Abstract
Background
Food reluctance can present as fussiness, picky eating, slowness in eating, and high
satiety responsiveness. It can be associated with inadequate weight gain during early
childhood. Although a majority of preschoolers attend daycare centers, associations
between their eating behaviors at daycare and their body composition have not been
studied.
Objective
Our aim was to develop an estimate of food reluctance and to assess the relationship
between food reluctance at daycare and body mass index (BMI) and waist circumference
of preschoolers.
Design
We conducted a cross-sectional secondary analyses. Food reluctance was estimated using
weighted digital plate waste analysis. Intra-rater, inter-rater, and test−retest reliability
and convergent validity of the food reluctance score were tested. The food reluctance
score was then compared to preschool children’s BMI and waist circumference.
Participants/setting
Participants included 309 children aged 3 to 5 years in 24 daycare centers across
the Canadian province of New Brunswick.
Main outcome measures
Preschool children’s waist circumference and age-adjusted BMI derived from objectively
measured height and weight were analyzed.
Statistical analyses performed
Intraclass correlations were used to determine the reliability of the new estimate.
Spearman correlation was used to compare the estimate with parental report of food
reluctance. Multivariate linear regressions were used to examine the relationship
between food reluctance and waist circumference and age-adjusted BMI.
Results
The estimated food reluctance score demonstrated excellent inter- and intra-rater
reliability (intraclass correlation>0.97; P<0.0001) and good test−retest reliability (intraclass correlation=0.72; P<0.0001). It also provided evidence of convergent validity through correlation with
reluctance-related subscales of the Child Eating Behavior Questionnaire (ρ=.53, P<0.0001). Greater demonstration of food reluctance at the daycare center was associated
with a lower age-adjusted BMI (adjusted β −1.41; 95% CI −.15 to −2.67), but was not
associated with children’s waist circumference (adjusted β −.60; 95% CI −2.06 to .86).
Conclusions
Signs of food reluctance can be observed in daycare and relate to lower BMI among
preschoolers.
Keywords
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Biography
V. Surette is a registered dietician and territory manager, Nestlé Canada, Montreal, Quebec; at the time of the study, she was a graduate student, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada.
Biography
S. Ward is assistant professor of nutrition, Université de Moncton, Moncton, Canada; at the time of the study, she was a PhD candidate, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada.
Biography
P. Morin is an associate professor, Faculty of Physical Activity Sciences, Université de Sherbrooke, Sherbrooke, Canada.
Biography
H. Vatanparast is an associate professor, University of Saskatchewan, School of Public Health, Saskatoon, Canada.
Biography
M. Bélanger is an associate professor and director of research, Université de Sherbrooke, Centre de formation médicale du Nouveau-Brunswick, Moncton, Canada, and an epidemiologist, Réseau de santé Vitalité, Bathurst, Canada.
Article info
Publication history
Published online: September 14, 2017
Accepted:
July 11,
2017
Received:
July 27,
2016
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT Healthy Start/Départ Santé is financially supported by grants from the Public Health Agency of Canada, the Consortium national de formation en santé, the Heart and Stroke Foundation of Canada and the Community Initiative Fund from the Government of Saskatchewan. Véronique Surette was funded through a Faculté de médecine et des sciences de la santé de l’Université de Sherbrooke Graduate Scholarship and Stéphanie Ward was funded through a Canadian Institutes of Health Research Charles Best Canada Graduate Scholarships Doctoral Award and a Gérard-Eugène-Plante Doctoral Scholarship.
Identification
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© 2017 by the Academy of Nutrition and Dietetics.
