Child eating behavior predicts body mass index after 1 year: results from the Swiss Preschooler's Health Study (SPLASHY)

Yoan Mihov; Andrea H Meyer; Tanja H Kakebeeke; Kerstin Stülb; Amar Arhab; Annina E Zysset; Claudia S Leeger-Aschmann; Einat A Schmutz; Susi Kriemler; Oskar G Jenni; Jardena J Puder; Nadine Messerli-Bürgy; Simone Munsch

doi:10.3389/fpsyg.2024.1292939

Child eating behavior predicts body mass index after 1 year: results from the Swiss Preschooler's Health Study (SPLASHY)

Front Psychol. 2024 Apr 2:15:1292939. doi: 10.3389/fpsyg.2024.1292939. eCollection 2024.

Authors

Yoan Mihov¹, Andrea H Meyer^{1

2}, Tanja H Kakebeeke^{3

4}, Kerstin Stülb¹, Amar Arhab⁵, Annina E Zysset³, Claudia S Leeger-Aschmann⁶, Einat A Schmutz⁶, Susi Kriemler⁶, Oskar G Jenni^{3

4}, Jardena J Puder⁵, Nadine Messerli-Bürgy⁷, Simone Munsch¹

Affiliations

¹ Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Freiburg, Switzerland.
² Department of Psychology, University of Basel, Basel, Switzerland.
³ Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland.
⁴ Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
⁵ Obstetric Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
⁶ Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
⁷ Institute of Psychology, FADO, University of Lausanne, Lausanne, Switzerland.

Abstract

Child obesity is a growing global issue. Preventing early development of overweight and obesity requires identifying reliable risk factors for high body mass index (BMI) in children. Child eating behavior might be an important and malleable risk factor that can be reliably assessed with the parent-report Child Eating Behavior Questionnaire (CEBQ). Using a hierarchical dataset (children nested within child care centers) from a representative cohort of Swiss preschool children, we tested whether eating behavior, assessed with a 7-factor solution of the CEBQ, and BMI at baseline predicted the outcome BMI after 1 year, controlling for socioeconomic status (n = 555; 47% female; mean age = 3.9 years, range: 2.2-6.6; mean BMI = 16 kg/m², range: 11.2-23; mean age- and sex-corrected z-transformed BMI, zBMI = 0.4, range -4 to +4.7). The statistical model explained 65.2% of zBMI at follow-up. Baseline zBMI was a strong positive predictor, uniquely explaining 48.8% of outcome variance. A linear combination of all CEBQ scales, taken together, explained 10.7% of outcome variance. Due to their intercorrelations, uniquely explained variance by any individual scale was of negligible clinical relevance. Only food responsiveness was a significant predictor, when accounting for all other predictors and covariates in the model, and uniquely explained only 0.4% of outcome variance. Altogether, our results confirm, extend, and refine previous research on eating behavior and zBMI in preschool children, by adjusting for covariates, accounting for intercorrelations between predictors, partitioning explained outcome variance, and providing standardized beta estimates. Our findings show the importance of carefully examining the contribution of predictors in multiple regression models for clinically relevant outcomes.

Keywords: BMI; CEBQ; SPLASHY; eating behavior; preschooler.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The study was funded by a Sinergia grant from the Swiss National Research Foundation SNSF (grant number: 147673) (http://p3.snf.ch/project-147673), the Jacobs Foundation and by a funding to NM-B by the SNSF (grant number: 170503) (http://p3.snf.ch/Project-170503). The Swiss National Research Foundation and the Jacobs Foundation neither interfered with the design of the study nor provided direct support (e.g., subject recruitment).