Abstract
BackgroundEscalating weight gain among the Malaysian paediatric population necessitates identifying modifiable behaviours in the obesity pathway.ObjectivesThis study describes the adaptation and validation of the Children’s Eating Behaviour Questionnaire (CEBQ) as a self-report for adolescents, investigates gender and ethnic differences in eating behaviour and examines associations between eating behaviour and body mass index (BMI) z-scores among multi-ethnic Malaysian adolescents. MethodologyThis two-phase study involved validation of the Malay self-reported CEBQ in Phase 1 (n = 362). Principal Axis Factoring with Promax rotation, confirmatory factor analysis and reliability tests were performed. In Phase 2, adolescents completed the questionnaire (n = 646). Weight and height were measured. Gender and ethnic differences in eating behaviour were investigated. Associations between eating behaviour and BMI z-scores were examined with complex samples general linear model (GLM) analyses, adjusted for gender, ethnicity and maternal educational level. ResultsExploratory factor analysis revealed a 35-item, 9-factor structure with ‘food fussiness’ scale split into two. In confirmatory factor analysis, a 30-item, 8-factor structure yielded an improved model fit. Reliability estimates of the eight factors were acceptable. Eating behaviours did not differ between genders. Malay adolescents reported higher Food Responsiveness, Enjoyment of Food, Emotional Overeating, Slowness in Eating, Emotional Undereating and Food Fussiness 1 scores (p<0.05) compared to Chinese and Indians. A significant negative association was observed between BMI z-scores and Food Fussiness 1 (‘dislike towards food’) when adjusted for confounders.ConclusionAlthough CEBQ is a valuable psychometric instrument, adjustments were required due to age and cultural differences in our sample. With the self-report, our findings present that gender, ethnic and weight status influenced eating behaviours. Obese adolescents were found to display a lack of dislike towards food. Future longitudinal and qualitative studies are warranted to further understand behavioural phenotypes of obesity to guide prevention and intervention strategies.
Highlights
Countries across the spectrum of development are grappling with burgeoning rates of childhood obesity [1,2] recent evidence of plateauing prevalence in few countries has emerged [3]
Studies in different cultures are necessary to provide insights into the similarities and differences inherent across cultural borders with regards to eating behaviours related to obesity. This present study describes the adaptation of the Children’s Eating Behaviour Questionnaire (CEBQ) as a self-report among adolescents in the local setting
PAF with Promax rotation produced a nine-factor solution with eigenvalues above 1.0 which accounted for 54.15% of the total variance (Table 1)
Summary
Countries across the spectrum of development are grappling with burgeoning rates of childhood obesity [1,2] recent evidence of plateauing prevalence in few countries has emerged [3]. Escalating weight gain among the Malaysian paediatric population necessitates identifying modifiable behaviours in the obesity pathway. Objectives: This study describes the adaptation and validation of the Children’s Eating Behaviour Questionnaire (CEBQ) as a self-report for adolescents, investigates gender and ethnic differences in eating behaviour and examines associations between eating behaviour and body mass index (BMI) z-scores among multi-ethnic Malaysian adolescents. Gender and ethnic differences in eating behaviour were investigated. Associations between eating behaviour and BMI z-scores were examined with complex samples general linear model (GLM) analyses, adjusted for gender, ethnicity and maternal educational level. A 30-item, 8-factor structure yielded an improved model fit. With the self-report, our findings present that gender, ethnic and weight status influenced eating behaviours. Future longitudinal and qualitative studies are warranted to further understand behavioural phenotypes of obesity to guide prevention and intervention strategies
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