Brief parent-report measure of slowness in eating is associated with weight status in children with cystic fibrosis over a 3-year follow-up

Objective

Eating behaviors are potential targets to improve outcomes including metabolic health in those with CF. We aimed to test whether slowness in eating was associated with weight status over 3 year follow-up in children with CF, using the slowness in eating subscale from the Child Eating Behavior Questionnaire (CEBQ), a brief parent-report instrument.

Methods

Parents of 60 patients (mean age 7.7±3.2; 66.7% male) completed the CEBQ, including the 4-item subscale assessing slowness in eating (CEBQ-SE), during regular clinic hours, at study entry. Body Mass Index z-scores (BMIz) were calculated using anthropometric data collected at baseline and at 1, 2, and 3 year follow-up for use in Linear Mixed Models (LMM).

Results

Children’s CEBQ-SE scores were used to create 3 CEBQ-SE tertiles. Based on model estimates, at all time-points, the low CEBQ-SE tertile (fastest eaters) had a greater BMIz (Baseline: 0.46, Yr 1: 0.58; Yr 2: 0.64; Yr 3: 0.67) than both the medium CEBQ-SE tertile (Baseline: -0.09, Yr 1: -0.06, Yr 2: -0.03, Yr 3: -0.02) and high CEBQ-SE tertile (Baseline: -0.05, Yr 1: 0.08, Yr 2: 0.10, Yr 3: 0.01). Sensitivity analyses either omitting children who had ever used a gastric tube, or children who had never been on appetite-stimulating medication, demonstrated the utility of these interventions to promote reaching weight status goals, particularly for children with low BMIz and slow eating.

Conclusion

Low slowness in eating at baseline was associated with high BMIz 1, 2, and 3 years later in children with CF. The CEBQ-SE subscale could identify children who could benefit from early intervention to optimize weight status and eating behavior.