Child Eating Behavior Questionnaire Research Articles

Complementary Feeding and Child Appetitive Traits in a Sample of Hispanic Mother-Child Dyads.

Complementary feeding practices may contribute to toddler eating practices that affect weight outcomes. Studies are needed to understand the relationship between complementary feeding practices and toddler dietary self-regulation. This study tests the hypothesis that earlier complementary food introduction predicts toddler food responsiveness and emotional overeating (ie, tendency to overeat in response to food cues and emotions, respectively), and considers whether introduction of certain foods better predict toddler dietary self-regulation. This study is a secondary analysis of data from a parent longitudinal birth cohort study on early growth/development among Hispanic mother-infant dyads. The analytic sample included 174 mother-child dyads recruited from maternity clinics affiliated with the University of Southern California in Los Angeles County. Recruitment and data collection were ongoing from July 2016 to April 2020. At 1-, 6-, 12-, and 24-months postpartum, mothers reported exclusive breastfeeding duration and age of complementary food introduction via questionnaire. Child food responsiveness and emotional overeating scores calculated from the Child Eating Behavior Questionnaire at 12 and 24 months of age. Separate linear mixed models with repeated measures were used to examine associations between age of complementary food introduction as a predictor of child food responsiveness or emotional overeating, controlling for infant sex, birth body mass index z score, duration of exclusive breastfeeding, and mother's body mass index. In separate models, delaying complementary food introduction by 1 month was associated with a 6% reduction in food responsiveness (P= 0.007) and a 5% reduction in emotional overeating scores (P= 0.013). Fifty-eight unique combinations of complementary foods introduced first were found, precluding analyses to examine whether specific combinations were related to eating behavior outcomes due to sample size limitations. Earlier complementary feeding was associated with higher food responsiveness and emotional overeating scores among Hispanic children. Future studies in larger samples are needed to characterize patterns of complementary food introduction and their influence on child self-regulation.

Children’s eating attitudes test (ChEAT): validation and reliability in Turkish children

ObjectivesThis study aims to examine the validity and reliability of the children’s eating attitudes test (ChEAT) in Turkish children.MethodsThe participants were 331 children (137 boys and 194 girls, ages 8–15). Data was collected through face-to-face interviews using a questionnaire containing socio-demographic characteristics, the ChEAT, and the children's eating behaviour questionnaire (CEBQ). Exploratory factor analysis (EFA) was performed to determine the factor structure of the Turkish version of the ChEAT. Additionally, the reliability was examined in terms of internal consistency and test–retest reliability. All statistical analyses were performed using Mplus Trial Version and SPSS 11.5 (SPSS, Chicago, IL, USA).ResultsAccording to the goodness-of-fit statistic, a three-factor solution was appropriate and compatible with clinical considerations. The three factors explained 50.1% of the variance. Cronbach’s alpha coefficient was 0.75 for ChEAT-26, 0.67 for “Preoccupation with thinness and food”, 0.63 for “Social pressure to eat”, and 0.71 for “Dieting”. Furthermore, the test–retest reliability was 0.72, 0.62, 0.59, and 0.59 respectively. Statistically significant correlations between the ChEAT and CEBQ were found (p < 0.05). “Preoccupation with thinness and food” was significantly higher in obese children (p < 0.05), while “Social pressure to eat” was lower (p < 0.001). Sex, grade, BMI, parental education in addition to working status affected the ChEAT-26 scores.ConclusionsThe present study has provided preliminary evidence for the validity and reliability of a Turkish version of the ChEAT.

A qualitative inquiry of parents of extremely picky eaters: Experiences, strategies and future directions

Background/aimPicky eating is a common childhood phenomenon in younger children, impacting family relationships and mealtimes. Limited qualitative studies have explored parents’ experiences of parenting an extremely picky eater. This study aimed to address this gap. MethodsThis exploratory qualitative research design included participants who were Australian-based parents (n = 10) of children aged 2–6 years with a minimum picky eating score of 3.33, indicating extreme picky eating, on the Food Fussiness subscale of the Child Eating Behavior Questionnaire (CEBQ). Parents were interviewed online via Zoom using semi-structured interviews focused on their experiences of having a child who is a picky eater. Reflexive thematic analysis was used to analyze the data. ResultsFive themes were identified: 1The picky eating journey for parents. 2Picky eating impacts families and mealtimes. 3Parents have attempted multiple strategies to manage picky eating. 4Emotions associated with parenting an extremely picky eater. 5Parents of extremely picky eaters have a positive outlook for the future. ConclusionThis qualitative study demonstrates that parents' experiences of parenting an extremely picky eater are varied. Parents desire health professionals who listen to their concerns and provide evidence-based knowledge around parent feeding practices to positively impact picky eating.

