Validation of the Children's Eating Behavior Questionnaire in 3 year old children of a multi-ethnic Asian population: The GUSTO cohort study

Abstract

The Children's Eating Behaviour Questionnaire (CEBQ) was developed to measure eating behaviors related to obesity risk in children. However, this questionnaire has not been validated for use in South East Asia, where parenting practices are different from those in western countries and child obesity rates are increasing. The aim of this study was to examine the validity of the CEBQ administered to mothers of children aged 3 years in Singapore. Confirmatory factor analysis (CFA) was used to examine if the original 35-item, 8-factor model was supported in our cohort. Participants were 636 mother-child dyads (mean (SD) child age=36.7 (1.6) months), from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort in which the mothers Request for reprints will be available from the author.Conflict of interest P.D.G., K.M.G., and Y.S.C. have received reimbursement for speaking at conferences sponsored by companies selling nutritional products. These authors are part of an academic consortium that has received research funding from Abbot Nutrition, Nestec, and Danone. None of the other authors report any potential conflict of interest. Authors ContibutionsAll authors were involved in all parts of the study and approved the final manuscript. The contributions are listed below. SMS, KMG, FY and YSC designed and led the GUSTO study. PLQ contributed to the statistical analysis and writing of the manuscript. CYB provided intellectual contribution to the write-up of the manuscript and advice on the statistical analysis. PLQ and MFFC were responsible for finalizing the manuscript. Europe PMC Funders Group Europe PMC Funders Author ManuscriptsEurope PMC Funders Author Manuscripts were characterized in pregnancy and children were followed up to age 3 years. The CFA showed a poor model fit; RMSEA=0.072 (PCLOSE<0.001), SRMR=0.094, CFI=0.826, and TLI=0.805. Exploratory factor analysis revealed a 35 item, 7-factor structure (factor loadings ≥ 0.35): enjoyment of food, food fussiness, emotional overeating, desire to drink, emotional under eating, satiety responsiveness and slowness in eating. Cronbach's alpha estimates ranged from 0.70-0.88 for the 7 subscales. Convergent validity tests via correlation analysis revealed that emotional under eating (r=-0.14), slowness in eating (r=-0.16) and satiety responsiveness (r=-0.11) were negatively correlated with BMI z-score at 3 years, while enjoyment of food (r=0.12) was positively correlated, p<0.05. In conclusion, we found a revised 7-factor structure of the CEBQ more appropriate for examining eating behavior in 3 year old children in the Singapore setting. Further replication studies in a separate cohort study are warranted before further use of these factor structures generated.

Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population

“…As with other reported studies, the use of pressure to encourage a child to eat was not associated with any of the dietary intakes in our study[ 17 , 18 ], but only with lower BMI z -scores [ 14 ]. This feeding practice has also been associated with eating behaviours such as lower enjoyment of food [ 49 – 51 ], which has been shown in our own cohort study to be related to lower BMI z-scores [ 52 ].This suggests that maternal use of pressure might not have a direct impact on specific foods consumed by the children, but could still influence the overall calorie intake of the child. Like the practice of food restrictions, the use of pressure to eat may be a reaction driven by the mother’s perception that their child is not gaining enough weight[ 45 , 53 , 54 ], but without the intention of promoting intake or avoidance of specific food groups.…”

Reduced Eating Pace (RePace) Behavioral Intervention for Children Prone to or with Obesity: Does the Turtle Win the Race?

“…Higher scores reflect slower eating pace, as perceived by the participating parent. The subscale showed a test‐retest reliability of r = 0.83 in the original study sample , was psychometrically supported in other validation studies , and had been used extensively with young children internationally.…”

Validation of the Children’s Eating Behavior Questionnaire in 5 and 6 Year-Old Children: The GUSTO Cohort Study

“…However, subsequent validation studies in other Western countries and in Asian countries have shown mixed results, with some replicating the original subscales (Mallan et al, 2013; Domoff et al, 2015), while others could not (Sleddens et al, 2008; Santos et al, 2011; Svensson et al, 2011; Cao et al, 2012; Quah et al, 2017). For studies that have failed to replicate the original subscales, exploratory factor analysis (EFA) was used to generate revised subscales that were more culturally relevant to Western countries like Sweden (Svensson et al, 2011), the Netherlands (Sleddens et al, 2008), Chile (Santos et al, 2011), and to Asian countries such as China (Cao et al, 2012), and Singapore (Quah et al, 2017).…”