Alison Fildes

• PhD
• Fellow at University of Leeds

Fruits and vegetables are rich in dietary fibre, vitamins and minerals making them beneficial for health. The UK’s Eatwell Guide (EWG) ⁽¹⁾ recommends fruits and vegetables make up 40% of the diet (by weight), but on average they contribute less than 29% to the UK diet ⁽²⁾ . Prominent product placement can boost sales. We explored the effect of plac...

The current cost‐of‐living crisis is disproportionately affecting families experiencing poverty and is likely to be amplifying existing dietary inequalities and challenges, such as food insecurity (FI). Government policies designed to address diet inequality in the UK have historically had minimal impact on population diet and health and may have e...

Background Food fussiness (FF) describes the tendency to eat a small range of foods, due to pickiness and/or reluctance to try new foods. A common behaviour during childhood, and a considerable cause of caregiver concern; its causes are poorly understood. This is the first twin study of genetic and environmental contributions to the developmental t...

Introduction & Background On 1 October 2022, new legislation came into force for England restricting the placement of some food and drink products high in fat, sugar and salt (HFSS). Products such as confectionery can no longer be placed at store entrances, ends of aisles, or at the checkout in large retail stores and their online equivalents. Obje...

Excess weight gained during the early years and, in particular, rapid weight gain in the first 2 years of life, are a major risk factors for adult obesity. The growing consensus is that childhood obesity develops from a complex interaction between genetic susceptibility and exposure to an ‘obesogenic’ environment. Behavioural susceptibility theory...

Background The obesogenic quality of the home environment is hypothesised to play an important role in children’s weight development but few prospective studies have investigated relationships between the home environment and adiposity across childhood. Objective To investigate the continuity and stability of the home environment from ages 4 to 12...

In 2015, Tesco Express convenience stores implemented a healthy checkouts initiative; products high in fat, salt or sugar were removed from in‐queue areas. We compare purchasing of less healthy foods before and after its introduction. Tesco provided store‐level sales data (n = 1151) for Express stores in England over two 8‐week periods, May–July 20...

Purpose Given the variability in adiposity despite ubiquitous exposure to obesogenic food environments, it has been suggested that individuals respond in divergent ways to the environment they live in. The food environment becomes more ‘permissive’ as children age; therefore, genetic predisposition for a more avid appetite can be better expressed,...

Decisions about what, how much and when to eat are complex processes influenced by many interconnected factors. Appetite traits are the drivers behind these processes, reflecting a complex combination of the internal signals of hunger and/or fullness, with environmental cues, such as attitudes and psychosocial factors related to food selection and...

Purpose The Adult Eating Behaviour Questionnaire (AEBQ) is a newly developed questionnaire adapted from the widely used Child Eating Behaviour Questionnaire. This questionnaire assesses four food approach scales, namely hunger, food responsiveness, emotional overeating (EOE) and enjoyment of food, and four food avoidance scales, namely satiety resp...

Purpose Appetitive traits in adults and their associations with weight can be measured using the Adult Eating Behaviour Questionnaire (AEBQ). The aim of this study was to confirm the factor structure of the Spanish AEBQ (AEBQ-Esp) in a Mexican sample and explore associations between the eight traits with body mass index (BMI). Method A sample of 1...

Abstract Background The home environment is thought to influence children’s weight trajectories. However, few studies utilise composite measures of the home environment to examine associations with energy balance behaviours and weight. The present study aimed to adapt and update a comprehensive measure of the obesogenic home environment previously...

DOI: 10.1159/000520153

Appetitive traits are associated with weight and could be managed using behavioural strategies. Personalised approaches to weight loss could use a person's appetitive trait profile to tailor weight management advice. This study aimed to explore participants’ experiences of a brief Appetitive Trait Tailored Intervention (ATTI) based on participants’...

es have consistently associated appetitive behaviors with child body mass index. However, few prospective studies have investigated the association between appetite and other measures of body composition and its directionality. We aimed to investigate the bi-directional relationship between appetitive behaviors and body composition in school-aged c...

