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Eating Behavior and Weight in Children
Abstract
The idea that eating styles might influence weight is not new. In 1968, Stanley Schachter published a seminal paper proposing
the “externality theory” of obesity (Schachter 1968). It described a series of innovative experiments in which the eating
behavior of a clinical sample of severely obese individuals was compared with the eating behavior of normal-weight individuals,
using a variety of physiological and environmental manipulations. The conclusion was that the obese were more reactive to
external cues of food (such as smell or taste) and less responsive to internal physiological sensations related to hunger
and satiety, indicating a weakening of normal appetitive controls. In modern environments where highly palatable food is abundant
and cheap, high external responsiveness could lead to over-eating and weight gain, especially if it is not buffered by strong
satiety sensitivity.
... Although research has revealed a great deal about what influences eating behavior (Gahagan, 2012), much still remains unclear about its etiology. To illustrate, it is often assumed that parents influence children's eating behavior-yet most of the existing literature is cross sectional (Llewellyn, Carnell, & Wardle, 2011). Longitudinal studies provide one means of investigating potential determinants of eating behavior. ...
Eating more or eating less in response to negative emotions, called emotional over‐ and undereating, is common in children, but research on the etiology of these behaviors is in its infancy. Drawing on a large, representative community sample of Norwegian children followed up on a biennial basis from 6 to 10 years of age (analysis sample: n = 802), child and contextual predictors (i.e., child temperament, depression symptoms, serious life events, family functioning, parental sensitivity and structuring) of change in emotional over‐ and undereating were examined. Results revealed that low (temperamental) soothability and less parental structuring at age 6 predicted increased emotional overeating at age 10 and that lower family functioning at age 6 predicted more emotional undereating during the same period.
... Although research has revealed a great deal about what influences eating behavior (Gahagan, 2012), much still remains unclear about its etiology. To illustrate, it is often assumed that parents influence children's eating behavior-yet most of the existing literature is cross sectional (Llewellyn, Carnell, & Wardle, 2011). Longitudinal studies provide one means of investigating potential determinants of eating behavior. ...
Children’s eating behavior influences energy intake and thus weight through choices of type and amount of food. One type of eating behavior, food responsiveness, defined as eating in response to external cues such as the sight and smell of food, is particularly related to increased caloric intake and weight. Because little is known about the potential determinants of such behavior, we focus herein on child and parent predictors of food responsiveness in a large community sample of Norwegian 6-year-olds, followed up at ages 8 and 10. To measure children’s food responsiveness, parents completed the Children’s Eating Behavior Questionnaire. Potential predictors were children’s inhibition and symptoms of attention-deficit/hyperactivity disorder and depression, and parents’ instrumental and controlling feeding practices as well as parental restrained eating. After accounting for children’s initial levels of food responsiveness within a hybrid fixed effects method that takes into consideration all unmeasured time-invariant confounders, more child attention-deficit/hyperactivity disorder symptoms and greater restrained eating by parents predicted more food responsiveness at both ages 8 and 10. These results may provide important insights for efforts to prevent overeating.
... Although research has revealed a great deal about what influences eating behavior (Gahagan, 2012), much still remains unclear about its etiology. To illustrate, it is often assumed that parents influence children's eating behavior-yet most of the existing literature is cross sectional (Llewellyn, Carnell, & Wardle, 2011). Longitudinal studies provide one means of investigating potential determinants of eating behavior. ...
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 between parental emotional feeding and child emotional eating. The results revealed that higher levels of emotional feeding predicted higher levels of emotional eating and vice versa, adjusting for body mass index and initial levels of feeding and eating. Higher levels of temperamental negative affectivity (at age 4) increased the risk for future emotional eating and feeding.
... This finding was expected and can be attributed to different factors, the heritability of eating disorders, learned behavior pattern, depressive states, and stress. Clare et al. (2011) have reported that psychological, social, and behavioral processes play a role in the development of eating behaviors during infancy and childhood, and they described the five feeding styles of eating behavior in childhood: (a) restriction of particular kinds of (unhealthy) foods or amounts of food; (b) pressure or excessive encouragement to consume more food, especially during a meal; (c) instrumental feeding -using food as a reward to manipulate behavior; (d) emotional feeding -using food to manage the child's negative emotional states; and (e) exposure -children eat what their parents give them, and may copy their parents' eating behaviors. Motivation to eat is a relative reinforcing value of food, whereas the prevalence of youth with a high motivation to eat is currently unknown; this appetitive trait has been detected in 8-year-old children (Temple et al., 2008). ...
Objectives
To determine the psychiatric disorders that accompany pediatric obesity and to compare boys and girls in terms of the presence of these disorders.
Methods
This is a descriptive cross-sectional outpatient study. The study sample included 52 overweight youngsters (26 girls and 26 boys) who presented to the endocrinology clinic in Abo-elrish pediatric hospital with increased body weight. The endocrinal profile revealed no abnormality and it was established as constitutional obesity. The following tools were applied: the Anxiety Scale for Children, the Depression Scale for Children, and the Self-Concept Scale and Behavioral Checklist for Children. Weight and height were measured and the adjusted BMI was calculated.
Results
Eight (15.4%) of the children were depressed, 16 (30.8%) were moderately anxious, and 10 (19.2%) were highly anxious. Twenty-four (46.2%) of the children had a low self-concept and 28 (53.8%) had a positive self-concept. The entire sample of children had an eating disorder. Comparative results of boys and girls showed that all girls were in the primary stage, whereas the boys were distributed throughout the stages of education. Four (15.4%) boys and girls were depressed. Half of the boys were not anxious, 10 (38.5%) of the other half were moderately anxious, and four (15.4%) of them were highly anxious. Six (23.1%) of the girls had moderate anxiety and another six (23.1%) were highly anxious. Sixteen (61.5%) of the girls had a low self-concept, whereas only eight (30.8%) of the boys had a low self-concept with a statistical significance (P=0.050). Eight (30.8%) boys and girls had a withdrawal problem. Eight (30.8%) boys had anxiety/depression and only four (15.4%) girls had anxiety/depression.
