Young children who went for sweet cookies rather than salty chips or puffs were one of many metrics examined in a new study that looked at eating in the absence of hunger (EAH) in children under three-years-old. The study, “Eating in the Absence of Hunger and Weight Gain in Low-income Toddlers”, was carried out by researchers from C.S. Mott Children’s Hospital at the University of Michigan and sought to overcome previous gaps in EAH research.
Although EAH is known to be linked with childhood obesity, past research has several gaps that the study’s authors felt needed to be addressed: Basically, although EAH is known to play a role in childhood obesity, no one before now has sought to see if EAH can be seen in toddlers (past research covers ages three to 13).
Low-income and non-white groups are also underrepresented in EAH research, which is important since these groups are disproportionately affected by childhood obesity.
Lastly, there is minimal research available that looks at how associations between EAH and body fat gain can be affected by the type of food being eaten.
The Mott research team sought to tackle these gaps and devised a study with the following objectives:
- Identify possible predictors of EAH in low-income toddlers
- Describe the affect (mood) of the child during EAH
- Test whether EAH in toddlers could be a predictor of body mass index (BMI)
- Examine if the type of food eaten during periods of EAH can be used to predict BMI impact
The Mott Study: Summary
- The study looked at 209 low-income children between ages 21 and 27 months with mothers who were at least 18-years-old and lacked a four-year college education or higher. The child had to have no pre-existing food allergies or other health problems
- Data collections were performed at 21, 27, and 33 months of age, with each collection taking five days
- Among various metrics that were evaluated were gender, child age, maternal age, family structure, family chaos, ethnicity, food security, maternal BMI, and maternal depression
- An EAH test was also performed on the last day of each collection. During the test, the child fasted for an hour and was fed a filling lunch. The child was then presented with a tray of cookies and chips and allowed to eat as much as they wanted. What was eaten was recorded and the child’s affect upon the presentation and removal of the food was also noted.
- None of the child, maternal, or family metrics showed correlations with the amount of salty chips that were consumed or how negatively a child reacted when the treats were removed
- Being a boy, an older child, and a higher maternal education were correlated with more EAH for sweets and a greater positive affect when the treat tray was first presented
- The sweets were associated with a higher impact on the children’s BMI increase than the salty foods
- The BMI increase associated with sweets was small but statistically significant
What This Means for Children and Why It Matters
The study is the first to look at EAH habits in children three years of age and younger. It suggests a link between EAH habits and weight gain can be present at an earlier age than current research proposes.
The study further suggests that EAH habits surrounding sweet foods rather than salty ones are a possible predictor of BMI.
Although a single study cannot be used to try and draw or generalize conclusions, it serves as a solid foundation that can be used to build further research and insights into early childhood eating habits and how they can impact childhood obesity.
Why this matters is relatively simple. It has been shown in previous research that behavioural interventions can help improve eating habits in children and mitigate the risk of childhood obesity.
Being able to identify earlier periods where obesity risk factors can be seen allows for interventions to get delivered sooner and maximize their possible effects.
Limitations of the Study
Although the first to cover EAH in toddlers, the study still has certain limits that need to be kept in mind. Most importantly is the fact that only about a third of the children were present for all three measurement periods.
This resulted in less data than initially hoped for and could impact the reliability of the findings. Additional factors that could have influenced the EAH behaviors include:
• The amount of sweet versus salty food on the treat tray (there were more sweet than salty options)
• The fact that the researcher presenting the tray ate a sweet food but not a salty one in front of the child (a measure taken to encourage them to eat from the tray)
• The fact that the researcher was present during the EAH test (which could have influenced behaviour)
Despite these issues, the Mott study is still an excellent first step into getting more understanding of what can influence childhood eating habits and by extension childhood obesity.
“Eating in the Absence of Hunger and Weight Gain in Low-income Toddlers” will be published in the May 2016 issue of the journal, Pediatrics.
Miller, A., et. al., “Eating in the Absence of Hunger and Weight Gain in Low-income Toddlers,” Pediatrics, 2016; 137(5):e20153786.
“Chips or cookies? Toddlers with sweet tooth more likely to experience weight gain,” University of Michigan Health System web site, April 18, 2016; http://www.uofmhealth.org/news/archive/201604/chips-or-cookies.