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Associations of appetitive behaviors in 7-year-old children with their cardiometabolic health at 10 years of age

  • Sarah Warkentin
    Correspondence
    Corresponding author. EPIUnit – Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Rua das Taipas, 135-139, 4050-600, Porto, Portugal.
    Affiliations
    EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal
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  • Ana Cristina Santos
    Affiliations
    EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal

    Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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  • Andreia Oliveira
    Affiliations
    EPIUnit - Instituto de Saúde Pública, Universidade do Porto [Institute of Public Health, University of Porto], Porto, Portugal

    Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Published:January 21, 2020DOI:https://doi.org/10.1016/j.numecd.2020.01.007

      Highlights

      • Child appetitive traits are associated with cardiometabolic risk 3 years later
      • Food approach behaviors are associated with increased cardiometabolic risk.
      • Food avoidant behaviors are associated with lower cardiometabolic risk.
      • Associations with cardiometabolic health are highly dependent on child's adiposity.

      Abstract

      Background and Aims

      Atherosclerosis begins early in life, thus optimal cardiovascular health needs to be promoted early. We investigated whether appetitive behaviors among 7 year olds are associated with their cardiometabolic health years later.

      Methods and Results

      A sample of 2951 children from a Portuguese birth cohort was analyzed. The Children's Eating Behavior Questionnaire assessed eating behaviors, and a measure of cardiometabolic risk (higher risk group: those in the upper quartile of triglycerides, homeostatic model assessment-insulin resistance, waist circumference and systolic blood pressure and in the lower quartile of high-density lipoprotein cholesterol z-scores) was created. Linear and logistic regressions were run. Children with more food avoidant behaviors had lower cardiometabolic risk (Satiety Responsiveness – boys: OR = 0.39, 95% CI 0.16; 0.93, girls: OR=0.37, 95% CI 0.17; 0.82 and Slowness in eating – boys: OR = 0.49, 95% CI 0.25; 0.95, girls: OR = 0.49, 95% CI 0.27; 0.91). Food approach behaviors (Food responsiveness (CEBQ-FR), Enjoyment of food (CEBQ-EF) and Emotional overeating (CEBQ-EOE)) increased cardiometabolic risks (e.g. CEBQ-FR: boys: OR = 2.50, 95% CI 1.45; 4.32, girls: OR = 2.33, 95% CI 1.46; 3.71). CEBQ-EF had stronger effects in boys, while CEBQ-EOE was positively associated with cardiometabolic risk among girls. When adjusting for BMIz at 7y, associations did not remain significant. Appetitive behaviors were also associated with isolated cardiometabolic parameters; the strongest association being with waist circumference.

      Conclusions

      Appetitive behaviors at 7-years are associated with cardiometabolic risk at age 10. While ‘food avoidant’ behaviors protect against cardiometabolic risk and ‘food approach’ behaviors increase cardiometabolic risk, these associations are largely dependent of child's adiposity.

