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Fox CK, Molitor SJ, Vock DM, Peterson CB, Crow SJ, Gross AC. Appetitive and psychological phenotypes of pediatric patients with obesity. Pediatr Obes 2024; 19:e13101. [PMID: 38290813 DOI: 10.1111/ijpo.13101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 12/15/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Obesity is a heterogeneous disease with variable treatment response. Identification of the unique constellation of contributors to obesity may allow for targeted interventions and improved outcomes. OBJECTIVE Identify empirically derived phenotypes of pediatric patients with obesity based on appetitive and psychological correlates of obesity. METHODS This cross-sectional study included patients aged 5-12 years who were treated in a weight management clinic and completed standard intake questionnaires including Child Eating Behavior Questionnaire (CEBQ), Vanderbilt ADHD Scale and Pediatric Symptom Checklist. Phenotypes were elicited using latent profile analysis of 12 indicators: eight CEBQ subscales, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms. RESULTS Parents/guardians of 384 patients (mean age 9.8 years, mean BMI 30.3 kg/m2 ) completed the intake questionnaires. A 4-phenotype model best fits the data. Hedonic Impulsive phenotype (42.5%) exhibited high food enjoyment and hyperactivity/impulsivity. Inattentive Impulsive phenotype (27.4%) exhibited overall low food approach and high food avoid behaviours, and highest inattention. Hedonic Emotional phenotype (20.8%) scored the highest on food enjoyment, internalizing and externalizing symptoms. Picky Eating phenotype (9.3%) scored the lowest on food approach, inattention, hyperactivity/impulsivity, internalizing and externalizing symptoms. CONCLUSION Appetitive traits and psychological symptoms appear to cluster in distinct patterns, giving rise to four unique phenotypic profiles, which, if replicated, may help inform the development of tailored treatment plans.
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Affiliation(s)
- Claudia K Fox
- Center for Pediatric Obesity Medicine and Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Stephen J Molitor
- Division of Pediatric Psychology and Developmental Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - David M Vock
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Amy C Gross
- Center for Pediatric Obesity Medicine and Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
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Cummings JR, Lipsky LM, Faith MS, Nansel TR. Developmental trajectory of appetitive traits and their bidirectional relations with body mass index from infancy to early childhood. Clin Obes 2024; 14:e12620. [PMID: 37669768 PMCID: PMC10841422 DOI: 10.1111/cob.12620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/07/2023]
Abstract
Appetitive traits, including food responsiveness, enjoyment of food, satiety responsiveness and slowness in eating, are associated with childhood body mass index. Change in appetitive traits from infancy to childhood and the direction of causality between appetitive traits and body mass index are unclear. The present study examined the developmental trajectory of appetitive traits and their bidirectional relations with body mass index, from infancy to early childhood. Mothers in the Pregnancy Eating Attributes Study and follow-up (n = 162) reported child appetitive traits using the Baby and Child Eating Behaviour Questionnaires at ages 6 months and 3.5 years, respectively. Standardized body mass index (zBMI) was calculated from child anthropometrics. Cross-lagged panel models estimated bidirectional relations between appetitive traits and zBMI. Food responsiveness, satiety responsiveness and slowness in eating increased from infancy to early childhood. In cross-lagged panel models, lower infant satiety responsiveness (B ± SE = -0.45 ± 0.19, p = .02) predicted greater child zBMI. Infant zBMI did not predict child appetitive traits (p-values >.36). From infancy to early childhood, appetitive traits may amplify. Appetitive traits, particularly satiety responsiveness, appear to influence body mass index during this period, suggesting early intervention targeting these traits may reduce childhood obesity.
