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

<p>Abstract</p> <p>Background</p> <p>The Children's Eating Behaviour Questionnaire (CEBQ) is a multi-dimensional, parent-reported questionnaire measuring children's eating behaviours related to obesity risk, i.e. 'enjoyment of food', 'food responsiveness', 'slowness in eating' and 'satiety responsiveness'. It has not previously been validated in a Swedish population, neither on children under the age of 2 years. In the present study we examined the factor structure and the reliability of the Swedish version of the CEBQ, for use in an obesity intervention programme targeting preschool children 1-6 years. Further, the associations between eating behaviours and children's age, gender and relative weight (BMI SDS) and parental weight were investigated.</p> <p>Methods</p> <p>Parents to 174 children aged 1-6 years (50% girls, mean age 3.8 years), recruited from five kindergartens in Stockholm, completed the Swedish version of the CEBQ. Data on children's weight and height, parental weight, height and educational level was collected. Children's relative weight was calculated for a subpopulation (mean BMI SDS -0.4, n = 47). Factorial validation (Principal Component Analysis) on all CEBQ items was performed. Differences in eating behaviours by age, gender and parental weight were examined. Correlations between eating behaviours and the child's BMI SDS were analysed controlling for age, gender, parental weight and education in linear regression analyses.</p> <p>Results</p> <p>The factor analysis revealed a seven factor solution with good psychometric properties, similar to the original structure. The behaviour scales 'overeating'/'food responsiveness', 'enjoyment of food' and 'emotional undereating' decreased with age and 'food fussiness' increased with age. Eating behaviours did not differ between girls and boys. The children's relative weight was not related to any of the eating behaviours when controlling for age, gender, parental weight and education, and only associated with parental weight status.</p> <p>Conclusions</p> <p>Our results support the use of the CEBQ as a psychometric instrument for assessing children's eating behaviours in Swedish children aged 1-6 years. Measuring obesity related eating behaviours in longitudinal and interventional studies would offer opportunities for studying causal effects of eating behaviours in the development of obesity in children.</p

Eating behaviour patterns in Chinese children aged 12-18 months and association with relative weight - factorial validation of the Children's Eating Behaviour Questionnaire

<p>Abstract</p> <p>Background</p> <p>Eating behaviours have been suggested relating to obesity development. The Children's Eating Behaviour Questionnaire (CEBQ) is a parent-report measure constructed to assess multiple dimensions of eating behavior for children. This study aimed to test the validity of the Chinese version of Children's Eating Behaviour Questionnaire (CEBQ) in Chinese children aged 12-18 months. We examined factor structure and the reliability of the Chinese version of the CEBQ, the associations between children's eating behaviours and children's weight (BMI SDS) were assessed.</p> <p>Methods</p> <p>219 questionnaires were filled out by the caregivers, approached in community health care centers in two cities in China. BMI of each child was calculated and converted to BMI SDS. Factor validation (Principal Component Analysis, exploratory factor analysis) on all CEBQ items was performed and gender difference in eating behaviours was examined. Correlations between eating behaviours and the child's BMI SDS were analyzed by linear regression analysis controlling for gender, parental combined weight, and education.</p> <p>Results</p> <p>The factor analysis revealed a seven-factor solution, with factor 'food responsiveness' (FR) split into two. 'Satiety responsiveness' (SR) and 'Enjoyment of food' (EF) factors were not detected. Interestingly, boys scored higher than girls in the FR scales, whereas girls had a higher score in 'food fussiness' (FF) scale.</p> <p>Conclusions</p> <p>We conclude that although a valuable psychometric instrument, CEBQ might be affected by age and cultural differences. Therefore, adjusting it in order to fit the Chinese population was suggested. We did not find an association between eating behaviours and children's BMI SDS, when it was controlled for gender and parental weight.</p