      Keywords

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      References

        • Laitinen T.T.
        • Pahkala K.
        • Magnussen C.G.
        • Viikari J.S.A.
        • Oikonen M.
        • Taittonen L.
        • et al.
        Ideal cardiovascular health in childhood and cardiometabolic outcomes in adulthood: the cardiovascular risk in young Finns study.
        Circulation. 2012; 125: 1971-1978https://doi.org/10.1161/CIRCULATIONAHA.111.073585
        • Pahkala K.
        • Hietalampi H.
        • Laitinen T.T.
        • Viikari J.S.A.
        • Rönnemaa T.
        • Niinikoski H.
        • et al.
        Ideal cardiovascular health in adolescence: effect of lifestyle intervention and association with vascular intima-media thickness and elasticity (the special turku coronary risk factor intervention project for children [STRIP] study).
        Circulation. 2013; 127: 2088-2096https://doi.org/10.1161/CIRCULATIONAHA.112.000761
        • Lloyd-Jones D.M.
        • Hong Y.
        • Labarthe D.
        • Mozaffarian D.
        • Appel L.J.
        • Van Horn L.
        • et al.
        Defining and setting national goals for cardiovascular health promotion and disease reduction: the american heart association's strategic impact goal through 2020 and beyond.
        Circulation. 2010; 121: 586-613https://doi.org/10.1161/CIRCULATIONAHA.109.192703
        • Bridger T.L.
        • Wareham A.
        Beyond BMI: the next chapter in childhood obesity management.
        Curr Obes Rep. 2014; 3: 321-329https://doi.org/10.1007/s13679-014-0114-y
        • Juhola J.
        • Magnussen C.G.
        • Viikari J.S.A.
        • Kähönen M.
        • Hutri-Kähönen N.
        • Jula A.
        • et al.
        Tracking of serum lipid levels, blood pressure, and body mass index from childhood to adulthood: the cardiovascular risk in young Finns study.
        J Pediatr. 2011; 159: 584-590https://doi.org/10.1016/j.jpeds.2011.03.021
        • Joshi S.M.
        • Katre P.A.
        • Kumaran K.
        • Joglekar C.
        • Osmond C.
        • Bhat D.S.
        • et al.
        Tracking of cardiovascular risk factors from childhood to young adulthood - the Pune children's study.
        Int J Cardiol. 2014; 175: 176-178https://doi.org/10.1016/j.ijcard.2014.04.105
        • Telama R.
        • Yang X.
        • Leskinen E.
        • Kankaanpää A.
        • Hirvensalo M.
        • Tammelin T.
        • et al.
        Tracking of physical activity from early childhood through youth into adulthood.
        Med Sci Sports Exerc. 2014; 46: 955-962https://doi.org/10.1249/MSS.0000000000000181
        • Movassagh E.Z.
        • Baxter-Jones A.D.G.
        • Kontulainen S.
        • Whiting S.J.
        • Vatanparast H.
        Tracking dietary patterns over 20 years from childhood through adolescence into young adulthood: the saskatchewan pediatric bone mineral accrual study.
        Nutrients. 2017; 9: 1-14https://doi.org/10.3390/nu9090990
        • Skinner A.C.
        • Perrin E.M.
        • Moss L.A.
        • Skelton J.A.
        Cardiometabolic risks and severity of obesity in children and young adults.
        N Engl J Med. 2015; 373: 1307-1317https://doi.org/10.1056/NEJMoa1502821
        • World Health Organization (WHO)
        Technical package for cardiovascular disease management in primary health care.
        2016https://doi.org/10.1016/j.cortex.2008.06.011
        • Wardle J.
        • Guthrie C.A.
        • Sanderson S.
        • Rapoport L.
        Development of the children's eating behaviour questionnaire.
        JCPP (J Child Psychol Psychiatry). 2001; 42: 963-970https://doi.org/10.1111/1469-7610.00792
        • Carnell S.
        • Pryor K.
        • Mais L.A.
        • Warkentin S.
        • Benson L.
        • Cheng R.
        Lunch-time food choices in preschoolers: relationships between absolute and relative intakes of different food categories, and appetitive characteristics and weight.
