Faster eating rates are associated with higher energy intakes during an ad libitum meal, higher BMI and greater adiposity among 4·5-year-old children: results from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort

Abstract

Faster eating rates are associated with increased energy intake, but little is known about the relationship between children's eating rate, food intake and adiposity. We examined whether children who eat faster consume more energy and whether this is associated with higher weight status and adiposity. We hypothesised that eating rate mediates the relationship between child weight and ad libitum energy intake. Children (n 386) from the Growing Up in Singapore Towards Healthy Outcomes cohort participated in a video-recorded ad libitum lunch at 4·5 years to measure acute energy intake. Videos were coded for three eating-behaviours (bites, chews and swallows) to derive a measure of eating rate (g/min). BMI and anthropometric indices of adiposity were measured. A subset of children underwent MRI scanning (n 153) to measure abdominal subcutaneous and visceral adiposity. Children above/below the median eating rate were categorised as slower and faster eaters, and compared across body composition measures. There was a strong positive relationship between eating rate and energy intake (r 0·61, P<0·001) and a positive linear relationship between eating rate and children's BMI status. Faster eaters consumed 75 % more energy content than slower eating children (Δ548 kJ (Δ131 kcal); 95 % CI 107·6, 154·4, P<0·001), and had higher whole-body (P<0·05) and subcutaneous abdominal adiposity (Δ118·3 cc; 95 % CI 24·0, 212·7, P=0·014). Mediation analysis showed that eating rate mediates the link between child weight and energy intake during a meal (b 13·59; 95 % CI 7·48, 21·83). Children who ate faster had higher energy intake, and this was associated with increased BMI z-score and adiposity.

Keywords: BMI z BMI z-score; SAT subcutaneous adipose tissue; VA visceral adipose tissue; Adiposity; Childhood obesity; Children; Eating rate; Energy intake; Mastication.

Figure 1

Relationship between eating rate and energy consumed during lunch (Pearson’s r; p<0.001; N=386).

Figure 2

Simple slopes analysis representing the moderating effects of time spent eating on the relationship between eating rate (z-scores) and energy consumed during lunch (N=386). The four groups represent active mealtime quartiles from 1 (shortest time spent eating) to 4 (longest time spent eating). The following cut-offs were used: 1 (<11.6 minutes), 2 (11.6<15.01 minutes), 3 (15.01<18.8 minutes), 4 (≥18.8 minutes). Interaction 1 (β= 18.26, p<0.001, 95%CI [11.11, 25.42]). Interaction 2 (β=31.99, p<0.001, 95%CI [26.98, 37.00]). Interaction 3 (β= 28.81, p<0.001 95%CI [21.75, 35.87]). Interaction 4 (β=40.18, p<0.001, 95%CI [26.78, 53.58]).

Figure 3

Energy consumed during lunch by children in the slower and faster eating group (adjusted for sex and ethnicity, mean ± SEM; p<0.001; N=386).

Figure 4

(a, b) Group differences in eating rate between children classified as healthy weight (n= 347) and overweight (n= 31) by BMI status (a) and three groups of children classified as lower (n=194) and upper range (n=153) of healthy weight and overweight (n= 31), by BMI status (Adjusted Mean ± SEM). *p<0.05;**p<0.01 ns= non-significant.

Figure 5

Differences between slower (n= 88) and faster eaters (n= 65) in subcutaneous (SAT) and visceral adiposity (VA) in the abdominal area (Means ± SEM). *p<0.05

Figure 6

Model of children’s BMI as a predictor of energy consumed mediated by eating rate (n=378).