Background Given the great variability in adiposity and the exposure to obesogenic food environments, it has been suggested that individuals respond in divergent ways to the environment they live in. Our aim was to explore the genetic and environmental contribution of variations on appetitive behaviors in 10-year-old Portuguese children. Methods P...

This systematic review and meta‐analysis aimed to quantify associations between Child Eating Behavior Questionnaire (CEBQ) and Baby Eating Behavior Questionnaire (BEBQ) appetitive traits (food approach: Food Responsiveness [FR], Enjoyment of Food [EF], Emotional Overeating [EOE], and Desire to Drink [DD]; food avoidant: Satiety Responsiveness [SR],...

PurposeAppetitive behaviours have been associated with body mass index (BMI). However, existing data were largely derived from cross-sectional studies and cannot provide insight into the direction of associations. We aimed to explore the bidirectionality of these associations in school-age children.Methods Participants are from the Generation XXI b...

Background Extensive research has demonstrated the role of the Home Environment (HE) in shaping children’s energy balance behaviours. Less is known about direct relationships with bodyweight. This review examines associations between the social and physical aspects of three pre-defined Home Environment domains (food, physical activity and media) an...

Background Health Care Professionals struggle to initiate conversations about overweight in toddlerhood. A novel 3D body size scale (3D BSS) may facilitate engagement with this topic during pediatric appointments. Objectives To explore barriers and facilitators to using the 3D BSS through a mixed‐methods design. Methods For the qualitative phase,...

Introduction Appetitive traits, including Food Responsiveness, Enjoyment of Food, Satiety Responsiveness, Emotional Over- and Under-Eating, Food Fussiness and Slowness in Eating, have been captured across childhood using the Children’s Eating Behavior Questionnaire (CEBQ). The Adult Eating Behavior Questionnaire (AEBQ) has explored these traits in...

Background: Most children eat fewer vegetables than recommended. Storybooks and sensory play may increase vegetable intake. Objective: This study tested the effects on intake of learning about an unfamiliar vegetable (celeriac) through storybooks and sensory play. It was predicted that an illustrated, congruent storybook would increase intake of...

Background Physical inactivity is a persistent challenge among girls. School-based physical activity (PA) interventions have shown mixed effects on girl’s activity levels, with multi-component approaches involving both school and community links appearing more effective for sustainable change. The purpose of the current research was to gather views...

Background Removing unhealthy products from checkouts will arguably reduce impulse purchasing, but evidence is lacking. In 2015, Tesco Express stores implemented so-called healthy checkouts; products high in sugar, fat, or salt (defined by national Nutrient Profiling Model criteria) were removed from in-queue areas. We aimed to compare the purchasi...

Importance The early obesogenic home environment is consistently identified as a key influence on child weight trajectories, but little research has examined the mechanisms of that influence. Such research is essential for the effective prevention and treatment of overweight and obesity. Objective To test behavioral susceptibility theory’s hypothe...

IMPORTANCE The early obesogenic home environment is consistently identified as a key influence on child weight trajectories, but little research has examined the mechanisms of that influence. Such research is essential for the effective prevention and treatment of overweight and obesity. OBJECTIVE To test behavioral susceptibility theory’s hypothes...

Objective: Child fussy eating has been associated with a range of maternal feeding practices; however, whether effects are parent-driven, child-driven, or bidirectional (i.e., both) remains unclear. This study tested for bidirectional relationships between nonresponsive and structure-related maternal feeding practices and child fussy eating at age...

Objective Child fussy eating has been associated with a range of maternal feeding practices; however, whether effects are parent-driven, child-driven, or bidirectional (i.e., both) remains unclear. This study tested for bidirectional relationships between nonresponsive and structure-related maternal feeding practices and child fussy eating at age 2...

Background Emotional over‐eating (EOE) and emotional under‐eating (EUE) are common behaviours that develop in early childhood and are hypothesised to play a role in weight status. Data from a British twin cohort demonstrated that environmental, rather than genetic, factors shape individual differences in both behaviours in early childhood. Objecti...

