Child Eating Behavior Research Articles

Patterns of food and physical activity environments related to children's food and activity behaviors: A latent class analysis

Relationships between food and physical activity (PA) environments and children's related behaviors are complex.Latent class analyses derived patterns from proximity to healthy and unhealthy food outlets, PA facilities and parks, and counts of residential dwellings and intersections. Regression analyses examined whether derived classes were related to food consumption, PA, and overweight among 404 low-income children.Compared to children living in Low PA-Low Food environments, children in High Intersection&Parks-Moderate Density&Food, and High Density-Low Parks-High Food environments, had significantly greater sugar-sweetened beverage consumption (ps<0.01) and overweight/obesity (ps<0.001). Children in the High Density-Low Parks-High Food environments were more likely to walk to destinations (p = 0.01)Recognizing and leveraging beneficial aspects of neighborhood patterns may be more effective at positively influencing children's eating and PA behaviors compared to isolating individual aspects of the built environment.

Family Food Environment and Child Eating Behavior in a Private School of Abu Dhabi

Aim: Dietary habits developed during childhood and continued through adulthood. Children’s eating behaviours should be monitorining to avoid possible nutritional deficiencies which have been found to be strongly related to the development of future disease such as obesity, diabetes type 2 and others. The main aim of this study is to explore the relationship between family food environment and the eating behavior during dinnertime among children aged 4 to 6 years old in Abu Dhabi. A cross-sectional study was carried out that examined the relationship between family food environment and child’s eating behaviour around dinnertime.Methods: 61 families participated in the study with their children aged 4-6 years old from a private school. They completed a questionnaire that included questions about demographics, eating behaviour and food environment.Results: 82% of the mothers were reported to be responsible for feeding the children. Most of the families had dinner together three or more times a week. Half of the children got a high score in the child’s eating behaviour scale, indicating that they had positive eating behaviour. The results also showed that children of highly educated mothers were more likely to have positive eating behaviour, compared to children of mothers with lower education (p &lt; .05). There was a significant positive correlation between modelling of eating and child eating behaviour ( Pearson’s r = .56, p &lt; .01), and a significant negative correlation between pressure to eat and child eating behaviour (Pearson’s r = -.35, p &lt; .01).Conclusion: This study is in line with other studies showing that aspects in the family food environment have an influence on eating behaviour of children. Educating parents on food environment and its impact on child behaviour is crucial in order to make them able to develop feeding strategies most likely to benefit children's’ health.

Easier said than done: a qualitative study conducted in the USA exploring Latino family child care home providers as role models for healthy eating and physical activity behaviours

ObjectiveLatinos are the largest and most rapidly growing minority population group in the USA and are disproportionally affected by obesity and related chronic diseases. Child care providers likely influence the...

The Influence of Home and School Environments on Children’s Diet and Physical Activity, and Body Mass Index: A Structural Equation Modelling Approach

Introduction The home and school environments play important roles in influencing children's health behaviours. However, their simultaneous influence on childhood obesity has not yet been examined. We explore the relationship of the home and school environments with childhood obesity, to determine whether this relationship is mediated by children's fruit and vegetable intake and physical behaviours. Methods This study uses baseline data from 9 to 11year old children, their parents and school principals (matched data n = 2466) from the Obesity Prevention and Lifestyle Project. Child-reported behaviours, parent-reported home environment and principal-reported school environment data were collected via questionnaires. Trained researchers measured children's height and weight, and Body Mass Index (BMI, kg/m2) was calculated. Structural equation modelling was used to assess the relationship of the home and school environments with children's fruit and vegetable intake, physical activity behaviours, and children's BMI. Result The home diet environment was positively associated with child diet (β = 0.18, p < 0.001). The home physical activity environment had the largest inverse association with BMI (β = - 0.11, p < 0.001), indirectly through child physical activity (β = 0.28 ,p < 0.001). Schools' healthy eating policy implementation was significantly associated with child diet (β = 0.52, p < 0.05), but physical activity policy was not associated with child activity (β = - 0.007, p > 0.05). The school environment was not associated with child BMI. Discussion The home environment had a stronger association with healthier child behaviours, compared to the school environment. These findings suggest that future childhood obesity interventions targeting healthier home environments and supporting parents can promote healthier child eating and physical activity behaviours.