Breastfeeding practices and policies in WHO European Region Member States

Abstract Objective: To provide an update on current practices and policy development status concerning breastfeeding in the WHO European Region. Design: National surveys and studies conducted by national health institutions were prioritized. Sub-national data were included where no national data or studies existed. Information on national breastfeeding policies was collected mainly from the WHO Seventh Meeting of Baby-Friendly Hospital Initiative Coordinators and European Union projects. Owing to the different data sources and methods, any comparisons between countries must be made with caution. Setting: WHO European Member States. Results: Data from fifty-three WHO European Member States were investigated; however, a large proportion had not reported any data. Rates of early initiation of breastfeeding, exclusive breastfeeding and continued breastfeeding to 1 year all varied considerably within the WHO European Region. Exclusive breastfeeding rates declined considerably after 4 months, and were low in infants under 6 months and at 6 months of age. The majority of the countries with existing data reported having a national infant and young child feeding policy and the establishment of a national committee on breastfeeding or infant and young child feeding. The majority of the countries with existing data reported having babyfriendly hospitals, although the proportion of baby-friendly hospitals to the total number of national hospitals with maternity units was low in most countries. Conclusions: Breastfeeding practices within the WHO European Region, especially exclusive breastfeeding rates, are far from complying with the WHO recommendations. There are marked differences between countries in breastfeeding practices, infant and young child feeding policy adoption and proportion of baby-friendly hospitals

Men in Macau SAR have higher prevalence in metabolic syndrome and among related metabolic components: a cross-sectional Macau Health Survey

Abstract Background: Macau has recently experienced expansive socioeconomic growth, leading to lifestyle changes that could have contributed to the development of certain diseases. Little information exists on the prevalence of metabolic syndrome (MetS) and associated risk factors. This information is important, since the management of MetS is tightly connected with prevention of cardiovascular diseases in the population. Methods: This study is based on the cross-sectional Macau Health Survey 2006. Information on anthropometry, physical measurements, socio-demographics, laboratory tests and life-style habits was collected by trained health professionals from a random sub-population sample, aged 18-44 (32.6 ± 8.3). Body Mass Index (BMI) cut-offs were based on WHO criteria for Asian population. The prevalence of MetS, as defined by the International Diabetes Federation was calculated and the associated lifestyle factors were analysed. Results: Among Macau&apos;s adults (n = 1592), the age-adjusted prevalence of MetS was over two times higher in men (10.5%) than in woman (3.7%), (p &lt;0.01). 15.8% were overweight (BMI ≥23 &lt; 25) and 18.8% were obese (BMI ≥25). Man had significantly higher risk profile in almost all components of MetS (p &lt;0.001), except the waist circumference and HDL. BMI, age and education were significantly related to MetS in both genders (p &lt;0.001). Conclusions: We found significant gender differences in MetS among the 18 -44 year old population of Macau, which should be addressed separately in the gender-specific preventive strategies

Measuring connectedness to nature in preschool children in an urban setting and its relation to psychological functioning.

BackgroundThe urban environment has been criticized for promoting 'nature-deficit' and 'child-nature disconnectedness'. Keeping in mind the importance of nature exposure and its extensive health benefits, many environmental programs around the world hope to (re)connect children with nature. To evaluate the effectiveness of such efforts, valid tools to measure Connectedness to Nature (CN) are needed but do not exist today, especially for use with pre-schoolers.MethodsThe original CN Index was modified and tested among the Parents of Preschool Children (CNI-PPC) in an urban setting (Hong Kong) for its internal consistency (n = 299) and external validity (n = 194). The 'Strength and Difficulties Questionnaire' (SDQ) was chosen for divergent and convergent analysis. Conventional recommendations for test adaptation and translation were used.ResultsConfirmatory factor analysis (CFA) revealed that the 16-item scale adequately captured four major dimensions: enjoyment of nature, empathy for nature, responsibility toward nature, and awareness of nature (Cronbach's α were respectively .86, .87, .75 and .80). When tested against the SDQ, a validated measure for child psychological functioning, and identification of children's problem behaviours, three CNI-PPC factors influenced the SDQ outcomes: (1) the more enjoyment of nature children displayed the less overall distress and impairment they exhibited (β = -.64); (2) greater responsibility toward nature in children was associated with less hyperactivity (β = -.50), fewer behavioural and peer difficulties (β = -.62 and β = -.65 respectively) and improved prosocial behaviour (β = .77); (3) the more aware children were of nature, the less emotional difficulties they exhibited (β = -.51). The variance explained was large (range R2 = .42 to .80).ConclusionsThus, CNI-PPC factors have meaningful and substantive associations with the strengths and difficulties parents perceive in their children. This indicates that the CNI-PPC is a valid and reliable instrument to measure CN at an age when children cannot respond for themselves. Further, this simple tool can help researchers/practitioners to better understand how connectedness to nature affects child psychological functioning and wellbeing.Trial registrationClinicalTrials.gov Identifier: NCT02715544. Registered 8 March 2016