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Infant and Early Child Appetite Traits and Child Weight and Obesity Risk in Low-Income Hispanic Families



      Child appetite traits (ATs) are associated with later child weight and obesity risk. Less research has focused on ATs in low-income Hispanic children or included longitudinal associations with infant weight.


      To determine stability of ATs during infancy and childhood and their relationship with subsequent weight and obesity risk at age 3 years among low-income Hispanic children.


      A secondary longitudinal analysis of data from the Starting Early Program randomized controlled obesity prevention trial.


      Three hundred twenty-two low-income, Hispanic mother–child pairs enrolled between 2012 and 2014 in a public hospital in New York City.

      Main outcome measures

      ATs, including Slowness in Eating, Satiety Responsiveness, Food Responsiveness, and Enjoyment of Food were assessed using the Baby and Child Eating Behavior Questionnaires at ages 3 months, 2 years, and 3 years. Main outcome measures were child standardized weight-for-age z score (WFAz) and obesity risk (WFA≥95th percentile) at age 3 years.

      Statistical analyses performed

      AT stability was assessed using correlations and multilevel modeling. Linear and logistic regression analyses examined associations between ATs and child WFAz and obesity risk at age 3 years.


      There was limited stability for all ATs measured over time. During infancy, Slowness in Eating was associated with lower 3-year WFAz (B = –0.18, 95% CI –0.33 to –0.04; P = 0.01). At age 2 years, Slowness in Eating and Satiety Responsiveness were associated with lower WFAz (B = –0.29, 95% CI –0.47 to –0.12; P < 0.01; B = –0.36, 95% CI –0.55 to –0.17; P < 0.01) and obesity risk (adjusted odds ratio 0.49, 95% CI 0.28 to 0.85; adjusted odds ratio 0.61, 95% CI 0.38 to 0.99) at 3 years. Increased Slowness in Eating and Satiety Responsiveness over time were associated with lower 3-year WFAz (B = –0.74, 95% CI –1.18 to –0.2 [Slowness in Eating]; B = –1.19, 95% CI –1.87 to –0.52 [Satiety Responsiveness], both P values = 0.001). Higher Enjoyment of Food over time was associated with higher 3-year WFAz (B = 0.62, 95% CI 0.24 to 1.01; P = 0.002).


      Infants with lower Slowness in Eating and Satiety Responsiveness may have higher levels of obesity risk and need more tailored approaches to nutrition counseling and obesity prevention.


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        • Hales C.M.
        • Carroll M.D.
        • Fryar C.D.
        • Ogden C.L.
        Prevalence of Obesity Among Adults and Youth: United States, 2015–2016.
        National Center for Health Statistics, Hyattsville, MD2017 (NCHS Data Brief No. 288)
        • Hawkins S.S.
        • Oken E.
        • Gillman M.W.
        Early in the life course: time for obesity prevention.
        in: Halfon N. Forrest C.B. Lerner R.M. Faustman E.M. Handbook of Life Course Health Development. Springer International Publishing, New York2018: 169-196
        • Vandyousefi S.
        • Whaley S.E.
        • Widen E.M.
        • et al.
        Association of breastfeeding and early exposure to sugar-sweetened beverages with obesity prevalence in offspring born to mothers with and without gestational diabetes mellitus.
        Pediatr Obes. 2019; 14: 1-9
        • Van Jaarsveld C.H.M.
        • Boniface D.
        • Llewellyn C.H.
        • Wardle J.
        Appetite and growth a longitudinal sibling analysis.
        JAMA Pediatr. 2014; 168: 345-350
        • Webber L.
        • Hill C.
        • Saxton J.
        • Van Jaarsveld C.H.M.
        • Wardle J.
        Eating behaviour and weight in children.
        Int J Obes. 2009; 33: 21-28
        • Ramsay M.
        Feeding skill, appetite and feeding behaviours of infants and young children and their impact on growth and psychosocial development.
        • McDonald Culp A.
        The transactional model of development: how children and contexts shape each other.
        Infant Mental Health J. 2010; : 115-117
        • Anzman-Frasca S.
        • Stifter C.A.
        • Birch L.L.
        Temperament and childhood obesity risk: a review of the literature.
        J Dev Behav Pediatr. 2012; 33: 732-745
      1. Powell F, Farrow C, Haycraft E, Meyer C. Appetite regulation in early childhood: The impact of parenting behaviours and child temperament. Appet Regul Role Dis Control. Published online 2011:1-28.

