The Association of Eating Behaviour on the Growth of Children from the Interior Districts of Sabah, Malaysia

Abstract

Background The double burden of malnutrition among children is an emerging public health problem, especially in developing countries. Eating behaviours have been hypothesised to contribute to both being underweight and overweight in children and adults. The objective of this study was to examine the association between the Child Eating Behaviour Questionnaire (CEBQ) subscale scores and body mass index (BMI) z-scores among Malaysian children under-5 years. Methods This was a cross-sectional study conducted in 2020 by recruiting a sample of 500 children aged 24–59 months old from clinics located in the interior districts of Sabah, Malaysia. The CEBQ was completed by the mothers on behalf of the child to assess their eating behaviour traits. The height and weight of the child were measured using standardised instrument. The BMI-for-age percentile, z-scores for BMI-for-age, height-for-age and weight-for-age were determined and classified using World Health Organization AnthroPlus software. The relationship between the CEBQ subscale scores and BMI z-scores were evaluated using multiple linear regression models adjusting for potential confounders. Results The prevalence of underweight, stunting and wasting were 20.2%, 29.2% and 5.6%, respectively, whereas the prevalence of overweight and obese was 5.0%. There were significant positive association between Food responsiveness, Emotional overeating, Enjoyment of food with BMI z-scores (p<0.05; unstandardised regression coefficient: 0.17 to 0.38). In contrast, there were significant negative association between Satiety responsiveness, Slowness of eating, Food fussiness with BMI z-scores (p<0.01; unstandardised regression coefficient: −0.35 to −0.36). Conclusion These findings show that specific eating behaviours can influence the growth of children under-5 years. Therefore, policymakers should formulate a nutrition policy that incorporates behavioural assessment and behavioural intervention in the prevention and management of malnutrition among children in Malaysia.

Validation of the Children’s Eating Behaviour Questionnaire in Poland

“…Meanwhile, obese children tend to eat faster, are more sensitive to external food signals and have a lower responsiveness to internal satiety signals [16]. So, as eating behaviour patterns become established in the preschool years and tend to remain stable through childhood to the adulthood, excessive body weight may persist from early childhood into the adult years [17].…”

“…It was developed by Wardle et al in 2001, as a useful tool to measure the eating styles in children, as the early precursors of obesity or eating disorders [15]. The CEBQ has been successfully adapted and used in many countries to measure associations between eating behaviours and body weight in children [17][18][19][20][21][22]. The questionnaire contains 35 questions addressed to parents, covering eight dimensions of eating styles: (1) Food Responsiveness-to measure eating in response to external food cues, (2) Emotional Overeating and (3) Emotional Undereatingto show the increase and decrease eating response to negative emotions (anger, anxiety), (4) Enjoyment of Food-to show the general interest in food, (5) Desire to Drink-to detect the increased desire to drink, especially sweetened drinks, (6) Satiety Responsiveness-to reflect the ability to regulate the amount of eaten food by internal satiety clues, (7) Slowness in Eating-to show the gradually reduced interest in a meal during its eating, and (8) Fussiness-to reflect the unwillingness to try new kinds of food and a lack of interest in food [13,15].…”