Obesity, body image, and its impact on children's eating and exercise behaviors in China: A nationwide longitudinal study

Body image seems to mediate the association between obesity and health behaviors as well as weight control attempts. We examined the distribution of children's body image by demographic characteristics and their subsequent associations with eating, exercise, and weight change. Child body image and health behaviors from the China Health National Survey 2000–2011 were assessed at baseline and in follow-up for 6- to 17-year-old children during 2000–2011 using mixed models. There was a large discrepancy between children's actual weight status (overweight: 16.9%) vs. self-rated body image (fat: 2.4% in 2011). Less than 1% of children desired a fat body; girls were more likely to want to be thin (52.5% vs. 40.9%) than boys. About 11% of children needed to lose weight in order to be at their desired baseline. During follow-up, those needing weight loss to be as desired were more likely to attempt dieting to change their weight (OR, 95% CI=1.9, 1.1–3.5 in boys; 1.7, 1.1–2.5 in girls) and less likely to feel they had enough physical activity (OR, 95% CI=0.5, 0.4–0.7 in boys; 0.6, 0.5–0.9 in girls), although their weight gain had been significantly higher than those having consistent self and desired body images (β [SE]=0.4 [0.1] in boys; 0.2 [0.1] in girls, all p<0.05). However, no significant difference was shown in subsequent health behaviors among overweight children by body image discrepancy. The discrepancy in self vs. desired body image motivated children to change their obesity-related health behaviors among non-overweight children in China.

Perceived child eating behaviours and maternal migrant Background

The Child Eating Behaviour Questionnaire (CEBQ) is a well-established instrument in the study of obesity-related eating behaviours among children. However, research using the CEBQ in multicultural ...

Validation of a Shortened Version of the Children's Eating Behavior Questionnaire and Associations with BMI in a Clinical Sample of Latino Children

ObjectiveTo examine the validity of the Children's Eating Behavior Questionnaire (CEBQ) through the associations of its 3 subscale scores (food responsiveness, slowness in eating, and satiety responsiveness) with body mass index (BMI). DesignCross-sectional study of baseline data from a clinic-based obesity prevention and control randomized controlled trial. ParticipantsLatino pediatric patients (n = 295) aged 5–11 years from a federally qualified health center in San Diego County, CA, with BMI percentiles ranging from 75.5 to 99.0. Main Outcome MeasureChild BMI-for-age percentile computed using the standardized program for the 2000 Centers for Disease Control and Prevention growth charts. AnalysisPrincipal components analysis and multivariate linear regressions. ResultsPrincipal components analysis showed a factor structure relatively similar to that of the original 3 CEBQ subscales, with acceptable internal consistency and between-subscale correlations. Analyses demonstrated the validity of the 3 subscales: child BMI was positively associated with food responsiveness (β = .336; P ≤ .001) and negatively associated with slowness in eating (β = −.209; P ≤ .001) and satiety responsiveness (β = −.211; P ≤ .001). Conclusions and ImplicationsThe 14-item CEBQ scale may be useful for assessing obesogenic eating behaviors of Latino children. Further study is needed to replicate these findings.

A qualitative study conducted in the USA exploring Latino fathers' beliefs, attitudes and practices related to their young children's eating, physical activity and sedentary behaviours.