Switching between foods: A potential behavioral phenotype of hedonic hunger and increased obesity risk in children

ContextReward-based eating is a trait that increases risk for eating in the absence of hunger (EAH) and obesity. Eating behaviors such as switching more frequently between different foods may increase intake during EAH by delaying the onset of sensory-specific satiation (SSS); however, this question has not been empirically tested. Objectives1) Test whether switching between foods mediates the relationship between reward-based eating and EAH intake. 2) Test whether switching between foods during EAH moderates the relationship between reward-based eating and weight status. MethodsData were analyzed from a study assessing decision-making in children (n = 63 children; 9.4 ± 1.4 years, 77.0 ± 22.4 BMI%tile). Reward-based eating was quantified using the Children's Eating Behaviour Questionnaire. EAH was assessed as the amount of palatable food consumed following ad libitum consumption of a standard meal. Videos of eating behavior were coded for eating time, number of different foods consumed, and food switches. Ordinary least squares regressions were conducted to test hypotheses. ResultsSwitching was positively associated with EAH intake for both kcal (p < 0.01) and grams (p < 0.01) such that each additional switch was associated with an increased intake of 17.0 kcal or 3.5 gs. Switching mediated the relationship between reward-based eating and EAH (p < 0.01) such that more frequent switching fully accounted for the positive association between reward-based eating and EAH (ps < 0.01). While reward-based eating was also positively associated with weight status (p < 0.01), this association was moderated by food switching (p < 0.01) such that the relationship was stronger for children who switch more frequently (p < 0.01). ConclusionsFrequent switching between foods was positively associated with EAH intake and mediated the relationship between reward-based eating and EAH. Moreover, reward-based eating was more strongly related to weight status in children who switched more frequently. Thus, food switching may contribute to overconsumption and be an important behavioral indicator of increased obesity risk in children. Studies across multiple meals and contexts will help determine if switching is a reliable behavioral phenotype.

The association of early feeding practices with eating behaviors and maternal indulgent feeding behaviors among Saudi preschoolers.

Evidence from previous work suggest that feeding practices during the first years of life may influence the development of eating behaviors later in childhood. Early feeding practices may also predict later maternal feeding behaviors. Mothers from an Arab/Middle Eastern background may adopt unique early feeding practices. The objective of this study was to examine the association of offering fruit juice and date syrup-milk mixture in a baby bottle during infancy with: 1) Child eating behaviors during preschool years; 2) Maternal indulgent feeding practices during preschool years. Mothers of preschoolers (n = 115) completed questions adopted from the Children's Eating Behavior Questionnaire (CEBQ), Child Feeding Questionnaire-Arabic (CFQ-A), as well as questions assessing early feeding practices and demographic characteristics. Unadjusted and adjusted logistic regression models were tested to examine the association of early feeding practices with child eating behaviors and maternal indulgent feeding behaviors. Odds ratios (ORs) and respective 95% confidence intervals (CI) were derived. Adjusting for covariates, children who were ever offered fruit juice in a baby bottle as infants were more likely to have high food responsiveness at preschool, compared to children who were not (OR = 2.93, 95% CI = 1.16, 7.42). Mothers who reported ever offering fruit juice in a baby bottle when their children were infants were more likely to adopt greater use of food as a reward when their children were at preschool (OR = 3.25, 95% CI = 1.22, 8.68). Early feeding practices are associated with child eating and maternal feeding behaviors later in childhood. Future longitudinal studies are needed to further establish these associations. Findings from this study can help inform community awareness and education programs to prevent maladaptive feeding practices and promote appropriate feeding strategies throughout childhood.

