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Öğütlü H, Kaşak M, Doğan U, Zickgraf HF, Türkçapar MH. Psychometric properties of the nine-item avoidant/restrictive food intake disorder screen (NIAS) in Turkish children. J Eat Disord 2024; 12:30. [PMID: 38374128 PMCID: PMC10875749 DOI: 10.1186/s40337-024-00987-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/10/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND The nine item avoidant/restrictive food intake disorder screen (NIAS) is a short and practical assessment tool specific to ARFID with three ARFID phenotypes such as "Picky eating," "Fear," and "Appetite". This study aimed to evaluate the psychometric properties of the Turkish translation of the NIAS parent form and to investigate the relationship between ARFID symptoms and anxiety, depression symptoms, and eating behaviors in a sample of Turkish children. METHOD Parents were asked to provide their children's sociodemographic data and to complete the NIAS, Eating Disorder Examination Questionnaire-Short (EDE-QS), Children's Eating Behavior Questionnaire (CEBQ), and Revised Child Anxiety and Depression Scale (RCADS) scales. RESULTS The sample included 440 participants between 6 and 12 ages. Turkish NIAS demonstrated good internal consistency. The three-factor model of the Turkish NIAS was in an acceptable structure. The Turkish NIAS scale was shown to be valid and reliable. NIAS scores were shown to be higher in underweight participants. The NIAS-parent version subscales showed expected convergent and divergent validity with the CEBQ, EDEQ-S, and RCADS scales in children, except CEBQ emotional overeating and desire to drink subscales were correlated with NIAS. CONCLUSION The Turkish version of the NIAS is valid and reliable in evaluating ARFID symptoms in children.
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Affiliation(s)
- Hakan Öğütlü
- Department of Child and Adolescent Psychiatry, Cognitive Behavioral Psychotherapies Association, Karum Is Merkezi Iran Caddesi No: 21 Gaziosmanpasa Mah., 06680, Cankaya, Ankara, Turkey.
| | - Meryem Kaşak
- Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ankara, Turkey
| | - Uğur Doğan
- Departman of Guidance and Counseling, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Hana F Zickgraf
- Department of Psychology, University of South Alabama, Mobile, AL, USA
- Department of Pediatrics, Emory University, Atlanta, GA, USA
- Rogers Behavioral Health, Oconomowoc, WI, USA
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Hasbani EC, Félix PV, Sauan PK, Maximino P, Machado RHV, Ferrari G, Fisberg M. How parents' feeding styles, attitudes, and multifactorial aspects are associated with feeding difficulties in children. BMC Pediatr 2023; 23:543. [PMID: 37898797 PMCID: PMC10612164 DOI: 10.1186/s12887-023-04369-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/15/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Parental complaints about feeding difficulties (FD) during childhood are frequent in pediatrics. Behavioral factors about children's feeding and parental aspects are fundamental in solving these problems, but research in this area lacks information considering the joint presence of fathers and mothers. Thus, this study aimed to investigate the features of children, parents and mealtime practices related to FD reported by fathers and mothers and to identify parenting styles, mealtime actions, practices and factors associated with FD in children. METHODS 323 parents (226 mothers and 97 fathers) of children aged 1 to 7 years were recruited in the emergency waiting room at Sabará Hospital Infantil, in São Paulo, Brazil, and self-completed electronic questionnaires on parenting style (Caregiver's Feeding Styles Questionnaire), parents' mealtime actions (Parent Mealtime Action Scale), socioeconomic information, personal and children's health data and routine meal practices. RESULTS The prevalence of FD in children was 26.6%. Indulgent parenting style was the most frequent (44.2%), followed by authoritarian (25.1%), authoritative (23.8%), and uninvolved (6.9%) styles. Most parents (75.8%) reported presence during meals, and 83.6% used distractions. Regression analyses after adjustments showed, as factors associated with FD, female children (OR: 2.06; 95%CI: 1.19-3.58), parents' FD history (OR: 3.16; 95%CI: 1.77-5.64), and greater frequency of parents' behavior of offering many food options (OR: 2.69; 95%CI: 1.18-6.14). Parents with indulgent styles had decreased chances of reporting FD in their children (OR: 0.13; 95%CI: 0.06-0.27). Furthermore, the practice of children sharing the family menu (OR: 0.43; 95%CI: 0.18-0.99) and higher frequency of parents' behavior of setting snack limits (OR: 0.44; 95%CI: 0.23-0.85) were inversely associated with FD. CONCLUSIONS This study reinforces the multifactorial aspects involved in the feeding difficulties context. It points out the importance of expanding knowledge of the individual role of fathers and mothers to compose a scenario that can guide future studies and interventions. TRIAL REGISTRATION CAAE #99221318.1.0000.5567 with registration number 2,961,598.
