A new study published in The Lancet Child & Adolescent Health has found significant connections between appetitive traits in early childhood and the development of eating disorders in adolescence. The research highlights the importance of understanding these traits as potential risk factors for eating-related issues later in life.
Eating disorders and obesity are prevalent mental health issues worldwide, often co-occurring with other psychological conditions and associated with high mortality rates. Given the lack of effective preventive strategies, there is a pressing need for epidemiological studies to identify novel risk factors and treatment options. The study posits that similarities between eating disorders and body mass index (BMI), including food intake control and genetic overlap, warrant further exploration through behavioral susceptibility theory.
The research team examined data from two longitudinal cohorts: the Gemini study in Wales and England and the Generation R study in Rotterdam. They assessed appetitive traits using the Child Eating Behaviour Questionnaire (CEBQ), gathering information from parents of children aged four to five and self-reports from adolescents aged 12 to 14.
The study focused on symptoms related to overeating disorders, such as binge eating and emotional eating, as well as restrained eating behaviors, including compensatory actions. The Generation R cohort included 9,745 children born to pregnant women with expected delivery dates between April 2002 and January 2006, while the Gemini cohort consisted of 4,804 children, including 2,402 twin pairs.
Researchers applied logistic regression analyses to determine odds ratios (OR) while adjusting for various sociodemographic factors, including age, sex, ethnicity, household income, maternal education, and BMI. They also examined interaction effects by biological sex and conducted meta-analyses to pool results.
The study included 2,801 participants from the Generation R cohort and 869 from the Gemini study. Key findings revealed that emotional overeating in early childhood was associated with a higher likelihood of compensatory behaviors in adolescence (OR, 1.2). Conversely, higher satiety responsiveness was linked to lower odds of uncontrolled eating (OR, 0.9) and compensatory behaviors (OR, 0.9).
Notably, slow eating in early childhood was found to significantly reduce the risk of restrained eating and compensatory behaviors in adolescence (OR, 0.9 for both). The researchers hypothesized that increased responsiveness to food during early childhood would elevate the risk of overeating disorders in adolescence, particularly binge eating (pooled OR, 1.5). However, the findings indicated that higher food responsiveness also correlated with an increased risk of restrictive eating.
The analysis further revealed that emotional overeating in childhood was linked to a higher risk of uncontrolled eating in adolescence, particularly among participants in the Gemini cohort (OR, 1.5). Interestingly, traits of food aversion in childhood did not correlate with increased odds of restricted eating in adolescence. Instead, slow eating behaviors were associated with reduced chances of moderate to high restrained eating symptoms (pooled OR, 0.9).
Among the Generation R participants, the link between slow eating and reduced odds of restrained eating was more pronounced in females. In contrast, positive associations between emotional overeating in early childhood and binge eating were observed only in male participants from the Gemini study.
Conclusion
The findings of this study underscore the significant impact of early childhood appetite traits on the risk of developing eating disorders during adolescence. Specifically, while higher food responsiveness increases the likelihood of such disorders, traits like slow eating and high satiety responsiveness can mitigate these risks. The researchers advocate for parental feeding practices that promote healthy eating habits, such as teaching children to recognize internal hunger and fullness cues, encouraging slower eating, and avoiding using food as a reward or comfort.
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