 0.463-point higher mean score for ‘Desire to Drink’ (95% CI = 0.054,0.870, p = 0.027) and higher ‘Slowness to Eat’ (B = 0.388, 95% CI = 0.044,0.733, p = 0.027) when compared with the highest SES group. Screen time (hours) was associated with higher ‘Food Fussiness’ (B = 0.032, 95% CI = 0.014,0.051, p = 0.001). Those who attended childcare had higher scores for ‘Desire to Drink’(p = 0.046). No relationship was observed between longer duration (years) spent in childcare and eating behaviours.

Conclusions

In this cohort, the ecological factors examined had an influence on children’s eating behaviours aged 5-years-old. Our results illustrate the complexity of the relationship between the child’s environment, eating behaviour and children’s body composition. Being aware of the ecological factors that impact the development of eating behaviours, in the pre-school years is vital to promote optimal childhood appetitive traits, thus reducing the risk of issues with excess adiposity long-term.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-022-03423-x.

Plate Waste in School Catering in Rezekne, Latvia

This research was conducted within the framework of a research project aimed at detecting patterns of plate waste and developing recommendations for improving catering in seven schools in Rezekne city (Latvia) by a combination of observation, physical weighing, semi-structured interview approaches and statistical analysis of variance (ANOVA). We identified plate waste (including wasted beverages), which remains after the lunch of schoolchildren in grades 1–7, examining a total of 7064 lunch samples. The originality of the research is due to the fact that a unified menu was designed for the field study, which ensured the same field study conditions in all the schools. The results of the research revealed that the average weight of plate waste per schoolchild reached 178 g, and the total weight of plate waste accounted for 28.75% of the total weight of food served. No significant differences in plate waste weight between various age groups and grades of schoolchildren were found, which was also confirmed by a one-way ANOVA test. An analysis of plate waste by food category showed that beverages accounted for the largest share of total plate waste (42.24%), followed by staple food (28.38%) and meat (11.77%). An analysis of plate waste shares of food served (%) by food category revealed a similar situation: the largest share of food served was made up of beverages (37.56%), followed by staple food (36.48%) and meat (28.77%). An analysis of the monetary value of food waste showed that the average cost of plate waste (excluding beverage) per schoolchild was EUR 0.236, which represented 16.6% of the national and municipal funding of EUR 1.42 per portion. Given the research results, the authors have concluded that in order to reduce the amount of plate waste generated by Rezekne city schools, school menus should be based not only on the requirements prescribed by relevant legal acts but also on cooking processes that meet the requirements of modern consumers (learners), e.g., by following trends in cooking practices in society to make the learners interested in consuming school food.

Validity of the Adult Eating Behavior Questionnaire and Its Relationship with Parent-Reported Eating Behaviors among Adolescents in Portugal

The Adult Eating Behavior Questionnaire (AEBQ) is a tool developed in the UK, used in the investigation of appetitive traits in adults and adolescents, and later validated in a number of countries. To date, the validity of the AEBQ has not been tested on Portuguese-speaking popula-tions. The aim of this study was to validate the AEBQ in a sample of Portuguese adolescents. Participants were 4483 13-year-olds enrolled in the population-based cohort study Generation XXI. Appetitive traits were self-reported by adolescents through the AEBQ and parents also reported adolescent eating behaviors. Confirmatory and exploratory factor analyses were conducted. Construct validity was tested through correlations between AEBQ subscales and parent-reported eating behaviors, and linear regressions between AEBQ subscales and adolescent body mass index z-scores were performed. Adequate internal consistency and several associations with parent-reported eating behaviors and measured adolescent body mass index z-scores were found. This study supports the validity of a five-factor AEBQ (Food Responsiveness and Enjoyment of Food; Slowness in Eating; Food Fussiness; Emotional Over- and Undereating) to measure appetitive traits among Portuguese adolescents and provides a convenient and easy-to-use tool to be used in large-scale research.

Diet quality in preschool children and associations with individual eating behavior and neighborhood socioeconomic disadvantage. The STEPS Study

A good quality diet in childhood is important for optimal growth as well as for long-term health. It is not well established how eating behaviors affect overall diet quality in childhood. Moreover, very few studies have considered the association of diet quality and a neighborhood socioeconomic disadvantage in childhood. Our aim was to investigate how diet quality is associated with eating behaviors and neighborhood disadvantage and their interaction in preschool age children in Finland. The participants were from the Steps to Healthy Development Study at age 2 y (n = 780) and 5 y (n = 653). Diet quality was measured with a short questionnaire on habitual food consumption and eating behavior was assessed with the child eating behavior questionnaire to indicate the child's eating style regarding food approach and food avoidance dimensions. Information on neighborhood socioeconomic disadvantage were obtained from the statistics Finland grid database. We found that diet quality was higher at 5 years compared to 2 years of age (p < 0.001). Food approach subscale, enjoyment of food, was positively associated with the diet quality (p < 0.001 for 2 and 5 y) while subscale desire to drink was negatively associated with the diet quality (p = 0.001 for 2 and 5 y). Food avoidance was negatively associated with the diet quality both at 2 and at 5 years of age (p < 0.001). A higher neighborhood disadvantage was negatively associated with the diet quality at the age of 2 years (p = 0.02), but not at the age of 5 years. Eating behavior had similar associations with diet quality both in affluent and deprived neighborhoods. Our results suggest that both the eating behavior and neighborhood disadvantage are, already in the early age, important factors when considering children's diet quality.