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Affiliation(s)
- Jenna R. Cummings
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Leah M. Lipsky
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
| | - Myles S. Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo – SUNY, 420 Bady Hall, Buffalo, NY, 14250, USA
| | - Tonja R. Nansel
- Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20817, USA
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González-Toribio J, Hunot-Alexander C, Vásquez-Garibay EM, Larrosa-Haro A, Casillas-Toral E, Curiel-Curiel CP. Association between Maternal and Toddler Appetitive Traits in a Mexican Population. Behav Sci (Basel) 2023; 13:849. [PMID: 37887499 PMCID: PMC10604555 DOI: 10.3390/bs13100849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/08/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023] Open
Abstract
The Child Eating Behaviour Questionnaire for toddlers (CEBQ-T-Mex) and the Adult Eating Behaviour Questionnaire (AEBQ-Esp) measure appetitive traits (ATs) in children and adults, respectively, both validated for use in Spanish. ATs are inherited variations in appetite, present from birth, that are reasonably stable throughout childhood and can explain why some infants over- or undereat in response to environmental exposures. "Food approach" traits predispose to overweight while "food avoidance" traits provide protection, but little is known about the relationships between parents' and their toddler's ATs. The aim was to examine the associations between maternal and toddler appetitive traits, using the AEBQ-Esp and CEBQ-T-Mex, and to examine the associations between ATs and Body Mass Index z-scores (BMIz). Sociodemographic data and the weights and heights of mothers and toddlers (aged 12-36 months) were collected from a teaching hospital in Guadalajara, Mexico. Mothers completed both the AEBQ-Esp and the CEBQ-T-Mex. Direct correlations were found between the ATs of toddlers and their mother (p < 0.005), except for "Slowness in Eating" (SE), and only an inverse correlation was found between the "Satiety Responsiveness" (SR) of toddlers and their BMIz (r = -0.147; p = 0.007). These results suggest that ATs could potentially run in families. These may be useful targets for family-wide interventions to support the development and maintenance of healthy eating behaviours in childhood.
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Affiliation(s)
- Jocelyn González-Toribio
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Salvador Quevedo y Zubieta No. 750, Edificio Anexo al Hospital Civil “Dr. Juan I. Menchaca”, Piso 3, Guadalajara C.P. 44340, Jalisco, Mexico; (J.G.-T.); (E.M.V.-G.); (A.L.-H.); (C.P.C.-C.)
| | - Claudia Hunot-Alexander
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Salvador Quevedo y Zubieta No. 750, Edificio Anexo al Hospital Civil “Dr. Juan I. Menchaca”, Piso 3, Guadalajara C.P. 44340, Jalisco, Mexico; (J.G.-T.); (E.M.V.-G.); (A.L.-H.); (C.P.C.-C.)
| | - Edgar Manuel Vásquez-Garibay
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Salvador Quevedo y Zubieta No. 750, Edificio Anexo al Hospital Civil “Dr. Juan I. Menchaca”, Piso 3, Guadalajara C.P. 44340, Jalisco, Mexico; (J.G.-T.); (E.M.V.-G.); (A.L.-H.); (C.P.C.-C.)
| | - Alfredo Larrosa-Haro
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Salvador Quevedo y Zubieta No. 750, Edificio Anexo al Hospital Civil “Dr. Juan I. Menchaca”, Piso 3, Guadalajara C.P. 44340, Jalisco, Mexico; (J.G.-T.); (E.M.V.-G.); (A.L.-H.); (C.P.C.-C.)
| | - Erika Casillas-Toral
- Hospital Civil Juan I. Menchaca, Salvador Quevedo y Zubieta 750, Guadalajara C.P. 44340, Jalisco, Mexico;
| | - Carmen Patricia Curiel-Curiel
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Salvador Quevedo y Zubieta No. 750, Edificio Anexo al Hospital Civil “Dr. Juan I. Menchaca”, Piso 3, Guadalajara C.P. 44340, Jalisco, Mexico; (J.G.-T.); (E.M.V.-G.); (A.L.-H.); (C.P.C.-C.)
