Abstract
A variety of eating behaviors among children have been associated with obesity risk and are thought to broadly reflect child appetite self-regulation (ASR). While ASR is thought to occur on cognitive, emotional, motivational, biological, and behavioral levels, the inter-relatedness of ASR constructs as assessed by different methods/measures is not well-characterized. This narrative review describes the correspondence between different methods/measures of child ASR constructs as assessed by self-report questionnaires and/or observational tasks and their relationship to child standardized body mass index (BMIz). Research involving at least two different methods/measures is presented including observational tasks such as the Eating in the Absence of Hunger task, compensation trials, and eating rate, as well as various child eating behavior self-report questionnaires. Keyword searches in the PubMed and PsycINFO databases for articles published between 2000 and July 2021 identified 21,042 articles. Eighteen articles met the inclusion criteria and examined at least two of the targeted measures. Studies comparing questionnaire data with other questionnaire data showed the most evidence of significant associations (r values ranging from −0.45 to 0.49), whereas studies comparing questionnaires with observational tasks mostly showed weak (r values ranging from −0.17 to 0.19) or not significant associations, with only few studies finding moderate associations (r values ranging from −0.38 to 0.33). Studies comparing different observational tasks showed no significant associations. Overall, studies comparing self-report questionnaires showed the most correspondence, whereas those comparing observational tasks showed no correspondence. Studies across methods (questionnaires with tasks) showed less correspondence. Significant associations were found between ASR constructs and child BMIz across five studies using self-report questionnaires and two studies using observational tasks. Future research is needed to clearly define the various ASR constructs, their expected correspondence, and the strength of that correspondence, as well as the relations between ASR constructs and child weight among youth with and without overweight/obesity.
Highlights
Child appetite self-regulation (ASR) has been identified as a central mechanism in the development of childhood obesity and has been targeted as a modifiable target in childhood obesity prevention programs (1–6)
The current review focused on original research studies that included self-report questionnaires and/or observational tasks to assess common ASR constructs
The review focuses on children ages 2–12 years for two reasons: (1) eating behaviors mainly develop during this period and (2) this is the time when children are still somewhat dependent on their caregivers while becoming more autonomous and independent in their food choices (28). This narrative review of the literature involved an iterative process of searching for original research articles that included at least two assessments of child ASR constructs from self-report questionnaires and observational tasks
Summary
Child appetite self-regulation (ASR) has been identified as a central mechanism in the development of childhood obesity and has been targeted as a modifiable target in childhood obesity prevention programs (1–6). Top-down cognitive processes of ASR, such as inhibitory control, are thought to moderate bottom-up biologically drives toward food approach and avoidance. ASR as a process or a skill can be measured using observational methods (e.g., Eating in the Absence of Hunger protocol), whereas ASR as a trait can be measured using a survey (e.g., the Children’s Eating Behavior Questionnaire). While these recent theoretical advances provide a robust conceptual framework, measurement of ASR remains quite varied, and the inter-relatedness of different ASR constructs as measured by the various methods and measures is not well-characterized
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