Increasing evidence documents fathers' influential role in their children's eating, physical activity (PA) and sedentary behaviours (SB). We aimed to expand limited existing research examining fathers' influence in these areas by exploring Latino fathers' beliefs, attitudes and practices related to eating, PA and SB of their young children. Seven focus group discussions were conducted in Spanish with Latino fathers (n 28) of children aged 2-8 years. Audio recordings were transcribed and translated verbatim without identifiers. Data were analysed using thematic analysis to identify key concepts and themes using NVivo 11 software. Fathers expressed positive beliefs and attitudes about the importance of healthy eating for their young children, themselves and their families. Nevertheless, the majority reported familial practices including eating out, getting take-out, etc. that have been linked to increased obesity risk among Latino children. Fathers were more involved and engaged in children's PA than eating and feeding. However, several fathers reported engaging predominantly in sedentary activities with their children, appeared permissive of children's sedentary habits and struggled to set limits on children's screen-time. We provide new information on Latino fathers' beliefs and child feeding and PA practices that may provide important targets for interventions aimed at promoting healthful eating and PA behaviours of Latino children. Future research should further quantify the influence of Latino fathers' parenting styles and practices on development of children's eating, PA and SB. This information is needed to identify risk factors amenable to interventions and to design culturally appropriate parenting and family-based interventions targeting Latino children's home environment and designed to meet this ethnic group's specific needs.

Food Reluctance of Preschool Children Attending Daycare Centers Is Associated with a Lower Body Mass Index

BackgroundFood reluctance can present as fussiness, picky eating, slowness in eating, and high satiety responsiveness. It can be associated with inadequate weight gain during early childhood. Although a majority of preschoolers attend daycare centers, associations between their eating behaviors at daycare and their body composition have not been studied. ObjectiveOur aim was to develop an estimate of food reluctance and to assess the relationship between food reluctance at daycare and body mass index (BMI) and waist circumference of preschoolers. DesignWe conducted a cross-sectional secondary analyses. Food reluctance was estimated using weighted digital plate waste analysis. Intra-rater, inter-rater, and test−retest reliability and convergent validity of the food reluctance score were tested. The food reluctance score was then compared to preschool children’s BMI and waist circumference. Participants/settingParticipants included 309 children aged 3 to 5 years in 24 daycare centers across the Canadian province of New Brunswick. Main outcome measuresPreschool children’s waist circumference and age-adjusted BMI derived from objectively measured height and weight were analyzed. Statistical analyses performedIntraclass correlations were used to determine the reliability of the new estimate. Spearman correlation was used to compare the estimate with parental report of food reluctance. Multivariate linear regressions were used to examine the relationship between food reluctance and waist circumference and age-adjusted BMI. ResultsThe estimated food reluctance score demonstrated excellent inter- and intra-rater reliability (intraclass correlation>0.97; P<0.0001) and good test−retest reliability (intraclass correlation=0.72; P<0.0001). It also provided evidence of convergent validity through correlation with reluctance-related subscales of the Child Eating Behavior Questionnaire (ρ=.53, P<0.0001). Greater demonstration of food reluctance at the daycare center was associated with a lower age-adjusted BMI (adjusted β −1.41; 95% CI −.15 to −2.67), but was not associated with children’s waist circumference (adjusted β −.60; 95% CI −2.06 to .86). ConclusionsSigns of food reluctance can be observed in daycare and relate to lower BMI among preschoolers.

Feeding Guidelines for Infants and Young Toddlers

Responsive parenting is a caregiving style expected to foster the development of self-regulation and promote optimal cognitive, social, and emotional development from the beginning of life. Critical dimensions of responsive parenting include feeding, sleeping, soothing, and play/physical activity; all are highly interconnected with each other. Responsive parenting interventions have been shown to have a beneficial impact on child feeding behaviors and weight outcomes. An expert panel convened by Healthy Eating Research, a national program of the Robert Wood Johnson Foundation, developed evidence-based guidelines for feeding infants and toddlers during the first 2 years of life. These responsive feeding guidelines were developed after an evidence-based consensus methodology. The guidelines address the periods of gestation, birth to 6 months, more than 6 months to 1 year, and more than 1 to 2 years. Fundamental principles of the guidelines include hunger and satiety cues, developmental milestones that indicate readiness for introduction of solids, and responsive approaches to repeatedly expose the young child to a variety of healthy foods and age-appropriate textures in the context of a stable and predictable nurturing environment.