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Affiliation(s)
- Evelin Czarny Hasbani
- Sciences Applied to Pediatrics Postgraduate Program, Federal University of São Paulo, Rua Botucatu, 598, Vila Clementino, São Paulo, 04023-062, SP, Brazil.
| | - Paula Victória Félix
- School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, 01246-904, SP, Brazil
| | - Patricia Kawai Sauan
- Consulting and Training, Rua José Maria Lisboa, 586, São Paulo, 01423-000, SP, Brazil
| | - Priscila Maximino
- CENDA (Excellency Center for Nutrition and Feeding Difficulties), Instituto PENSI-Jose Luiz E. Setubal Foundation, Av Angelica 2071, CEP 01227-200, São Paulo, Brazil
| | | | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Chile
| | - Mauro Fisberg
- Sciences Applied to Pediatrics Postgraduate Program, Federal University of São Paulo, Rua Botucatu, 598, Vila Clementino, São Paulo, 04023-062, SP, Brazil
- CENDA (Excellency Center for Nutrition and Feeding Difficulties), Instituto PENSI-Jose Luiz E. Setubal Foundation, Av Angelica 2071, CEP 01227-200, São Paulo, Brazil
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McCaffery H, Zaituna J, Busch S, Kaciroti N, Miller AL, Lumeng JC, Rosenblum KL, Gearhardt A, Pesch MH. Developmental trajectories of eating behaviors and cross-lagged associations with weight across infancy. Appetite 2023; 188:106978. [PMID: 37495177 PMCID: PMC10844930 DOI: 10.1016/j.appet.2023.106978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/01/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
Examining typical developmental trajectories of infant eating behaviors, correlates of those trajectories, and cross-lagged associations between eating behaviors and anthropometry, is important to understand the etiology of these behaviors and their relevance to growth early in the lifespan. Mothers (N = 276) completed the Baby Eating Behavior Questionnaire (BEBQ) and infant anthropometrics were measured at ages 1, 2, 4, 6, and 10 months. Infant and maternal characteristics were collected by maternal report. Trajectories of eating behaviors were identified using latent class growth modeling and bivariate analyses examined associations of infant eating behavior trajectory membership with infant and maternal characteristics. Cross-lagged analyses examined associations between BEBQ subscales and infant weight-for-length z-score. Infant eating behavior trajectories included: Consistently High (62%) and Consistently Moderate (38%) Enjoyment of Food; Consistently High (9%), Moderate & Decreasing (43%), and Low & Decreasing (48%) Food Responsiveness; and Consistently High (62%) and Moderate & Decreasing (38%) General Appetite. Trajectory group membership was not associated with infant sex, gestational age, birthweight, or having been exclusively fed breastmilk at 2 months. Consistently High trajectories for Enjoyment of Food, Food Responsiveness, and General Appetite were associated with maternal demographic markers of psychosocial risk (e.g., lower maternal age and educational attainment). Food Responsiveness and General Appetite tracked strongly across infancy within individuals. Cross-lagged associations of Enjoyment of Food, Food Responsiveness, and General Appetite with weight-for-length z-score across infancy were generally null. Much additional work is needed to understand eating behaviors in infancy, their development, and their etiology. Further understanding of infant eating behaviors will provide the basis for future interventions to improve life course nutrition, growth, and health.
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Affiliation(s)
- Harlan McCaffery
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Julie Zaituna
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Sophie Busch
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA; School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
| | | | - Ashley Gearhardt
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
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Trolio V, Racine SE. Exploring latent profiles of disordered eating using an indicator of dietary restriction in an undergraduate sample of men and women. Int J Eat Disord 2023; 56:1603-1613. [PMID: 37158655 DOI: 10.1002/eat.23985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Latent class or latent profile analysis (LPA) studies in patients with eating disorders consistently identify a low-weight, restrictive eating subgroup that does not endorse weight/shape concerns. To date, similar studies in samples unselected for disordered eating symptoms have not identified a high restriction-low weight/shape concerns group, which may be due to a lack of inclusion of measures of dietary restriction. METHOD We conducted an LPA using data from 1623 college students (54% female) recruited across three different studies. The Eating Pathology Symptoms Inventory Body Dissatisfaction, Cognitive Restraint, Restricting, and Binge Eating subscales were used as indicators, and body mass index, gender, and dataset were covaried. Purging, excessive exercise, emotion dysregulation, and harmful alcohol use were compared across resulting clusters. RESULTS Fit indices supported a 10-class solution, including five disordered eating groups (largest to smallest): "Elevated General Disordered Eating", "Body Dissatisfied Binge Eating," "Most Severe General Disordered Eating," "Non-Body Dissatisfied Binge Eating," and "Non-Body Dissatisfied Restriction." The "Non-Body Dissatisfied Restriction" group scored as low on other measures of traditional eating pathology and harmful alcohol use as non-disordered eating groups but scored as high on a measure of emotion dysregulation as other disordered eating groups. DISCUSSION This study is the first to identify a latent restrictive eating group that does not endorse traditional disordered eating cognitions in an unselected sample of undergraduate students. Results underscore the importance of using measures of disordered eating behaviors without implied motivation to capture overlooked problematic eating patterns in the population that are distinct from our "traditional" understanding of disordered eating. PUBLIC SIGNIFICANCE We identified a group of individuals with high levels of restrictive eating but low body dissatisfaction and intent to diet in an unselected adult sample of men and women. Results underscore the need to investigate restrictive eating outside of the traditional lens of body shape concerns. Findings also suggest that individuals with nontraditional eating difficulties may struggle with emotion dysregulation, putting them at risk of poor psychological and relational outcomes.
