Prospective associations between problematic eating attitudes in midchildhood and the future onset of adolescent obesity and high blood pressure

Kaitlin Wade, Michael S. Kramer, Emily Oken, Nicholas Timpson, Oleg Skugarevsky, Rita Patel, Natalia Bogdanovich, Konstantin Vilchuck, George Davey Smith, Jennifer Thompson, Richard Martin

Research output: Contribution to journalArticle (Academic Journal)peer-review

15 Citations (Scopus)
323 Downloads (Pure)


Background: Clinically diagnosed eating disorders may have adverse cardiometabolic consequences, including overweight or obesity and high blood pressure. However, the link between problematic eating attitudes in early adolescence, which can lead to disordered eating behaviors, and future cardiometabolic health is, to our knowledge, unknown. Objective: We assessed whether variations in midchildhood eating attitudes influence the future development of overweight or obesity and high blood pressure. Design: Of 17,046 children who participated in the Promotion of Breastfeeding Intervention Trial (PROBIT), we included 13,557 participants (79.5% response rate) who completed the Children’s Eating Attitudes Test (ChEAT) at age 11.5 y and in whom we measured adiposity and blood pressure at ages 6.5, 11.5, and 16 y. We assessed whether ChEAT scores ≥85th percentile (indicative of problematic eating attitudes) compared with scores <85th percentile at age 11.5 y were associated with new-onset overweight, obesity, high systolic blood pressure, or high diastolic blood pressure between midchildhood and early adolescence. Results: After controlling for baseline sociodemographic confounders, we observed positive associations of problematic eating attitudes at age 11.5 y with new-onset obesity (OR: 2.18; 95% CI: 1.58, 3.02), new-onset high systolic blood pressure (OR: 1.34; 95% CI: 1.05, 1.70), and new-onset high diastolic blood pressure (OR: 1.25; 95% CI: 0.99, 1.58) at age 16 y. After further controlling for body mass index at age 6.5 y, problematic eating attitudes remained positively associated with new-onset obesity (OR: 1.80; 95% CI: 1.28, 2.53); however, associations with new-onset high blood pressure were attenuated (OR: 1.14; 95% CI: 0.89, 1.45 and OR: 1.09; 95% CI: 0.86, 1.39 for new-onset systolic and diastolic blood pressure, respectively). Conclusions: Problematic eating attitudes in midchildhood seem to be related to the development of obesity in adolescence, a relatively novel observation with potentially important public health implications for obesity control. PROBIT was registered at as NCT01561612 and as ISRCTN37687716.
Original languageEnglish
Pages (from-to)306-312
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Issue number2
Early online date14 Dec 2016
Publication statusPublished - Feb 2017


  • Problematic eating attitudes
  • Blood pressure
  • Adiposity
  • Prospective
  • Adolescents


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