Assessment of eating attitudes and dieting behaviors in healthy children: Confirmatory factor analysis of the Children's Eating Attitudes Test

Abstract

Objective: The Children’s Eating Attitudes Test (ChEAT) is a self-report questionnaire that is conventionally summarised with a single score to identify ‘problematic’ eating attitudes, masking informative variability in different eating attitude domains. This study evaluated the empirical support for single-versus multifactor models of the ChEAT. For validation, we compared how well the single- versus multifactor-based scores predicted BMI. Method: Using data from 13,674 participants of the 11.5 year-follow-up of the Promotion of Breastfeeding Intervention Trial (PROBIT) in the Republic of Belarus, we conducted confirmatory factor analysis to evaluate the performance of 3- and 5-factor models, which were based on past studies, to a single-factor model representing the conventional summary of the ChEAT. We used cross-validated linear regression models and the reduction in mean squared error (MSE) to compare the prediction of BMI at 11.5y and 16y by the conventional and confirmed factor-based ChEAT scores. Results: The 5-factor model, based on 14 of the original 26 ChEAT items, had good fit to the data whereas the 3- and single-factor models did not. The MSE for concurrent (11.5y) BMI regressed on the 5-factor ChEAT summary was 35% lower than that of the single-score models, which reduced the MSE from the null model by only 1–5%. The MSE for BMI at 16y was 20% lower. Discussion: We found that a parsimonious 5-factor model of the ChEAT explained the data collected from healthy Belarusian children better than the conventional summary score and thus provides a more discriminating measure of eating attitudes.

Caregiver‐reported household food insecurity and child‐reported food insecurity in relation to eating disorder risk factors and symptoms among preadolescent children

“…The reliability and validity of the ChEAT have been shown in various studies (Lommi et al, 2020 ; Maloney et al, 1988 ; Rojo‐Moreno et al, 2011 ; Smolak & Levine, 1994 ). Consistent with previous research, responses for two of the original 26 ChEAT items were dropped from this study: #19 (“I can show self‐control around food”) and #25 (“I enjoy trying new rich foods”) (Lommi et al, 2020 ; Maloney et al, 1988 ; Murphy et al, 2019 ; Smolak & Levine, 1994 ). The resulting ChEAT‐24 total score had a possible range of 0–72, where higher scores indicate more ED risk factors/symptoms.…”

“…To examine specific ED risk factors/symptoms, we also used a set of continuous ChEAT subscale scores recommended by Murphy et al ( 2019 ): dieting, food preoccupation, weight preoccupation, vomiting, and social pressure to eat or gain weight. The questionnaire items that comprise the ChEAT‐24 and its subscales, as well as possible ranges for the subscale scores, are shown in Table 1 .…”

“… a The ChEAT‐26 was designed by Maloney et al ( 1988 ). b ChEAT subscales recommended by Murphy et al ( 2019 ). c Item numbers based on order numbers from the original ChEAT‐26.…”

“…aThe ChEAT-26 was designed byMaloney et al (1988). b ChEAT subscales recommended byMurphy et al (2019).c Item numbers based on order numbers from the original ChEAT-26. ChEAT-26 items 19 and 25 are excluded from the ChEAT-24.We used linear mixed regression models with children (Level 1) clustered within households (Level 2) to estimate the mean difference in ChEAT-24 total scores and subscale scores by caregiverreported household FI and, in separate models, by child-reported FI.…”

Greater social adversity is associated with more disordered eating attitudes and behaviors among children from Southeast Michigan

“…Recent literature suggests higher reliability when two questions (number 19 and 25) are removed from the total ChEAT‐26, resulting in a ChEAT‐24 (Lommi et al, 2020 ). Question number 19 and 25 have been found to correlate negatively with total ChEAT scores (Murphy et al, 2019 ), therefore the ChEAT‐24 is used in this study.…”