- Licenciatura en Nutrición, Centro Universitario del Sur, Universidad de Guadalajara, Av. Enrique Arreola Silva No. 883, Colonia Centro, Ciudad Guzmán C.P. 49000, Jalisco, Mexico
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Liu Y, Kong Y, Li Z, Zhang G, Wang L, Yu G. Relationships between parental responsive feeding and infant appetitive traits: The moderating role of infant temperament. Front Psychol 2023; 14:1115274. [PMID: 36814664 PMCID: PMC9939436 DOI: 10.3389/fpsyg.2023.1115274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
Introduction Between the ages of 6 and 12 months is a crucial stage for children to develop appetitive self-regulation. Evidence suggests that a combination of parental responsive feeding and infant temperament (surgency, effortful control, negative affect) shapes infant appetitive traits (food approach, food avoidance). There is a need for research to explore these relationships, in order to provide guidance for the design of an effective intervention to improve appetitive traits. The objective of the current study was to explore the moderating role of infant temperament in the relationship between parental responsive feeding and infant appetitive traits. Methods A total of 616 questionnaires, measuring parental responsive feeding, infant appetitive traits, and infant temperament, were collected from parents with infants aged 6-12 months. Results Results revealed that responsive feeding was associated with both food approach and food avoidance. Furthermore, only lower levels of surgency significantly moderated the relationship between responsive feeding and food approach, while responsive feeding was associated with food avoidance irrespective of infant temperament. Discussion These findings suggest that a strategy embedding responsive feeding interventions should be adopted to reduce infant food avoidance and low-surgent infant food approach, and interventions that are tailored toward food approach for infants with effortful control, negative affect, or higher levels of surgency should be further sought.
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Affiliation(s)
- Yan Liu
- School of Nursing, Qingdao University, Qingdao, Shandong, China
| | - Yan Kong
- Department of Nursing, The Affiliated Women and Children’s Hospital of Qingdao University, Qingdao, China
| | - Zhihui Li
- Department of Nursing, The Affiliated Women and Children’s Hospital of Qingdao University, Qingdao, China
| | - Guanghua Zhang
- Department of Nursing, The Affiliated Women and Children’s Hospital of Qingdao University, Qingdao, China
| | - Lin Wang
- Office of President, The Affiliated Women and Children’s Hospital of Qingdao University, Qingdao, China
| | - Guiling Yu
- Department of Nursing, The Affiliated Women and Children’s Hospital of Qingdao University, Qingdao, China,*Correspondence: Guiling Yu, ✉
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Harris HA, Bowling A, Santos S, Greaves‐Lord K, Jansen PW. Child ADHD and autistic traits, eating behaviours and weight: A population-based study. Pediatr Obes 2022; 17:e12951. [PMID: 35751176 PMCID: PMC9786764 DOI: 10.1111/ijpo.12951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/07/2022] [Accepted: 05/31/2022] [Indexed: 12/30/2022]
Abstract
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: ADHDHigh , ASDHigh , ADHD+ASDHigh and REF (reference group: ADHD+ASDLow ). 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 + ASDHigh 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). ASDHigh children were more food avoidant, while ADHDHigh children had more food approach behaviours and greater BMIz. ADHDHigh 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.
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Affiliation(s)
- Holly A. Harris
- Department of Child & Adolescent Psychiatry/PsychologyErasmus MC, University Medical CenterRotterdamThe Netherlands,Generation R StudyErasmus MC, University Medical CenterRotterdamThe Netherlands
| | - April Bowling
- Department of Public Health and NutritionMerrimack College, School of Health SciencesNorth AndoverMassachusettsUSA,Department of PsychiatryUniversity of Massachusetts Chan Medical SchoolWorcesterMassachusettsUSA
| | - Susana Santos
- Generation R StudyErasmus MC, University Medical CenterRotterdamThe Netherlands,Department of PediatricsErasmus MC – Sophia Children's Hospital, University Medical Center RotterdamRotterdamThe Netherlands
| | - Kirstin Greaves‐Lord