Conclusion
Low self-concept and eating disorders compensated for the absence of other psychiatric comorbidities, especially depression and anxiety.
... This eating behavior has also been estimated to be highly genetic, with estimates anywhere from 62 to 84 percent heritability (C. Llewellyn, Carnell, & Wardle, 2011;C. H. Llewellyn, van Jaarsveld, Boniface, Carnell, & Wardle, 2008;C. ...
Childhood obesity is associated with stress. However, most treatment strategies include only dietary and physical activity approaches. Mindfulness may assist in weight reduction, but its effectiveness is unclear. We assessed the effect of mindfulness on stress, appetite regulators, and weight of children with obesity and anxiety. A clinical study was conducted in a pediatric hospital. Eligible children were 10–14 years old, BMI ≥95th percentile, Spence anxiety score ≥55, and who were not taking any medication or supplementation. Participants were assigned to receive an 8-week conventional nutritional intervention (CNI) or an 8-week mindfulness-based intervention plus CNI (MND-CNI). Anthropometry, body composition, leptin, insulin, ghrelin, cortisol, and Spence scores were measured at baseline and at the end of the intervention. Anthropometry was analyzed again 8 weeks after concluding interventions. Log-transformed and delta values were calculated for analysis. Thirty-three MND-CNI and 12 CNI children finished interventions; 17 MND-CNI children accomplished 16 weeks. At the end of the intervention, significant reductions in anxiety score (−6.21 ± 1.10), BMI (−0.45 ± 1.2 kg/m ² ), body fat (−1.28 ± 0.25%), ghrelin (−0.71 ± 0.37 pg/mL), and serum cortisol (−1.42 ± 0.94 µg/dL) were observed in MND-CNI children. Changes in anxiety score, ghrelin, and cortisol were different between groups ( P < 0.05). Children who completed 16 weeks decreased BMI after intervention (−0.944 ± 0.20 kg/m ² , P < 0.001) and remained lower 8 weeks later (−0.706 ± 0.19 kg/m ² , P = 0.001). We concluded that mindfulness is a promising tool as an adjunctive therapy for childhood obesity. However, our findings need confirmation in a larger sample population.
Inadequate eating behavior and physical inactivity contribute to the current epidemic of childhood obesity. The aim of this study was to assess the association between eating behavior scores and childhood obesity in Chilean children.
We recruited 126 obese, 44 overweight and 124 normal-weight Chilean children (6-12 years-old; both genders) according to the International Obesity Task Force (IOTF) criteria. Eating behavior scores were calculated using the Child Eating Behavior Questionnaire (CEBQ). Factorial analysis in the culturally-adapted questionnaire for Chilean population was used to confirm the original eight-factor structure of CEBQ. The Cronbach's alpha statistic (>0.7 in most subscales) was used to assess internal consistency. Non-parametric methods were used to assess case-control associations.
Eating behavior scores were strongly associated with childhood obesity in Chilean children. Childhood obesity was directly associated with high scores in the subscales "enjoyment of food" (P < 0.0001), "emotional overeating" (P < 0.001) and "food responsiveness" (P < 0.0001). Food-avoidant subscales "satiety responsiveness" and "slowness in eating" were inversely associated with childhood obesity (P < 0.001). There was a graded relation between the magnitude of these eating behavior scores across groups of normal-weight, overweight and obesity groups.
Our study shows a strong and graded association between specific eating behavior scores and childhood obesity in Chile.
Background:
Apolipoprotein A-II (APOA2) plays an ambiguous role in lipid metabolism, obesity, and atherosclerosis.
Methods:
We studied the association between a functional APOA2 promoter polymorphism (-265T>C) and plasma lipids (fasting and postprandial), anthropometric variables, and food intake in 514 men and 564 women who participated in the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN) study. We obtained fasting and postprandial (after consuming a high-fat meal) measures. We measured lipoprotein particle concentrations by proton nuclear magnetic resonance spectroscopy and estimated dietary intake by use of a validated questionnaire.
Results:
We observed recessive effects for this polymorphism that were homogeneous by sex. Individuals homozygous for the -265C allele had statistically higher body mass index (BMI) than did carriers of the T allele. Consistently, after multivariate adjustment, the odds ratio for obesity in CC individuals compared with T allele carriers was 1.70 (95% CI 1.02-2.80, P = 0.039). Interestingly, total energy intake in CC individuals was statistically higher [mean (SE) 9371 (497) vs 8456 (413) kJ/d, P = 0.005] than in T allele carriers. Likewise, total fat and protein intakes (expressed in grams per day) were statistically higher in CC individuals (P = 0.002 and P = 0.005, respectively). After adjustment for energy, percentage of carbohydrate intake was statistically lower in CC individuals. These associations remained statistically significant even after adjustment for BMI. We found no associations with fasting lipids and only some associations with HDL subfraction distribution in the postprandial state.
Conclusions:
The -265T>C polymorphism is consistently associated with food consumption and obesity, suggesting a new role for APOA2 in regulating dietary intake.
Background: It was shown that men who were conceived during the Dutch famine of 1944–1945 had higher rates of obesity at age 19 y than those conceived before or after it.
Objective: Our objective was to study the effects of prenatal exposure to the Dutch famine on obesity in women and men at age 50 y.
Design: We measured the body size of 741 people born at term between November 1943 and February 1947 in Amsterdam. We compared people exposed to famine in late, mid, or early gestation (exposed participants) with those born before or conceived after the famine period (nonexposed participants).
Results: The body mass index (BMI; in kg/m²) of 50-y-old women exposed to famine in early gestation was significantly higher by 7.4% (95% CI: 0.7%, 14.5%) than that of nonexposed women. BMI did not differ significantly in women exposed in mid gestation (−2.1%; −7.0%, 3.1%) or in late gestation (−1.3%; −6.3%, 3.9%). In 50-y-old men, BMI was not significantly affected by exposure to famine during any stage of gestation: BMI differed by 0.4% (−3.5%, 4.5%) in men exposed to famine in late gestation, by −1.2% (−5.5%, 3.3%) in those exposed in mid gestation, and by 0.5% (−4.6%, 6.0%) in those exposed in early gestation compared with nonexposed men.