Hubungan Profil Sensori dengan Perilaku Makan Anak Autism Spectrum Disorder (ASD)

Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication, limited interests, and repetitive behavior. In children with ASD, eating disorders are characterized by eating behavior, namely food selectivity. Objectives: This research was conducted to look at the relationship between sensory profiles and eating behavior in children with ASD in 2022. Method: Using correlational observational research with a cross-sectional design. Determining the sample size was carried out using consecutive sampling and it found that 97 respondents were parents of children with ASD who met the inclusion and exclusion criteria on the Autism Spectrum Disorder Care Platform. Data collection was carried out online using standard Short Sensory Profile (SSP) and Child Eating Behavior Questionnaire (CEBQ) instruments. Bivariate statistical test, this study uses Spearman correlation. Result: From the research results, it was found that the relationship between the sensory profile and the eating behavior of children with ASD was 0.138 or p-value&gt; 0.05. Conclusion: There is a relationship between sensory profiles and the eating behavior of children with autism spectrum disorder (ASD) at the ASD Research Center in 2022.

THE EFFECT OF HYPNOPARENTING AS AN EFFORT TO IMPROVE THE APPETITE OF PRESCHOOL-AGED CHILDREN WITH PICKY EATER

Picky eater is a child eating problem that is often complained of by parents which causes a low appetite at mealtimes, usually occurring in preschool-aged 3-5 years. Picky eaters accompanied by a decrease in appetite if left unchecked for a long time can cause children to lack nutritional intake which results in a low nutritional status of children. Parents' efforts are needed to fix children's eating problems, which is hypnoparenting. Hypnoparenting is applied as coaching children with the principle of hypnosis through suggestions given by parents to the child's subconscious mind. To determine the effect of hypnoparenting as an effort to improve the appetite of preschoolers with picky eaters. The research design uses pre-experimental with one group pretest posttest. The research respondents were 26 children aged 3-5 years. Data collection was carried out by filling out questionnaires (Child Eating Behavior Questionnaire and picky eater questionnaires) which were analyzed using the Wilcoxon test. Obtained from the results of the Wilcoxon analysis test, the significance value of appetite was p value 0.005 ≤ 0.05 and the picky eater's significance value was p value 0.000 ≤ 0.05, then Ha was accepted and H0 was rejected which means there is an influence of hypnoparenting as an effort to improve the appetite of preschool-aged children with picky eaters. 26 preschool-aged children (100%) have poor appetites with picky eaters before hypnoparenting, and 19 preschool-aged children (73.1%) have good appetites without being picky eaters so there are an influence on the appetite of preschool-aged children before and after hypnoparenting.

Taste and smell alterations affect nutritional status in children under chemotherapy.

This study aimed to evaluate the incidence of self-reported taste and smell alterations (TSA) in cancer paediatric patients and evaluate the impact of TSA on nutritional status in this population. We also developed and validated a composite score to detect TSA in children undergoing chemotherapy. Paediatric patients who were undergoing chemotherapy in a paediatric oncology unit were included. TSA were assessed from the Gustonco questionnaire from which a composite score was developed and internally validated, eating behaviour was assessed using Child Eating Behaviour Questionnaire, and major weight loss was defined from nutritional status. All data were calculated at 1, 3 and 6 months after chemotherapy start. Associations between nutritional status and scores were studied by using logistic models. Among 49 patients included, TSA occurred in 71.7% of patients at 1 month after chemotherapy start and persisted at 3 and 6 months. TSA led to altered appetite since 1 month after chemotherapy start. The occurrence of a major weight loss at 6 months seemed to be associated with a high Gustonco score. Taste and smell alterations often occurred in paediatric cancer patients after chemotherapy start and seemed to be associated with impaired nutrition at 6 months after chemotherapy.

Weight Gain in Early Infancy Impacts Appetite Regulation in the First Year of Life. A Prospective Study of Infants Living in Cyprus