Associations of preschoolers' dietary patterns with eating behaviors and parental feeding practices at a 12-month follow-up of obesity treatment

Although dietary patterns are key to the management of childhood obesity, they are rarely assessed and thus poorly understood. This study examines preschoolers' dietary patterns and correlates 12 months after the start of obesity treatment (n = 99, mean age 5.2 years, 52% girls). A food frequency questionnaire (FFQ), the Child Eating Behavior Questionnaire (CEBQ), Child Feeding Questionnaire (CFQ) and Lifestyle Behavior Checklist (LBC) were answered by parents to assess children's food intake, eating behaviors, parental feeding practices, and obesity-related behaviors, respectively. Principal component analysis identified dietary patterns based on FFQ data. Through multiple linear regressions we examined correlations between a healthy (HD) and a less healthy (LHD) dietary pattern and mean scores of the CEBQ, CFQ, LBC scales as well as BMI z-scores. The reported intake of items in the LHD decreased after treatment while no differences were found for the HD. Children's eating behaviors, in particular food fussiness, showed consistent associations with diet (b = -0.39, 95% CI -0.63, -0.14 for HD and b = 0.41, 95% CI 0.15, 0.66 for LHD). Feeding practices and obesity-related behaviours were weakly associated with the dietary patterns (HD and Monitoring: b = 0.36, 95% CI 0.09, 0.62; LHD and Screen time b = 0.08, 95% CI 0.01, 0.15). Among the measured variables, eating behaviors had the largest impact on children's dietary patterns. The LHD was associated with a higher BMI z-score but no associations were found between changes in LHD intake and changes in BMI z-scores. Our findings suggest that decreasing food fussiness in children with obesity is key to positive dietary changes. Assessment of children's eating behaviors can help tailor dietary advice and provide support for families of children with obesity.

A comparison of food avoidant behaviours and sensory sensitivity in adults with and without Tourette syndrome

Food selectivity has been shown to be more persistent and severe in children with Tourette syndrome (TS) compared to their typically developing peers. The current study aimed to examine differences in food selectivity, food neophobia and Avoidant Restrictive Food Intake Disorder (ARFID)-associated behaviours, between adults with and without TS. Fifty-three adults diagnosed with TS were compared to 53 neurotypical adults and completed the following measures online: Adult Eating Behaviour Questionnaire (AEBQ), Nine-Item Avoidant/Restrictive Food Intake disorder screen (NIAS), Food Neophobia Scale (FNS) and the Sensory Perception Quotient (SPQ). Higher levels of food avoidant behaviours, in terms of food fussiness, food neophobia and ARFID-associated behaviours, were identified in adults with TS compared to adults without TS. While heightened sensory sensitivity failed to predict food fussiness, greater sensitivity to taste was found to be predictive of food neophobia in TS. These are the first findings to suggest that food avoidant behaviours are more prevalent for adults with TS and signal a need to address health implications.

Concurrent Validity of the Adult Eating Behavior Questionnaire in a Canadian Sample

The current study aimed to test the factor structure of the Adult Eating Behavior Questionnaire (AEBQ), its construct validity against the Three-Factor Eating Questionnaire (TFEQ-R18) and its associations with body mass index (BMI) in Canadian adults (n = 534, 76% female). Confirmatory factor analysis (CFA) revealed that a seven-factor AEBQ model, with the Hunger subscale removed, had better fit statistics than the original eight-factor structure. Cronbach's alpha was used to assess the internal reliability of each subscale and resulted with α > 0.70 for all subscales except for Hunger (α = 0.68). Pearson's correlations were used to inform the convergent and discriminant validation of AEBQ against the TFEQ-R18 and to examine the relationship between AEBQ and BMI. All AEBQ Food Approach subscales positively correlated with that of the TFEQ-R18 Emotional Eating and Uncontrolled Eating subscales. Similarly, BMI correlated positively with Food Approach subscales (except Hunger) and negatively with Food Avoidance subscales (except Food Fussiness). These results support the use of a seven-factor AEBQ for adults self-reporting eating behaviors, construct validity of the AEBQ against TFEB-R18, and provide further evidence for the association of these traits with BMI.