        Physiol Behav. 2016; 162: 151-160https://doi.org/10.1016/j.physbeh.2016.03.028
        • Albuquerque G.
        • Severo M.
        • Oliveira A.
        Early life characteristics associated with appetite-related eating behaviors in 7-year-old children.
        J Pediatr. 2017; 180 (e2): 38-46https://doi.org/10.1016/j.jpeds.2016.09.011
        • Van Jaarsveld C.H.M.
        • Llewellyn C.H.
        • Johnson L.
        • Wardle J.
        Prospective associations between appetitive traits and weight gain in infancy.
        Am J Clin Nutr. 2011; 94: 1562-1567https://doi.org/10.3945/ajcn.111.015818.Individual
        • de Barse L.M.
        • Tiemeier H.
        • Leermakers E.T.M.
        • Voortman T.
        • Jaddoe V.W.V.
        • Edelson L.R.
        • et al.
        Longitudinal association between preschool fussy eating and body composition at 6 years of age: the Generation R Study.
        Int J Behav Nutr Phys Activ. 2015; 12: 2-9https://doi.org/10.1186/s12966-015-0313-2
        • Quah P.L.
        • Chan Y.H.
        • Aris I.M.
        • Pang W.W.
        • Toh J.Y.
        • Tint M.T.
        • et al.
        Prospective associations of appetitive traits at 3 and 12 months of age with body mass index and weight gain in the first 2 years of life.
        BMC Pediatr. 2015; 15: 1-10https://doi.org/10.1186/s12887-015-0467-8
        • Derks I.P.M.
        • Sijbrands E.J.G.
        • Wake M.
        • Qureshi F.
        • van der Ende J.
        • Hillegers M.H.J.
        • et al.
        Eating behavior and body composition across childhood: a prospective cohort study.
        Int J Behav Nutr Phys Activ. 2018; 15: 1-9https://doi.org/10.1186/s12966-018-0725-x
        • Fildes A.
        • Mallan K.M.
        • Cooke L.
        • van Jaarsveld C.H.M.
        • Llewellyn C.H.
        • Fisher A.
        • et al.
        The relationship between appetite and food preferences in British and Australian children.
        Int J Behav Nutr Phys Activ. 2015; 12: 1-10https://doi.org/10.1186/s12966-015-0275-4
        • Chan R.S.M.
        • Woo J.
        Prevention of overweight and obesity: how effective is the current public health approach.
        Int J Res Public Heal. 2010; 73390: 765-783https://doi.org/10.3390/ijerph7030765
        • Van Horn L.
        • Carson J.A.S.
        • Appel L.J.
        • Burke L.E.
        • Economos C.
        • Karmally W.
        • et al.
        Recommended dietary pattern to achieve adherence to the American heart association/American college of cardiology (AHA/ACC) guidelines: a scientific statement from the American heart association.
        Circulation. 2016; 134: e505-e529https://doi.org/10.1161/CIR.0000000000000462
        • Webber L.
        • Hill C.
        • Saxton J.
        • Van Jaarsveld C.H.M.
        • Wardle J.
        Eating behaviour and weight in children.
        Int J Obes. 2009; 33: 21-28https://doi.org/10.1038/ijo.2008.219
        • Warkentin S.
        • Mais L.A.
        • Latorre M.R.D.O.
        • Carnell S.
        • Taddei J.A.A.C.
        Parents matter: associations of parental BMI and feeding behaviors with child BMI in Brazilian preschool and school-aged children.
        Front Nutr. 2018; 5https://doi.org/10.3389/fnut.2018.00069
        • Santos J.L.
        • Ho-Urriola J.A.
        • González A.
        • Smalley S.V.
        • Domínguez-Vásquez P.
        • Cataldo R.
        • et al.
        Association between eating behavior scores and obesity in Chilean children.
        Nutr J. 2011; 10: 1-8https://doi.org/10.1186/1475-2891-10-108
        • Eloranta A.M.
        • Lindi V.
        • Schwab U.
        • Tompuri T.
        • Kiiskinen S.
        • Lakka H.M.
        • et al.
        Dietary factors associated with overweight and body adiposity in Finnish children aged 6-8 years: the PANIC Study.
        Int J Obes. 2012; 36: 950-955https://doi.org/10.1038/ijo.2012.89
