Associations between dietary patterns, eating behaviours, and body composition and adiposity in 3-year-old children of mothers with obesity

Background: The relationships between eating habits, behaviours, and the development of obesity in preschool children is not well established. Objective: As children of mothers with obesity are themselves at risk of obesity, we examined these relationships in a cohort of 482 three-year-old children of mothers with obesity from the UK Pregnancy Better Eating and Activity Trial (UPBEAT). Method: Dietary patterns were derived using factor analysis of an 85-item food frequency questionnaire (FFQ). Eating behaviours were assessed using the Children's Eating Behaviour Questionnaire (CEBQ). Measures of body composition included age-specific BMI cut-offs, WHO z scores, sum of skinfolds, waist and arm circumferences, and body fat percentage. Using adjusted regression analysis, we examined associations between dietary patterns, eating behaviours, and measures of body composition. Results: Three distinct dietary patterns were defined: “healthy/prudent,” “African/Caribbean,” and “processed/snacking.” The “processed/snacking” pattern was associated with greater odds of obesity; OR 1.53 (95% CI, 1.07-2.19). The “African/Caribbean” and the “healthy/prudent” patterns were associated with a lower arm circumference (β = −0.23 cm [−0.45 to −0.01]) and sum of skinfolds (β = −1.36 cm [−2.88 to −0.37]), respectively. Lower enjoyment of food and food responsiveness, and greater slowness in eating and satiety, were associated with lower arm and waist circumferences, WHO z scores, and obesity (all P <.05). Conclusion: In children of mothers with obesity, those who had higher scores on a “processed/snacking” dietary pattern had greater odds of obesity. In contrast, slowness in eating was associated with lower measures of body composition. These novel findings highlight modifiable behaviours in high-risk preschool children which could contribute to public health strategies for prevention of childhood obesity.