Experiences and lessons learned for delivery of micronutrient powders interventions.

An effective delivery strategy coupled with relevant social and behaviour change communication (SBCC) have been identified as central to the implementation of micronutrient powders (MNP) interventions, but there has been limited documentation of what works. Under the auspices of “The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,” three working groups were formed to summarize experiences and lessons across countries regarding MNP interventions for young children. This paper focuses on programmatic experiences related to MNP delivery (models, platforms, and channels), SBCC, and training. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that most countries distributed MNP free of charge via the health sector, although distribution through other platforms and using subsidized fee for product or mixed payment models have also been used. Community‐based distribution channels have generally shown higher coverage and when part of an infant and young child feeding approach, may provide additional benefit given their complementarity. SBCC for MNP has worked best when focused on meeting the MNP behavioural objectives (appropriate use, intake adherence, and related infant and young child feeding behaviours). Programmers have learned that reincorporating SBCC and training throughout the intervention life cycle has allowed for much needed adaptations. Diverse experiences delivering MNP exist, and although no one‐size‐fits‐all approach emerged, well‐established delivery platforms, community involvement, and SBCC‐centred designs tended to have more success. Much still needs to be learned on MNP delivery, and we propose a set of implementation research questions that require further investigation.

Children's food and satiety responsiveness in association with post-prandial glucose following a standardized liquid meal.

Children's responsiveness to food cues and satiety may put them at greater risk for obesity; however, little is known about the physiological mechanisms underlying children's responsiveness to food and satiety. The objective of this study was to examine the association between children's post-prandial glucose responses and maternal report of their eating behaviours. A secondary data analysis was conducted using partial correlation analyses adjusted for gender in a sample of children aged 5-10 years and their mothers (N = 28 dyads). Standardized liquid meal tests were administered to children and blood samples were obtained over the following 4 h. Mothers completed the Children's Eating Behaviour Questionnaire. An earlier post-prandial peak glucose concentration was associated with greater food responsiveness (r = -0.39, P = 0.04) but not satiety responsiveness. The percent increase in glucose from fasting to peak also tended to be inversely associated with greater food responsiveness (r = -0.38, P = 0.05). Results suggest that earlier and smaller post-prandial glucose excursions may be related to children's response to food cues. Future research should use objective methods to examine whether the association of post-prandial glucose with food responsiveness prospectively contributes to weight gain.

Emotional over- and under-eating in early childhood are learned not inherited

Emotional overeating (EOE) has been associated with increased obesity risk, while emotional undereating (EUE) may be protective. Interestingly, EOE and EUE tend to correlate positively, but it is unclear whether they reflect different aspects of the same underlying trait, or are distinct behaviours with different aetiologies. Data were from 2054 five-year-old children from the Gemini twin birth cohort, including parental ratings of child EOE and EUE using the Child Eating Behaviour Questionnaire. Genetic and environmental influences on variation and covariation in EUE and EOE were established using a bivariate Twin Model. Variation in both behaviours was largely explained by aspects of the environment completely shared by twin pairs (EOE: C = 90%, 95% CI: 89%-92%; EUE: C = 91%, 95% CI: 90%-92%). Genetic influence was low (EOE: A = 7%, 95% CI: 6%-9%; EUE: A = 7%, 95% CI: 6%-9%). EOE and EUE correlated positively (r = 0.43, p < 0.001), and this association was explained by common shared environmental influences (BivC = 45%, 95% CI: 40%-50%). Many of the shared environmental influences underlying EUE and EOE were the same (rC = 0.50, 95% CI: 0.44, 0.55). Childhood EOE and EUE are etiologically distinct. The tendency to eat more or less in response to emotion is learned rather than inherited.