Conclusions: Maternal malnutrition during early gestation was associated with higher BMI and waist circumference in 50-y-old women but not in men. These findings suggest that pertubations of central endocrine regulatory systems established in early gestation may contribute to the development of abdominal obesity in later life.
Confirmatory factor analysis (CFA) is a statistical procedure frequently used to test the fit of data to measurement models. Published CFA studies typically report factor pattern coefficients. Few reports, however, also present factor structure coefficients, which can be essential for the accurate interpretation of CFA results. The interpreta-tion errors that can arise when CFA results are interpreted without considering struc-ture coefficients are described, and some examples from current literature illustrating these errors are also presented. The close association between factor analysis and measurement has been previ-ously noted (cf. Thompson & Daniel, 1996). Thus Nunnally (1978) long ago sug-gested that "factor analysis is intimately involved with questions of validity … Factor analysis is at the heart of the measurement of psychological constructs" (pp. 112–113). Both exploratory factor analysis (EFA; cf. Gorsuch, 1983) and confirmatory factor analysis (CFA; cf. Byrne, 1994) are frequently employed in measurement studies. Because CFA directly tests the fit of theoretically or empirically grounded models to data, these models are especially useful, for at least three reasons. First, CFA allows several rival models to be fit to data, and consequently better honors the role of falsification within scientific inquiry (Popper, 1962). Falsifica-STRUCTURAL EQUATION MODELING, 10(1), 142–153 Copyright © 2003, Lawrence Erlbaum Associates, Inc.
To examine the association between eating in the absence of hunger (EAH) and adiposity in children.
Two cross-sectional studies in community settings.
For study 1, 348 children (178 girls and 170 boys) aged 7-9 years were recruited as part of the Physical Exercise and Appetite in Children Study. In study 2, participants were a subsample of children aged 9-12 years (N=316; 192 girls and 124 boys) from the Twins Early Development Study.
EAH was operationalized as intake of highly palatable sweet snacks after a mixed meal at school (study 1) or home (study 2). Weight (kg) and height (m) measurements were used to calculate the body mass index (BMI) s.d. scores. Children were grouped using the standard criteria for underweight, healthy weight, overweight and obesity. The healthy weight range was further subdivided into lower healthy weight (<or=50th centile) and higher healthy weight (>50th centile) to examine the distribution of EAH across the adiposity continuum.
In both studies, EAH showed a significant positive association with adiposity in boys after adjusting for covariates (P<0.001), with a linear increase in the intake across underweight, healthy weight and overweight groups. The association between EAH and adiposity was not significant in girls in either study, although in study 1, results showed a quadratic trend, with EAH increasing through the underweight and healthy weight ranges and decreasing in overweight and obese groups.
EAH is a behavioural phenotype that is not specific to overweight children but instead shows a graded association with adiposity across the weight continuum, particularly in boys. In this study, the effect was less pronounced in girls, which may reflect social desirability pressures constraining food intake among heavier girls.
We review the literature on the familial resemblance of body mass index (BMI) and other adiposity measures and find strikingly convergent results for a variety of relationships. Results from twin studies suggest that genetic factors explain 50 to 90% of the variance in BMI. Family studies generally report estimates of parent-offspring and sibling correlations in agreement with heritabilities of 20 to 80%. Data from adoption studies are consistent with genetic factors accounting for 20 to 60% of the variation in BMI. Based on data from more than 25,000 twin pairs and 50,000 biological and adoptive family members, the weighted mean correlations are .74 for MZ twins, .32 for DZ twins, .25 for siblings, .19 for parent-offspring pairs, .06 for adoptive relatives, and .12 for spouses. Advantages and disadvantages of twin, family, and adoption studies are reviewed. Data from the Virginia 30,000, including twins and their parents, siblings, spouses, and children, were analyzed using a structural equation model (Stealth) which estimates additive and dominance genetic variance, cultural transmission, assortative mating, nonparental shared environment, and special twin and MZ twin environmental variance. Genetic factors explained 67% of the variance in males and females, of which half is due to dominance. A small proportion of the genetic variance was attributed to the consequences of assortative mating. The remainder of the variance is accounted for by unique environmental factors, of which 7% is correlated across twins. No evidence was found for a special MZ twin environment, thereby supporting the equal environment assumption. These results are consistent with other studies in suggesting that genetic factors play a significant role in the causes of individual differences in relative body weight and human adiposity.
To investigate the neural mechanisms of food motivation in children and adolescents, and examine brain activation differences between healthy weight (HW) and obese participants.
Ten HW children (ages 11-16; BMI < 85%ile) and 10 obese children (ages 10-17; BMI >95%ile) matched for age, gender and years of education.
Functional magnetic resonance imaging (fMRI) scans were conducted twice: when participants were hungry (pre-meal) and immediately after a standardized meal (post-meal). During the fMRI scans, the participants passively viewed blocked images of food, non-food (animals) and blurred baseline control.
Both groups of children showed brain activation to food images in the limbic and paralimbic regions (PFC/OFC). The obese group showed significantly greater activation to food pictures in the PFC (pre-meal) and OFC (post-meal) than the HW group. In addition, the obese group showed less post-meal reduction of activation (vs pre-meal) in the PFC, limbic and the reward-processing regions, including the nucleus accumbens.
Limbic and paralimbic activation in high food motivation states was noted in both groups of participants. However, obese children were hyper-responsive to food stimuli as compared with HW children. In addition, unlike HW children, brain activations in response to food stimuli in obese children failed to diminish significantly after eating. This study provides initial evidence that obesity, even among children, is associated with abnormalities in neural networks involved in food motivation, and that the origins of neural circuitry dysfunction associated with obesity may begin early in life.
A strong genetic influence on appetitive traits has been shown in children and adults, but no studies have examined appetite in early infancy, even though avidity of appetite has been linked with a higher risk of obesity.
The objective was to investigate the heritability in early infancy of 4 appetitive traits that have been shown to be heritable later in childhood.
