Validation of the Children's Eating Behavior Questionnaire in 5 and 6 Year-Old Children: The GUSTO Cohort Study.

Phaik Ling Quah,Yung Seng Lee,Anna Fogel,Hwee Lin Wee,Mary F F Chong,Keith M Godfrey,Keri Mccrickerd,Kok Hian Tan,Lisa R Fries,Lynette P C Shek,Ciaran G Forde,Ai Ting Goh,Izzuddin M Aris,Fabian Yap,Iccha Basnyat,Wei Wei Pang,Mei Jun Chan,Yap-Seng Chong

doi:10.3389/fpsyg.2019.00824

Abstract

Revised subscales of the Children’s Eating Behavior Questionnaire (CEBQ) have been proposed to be more appropriate for assessing appetitive traits in Singaporean 3 year-olds, but the CEBQ has not yet been validated in older children in this population. The current study aimed to validate the CEBQ at ages 5 (n = 653) and 6 (n = 449) in the ethnically diverse GUSTO cohort. Confirmatory factor analysis (CFA) examined whether the established eight-factor model of the CEBQ was supported in this sample. Overall, the CFA showed a poor model fit at both ages 5 and 6. At both ages 5 and 6, an exploratory factor analysis revealed a six-factor structure: food fussiness, enjoyment of food, slowness in eating, emotional undereating, emotional overeating and desire to drink. Cronbach’s alpha estimates ranged from 0.70 to 0.85 for all subscales. Criterion validity was tested by correlating subscales with the weight status of 6 years of age. At age 5 and 6, lower scores of slowness of eating while higher scores of enjoyment of food was associated with child overweight. At age 6, higher scores of desire to drink was also associated child overweight. In conclusion, a revised six factor-structure of the CEBQ at ages 5 and 6 were more appropriate for examining appetitive traits in this sample.

Highlights

MATERIALS AND METHODSIndividual differences in appetitive traits may determine how children learn to regulate their food intake, which eventually determines their weight gain later on in life (Fisher and Birch, 2002; Jansen et al, 2003; Wardle, 2007)
We have previously demonstrated that among Singaporean preschoolers that Children’s Eating Behavior Questionnaire (CEBQ) administered at children aged 3 year old was a poor fit to the original questionnaire by Wardle et al (2001)
The main participants were pregnant Chinese, Malay, and Indian women recruited at 14 weeks of gestation from 2 major public maternity units of Kandang Kerbau Women’s and Children’s Hospital (KKH) and the National University Hospital (NUH) in Singapore from June 2009 to September 2010

Summary

Introduction

MATERIALS AND METHODSIndividual differences in appetitive traits may determine how children learn to regulate their food intake, which eventually determines their weight gain later on in life (Fisher and Birch, 2002; Jansen et al, 2003; Wardle, 2007). The Children’s Eating Behavior Questionnaire (CEBQ) (Wardle et al, 2001) is a parental-report instrument, developed to measure four food-approach subscales (food responsiveness, enjoyment of food, emotional overeating, and desire to drink), and four food-avoidant subscales (slowness in eating, satiety responsiveness, food fussiness, and emotional undereating) using 35 items It was validated in the United Kingdom, in a sample of children with a mean age of 5 years with the use of directly observed measures of eating behavior (Carnell and Wardle, 2007), and has since been widely used in other countries (Croker et al, 2011; van Jaarsveld et al, 2011; Fuemmeler et al, 2013). For studies that have failed to replicate the original subscales, exploratory factor analysis (EFA) was used to generate revised subscales that were more culturally relevant to Western countries like Sweden (Svensson et al, 2011), the Netherlands (Sleddens et al, 2008), Chile (Santos et al, 2011), and to Asian countries such as China (Cao et al, 2012), and Singapore (Quah et al, 2017)

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