Measuring short-term eating behaviour and desire to eat: Validation of the child eating behaviour questionnaire and a computerized 'desire to eat' computerized questionnaire

The Child Eating Behaviour Questionnaire (CEBQ) is designed to measure 'usual' eating behaviour, with no time period attached, thus may not be suitable for assessing the effectiveness of short-term experimental studies. The aim of this study was to validate i) the CEBQ adapted to measure 'past week' rather than 'usual' eating behaviour, and ii) a computerized questionnaire assessing desire to eat core and non-core foods, against an objective measure of eating behaviour and food intake (eating in the absence of hunger (EAH) experiment). Children (n = 103) aged 8-12 years completed the desire to eat questionnaire followed by the EAH experiment while primary caregivers completed the adapted CEBQ. Results from the CEBQ showed that children with greater 'satiety responsiveness' (1-point higher) consumed less energy (-342 kJ; 95% CI -574, -110) whereas those with greater 'enjoyment of food' scale consumed more energy (380 kJ; 95% CI 124, 636) during the ad-libitum phase of the EAH experiment. Higher scores for slowness in eating (-705 kJ; 95% CI -1157, -254), emotional undereating (-590 kJ; 95% CI -1074, -106) and food fussiness (-629 kJ; 95% CI -1103, -155) were associated with lower total energy intake. Children who expressed greater desire to eat non-core foods consumed more energy in total (275 kJ; 95% CI 87, 463). Overall, this adapted CEBQ appears valid for measuring several short-term eating behaviours in children. The desire to eat questionnaire may be useful for identifying short-term susceptibility to overeating, however further investigation into how ratings of desire relate to the intake of highly palatable, energy dense foods is warranted.

How do young children eat after an obesity intervention? Validation of the Child Eating Behaviour Questionnaire using the Rasch Model in diverse samples from Australia and Sweden

Child eating behaviours have consistently been linked to child weight status. Yet, changes in child eating behaviours during early obesity treatment are rarely evaluated. Psychometric evaluation of the Child Eating Behaviour Questionnaire (CEBQ) is common, but results are sample-dependent and included items may not capture the full range of the underlying traits. Rasch analysis can overcome these disadvantages. The aim of this paper was to assess child eating behaviours measured by the CEBQ after a 12-month obesity intervention applying the Rasch model for the validation of the CEBQ. The Rasch-based fit statistics were applied in children from two samples, Australian and Swedish (n = 1724). Changes in eating behaviours amongst children aged 4-6 years were examined in the More and Less RCT for obesity treatment (n = 177), which compared a parenting programme (with and without boosters) against standard treatment. Parents completed the CEBQ at four time points over 12-months. Linear mixed models were applied to estimate treatment effects on the CEBQ, refined according to Rasch, over time. We found that the validity of CEBQ was confirmed after removing 4 items (item fit statistics outside range 0.5-1.5). When the refined CEBQ was used in the assessment of the RCT, there were no differences in parental reports of changes in children's eating behaviours between the parenting programme and standard treatment (group-by-time interactions p > 0.05). However, in the total sample food approach behaviours decreased while fussy eating behaviours increased (p < 0.05). In conclusion, the refined CEBQ proved to be a valid tool for examining parent-reported child eating behaviours. Early obesity treatment may decrease eating behaviours associated with higher child weight. Future research should address the associations between changes in child weight status and eating behaviours.

Longitudinal bidirectional relationship between children's appetite and diet quality: A prospective cohort study

This study explored the relationship between eating behaviours and diet quality, from 7 to 10y. The sample included 3879 children evaluated, from the Portuguese birth cohort Generation XXI, with complete information on Food Frequency Questionnaire (FFQ) and the Children Eating Behaviour Questionnaire (CEBQ). A healthy eating index (HEI) (range: 9-31) was developed to evaluate the child's diet quality. The eight CEBQ's eating behaviours were included in the analysis. Generalised linear models were used to estimate the associations. Adjusted structural equation modelling was performed to study the direction of the associations. Eating behaviours measured at age 7y tracked to age 10y. A bidirectional inverse association between the food fussiness trait and diet quality was found, with a similar magnitude (p < 0.001), thus a higher score on food fussiness predicted a lower quality of the diet. A higher HEI score at 7y was associated with lower satiety responsiveness at 10y (β_standardized = -0.039), and a higher HEI score at age 10y was associated with higher enjoyment of food at 7y (β_standardized = 0.046). Eating behaviours were linked to diet quality in children with high enjoyment of food and low food fussiness at age 7y linked to a high-quality diet at 10y. In addition, children with high-quality diets at 7y were more likely to have lower food fussiness and satiety responsiveness at 10y. Given the stability of eating behaviours and the bidirectional nature of effects between eating behaviours and dietary quality in the long term, tailored interventions may be needed to encourage the acquisition of healthy eating behaviours and habits in early life.

Exposure to models' positive facial expressions whilst eating a raw vegetable increases children's acceptance and consumption of the modelled vegetable

Research has shown that seeing positive facial expressions (FEs) towards food increased children's desire to eat foods rated as disliked. However, the effect of adults' positive FEs whilst eating a raw vegetable on children's acceptance and intake of nutritious foods that are less preferred (e.g., vegetables) remains to be established. This study aimed to examine the effect of models' FEs eating raw broccoli on children's acceptance and intake of raw broccoli. 111 children aged 4-6 years (64 male, 47 female) were randomised to watch a video of unfamiliar adult models eating raw broccoli with a positive or neutral facial expression (FE), or a non-food control video. Children's acceptance and intake of raw broccoli was assessed. Data about parent and child characteristics was provided by parents. There was a main effect of FE type on children's frequency of tastes (p = .03) and intake of broccoli (p = .02). Children who were exposed to models eating broccoli with positive FEs had greater frequency of tastes (p = .04) and intake of broccoli (p = .03), than children in the control condition, but not compared to children in the neutral FE condition (p > .05). There was no effect of positive FEs on children's willingness to try broccoli (p > .05). These findings suggest that observing others enjoy a commonly disliked vegetable can encourage children's tastes and intake of the vegetable. Thus, exposing children to others enjoying vegetables could be a useful strategy for encouraging healthier eating in children. Further work is needed to determine whether a single exposure is sufficient and whether these effects are sustained over time.

