Associations between pre-school children's eating behaviour traits and dietary quality, and the potential moderation of age on these associations

Pre-school children’s dietary intake in Australia is substandard, with only 18% of children aged 2–3 years meeting the recommended intake for vegetables, and more than one-third of their daily kilojoules coming from energy-dense, nutrient-poor foods. Several child eating behaviour traits (e.g., food fussiness, enjoyment of food, satiety responsiveness and food responsiveness) are associated with the dietary intake of pre-school children(1). However, the associations between child eating behaviour traits and overall dietary quality in pre-school children have not been examined, which is important as children do not consume food groups or nutrients in isolation. It is also important to understand how biological factors such as age may influence child eating behaviours, given that eating behaviour traits such as food fussiness can develop and change with age(2). Therefore, the aims of this study were to examine the associations between preschool children’s eating behaviour traits and their dietary quality and to examine the moderating effect of children’s age on these associations. Cross-sectional survey data was collected online from mothers of pre-school aged children (2–5 years) from across Australia. The Children’s Eating Behaviour Questionnaire (CEBQ) measured four child eating behaviour traits: food fussiness, enjoyment of food, food responsiveness and satiety responsiveness. A validated thirteen-item food frequency questionnaire measured child dietary quality; 5 items measured healthy foods/behaviours, and 8 measured discretionary foods/unhealthy behaviours, with a maximum score of 65(3). Linear regression assessed associations between child eating behaviour traits and dietary quality, including interactions between child eating behaviour traits and child age. Of the 1367 respondents, half of the children were male (50.2%) and the mean age of the children was 3.3 years (SD = 1.0). The mean child dietary quality score was 51.9 (out of 65, range 21 to 64). Enjoyment of food was positively associated with dietary quality (B coefficient: 2.51, p < 0.001), whilst food fussiness and satiety responsiveness were inversely associated with dietary quality (B coefficients: −2.59 and −2.25, respectively, p < 0.001), and food responsiveness was not related to diet quality. Child age moderated associations between food fussiness and dietary quality (B coefficient: −0.38, p = 0.025), but not the other eating behaviour traits. The difference in dietary quality between lower and higher food fussiness was most pronounced among 5-year-old children. In conclusion, the findings from this study suggests that future interventions targeting poor dietary quality of pre-school children should consider targeting children with lower food enjoyment or higher food fussiness or satiety as possible ways to improve child dietary quality. Future interventions should also have a particular focus on strategies to reduce food fussiness for older preschoolers, as well as fussiness prevention strategies for younger preschoolers.