- Department of PediatricsErasmus MC – Sophia Children's Hospital, University Medical Center RotterdamRotterdamThe Netherlands,Department of PsychologyUniversity of GroningenGroningenThe Netherlands,Autisme Team North‐NetherlandJonx part of Lentis Psychiatric InstituteGroningenThe Netherlands
| | - Pauline W. Jansen
- Department of Child & Adolescent Psychiatry/PsychologyErasmus MC, University Medical CenterRotterdamThe Netherlands,Generation R StudyErasmus MC, University Medical CenterRotterdamThe Netherlands,Department of Psychology, Education & Child StudiesErasmus University RotterdamRotterdamThe Netherlands
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Cohen TR, Kakinami L, Plourde H, Hunot-Alexander C, Beeken RJ. Concurrent Validity of the Adult Eating Behavior Questionnaire in a Canadian Sample. Front Psychol 2021; 12:779041. [PMID: 34925181 PMCID: PMC8675385 DOI: 10.3389/fpsyg.2021.779041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/02/2021] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Tamara R. Cohen
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada
- PERFORM Centre, Concordia University, Montreal, QC, Canada
| | - Lisa Kakinami
- PERFORM Centre, Concordia University, Montreal, QC, Canada
- Department of Mathematics and Statistics, Concordia University, Montreal, QC, Canada
| | - Hugues Plourde
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Claudia Hunot-Alexander
- Instituto de Nutrición Humana, Departamento de Reproducción Humana, Crecimiento y Desarrollo Infantil, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - Rebecca J. Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Hunot-Alexander C, González-Toribio J, Vásquez-Garibay EM, Larrosa-Haro A, Casillas-Toral E, Curiel-Curiel CP. Validity and Reliability of the Baby and Child Eating Behavior Questionnaire, Toddler Version (BEBQ-Mex and CEBQ-T-Mex) in a Low Sociodemographic Sample Recruited in a Mexican Hospital. Behav Sci (Basel) 2021; 11:168. [PMID: 34940103 PMCID: PMC8698384 DOI: 10.3390/bs11120168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/22/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to validate and measure the internal reliability of the Baby and Child Eating Behavior Questionnaires for Toddlers (BEBQ-Mex and CEBQ-T-Mex), that evaluate appetitive trait (ATs). Mothers recruited from a public hospital in Guadalajara, Mexico, completed the BEBQ-Mex or CEBQ-T-Mex along with information on sociodemographic characteristics. Internal reliability of the BEBQ-Mex was sufficient for Food Responsiveness (FR) (Cronbach α = 0.82), while Enjoyment of Food (EF) and Satiety Responsiveness (SR) showed poor reliability (α = 0.56) and Slowness in Eating (SE) had unacceptable reliability (a = 0.36). All reliability values for the CEBQ-T-Mex were acceptable (>0.70), except for SE (α = 0.64). Confirmatory factor analysis (CFA) revealed an adequate model fit for the BEBQ-Mex, except the SE subscale. CFA for the CEBQ-T-Mex confirmed the six-factor structure. Mothers of a low sociodemographic background were unable to recognize their infants' ATs; the BEBQ-Mex partly met the criteria for validity and reliability. Mothers from similar sociodemographic characteristics were more able to recognize the ATs of their toddlers than their infants; the CEBQ-T-Mex was found to be a valid and reliable tool. Findings support the need to help mothers' ability to recognize their infants' ATs, which have been previously associated with weight and growth.
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Affiliation(s)
- Claudia Hunot-Alexander
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Col. Independencia, Guadalajara C.P. 44340, Jalisco, Mexico; (C.H.-A.); (J.G.-T.); (A.L.-H.); (C.P.C.-C.)
| | - Jocelyn González-Toribio
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Col. Independencia, Guadalajara C.P. 44340, Jalisco, Mexico; (C.H.-A.); (J.G.-T.); (A.L.-H.); (C.P.C.-C.)
| | - Edgar Manuel Vásquez-Garibay
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Col. Independencia, Guadalajara C.P. 44340, Jalisco, Mexico; (C.H.-A.); (J.G.-T.); (A.L.-H.); (C.P.C.-C.)
| | - Alfredo Larrosa-Haro
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Col. Independencia, Guadalajara C.P. 44340, Jalisco, Mexico; (C.H.-A.); (J.G.-T.); (A.L.-H.); (C.P.C.-C.)
| | - Erika Casillas-Toral
- Hospital Civil “Dr. Juan I. Menchaca”, Salvador Quevedo y Zubieta 750, Guadalajara CP 44340, Jalisco, Mexico;
| | - Carmen Patricia Curiel-Curiel
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Col. Independencia, Guadalajara C.P. 44340, Jalisco, Mexico; (C.H.-A.); (J.G.-T.); (A.L.-H.); (C.P.C.-C.)