        • Tay C.W.
        • Chin Y.S.
        • Lee S.T.
        • Khouw I.
        • Poh B.K.
        Association of eating behavior with nutritional status and body composition in primary school-aged children.
        Asia Pac J Publ Health. 2016; 28: 47S-58Shttps://doi.org/10.1177/1010539516651475
        • Larsen P.S.
        • Kamper-Jørgensen M.
        • Adamson A.
        • Barros H.
        • Bonde J.P.
        • Brescianini S.
        • et al.
        Pregnancy and birth cohort resources in Europe: a large opportunity for aetiological child health research.
        Paediatr Perinat Epidemiol. 2013; 27: 393-414https://doi.org/10.1111/ppe.12060
        • Alves E.
        • Correia S.
        • Barros H.
        • Azevedo A.
        Prevalence of self-reported cardiovascular risk factors in Portuguese women: a survey after delivery.
        Int J Publ Health. 2012; 57: 837-847https://doi.org/10.1007/s00038-012-0340-6
        • Matthews D.R.
        • Hosker J.P.
        • Rudenski A.S.
        • Naylor B.A.
        • Treacher D.F.
        • Turner R.C.
        Homeostasis model assessment: insulin resistance and ?-cell function from fasting plasma glucose and insulin concentrations in man.
        Diabetologia. 1985; 28: 412-419https://doi.org/10.1007/BF00280883
        • Gibson R.S.
        Principles of nutritional assessment.
        2nd ed. Oxford University Press, 2005
        • World Health Organization
        WHO | the WHO child growth standards.
        World Health Organization, Geneva2006
      1. National high blood pressure education program working group on high blood pressure in children and adolescents.
        in: Fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Washington, DC. 2005
        • Andersen L.B.
        • Lauersen J.B.
        • Brønd J.C.
        • Anderssen S.A.
        • Sardinha L.B.
        • Steene-Johannessen J.
        • et al.
        A new approach to define and diagnose cardiometabolic disorder in children.
        J Diabetes Res. 2015; 2015: 1-10https://doi.org/10.1155/2015/539835
        • Zimmet P.
        • Alberti K.G.M.
        • Kaufman F.
        • Tajima N.
        • Silink M.
        • Arslanian S.
        • et al.
        The metabolic syndrome in children and adolescents ? an IDF consensus report.
        Pediatr Diabetes. 2007; 8: 299-306https://doi.org/10.1111/j.1399-5448.2007.00271.x
        • Yin J.
        • Li M.
        • Xu L.
        • Wang Y.
        • Cheng H.
        • Zhao X.
        • et al.
        Insulin resistance determined by Homeostasis Model Assessment (HOMA) and associations with metabolic syndrome among Chinese children and teenagers.
        Diabetol Metab Syndrome. 2013; 5: 1-9https://doi.org/10.1186/1758-5996-5-71
        • Vilela S.
        • Severo M.
        • Moreira T.
        • Ramos E.
        • Lopes C.
        Evaluation of a short food frequency questionnaire for dietary intake assessment among children.
        Eur J Clin Nutr. 2018; 73: 679-691https://doi.org/10.1038/s41430-018-0200-4
        • Passos DR dos
        • Gigante D.P.
        • Maciel F.V.
        • Matijasevich A.
        Children's eating behavior: comparison between normal and overweight children from a school in Pelotas, Rio Grande do Sul, Brazil.
        Rev Paul Pediatr (English. 2015; 33: 42-49https://doi.org/10.1016/S2359-3482(15)30029-4
        • Frühbeck G.
        • Busetto L.
        • Dicker D.
        • Yumuk V.
        • Goossens G.H.
        • Hebebrand J.
        • et al.
        The ABCD of obesity: an EASO position statement on a diagnostic term with clinical and scientific implications.
        Obes Facts. 2019; : 131-136https://doi.org/10.1159/000497124
        • Freedman D.S.
        • Sherry B.
        The validity of BMI as an indicator of body fatness and risk among children.
        Pediatrics. 2009; 124: S23-S34https://doi.org/10.1542/peds.2008-3586e
        • Freedman D.S.
