Loh Debbie Ann, Moy Foong Ming, Zaharan Nur Lisa, Mohamed Zahurin
Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
PLoS One. 2013 Dec 5;8(12):e82885. doi: 10.1371/journal.pone.0082885. eCollection 2013.
Escalating weight gain among the Malaysian paediatric population necessitates identifying modifiable behaviours in the obesity pathway.
This study describes the adaptation and validation of the Children's Eating Behaviour Questionnaire (CEBQ) as a self-report for adolescents, investigates gender and ethnic differences in eating behaviour and examines associations between eating behaviour and body mass index (BMI) z-scores among multi-ethnic Malaysian adolescents.
This two-phase study involved validation of the Malay self-reported CEBQ in Phase 1 (n = 362). Principal Axis Factoring with Promax rotation, confirmatory factor analysis and reliability tests were performed. In Phase 2, adolescents completed the questionnaire (n = 646). Weight and height were measured. Gender and ethnic differences in eating behaviour were investigated. Associations between eating behaviour and BMI z-scores were examined with complex samples general linear model (GLM) analyses, adjusted for gender, ethnicity and maternal educational level.
Exploratory factor analysis revealed a 35-item, 9-factor structure with 'food fussiness' scale split into two. In confirmatory factor analysis, a 30-item, 8-factor structure yielded an improved model fit. Reliability estimates of the eight factors were acceptable. Eating behaviours did not differ between genders. Malay adolescents reported higher Food Responsiveness, Enjoyment of Food, Emotional Overeating, Slowness in Eating, Emotional Undereating and Food Fussiness 1 scores (p<0.05) compared to Chinese and Indians. A significant negative association was observed between BMI z-scores and Food Fussiness 1 ('dislike towards food') when adjusted for confounders.
Although CEBQ is a valuable psychometric instrument, adjustments were required due to age and cultural differences in our sample. With the self-report, our findings present that gender, ethnic and weight status influenced eating behaviours. Obese adolescents were found to display a lack of dislike towards food. Future longitudinal and qualitative studies are warranted to further understand behavioural phenotypes of obesity to guide prevention and intervention strategies.
马来西亚儿童群体中体重增加的情况不断升级，因此有必要确定肥胖途径中可改变的行为。
本研究描述了儿童饮食行为问卷（CEBQ）作为青少年自我报告工具的改编和验证过程，调查饮食行为中的性别和种族差异，并研究马来西亚多民族青少年的饮食行为与体重指数（BMI）z评分之间的关联。
这项两阶段研究在第一阶段（n = 362）对马来语自我报告的CEBQ进行了验证。进行了主成分因子分析（采用Promax旋转）、验证性因子分析和信度测试。在第二阶段，青少年完成问卷（n = 646）。测量了体重和身高。调查了饮食行为中的性别和种族差异。采用复杂样本一般线性模型（GLM）分析饮食行为与BMI z评分之间的关联，并对性别、种族和母亲教育水平进行了调整。
探索性因子分析揭示了一个35项、9因子的结构，其中“食物挑剔”量表分为两个部分。在验证性因子分析中，一个30项、8因子的结构产生了更好的模型拟合。八个因子的信度估计值是可以接受的。饮食行为在性别之间没有差异。与华人和印度人相比，马来青少年报告的食物反应性、对食物的享受、情绪性暴饮暴食、进食缓慢、情绪性进食不足和食物挑剔1得分更高（p<0.05）。在调整混杂因素后，观察到BMI z评分与食物挑剔1（“对食物的厌恶”）之间存在显著的负相关。
尽管CEBQ是一种有价值的心理测量工具，但由于我们样本中的年龄和文化差异，仍需要进行调整。通过自我报告，我们的研究结果表明性别、种族和体重状况会影响饮食行为。发现肥胖青少年对食物缺乏厌恶感。未来有必要进行纵向和定性研究，以进一步了解肥胖行为表型，从而指导预防和干预策略。