BackgroundEating behavior is associated with weight gain in infancy and childhood. Few studies found a bidirectional association between weight gain and eating behavior development in childhood, but there is little data on the association in early infancy, a period critical for the programming of obesity risk. ObjectiveWe investigated the bidirectional association between appetite traits and weight gain during the first year of life. MethodsParticipants were part of a cohort of 432 infants born in Cyprus. Appetite traits were measured using the Baby Eating Behavior Questionnaire or the Child Eating Behavior Questionnaire at age 2 to 4 wk, 6 mo, and 12 mo. Weight and length were collected at birth, 4 wk, 6 mo, and 12 mo. Multivariable linear regression was used to analyze associations between appetite traits at 2 to 4 wk and 6 mo and weight for age z-score change (WFAZC) between 4 wk and 6 mo and 6 and 12 mo. Associations were also analyzed in the opposite direction, between WFAZC from birth to 4 wk, 4 wk to 6 mo, and 6 mo to 12 mo and appetite traits at 4 wk, 6 mo, and 12 mo. ResultsSatiety responsiveness (SR) at 2 to 4 wk was associated with lower WFAZC from 4 wk to 6 mo (β: −0.17; 95% CI: −0.30, −0.04) and SR at age 6 mo was associated with lower WFAZC from 6 to 12 mo (β: −0.09; 95% CI: −0.17, −0.02). WFAZC from 4 wk to 6 mo was associated with higher enjoyment of food at 12 mo (β: 0.11; 95% CI: 0.01, 0.20), higher food responsiveness at 12 mo (β: 0.17; 95% CI: 0.04, 0.30), and lower SR at both 6 mo (β: −0.11; 95% CI: −0.21, −0.01) and 12 mo (β: −0.14; 95% CI: −0.24, −0.03). ConclusionsWe found a bidirectional association between weight gain and appetite traits in infancy, suggesting that the effect of postnatal weight gain on obesity development is partly mediated by programming of appetite traits.

Parent-reported child appetite moderates relationships between child genetic obesity risk and parental feeding practices.

Food parenting practices are associated with child weight. Such associations may reflect the effects of parents' practices on children's food intake and weight. However, longitudinal, qualitative, and behavioral genetic evidence suggests these associations could, in some cases, reflect parents' response to children's genetic risk for obesity, an instance of gene-environment correlation. We tested for gene-environment correlations across multiple domains of food parenting practices and explored the role of parent-reported child appetite in these relationships. Data on relevant variables were available for N = 197 parent-child dyads (7.54 ± 2.67 years; 44.4% girls) participating in RESONANCE, an ongoing pediatric cohort study. Children's body mass index (BMI) polygenic risk score (PRS) were derived based on adult GWAS data. Parents reported on their feeding practices (Comprehensive Feeding Practices Questionnaire) and their child's eating behavior (Child Eating Behavior Questionnaire). Moderation effects of child eating behaviors on associations between child BMI PRS and parental feeding practices were examined, adjusting for relevant covariates. Of the 12 parental feeding practices, 2 were associated with child BMI PRS, namely, restriction for weight control (β = 0.182, p = 0.011) and teaching about nutrition (β = -0.217, p = 0.003). Moderation analyses demonstrated that when children had high genetic obesity risk and showed moderate/high (vs. low) food responsiveness, parents were more likely to restrict food intake to control weight. Our results indicate that parents may adjust their feeding practices in response to a child's genetic propensity toward higher or lower bodyweight, and the adoption of food restriction to control weight may depend on parental perceptions of the child's appetite. Research using prospective data on child weight and appetite and food parenting from infancy is needed to further investigate how gene-environment relationships evolve through development.

Association between stress and eating behaviour among Malaysian adolescents prior to examination

Studies have shown the prevalence of mental health and obesity among adolescents is at increasing trend due to urbanisation and changes in lifestyle. This study is to investigate the level of stress and its impact on eating behaviour among Malaysian adolescents. A total of 797 multi-ethnic Malaysian secondary school student participated in this cross-sectional study. Data was collected two weeks prior to final year examination. A validated Cohen Perceived Stress Scale questionnaire was used to assess the stress level with subsample analysis of 261 participants’ saliva cortisol level. A validated Child Eating Behaviour questionnaire was used to explore eating behaviours. There were 29.1% adolescents having high stress with the mean saliva cortisol 3.8 nmol/L. A positive correlation was observed between perceived stress and emotional overeating; stronger among urban (r = 0.32), female (r = 0.31), underweight (r = 0.34) and moderately stressed adolescents (r = 0.24). In addition, a positive correlation was found between perceived stress and food responsiveness; strongest among Malay (r = 0.23), male (r = 0.24), underweight (r = 0.30) and adolescents with high perceived stress (r = 0.24). The perceived stress level prior to exam period affects the emotional eating and external eating patterns of adolescents.

