Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden.
Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
Int J Behav Nutr Phys Act. 2019 Sep 3;16(1):76. doi: 10.1186/s12966-019-0845-y.
Research on picky eating in childhood obesity treatment is limited and inconsistent, with various instruments and questions used. This study examines the role of picky eating in a randomized controlled obesity intervention for preschoolers using subscales from two instruments: The Child Eating Behavior Questionnaire (CEBQ) and the Lifestyle Behavior Checklist (LBC).
The study includes 130 children (mean age 5.2 years (SD 0.7), 54% girls, mean Body Mass Index (BMI) z-score 2.9 (SD 0.6)) and their parents (nearly 60% of non-Swedish background, 40% with university degree). Families were randomized to a parent-group treatment focusing on evidence-based parenting practices or to standard treatment focusing on lifestyle changes. The children's heights and weights (BMI z-score) were measured at baseline, and at 3, 6 and 12 months post baseline. At these time-points, picky eating was reported by parents using the CEBQ (Food Fussiness scale, 6 items) and 5 items from the LBC. Child food intake was reported with a Food Frequency Questionnaire (FFQ). Pearson correlation was used to study associations between baseline picky eating and baseline BMI z-scores and food intake. Mixed effects models were used to study associations between the two measurements of picky eating and changes in picky eating, to assess the effects of changes in picky eating on BMI z-scores, and to evaluate baseline picky eating as a predictor of changes in BMI z-scores.
Neither the standard treatment nor the parent-group treatment reduced the degree of picky eating (measured with CEBQ or LBC). Baseline picky eating measured with the CEBQ was associated with a lower BMI z-score and lower intake of vegetables. Children with a higher degree of picky eating at baseline (measured with the CEBQ) displayed a lower degree of weight loss. When degree of picky eating was examined, for 25% of the children, the CEBQ and the LBC yielded diverging results.
Baseline picky eating may weaken the effectiveness of obesity treatment, and assessments should be conducted before treatment to adjust the treatment approach. Different measurements of picky eating may lead to different results. The CEBQ seems more robust than the LBC in measuring picky eating.
Clinicaltrials.gov , NCT01792531. Registered 15 February 2013 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01792531.
儿童肥胖症治疗中关于挑食的研究有限且不一致，使用了各种仪器和问题。本研究使用两种工具（儿童饮食行为问卷（CEBQ）和生活方式行为检查表（LBC）的子量表），研究了在针对学龄前儿童的随机对照肥胖干预中挑食的作用。
该研究包括 130 名儿童（平均年龄 5.2 岁（SD 0.7），54%为女孩，平均 BMI z 分数为 2.9（SD 0.6））及其父母（近 60%非瑞典背景，40%具有大学学历）。家庭被随机分配到以循证育儿实践为重点的家长小组治疗或以生活方式改变为重点的标准治疗。在基线、3、6 和 12 个月时测量了儿童的身高和体重（BMI z 分数）。在这些时间点，父母使用 CEBQ（食物挑剔量表，6 项）和 LBC 的 5 项报告儿童的挑食情况。使用食物频率问卷（FFQ）报告儿童的食物摄入量。使用 Pearson 相关分析研究基线挑食与基线 BMI z 分数和食物摄入量之间的关系。使用混合效应模型研究两次挑食测量之间以及挑食变化之间的关系，评估挑食变化对 BMI z 分数的影响，并评估基线挑食作为 BMI z 分数变化的预测因子。
标准治疗或家长小组治疗均未降低挑食程度（使用 CEBQ 或 LBC 测量）。使用 CEBQ 测量的基线挑食与较低的 BMI z 分数和较低的蔬菜摄入量有关。基线时挑食程度较高的儿童（使用 CEBQ 测量）体重减轻程度较低。当检查挑食程度时，对于 25%的儿童，CEBQ 和 LBC 得出了不同的结果。
基线挑食可能会削弱肥胖症治疗的效果，治疗前应进行评估，以调整治疗方法。挑食的不同测量方法可能会导致不同的结果。CEBQ 似乎比 LBC 更能准确测量挑食。
Clinicaltrials.gov，NCT01792531。2013 年 2 月 15 日注册-回顾性注册，https://clinicaltrials.gov/ct2/show/NCT01792531。
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