Appetitive behaviors and body composition in school-age years: Bi-directional analyses in a population-based birth cohort

Cross-sectional studies have consistently associated appetitive behaviors with child body mass index. However, few prospective studies have investigated the association between appetite and other measures of body composition and its directionality. We aimed to investigate the bi-directional relationship between appetitive behaviors and body composition in school-aged children. Data from 3668 children of the Generation XXI birth cohort were analyzed. Appetitive behaviors were assessed at 7 and 10 years through the Children's Eating Behavior Questionnaire. Higher fat mass and fat-free mass were measured through tetrapolar bioelectric impedance and waist-to-weight and waist-to-height ratios were calculated. Fat and fat-free mass indexes, waist-to-weight and waist-to-height age- and sex-specific z-scores were then calculated. Cross-lagged analyses were performed (body composition at 7 to appetitive behaviors at 10 and the reverse) to measure the magnitude and direction of associations. Fat mass and waist-to-height ratio at 7y predicted greater food approach behaviors at 10y (Enjoyment of Food, Food Responsiveness, Desire to Drink and Emotional Overeating), but not waist-to-weight, which seems to be consequence of child's avid appetite (e.g. Enjoyment of Food at 7y: β_standardized = 0.085, 95%CI = 0.041; 0.128, p < 0.001). Child scores on food avoidant behaviors, such as Satiety Responsiveness (β_standardized = -0.073, 95%CI = -0.110;-0.034, p < 0.001) and Slowness in Eating (β_standardized = -0.080, 95% CI = -0.120;-0.041, p < 0.001) at 7y predicted lower fat-free mass at 10. Appetitive behaviors may not solely predict weight status, but the path of association between body composition and later appetitive behavior may also be true, especially for food approaching behaviors and adipose tissue. Interventions aiming to prevent excess weight should focus on appetitive behaviors. Moreover, in children with higher adiposity, other pathways also seem to regulate appetite and need to be considered in interventions.

Associations between Food Preferences, Food Approach, and Food Avoidance in a Polish Adolescents' COVID-19 Experience (PLACE-19) Study Population

Food preferences are among the strongest predictors of the food choices of adolescents. These are associated with appetitive traits (food approach and avoidance) to some extent. However, no research has been conducted so far analyzing the association between food preferences and appetitive traits of adolescents. The aim of this study was to evaluate the associations between food preferences and appetitive traits in adolescents (aged 15-20 years) within the Polish Adolescents' COVID-19 Experience (PLACE-19) Study population. The PLACE-19 Study was carried out in a population-based sample of 2448 secondary school students sampled across the country (random quota sampling). Food preferences (including the preference for vegetables, fruit, meat/fish, dairy, snacks, and starches) of the adolescents were assessed using the validated Food Preference Questionnaire (FPQ) while their appetitive traits (hunger, food responsiveness, emotional overeating, enjoyment of food, satiety responsiveness, emotional undereating, food fussiness, slowness in eating) were assessed using the validated Adult Eating Behavior Questionnaire (AEBQ). The k-means clustering was performed to identify the homogenous clusters of respondents based on their preferences, and linear regression was performed to determine the relationship between food preferences and appetitive traits with a model adjusted for sex and age. Based on their preferences, three homogenous clusters of respondents were defined: low-preferring respondents (low preference for all food categories), respondents preferring snacking foods (low preference for all food categories, except for fruit and snacks), and high-preferring respondents (high preference for all food categories). The low-preferring respondents showed the lowest values for all appetitive traits (p = 0.0008), as well as the lowest total score (p = 0.0001), except for food fussiness, for which they showed the highest value (p = 0.0008). All preference scores were positively associated with traits such as hunger, food responsiveness, enjoyment of food, and emotional under-eating, while negatively associated with food fussiness (all p < 0.05). The largest amount of variance was observed for preference for dairy (14.6%; R² = 0.146, p = 0.008) and snacks with respect to enjoyment of food (16.2%; R² = 0.162, p = 0.008), for vegetable with respect to food fussiness (22%; R² = 0.220, p = 0.008), and for meat/fish with respect to enjoyment of food (19.9%; R² = 0.199, p = 0.008) and food fussiness combined (19.1%; R² = 0.191, p = 0.008). These results support the association of food preferences with both food approach traits and food avoidance traits.

Complementary Feeding Methods-A Review of the Benefits and Risks

Complementary feeding methods have the potential to not only ensure a diet of nutritional adequacy but also promote optimal food-related behaviours and skills. While the complementary feeding practice known as baby-led weaning (BLW) has gained popularity, evidence supporting the potential benefits and/or risks for infant growth, development, and health warrants consideration. A review of 29 studies was conducted with findings indicating that parents who implement BLW typically have higher levels of education, breastfeed for longer, and differ in other personality traits. Fear of choking was an important factor in parents’ decision not to implement BLW; however, this fear was not supported by the literature. Benefits of BLW included lower food fussiness, higher food enjoyment, lower food responsiveness, and higher satiety responsiveness. While this profile of eating behaviours confers a reduced obesity risk, few studies have examined the relationship between BLW and infant growth robustly. BLW does not seem to increase the risk of inadequate zinc or iron intake; however, emphasis needs to be given to ensuring adequate intake of these micronutrients among all infants. A better understanding of the impacts of BLW is needed to inform evidence-based recommendations to support and guide parents in complementary feeding methods.

