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  • Diet and eating behaviour of children in Baseline - the good, the bad and the fattening?

    PLUS A brief update on vitamin D in BL 2-year olds…

    30/06/2015 M Kiely, UCC 1

    Mairead Kiely, Elaine McCarthy & Carol Ni Chaoimh

    Vitamin D Research Group and INFANT

    University College Cork

    http://www.ucc.ie/

  • • Eating behaviours vary on a continuum from picky eating to overeating and binge eating

    • Behaviours influenced by genetic and environmental factors in early life

    • In children, eating behaviours measured by

    – Behavioural & Psychometric tests

    • Children’s Eating Behaviour Questionnaire (CEBQ) (Wardle et al., 2001)

    • Associations between eating behaviours and weight status have been identified in children aged >3 years

    • Limited research in pre-school age children (

  • To explore associations between eating behaviours & weight status

  • Biobanking

    TEWL* Body fat %

    Anthropometry Neonatal course

    Feeding Growth Body fat % Eczema, TEWL* Food allergy General health Childhood illness Developmental screening

    Biobanking

    Anthropometry Skin prick testing (allergy)

    Neurodevelopment assessment Nutritional assessment

    2137

    Birth 2m 6m 12m 24m

    *Trans-epidermal water loss (TEWL)

    5 Years

    Biobanking Growth Nutrition Body Composition Bone - length, size, BMC, BMD Atopic disease progression Neurodevelopment Muscle strength General health/ illness

  • Methodology

    • Eating behaviours were assessed at the study’s 24 month appointment

    • The CEBQ contains 8 eating behaviour subscales

    • Enjoyment of Food • Emotional Overeating • Desire to Drink • Food Responsiveness • Satiety Responsiveness • Slowness in Eating • Food Fussiness • Emotional Under-eating

    Food Approach Subscales

    Food Avoidant Subscales

  • Methodology • Each subscale contains 3-5 questions related to that eating

    behaviour “My child refuses new foods at first” Food Fussiness • Scoring based on a five-point Likert scale

    1 = Never 2 = Rarely 3 = Sometimes 4 = Often 5 = Always

    • Reverse scoring was also applied “My child finishes their meal quickly” Slowness in Eating

  • IOTF Child Grade Adult BMI

    Range (kg/m2)

    Thinness Grade 3

  • Day of Week

    Time

    Type of Meal (e.g. snack, drink,

    lunch)

    Where meal was prepared

    (e.g. home, crèche)

    Where was meal eaten

    (e.g. in car, in front of tv)

    Who was with the child

    (e.g. parent, childminder)

    Fed Self Mainly Yes/No

    Office Use

    Weight of plate,

    bowl, cup (g)

    Description of Food or Drink (include brand and cooking method)

    Amount/ Weight of

    food or drink

    (g)

    Weight of plate, bowl, cup with

    leftovers (g)

    Description of Leftovers

    Description of dropped food/spillages

    Dietary Assessment Methodology

  • Dietary Assessment Methodology

  • Subject Characteristics

    1189 participants with complete anthropometric and eating behaviour data were included in analysis

    – All term infants

    – Mean (SD) age of 25 (0.9) months

    – Maternal characteristics

    99% Caucasian

    88% attended 3rd level education

    – Child weight status according to IOTF BMI cut-offs

    6% underweight

    80% normal weight

    14% overweight/obese

  • Results CEBQ Food Avoidant Subscale Median Scores and Gender

    * significant difference P

  • Results CEBQ Food Approach Subscale Median Scores and Weight Status

    * significant difference P

  • Results CEBQ Food Approach Grouped Median Score and Weight Status

    * significant difference P

  • Results CEBQ Food Avoidant Subscale Median Scores and Weight Status

    * significant difference P

  • Results CEBQ Food Avoidant Grouped Median Score and Weight Status

    * significant difference P

  • OR (95% CI) P-value

    Food Approach Behaviours

    Enjoyment of Food 1.90 (1.46, 2.48)

  • CEBQ subscales as potential risk factors for underweight at 2 years*

    OR (95% CI) P-value

    Food Approach Behaviours

    Enjoyment of Food 0.63 (0.45, 0.89) 0.008

    Food Responsiveness 0.49 (0.32, 0.75)

  • • No significant differences in food or energy, fat, carb or protein intakes between low, medium and high CEBQ subscale scores

    • Picky Eating

    – 21% of children were identified as picky eaters by parents

    – No significant differences in macronutrient intakes between picky and non-picky eaters

    – Picky eaters ate more biscuits, cakes and processed meats but less vegetables than non-picky eaters

    – Picky eaters were significantly shorter and lighter than non- picky eaters

    Results

  • Results

    11

    82

    7 5

    79

    16

    0

    10

    20

    30

    40

    50

    60

    70

    80

    90

    Underweight Normal weight Overweight/obese

    Picky Eater

    Non-picky Eater

    • IOTF BMI classifications of picky and non-picky eaters

    *

    * *

    * significant difference P

  • Conclusions

    • Eating behaviours are associated with weight status in two- year old children in Ireland

    • Food approach behaviours

    – positively associated with the risk of overweight/obesity

    – negatively associated with the risk of underweight

    • Food avoidant behaviours

    – negatively associated with the risk of overweight/obesity

    – positively associated with the risk of underweight

    • Picky eating behaviour associated with a lack of dietary diversity and the risk of underweight at two years

  • • At what age do these behaviours develop in childhood? Are these behaviours present before two years of age?

    • What is the genesis of unhealthy eating behaviours in young children?

    – Environmental factors

    – Genetic influences

    • Can these behaviours be modified in early childhood?

    – Potential means of an intervention strategy against later overweight and obesity

    Future directions…

  • Thank you. Any questions?

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