Avoidant/Restrictive Food Disorder (ARFID), Food Neophobia, Other Eating-Related Behaviours and Feeding Practices among Children with Autism Spectrum Disorder and in Non-Clinical Sample: A Preliminary Study.

Previous research shows that children with autism spectrum disorder (ASD) may experience several difficulties-including those related to eating-and this area of research needs to be explored further. This study had two main objectives: (1) comparison of the clinical (autism spectrum disorder) and non-clinical sample of children in terms of avoidant/restrictive food disorder, food neophobia, other eating-related behaviours and feeding practices; (2) assessment of selected predictors of food neophobia. The final sample included 54 children and parents from the clinical sample (ASD) and 51 from the non-clinical sample. Parents completed: the autism spectrum rating scales (ASRS), the eating disorders in youth questionnaire (EDY-Q), the children food neophobia scale (CFNS), the child eating behaviour questionnaire (CEBQ), the child feeding questionnaire (CFQ), and a socio-demographic survey. Our analysis allowed us to partially confirm the first hypothesis since the clinical sample (vs. the non-clinical group) had significantly higher scores in such variables as (a) avoidant/restrictive food disorder (ARFID), (b) food neophobia, (c) other eating-related behaviours: emotional under-eating, desire to drink, food fussiness, (d) feeding practices: pressure to eat. Moreover, our analysis of predictors of food neophobia in the clinical and non-clinical samples also allowed us to partially confirm the second hypothesis because it turned out that only in the clinical sample (vs. the non-clinical sample) were the predictors significantly associated with food neophobia, but only two of them (food fussiness and selective eating). In conclusion, our study showed that children with ASD (compared to children without this diagnosis) experience increased difficulties in eating behaviours, and their parents present a stronger intensity of the feeding practice based on pressure to eat. This study showed that feeding problems for children in the ASD sample are a significant problem, and it is still worth exploring this area in research.

Dokuz Maddeli Kaçıngan/Kısıtlayıcı Gıda Alım Bozukluğu Tarama Ölçeği (NIAS) Ebeveyn Bildirimi’nin Türkçe Versiyonunun Geçerlik ve Güvenirliği

Background and aims: The current study aimed to evaluate the psychometric properties of a Turkish version of The Nine Item Avoidant/Restrictive Food Intake Disorder Screen Parent Report (NIAS-PR), which measures the avoidant/restrictive food intake disorder (ARFID) symptoms by parents. NIAS-PR includes three subscales picky eating, poor appetite/limited interest in eating, and fear of aversive consequences from eating. Also, our secondary aim was to assess the relationship between ARFID-related eating behaviours and emotional-behavioural symptoms of children and parents' psychological status. Methods: The NIAS-PR was translated into Turkish with standard procedures. Two hundred sixty-eight children (133 girls, 49.6%; mean age 8.62, age range from 2 to 18 years) and parents (175 mothers, 65.2%) were included in the study. The factor structure was confirmed using confirmatory factor analysis (CFA). The results were compared to the validated Turkish Children’s Eating Behavior Questionnaire (CEBQ) to determine the convergent validity. Internal consistency (Cronbach alpha coefficient) analysis was used to determine the reliability of the NIAS-PR. Results: The current study provided evidence for the validity of the translated Turkish version of the NIAS-PR in the pediatric population. The three-factor structure of the NIAS—Picky eating, Appetite, and Fear—was replicated in the Turkish NIAS-PR. The NIAS-PR subscales showed the expected patterns of correlations with the CEBQ subscales. The reliability of the Turkish version of NIAS-PR proved to be satisfactory (total Cronbach's alpha=0.90) in the pediatric population (2-18 years). Conclusions: This study demonstrated a good internal consistency of the Turkish version of the NIAS-PR. We confirmed the three-factor structure of the Turkish version of NIAS-PR. NIAS-PR is a brief, reliable instrument for ARFID research in Turkish children and adolescents. The NIAS-PR is developed as a screening questionnaire, so health professionals should use it to investigate ARFID-related eating behaviours further. It is worth mentioning that deepening these eating symptoms with clinical interviews is necessary.

