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

Background: 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. Methods: 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. Results: 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. Conclusions: 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.