title: The association of early childhood cognitive development and behavioural difficulties with pre-adolescent problematic eating attitudes.
abstract: OBJECTIVE
  Few studies have prospectively investigated associations of child cognitive ability and behavioural difficulties with later eating attitudes. We investigated associations of intelligence quotient (IQ), academic performance and behavioural difficulties at 6.5 years with eating attitudes five years later.
  
  
  METHODS
  We conducted an observational cohort study nested within the Promotion of Breastfeeding Intervention Trial, Belarus. Of 17,046 infants enrolled at birth, 13,751 (80.7%) completed the Children's Eating Attitude Test (ChEAT) at 11.5 years, most with information on IQ (n = 12,667), academic performance (n = 9,954) and behavioural difficulties (n = 11,098) at 6.5 years. The main outcome was a ChEAT score ≥ 85th percentile, indicative of problematic eating attitudes.
  
  
  RESULTS
  Boys with higher IQ at 6.5 years reported fewer problematic eating attitudes, as assessed by ChEAT scores ≥ 85th percentile, at 11.5 years (OR per SD increase in full-scale IQ = 0.87; 0.79, 0.94). No such association was observed in girls (1.01; 0.93, 1.10) (p for sex-interaction = 0.016). In both boys and girls, teacher-assessed academic performance in non-verbal subjects was inversely associated with high ChEAT scores five years later (OR per unit increase in mathematics ability = 0.88; 0.82, 0.94; and OR per unit increase in ability for other non-verbal subjects = 0.86; 0.79, 0.94). Behavioural difficulties were positively associated with high ChEAT scores five years later (OR per SD increase in teacher-assessed rating = 1.13; 1.07, 1.19).
  