Baby's first bites: Association between observed maternal feeding behavior and infant vegetable intake and liking

Positive experiences with the introduction of solid food in infancy may lead to positive associations with feeding in both parent and infant. During this transitional period, parental feeding behavior and infant eating behavior might mutually reinforce each other. A feeding style that is found to be associated with positive child eating behavior, is sensitive feeding. In the present study we tested bidirectional prospective relations between mother and infant behavior in a cross-lagged model using observations of two feeds on two consecutive days on which the first bites of solid food were offered. The sample consisted of 246 first-time mothers and their infants, whose feeding interactions were videotaped during two home visits. Maternal sensitive feeding behavior (consisting of responsiveness to child feeding cues, general sensitivity and non-intrusiveness) and maternal positive and negative affect were coded. In addition, infant vegetable intake was weighed and vegetable liking was reported by mother. Results showed at least some stability of maternal feeding behavior and infant vegetable intake and liking from the first to the second feed. In addition, during the second feed maternal sensitive feeding and positive affect were associated with infant vegetable intake (r=.34 and r=.14) and liking (r=.33 and r=.39). These associations were mostly absent during the first feed. Finally, infant vegetable liking during the first feed positively predicted maternal sensitive feeding behavior during the second feed (β=.25), suggesting that the infant's first response might influence maternal behavior. Taken together, mother and infant seem more attuned during the second feed than during the first feed. Future studies might include multiple observations over a longer time period, or micro-coding. Such insights can inform prevention programs focusing on optimizing feeding experiences during the weaning period.

Children's eating behaviour traits and dental caries

OBJECTIVES

This cross-sectional study aimed to assess eating behavior traits in children with or without dental caries.

METHODS

A sample of 580 children aged 8 years enrolled in 20 public schools in the city of Pelotas, Brazil were included. Parents/caregivers provided sociodemographic information and answered the Children's Eating Behavior Questionnaire (CEBQ) to assess eating behavior traits. This instrument possesses the subscales: food responsiveness, enjoyment of food, satiety responsiveness, slowness in eating, food fussiness, emotional overeating, emotional undereating, and desire to drink. To assess the presence of decayed, missing or filled teeth (DMFT/dmft), the World Health Organization (WHO) criteria were adopted. WHO criteria were used to evaluate presence of overweight and obesity. Analysis of variance (ANOVA) was used to compare the mean score in each CEBQ subscale according to the different exposure variables. Linear regression was used to assess the association between dental caries and CEBQ subscales means.

RESULTS

Approximately half of the children were male (51.03 percent) and 66.73 percent had low/middle socioeconomic status. The mean DMFT/dmft was 2.41, ranging from 0 to 13, and 63 percent of the children showed DMFT/dmft > 0. After adjustments for potential confounders, children with dental caries showed higher scores on the subscales desire to drink (P = 0.03), and satiety responsiveness (P = 0.04).

CONCLUSION

The present study showed that some aspects of eating behaviors differ in children with or without caries. Such knowledge adds to the understanding of the multifactorial etiology of caries and may help in the development of nutritional interventions to promote healthy eating behaviors, with benefits for oral health.

Mealtime Behaviors and Food Preferences of Students with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a lack of social communication and restrictive, repetitive behaviors or interests. This study aimed to examine the mealtime behaviors and food preferences of students with ASD. An online questionnaire on mealtime behavior and food preferences of ASD students was conducted by caregivers including parents, and the average age of ASD students was 14.1 ± 6.1. The analysis of mealtime behavior resulted in classification into three clusters: cluster 1, the "low-level problematic mealtime behavior group"; cluster 2, the "mid-level problematic mealtime behavior group"; and cluster 3, the "high-level problematic mealtime behavior group". Cluster 1 included older students than other clusters and their own specific dietary rituals. Meanwhile, cluster 3 included younger students than other clusters, high-level problematic mealtime behavior, and a low preference for food. In particular, there were significant differences in age and food preference for each subdivided ASD group according to their eating behaviors. Therefore, the content and method of nutrition education for ASD students' needs a detailed approach according to the characteristics of each group.