Background: Autism spectrum disorder (ASD) has been linked with eating- and feeding-related atypicalities, including food neophobia (FN) (refusal to try unfamiliar foods), since its earliest description. Nevertheless, whether associations between ASD traits and FN extend subclinically into the broader population of children and their potential add...

Beverage preferences are an important driver of consumption, and strong liking for beverages high in energy (e.g. sugar-sweetened beverages [SSBs]) and dislike for beverages low in energy (e.g. non-nutritive sweetened beverages [NNSBs]) are potentially modifiable risk factors contributing to variation in intake. Twin studies have established that b...

Individuals who are overweight are more likely to underestimate their body size than those who are normal weight, and overweight underestimators are less likely to engage in weight loss efforts. Underestimation of body size might represent a barrier to prevention and treatment of overweight; thus insight in how underestimation of body size develops...

Background One in five British children are overweight or obese when entering primary school but most parents fail to recognise child overweight. Health-care professionals are expected to manage childhood overweight, but initiating conversations with parents is difficult. The aim of this study was to inform the development of a visual and language...

Background. Appetitive traits measured using the Adult Eating Behaviour Questionnaire (AEBQ) were found to be associated with weight in a sample of British adults. Validation of the AEBQ in different languages is essential to enable these associations to be studied in other populations. Mexico represents one the largest overweight and obese populat...

Purpose: Variability in the timing of infant developmental milestones is poorly understood. We used a twin analysis to estimate genetic and environmental influences on motor development and activity levels in infancy. Method: Data were from the Gemini Study, a twin birth cohort of 2,402 families with 10 twins born in the United Kingdom in 2007. Par...

Background The aims of this study were to evaluate the factor structure of the newly developed Adult Eating Behaviour Questionnaire (AEBQ) (Hunot et al., Appetite 105:356-63, 2016) in an Australian sample, and examine associations between the four food approach and four food avoidance appetitive traits with body mass index (BMI). Methods Participa...

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 fi...

Background Picky eating is prevalent in childhood. Because pickiness concerns parents and is associated with nutrient deficiency and psychological problems, the antecedents of pickiness need to be identified. We propose an etiological model of picky eating involving child temperament, sensory sensitivity and parent-child interaction. Methods Two c...

Background Research suggests a role for both fat mass and muscle mass in appetite regulation, but the longitudinal relationships between them have not yet been examined in children. The present study therefore aimed to explore the prospective relationships between fat mass, muscle mass and the appetitive traits food responsiveness and satiety respo...

Emotional overeating (EOE) is the tendency to eat more in response to negative emotions; its etiology in early life is unknown. We established the relative genetic and environmental influences on EOE in toddlerhood and early childhood. Data were from Gemini, a population-based cohort of 2,402 British twins born in 2007. EOE was measured using the “...

Emotional eating, that is, eating more in response to negative mood, is often seen in children. But the origins of emotional eating remain unclear. In a representative community sample of Norwegian 4-year-olds followed up at ages 6, 8, and 10 years (analysis sample: n = 801), one potential developmental pathway was examined: a reciprocal relation b...

Purpose of review: There is considerable variability in human body weight, despite the ubiquity of the 'obesogenic' environment. Human body weight has a strong genetic basis and it has been hypothesised that genetic susceptibility to the environment explains variation in human body weight, with differences in appetite being implicated as the media...

Table S1. Items on the CEBQ used to calculate Food Neophobia and Food Fussiness scores. Table S2. Parameter estimates (95% confidence intervals) for A, C, and E for males and females considering qualitative and quantitative sex differences in food neophobia. Table S3. Parameter estimates (95% confidence intervals) for A, C, and E for males and fe...

Appendix S1. STROBE statement – list of items that should be included in reports of cohort studies. Appendix S2. Flow of families through the Gemini study between 2007 and 2011.

Supplementary material

Picky eating is prevalent in childhood and is associated with negative health outcomes. Therefore early detection of pickiness is pertinent. Because no psychometric measure of picky/fussy eating has been validated we aimed to examine the screening efficiency of the 6-item ‘Food Fussiness’ (FF) scale from the Children’s Eating Behavior Questionnaire...

