Validation of a Classroom Version of the Eating in the Absence of Hunger Paradigm in Preschoolers

Emily E Hohman; Katherine M McNitt; Sally G Eagleton; Lori A Francis; Kathleen L Keller; Jennifer S Savage

doi:10.3389/fnut.2021.787461

Validation of a Classroom Version of the Eating in the Absence of Hunger Paradigm in Preschoolers

Front Nutr. 2022 Jan 5:8:787461. doi: 10.3389/fnut.2021.787461. eCollection 2021.

Authors

Emily E Hohman¹, Katherine M McNitt^{1

2}, Sally G Eagleton^{1

2

3}, Lori A Francis⁴, Kathleen L Keller², Jennifer S Savage^{1

2}

Affiliations

¹ Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA, United States.
² Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, United States.
³ Frank Porter Graham Child Development Institute, The University of North Carolina, Chapel Hill, NC, United States.
⁴ Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States.

Abstract

Eating in the absence of hunger (EAH), a measure of children's propensity to eat beyond satiety in the presence of highly palatable food, has been associated with childhood obesity and later binge eating behavior. The EAH task is typically conducted in a research laboratory setting, which is resource intensive and lacks ecological validity. Assessing EAH in a group classroom setting is feasible and may be a more efficient alternative, but the validity of the classroom assessment against the traditional individually-administered paradigm has not been tested. The objective of this study was to compare EAH measured in a classroom setting to the one-on-one version of the paradigm in a sample of Head Start preschoolers. Children (n = 35) from three classrooms completed both classroom and individual EAH tasks in a random, counterbalanced order. In the group condition, children sat with peers at their classroom lunch tables; in the individual condition, children met individually with a researcher in a separate area near their classroom. In both conditions, following a meal, children were provided free access to generous portions of six snack foods (~750 kcal) and a selection of toys for 7 min. Snacks were pre- and post-weighed to calculate intake. Parents completed a survey of their child's eating behaviors, and child height and weight were measured. Paired t-tests and intraclass correlation coefficients were used to compare energy intake between conditions, and correlations between EAH intake and child BMI, eating behaviors, and parent feeding practices were examined to evaluate concurrent validity. Average intake was 63.0 ± 50.4 kcal in the classroom setting and 53.7 ± 44.6 in the individual setting, with no significant difference between settings. The intraclass correlation coefficient was 0.57, indicating moderate agreement between conditions. Overall, the EAH protocol appears to perform similarly in classroom and individual settings, suggesting the classroom protocol is a valid alternative. Future studies should further examine the role of age, sex, and weight status on eating behavior measurement paradigms.

Keywords: children; disinhibited eating; eating behavior; eating in the absence of hunger; measure.

Grants and funding

R01 DK120754/DK/NIDDK NIH HHS/United States