title: Validation of the Children's Eating Behavior Questionnaire in 3 year old children of a multi-ethnic Asian population: The GUSTO cohort study.
abstract: The Children's Eating Behaviour Questionnaire (CEBQ) was developed to measure eating behaviors related to obesity risk in children. However, this questionnaire has not been validated for use in South East Asia, where parenting practices are different from those in western countries and child obesity rates are increasing. The aim of this study was to examine the validity of the CEBQ administered to mothers of children aged 3 years in Singapore. Confirmatory factor analysis (CFA) was used to examine if the original 35-item, 8-factor model was supported in our cohort. Participants were 636 mother-child dyads (mean (SD) child age = 36.7 (1.6) months), from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort in which the mothers were characterized in pregnancy and children were followed up to age 3 years. The CFA showed a poor model fit; RMSEA = 0.072 (PCLOSE<0.001), SRMR = 0.094, CFI = 0.826, and TLI = 0.805. Exploratory factor analysis revealed a 35 item, 7-factor structure (factor loadings ≥ 0.35): enjoyment of food, food fussiness, emotional overeating, desire to drink, emotional under eating, satiety responsiveness and slowness in eating. Cronbach's alpha estimates ranged from 0.70 to 0.88 for the 7 subscales. Convergent validity tests via correlation analysis revealed that emotional under eating (r = -0.14), slowness in eating (r = -0.16) and satiety responsiveness (r = -0.11) were negatively correlated with BMI z-score at 3 years, while enjoyment of food (r = 0.12) was positively correlated, p < 0.05. In conclusion, we found a revised 7-factor structure of the CEBQ more appropriate for examining eating behavior in 3 year old children in the Singapore setting. Further replication studies in a separate cohort study are warranted before further use of these factor structures generated.
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore.
authors.forename: Phaik Ling
authors.initials: PL
authors.lastname: Quah
authors.affiliation: Center for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore; Department for International Health, University of Tampere, Finland.
authors.forename: Yin Bun
authors.initials: YB
authors.lastname: Cheung
authors.affiliation: Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
authors.forename: Wei Wei
authors.initials: WW
authors.lastname: Pang
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore.
authors.forename: Jia Ying
authors.initials: JY
authors.lastname: Toh
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Duke-NUS Graduate Medical School, Lee Kong Chian School of Medicine, Singapore; Department of Paediatrics, KK Women's and Children's Hospital, Singapore.
authors.forename: Fabian
authors.initials: F
authors.lastname: Yap
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
authors.forename: Yap Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore. Electronic address: ephmcff@nus.edu.sg.
authors.forename: Chong Foong-Fong
authors.initials: CF
authors.lastname: Mary
mesh_terms: D044466:Asian People / Q000208:ethnology / Q000523:psychology*; D015992:Body Mass Index; D002652:Child Behavior / Q000523:psychology*; D002675:Child, Preschool; D015331:Cohort Studies; D005006:Ethnicity / Q000523:psychology; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006801:Humans; D006963:Hyperphagia / Q000208:ethnology / Q000523:psychology; D008297:Male; D009035:Mothers / Q000523:psychology*; D011594:Psychometrics; D015203:Reproducibility of Results; D012527:Satiation; D012846:Singapore; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Children's eating behavior questionnaire; Confirmatory factor analysis; Exploratory factor analysis