Food switching at a meal is positively associated with change in adiposity among children at high-familial risk for obesity

Abstract

Switching between different foods while eating has been positively associated with weight status and intake in children. Evidence suggests that switching behavior is consistent within children across meals, however, it is unclear how switching relates to changes in adiposity over time. In a 1-year longitudinal study, we assessed whether food switching predicted changes in fat mass index (FMI: fat mass kg/height m²) in 7–8-year-old children and tested if familial risk of obesity moderated this relationship. At baseline, seventy-four children without obesity (7.8 ± 0.6 y; 37F) consumed four ad libitum meals of varying portion sizes, each consisting of chicken nuggets, macaroni and cheese, grapes, and broccoli. For each child, the average number of food switches was calculated from video recordings across the four meals. To assess change in adiposity over time, children completed a dual energy x-ray absorptiometry scan for assessment of FMI at baseline and follow-up (≥1 year later). Familial risk of obesity was determined by maternal BMI (high-risk: ≥30 kg/m², n = 32 vs. low-risk: <25 kg/m², n = 42). Food switching at baseline was positively associated with changes in FMI over 1 year (p = 0.03). In addition to the 37% of variance in FMI change explained by known factors influencing adiposity, food switching accounted for an additional 4% of the variance (p = 0.03). Further, there was an interaction between familial risk status and food switching (p = 0.04) such that the relationship between switching and FMI change was only significant in high-risk children. Overall, children's food switching behavior assessed at laboratory meals predicted change in adiposity over 1 year. Food switching could be a behavioral marker for, and contribute to, pediatric obesity risk particularly in children with a familial predisposition.