Data are from the Gemini Study, a population-based sample of twins (n = 2402 pairs) born in England and Wales in 2007. To describe their children's eating behavior during the first 3 mo of life while they were still exclusively milk fed, the parents of the twins completed 4 subscales of the Baby Eating Behavior Questionnaire: "enjoyment of food," "food responsiveness," "slowness in eating," and "satiety responsiveness." Heritability was estimated by using quantitative genetic model fitting.
Heritability was high for slowness in eating (84%; 95% CI: 83%, 86%) and satiety responsiveness (72%; 95% CI: 65%, 80%) and moderate for food responsiveness (59%; 95% CI: 52%, 65%) and enjoyment of food (53%; 95% CI: 43%, 63%).
Genetically determined variability in appetitive traits may be one of the pathways through which genes influence the growth rate in infancy. Early identification of infants with avid appetites may make it possible to implement strategies to attenuate the expression of these traits before excessive weight gain occurs.
Gemini is a cohort study of young twins in the United Kingdom designed to assess genetic and environmental influences on early childhood weight trajectories with a focus on infant appetite and the family environment. A total of 2402 families with twins born in England and Wales between March and December 2007 agreed to participate and returned completed baseline questionnaires. The sample includes 1586 same-sex and 816 opposite-sex twins. The study is currently funded for 5 years of follow-up, but is planned to continue into early adolescence and beyond, pending funding. With current funding of the study, families will be followed up when twins are: 8 months old (baseline), and then at 15, 20, 24, 36 and 48 months of age. Gemini is in its early stages, with baseline and first follow-up data collection completed. This is the first twin cohort to focus on childhood weight gain with detailed and repeated measures of children's appetite, food preferences, activity behavior and parental feeding styles, alongside detailed and repeated collection of anthropometrics. This article reviews the rationale for the Gemini study, its representativeness and the main measures.
The relative reinforcing value (RRV) of food, defined as how hard an individual is prepared to work to gain access to food rather than a nonfood alternative, has been shown to be higher in obese adults and children than in their normal-weight counterparts. However, these cross-sectional studies are unable to determine whether a high RRV of food is predictive of adiposity change or whether it is a consequence of being obese.
The objective was to examine the association between the RRV of food and 1-y weight gain in children aged 7-10 y.
An observational longitudinal study design was used. The RRV of food was determined by using a questionnaire method at baseline when the children (n = 316) were aged 7-9 y. Adiposity [body mass index (BMI), BMI SD score, fat mass index, waist circumference, and waist circumference SD score] was assessed at baseline and after 1 y.
Regression analyses indicated that the RRV of food was not associated with any measure of adiposity at baseline or at the 1-y follow-up (all P > 0.58). Changes in BMI (B = 0.06, P < 0.001), BMI SD score (B = 0.03, P = 0.001), and fat mass index (B = 0.09, P = 0.001) after 1 y were significantly predicted by the RRV of food at baseline.
The RRV of food predicted the change in adiposity over a relatively short-term period of 1 y and thus may be associated with the development of obesity. The lack of association in cross-sectional analyses indicates that this behavior is a risk factor for weight gain, although weight differences may not emerge until later childhood.
Dietary energy density (DED) does not have a simple linear relationship to fat mass in children, which suggests that some children are more susceptible than others to the effects of DED. Children with the FTO (rs9939609) variant that increases the risk of obesity may have a higher susceptibility to the effects of DED because their internal appetite control system is compromised. We tested the relationship between DED and fat mass in early adolescence and its interaction with FTO variants.
We carried out a prospective analysis on 2,275 children enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). Diet was assessed at age 10 y using 3-day diet diaries. DED (kJ/g) was calculated excluding drinks. Children were genotyped for the FTO (rs9939609) variant. Fat mass was estimated at age 13 y using the Lunar Prodigy Dual-energy X-ray Absorptiometry scanner. There was no evidence of interaction between DED at age 10 y and the high risk A allele of the FTO gene in relation to fat mass at age 13 y (beta = 0.005, p = 0.51), suggesting that the FTO gene has no effect on the relation between DED at 10 y and fat mass at 13 y. When DED at 10 y and the A allele of FTO were in the same model they were independently related to fat mass at 13 y. Each A allele of FTO was associated with 0.35+/-0.13 kg more fat mass at 13 y and each 1 kJ/g DED at 10 y was associated with 0.16+/-0.06 kg more fat mass at age 13 y, after controlling for misreporting of energy intake, gender, puberty, overweight status at 10 y, maternal education, TV watching, and physical activity.
This study reveals the multi-factorial origin of obesity and indicates that although FTO may put some children at greater risk of obesity, encouraging a low dietary energy density may be an effective strategy to help all children avoid excessive fat gain.
Objective
Emotion‐induced eating has been implicated as a risk factor for the development of obesity, yet no research has been done on emotion‐induced eating in children. The National Heart, Lung, and Blood Institute Growth and Health Study (NGHS), a multicenter collaborative study of risk factors for obesity, developed an instrument for measuring emotion‐induced eating in children and tested hypotheses regarding the association of emotion‐induced eating with food intake and adiposity in preadolescent children.
Method
Subjects were 1,213 black girls and 1,166 white girls who were 9 and 10 at study entry. Baseline data were utilized in this report. Girls were assessed by trained female health examiners who recorded height, weight, and indices of sexual maturation. Girls kept a 3‐day food diary. Dietary data were coded and analyzed for total caloric and macro nutrient intake. A measure of emotion‐induced eating was derived from seven questions about eating in response to emotions (Cronbach's alpha = .78).
Results
Black girls had significantly higher emotion‐induced eating scores than white girls (10.8 vs. 9.7, p < .0001). For white girls, but not for black girls, emotion‐induced eating was associated with increased intake of sucrose. In both races, a modest inverse association was found between body mass index and emotion‐induced eating.
Discussion
Prospective studies are needed to explore further the role of emotion‐induced eating and food intake and the role of emotion‐induced eating in the development of obesity. © 1999 by John Wiley & Sons, Inc. Int J Eat Disord 25: 389–398, 1999.