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Affiliation(s)
- Vittoria Trolio
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Quebec, Canada
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Gotow N, Nagai Y, Taguchi T, Kino Y, Ogino H, Kobayakawa T. Change in preference for vegetables and their perceptual attributes as a function of age and pickiness. Food Res Int 2023; 170:112967. [PMID: 37316010 DOI: 10.1016/j.foodres.2023.112967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
- Naomi Gotow
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba Central 6, 1-1-1, Higashi, Tsukuba, Ibaraki 305-8566, Japan.
| | - Yuko Nagai
- Kagome Co., Ltd., 17, Nishitomiyama, Nasushiobara-shi, Tochigi 329-2762, Japan.
| | - Taro Taguchi
- Kagome Co., Ltd., 17, Nishitomiyama, Nasushiobara-shi, Tochigi 329-2762, Japan.
| | - Yuko Kino
- Kagome Co., Ltd., 17, Nishitomiyama, Nasushiobara-shi, Tochigi 329-2762, Japan.
| | - Hiroyuki Ogino
- Kagome Co., Ltd., 17, Nishitomiyama, Nasushiobara-shi, Tochigi 329-2762, Japan.
| | - Tatsu Kobayakawa
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba Central 6, 1-1-1, Higashi, Tsukuba, Ibaraki 305-8566, Japan.
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Papaioannou MA, Power TG, O’Connor TM, Fisher JO, Micheli NE, Hughes SO. Child Weight Status: The Role of Feeding Styles and Highly Motivated Eating in Children. CHILDREN 2023; 10:children10030507. [PMID: 36980065 PMCID: PMC10047856 DOI: 10.3390/children10030507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/26/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023]
Abstract
Although parental feeding plays an important role in child eating and weight status, high food motivation among children may also be a factor shaping how feeding impacts child weight. This study explored whether individual differences in preschool children’s food motivation interacted with mothers’ feeding styles in predicting subsequent child weight status. Participants included 129 Hispanic Head Start mother/child dyads. Data were collected at ages 4–5 years (Time 1) and 7–9 (Time 3). Staff measured heights/weights and observed children in an eating in the absence of hunger task. Mothers reported on feeding styles/practices and children’s eating behaviors. A principal components analysis derived a measure of highly motivated eating in children. Multiple regressions predicted Time 3 child BMI z-scores. Time 3 BMI z-scores were positively predicted by authoritative and indulgent feeding styles and negatively predicted by monitoring. Since feeding style interacted with highly motivated eating, separate regressions were run for high and low food motivation in children. Unexpectedly, results showed that authoritative feeding positively predicted Time 3 child BMI z-scores only for children showing low levels of food motivation. Characterizing differential parental feeding and child eating phenotypes may assist in tailoring childhood obesity prevention programs for the target populations.
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Affiliation(s)
- Maria A. Papaioannou
- Department of Pediatrics, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Thomas G. Power
- Department of Human Development, Washington State University, Pullman, WA 99164, USA
| | - Teresia M. O’Connor
- Department of Pediatrics, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jennifer O. Fisher
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, PA 19122, USA
| | - Nilda E. Micheli
- Department of Pediatrics, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sheryl O. Hughes
- Department of Pediatrics, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
- Correspondence: ; Tel.: +1-713-798-7017
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7
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DeJesus JM, Venkatesh S, Elmore-Li CR. Food as a key disgust elicitor in infancy and childhood: Previous research and opportunities for future study. Bull Menninger Clin 2023; 87:92-112. [PMID: 37871192 DOI: 10.1521/bumc.2023.87.suppa.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Disliked foods may have important value in the study of the development of disgust. The current review draws from literature across disciplines, including theories of disgust and studies of the development of eating behavior and food preferences, to highlight food as an important category of disgust responses across a wide age range, including children as young as 3 years old and adults. Children's disgust responses to certain types of food are considered to be both innate and culturally constrained behaviors, and their perceptions of other people's food choices indicate potential links between foods and cultural groups. We end by discussing several ongoing and future research areas, including connections between disgust responses and food rejection in infancy and children's food rejection behaviors across cultures.
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Affiliation(s)
- Jasmine M DeJesus
- Department of Psychology, University of North Carolina at Greensboro
| | - Shruthi Venkatesh
- Department of Psychology, University of North Carolina at Greensboro
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Brown CL, Ip EH, Skelton J, Lucas C, Vitolins MZ. Parental concerns about picky eating and undereating, feeding practices, and child's weight. Obes Res Clin Pract 2022; 16:373-378. [PMID: 36097260 DOI: 10.1016/j.orcp.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/29/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Parents' concerns about their child's feeding may lead parents to pressure their child to eat, which may lead to a greater risk for obesity. We aimed to assess if parental concerns for picky eating and undereating are associated with pressure to eat and increased child BMI z-score (BMIz). METHODS We performed a cross-sectional study of 328 parents of healthy preschoolers assessing parent concerns about picky eating (Child Eating Behavior Questionnaire) and child undereating ("Are you concerned …doesn't eat enough?"), parent pressure to eat (Child Feeding Questionnaire), and covariates. Dyads' heights and weights were measured. Structural equation modeling (SEM) was performed to examine the relationships between parental concerns, pressure to eat, and child BMIz. Measurement models were tested and refined, and the structural model was tested. Model fit was determined using multiple goodness-of-fit indices. RESULTS Dyads were racially and socioeconomically diverse. The SEM model demonstrated good goodness-of-fit. Children who were perceived as not eating enough had significantly higher picky eating scores (β 0.756; p < 0.001). Parents had higher pressure to eat scores if children were more picky (β 0.148; p = 0.02) or were perceived as not eating enough (β 0.654; p < 0.001). Parental pressure to eat was not associated with the child's BMIz. CONCLUSIONS In a cohort of diverse preschoolers, parent concerns about eating were associated with increased pressure to eat, but pressure to eat was not associated with BMIz. Identifying these relationships is important to develop effective interventions to improve feeding practices in young children.