The relationship between maternal dietary patterns during pregnancy in women with gestational diabetes mellitus and infant appetitive feeding behaviour at 6 months

Early dietary exposure may influence infant appetitive feeding behaviour, and therefore their later health. Maternal diabetes in pregnancy is associated with an increased risk of obesity in the offspring. We, therefore, examined third-trimester dietary patterns of women with gestational diabetes, their offspring's appetitive feeding behaviour at 6 months of age, and relationships between these. We used data from a prospective cohort of women with gestational diabetes and assessed maternal dietary patterns at 36 weeks' gestation using principal component analysis; infant appetitive feeding behaviour at 6 months of age using the Baby Eating Behaviour Questionnaire; and relationships between these using general linear modelling and chi-square tests. In 325 mother-infant dyads, we identified three distinct maternal dietary patterns: 'Junk,' 'Mixed,' and 'Health-conscious.' The maternal 'Health-conscious' pattern was inversely associated with 'enjoyment of food' in their sons (β - 0.24, 95% CI - 0.36 to - 0.11, p = 0.0003), but not daughters (β - 0.02, 95% CI - 0.12 to 0.08, p = 0.70), and was positively associated with 'slowness in eating,' (β 0.13, 95% CI 0.02 to 0.24, p = 0.01). Third-trimester dietary patterns in women with gestational diabetes may have sex-specific effects on infant appetitive feeding behaviour at 6 months of age.

Ultra-processed food consumption, appetitive traits and BMI in children: a prospective study

This study aimed to investigate the association of ultra-processed food consumption at 4 and 7 years of age with appetitive traits at 7 years and BMI at 10 years of age. Participants were 1175 children of the population-based birth cohort Generation XXI, who provided food diaries and complete data on socio-demographic variables, anthropometric measures and the Portuguese Children's Eating Behaviour Questionnaire (P-CEBQ). Foods were grouped according to NOVA classification into: 'unprocessed, minimally or moderately processed, and culinary preparations'; 'processed' and 'ultra-processed'. To assess tracking of groups' consumption, Pearson's correlation coefficient (r) and the intraclass correlation coefficient (ICC) were calculated. Generalised linear models were fitted to test main associations, mediators and interactions among the variables. Ultra-processed consumption exhibited a fair level of stability between ages 4 and 7 years (r 0·34; ICC = 0·32; 95 % CI 0·25, 0·39), corresponding, respectively, to 27·3 % (1881·9 (SD 908·8) kJ/d) and 29·3 % (2204·5 (SD 961·1) kJ/d) of total energy intake. After adjusting for maternal and child characteristics, higher ultra-processed consumption at 4 years was associated directly with 'Food Responsiveness' (β = 0·019; 95 % CI 0·007, 0·037) and indirectly through energy intake with avoidant traits: 'Food Fussiness' (β = -0·007; 95 % CI 0·002, 0·012) and 'Satiety Responsiveness' (β = -0·007; 95 % CI 0·003, 0·012). Ultra-processed consumption at 4 years old was associated with BMI at 10 years old, but appetitive behaviours were not powerful mediators of this association. The results suggest a path by which ultra-processed products may impact on later appetitive traits and higher BMI in children.

Factors influencing food waste during lunch of fourth-grade school children

This study aims to explore the factors that influence plate waste at lunches served in primary schools. Data was collected for all fourth-grade children attending 21 primary schools from the city of Porto (Portugal) (n = 463). Plate waste was evaluated by the weighing method and factors influencing plate waste were collected by observation of menu and canteen characteristics and through the application of a questionnaire to children aiming to evaluate factors related to preferences and dietary patterns. Logistic regression was performed to identify predictors of plate waste. It was observed that fish menus and composed dishes showed a higher tendency for increased plate waste. However, this effect was not observed when adjusted for other variables. Soups without pulses and blended soups were less likely to be discarded by children. The presence of the teacher during meals and the possibility for children to leave the canteen whenever they wish, protected both the main dish and the soup from being wasted. A higher number of children in the canteen was associated with increased soup waste. As expected, children more pleased with the sensory characteristics of the main dish and soup were less likely to waste food. Children who consumed high-saturated fat content mid-morning snacks were more likely to waste soup. The main factors associated with plate waste were related to the presence of teachers during the mealtime, school meal policies and the meals' sensory characteristics. Additionally, soup waste was determined by its composition, mid-morning snacks and the number of children in the canteen.

Associations of appetitive behaviors in 7-year-old children with their cardiometabolic health at 10 years of age

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.

Associations between appetitive traits, dietary patterns and weight status of children attending the School Kids Intervention Program

BACKGROUND

The nexus between appetitive traits, dietary patterns and weight status has predominantly been studied in a mixed sample (healthy weight, overweight and obese sample).

AIM

This cross-sectional study examined associations between overweight/obese children's appetitive traits, dietary patterns and weight status.

METHODS

We studied children (N = 58, body mass index z-score: 2.25±0.46), 4-12 years attending the School Kids Intervention Program. Children's appetitive traits and dietary patterns were measured with the Child Eating Behaviour Questionnaire and Children's Dietary Questionnaire, respectively. Children's height and weight were used to compute body mass index z-score; waist circumference was also measured and waist-to-height ratio was calculated.

RESULTS

After controlling for children's age and gender, hierarchical linear regression analyses showed that lower scores for slowness in eating were associated with higher body mass index z-scores in children (β = -0.31, p = 0.01). Higher scores for emotional overeating were associated with higher waist-to-height ratio in children (β = 0.48, p = 0.01). Higher scores for fussiness were correlated with lower scores for fruits and vegetables (β = -0.59, p < 0.001) and higher scores for non-core foods (β = 0.26, p = 0.04).