Mothers' descriptions of their feeding strategies in response to fussy eating with children of different levels of trait fussiness

Parent feeding practices influence a child's dietary intake. Many studies examining how parents react to children's fussy eating behaviours have been limited to questionnaire measures, which assess a limited number of feeding practices. There is a lack of research exploring the range of strategies parents use when their child is being fussy and/or refusing to eat. Therefore, the aims of this study are to describe the strategies used by mothers when their child is being fussy or refusing to eat, and to assess differences in the strategies depending on the child's trait fussiness levels. In 2018, 1504 mothers of children aged 2–5 years completed an online survey. Trait fussiness was assessed using the Children's Eating Behaviour Questionnaire. Mothers were also asked the open-ended question “What are the strategies you use when your child is being fussy or refusing to eat?“. Inductive thematic analysis was conducted using NVivo. Themes were compared by child trait fussiness levels. Seven main themes were identified: child-led feeding/trust in child's appetite, spectrum of pressure, home or family strategies, different types of food offerings, communication, avoid certain strategies, and never or rarely fussy. Mothers of children with severe trait fussiness levels reported more pressuring or persuasive strategies. This study provides novel information regarding the diverse range of feeding practices parents use in response to children's fussy eating behaviours. Mothers used more feeding strategies typically associated with unhealthy dietary intake for children of high levels of trait fussiness. It is important that future interventions tailor the information to provide support to parents of children with high levels of trait fussiness regarding the use of feeding practices recommended to support healthy dietary intake.

Discordance between assessments of food cue responsiveness: Implications for assessment in youth with overweight/obesity

Food cue responsiveness (FCR), broadly defined as behavioral, cognitive, emotional and/or physiological responses to external appetitive cues outside of physiological need, contributes to overeating and obesity among youth and adults. A variety of measures purportedly assess this construct, ranging from youth- or parent-report surveys to objective eating tasks. However, little research has assessed their convergence. It is especially important to evaluate this in children with overweight/obesity (OW/OB), as reliable and valid assessments of FCR are essential to better understand the role of this critical mechanism in behavioral interventions. The present study examined the relationship between five measures of FCR in a sample of 111 children with OW/OB (mean age = 10.6, mean BMI percentile = 96.4; 70% female; 68% white; 23% Latinx). Assessments included: objectively measured eating in the absence of hunger (EAH), parasympathetic activity when exposed to food, parent reported food responsiveness subscale from the Child Eating Behavior Questionnaire (CEBQ-FR), child self-reported Power of Food total score (C-PFS), and child self-reported Food Cravings Questionnaire total score (FCQ-T). Statistically significant spearman correlations were found between EAH and CEBQ-FR (ρ = 0.19, p < 0.05) and parasympathetic reactivity to food cues with both C-PFS (ρ = -0.32, p = 0.002) and FCQ-T (ρ = -0.34, p < 0.001). No other associations were statistically significant. These relationships remained significant in subsequent linear regression models controlling for child age and gender. The lack of concordance between measures assessing highly conceptually related constructs is of concern. Future studies should seek to elucidate a clear operationalization of FCR, examine the associations between FCR assessments in children and adolescents with a range of weight statuses, and evaluate how to best revise these measures to accurately reflect the latent construct being assessed.

Associations of parent feeding behaviors and early life food exposures with early childhood appetitive traits in an observational cohort study

PurposeChild appetitive traits, eating styles that reflect responsiveness to external influences and internal hunger and satiety signals, are associated with eating behaviors and susceptibility to excess weight gain. However, relatively little is known about early life influences on child appetitive traits. This study investigated relations of early life maternal feeding behaviors and food exposures with appetitive traits at age 3.5 years. MethodsParticipants of the Pregnancy Eating Attributes Study (PEAS) and follow-up study were enrolled in early pregnancy and followed prospectively. This analysis included data collected from baseline through child aged 3.5-years (n = 160). Child appetitive traits at age 3.5 years were measured using the Child Eating Behavior Questionnaire. Age at introduction to fruit, vegetables, discretionary sweets, and discretionary savory foods was assessed, along with intake frequency at infant ages 6, 9, and 12 months, and 2 years. Maternal feeding to soothe was assessed at child aged 3, 6, and 12 months. Maternal permissive feeding was assessed at child aged 2 years. Multiple linear regressions estimated relations of maternal feeding behaviors and infant food exposures with child appetitive traits at age 3.5 years, controlling for sociodemographics and breastfeeding duration. ResultsMaternal feeding to soothe at 6 (r = 0.39, p < 0.001) and 12 months (r = 0.39, p < 0.001) was positively associated with permissive feeding at 2 years. Maternal feeding to soothe at 12 months and permissive feeding at 2 years were associated with greater child emotional overeating, emotional undereating, and desire to drink. Older age at introduction to fruit (β = 0.20±0.08, p = 0.01) and younger age at introduction to discretionary sweet foods (β = −0.07±0.04, p = 0.06) were associated with greater emotional overeating. Older age at introduction to vegetables (β = 0.22±0.11, p = 0.04) and less frequent feeding of fruit (β = −0.20±0.08, p = 0.01) were associated with greater food fussiness. ConclusionsAssociations of emotional eating with parent feeding behaviors and early life food exposures suggest the potential for interventions targeting early life feeding to have long-term impact on child appetitive traits and diet quality.