Association of Household Food- and Drink-Sharing Practices With Human Herpesvirus 8 Seroconversion in a Cohort of Zambian Children.

Human herpesvirus 8 (HHV-8) infection occurs in early childhood and is associated with human immunodeficiency virus type 1 (HIV-1) infection and risk for Kaposi sarcoma, but behaviors associated with HHV-8 transmission are not well described. We enrolled and followed a prospective cohort of 270 children and their household members to investigate risk factors for HHV-8 transmission in Lusaka, Zambia. We report an incidence of 30.07 seroconversions per 100 child-years. Independent risk factors for HHV-8 incident infection included having a child who shared utensils with a primary caregiver (hazards ratio [HR], 2.33; 95% confidence interval [CI], 1.49-7.14), having an increasing number of HHV-8-infected household members (HR, 1.27; 95% CI, 1.09-2.79), and having ≥5 siblings/children in the household (HR, 2.24; 95% CI, 1.03-4.88). Playing with >5 children a day was protective against infection (HR, 0.54; 95% CI, .33-0.89), as was increasing child age (HR, 0.96; 95% CI, .93-.99). This is the first study to find a temporal association between limited child feeding behaviors and risk for HHV-8 infection. Child food- and drink-sharing behaviors should be included in efforts to minimize HHV-8 transmission, and households with a large number of siblings should receive additional counseling as childhood infections occur in the home context.

Managing common feeding difficulties in toddlers and pre-school children

Abstract Feeding problems in young children are common and although they are a cause of significant worry to many parents, most will resolve without intervention by health professionals. Some of the most frequently reported problems are picky eating, neophobia (refusal to eat new foods), dislike of certain food textures or food groups (usually vegetables!) and simply not eating enough. This review will describe the common features of these difficulties and provide some evidence-based techniques for minimising their effect. We will also discuss the management of parental anxiety around child feeding which not only impacts negatively on family relationships and interactions at mealtimes, but may even exacerbate the child's problematic eating behaviour.

Effects of selected socio-demographic characteristics on nutrition knowledge and eating behavior of elementary students in two provinces in China

BackgroundNational and international child health surveys have indicated an increase in childhood obesity in China. The increase has been attributed to a rising standard of living, increasing availability of unhealthy foods, and a lack of knowledge about healthy diet. The objective of this study was to assess the effect of selected socio-demographic characteristics on the BMI, nutrition knowledge, and eating behavior of elementary school children.MethodsMultistage stratified cluster sampling was used. Information on demographics, nutrition knowledge, and eating behavior was gathered by means of questionnaires. The schools’ doctors provided the height and weight data. The study was set in one economically advantaged and one economically disadvantaged province in China. The participants were Grade 3 students, ages 8–10 years (N = 3922).ResultsA cluster analysis identified four socio-demographic variables distinguished by parental education and family living arrangement. A one-way ANOVA compared differences among the clusters in BMI, child nutrition knowledge, and child eating behavior. Students in the cluster with lowest parent education level had the lowest nutrition knowledge scores and eating behavior scores. There was no significant benefit from college education versus high school education of parents in the other three clusters. BMI was not affected by parent education level.ConclusionThe nutrition status of elementary school age children will benefit most by increasing the general level of education for those adults who are presently least educated.

FTO genotype and weight status among preadolescents: Assessing the mediating effects of obesogenic appetitive traits