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Affiliation(s)
- Callie L Brown
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, United States; Department of Epidemiology and Prevention, Wake Forest School of Medicine, United States.
| | - Edward H Ip
- Department of Biostatistics, Wake Forest School of Medicine, United States
| | - Joseph Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, United States; Department of Epidemiology and Prevention, Wake Forest School of Medicine, United States
| | - Caroline Lucas
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Mara Z Vitolins
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, United States
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Review and meta-analysis for the caregiver's feeding styles questionnaire administered to low-income families. Eat Behav 2022; 46:101659. [PMID: 35964363 DOI: 10.1016/j.eatbeh.2022.101659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/29/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022]
Abstract
The Caregiver's Feeding Styles Questionnaire (CFSQ) is a well-established measure which uses scores along two dimensions of demandingness and responsiveness to classify low-income parents into one of four feeding style typologies (authoritative, authoritarian, indulgent, and uninvolved; Hughes, et al., 2005). The measure is widely used by researchers to explore the relationship between feeding style and child weight status but has not been evaluated comprehensively in a review or meta-analysis. The aims of this study were to 1) compare established median cutoffs for responsiveness and demandingness in parent feeding (k = 5; see Hughes et al., 2012) to current median splits along these two dimensions for a larger sample of articles (k = 19) and 2) evaluate the relation between children's BMI, demandingness and responsiveness, and parent feeding style categories. Results indicated that the cutoffs for responsiveness and demandingness initially established based on five studies of low-income families did not differ significantly with the addition of 19 studies. Child BMI z-scores (k = 8) were above average for all four parent feeding style categories and highest for indulgent parents, which was consistent with the literature outlining low-income children at higher risk for obesity and children of indulgent parents being particularly at risk. While heterogeneity of samples should be considered, study results suggested that the CFSQ distribution for responsiveness and demandingness was relatively generalizable across low-income samples, though heterogeneity was higher among caregiver's feeding style categories. Furthermore, the study confirmed that parent feeding styles were related to child weight status in a meaningful way, but all children in these low-income samples, on average, were heavier than their same-aged peers across all parent feeding styles.
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10
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Fisher JO, Hughes SO, Miller AL, Horodynski MA, Brophy-Herb HE, Contreras DA, Kaciroti N, Peterson KE, Rosenblum KL, Appugliese D, Lumeng JC. Characteristics of eating behavior profiles among preschoolers with low-income backgrounds: a person-centered analysis. Int J Behav Nutr Phys Act 2022; 19:91. [PMID: 35870976 PMCID: PMC9308918 DOI: 10.1186/s12966-022-01323-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individual differences in eating behaviors among young children are well-established, but the extent to which behaviors aggregate within individuals to form distinct eating behavior profiles remains unknown. Our objectives were to identify eating behavior profiles among preschool-aged children and evaluate associations with temperament and weight. METHODS A secondary, cross-sectional analysis of baseline data from 2 cohort studies was conducted involving 1004 children aged 3-4 years and their parents with low-income backgrounds. Children's eating behaviors and temperament were assessed by parental report. Body mass index z-scores and weight status were calculated using measured heights and weights. Latent profile analysis (LPA) was used to generate profiles and bivariate analyses were used to evaluate associations with temperament and weight status. RESULTS LPA revealed the presence of 3 eating behavior profiles among children. Children with High Food Approach profiles (21.2%) had lower temperamental inhibitory control and the highest percent of children with obesity relative to the other profiles. Children with High Food Avoidant profiles (35.6%) had lower temperamental impulsivity and lower BMI z-scores relative to the other profiles, whereas children with Moderate Eating profiles (intermediary levels of all behaviors; 43.2%) had higher temperamental inhibitory control and lower anger/frustration, than other profiles. CONCLUSIONS Young children's eating behaviors appear to aggregate within individuals to form empirically distinct profiles reflecting food approach, food avoidance, and moderate approaches to eating that are differentiated by aspects of temperament and weight. Future work should seek to understand the extent to which health promotion and obesity prevention approaches should be tailored to take into account children's fundamental dispositions towards eating.
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Affiliation(s)
- Jennifer Orlet Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA.
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Dawn A Contreras
- Health and Nutrition Institute, Michigan State University Extension, East Lansing, MI, USA
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
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11
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Schwarzlose RF, Hennefield L, Hoyniak CP, Luby JL, Gilbert KE. Picky Eating in Childhood: Associations With Obsessive-Compulsive Symptoms. J Pediatr Psychol 2022; 47:816-826. [PMID: 35238927 PMCID: PMC9297090 DOI: 10.1093/jpepsy/jsac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To test whether childhood picky eating (PE)-a behavior previously linked to many forms of psychopathology-is specifically associated with symptoms of obsessive-compulsive disorder (OCD). METHODS We investigated the relationship between PE and symptoms of several forms of psychopathology in two separate observational samples: a sample of 110 children (5 and 6 years old) and a sample of 210 children (8 and 9 years old) drawn from a longitudinal study. In each sample, regression models based on psychiatric symptoms or diagnoses were used to assess the specificity of PE associations while accounting for cooccurring symptoms or comorbidities. RESULTS Although bivariate associations emerged between PE and multiple forms of psychopathology, multivariate analyses revealed these associations were driven by a strong and specific association between PE and symptoms of OCD in both samples. Moreover, PE among 8- and 9-year-olds in the longitudinal study predicted emergence of additional later psychopathology, specifically attention-deficit/hyperactivity disorder (ADHD). CONCLUSIONS Findings suggest that PE, an easily identifiable clinical presentation, is also a specific marker for obsessive-compulsive symptomatology in school-age children and may impart risk for ADHD later in childhood.