The Development of Appetite: Tracking and Age-Related Differences in Appetitive Traits in Childhood

Appetitive traits are associated with body weight. Increased understanding of how appetitive traits evolve from early life could advance research on obesity risk and inform intervention development. We report on tracking and age-related differences in appetitive traits in childhood within the RESONANCE cohort. Parents of RESONANCE children aged 6.02 ± 2.99 years completed the Child Eating Behavior Questionnaire (CEBQ). Pearson correlations of appetitive traits and age were tested for all participants contributing at least one observation, using each participant's first observation (N = 335). Children's first and second observations of the CEBQ (n = 127) were used to test tracking (paired correlations) and age-related differences (paired t-tests) within individuals. CEBQ correlations with age suggested that satiety responsiveness, slowness in eating, emotional undereating, and desire to drink decreased with age (r = -0.111 to r = -0.269, all p < 0.05), while emotional overeating increased with age (r = 0.207, p < 0.001). Food fussiness demonstrated a quadratic relationship with age. Paired t-tests further supported an increase in emotional overeating with age (M: 1.55 vs. 1.69, p = 0.005). All CEBQ subscales demonstrated moderate to high tracking (r = 0.533 to r = 0.760, p < 0.001). Our initial findings within the RESONANCE cohort suggest that food avoidant traits are negatively related with age, while emotional overeating increases with age, and that appetitive traits track through childhood.

Processed Food–Sweets Patterns and Related Behaviors with Attention Deficit Hyperactivity Disorder among Children: A Case–Control Study

Previous studies have focused on the associations between core symptoms and dietary intake in children with attention deficit hyperactivity disorder (ADHD). However, few studies have explored how dietary patterns and behaviors relate to the risk of ADHD. The aim of our study is to explore the associations between dietary patterns and behaviors and the risk of ADHD, which could provide evidence for follow-up and treatments for children with ADHD. We conducted a case-control study, including 102 children diagnosed with ADHD and 102 healthy children. The food frequency questionnaire (FFQ) and the children's eating behavior questionnaire (CEBQ) were used to investigate food consumption and eating behaviors. We applied exploratory factor analysis for constructing dietary patterns, and the factor scores were adopted for log-binomial regression to assess the associations between how dietary patterns and eating behaviors affect the risk of ADHD. We extracted five dietary patterns with a cumulative contribution rate of 54.63%. Processed food-sweets scores revealed positive associations with an increased risk of ADHD (OR = 1.451, 95% CI: 1.041-2.085). Moreover, processed food-sweets tertile 3 was associated with an increased risk of ADHD (OR = 2.646, 95% CI: 1.213-5.933). In terms of eating behaviors, the group with a higher score relating to a desire to drink was also positively correlated with the risk of ADHD (OR = 2.075, 95% CI: 1.137-3.830). In the treatment and follow-up of children with ADHD, dietary intake and eating behaviors should be considered.