Background: Obese parents are more likely to have obese children. Parents provide both the genes and eating environment for their children and familial patterns of adiposity are the result of gene-environment interactions. Environmental factors are implicated in the rapid increases in prevalence of childhood overweight that have occurred in the past 2 decades. Examination of aspects of the family environment may provide insight into increases in childhood overweight over time.
Objective: We examined parental characteristics associated with overweight and eating behaviors in preschool children.
Design: Seventy-five preschool children and their parents were recruited from local daycare centers. Information was obtained on parents' body mass indexes (BMIs), dietary restraint, and dietary disinhibition. A behavioral index of disinhibited eating in children was used to measure children's eating when given free access to palatable snack foods in the absence of hunger. Children's weight-for-height values were also calculated.
Results: Maternal dietary disinhibition (R² = 0.35, P < 0.01) and maternal BMI (R² = 0.19, P < 0.05) positively predicted daughters' overweight. Maternal disinhibition (R² = 0.35, P < 0.05) mediated the relation between mothers' BMI and daughters' overweight when both maternal disinhibition and maternal BMI were used to predict daughters' overweight. Furthermore, when both mothers' disinhibition and daughters' free access intakes were used to predict daughters' overweight, mothers' disinhibition (P < 0.05) showed independent prediction.
Conclusions: These findings suggest that familial influences on child overweight differ according to parent and child sex. Also, these results suggest that mothers' dietary disinhibition mediates familial similarities in degree of overweight for mothers and daughters.
Background: Serotonin (5-hydroxytryptamine; 5-HT) is a key mediator in the control of food intake and is probably involved in the etiology of anorexia nervosa. An association between a polymorphism of the 5-HT receptor (5-HT2A) gene promoter (−1438G/A) and anorexia nervosa has been reported.
Objective: We investigated the relation between the −1438G/A polymorphism of the 5-HT2A gene and the energy and macronutrient intakes of children and adolescents.
Design: This cross-sectional study included 370 children and adolescents aged 10–20 y (176 boys and 194 girls from 251 families) drawn from the Stanislas Family Study. Energy and macronutrient intakes were assessed by using 3-d food records. The −1438G/A polymorphism was analyzed by polymerase chain reaction and then by Hpa II digestion.
Results: In the overall group, after adjustment for age, sex, weight, height, and family correlation, the A allele was significantly associated with lower energy (P for trend = 0.045) and with total, monounsaturated, and saturated fat intakes expressed in g/d (P for trend = 0.007, 0.005, and 0.006, respectively). Subjects with the GA genotype had intermediate values. In addition, genotype × sex and genotype × age interactions were not significant.
Conclusions: The 5-HT2A gene polymorphism in the promoter region is associated with energy and fat intakes in young people. This could be explained by the role of the serotonergic system as a determinant of food intakes and eating behavior.
The development of the Dutch Eating Behaviour Questionnaire (DEBQ) with scales for restrained, emotional, and external eating is described. Factor analyses have shown that all items on restrained and external eating each have high loadings on one factor, but items on emotional eating have two dimensions, one dealing with eating in response to diffuse emotions, and the other with eating in response to clearly labelled emotions. The pattern of corrected item-total correlation coefficients and of the factors was very similar for various subsamples, which indicates a high degree of stability of dimensions on the eating behavior scales. The norms and Cronbach's alpha coefficients of the scales and also the Pearson's correlation coefficients to assess interrelationships between scales indicate that the scales have a high internal consistency and factorial validity. However, their external validity has yet to be investigated.
In exploration of the relation between obesity and heightened responsiveness to prominent stimuli, an examination was made of the visual and taste responsiveness of 1–3 day old babies whose parents were both overweight or were both of normal weight. Twelve infants of overweight parentage (OP) and 12 infants of normal weight parentage (NP) were presented with three trials with a pair of red stripes, and with three different concentrations of a glucose solution followed by sterile water. Results indicated differences in visual and taste responsiveness between NP and OP babies. OP babies' average responses to water following glucose were lower than those of NP babies. Presented with two stripes in the visual field, OP babies shifted their gaze significantly more often and with greater magnitude than NP babies did. NP and OP babies did not differ significantly on a variety of physical and developmental measures; estimated gestational age, firthweight, skinfold thickness (SFT), and weight/length2 (BMI) were similar for the two groups. Supplemental analyses of the taste data, classifying babies according to SFT and BMI, however, indicated that while most babies preferred glucose solutions of increasing concentration, “thin” babies did not.
Events in early life are associated with changes in the risk of disease in later life. There is increasing evidence that these associations are mediated by permanent transcriptional changes in metabolic pathways, in some cases linked to epigenetic alterations. We have proposed that this phenomenon of ‘developmental induction’ is not a manifestation of pathophysiological processes but rather represents the consequence of developmental decisions made during fetal and early postnatal life to maximize subsequent fitness. However, this fitness advantage is lost if the early and later environments are mismatched. Rats undernourished in utero by maternal underfeeding develop features of the metabolic syndrome, especially if fed on a high-fat diet, but transient neonatal treatment with leptin reverses induction of this adverse metabolic phenotype. This observation demonstrates that developmental programming is reversible and provides strong support for the match-mismatch or predictive model for the origins of developmental programming.
Parents frequently employ contingencies in attempts to regulate children's food intake. To investigate the effects of instrumental eating on food preferences, each of 45 preschool children was assigned to either an instrumental eating or a control condition. In the instrumental conditions (N = 31), children consumed an initially novel beverage to obtain a reward. To test predictions regarding the contributions of (1) an extension of the response deprivation theory of instrumental performance, and (2) extrinsic motivation theory in accounting for negative shifts in preference noted in a previous experiment, 4 instrumental eating conditions were generated by crossing 2 levels of relative amount consumed (baseline, baseline plus) with 2 levels of type of reward (tangible, verbal praise). To control for the effects of exposure on preference, 2 groups of children (N = 7 per group) received the same number of snack sessions, but with no contingency in effect. Preference data obtained before and after the series of snack sessions demonstrated a significant negative shift in preference for the 4 instrumental groups, while the control groups showed a slight but not significant increase in preference. The implications of the data for child feeding practices are discussed.