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Affiliation(s)
| | - Laura Hennefield
- Department of Psychiatry, Washington University School of Medicine in St Louis, USA
| | - Caroline P Hoyniak
- Department of Psychiatry, Washington University School of Medicine in St Louis, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St Louis, USA
| | - Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine in St Louis, USA
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12
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Russell CG, Appleton J, Burnett AJ, Rossiter C, Fowler C, Denney-Wilson E, Jansen E. Infant Appetitive Phenotypes: A Group-Based Multi-Trajectory Analysis. Front Nutr 2022; 8:749918. [PMID: 35004800 PMCID: PMC8740295 DOI: 10.3389/fnut.2021.749918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/19/2021] [Indexed: 12/28/2022] Open
Abstract
Background: Examining appetitive traits with person-centered analytical approaches can advance the understanding of appetitive phenotype trajectories across infancy, their origins, and influences upon them. The objective of the present study was to empirically describe appetitive phenotype trajectories in infancy and examine the associations with infant and parent factors. Materials and Methods: In this longitudinal cohort study of Australian infants, parents completed three online surveys ~3 months apart, beginning when the infant was <6 months. Appetitive traits were assessed with the Baby Eating Behavior Questionnaire (BEBQ) and parent feeding practices with the Feeding Practices and Structure Questionnaire (FPSQ) infant and toddler version. Parent demographics and cognitions were also collected. Infant weight and length were transcribed from health records and converted to a BMI z-score. Group-based trajectory modeling identified appetitive phenotype trajectories using the BEBQ. Multilevel modeling examined change in feeding practices and child BMI z-score over time by appetitive phenotype trajectories. Results: At time 1, 380 participants completed the survey (mean infant age 98 days), 178 at time 2 (mean infant age 198 days), and 154 at time 3 (mean infant age 303 days). Three multi-trajectory appetitive phenotype groups were identified and labeled as (Phenotype 1) food avoidant trending toward low food approach (21.32% of infants), (Phenotype 2) persistently balanced (50.53% of infants), and (Phenotype 3) high and continuing food approach (28.16% of infants). Formula feeding was more common in Phenotype 1 (p = 0.016). Parents of infants in Phenotype 1 were more likely to rate them as being more difficult than average, compared to infants with phenotypes 2 or 3. Phenotype 2 had the greatest increase in persuasive feeding over time [0.30; 95% CI (0.12, −0.47)]. Conclusions: Distinct multi-trajectory appetitive phenotype groups emerge early in infancy. These trajectories appear to have origins in both infant and parent characteristics as well as parent behaviors and cognitions. The infant multi-trajectory appetitive phenotype groups suggest that for some infants, difficulties in self-regulating appetite emerge early in life. Investigation of infant multi-trajectory appetitive phenotype groups that utilize a range of measures, examine relationships to key covariates and outcomes, and extend from infancy into childhood are needed.
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Affiliation(s)
- Catherine G Russell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Jessica Appleton
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia.,Tresillian Family Care Centres, Belmore, Sydney, NSW, Australia
| | - Alissa J Burnett
- Faculty of Health, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia.,Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia
| | - Cathrine Fowler
- Tresillian Family Care Centres, Belmore, Sydney, NSW, Australia.,Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, NSW, Australia.,Sydney Local Health District, Sydney, NSW, Australia
| | - Elena Jansen
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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13
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Kim YK, Di Martino JM, Nicholas J, Rivera-Cancel A, Wildes JE, Marcus MD, Sapiro G, Zucker N. Parent strategies for expanding food variety: Reflections of 19,239 adults with symptoms of Avoidant/Restrictive Food Intake Disorder. Int J Eat Disord 2022; 55:108-119. [PMID: 34761436 PMCID: PMC8841112 DOI: 10.1002/eat.23639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/13/2021] [Accepted: 10/13/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To characterize helpful parent feeding strategies using reflections on childhood eating experiences of adults with symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID). METHOD We explored a unique text-based dataset gathered from a population of N = 19,239 self-identified adult "picky eaters." The sample included adults with symptoms of ARFID as evidenced by marked interference in psychosocial functioning, weight loss/sustained low weight, and/or nutritional deficiency (likely ARFID), and non-ARFID participants. We leveraged state-of-the-art natural language processing (NLP) methods to classify feeding strategies that were perceived as helpful or not helpful. The best classifiers that distinguished helpful approaches were further analyzed using qualitative coding according to a grounded theory approach. RESULTS NLP reliably and accurately classified the perceived helpfulness of caregivers' feeding strategies (82%) and provided information about features of helpful parent strategies using recollections of adults with varying degrees of food avoidance. Strategies perceived as forceful were regarded as not helpful. Positive and encouraging strategies were perceived as helpful in improving attitudes toward food and minimizing social discomfort around eating. Although food variety improved, adults still struggled with a degree of avoidance/restriction. DISCUSSION Adults perceived that positive parent feeding strategies were helpful even though they continued to experience some degree of food avoidance. Creating a positive emotional context surrounding food and eating with others may help to eliminate psychosocial impairment and increase food approach in those with severe food avoidance. Nevertheless, additional tools to optimize parent strategies and improve individuals' capacity to incorporate avoided foods and cope with challenging eating situations are needed.