Eating behavior-mediated association between attention deficit hyperactivity disorder and body fat mass

BackgroundAdverse eating behaviors and a high rate of obesity have been identified among children diagnosed with attention deficit hyperactivity disorder (ADHD). In this study, we investigate the relationships between eating behaviors and body fat mass among children with ADHD. MethodsAll participants were recruited from the Children's Health Care Department of the Children's Hospital of Nanjing Medical University from June 2019 to June 2020. ADHD was diagnosed according to the diagnostic criteria of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by psychiatrists. Core ADHD symptoms defined by the DSM-5 were inattention and hyperactivity/impulsivity. The anthropomorphic indices defined by the World Health Organization (WHO) were utilized in this study (body mass index [BMI], underweight, normal body mass, overweight, obesity, short stature). Body fat mass, fat mass percentage (FM%), skeletal muscle mass, skeletal muscle mass percentage (SMM%) were tested via body composition meter, and eating behaviors were assessed by parents using the Chinese version of the Children's Eating Behavior Questionnaire (CEBQ). The CEBQ was comprised of subscales related to food avoidant behaviors (satiety responsiveness, slowness in eating, fussiness, and emotional undereating) and food approach behaviors (food responsiveness, enjoyment of Food, desire to drink, and emotional overeating). The associations among ADHD, obesity and adverse eating behavior were tested through correlation analysis, and a mediating effect model was established to explore the effect of eating behaviors. ResultsA total of 548 participants aged 4–12 years were recruited. Among them, 396 were diagnosed with ADHD, with the remaining 152 enrolled in a control group. Compared with the control group, the ADHD group had higher incidences of overweight (22.5% vs. 14.5%) and obesity (13.4% vs. 8.6%) (p < 0.05). The ADHD group was more likely to display “slowness in eating” (11.01 ± 3.32 vs. 9.74 ± 2.95), “fussiness” (15.61 ± 3.54 vs. 15.03 ± 2.84), “food responsiveness” (11.96 ± 4.81 vs. 9.88 ± 3.71) and “desire to drink” (8.34 ± 3.46 vs. 6.58 ± 2.72) (p < 0.05). Moreover, The FM% of children with ADHD was positively correlated with inattention (β = 0.336, 95% CI: 0.001 to 0.673) and “food responsiveness” (β = 0.509, 95% CI: 0.352 to 0.665) in the multiple linear regression model. The mediation effect model showed that “food responsiveness” accounted for a significant portion (64.2%) of the mediating effect. ConclusionChildren with ADHD had higher prevalence of overweight and obesity. As an important risk factor, food responsiveness may connect core symptoms of ADHD with obesity.

The effect of modest changes in sleep on dietary intake and eating behavior in children: secondary outcomes of a randomized crossover trial

BackgroundInsufficient sleep duration increases obesity risk in children, but the mechanisms remain unclear. ObjectivesThis study seeks to determine how changes in sleep influence energy intake and eating behavior. MethodsSleep was experimentally manipulated in a randomized, crossover study in 105 children (8–12 y) who met current sleep guidelines (8–11 h/night). Participants went to bed 1 h earlier (sleep extension condition) and 1 h later (sleep restriction condition) than their usual bedtime for 7 consecutive nights, separated by a 1-wk washout. Sleep was measured via waist-worn actigraphy. Dietary intake (2 24-h recalls/wk), eating behaviors (Child Eating Behavior Questionnaire), and the desire to eat different foods (questionnaire) were measured during or at the end of both sleep conditions. The type of food was classified by the level of processing (NOVA) and as core or noncore (typically energy-dense foods) foods. Data were analyzed according to ‘intention to treat’ and ‘per protocol,’ an a priori difference in sleep duration between intervention conditions of ≥30 min. ResultsThe intention to treat analysis (n = 100) showed a mean difference (95% CI) in daily energy intake of 233 kJ (−42, 509), with significantly more energy from noncore foods (416 kJ; 6.5, 826) during sleep restriction. Differences were magnified in the per-protocol analysis, with differences in daily energy of 361 kJ (20, 702), noncore foods of 504 kJ (25, 984), and ultraprocessed foods of 523 kJ (93, 952). Differences in eating behaviors were also observed, with greater emotional overeating (0.12; 0.01, 0.24) and undereating (0.15; 0.03, 0.27), but not satiety responsiveness (−0.06; −0.17, 0.04) with sleep restriction. ConclusionsMild sleep deprivation may play a role in pediatric obesity by increasing caloric intake, particularly from noncore and ultraprocessed foods. Eating in response to emotions rather than perceived hunger may partly explain why children engage in unhealthy dietary behaviors when tired.This trial was registered at Australian New Zealand Clinical Trials Registry; ANZCTR as CTRN12618001671257.