title: A description of an 'obesogenic' eating style that promotes higher energy intake and is associated with greater adiposity in 4.5year-old children: Results from the GUSTO cohort.
abstract: Recent findings confirm that faster eating rates support higher energy intakes within a meal and are associated with increased body weight and adiposity in children. The current study sought to identify the eating behaviours that underpin faster eating rates and energy intake in children, and to investigate their variations by weight status and other individual differences. Children (N=386) from the Growing Up in Singapore towards Healthy Outcomes (GUSTO) cohort took part in a video-recorded ad libitum lunch at 4.5years of age 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) and measures of eating microstructure: eating rate (g/min), total oral exposure (min), average bite size (g/bite), chews per gram, oral exposure per bite (s), total bites and proportion of active to total mealtime. Children's BMIs were calculated and a subset of children underwent MRI scanning to establish abdominal adiposity. Children were grouped into faster and slower eaters, and into healthy and overweight groups to compare their eating behaviours. Results demonstrate that faster eating rates were correlated with larger average bite size (r=0.55, p<0.001), fewer chews per gram (r=-0.71, p<0.001) and shorter oral exposure time per bite (r=-0.25, p<0.001), and with higher energy intakes (r=0.61, p<0.001). Children with overweight and higher adiposity had faster eating rates (p<0.01) and higher energy intakes (p<0.01), driven by larger bite sizes (p<0.05). Eating behaviours varied by sex, ethnicity and early feeding regimes, partially attributable to BMI. We propose that these behaviours describe an 'obesogenic eating style' that is characterised by faster eating rates, achieved through larger bites, reduced chewing and shorter oral exposure time. This obesogenic eating style supports acute energy intake within a meal and is more prevalent among, though not exclusive to, children with overweight. Clinical Trial Registry Number: NCT01174875; https://clinicaltrials.gov/.
authors.affiliation: Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.
authors.forename: Anna
authors.initials: A
authors.lastname: Fogel
authors.affiliation: Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.
authors.forename: Ai Ting
authors.initials: AT
authors.lastname: Goh
authors.affiliation: Nestle Research Center, Lausanne, Switzerland.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Fries
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Singapore.
authors.forename: Suresh Anand
authors.initials: SA
authors.lastname: Sadananthan
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Singapore; Singapore Bio-Imaging Consortium, A*STAR, Singapore.
authors.forename: S Sendhil
authors.initials: SS
authors.lastname: Velan
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Singapore.
authors.forename: Navin
authors.initials: N
authors.lastname: Michael
authors.affiliation: Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Mya Thway
authors.initials: MT
authors.lastname: Tint
authors.affiliation: Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore.
authors.forename: Marielle Valerie
authors.initials: MV
authors.lastname: Fortier
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Singapore.
authors.forename: Mei Jun
authors.initials: MJ
authors.lastname: Chan
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Singapore.
authors.forename: Jia Ying
authors.initials: JY
authors.lastname: Toh
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: KK Women's and Children's Hospital, Singapore.
authors.forename: Kok Hian
authors.initials: KH
authors.lastname: Tan
authors.affiliation: KK Women's and Children's Hospital, Singapore.
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Lynette P
authors.initials: LP
authors.lastname: Shek
authors.affiliation: Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Douglas Mental Health University Institute, McGill University, Montréal, Canada.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Meaney
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore.
authors.forename: Birit F P
authors.initials: BFP
authors.lastname: Broekman
authors.affiliation: Singapore Institute for Clinical Sciences, A*STAR, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Yung Seng
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Mary Foong Fong
authors.initials: MFF
authors.lastname: Chong
authors.affiliation: Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: ciaran_forde@sics.a-star.edu.sg.
authors.forename: Ciarán G
authors.initials: CG
authors.lastname: Forde
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D050154:Adiposity; D000886:Anthropometry; D015992:Body Mass Index; D002675:Child, Preschool; D002149:Energy Intake / Q000502:physiology*; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D005518:Food Preferences / Q000523:psychology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009765:Obesity / Q000503:physiopathology* / Q000523:psychology*; D010287:Parent-Child Relations; D063766:Pediatric Obesity / Q000523:psychology*; D013997:Time Factors; D055698:Touch Perception