title: Prospective associations between problematic eating attitudes in midchildhood and the future onset of adolescent obesity and high blood pressure.
abstract: Clinically diagnosed eating disorders may have adverse cardiometabolic consequences, including overweight or obesity and high blood pressure. However, the link between problematic eating attitudes in early adolescence, which can lead to disordered eating behaviors, and future cardiometabolic health is, to our knowledge, unknown.
  
  
  
  We assessed whether variations in midchildhood eating attitudes influence the future development of overweight or obesity and high blood pressure.
  
  
  
  Of 17,046 children who participated in the Promotion of Breastfeeding Intervention Trial (PROBIT), we included 13,557 participants (79.5% response rate) who completed the Children's Eating Attitudes Test (ChEAT) at age 11.5 y and in whom we measured adiposity and blood pressure at ages 6.5, 11.5, and 16 y. We assessed whether ChEAT scores ≥85th percentile (indicative of problematic eating attitudes) compared with scores <85th percentile at age 11.5 y were associated with new-onset overweight, obesity, high systolic blood pressure, or high diastolic blood pressure between midchildhood and early adolescence.
  
  
  
  After controlling for baseline sociodemographic confounders, we observed positive associations of problematic eating attitudes at age 11.5 y with new-onset obesity (OR: 2.18; 95% CI: 1.58, 3.02), new-onset high systolic blood pressure (OR: 1.34; 95% CI: 1.05, 1.70), and new-onset high diastolic blood pressure (OR: 1.25; 95% CI: 0.99, 1.58) at age 16 y. After further controlling for body mass index at age 6.5 y, problematic eating attitudes remained positively associated with new-onset obesity (OR: 1.80; 95% CI: 1.28, 2.53); however, associations with new-onset high blood pressure were attenuated (OR: 1.14; 95% CI: 0.89, 1.45 and OR: 1.09; 95% CI: 0.86, 1.39 for new-onset systolic and diastolic blood pressure, respectively).
  
  
  
  Problematic eating attitudes in midchildhood seem to be related to the development of obesity in adolescence, a relatively novel observation with potentially important public health implications for obesity control. PROBIT was registered at clinicaltrials.gov as NCT01561612 and isrctn.com as ISRCTN37687716.
authors.affiliation: School of Social and Community Medicine, Faculty of Health Sciences, kaitlin.wade@bristol.ac.uk.|Medical Research Council Integrative Epidemiology Unit, and.
authors.forename: Kaitlin H
authors.initials: KH
authors.lastname: Wade
authors.affiliation: Departments of Pediatrics and.|Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Quebec, Canada.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kramer
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.affiliation: School of Social and Community Medicine, Faculty of Health Sciences.|Medical Research Council Integrative Epidemiology Unit, and.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Timpson
authors.affiliation: Department of Psychiatry and Medical Psychology, Belarusian State Medical University, Minsk, Belarus; and.
authors.forename: Oleg
authors.initials: O
authors.lastname: Skugarevsky
authors.affiliation: School of Social and Community Medicine, Faculty of Health Sciences.
authors.forename: Rita
authors.initials: R
authors.lastname: Patel
authors.affiliation: National Research and Applied Medicine Mother and Child Centre, Minsk, Belarus.
authors.forename: Natalia
authors.initials: N
authors.lastname: Bogdanovich
authors.affiliation: National Research and Applied Medicine Mother and Child Centre, Minsk, Belarus.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Vilchuck
authors.affiliation: School of Social and Community Medicine, Faculty of Health Sciences.|Medical Research Council Integrative Epidemiology Unit, and.
authors.forename: George
authors.initials: G
authors.lastname: Davey Smith
authors.affiliation: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Thompson
authors.affiliation: School of Social and Community Medicine, Faculty of Health Sciences.|Medical Research Council Integrative Epidemiology Unit, and.|University Hospitals Bristol National Health Service Foundation Trust, National Institute for Health Research Bristol Nutrition Biomedical Research Unit, University of Bristol, Bristol, United Kingdom.
authors.forename: Richard M
authors.identifier: 0000-0002-7992-7719
authors.initials: RM
authors.lastname: Martin
mesh_terms: D050154:Adiposity; D000293:Adolescent; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D016000:Cluster Analysis; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D015999:Multivariate Analysis; D050177:Overweight / Q000175:diagnosis / Q000523:psychology; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: adiposity; adolescents; blood pressure; problematic eating attitudes; prospective