        • Butte N.F.
        • Taveras E.M.
        • Lundeen E.A.
        • Blanck H.M.
        • Goodman A.B.
        • et al.
        BMI z-Scores are a poor indicator of adiposity among 2- to 19-year-olds with very high BMIs, NHANES 1999-2000 to 2013-2014.
        Obesity. 2017; vol. 25: 739-746https://doi.org/10.1002/oby.21782
        • Carnell S.
        • Wardle J.
        Appetite and adiposity in children: evidence for a behavioral susceptibility theory of obesity.
        Am J Clin Nutr. 2008; 88: 22-29https://doi.org/10.1093/ajcn/88.1.22
        • Santos S.
        • Severo M.
        • Lopes C.
        • Oliveira A.
        Anthropometric indices based on waist circumference as measures of adiposity in children.
        Obesity. 2018; 26: 810-813https://doi.org/10.1002/oby.22170
        • Rahill S.
        • Kennedy A.
        • Walton J.
        • McNulty B.A.
        • Kearney J.
        The factors associated with food fussiness in Irish school-aged children.
        Publ Health Nutr. 2019; 22: 164-174https://doi.org/10.1017/S1368980018002835
        • Berger P.K.
        • Hohman E.E.
        • Marini M.E.
        • Savage J.S.
        • Birch L.L.
        Girls' picky eating in childhood is associated with normal weight status from ages 5 to 15 y.
        Am J Clin Nutr. 2016; 104: 1577-1582https://doi.org/10.3945/ajcn.116.142430
        • Vilela S.
        • Hetherington M.M.
        • Oliveira A.
        • Lopes C.
        Tracking diet variety in childhood and its association with eating behaviours related to appetite: the generation XXI birth cohort.
        Appetite. 2018; 123: 241-248https://doi.org/10.1016/j.appet.2017.12.030
        • Taylor C.M.
        • Northstone K.
        • Wernimont S.M.
        • Emmett P.M.
        Macro-and micronutrient intakes in picky eaters: a cause for concern?1-3.
        Am J Clin Nutr. 2016; https://doi.org/10.3945/ajcn.116.137356
        • Viana V.
        • Sinde S.
        • Saxton J.C.
        Children's eating behaviour questionnaire: associations with BMI in Portuguese children.
        Br J Nutr. 2008; 100: 445-450https://doi.org/10.1017/S0007114508894391
        • Shin Y.N.
        • Kim D.H.
        • Bok A.R.
        • Jang J.S.
        • Nam G.E.
        • Lee K.S.
        • et al.
        Eating rate is associated with cardiometabolic risk factors in Korean adults.
        Nutr Metabol Cardiovasc Dis. 2012; https://doi.org/10.1016/j.numecd.2012.02.003
        • Blissett J.
        • Haycraft E.
        • Farrow C.
        Inducing preschool children's emotional eating: relations with parental feeding practices.
        Am J Clin Nutr. 2010; 17: 359-365https://doi.org/10.3945/ajcn.2010.29375
        • Vandeweghe L.
        • Vervoort L.
        • Verbeken S.
        • Moens E.
        • Braet C.
        Food approach and food avoidance in young children: relation with reward sensitivity and punishment sensitivity.
        Front Psychol. 2016; 7: 1-10https://doi.org/10.3389/fpsyg.2016.00928
        • Pinto A.
        • Santos A.C.
        • Lopes C.
        • Oliveira A.
        Dietary patterns at 7 year-old and their association with cardiometabolic health at 10 year-old.
        Clin Nutr. 2019; https://doi.org/10.1016/j.clnu.2019.05.007
        • Sardinha L.B.
        • Santos D.A.
        • Silva A.M.
        • Grøntved A.
        • Andersen L.B.
        • Ekelund U.
        A comparison between BMI, waist circumference, and waist-to-height ratio for identifying cardio-metabolic risk in children and adolescents.
        PloS One. 2016; 11e0149351https://doi.org/10.1371/journal.pone.0149351
        • Reuter C.P.
        • Andersen L.B.
        • de Moura Valim A.R.
        • Reuter É.M.
        • Borfe L.
        • Renner J.D.P.
        • et al.
        Cutoff points for continuous metabolic risk score in adolescents from southern Brazil.
        Am J Hum Biol. 2019; e23211https://doi.org/10.1002/ajhb.23211