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Costa A, Pereira R, Severo M, Hetherington MM, Oliveira A. Appetitive traits from childhood to adolescence: Analysis of their stability, derivation of trajectory profiles, and associated characteristics. Appetite 2024; 193:107149. [PMID: 38049034 DOI: 10.1016/j.appet.2023.107149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 12/06/2023]
Abstract
This study aimed to assess the potential stability of appetitive traits from childhood to early adolescence, identify groups of individuals with distinct trajectories for these traits, and explore their association with other child and family characteristics. Participants were 5040 children from the Generation XXI cohort. Appetitive traits were assessed with the Children's Eating Behaviour Questionnaire (CEBQ) at ages seven, 10, and 13 (eight subscales). Mixed-effect models estimated individual trajectories of appetitive traits and Gaussian mixture models identified groups following different trajectories (appetitive trait trajectory profiles). Appetitive traits showed moderate-to-high stability across the three ages (intra-class correlation coefficients:0.66-0.83); most of the variance observed across time were due to persistent individual differences rather than age-related changes. Six appetitive trait trajectory profiles were identified: 'Moderate appetite' (scores close to the average) (29% of children), 'Small to moderate appetite' (lowest food approach and emotional eating) (26%), 'Increasing appetite' (increasing food approach) (15%), 'Avid appetite' (highest food approach and lowest food avoidance) (12%), 'Smallest appetite' (highest food avoidance and low food approach) (10%), and 'Small appetite but increasing' (decreasing high food avoidance and Desire to Drink) (8%). In multinomial logistic regression, these profiles were associated with different child and family characteristics. Compared to children with a 'Moderate appetite' profile, those with higher BMI, who desired a thinner body, whose mothers were younger, had lower education, higher pre-pregnancy BMI (OR = 1.07; 95%CI:1.04,1.09), smoked during pregnancy (OR = 1.51; 95%CI:1.21,1.90), and used more restrictive feeding practices (OR = 1.79; 95%CI:1.57,2.03) had increased odds of belonging to the 'Avid Appetite'. In conclusion, distinct appetitive trait trajectory profiles emerged, differentiating individuals with avid and small appetites. These findings have implications for identifying children at higher risk for obesogenic profiles.
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Affiliation(s)
- Alexandra Costa
- EPIUnit - Instituto de Saúde Pública, Universidade Do Porto, Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Universidade Do Porto, Rua Das Taipas, N° 135, 4050-600, Porto, Portugal
| | - Rita Pereira
- EPIUnit - Instituto de Saúde Pública, Universidade Do Porto, Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Universidade Do Porto, Rua Das Taipas, N° 135, 4050-600, Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade Do Porto, Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Universidade Do Porto, Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Departamento de Ensino Pré-Graduado, Instituto de Ciências Biomédicas Abel Salazar, Universidade Do Porto, Largo Prof. Abel Salazar, Nº24, 4099-001, Porto, Portugal
| | | | - Andreia Oliveira
- EPIUnit - Instituto de Saúde Pública, Universidade Do Porto, Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional Em Saúde Populacional (ITR), Universidade Do Porto, Rua Das Taipas, N° 135, 4050-600, Porto, Portugal; Departamento de Saúde Pública e Ciências Forenses e Educação Médica, Faculdade de Medicina, Universidade Do Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
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Negrea MO, Negrea GO, Săndulescu G, Neamtu B, Costea RM, Teodoru M, Cipăian CR, Solomon A, Popa ML, Domnariu CD. Assessing Obesogenic School Environments in Sibiu County, Romania: Adapting the ISCOLE School Environment Questionnaire. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1746. [PMID: 38002837 PMCID: PMC10670591 DOI: 10.3390/children10111746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/20/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023]
Abstract
The impact of the school environment on childhood weight status has garnered significant attention in recent years. This study aimed to adapt and validate the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) School and Environment questionnaire in order to assess the potential obesogenic impact of school environments in Sibiu County, Romania. The ISCOLE questionnaire was chosen for its rigorous methodology. It was derived from a comprehensive study conducted across 12 countries which aimed to capture multifaceted influences on childhood weight while emphasizing educational settings in the collection of data. To guide the translation and adaptation of the questionnaire, a multidisciplinary committee was assembled which comprised experts in teaching and school administration to ensure target responder relevance, experts in clinical research to ensure methodological robustness, experts in language adaptation to preserve the original intent of the survey, and experts in public health to steer the interpretation of the results, with potential policy implications. The data were analyzed by distinguishing between urban and rural settings, and a two-step cluster analysis was implemented to identify potential intervention targets. To assess the validity of the adapted tool, the questionnaire's construct validity and internal consistency were explored. A response rate of 71.2% of the approached schools in Sibiu County was achieved. Of the 84 responding school representatives, 37 (44%) were from a rural setting. The rural schools had significantly more limited access to gymnasiums, secured lockers, showers, and bicycle racks, and exhibited more serious problems regarding the inadequate disposal of garbage in the school vicinity. A two-step cluster analysis revealed distinct school categories, providing opportunities for public policy interventions. One of these primarily concerned rural schools with limited infrastructure but with proactive practices and policies which were termed "unable but willing"; on the opposing spectrum, the category "able but unwilling" mainly comprised urban schools which had available facilities but lacked local proactive initiatives. The findings emphasize the urgent need for targeted measures to bridge these discrepancies by investing in infrastructure in rural schools and promoting active school practices and policies in urban settings. The assessment of obesogenic school environments in Sibiu County provides a pilot model for broader applications due to the diverse school landscape and supportive local authorities. The results, which were achieved using low-cost methods, can guide future educational policies, health promotion initiatives, and preventive interventions.
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Affiliation(s)
- Mihai Octavian Negrea
- Medical Clinical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (M.T.); (C.R.C.); (A.S.); (M.L.P.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | | | - Gabriela Săndulescu
- “Gheorghe Lazăr” National College, 1–3 Gheorghe Lazăr Str., 550165 Sibiu, Romania;
| | - Bogdan Neamtu
- Medical Clinical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (M.T.); (C.R.C.); (A.S.); (M.L.P.)
- Department of Clinical Research, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania;
| | - Raluca Maria Costea
- Department of Clinical Research, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania;
- Pediatric Neurology Department, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania
| | - Minodora Teodoru
- Medical Clinical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (M.T.); (C.R.C.); (A.S.); (M.L.P.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | - Călin Remus Cipăian
- Medical Clinical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (M.T.); (C.R.C.); (A.S.); (M.L.P.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | - Adelaida Solomon
- Medical Clinical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (M.T.); (C.R.C.); (A.S.); (M.L.P.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | - Mirela Livia Popa
- Medical Clinical Department, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania; (M.O.N.); (B.N.); (M.T.); (C.R.C.); (A.S.); (M.L.P.)
- County Clinical Emergency Hospital of Sibiu, 2–4 Corneliu Coposu Str., 550245 Sibiu, Romania
| | - Carmen Daniela Domnariu
- Department of Dental Medicine and Nursing, Faculty of Medicine, “Lucian Blaga” University, 550024 Sibiu, Romania;
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