The effects of several social-affective presentation contexts on the formation of preschool children's food preferences were investigated. The children's preferences for a set of snack foods were initially assessed and a neutral food, neither highly preferred nor nonpreferred, was selected for each child. This snack food was then presented to the child in one of four social-affective contexts: (1) as a reward; (2) noncontingently, paired with adult attention; (3) in a nonsocial context; (4) at snack time. 16 children participated in each condition. Half of the children in each condition received a sweet snack food, half a nonsweet snack food. Results indicated that presenting foods as rewards or presenting them noncontingently paired with adult attention produced significant increases in preference, and the effects persisted for at least 6 weeks following termination of the presentations. In contrast, no consistent changes in preference were noted when the foods were presented in a nonsocial context or at snack time. The results suggest that the social-affective context in which foods are presented is extremely important in the formation of young children's food preferences.
This study examined the relationship between general maternal parenting style, maternal eating cues, and a child's eating behavior during mealtime. We expected that the general style would relate to the number of specific eating cues and that mothers who used more eating prompts would have children that ate more and at a faster rate. Seventy-seven children (39 girls, 38 boys), aged 3.5 years, visited the laboratory with their mothers for a videotaped lunch. Videotapes of each laboratory visit were coded for the child's eating rate and maternal parenting style, which was measured as the level of maternal control and support and the number and type of eating prompts given during a meal. Caloric intake was also calculated. The number and rate of verbal and physical encouragements and discouragements were significantly related to measures of general maternal parenting style and meal duration. The rates of food offers, food presentations, and total prompts were all significantly related to the child's rate of calorie intake. However, a mother's level of support or control was not related to the child's eating behavior. Although general maternal parenting style did not predict the child's eating behavior, these behaviors were related to the frequency of maternal eating prompts, which in turn were significantly related to the number of calories eaten and the time spent eating by the child. Children who ate the fastest had mothers who delivered eating prompts at a higher frequency. These findings may have implications for the development of obesity later in childhood, as a function of rapid eating or of poor self-regulation.
PURPOSE: To evaluate the extent to which levels of physical activity and nutrient intake aggregate in families, and secondarily, to assess the repeatability of these behavioral measures over a 5-year period.METHODS: Measurements were obtained in a population-based sample consisting of 1364 members of 42 large Mexican American families. Nutrient intake was assessed by a food frequency questionnaire validated for use in this population. Usual level of physical activity was estimated using a 7-day recall questionnaire.RESULTS: Correlations between baseline (obtained 1992-1995) and follow-up (obtained 1996 to 2000) measures of all behaviors were highly significant (p < 0.001), ranging from 0.24 for % of calories derived from fat to 0.44 for % of calories derived from alcohol. Familial effects, estimated using variance component methods, were stronger when modeled as a genetic heritability than as a shared household effect; as a heritability they accounted for a significant portion of the total variation of all traits (9% for physical activity levels, p < 0.05; and 13–26% for nutrient intake, p < 0.001 for all).CONCLUSIONS: Measurements of physical activity and dietary behaviors in this population tracked over 5 years, and there was a significant degree of aggregation of these behaviors within families. Understanding the sources of these family effects may facilitate efforts to improve cardiovascular health.
How children acquire preferences for added sugar and salt was examined by investigating the effects of repeated exposure to 1 of 3 versions of a novel food (sweetened, salty, or plain tofu) on children's preference for those and other similar foods. Participants were 39 4- and 5-yr-olds assigned to taste only 1 of 3 flavored versions 15 times over several weeks. Preferences for all versions were obtained before, during, and after the exposure series. Preference increased for the exposed version only. Experience with 1 flavored version did not produce generalized liking for all 3 versions of the food. Experience with 1 version (flavored or plain) actually produced a decline in preference for the other version. This was true whether children had experience with plain or flavored versions of the food. The acquired preference was restricted to the particular food/flavor complex; through exposure, children seemed to learn whether it was appropriate to add salt or sugar to a particular food. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Electronic computers facilitate greatly carrying out factor analysis. Computers will help in solving the communality problem and the question of the number of factors as well as the question of arbitrary factoring and the problem of rotation. "Cloacal short-cuts will not be necessary and the powerful methods of Guttman will be feasible." A library of programs essential for factor analysis is described, and the use of medium sized computers as the IBM 650 deprecated for factor analysis. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Reports studies to examine the hypothesis that obese persons are more responsive to external cues and less to internal physiological cues associated with hunger, than nonobese persons. Various experiments were carried out in which preliminary eating, fear, circumstances of eating, and manipulating time were related to amounts eaten by normal and obese Ss under controlled conditions. In addition, other studies on effects of taste, fasting, choice of eating place, and time-zone changes on eating patterns of obese and nonobese Ss are reviewed. Results consistently support the finding that the obese are "relatively insensitive to variations in the physiological correlates of food deprivation but highly sensitive to environmental, food-related cues . . . ." These findings help to explain why many weight control programs for the obese are temporary in their effectiveness. (18 ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The current investigation assessed the relationship between observed child mealtime behavior, physical activity, selected parent behaviors, and child relative weight. Subjects were 30 (15 male, 15 female) preschool children varying in age from 22 to 46 months (mean = 30.5 months). Each subject and parents were observed during the dinnertime meal with an observational instrument designed to measure children's mealtime behaviors and parental influences on child eating. Further, children's activity levels were assessed for one hour and parental influences on child activity were observed. Results indicated that parental encouragements to eat correlated both with the percent of time the child ate and with child relative weight. Similarly, parental encouragements to be active correlated to extreme levels of child motor activity and negatively to relative weight. Implications of the current study are discussed and the present findings are compared and contrasted with previous research.