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Affiliation(s)
| | | | - Julia Nicholas
- Psychiatry and Behavioral Sciences, Duke University, USA
| | | | | | | | - Guillermo Sapiro
- Electrical and Computer Engineering, Duke University, USA,Computer Sciences, Duke University, USA,Biomedical Engineering, Duke University, USA,Mathematics, Duke University, USA
| | - Nancy Zucker
- Psychiatry and Behavioral Sciences, Duke University, USA,Psychology and Neuroscience, Duke University, USA
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14
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Smith BL, Gutierrez R, Ludlow AK. A comparison of food avoidant behaviours and sensory sensitivity in adults with and without Tourette syndrome. Appetite 2022; 168:105713. [PMID: 34563498 DOI: 10.1016/j.appet.2021.105713] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 02/06/2023]
Abstract
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.
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Affiliation(s)
- Bobbie L Smith
- Department of Psychology, Sport and Geography, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
| | - Roberto Gutierrez
- Department of Psychology, Sport and Geography, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
| | - Amanda K Ludlow
- Department of Psychology, Sport and Geography, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
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15
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Rolle H, Vollrath J, Kiess W, Flemming G. 3/w mit Perzentilenknick und selektivem Essverhalten. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01360-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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16
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Caputi M, Dulay KM, Bulgarelli D, Houston-Price C, Cerrato G, Fanelli M, Masento NA, Molina P. See & Eat! Using E-books to Promote Vegetable Eating Among Preschoolers: Findings From an Italian Sample. Front Psychol 2021; 12:712416. [PMID: 34512470 PMCID: PMC8430236 DOI: 10.3389/fpsyg.2021.712416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/16/2021] [Indexed: 12/03/2022] Open
Abstract
Different strategies have been developed to help parents with introducing new or disliked vegetables. Nonetheless, many parents of preschoolers struggle against children's refusal to eat vegetables. In this study, we aimed to evaluate the effectiveness of e-books in promoting positive attitudes toward vegetables through repeated visual exposures. A total of 61 families with preschoolers joined the See & Eat study and received an e-book about one of two vegetables chosen from a list of 24. Parents provided ratings of children's willingness to taste, intake, and liking of the chosen vegetables before and after reading the e-book; parents also evaluated their children's food fussiness and their agreement with respect to three mealtime goals of the family. Using a 2 (vegetable: target or non-target) × 2 (time: pre-test or post-test) within-subjects analysis, results from 53 families revealed a significant increase in children's willingness to taste, intake, and liking at post-test of both target and non-target vegetables. Following a two-week parent-child e-book reading intervention, children's food fussiness and parents' endorsement of positive mealtime goals slightly but significantly increased. Results suggest that e-books are effective in encouraging healthy eating among preschoolers and that the positive effect of e-book reading can generalize to other vegetables.
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Affiliation(s)
- Marcella Caputi
- Department of Psychology, Università degli Studi di Torino, Torino, Italy.,Sigmund Freud University, Milano, Italy
| | - Katrina May Dulay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom.,Department of Education, University of Oxford, Oxford, United Kingdom
| | | | - Carmel Houston-Price
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Giuseppina Cerrato
- Department of Chemistry, Università degli Studi di Torino, Torino, Italy
| | - Mauro Fanelli
- Department of Chemistry, Università degli Studi di Torino, Torino, Italy
| | - Natalie A Masento
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Paola Molina
- Department of Psychology, Università degli Studi di Torino, Torino, Italy.,Interuniversity Department of Regional and Urban Studies and Planning, Università degli Studi di Torino, Torino, Italy
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17
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Regulatory parental feeding behaviors, emotion suppression, and emotional eating in the absence of hunger: Examining parent-adolescent dyadic associations. Appetite 2021; 167:105603. [PMID: 34280470 DOI: 10.1016/j.appet.2021.105603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/07/2021] [Accepted: 07/14/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The present study aimed to improve the understanding of inter- and intrapersonal processes implicated in emotional eating using a large community sample of parent-adolescent dyads. METHOD Participants included 1823 parent and adolescent dyads who completed the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study. Parents and adolescents each completed measures assessing parents' feeding behaviors, and participants' own emotional functioning and eating behaviors. Actor-partner interdependence models examined dyadic associations among participants' reports of parents' regulatory feeding behaviors (allowing adolescents to eat for emotional comfort purposes, controlling adolescents' "junk" food/sugary drink intakes), emotion suppression, and emotional eating in the absence of hunger. RESULTS Multiple within-person, cross-dyad member, and divergent parent versus adolescent dyadic effects were identified that differed based on the parental feeding behavior that parents and adolescents reported on. For example, adolescents' reports that their parents regulate their "junk" food/sugary drink intakes were associated with lower levels of their own emotion suppression and, in turn, lower levels of both their own and their parents' emotional eating, whereas parents' reports that they regulate their adolescents' "junk" food/sugary drink intakes were associated with higher levels of their own emotion suppression and emotional eating. CONCLUSIONS These findings underscore the complex interconnectivity among parental feeding behaviors, emotion dysregulation, and emotional eating within the parent-adolescent dyadic context, and support the use of preventive disordered eating interventions focused on enhancing healthy parent feeding behaviors and adaptive emotion regulation skills from a family-based perspective.