        • Faith M.S.
        • Hittner J.B.
        Infant temperament and eating style predict change in standardized weight status and obesity risk at 6 years of age.
        Int J Obes. 2010; 34: 1515-1523
        • Faith M.S.
        • Hittner J.B.
        • Hurston S.R.
        • et al.
        Association of infant temperament with subsequent obesity in young children of mothers with gestational diabetes mellitus.
        JAMA Pediatr. 2019; 173: 424-433
        • Sánchez U.
        • Weisstaub G.
        • Santos J.L.
        • Corvalán C.
        • Uauy R.
        GOCS cohort: Children’s Eating Behavior scores and BMI.
        Eur J Clin Nutr. 2016; 70: 925-928
        • Spence J.C.
        • Carson V.
        • Casey L.
        • Boule N.
        Examining behavioural susceptibility to obesity among Canadian pre-school children: the role of eating behaviours.
        Int J Pediatr Obes. 2011; 6: e501-e507
        • Farrow C.
        • Blissett J.
        Stability and continuity of parentally reported child eating behaviours and feeding practices from 2 to 5 years of age.
        Appetite. 2012; 58: 151-156
        • Sleddens E.F.C.
        • Kremers S.P.J.
        • Thijs C.
        The Children’s Eating Behaviour Questionnaire: factorial validity and association with Body Mass Index in Dutch children aged 6-7.
        Int J Behav Nutr Phys Act. 2008; 5: 1-9
        • Viana V.
        • Sinde S.
        • Saxton J.C.
        Children’s Eating Behaviour Questionnaire: associations with BMI in Portuguese children.
        Br J Nutr. 2008; 100: 445-450
        • Carnell S.
        • Wardle J.
        Measuring behavioural susceptibility to obesity: validation of the child eating behaviour questionnaire.
        Appetite. 2007; 48: 104-113
        • Wardle J.
        • Guthrie C.A.
        • Sanderson S.
        • Rapoport L.
        Development of the Children’s Eating Behaviour Questionnaire.
        J Child Psychol Psychiatry. 2001; 42: 963-970
        • Llewellyn C.H.
        • van Jaarsveld C.H.M.
        • Johnson L.
        • Carnell S.
        • Wardle J.
        Development and factor structure of the Baby Eating Behaviour Questionnaire in the Gemini birth cohort.
        Appetite. 2011; 57: 388-396
        • Ashcroft J.
        • Semmler C.
        • Carnell S.
        • van Jaarsveld C.H.M.
        • Wardle J.
        Continuity and stability of eating behaviour traits in children.
        Eur J Clin Nutr. 2008; 62: 985-990
        • Freitas A.
        • Albuquerque G.
        • Silva C.
        • Oliveira A.
        Appetite-related eating behaviours: an overview of assessment methods, determinants and effects on children’s weight.
        Ann Nutr Metab. 2018; 73: 19-29
        • Mallan K.M.
        • Fildes A.
        • de la Piedad Garcia X.
        • Drzezdzon J.
        • Sampson M.
        • Llewellyn C.
        Appetitive traits associated with higher and lower body mass index: evaluating the validity of the adult eating behaviour questionnaire in an Australian sample.
        Int J Behav Nutr Phys Act. 2017; 14: 1-8
        • Parkinson K.N.
        • Drewett R.F.
        • Le Couteur A.S.
        • Adamson A.J.
        Do maternal ratings of appetite in infants predict later Child Eating Behaviour Questionnaire scores and body mass index?.
        Appetite. 2010; 54: 186-190
        • Syrad H.
        • Johnson L.
        • Wardle J.
        • Llewellyn C.H.
        Appetitive traits and food intake patterns in early life.
        Am J Clin Nutr. 2016; 103: 231-235
        • Cao Y.T.
        • Svensson V.
        • Marcus C.
        • Zhang J.
        • Zhang J.D.
        • Sobko T.
        Eating behaviour patterns in Chinese children aged 12-18 months and association with relative weight—factorial validation of the Children’s Eating Behaviour Questionnaire.