CONCLUSION

Results observed in the current sample of overweight and obese children are consistent with previous studies examining healthy-weight children. Slowness in eating may foster an obesity 'protective' effect, whereas emotional overeating may promote susceptibility to weight gain. Fussy eating may impair diet quality by lower consumption of vegetables and fruits and higher intake of non-core foods. This evidence will support dietitians to consider children's appetitive traits when providing dietary consultation to support obesity management among overweight/obese children.

Using social media to explore regional cuisine preferences in China

Purpose

Food plays an important role in every culture around the world. Recently, cuisine preference analysis has become a popular research topic. However, most of these studies are conducted through questionnaires and interviews, which are highly limited by the time, cost and scope of data collection, especially when facing large-scale survey studies. Some researchers have, therefore, attempted to mine cuisine preferences based on online recipes, while this approach cannot reveal food preference from people’s perspective. Today, people are sharing what they eat on social media platforms by posting reviews about the meal, reciting the names of appetizers or entrees, and photographing as well. Such large amount of user-generated contents (UGC) has potential to indicate people’s preferences over different cuisines. Accordingly, the purpose of this paper is to explore Chinese cuisine preferences among online users of social media.

Design/methodology/approach

Based on both UGC and online recipes, the authors first investigated the cuisine preference distribution in different regions. Then, dish preference similarity between regions was calculated and few geographic factors were identified, which might lead to such regional similarity appeared in our study. By applying hierarchical clustering, the authors clustered regions based on dish preference and ingredient usage separately.

Findings

Experimental results show that, among 20 types of traditional Chinese cuisines, Sichuan cuisine is most favored across all regions in China. Geographical proximity is the more closely related to differences of regional dish preference than climate proximity.

Originality/value

Different from traditional definitions of regions to which cuisine belong, the authors found new association between region and cuisine based on dish preference from social media and ingredient usage of dishes. Using social media may overcome problems with using traditional questionnaires, such as high costs and long cycle for questionnaire design and answering.

Family food environment factors associated with obesity outcomes in early childhood

Background

In attempting to gain understanding of the family food environment (FFE), as a central context for the development of obesity and obesogenic eating behaviours during early childhood, attention has largely focused on the relationships of individual variables. This fails to capture the complex combinations of variables children are exposed to. To more authentically reflect the impact of the FFE on the development of obesity and obesogenic eating behaviours during early childhood, this study aims to derive composites of FFE variables using factor analysis.

Methods

FFE and eating behaviour data were available from 757 Australian children (2.0–5.0 years) via a parent-completed online survey. Children were categorised as normal weight, overweight or obese, based on parent-reported anthropometry (underweight children were excluded).

Results

Eight FFE factors were derived. Scores for factors ‘Negative Feeding Strategies’ and ‘Negative Nutrition Related Beliefs’ increased with child BMI category, while ‘Use of TV and devices’ and ‘Parent’s Nutrition Knowledge’ decreased. The FFE factor ‘Negative Feeding Strategies’ was positively associated with food fussiness, food responsiveness and slowness in eating, and negatively associated with parent body mass index (BMI) score. The FFE factor ‘Negative Nutrition Related Beliefs’ was positively associated with food responsiveness, as well as positively with parent BMI, male children, breastfeeding less than 6 months, and low-income status. The FFE factor ‘Television (TV) and devices’ was only positively associated with residing in a capital city. The FFE factor ‘Parent’s Nutrition Knowledge’ was negatively associated with slowness in eating, breastfeeding less than 6 months and low-income status, and positively with parent stress and residing in a capital city.

Conclusion

Consideration of the composite effect of FFE on child’s eating behaviours and obesity outcomes is important in guiding future research and obesity prevention initiatives by providing a more authentic picture of the FFE children are exposed to. Examining factors of FFE variables in conjunction with psycho-social variables, further articulates the reciprocal influence of these variables on environmental constructs thus assisting in understanding of inequitable distribution of obesity risk.

*keywords

childhood obesity, eating behaviours, early childhood, Family Food Environment, Factor Analysis,

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.

An examination of children's eating behaviours as mediators of the relationship between parents' feeding practices and early childhood body mass index z-scores

OBJECTIVE

Parent's use of restrictive feeding practices is associated with child weight. Similarly, the literature shows that children's eating behaviours are also associated with child weight. Given this interrelationship between children's eating behaviours, restrictive feeding practices and child weight, examination of possible mediator relationships is warranted. This study aimed to examine the relationships between overt restriction and covert restriction with child body mass index z-scores (BMIz) and determine if children's eating behaviours (satiety responsiveness and food responsiveness) act as mediators.

METHOD

Parents of Australian children (n = 977) 2.0-5.0 years of age (49.4% male) provided data in an online survey on child eating behaviours, parent's restrictive feeding practices and child anthropometrics (modified z-scores were created to screen for biologically implausible values). Correlation analysis was used to determine variables to include in mediation models. Hayes' PROCESS macros in spss was used to examine mediation, controlling for covariates of child BMIz.

RESULTS

Overt restriction was the only parent feeding practice related to child BMIz (B = 0.132, P = 0.04). Mediation analysis showed that the indirect effect of overt restriction on child BMIz (controlling for child age, gender, parent BMI and income) became non-significant when controlling for food responsiveness, thus suggesting full mediation, explaining 5.75% of the relation.