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18
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Associations between Child Mental Well-Being or Conflicts during Mealtime and Picky Eating Behaviour. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115621. [PMID: 34070271 PMCID: PMC8197404 DOI: 10.3390/ijerph18115621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 11/17/2022]
Abstract
Pickiness is an eating behavior that many families with young children face. Having joint family meals may impact the child’s pickiness, for instance by influencing their willingness to try novel foods. Moreover, picky children have been shown to display greater emotionality. The aim of this study was to investigate if children’s mental well-being and parent-reported conflicts during mealtime were associated with pickiness among obesity-prone children. Data was obtained from the baseline examination of the Healthy Start intervention study, the Danish Medical Birth registry and the Danish Health Visitor’s Child Health Database, and included 635 children aged 2–6 years that were all at high risk for becoming overweight later in life. Children’s mental well-being was measured by the strengths and difficulties questionnaire. Crude and adjusted ordinal logistic regressions were used to investigate the cross-sectional associations. Children had a higher odds associated with changing from a category of less pickiness to a category of more pickiness for each one point higher SDQ score (ORadj. = 1.35, 95% CI = 1.14; 1.61) and lower odds (ORadj. = 0.57, 95% CI = 0.38; 0.86) associated with changing pickiness category towards more pickiness for each one point higher SDQ prosocial score. Moreover, children with conflicts during mealtime had higher odds of being in a worse pickiness category compared to children without conflicts (ORadj. = 3.37, 95% CI = 2.27; 5.01). This study showed that among obesity-prone children, behavioral problems, as well as conflicts during mealtime, were associated with more picky behaviors. Further longitudinal studies are needed to confirm the findings, as are studies including general child population subsets.
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19
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Appetite self-regulation declines across childhood while general self-regulation improves: A narrative review of the origins and development of appetite self-regulation. Appetite 2021; 162:105178. [PMID: 33639246 DOI: 10.1016/j.appet.2021.105178] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 02/07/2023]
Abstract
This narrative review discusses the origins and development of appetite self-regulation (ASR) in childhood (from infancy to age 6 or 7 years). The origins, or foundations, are the biological infrastructure associated with appetite regulation and appetite self-regulation. Homeostatic regulation in infancy is examined and then evidence about developmental change in components of ASR. The main ASR-related components covered are: delay-of-gratification, caloric compensation, eating in the absence of hunger, food responsiveness/hedonics and fussy eating. The research included behavioral measures, parent-reports of appetitive traits and fMRI studies. There were two main trends in the evidence: a decline across childhood in the components of ASR associated with food approach (and therefore an increase in disinhibited eating), and wide individual differences. The decline in ASR contrasts with general self-regulation (GSR) where the evidence is of an improvement across childhood. For many children, bottom-up automatic reactive processes via food reward/hedonics or food avoidance as in fussy eating, appear not to be matched by improvements in top-down regulatory capacities. The prominence of bottom-up processes in ASR could be the main factor in possible differences in developmental paths for GSR and ASR. GSR research is situated in developmental science with its focus on developmental processes, theory and methodology. In contrast, the development of ASR at present does not have a strong developmental tradition to access and there is no unifying model of ASR and its development. We concluded (1) outside of mean-level or normative changes in the components of ASR, individual differences are prominent, and (2) there is a need to formulate models of developmental change in ASR together with appropriate measurement, research designs and data analysis strategies.
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20
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Graf MD, Karp SM, Lutenbacher M, Wasser H, Bushaw A, Dietrich MS. Clinical strategies for addressing obesity in infants and toddlers. Nurse Pract 2021; 46:28-33. [PMID: 33475327 DOI: 10.1097/01.npr.0000731552.88748.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Babies' earliest food experiences have a lifelong impact on eating preferences and dietary habits, laying the foundation for obesity risk. NPs have the opportunity to provide education about healthy infant feeding practices before the growth trajectory becomes abnormal and focus intensive education on at-risk families.
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21
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Chua SN, Fitzsimmons-Craft EE, Austin SB, Wilfley DE, Taylor CB. Estimated prevalence of eating disorders in Singapore. Int J Eat Disord 2021; 54:7-18. [PMID: 33314277 PMCID: PMC8011933 DOI: 10.1002/eat.23440] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/24/2020] [Accepted: 11/28/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE There is a lack of research on the prevalence of eating disorders (EDs) in Singapore. The aims of our study were to (a) estimate the prevalence of EDs, risk status, and help-seeking behaviors among adults in Singapore, (b) examine gender differences between ED status groups, and (c) characterize clinical profiles of ED status groups. METHOD We administered a cross-sectional survey that included a validated EDs screening tool to adults in Singapore. RESULTS A total of 797 Singaporean adults ages 21-77 years completed the ED screen. The majority of participants screened positive for a current DSM-5 clinical ED (6.2%), other specified feeding or ED (37.0%) or at high risk of developing an ED (19.5%). Only 1.6% of those who screened positive for an ED reported currently being in treatment. The ratio of males to females who screened positive for an ED was nearly 1:1. The clinical profiles of ED groups were consistent with the clinical presentations found in Western nations. DISCUSSION This is the first study in Singapore to estimate the prevalence of EDs in a large sample of adults. Results highlight the urgent need for more ED research and expansion of prevention and treatment programs to address the high prevalence of ED psychopathology in Singapore.
