Characteristics of eating behavior profiles among preschoolers with low-income backgrounds: A person-centered analysis

Authors: FISHER, JENNIFER - Temple University; HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC); MILLER, ALISON - University Of Michigan; HORODYNSKI, MILDRED - Michigan State University; BROPHY-HERB, HOLLY - Michigan State University; CONTRERAS, DAWN - University Of Michigan Medical School; KACIROTI, NIKO - University Of Michigan Medical School; PETERSON, KAREN - University Of Michigan; ROSENBLUM, KATHERINE - University Of Michigan Medical School; APPUGLIESE, DANIELLE - Consultant; LUMENG, JULIE - University Of Michigan Medical School

Submitted to: International Journal of Behavioral Nutrition and Physical Activity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/24/2022
Publication Date: 7/23/2022
Citation: Fisher, J.O., Hughes, S.O., Miller, A.L., Horodynski, M.A., Brophy-Herb, H.E., Contreras, D.A., Kaciroti, N., Peterson, K.E., Rosenblum, K.L., Appugliese, D., Lumeng, J.C. 2022. Characteristics of eating behavior profiles among preschoolers with low-income backgrounds: A person-centered analysis. International Journal of Behavioral Nutrition and Physical Activity. 19. Article 91. https://doi.org/10.1186/s12966-022-01323-y.
DOI: https://doi.org/10.1186/s12966-022-01323-y

Interpretive Summary: There is a pressing need for studies examining child eating traits to consider the "whole" child as opposed to individual traits within the child. Child eating behavior profiles can be useful in tailored obesity prevention programs designed to address children who are predisposed to overeating. Few studies have used this person-centered approach examining the whole child and instead have focused on only one type of eating behavior such as picky/fussy eating. To address this gap, we aimed to identify eating behavior profiles among preschool-aged children and evaluate their relationships with temperament and weight. Temperament refers to basic predispositions around reactivity and self-regulation that are believed to reflect an interaction of genetic, biological, and environmental factors. We analyzed baseline data from 2 studies involving 1004 children ages 3-4 years and their parents with low-income backgrounds. Parents provided information for their childrens' eating behaviors and temperament; researchers measured children's weights and heights to obtain their weight status. Statistical analysis showed three child eating behavior profiles: 1) High Food Avoidant, 2) High Food Approach, and 3) Moderate Eating. Most children, 43.2%, were categorized as Moderate Eaters, followed by the High Food Avoidant which included 35.6% of children, and High Food Approach which included 21.2% of children. Differences in temperament and weight status were seen across the three eating behavior profiles. Specifically, children with High Food Approach showed lower inhibitory control and had the highest rates of obesity compared to the other profiles. Children classified as High Food Avoidant showed lower impulsivity and lower weight scores relative to the other profiles Children classified as Moderate Eaters showed higher inhibitory control and lower anger/frustration type behaviors. Additional work is needed to better understand what parental feeding behaviors will foster the best health outcomes for each profile.

Technical Abstract: Individual differences in eating behaviors among young children are well-established, but the extent to which behaviors aggregate within individuals to form distinct eating behavior profiles remains unknown. Our objectives were to identify eating behavior profiles among preschool-aged children and evaluate associations with temperament and weight. A secondary, cross-sectional analysis of baseline data from 2 cohort studies was conducted involving 1004 children aged 3–4 years and their parents with low-income backgrounds. Children’s eating behaviors and temperament were assessed by parental report. Body mass index z-scores and weight status were calculated using measured heights and weights. Latent profile analysis (LPA) was used to generate profiles and bivariate analyses were used to evaluate associations with temperament and weight status. LPA revealed the presence of 3 eating behavior profiles among children. Children with High Food Approach profiles (21.2%) had lower temperamental inhibitory control and the highest percent of children with obesity relative to the other profiles. Children with High Food Avoidant profiles (35.6%) had lower temperamental impulsivity and lower BMI z-scores relative to the other profiles, whereas children with Moderate Eating profiles (intermediary levels of all behaviors; 43.2%) had higher temperamental inhibitory control and lower anger/frustration, than other profiles. Young children's eating behaviors appear to aggregate within individuals to form empirically distinct profiles reflecting food approach, food avoidance, and moderate approaches to eating that are differentiated by aspects of temperament and weight. Future work should seek to understand the extent to which health promotion and obesity prevention approaches should be tailored to take into account children’s fundamental dispositions towards eating.