Associations Between Birthweight and Appetite Traits: Appetite Traits Partially Mediate the Link Between Birthweight and Later Child Weight in Low-Income Hispanic Families

Objectives To examine whether: 1) birthweight was associated with child appetite traits (AT) at age 2 years; and 2) ATs mediated the link between birthweight and weight at age 3 years among Hispanic children. Methods This study is a secondary longitudinal analysis of data collected from the “Starting Early Program” randomized controlled obesity prevention trial of low-income, Hispanic mother-child pairs (n = 533). Birthweight-for-gestational-age z-scores (BWGAz) were determined using Fenton growth curves; weight-for-age z-scores (WFAz) were determined using World Health Organization growth charts. Four ATs, including Food Responsiveness (FR), Enjoyment of Food (EF), Satiety Responsiveness (SR), and Slowness in Eating (SE), were assessed using the Child Eating Behavior Questionnaire at age 2 years. Simple linear regression analysis was used to assess direct associations between BWGAz and each AT. Bootstrapping analyses were used to assess whether ATs were significantly associated with BWGAz, and mediated the relationship between BWGAz and later child WFAz. Results Of the 401 children with both BWGAz and AT measures, 49% were male with mean birthweight of 3.4 kg. After adjusting for covariates related to child weight, infants with higher BWGAz had lower SR scores at age 2 years (B = −0.11, 95%CI = −0.18 to − 0.04, P < 0.01) and higher WFAz at age 3 years (B = 0.39, 95%CI = 0.26 to 0.53; P < 0.001). Lower SR was also associated with higher WFAz at age 3 years (B = −0.42, 95%CI = −0.62 to −0.22, P < 0.001). A significant indirect effect of BWGAz on WFAz at age 3 years through SR at age 2 years was detected (B = 0.04, 95%CI = 0.01 to 0.08; P < 0.01 [indirect effect]); however, only 10% of the total effect was mediated by this indirect pathway. Therefore, SR partially mediated the positive relationship between BWGAz and child WFAz at age 3 years. BWGAz was not associated with other ATs. Conclusions Higher BWGAz was associated with lower SR scores at age 2 years and higher WFAz at age 3 years. SR partially mediated the link between BWGAz and child WFAz. Our findings warrant exploring additional pathways through which birthweight effects appetite traits, as well as later child weight. Funding Sources USDA AFRI.

Infant Appetite Traits and Early Infant Feeding Practices in Low-Income Hispanic Families

Objectives This study examined the association of infant appetite traits and exclusive breastfeeding (EBF), BF intensity, early introduction of complementary foods/liquids and 100% fruit juice consumption among Hispanic infants during the first year of life. Methods This study is a cross-sectional analysis of data collected from the “Starting Early Program" randomized controlled obesity prevention trial of low-income, Hispanic mother-child pairs (n = 533). Four infant appetite traits including Food Responsiveness (FR), Enjoyment of Food (EF), Satiety Responsiveness (SR), and Slowness in Eating (SE) were assessed using the Baby Eating Behavior Questionnaire. Each appetite trait was based on a 5-point Likert frequency scale. Infant feeding measures were collected using 24-hour recall methodology and survey based on the Infant Feeding Practices Study II. Linear and logistic regressions assessed the associations between appetite traits and infant feeding practices, specifically 1) EBF, 2) BF intensity (% of daily milk consumption that is breast milk), 3) early introduction to complementary foods/liquids defined as receiving prior to infant age 4 months, and 4) Any 100% fruit juice consumption at age 10 months. Results Of the 473 children with both appetite and infant feeding measures, 48% were male with mean birth weight of 3.4 kg. After adjusting for confounders, infants with higher SE scores had higher odds of EBF duration (≥3 months) (OR = 1.7, P < 0.001), and higher odds of having medium (20% ≤ score ≤ 80%) and high (>80%) BF intensity (OR = 1.8, P = 0.002; OR = 2.5, P < 0.001), compared to infants with lower SE scores. Infants with higher SE and SR were less likely to receive early complementary foods/liquids (OR = 0.59, P = 0.026; OR = 0.51, P = 0.009). Infants with higher EF were more likely to consume any 100% fruit juice at age 10 months (OR = 1.7, P = 0.047). The other appetite traits were not significantly related to infant feeding measures. Conclusions Higher SE was associated with greater EBF and BF intensity. Infants with higher SE and SR were less likely to have early introduction to complementary foods/liquids. Infants with higher EF were more likely to have juice at 10 months. Appetite traits are associated with potentially obesogenic feeding practices and may represent a target for early life infant feeding interventions. Funding Sources USDA AFRI.

Mothers’ eating style’s influence on their feeding practices and on their children’s appetite traits

Background: Overweight and obesity in children and adolescents has become an important public health concern in the last decades. To study the way mothers and children’s behavioral factors interact with each other, influencing eating and body weight, may provide information to be used in preventive and treatment strategies.Goals: To study the association of mothers’ eating style on their feeding behavior and on their children’s eating behavior.Methods: Cross-sectional observational study with a non-probabilistic sample of mother and child dyads (from three schools). Mothers’ eating behavior (assessed with Dutch Eating Behavior Questionnaire scale; DEBQ) was classified and they were grouped into three eating styles: restrictive, emotional-external or neutral styles. Mothers’ feeding restriction, pressure to eat and concern about child’s weight were assessed (through the Child Feeding Questionnaire; CFQ). Finally, mothers classified their child’s appetite behaviors (with the Children’s Eating Behaviour Questionnaire; CEBQ).Results: Overall, participated 279 mothers, aged between 23 and 59 years (Mean= 38.03 years, SD=5.09) and respective children (n=279), aged between 6 and 13 years (Mean= 9.43 years, SD= 1.35), 140 of those were females (50.2 %). Associations between mothers’ eating style, their feeding behaviors and children’s appetite traits showed that restrictive and emotional-external eating mothers had higher scores of CFQ and CEBQ items related with obesity, when compared to neutral eating style mothers. Mothers’ feeding restriction and children’s weight concern associated positively with children’s food approach behaviors (enjoyment of food, food responsiveness, emotional over-eating), and negatively with food avoidance behaviors (satiety responsiveness and slowness in eating). On the contrary, pressure to eat associated positively with food avoidance behaviors and negatively with food approach behaviors. Mother´s concern about child weight and feeding restriction were positively associated with CEBQ subscales that reflect food approach and negatively associated with subscales that reflect food avoidance. Pressure to eat had the symmetric associations. Discussion: Results support the hypothesis of the transmission of eating behaviors that promote obesity from mothers to children, and have implications both for prevention and children and adolescents’ obesity treatment. Therefore, mothers should be a part of the intervention when treating their children obesity