Emotional eating, i.e. eating more in response to negative mood, is often seen in children. But the origins of emotional eating remain unclear. In a representative community sample of Norwegian 4 year olds followed up at ages 6, 8, and 10 (analysis sample: n=801) we examined one potential developmental pathway: a reciprocal relation between parenta...

Previous research has identified associations between approach-related appetitive traits (Food Responsiveness [FR], Emotional Over-Eating [EOE]) and avoidance-related traits (Satiety Responsiveness [SR], Slowness in Eating [SE]) and BMI, measured using the newly developed Adult Eating Behaviour Questionnaire (AEBQ). Providing individuals with feedb...

Parental perception of zygosity might bias heritability estimates derived from parent rated twin data. This is the first study to examine if similarities in parental reports of their young twins’ behavior were biased by beliefs about their zygosity. Data were from Gemini, a British birth cohort of 2402 twins born in 2007. Zygosity was assessed twic...

Background: 'Food fussiness' (FF) is the tendency to be highly selective about which foods one is willing to eat, and emerges in early childhood; 'food neophobia' (FN) is a closely related characteristic but specifically refers to rejection of unfamiliar food. These behaviors are associated, but the extent to which their etiological architecture o...

Objective: The objective of the study is to evaluate the effect of gastric banding, gastric bypass and sleeve gastrectomy on medium to long-term diabetes control in obese participants with type 2 diabetes mellitus. Research design and methods: Matched cohort study using primary care electronic health records from the UK Clinical Practice Researc...

Objectives To estimate costs and outcomes of increasing access to bariatric surgery in obese adults and in population subgroups of age, sex, deprivation, comorbidity, and obesity category. Methods A cohort study was conducted using primary care electronic health records, with linked hospital utilization data, for 3,045 participants who underwent b...

The home environment is likely to influence children's diet and activity patterns and ultimately, their weight trajectories. Identifying family characteristics associated with a more ‘obesogenic’ home can provide insight into the determinants, and has implications for targeting and tailoring strategies to promote healthier lifestyles. The present s...

Background: This study aimed to use primary care electronic health records to evaluate the epidemiology of bariatric surgery in the UK. Methods: A cohort comprising all obese patients with a bariatric surgical procedure was drawn from the Clinical Practice Research Datalink (CPRD). Rates of bariatric surgery were estimated using the registered C...

Background Parental feeding practices are thought to play a causal role in shaping a child’s fussiness; however, a child-responsive model suggests that feeding practices may develop in response to a child’s emerging appetitive characteristics. We used a novel twin study design to test the hypothesis that mothers vary their feeding practices for twi...

Background: Food preferences vary substantially among adults and children. Twin studies have established that genes and aspects of the shared family environment both play important roles in shaping children's food preferences. The transition from childhood to adulthood is characterized by large gains in independence, but the relative influences of...

The Child Eating Behaviour Questionnaire (CEBQ) is a validated parent-report measure of appetitive traits associated with weight in childhood. There is currently no matched measure for use in adults. The aim of this study was to adapt the CEBQ into a self-report Adult Eating Behaviour Questionnaire (AEBQ) to explore whether the associations between...

Bariatric surgery is known to be an effective treatment for extreme obesity but access to these procedures is currently limited. Objective This study aimed to evaluate the costs and outcomes of increasing access to bariatric surgery for severe and morbid obesity. Design and methods Primary care electronic health records from the UK Clinical Pract...

Background: Food fussiness (FF) is common in early childhood and is often associated with the rejection of nutrient-dense foods such as vegetables and fruit. FF and liking for vegetables and fruit are likely all heritable phenotypes; the genetic influence underlying FF may explain the observed genetic influence on liking for vegetables and fruit....

We are grateful to Hunger and Tomiyama for their interest in our recent article. We agree with their assertion that excessive focus on body weight may sometimes lead to negative psychological and behavioral outcomes for some obese individuals. We also agree that physical fitness is an important measure that is associated with long-term health outco...