        Int J Behav Nutr Phys Act. 2012; 9: 5
        • Van Jaarsveld C.H.M.
        • Llewellyn C.H.
        • Johnson L.
        • Wardle J.
        Prospective associations between appetitive traits and weight gain in infancy.
        Am J Clin Nutr. 2011; 94: 1562-1567
        • Quah P.L.
        • Chan Y.H.
        • Aris I.M.
        • et al.
        Prospective associations of appetitive traits at 3 and 12 months of age with body mass index and weight gain in the first 2 years of life.
        BMC Pediatr. 2015; 15: 153
        • Shepard D.N.
        • Chandler-laney P.C.
        Prospective associations of eating behaviors with weight gain in infants.
        . 2015; 23: 1881-1885
        • Gross R.S.
        • Mendelsohn A.L.
        • Yin H.S.
        • et al.
        Randomized controlled trial of an early child obesity prevention intervention: impacts on infant tummy time.
        Obesity. 2017; 25: 920-927
        • Gross R.S.
        • Mendelsohn A.L.
        • Gross M.B.
        • Scheinmann R.
        • Messito M.J.
        Randomized controlled trial of a primary care-based child obesity prevention intervention on infant feeding practices.
        J Pediatr. 2016; 174: 171-177.e2
        • Quah P.L.
        • Cheung Y.B.
        • Pang W.W.
        • et al.
        Validation of the Children’s Eating Behavior Questionnaire in 3 year old children of a multi-ethnic Asian population: The GUSTO cohort study.
        Appetite. 2017; 113: 100-105
        • University College London Institute of Epidemiology & Health Care
        Eating behaviour questionnaires.
        • Howe L.D.
        • Tilling K.
        • Lawlor D.A.
        Accuracy of height and weight data from child health records.
        Arch Dis Child. 2009; 94: 950-954
        • Messito M.J.
        • Mendelsohn A.L.
        • Katzow M.W.
        • Scott M.A.
        • Vandyousefi S.
        • Gross R.S.
        Prenatal and Pediatric Primary Care-Based Child Obesity Prevention Program: a randomized trial.
        Pediatrics. 2020; 146
        • Gamliel A.
        • Ziv-Baran T.
        • Siegel R.M.
        • Fogelman Y.
        • Dubnov-Raz G.
        Using weight-for-age percentiles to screen for overweight and obese children and adolescents.
        Prev Med (Baltimore). 2015; 81: 174-179
        • Centers for Disease Control and Prevention
        A SAS program for the 2000 CDC Growth Charts (ages 0 to <20 years).
        • Kroenke K.
        • Spitzer R.L.
        • Williams J.B.W.
        The PHQ-9: Validity of a brief depression severity measure.
        J Gen Intern Med. 2001; 16: 606-613
        • Coleman-Jensen A.
        • Nord M.
        • Andrews M.
        • Carlson S.
        Household food security in the United States in 2010. ERR-125.
        • Holland E.
        • Simas T.A.M.
        • Curiale D.K.D.
        • Liao X.
        • Waring M.E.
        Self-reported pre-pregnancy weight versus weight measured at first prenatal visit: effects on categorization of pre-pregnancy body mass index.
        Matern Child Health J. 2013; 17: 1872-1878
      2. IBM SPSS Statistics for Windows [computer program]. Version 25.0. IBM Corp, Armonk, NY2017
      3. Stata [computer program]. Release 15. StataCorp LLC, College Station, TX2017
        • Robinson G.
        That BLUP is a good thing: the estimation of random effects.
        Stat Sci. 1991; 6: 15-51
        • Farrow C.V.
        • Galloway A.T.
        • Fraser K.
        Sibling eating behaviours and differential child feeding practices reported by parents.
        Appetite. 2009; 52: 307-312
        • Domoff S.E.
        • Miller A.L.
        • Kaciroti N.
        • Lumeng J.C.
        Validation of the Children’s Eating Behaviour Questionnaire in a low-income preschool-aged sample in the United States.
        Appetite. 2015; 95: 415-420
        • Loh D.A.
        • Moy F.M.
        • Zaharan N.L.