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Affiliation(s)
- Sook Ning Chua
- PCHD, National Institute of Education, Nanyang Technological University, Singapore
| | | | - S. Bryn Austin
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, Massachusetts
- Division of Adolescent and Young Adult Medicine, Boston Children’s Hospital
| | - Denise E. Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - C. Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
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22
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Koomar T, Thomas TR, Pottschmidt NR, Lutter M, Michaelson JJ. Estimating the Prevalence and Genetic Risk Mechanisms of ARFID in a Large Autism Cohort. Front Psychiatry 2021; 12:668297. [PMID: 34177659 PMCID: PMC8221394 DOI: 10.3389/fpsyt.2021.668297] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/07/2021] [Indexed: 12/27/2022] Open
Abstract
This study is the first genetically-informed investigation of avoidant/restrictive food intake disorder (ARFID), an eating disorder that profoundly impacts quality of life for those affected. ARFID is highly comorbid with autism, and we provide the first estimate of its prevalence in a large and phenotypically diverse autism cohort (a subsample of the SPARK study, N = 5,157 probands). This estimate, 21% (at a balanced accuracy 80%), is at the upper end of previous estimates from studies based on clinical samples, suggesting under-diagnosis and potentially lack of awareness among caretakers and clinicians. Although some studies suggest a decrease of disordered eating symptoms by age 6, our estimates indicate that up to 17% (at a balanced accuracy 87%) of parents of autistic children are also at heightened risk for ARFID, suggesting a lifelong risk for disordered eating. We were also able to provide the first estimates of narrow-sense heritability (h2) for ARFID risk, at 0.45. Genome-wide association revealed a single hit near ZSWIM6, a gene previously implicated in neurodevelopmental conditions. While, the current sample was not well-powered for GWAS, effect size and heritability estimates allowed us to project the sample sizes necessary to more robustly discover ARFID-linked loci via common variants. Further genetic analysis using polygenic risk scores (PRS) affirmed genetic links to autism as well as neuroticism and metabolic syndrome.
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Affiliation(s)
- Tanner Koomar
- Department of Psychiatry, The University of Iowa, Iowa City, IA, United States
| | - Taylor R Thomas
- Department of Psychiatry, The University of Iowa, Iowa City, IA, United States
| | - Natalie R Pottschmidt
- Department of Psychology, Pennsylvania State University, State College, PA, United States
| | - Michael Lutter
- Eating Recovery Center of San Antonio, San Antonio, TX, United States
| | - Jacob J Michaelson
- Department of Psychiatry, The University of Iowa, Iowa City, IA, United States
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23
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DeJesus JM, Venkatesh S. Show or tell: Children's learning about food from action vs verbal testimony. Pediatr Obes 2020; 15:e12719. [PMID: 32869955 DOI: 10.1111/ijpo.12719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 08/07/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Childhood obesity continues to be a critical health concern in the United States. Nonetheless, interventions that focus on delivering verbal lessons about food and health to children in preschool classrooms have had only modest effects. OBJECTIVES The present study examines the relative effectiveness of showing vs telling children about food to promote healthy eating, with a focus on unfamiliar foods and vegetables. METHODS Three- to six-year-old children (n = 71) were tested in a laboratory study in which they watched videos of two people eating apple-broccoli puree. One person took five bites of the food; the other said they liked the food. RESULTS Children did not differentiate between the food they saw someone eat and the food they heard someone talk about. Children's food intake was negatively associated with parent reports of children's eating behavior on the Food Fussiness subscale of the Child Eating Behavior Questionnaire. We found similar patterns in an analogous toy task. In an unfamiliar object task, children selected the action demonstration as the right way to use the object. CONCLUSIONS We find no evidence that action vs verbal testimony is more persuasive in guiding children's food choices, but action testimony may be persuasive in other domains. The associations between children's food intake and pickiness provide growing evidence of alignment between parent assessments of their children's typical eating behavior and children's food choices in laboratory studies.
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Affiliation(s)
- Jasmine M DeJesus
- Department of Psychology, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Shruthi Venkatesh
- Department of Psychology, University of North Carolina Greensboro, Greensboro, North Carolina, USA
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24
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Zucker NL, Hughes SO. The Persistence of Picky Eating: Opportunities to Improve Our Strategies and Messaging. Pediatrics 2020; 145:peds.2020-0893. [PMID: 32457217 PMCID: PMC7263049 DOI: 10.1542/peds.2020-0893] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Nancy L. Zucker
- Department of Psychiatry and Behavioral Sciences, School of Medicine and,Department of Psychology and Neuroscience, Duke University, Durham, North Carolina; and
| | - Sheryl O. Hughes
- Children’s Nutrition Research Center, Baylor College of Medicine, Houston, Texas
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