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Guzek D, Skolmowska D, Głąbska D. Associations between Food Preferences, Food Approach, and Food Avoidance in a Polish Adolescents' COVID-19 Experience (PLACE-19) Study Population. Nutrients 2021; 13:2427. [PMID: 34371936 DOI: 10.3390/nu13072427] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 12/11/2022] Open
Abstract
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.
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Guzek D, Skolmowska D, Głąbska D. Appetitive Traits in a Population-Based Study of Polish Adolescents within the PLACE-19 Study: Validation of the Adult Eating Behavior Questionnaire. Nutrients 2020; 12:E3889. [PMID: 33352678 DOI: 10.3390/nu12123889] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/10/2020] [Accepted: 12/17/2020] [Indexed: 12/12/2022] Open
Abstract
Appetitive traits of food approach or food avoidance are commonly measured using the Adult Eating Behavior Questionnaire (AEBQ). However, there is no Polish version of the AEBQ validated for adolescents, and to the best of our knowledge, no study completed with the Polish version of the AEBQ has been published thus far. The present study aimed to validate the AEBQ in a population-based sample of Polish secondary school students and to assess differences in appetitive traits between boys and girls within the Polish Adolescents' COVID-19 Experience (PLACE-19) Study. The PLACE-19 Study was conducted in a group of 2448 adolescents recruited in May 2020 through the random quota sampling of secondary schools. The AEBQ was used to assess food approach subscales (Food Responsiveness, Emotional Over-Eating, and Enjoyment of Food) and food avoidance subscales (Satiety Responsiveness, Emotional Under-Eating, Food Fussiness, and Slowness in Eating). To validate the questionnaire, the standardized factor loadings within confirmatory factor analysis (CFA) with weighted least squares (WLS) were analyzed, and invariance was verified. The CFA presented good model fit, with χ2 = 4826.105 (degrees of freedom (df) = 384), root mean square error of approximation (RMSEA) = 0.069 (90% confidence interval (CI): 0.067, 0.070), comparative fit index (CFI) = 0.90, and standardized root mean square residual (SRMR) = 0.08. The results revealed that, compared to the configural invariance model, the metric invariance model did not result in significantly decreased model fit, with ΔCFI = -0.002 and ΔRMSEA = -0.001, which were lower than the recommended cutoffs of 0.010 and 0.015, respectively. The scalar invariance model also did not result in significantly decreased fit of the model over the metric invariance model, with ΔCFI = -0.005 and ΔRMSEA = 0.000. Girls reported higher levels of Food Responsiveness (p < 0.0001), Emotional Over-Eating (p < 0.0001), Satiety Responsiveness (p < 0.0001), Emotional Under-Eating (p < 0.0001), and Slowness in Eating than boys (p < 0.0001), and the total AEBQ scores of girls were also higher (p < 0.0001). Positive inter-correlations were observed between all food approach subscales, as well as between Emotional Under-Eating and all food approach subscales for girls, boys, and the total sample; positive inter-correlations were also observed between the majority of food avoidance subscales. The present study confirmed the validity of the AEBQ in the studied population, and supported the associations between appetitive traits assessed using the AEBQ; it also indicated higher scores of both food approach and food avoidance subscales in girls than in boys in a population-based sample of Polish secondary school students.
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Liew J, Zhou Z, Perez M, Yoon M, Kim M. Parental Child-feeding in the Context of Child Temperament and Appetitive Traits: Evidence for a Biopsychosocial Process Model of Appetite Self-Regulation and Weight Status. Nutrients 2020; 12:E3353. [PMID: 33143216 DOI: 10.3390/nu12113353] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/17/2020] [Accepted: 10/29/2020] [Indexed: 12/20/2022] Open
Abstract
Pediatric obesity is a serious public health challenge and there is a need for research that synthesizes the various linkages among the child and parental factors that contribute to pediatric overweight and obesity. The main objective of this study was to examine potential mechanisms and pathways that might explain how child temperament is indirectly related to child body composition through appetitive traits and parental child-feeding practices. Participants consisted of 221 children between 4–6 years of age (51% males, mean age = 4.80 years, standard deviation = 0.85) and their parents (90.5% biological mothers, (Mage) = 32.02 years, (SDage) = 6.43) with 71% of the parents being married. Study variables included child temperament (negative affectivity and effortful control), child appetitive traits (food avoidance and food approach), controlling parental child-feeding practices (restrictive feeding and pressure to eat), and child body composition. Body composition were indexed by parent perceptions, body mass index (BMI), and percent body fat. Results showed that children with low levels of effortful control are more prone to exhibit food avoidance, which in turn is likely to elicit parental pressure to eat that in turn is linked to high child weight status. In addition, children with high levels of negative affectivity are prone to exhibit a food approach, which in turn is likely to elicit restrictive feeding from parents that in turn is linked to high child objective weight status. Findings situate controlling parental child-feeding practices in the context of child temperament and appetitive traits using a biopsychosocial framework of appetite self-regulation and weight. Results highlight that child appetite self-regulation processes and parental child-feeding practices could be essential components to target in childhood obesity preventive interventions.
