Associations between eating behaviours and cardiometabolic risk among adolescents in the Health Outcomes and Measures of the Environment study

Abstract

Background: Eating behaviours are associated with childhood obesity, but their associations with cardiometabolic risk are less clear.

Objectives: We evaluated cross-sectional associations between eating behaviours and cardiometabolic risk among 185 adolescents (age 12.4 ± 0.7 years; 53% female; body mass index (BMI)-z 0.72 ± 1.37) from Cincinnati, Ohio (HOME Study; enrolled 2003-2006).

Methods: Caregivers assessed adolescents' eating behaviours with the Child Eating Behaviour Questionnaire. We computed adolescents' cardiometabolic risk scores based on HOMA-IR, triglycerides to high-density lipoprotein cholesterol ratio, adiponectin to leptin ratio, systolic blood pressure, and cross-sectional area of fat inside the abdominal cavity. Using multivariable linear regression models, we estimated associations of eating behaviour subscales with cardiometabolic risk scores or individual risk components.

Results: Emotional overeating (ß = 1.34, 95% CI: 0.67, 2.01), food responsiveness (ß = 0.99, 95% CI: 0.41, 1.57), and emotional undereating (ß = 0.64, 95% CI: 0.08, 1.21) were associated with higher cardiometabolic risk scores. Satiety responsiveness (ß = -0.79, 95% CI: -1.59, 0.00) was associated with lower cardiometabolic risk scores. Adjusting for adolescent BMI-z at age 12 attenuated these associations, suggesting that adiposity may mediate these associations.

Conclusion: Hedonistic eating behaviours were associated with higher cardiometabolic risk in these adolescents.

Keywords: adolescents; cardiometabolic risk; eating behaviours; epidemiology; prevention.

Figure 1.

Participant flow diagram.

Figure 2:

Adjusted differences in cardiometabolic risk scores and individual components with a 1-unit increase in the Child Eating Behavior Questionnaire subscales: The HOME Study (N=185). From multivariable linear regressions adjusted for adolescent age, sex, race/ethnicity, pubic hair stage, depression, physical activity, maternal age, maternal income, and gestational serum cotinine concentrations. HOMA-IR, triglycerides to HDL ratio, leptin to adiponectin ratio, and cross-sectional area of fat inside the abdominal cavity had right-skewed distributions and were log₂-transformed in the models. Results are presented as ß values and respective 95% confidence intervals. CEBQ: Child Eating Behavior Questionnaire. CM: cardiometabolic. Visceral fat: cross-sectional area of fat inside the abdominal cavity (cm²). HOMA-IR: homeostatic model assessment of insulin resistance. HDL: high-density lipoprotein cholesterol. SBP: systolic blood pressure. FR: food responsiveness. EF: enjoyment of food. EOE: emotional overeating. DD: desire to drink. SR: satiety responsiveness. SE: slowness in eating. EUE: emotional undereating. FF: food fussiness.

Figure 3.

Adjusted differences in cardiometabolic risk scores with a 1-unit increase in the Child Eating Behavior Questionnaire subscales: The HOME Study (N=185). Model 1 (left panel) adjusted for adolescent age, sex, race/ethnicity, pubic hair stage, depression, physical activity, maternal age, maternal income, and gestational serum cotinine concentrations. We further adjusted for adolescent body mass index (age- and sex-standardized BMI z-scores) at age 12 years (middle panel) or age 8 years (right panel) to examine potential mediation by adolescent BMI. CEBQ: Child Eating Behavior Questionnaire. CM: cardiometabolic. FR: food responsiveness. EF: enjoyment of food. EOE: emotional overeating. DD: desire to drink. SR: satiety responsiveness. SE: slowness in eating. EUE: emotional undereating. FF: food fussiness. Results are presented as ß values and 95% confidence intervals.