Faster eating rates are associated with higher energy intakes during anad libitummeal, higher BMI and greater adiposity among 4·5-year-old children: results from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort

Abstract

Faster eating rates are associated with increased energy intake, but little is known about the relationship between children's eating rate, food intake and adiposity. We examined whether children who eat faster consume more energy and whether this is associated with higher weight status and adiposity. We hypothesised that eating rate mediates the relationship between child weight and ad libitum energy intake. Children (n 386) from the Growing Up in Singapore Towards Healthy Outcomes cohort participated in a video-recorded ad libitum lunch at 4·5 years to measure acute energy intake. Videos were coded for three eating-behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min). BMI and anthropometric indices of adiposity were measured. A subset of children underwent MRI scanning (n 153) to measure abdominal subcutaneous and visceral adiposity. Children above/below the median eating rate were categorised as slower and faster eaters, and compared across body composition measures. There was a strong positive relationship between eating rate and energy intake (r 0·61, P<0·001) and a positive linear relationship between eating rate and children's BMI status. Faster eaters consumed 75 % more energy content than slower eating children (Δ548 kJ (Δ131 kcal); 95 % CI 107·6, 154·4, P<0·001), and had higher whole-body (P<0·05) and subcutaneous abdominal adiposity (Δ118·3 cc; 95 % CI 24·0, 212·7, P=0·014). Mediation analysis showed that eating rate mediates the link between child weight and energy intake during a meal (b 13·59; 95 % CI 7·48, 21·83). Children who ate faster had higher energy intake, and this was associated with increased BMI z-score and adiposity.

A description of an ‘obesogenic’ eating style that promotes higher energy intake and is associated with greater adiposity in 4.5 year-old children: Results from the GUSTO cohort

“…Similar findings have been reported in studies conducted with children [4][5][6][7][8][9]. We have recently demonstrated that children who ate at a faster rate consumed on average 75% more energy compared to children who ate slower [10]. A better understanding of the specific behaviours through which these faster eating rates are achieved will inform intervention strategies to support weight management and help reduce excessive early childhood weight gain.…”

“…Among children whose BMI was in the overweight range, all children had higher levels of SAT. As reported previously, children with overweight tended to eat at a faster rate (g/min) than healthy weight children [10]. Subsequent analysis of specific differences in eating microstructure showed that faster eating rates among children with overweight and among children with higher abdominal adiposity were attributable to larger bite size.…”

“…In our previous study we showed substantial differences in BMI and whole-body adiposity between children who had slower versus faster eating rates [10]. Other features of eating microstructure beyond the eating rate may also differentiate between people with healthy weight and overweight, but results for these behaviours have been less consistent.…”

“…The frequency of foods chosen was compared within the cohort across healthy weight and overweight children, and faster and slower eaters (chi-square analysis). Previous analysis of the dataset demonstrated a strong positive relationship between eating rate and energy consumed during the ad-libitum meal (Pearson's r; r=0.61, p<0.001; see [10]). The current study investigated elements of eating microstructure through which these faster eating rates were achieved using correlations (Pearson's r).…”

A comparison of bite size and BMI in a cafeteria setting

“…Example behaviors that have been studied include slowing eating rate [29, 30], chewing food more slowly [31], reducing visible portion size [1], and controlling bite size [26]. Many of these eating behaviors, including eating rate, bite size, and time each bite spends in the oral cavity, are inter-related [9, 10, 21]. …”