Background: Appetitive traits and food preferences are key determinants of children's eating patterns but it is unclear how these behaviours relate to one another. This study explores relationships between appetitive traits and preferences for fruits and vegetables, and energy dense, nutrient poor (noncore) foods in two distinct samples of Austral...

We examined whether exposure to a greater number of fruits, vegetables, and noncore foods (ie, nutrient poor and high in saturated fats, added sugars, or added salt) at age 14 months was related to children's preference for and intake of these foods as well as maternal-reported food fussiness and measured child weight status at age 3.7 years. This...

We examined the probability of an obese person attaining normal body weight. We drew a sample of individuals aged 20 years and older from the United Kingdom's Clinical Practice Research Datalink from 2004 to 2014. We analyzed data for 76 704 obese men and 99 791 obese women. We excluded participants who received bariatric surgery. We estimated the...

Research suggests that repeatedly offering infants a variety of vegetables during weaning increases vegetable intake and liking. The effect may extend to novel foods. The present study aimed to investigate the impact of advising parents to introduce a variety of single vegetables as first foods on infants' subsequent acceptance of a novel vegetable...

To evaluate the evidence for association between obesity risk outcomes >12 months of age and timing of solid introduction in healthy term infants in developed countries, the large majority of whom are not exclusively breastfed to six months of age. Studies included were published 1990 to March 2013. Twenty-six papers with weight status or obesity p...

Parental control over feeding has been linked to child overweight. Parental control behaviours have been assumed to be exogenous to the child, but emerging evidence suggests they are also child-responsive. This study tests the hypothesis that parental control in early infancy is responsive to infant appetite and weight. Participants were 1920 mothe...

Fussy eating is common in early childhood and is associated with unhealthy dietary patterns; in particular a decreased preference for vegetables and fruits. Food preferences and fussiness are heritable in childhood. Observed associations between these phenotypes could be because there are common genes that influence them all. To quantify the extent...

Fruit/vegetable consumption in childhood has wide ranging implications including decreased risk of childhood obesity. Few studies have sought to predict children's intention and behaviour related to fruit/vegetable consumption in the context of weight status. This study sought to test the utility of the Theory of Planned Behaviour (TPB) for the pre...

Research suggests that repeatedly offering infants a variety of vegetables early during weaning, increases intake and liking of these vegetables and may facilitate acceptance of novel foods. Sixty mothers of 4–6 month old infants were randomised to an intervention group who were given guidance on introducing vegetables as first weaning foods, or a...

Background & Objectives Shorter sleep is associated with higher weight in children, but little is known about the mechanisms. The aim of this study was to test the hypothesis that shorter sleep was associated with higher energy intake in early childhood.Methods Participants were 1303 families from the Gemini twin birth cohort. Sleep duration was me...

Health professionals identify food provision in the home as a key influence on children's food preferences. In contrast, parents often perceive children's food preferences to be inborn. One explanation for this discrepancy could be that environmental and genetic influences vary by food type. We assessed genetic and environmental contributions to pr...

Repeated taste exposure, in combination with small rewards, has been shown to increase children's acceptance of disliked foods. However, previous studies have used direct contact with researchers or professionals for the implementation of the repeated exposure procedure. If mailed taste exposure instructions to parents produced comparable outcomes,...

Résumé présenté lors du 20e congrès international de nutrition à Grenade (Espagne) du 15 au 20 septembre 2013.

Résumé présenté lors du 20e congrès international de nutrition à Grenade (Espagne) du 15 au 20 septembre 2013

Please cite this paper as: van Jaarsveld C, Llewellyn C, Fildes A, Fisher A, Wardle J. Are my twins identical: parents may be misinformed by prenatal scan observations. BJOG 2012;119:517-518.

An individual's experience of flavours contributes to their unique pattern of food preferences. Exposure to a specific flavour can increase familiarity and result in greater acceptance of this flavour over time. This paper describes the earliest occurrences of flavour exposure; first in utero, via amniotic fluid, and later through breast or formula...