Failure to appreciate the role that aggregation plays in increasing reliability and validity and in establishing the range of generalization of findings has resulted in misunderstandings about the stability of behavior across time and situations, and in the conduct of experiments that produce results that tend to be neither generalizable nor replicable. Appropriate aggregation can reduce error variance associated with the unrepresentativeness of individual stimuli, situations, occasions, judges, items of behavior, and subjects. Inappropriate aggregation can result not only in a loss of information but also in a reduction in reliability as well as validity. Different approaches to prediction with single items of behavior are discussed, and it is concluded that single items tend to be too unreliable and too narrow in scope to measure broad dispositions such as traits. A major emphasis is that behavior is often so highly situationally specific that unless this is taken into account by procedures such as aggregation over situations and/or occasions, or by the investigation of events that are so highly ego-involving that experimental effects dominate situation-ally unique effects, results will tend to be unreplicable or ungeneralizable, no matter what their level of statistical significance.
Objective
To determine parental influences on obesity, the eating behavior of 80 obese and normal weight children (aged 8–12 years) was investigated in the laboratory.MethodA controlled repeated measures design was used. The mother was either present or absent while the child was eating in the laboratory. The eating style was measured by recording cumulative eating curves with a universal eating monitor, using yoghurt as a standardized experimental meal.ResultsThe eating behavior of obese children differed significantly from normal weight children only when the mother was present in the laboratory. Overweight children ate faster with larger bites and showed an acceleration of their eating rate toward the end of the meal.DiscussionSuch an eating style can be hypothesized to explain an increased calorie intake in obese children, promoting a positive energy balance in the long term. The data support a learning model of obesity in childhood, which also has implications for family treatment. © 2001 by John Wiley & Sons, Inc. Int J Eat Disord 30: 447–453, 2001.
Objective
Emotion-induced eating has been implicated as a risk factor for the development of obesity, yet no research has been done on emotion-induced eating in children. The National Heart, Lung, and Blood Institute Growth and Health Study (NGHS), a multicenter collaborative study of risk factors for obesity, developed an instrument for measuring emotion-induced eating in children and tested hypotheses regarding the association of emotion-induced eating with food intake and adiposity in preadolescent children.Method
Subjects were 1,213 black girls and 1,166 white girls who were 9 and 10 at study entry. Baseline data were utilized in this report. Girls were assessed by trained female health examiners who recorded height, weight, and indices of sexual maturation. Girls kept a 3-day food diary. Dietary data were coded and analyzed for total caloric and macro nutrient intake. A measure of emotion-induced eating was derived from seven questions about eating in response to emotions (Cronbach's alpha = .78).ResultsBlack girls had significantly higher emotion-induced eating scores than white girls (10.8 vs. 9.7, p < .0001). For white girls, but not for black girls, emotion-induced eating was associated with increased intake of sucrose. In both races, a modest inverse association was found between body mass index and emotion-induced eating.DiscussionProspective studies are needed to explore further the role of emotion-induced eating and food intake and the role of emotion-induced eating in the development of obesity. © 1999 by John Wiley & Sons, Inc. Int J Eat Disord 25: 389–398, 1999.
Individual differences in several aspects of eating style have been implicated in the development of weight problems in children and adults, but there are presently no reliable and valid scales that assess a range of dimensions of eating style. This paper describes the development and preliminary validation of a parent-rated instrument to assess eight dimensions of eating style in children; the Children's Eating Behaviour Questionnaire (CEBQ). Constructs for inclusion were derived both from the existing literature on eating behaviour in children and adults, and from interviews with parents. They included reponsiveness to food, enjoyment of food, satiety responsiveness, slowness in eating, fussiness, emotional overeating, emotional undereating, and desire for drinks. A large pool of items covering each of these constructs was developed. The number of items was then successively culled through analysis of responses from three samples of families of young children (N= 131; N= 187; N= 218), to produce a 35-item instrument with eight scales which were internally valid and had good test-retest reliability. Investigation of variations by gender and age revealed only minimal gender differences in any aspect of eating style. Satiety responsiveness and slowness in eating diminished from age 3 to 8. Enjoyment of food and food responsiveness increased over this age range. The CEBQ should provide a useful measure of eating style for research into the early precursors of obesity or eating disorders. This is especially important in relation to the growing evidence for the heritability of obesity, where good measurement of the associated behavioural phenotype will be crucial in investigating the contribution of inherited variations in eating behaviour to the process of weight gain.
Human obesity is associated with greater-than-average energy intake, although relatively few studies have tested the heritability of food intake. The present study examined the genetic architecture of measured caloric intake during laboratory test meals in 36 monozygotic and 18 dizygotic twin pairs. A series of analyses tested the hypotheses that (1) there would be a genetic influence on total caloric intake, (2) there would be genes influencing total caloric intake above and beyond those influencing body composition, (3) there would be a phenotypic association between total caloric intake and fat mass above and beyond any genetic influences, and (4) there would be genetic influences on macronutrient intake (i.e., fat, carbohydrate, and protein intake) above and beyond total caloric intake. Results suggested genetic influences on age- and sex-adjusted total caloric intake (24–33% of the variance), although 95% confidence intervals were wide and suggested that true heritability estimates might be considerably lower or higher. Caloric intake was influenced by both common and unique environmental factors. Greater-than-average caloric intake was associated with increased adiposity, despite probable genetic influences on both phenotypes. Finally, there was evidence for macronutrient-specific familial influences, although the extent to which they were genetic or environmental in origin could not be teased apart. Results suggest that human obesity may be influenced by behaviors that are themselves genetically regulated. However, further studies are needed to obtain more precise heritability estimates and a better understanding of the conditions under which genetic influences on energy intake emerge.
This study showed that a means-end relationship between two snacks exerts a negative influence on preference for the means snack in the contingency. Two snacks ranked of approximately equal medium appeal were individually chosen from an array by each of 86 children (ages 4 years, 4 months to 7 years, 2 months). Children were then assigned to a means-end condition (where one snack was eaten as a means of gaining the other), a temporal order control group (where one snack was presented and eaten before the other), or a mere exposure control group (where the children chose the order in which they ate the two snacks). Post-treatment rankings of the snacks showed that children in the means-end group came to devalue the means snack relative to the reward snack, despite the demonstrably equal prior appeal of the two snacks. Children in the temporal order and mere exposure control groups did not come to prefer the two snacks preferentially. Implications of the finding that adults can affect children's preferences by relatively minor variations in the manner of presentation are discussed.
