Associations between environmental factors and childhood eating behaviours in 5-year-old children: findings from the ROLO longitudinal birth cohort study

Introduction: Environmental factors contribute to the development of childhood eating behaviours. The evidence suggests that children from more disadvantaged backgrounds are at higher risk of overweight and obesity. The aim of the current study is to investigate how various environmental elements such as maternal socio‐economic status, education level and childcare exposure are associated with both food approach and food avoidant eating behaviours in children aged 5 years old. Methods: Data was collected as part of the secondary analysis of the ROLO (randomised control trial of low glycemic index diet) longitudinal birth cohort study. The ROLO mothers and their children were followed up at multiple timepoints since birth. At the 5 year follow up, childhood eating behaviours were measured using the Children's Eating Behavior Questionnaire (CEBQ). Socio‐economic status (SES) was measured using maternal education level and neighborhood deprivation. Lifestyle questionnaires were used to obtain information on childcare attendance and exposure at 5 years old. Statistical analysis was completed to determine associations between maternal SES, education level, childcare exposure and children's eating behaviours. Results: In the current analysis, 401 mother and child pairs were included, with CEBQ data available for n=306. Of these, 23% of children had a BMI in the overweight or obese range. Maternal data indicated 51% of mothers were considered in the highest SES group. A significant difference was observed between BMI of mothers from the highest SES group to those in the lower SES groups (p=0.003). Childcare was availed of by 89% of the cohort, with the median childcare exposure being 4.1 years. No associations were seen between Food approach eating behaviours and maternal SES or education level. However, children whose mothers were of lower SES had lower food fussiness scores compared to those in the highest SES category (B=‐2.717; CI‐5.063,‐0.372; p=0.023). Increased childcare exposure (years) was positively associated with food responsiveness (B=0.451; CI 0.032,0.872; p=0.035) and emotional overeating (0.272, CI 0.061,0.482; p=0.012), having adjusted for confounders. Conclusion: In this study, childhood eating behaviours were inversely associated with maternal SES, but this was more evident in food avoidant eating behaviours than food approach eating behaviours. Our findings suggest that longer exposure to childcare is positively associated with emotional overeating and food responsiveness. This indicates the importance of instilling healthy eating behaviours in settings both at home and outside the home.