CONCLUSION

Overt restriction and covert restriction have distinctly different relationships with children's eating behaviours. Food responsiveness appears an important intermediary in the relationship between overt restriction and child BMIz.

A comparison of maternal feeding responses to child fussy eating in low-income food secure and food insecure households

Children learn to like a wide variety of healthy foods through exposure in their early feeding environment. While some children may reject foods during this learning process, parents may perceive persistent refusal as 'fussy' or 'picky' eating. Low-income parents may provide fussy children with a narrow range of foods that they will like and accept to avoid food and economic waste; inadvertently limiting children's exposure to a variety of healthy foods. This 'risk aversion' to food rejection may be particularly salient in food insecure households where resources are further constrained. We aimed to examine if food insecurity modifies the relationship between child fussy eating and parents' food provision and feeding with respect to exposure to a variety of healthy foods. Australian mothers residing in a low-income community (N = 260) completed a cross-sectional survey on their preschool-aged child's 'food fussiness', household food insecurity and food exposure practices. Food exposure practices included the home availability of fruit and vegetables, and children's tasting of a variety of fruit and vegetables (food provision); and whether parents prepared alternative meals for their child (feeding). Mothers reporting food insecurity (11%) were less likely to have fruit frequently available in the home compared to mothers reporting food security. Food insecurity moderated the relationship between fussy eating and food exposure practices insofar that food secure mothers were more likely to prepare alternative meals for fussier children. Family resources and child fussy eating behaviours are identified as important contextual factors in food provision and feeding. Findings from the current study suggest that health professionals, researchers and policymakers tailor interventions to consider both the needs of families and child eating characteristics.

Association between eating frequency and eating behaviours related to appetite from 4 to 7 years of age: Findings from the population-based birth cohort generation XXI

The examination of specific characteristics of eating habits in childhood and its influence on eating behaviours is needed to better understand the establishment of appetite-related eating behaviours. This study aimed to assess the association between eating frequency (EF) (main meals vs. snacks) at 4 and 7y and problematic eating behaviours and appetite-related eating behaviours at 7y. The analysis included 1359 children from the birth cohort Generation XXI who provided 3-day food diaries, at both ages, and complete information on the Child Eating Behaviour Questionnaire, at 7y. Problematic eating behaviours were assessed using parental perception of child's poor eating (including not eating enough, eating too slow or overeating) at both ages. A time-of-day approach was used to distinguish main meals from snacks. A cross-lagged analysis was performed to check the direction of the association between EF and parental concerns regarding problematic eating behaviours. Associations between EF and appetite-related eating behaviours were evaluated through linear regression models. Between 4 and 7y a moderate tracking of EF was described as well as a strong tracking of parental concerns. We found a bidirectional relationship between EF and parental concerns. Prospectively, a higher frequency of snacks at 4y was independently associated with higher scores in 'Desire to Drink' at 7y (β = 0.051, 95%CI:0.009; 0.093). At 7y, a higher EF had a positive association with 'Satiety Responsiveness' but an inverse association with 'Enjoyment of Food'. A higher number of main meals had a positive association with 'Enjoyment of Food' and 'Food Responsiveness'. In conclusion, children who had more eating occasions seem to have more food-avoidance behaviours, traits that might protect these children from gaining excessive weight.

Perceived child eating behaviours and maternal migrant background

The Child Eating Behaviour Questionnaire (CEBQ) is a well-established instrument in the study of obesity-related eating behaviours among children. However, research using the CEBQ in multicultural samples is limited. This study aims to identify and examine differences in child eating behaviours as reported by Swedish-born and non-Swedish-born mothers living in Sweden. Mothers (n = 1310, 74 countries of origin, mean age 36.5 years, 63.6% with higher education, 29.2% with overweight or obesity) of children aged 3-8 years (mean age 4.8 years, 18.1% with overweight or obesity) completed the CEBQ. Responses were analysed using CEBQ subscales Food Responsiveness, Emotional Overeating, Enjoyment of Food, and Desire to Drink, clustering into Food Approach, and subscales Satiety Responsiveness, Slowness in Eating, Emotional Undereating, and Food Fussiness, clustering into Food Avoidance. Data were compared across seven regional groups, divided by maternal place of birth: (1) Sweden (n = 941), (2) Nordic and Western Europe (n = 68), (3) Eastern and Southern Europe (n = 97), (4) the Middle East and North Africa (n = 110), (5) East, South and Southeast Asia (n = 52), (6) Sub-Saharan Africa (n = 16), and (7) Central and South America (n = 26). Crude, partly and fully adjusted linear regression models controlled for child's age, gender and weight status, and mother's education, weight status and concern about child weight. The moderation effect of maternal concern about child weight was examined through interaction analyses. Results showed that while Food Approach and Food Avoidance behaviours were associated with maternal migrant background, associations for Food Fussiness were limited. Notably, mothers born in the Middle East and North Africa reported higher frequencies of both Food Approach (except for Enjoyment of Food) and Food Avoidance. The study highlights the importance of examining how regionally-specific maternal migrant background affects mothers' perceptions of child eating behaviours.