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Hunot-Alexander C, Beeken RJ, Goodman W, Fildes A, Croker H, Llewellyn C, Steinsbekk S. Confirmation of the Factor Structure and Reliability of the 'Adult Eating Behavior Questionnaire' in an Adolescent Sample. Front Psychol 2019; 10:1991. [PMID: 31636576 PMCID: PMC6788325 DOI: 10.3389/fpsyg.2019.01991] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/14/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction Appetitive traits, including Food Responsiveness, Enjoyment of Food, Satiety Responsiveness, Emotional Over- and Under-Eating, Food Fussiness and Slowness in Eating, have been captured across childhood using the Children’s Eating Behavior Questionnaire (CEBQ). The Adult Eating Behavior Questionnaire (AEBQ) has explored these traits in adults, but not adolescents. This study aimed to test the factor structure and reliability of the AEBQ in a sample of UK adolescents, and explore demographic differences. Materials and Methods Confirmatory factor analysis (CFA) tested an 8-factor and a 7-factor AEBQ, based on valid, completed AEBQ responses (n = 913) from adolescents aged 11–18 recruited from four London secondary schools. Test–retest reliability was analyzed in a subsample (n = 106) 2-weeks later, and 492 participants completed the Dutch Eating Behavior Questionnaire (DEBQ) to assess convergent validity. Demographic differences were explored using a multiple indicator multiple cause (MIMIC) model. Results The CFA revealed an adequate model fit for a 7-factor structure without Hunger [RMSEA = 0.038 (90% CI:0.035,0.041); CFI = 0.926, TLI = 0.916; and χ2(df = 595) = 8502.69, p < 0.001]. These seven subscales showed acceptable internal consistency (Cronbach’s α > 0.70). The ICC for the test–retest was above 0.70. Comparisons with the DEBQ supported the convergent validity of the AEBQ. Older age was associated with greater Food Responsiveness and Enjoyment of Food (all p-values < 0.005). Females reported higher levels of Emotional Over-Eating, Satiety Responsiveness, and Slowness in Eating than males (all p-values ≤ 0.003). Conclusion This study supports the use of the 7-factor AEBQ as a reliable measure of appetitive traits in adolescents.
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Affiliation(s)
- Claudia Hunot-Alexander
- Centro Universitario de Ciencias de la Salud, Departamento de Reproducción Humana, Crecimiento y Desarrollo Infantil, Instituto de Nutrición Humana, Universidad de Guadalajara, Guadalajara, Mexico
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, Yorkshire Cancer Research University Academic Fellow, Leeds, United Kingdom.,Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - William Goodman
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Alison Fildes
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Helen Croker
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Clare Llewellyn
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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He J, Sun S, Zickgraf HF, Ellis JM, Fan X. Assessing Appetitive Traits Among Chinese Young Adults Using the Adult Eating Behavior Questionnaire: Factor Structure, Gender Invariance and Latent Mean Differences, and Associations With BMI. Assessment 2019; 28:877-889. [PMID: 31328547 DOI: 10.1177/1073191119864642] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The current study examined the factor structure, measurement reliability, measurement invariance across genders, and latent gender mean differences, of a new Chinese translation of the Adult Eating Behavior Questionnaire (C-AEBQ) in a Chinese young adult sample (n = 1,068, 52.57% women). The associations between the appetitive traits assessed by the AEBQ and body mass index were also explored. The previously established eight-factor model of the AEBQ was supported in the present sample. The C-AEBQ had strong measurement invariance between genders. Cronbach's alpha estimates of the eight subscales of the C-AEBQ ranged from 0.76 to 0.97, and the test-retest reliability coefficients of the subscales ranged from 0.50 to 0.77. The C-AEBQ had adequate convergent and divergent validity, as supported by the theoretically expected correlations between C-AEBQ and the Three-Factor Eating Questionnaire. Furthermore, Satiety Responsiveness, Slowness in Eating, and Food Fussiness were inversely associated with body mass index. Overall, the C-AEBQ appears to be a psychometrically sound instrument as a comprehensive measure for appetitive traits for Chinese young adults.