  
  CONCLUSIONS
  Lower IQ, worse non-verbal academic performance and behavioural problems at early school age are positively associated with risk of problematic eating attitudes in early adolescence.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Richmond
authors.affiliation: Psychiatry and Medical Psychology Department, Belarussian State Medical University, Minsk, Belarus.
authors.forename: Oleg
authors.initials: O
authors.lastname: Skugarevsky
authors.affiliation: Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada.
authors.forename: Seungmi
authors.initials: S
authors.lastname: Yang
authors.affiliation: Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kramer
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom.
authors.forename: Kaitlin H
authors.initials: KH
authors.lastname: Wade
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Rita
authors.initials: R
authors.lastname: Patel
authors.affiliation: The National Research and Applied Medicine Mother and Child Centre, Minsk, Belarus.
authors.forename: Natalia
authors.initials: N
authors.lastname: Bogdanovich
authors.affiliation: The National Research and Applied Medicine Mother and Child Centre, Minsk, Belarus.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Vilchuck
authors.affiliation: The National Research and Applied Medicine Mother and Child Centre, Minsk, Belarus.
authors.forename: Natalia
authors.initials: N
authors.lastname: Sergeichick
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom.
authors.forename: George Davey
authors.initials: GD
authors.lastname: Smith
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and the Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America.
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom; MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom; National Institute of Health Research (NIHR) Bristol Biomedical Research Unit in Nutrition, University Hospitals Bristol NHS Trust and University of Bristol, Bristol, United Kingdom.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Martin
mesh_terms: D001290:Attitude; D002648:Child; D002657:Child Development; D002986:Clinical Trials as Topic; D003071:Cognition; D015331:Cohort Studies; D004435:Eating / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008137:Longitudinal Studies; D008297:Male
references.citation: Nutr Res Rev. 2009 Dec;22(2):220-43
references.pmid: 19930787
references.citation: Int J Epidemiol. 2014 Aug;43(4):1263-71
references.pmid: 24706729
references.citation: Int J Eat Disord. 2008 Nov;41(7):626-34
references.pmid: 18454484
references.citation: CMAJ. 2004 May 11;170(10):1559-61
references.pmid: 15136549
references.citation: Int J Epidemiol. 2014 Jun;43(3):679-90
references.pmid: 23471837
references.citation: J Dev Behav Pediatr. 2011 Oct;32(8):572-80
references.pmid: 21918471
references.citation: Eur Eat Disord Rev. 2011 Jul-Aug;19(4):322-30
references.pmid: 20672250
references.citation: Int J Eat Disord. 1997 Apr;21(3):273-8
references.pmid: 9097200
references.citation: Am J Health Behav. 2011 Jan-Feb;35(1):92-104
references.pmid: 20950162
references.citation: Lancet. 2003 Feb 1;361(9355):407-16
references.pmid: 12573387
references.citation: Psychother Psychosom Med Psychol. 2005 Jul;55(7):331-8
references.pmid: 15986283
references.citation: J Neuropsychol. 2010 Mar;4(Pt 1):89-106
references.pmid: 19619407
references.citation: PLoS One. 2012;7(1):e28331
references.pmid: 22253689
references.citation: BMJ. 1999 Mar 20;318(7186):765-8
references.pmid: 10082698
references.citation: Arch Gen Psychiatry. 2008 May;65(5):578-84
references.pmid: 18458209
references.citation: Pediatrics. 1989 Sep;84(3):482-9
references.pmid: 2788865
references.citation: Eat Behav. 2007 Apr;8(2):224-35
references.pmid: 17336792
references.citation: Appetite. 2012 Dec;59(3):679-87
references.pmid: 22885453
references.citation: J Am Acad Child Adolesc Psychiatry. 1988 Sep;27(5):541-3
references.pmid: 3182615
references.citation: Am J Health Behav. 2006 Mar-Apr;30(2):115-24
references.pmid: 16533096
references.citation: J Pediatr Gastroenterol Nutr. 1998 Aug;27(2):143-7
references.pmid: 9702643
references.citation: Int J Eat Disord. 2005;37 Suppl:S72-6; discussion S87-9
references.pmid: 15852325
references.citation: Neuropsychol Rev. 2004 Jun;14(2):99-113
references.pmid: 15264711
references.citation: J Adolesc. 1999 Jun;22(3):389-96
references.pmid: 10462429
references.citation: Int J Eat Disord. 1994 Nov;16(3):275-82
references.pmid: 7833961
references.citation: J Am Acad Child Adolesc Psychiatry. 1990 Jan;29(1):112-7
references.pmid: 2295562
references.citation: Int J Eat Disord. 2007 Jul;40(5):435-40
references.pmid: 17497707
references.citation: Int J Eat Disord. 2000 Jul;28(1):33-42
references.pmid: 10800012
references.citation: J Am Acad Child Adolesc Psychiatry. 2001 Dec;40(12):1434-40
references.pmid: 11765289
references.citation: Pediatrics. 2008 Mar;121(3):e435-40
references.pmid: 18310164
references.citation: J Am Coll Nutr. 2011 Apr;30(2):126-33
references.pmid: 21730220
references.citation: Nutr Diabetes. 2014 Jan 06;4:e100
references.pmid: 24394456
references.citation: CMAJ. 2001 Sep 4;165(5):547-52
references.pmid: 11563206
references.citation: J Child Psychol Psychiatry. 1995 Feb;36(2):191-202
references.pmid: 7759586
references.citation: Eur Child Adolesc Psychiatry. 2008 Dec;17 Suppl 1:82-91
references.pmid: 19132307
references.citation: Ann Gen Psychiatry. 2010 Dec 23;9:40
references.pmid: 21182794
references.citation: MedGenMed. 2004 Sep 27;6(3):49
references.pmid: 15520673
references.citation: Eur Child Adolesc Psychiatry. 1998 Sep;7(3):125-30
references.pmid: 9826298
references.citation: JAMA. 2001 Jan 24-31;285(4):413-20
references.pmid: 11242425
references.citation: J Health Psychol. 2006 Jul;11(4):567-76
references.pmid: 16769736