Polymorphisms in the Fat Mass and Obesity Associated (FTO) gene are robustly associated with overweight and obesity among children, although the underlying mechanisms are poorly understood. We tested if appetitive traits partially mediated the association between FTO genotype and increased BMI among a sample of US preadolescents. Data were from 178 unrelated 9–10 year olds who participated in an experimental study between 2013 and 2015. Children's DNA was isolated from buccal swabs, and the rs9939609 SNP in the FTO gene was genotyped. Children's age- and sex-adjusted BMI z-scores were computed using height and weight measured at the laboratory. Parents completed the Child Eating Behavior Questionnaire that includes three validated scales of habitual appetitive traits related to drive and regulation: satiety responsiveness, enjoyment of food and food responsiveness. Structural equation modeling was used to assess if those traits mediated the relationship between FTO and BMI z-score. The sample of children was 48.9% male and 91.0% non-Hispanic white. FTO distribution was in Hardy Weinberg equilibrium, and 16.3% of participants were homozygous for the high-risk allele. Mean BMI z-score was greatest among those with the high-risk genotype (ANOVA P < 0.01). In separate structural equation models adjusted for the child's sex and maternal education, decreased satiety responsiveness and increased food responsiveness each partially mediated the positive association between the high-risk genotype and increased BMI z-score (P-value for each indirect effect <0.05). Continued research is needed to better understand how other known genetic obesity risk factors may impact appetitive traits among children.

Impact of a Mindfulness-Based Program on Child Diet and Eating Behaviors

Impact of a Mindfulness-Based Program on Child Diet and Eating Behaviors

Development of an Instrument Designed to Assess Intentions to Use Division of Responsibility in Child Feeding

To minimize children's less-healthy eating behaviors, Satter proposes a division of responsibility in child feeding (sDOR): parents take responsibility for providing a healthy food environment and children have responsibility for choosing what and how much to eat. The Theory of Planned Behavior suggests a precursor to behavior is intention to perform that behavior. Hence, if parents plan (intend) to use sDOR, they will be more likely to do so. The objective of this study was to develop an instrument to measure sDOR intentions (sDOR-I). Using a cross-sectional study design, we surveyed 421 undergraduate students from a major southeastern university who were enrolled in randomly-selected undergraduate courses. Two hundred ninety-seven students who plan to have children provided complete, valid data for all variables. We created a sDOR-I scale by modifying 13 sDOR items (Lohse, Satter & Arnold, 2014). The items, scored from 0-4 (strongly disagree-strongly agree), were pretested with college students and refined. Appropriate items were reverse-coded and scores summed (possible range 0-52). Using factor analysis and scale reliability testing, we identified four subscales (Leadership, Autonomy, Indulgence and Pressure-to-Eat). Subscales were created by averaging item scores (none reverse-coded; range 0-4). Students scored between 20 and 41 on the sDOR-I (mean=29.06). Means for Leadership, Autonomy, Indulgence, and Pressure-to-Eat subscales (Cronbach's alphas) were 3.23 (.624), 2.27 (.386), 1.92 (.664), and 2.91 (.521) respectively. This study represents the first attempt to measure sDOR-I. Although further refinement of the scale may be indicated, understanding sDOR-I may lead to future development of interventions to improve child feeding behaviors.

Influencers of childhood over nutrition: a cross sectional study among primary school children in Kolkata, West Bengal, India

Background: Changing trends of dietary habits and lack of physical exercise force the world to face a modern era epidemic obesity which also affects our children counterpart. Childhood obesity is now a challenge of public health to combat with. Prevalence of childhood overnutrition (obesity and overweight) found to be rising in many developing countries including India in recent decades in many studies by different researchers, it is ranging from 2.9% to 14.3%, which makes our youth vulnerable to many life-threatening consequences.Methods: It was a school based cross sectional study done in primary schools of Barasat among 548 students of 3-11 years of age group. Parental perception towards child eating behaviour were assessed with the help of CEBQ questionnaire.Results: Among the total 548 students, as per BMI 38% were overweight and obese. Then hierarchical multiple logistic regression revealed that at Step one socio-demographic factors accounted for 16.9% of the variation in overnutrition status. Introducing the responses on selected life style factors in step two and CEBQ responses in final step explained an additional 9.9% and 5% of variation respectively. At all three-level model correctly predicted 62-70.3% of the dependent variables.Conclusions: The high proportion of over nourished children were found in our study, and this found to be related with parental perception about few lifestyle and child eating behaviour which calls for further research and interventional programme for this alarming topic in this age group.