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Affiliation(s)
- Jinbo He
- Chinese University of Hong Kong, Shenzhen, China
| | - Shengyan Sun
- Huzhou University, Huzhou, Zhejiang Province, China
| | | | | | - Xitao Fan
- Chinese University of Hong Kong, Shenzhen, China
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Russell CG, Russell A. Biological and Psychosocial Processes in the Development of Children's Appetitive Traits: Insights from Developmental Theory and Research. Nutrients 2018; 10:E692. [PMID: 29844283 PMCID: PMC6024602 DOI: 10.3390/nu10060692] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 12/16/2022] Open
Abstract
There has been increasing concern expressed about children's food intakes and dietary patterns. These are closely linked to children's appetitive traits (such as disinhibited eating and food fussiness/neophobia). Research has examined both biological and psychosocial correlates or predictors of these traits. There has been less focus on possible processes or mechanisms associated with children's development of these traits and research that links biological and psychosocial factors. There is an absence of research that links biological and psychosocial factors. In the present article, we outline a model intended to facilitate theory and research on the development of appetitive traits. It is based on scholarship from developmental theory and research and incorporates biological factors such as genetic predispositions and temperament as well as psychosocial factors in terms of parent cognitions, feeding styles and feeding practices. Particular attention is directed to aspects such as emotional eating and feeding, self-regulation of energy intake, and non-shared family environments. We highlight the opportunity for longitudinal research that examines bidirectional, transactional and cascade processes and uses a developmental framework. The model provides a basis for connecting the biological foundations of appetitive traits to system-level analysis in the family. Knowledge generated through the application of the model should lead to more effective prevention and intervention initiatives.
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Affiliation(s)
- Catherine G Russell
- Deakin University, Faculty of Health, School of Exercise and Nutrition Sciences, Centre for Advanced Sensory Science, 221 Burwood Highway, Burwood, VIC 3125, Australia.
| | - Alan Russell
- Flinders University, College of Education, Psychology and Social Work, Sturt Rd, Bedford Park, SA 5042, Australia.
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de Groot CJ, van den Akker ELT, Rings EHHM, Delemarre-van de Waal HA, van der Grond J. Brain structure, executive function and appetitive traits in adolescent obesity. Pediatr Obes 2017; 12:e33-e36. [PMID: 27241878 DOI: 10.1111/ijpo.12149] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/06/2016] [Accepted: 04/11/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children with obesity show differences in brain structure, executive function and appetitive traits when compared with lean peers. Little is known on the relationship between brain structure and these traits. OBJECTIVES To investigate the relationship between differences in brain structure and executive function and appetitive traits, in obese and lean adolescents. METHODS MRI was used to measure cortical thickness and subcortical volumes. Executive function was measured by a Stop Signal-and a Choice Delay Task. Appetitive traits were measured using the Child Eating Behaviour Questionnaire. RESULTS Adolescents with obesity had greater volumes of the pallidum; 1.78 mL (SE 0.03, p=0.014), when compared with controls; 1.65 mL (SE 0.02). In the group with obesity, greater pallidum volume was positively associated with the ability to delay reward in the Choice Delay Task (p=0.012). CONCLUSION The association between pallidum volumes and Choice Delay Task in obese adolescents supports the hypothesis that the pallidum plays an important role in executive dysfunction in obese children.
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Affiliation(s)
- C J de Groot
- Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - E L T van den Akker
- Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - E H H M Rings
- Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands.,Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - J van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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