Weight problems that arise in the first years of life tend to persist. Behavioral research in this period can provide information on the modifiable etiology of unhealthy weight. The present study aimed to replicate findings from previous small-scale studies by examining whether different aspects of preschooler’s eating behavior and parental feeding practices are associated with body mass index (BMI) and weight status -including underweight, overweight and obesity- in a population sample of preschool children. Cross-sectional data on the Child Eating Behaviour Questionnaire, Child Feeding Questionnaire and objectively measured BMI was available for 4987 four-year-olds participating in a population-based cohort in the Netherlands. Thirteen percent of the preschoolers had underweight, 8% overweight, and 2% obesity. Higher levels of children’s Food Responsiveness, Enjoyment of Food and parental Restriction were associated with a higher mean BMI independent of measured confounders. Emotional Undereating, Satiety Responsiveness and Fussiness of children as well as parents’ Pressure to Eat were negatively related with children’s BMI. Similar trends were found with BMI categorized into underweight, normal weight, overweight and obesity. Part of the association between children’s eating behaviors and BMI was accounted for by parental feeding practices (changes in effect estimates: 20-43%), while children’s eating behaviors in turn explained part of the relation between parental feeding and child BMI (changes in effect estimates: 33-47%). This study provides important information by showing how young children’s eating behaviors and parental feeding patterns differ between children with normal weight, underweight and overweight. The high prevalence of under- and overweight among preschoolers suggest prevention interventions targeting unhealthy weights should start early in life. Although longitudinal studies are necessary to ascertain causal directions, efforts to prevent or treat unhealthy child weight might benefit from a focus on changing the behaviors of both children and their parents.

Bullying and victimization are widespread phenomena in childhood and can have a serious impact on well-being. Children from families with a low socioeconomic background have an increased risk of this behaviour, but it is unknown whether socioeconomic status (SES) of school neighbourhoods is also related to bullying behaviour. Furthermore, as previous bullying research mainly focused on older children and adolescents, it remains unclear to what extent bullying and victimization affects the lives of younger children. The aim of this study is to examine the prevalence and socioeconomic disparities in bullying behaviour among young elementary school children.

Background: Parental feeding practices are associated with children’s body mass index (BMI). It has been generally assumed that parental feeding dete

Definitions and assessment methods of fussy/picky eating are heterogeneous and remain unclear. We aimed to identify an eating behavior profile reflecting fussy/picky eating in children and to describe characteristics of fussy eaters. Eating behavior was assessed with the Child Eating Behavior Questionnaire (CEBQ) in 4914 4-year olds in a population-based birth cohort study. Latent Profile Analysis (LPA) was used to identify eating behavior profiles based on CEBQ subscales. We found a “fussy” eating behavior profile (5.6% of children) characterized by high food fussiness, slowness in eating, and satiety responsiveness in combination with low enjoyment of food and food responsiveness. Fussy eaters were more often from families with low household income than non-fussy eaters (42% vs. 31.8% respectively; Χ ² (1) = 9.97, p < .01). When they were 14 months old, fussy eaters had a lower intake of vegetables (t [3008] = 2.42, p < .05) and fish (t [169.77] = 2.40, p < .05) but higher intake of savory snacks (t [153.69] = -2.03, p < .05) and sweets (t [3008] = -2.30, p < .05) compared to non-fussy eaters. Also, fussy eaters were more likely to be underweight at 4 years of age (19.3%) than non-fussy eaters (12.3%; Χ ² (1) = 7.71, p < .01). A distinct fussy eating behavior profile was identified by LPA, which was related to family and child characteristics, food intake, and BMI. This behavior profile might be used in future research and the development of interventions.

Fussy eating is common in young children, often raising concerns among parents. The use of pressuring feeding practices may provoke or worsen child fussiness, but these practices could equally be a parent's response to child fussy eating. In longitudinal analyses, we assessed directionality in the relation between fussy eating and parent's pressure to eat across childhood. Study participants were 4845 mother-child dyads from the population-based Generation R cohort in the Netherlands. The Child Behavior Checklist was used to assess fussy eating (2 items) at child ages 1½, 3 and 6years. Parents' pressure to eat was assessed with the Child Feeding Questionnaire (4 items) when children were 4years old. All scale scores were standardized. Linear regression analyses indicated that preschoolers' fussy eating prospectively predicted higher levels of parents' pressure to eat at child age 4years, independently of confounders (adjusted B=0.24, 95% CI: 0.21, 0.27). Pressure to eat at 4years also predicted more fussiness in children at age 6years, independently of confounders and of fussy eating at baseline (adjusted B=0.14, 95% CI: 0.11, 0.17). Path analyses indicated that the relation from fussy eating at 3years to parenting one year later was stronger than from pressure at 4years to fussy eating two years later (p<0.001). Our findings suggest bi-directional associations with parental pressuring feeding strategies being developed in response to children's food avoidant behaviors, but also seemingly having a counterproductive effect on fussiness. Thus, the use of pressure to eat should be reconsidered, while providing parents alternative techniques to deal with their child's fussy eating.

Although many cross-sectional studies reported that children with overweight or obesity show more food approaching and less food avoidant eating behaviors, there is a lack of replication in longitudinal studies. Therefore, the question remains whether healthcare professionals should target eating behaviors in childhood obesity interventions and prevention. We aimed to examine the longitudinal and possible bi-directional associations between eating behavior and body composition across childhood. Data was included from 3331 children participating in the Generation R Study. At 4 and 10 years, mothers reported on the Child Eating Behavior Questionnaire including the subscales Food Responsiveness, Enjoyment of Food, Emotional Overeating and Satiety Responsiveness, and children’s BMI was measured. Body composition, consisting of Fat Mass Index and Fat Free Mass Index was measured at 6 and 10 years with Dual-energy-X-ray-Absorptiometry scans. Cross-lagged models including both directions of the BMI – eating behavior association showed that a higher BMI at the age of 4 years predicted more food responsiveness and enjoyment of food and less satiety responsiveness at 10 years (e.g. satiety responsiveness:β = − 0.10, 95% CI = − 0.14, − 0.07), but no associations were found in the opposite direction. For emotional overeating, however, a bi-directional association was found with BMI predicting more emotional eating and vice versa. Multivariable linear regression analyses showed that associations were stronger for Fat Mass Index than for Fat Free Mass Index. Results showed that a higher BMI, and particularly higher fat mass, at pre-school age predicted more food approaching and less food avoidant eating behaviors at the age of 10 years, rather than the hypothesized reverse direction. This suggests that increased adiposity in early childhood might upregulate appetite and related eating behaviors.