To determine if toddlers who were considered "picky eaters" had lower dietary scores than non-picky eaters, and if family environment and socioeconomic status were significantly related to picky eater status and dietary scores.
An incomplete block design provided two interviews at randomly assigned times (24, 28, 32, or 36 months) of Caucasian mothers from upper socioeconomic (n=74) and lower socioeconomic status (n=44). Using trained interviewers, 6 days of food intake, two administrations of a questionnaire about toddler's eating behavior, and one administration of the Family Environment Scales were collected in the home. MANOVA, discriminant function analysis, and logistic regression procedures were used to determine significant differences between picky and non-picky eater groups.
Picky eaters had lower dietary variety (p=.03) and diversity scores (p=.009) than non-picky eaters. Mothers of picky eaters compared to those of non-picky eaters used persuasion (p=.0001) and ranked their child's eating behaviors as more problematic (p=.0001).
Toddlers perceived by their mothers as picky eaters had significantly lower dietary variety and diversity scores. Parents need information and strategies to increase the number of foods acceptable to their toddlers and to develop a sound feeding plan.
No study has examined a comprehensive set of approach and avoidance eating behaviours and their relationship with bodyweight among North American children. The purpose of this study was to test whether a variety of individual eating behaviours differed among weight status groups in a sample of Canadian pre-school children.
The sample included 4 and 5-year-old children (N=1 730), who attended a health center in and around Edmonton, Alberta, for a pre-school immunization shot between November 2005 and August 2007. A trained health assistant measured children's height and weight. Centers for Disease Control and Prevention (CDC) cut-off criteria were used to classify the children according to body weight status. Parents completed the Children's Eating Behaviour Questionnaire (CEBQ). A one-way between-groups multivariate analysis of variance was performed to investigate eating behaviour differences by weight status groups while adjusting for sex and neighbourhood socioeconomic status (SES).
Significant differences (p<0.01) were found between weight status groups for food responsiveness, emotional over-eating, enjoyment of food, satiety responsiveness, slowness in eating, and food fussiness. No significant differences were found for desire to drink or emotional under-eating. An inspection of mean scores showed graded positive linear patterns by weight for food responsiveness and enjoyment of food and graded negative linear patterns by weight for satiety responsiveness, slowness in eating, and food fussiness.
Future research should examine whether eating behaviours can be modified to reduce children's risk of becoming overweight or obese. In addition potential determinants of eating behaviours should be explored.
Incl. app., bibliographical references, index, answers pp; 593-619
Decades of epidemiological research have established that breastfeeding is associated with a modest reduction in risk of later overweight and obesity. However, no systematic effort has been made to delineate the mechanisms that may explain this association. This review summarizes evidence from a variety of disciplines to understand the potential mechanisms underlying this association. One possibility is that this association is spurious and that confounding factors fully or partially explain this association. Additionally, breastfeeding could confer protection by: encouraging the infant's emerging capabilities of self-regulation of intake; reducing problematic feeding behaviors on the part of caregivers that interfere with the infant's self-regulation of intake; and providing bioactive factors that regulate energy intake, energy expenditure, and cellular chemistry. These three protective effects may promote slower growth and lower body fat levels in breastfed infants, which reduce risk of overweight and obesity later in life.
In a longitudinal birth cohort maternal ratings of children's appetite made at 6 weeks, 12 months and 5-6 years were correlated with one another and with subscales from the Child Eating Behaviour Questionnaire (CEBQ) at 5-6 years, and body mass index (BMI) at 6-8 years. Statistically significant correlations were found between the children's appetite ratings. Appetite ratings in infancy were also correlated with the CEBQ subscale scores at 5-6 years to a limited extent, but not with the BMI at 6-8 years. The appetite rating at 5-6 years and three of the CEBQ subscales were independently associated with BMI. Children with higher levels of Emotional Over-Eating and Desire to Drink had higher BMIs, and children with higher levels of Satiety Responsiveness had lower BMIs. These results provide further evidence that there are concurrent associations between appetite ratings in childhood and BMI but suggest that appetite ratings in infancy are related only weakly to later appetite measures and do not predict later BMI.
It is often assumed that heightened liking for energy-dense foods contributes to the development of obesity, however previous findings on the association between adiposity and liking among common foods are inconclusive in adults and there is limited research in children. Therefore the present study assessed the association between adiposity and liking for fatty or sugary foods, fruits and vegetables in children. A community sample of children aged 7-9 years (N=366) were recruited as part of the Physical Exercise and Appetite in CHildren Study (PEACHES). Anthropometric measurements (BMI- and waist-SD scores, fat mass index) were taken alongside self-reported liking for a list of fatty or sugary foods, fruits and vegetables. Regression analyses were used to predict liking from continuous adiposity measures (BMI- and waist-SD score, fat mass index). Linear trend analysis was used to assess the patterning of liking across weight categories. Vegetables were liked less than fatty or sugary foods or fruit, but there was no difference between liking for fruit and for fatty or sugary foods. Boys had a higher liking for fatty or sugary foods than girls, although sex-by-adiposity interactions were not significant for any of the food categories. There was no association between liking for any of the food categories and adiposity. This suggests that overweight in children is not reflective of differences in liking for selected common foods. Variation in appetitive responsiveness to food with increasing adiposity may be more salient in the development of obesity.
Self-regulation is a complex process that involves consumers’ persistence, strength, motivation, and commitment in order to be able to override short-term impulses. In order to be able to pursue their long-term goals, consumers typically need to forgo immediate pleasurable experiences that are detrimental to reach their overarching goals. Although this sometimes involves resisting to simple and small temptations, it is not always easy, since the lure of momentary temptations is pervasive. In addition, consumers’ beliefs play an important role determining strategies and behaviors that consumers consider acceptable to engage in, affecting how they act and plan actions to attain their goals. This dissertation investigates adequacy of some beliefs typically shared by consumers about the appropriate behaviors to exert self-regulation, analyzing to what extent these indeed contribute to the enhancement of consumers’ ability to exert self-regulation.