        • Mohamed Z.
        Eating behaviour among multi-ethnic adolescents in a middle-income country as measured by the self-reported Children’s Eating Behaviour Questionnaire.
        . 2013; 8: 1-12
        • Svensson V.
        • Lundborg L.
        • Cao Y.
        • Nowicka P.
        • Marcus C.
        • Sobko T.
        Obesity related eating behaviour patterns in Swedish preschool children and association with age, gender, relative weight and parental weight—factorial validation of the Children’s Eating Behaviour Questionnaire.
        Int J Behav Nutr Phys Act. 2011; 8: 134
        • Mui P.
        • Hill S.E.
        • Thorpe R.J.
        Overweight and obesity differences across ethnically diverse subgroups of Asian American Men.
        Am J Mens Health. 2018; 12: 1958-1965
        • Bahorski J.S.
        • Schneider-Worthington C.R.
        • Chandler-Laney P.C.
        Modified eating in the absence of hunger test is associated with appetitive traits in infants.
        Eat Behav. 2020; 36: 101342
        • Birch L.L.
        • Anzman S.L.
        Learning to eat in an obesogenic environment: a developmental systems perspective on childhood obesity.
        Child Dev Perspect. 2010; 4: 138-143
        • Llewellyn C.H.
        • Van Jaarsveld C.H.M.
        • Plomin R.
        • Fisher A.
        • Wardle J.
        Inherited behavioral susceptibility to adiposity in infancy: a multivariate genetic analysis of appetite and weight in the Gemini birth cohort.
        Am J Clin Nutr. 2012; 95: 633-639
        • Llewellyn C.H.
        • Van Jaarsveld C.H.M.
        • Johnson L.
        • Carnell S.
        • Wardle J.
        Nature and nurture in infant appetite: analysis of the Gemini twin birth cohort.
        Am J Clin Nutr. 2010; 91: 1172-1179
        • Fisher J.O.
        • Cai G.
        • Jaramillo S.J.
        • Cole S.A.
        • Comuzzie A.G.
        • Butte N.F.
        Heritability of hyperphagic eating behavior and appetite-related hormones among hispanic children.
        Obesity. 2007; 15: 1484-1495
        • Corella D.
        • Carrasco P.
        • Sorlí J.V.
        • et al.
        Education modulates the association of the FTO rs9939609 polymorphism with body mass index and obesity risk in the Mediterranean population.
        Nutr Metab Cardiovasc Dis. 2012; 22: 651-658
        • Foraita R.
        • Günther F.
        • Gwozdz W.
        • et al.
        Does the FTO gene interact with the socioeconomic status on the obesity development among young European children? Results from the IDEFICS study.
        Int J Obes. 2015; 39: 1-6
        • Selzam S.
        • McAdams T.A.
        • Coleman J.R.I.
        • et al.
        Evidence for gene-environment correlation in child feeding: links between common genetic variation for BMI in children and parental feeding practices.
        PLoS Genet. 2018; 14e1007757
        • Fernandez C.
        • Dejesus J.M.
        • Miller A.L.
        • et al.
        Selective eating behaviors in children: an observational validation of parental report measures.
        Appetite. 2018; 127: 163-170


      S. Vandyousefi is a postdoctoral fellow, Department of Pediatrics, New York University Grossman School of Medicine, New York.


      R. S. Gross is an assistant professor of pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York.


      M. W. Katzow is an assistant professor, Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.


      M. A. Scott is chair, Department of Applied Statistics, Social Science, and Humanities, and a professor of applied statistics, New York University Steinhardt School of Culture, Education, and Human Development, New York.


      M. J. Messito is an associate professor clinical pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York.

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