Anne Tharner1, Pauline W Jansen2, Jessica C Kiefte-de Jong3, Henriette A Moll4, Albert Hofman3, Vincent W V Jaddoe5, Henning Tiemeier6, Oscar H Franco7. 1. Department of Epidemiology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands. Electronic address: a.tharner@erasmusmc.nl. 2. Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands; Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands. 3. Department of Epidemiology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands. 4. Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands. 5. Department of Epidemiology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands; Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands. 6. Department of Epidemiology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands; Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands. 7. Department of Epidemiology, Erasmus Medical Center, Erasmus University Rotterdam, Rotterdam, The Netherlands; Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.
Abstract
OBJECTIVE: To examine bidirectional associations between a child's fussy eating behavior and functional constipation. STUDY DESIGN: Participants were 4823 children enrolled in a prospective cohort study from pregnancy onward. We assessed fussy eating at age 4 years with the Child Eating Behavior Questionnaire, and assessed functional constipation using ROME II and III criteria with parental questionnaires at age 2, 3, 4, and 6 years. RESULTS: Higher food fussiness at age 4 years was associated with a greater risk of functional constipation at both 4 years (OR, 1.30; 95% CI, 1.20-1.42; P < .001 per 1 SD increase) and 6 years (OR, 1.12; 95% CI, 1.03-1.23; P < .05 per 1 SD increase). The converse was also observed; previous constipation predicted a greater risk of being a fussy eater at age 4 years (constipation at 2 years: OR, 2.05; 95% CI 1.43-2.94; P < .001; constipation at 3 years: OR, 1.72; 95% CI, 1.26-2.35, P < .001). Path analyses confirmed that the association between fussy eating and functional constipation was indeed bidirectional, showing that functional constipation at age 3 years predicted fussy eater classification at age 4 years (β = 0.06; P < .001), which in turn predicted functional constipation at age 6 years (β = 0.08: P < .001) independent of each other. CONCLUSION: A vicious cycle might develop in which children with functional constipation develop unhealthy eating behavior, which in turn increases the risk of functional gastrointestinal disease.
OBJECTIVE: To examine bidirectional associations between a child's fussy eating behavior and functional constipation. STUDY DESIGN:Participants were 4823 children enrolled in a prospective cohort study from pregnancy onward. We assessed fussy eating at age 4 years with the ChildEating Behavior Questionnaire, and assessed functional constipation using ROME II and III criteria with parental questionnaires at age 2, 3, 4, and 6 years. RESULTS: Higher food fussiness at age 4 years was associated with a greater risk of functional constipation at both 4 years (OR, 1.30; 95% CI, 1.20-1.42; P < .001 per 1 SD increase) and 6 years (OR, 1.12; 95% CI, 1.03-1.23; P < .05 per 1 SD increase). The converse was also observed; previous constipation predicted a greater risk of being a fussy eater at age 4 years (constipation at 2 years: OR, 2.05; 95% CI 1.43-2.94; P < .001; constipation at 3 years: OR, 1.72; 95% CI, 1.26-2.35, P < .001). Path analyses confirmed that the association between fussy eating and functional constipation was indeed bidirectional, showing that functional constipation at age 3 years predicted fussy eater classification at age 4 years (β = 0.06; P < .001), which in turn predicted functional constipation at age 6 years (β = 0.08: P < .001) independent of each other. CONCLUSION: A vicious cycle might develop in which children with functional constipation develop unhealthy eating behavior, which in turn increases the risk of functional gastrointestinal disease.
Authors: Pauline W Jansen; Lisanne M de Barse; Vincent W V Jaddoe; Frank C Verhulst; Oscar H Franco; Henning Tiemeier Journal: Physiol Behav Date: 2017-02-16