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Int J Eat Disord. 2019 Mar 2. doi: 10.1002/eat.23062. [Epub ahead of print]

Assessment of eating attitudes and dieting behaviors in healthy children: Confirmatory factor analysis of the Children's Eating Attitudes Test.

Author information

1
Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
2
Department of Psychology, Faculty of Science, McGill University Montreal, Quebec, Canada.
3
Department of Pediatrics, Faculty of Medicine, McGill University Montreal, Quebec, Canada.
4
Bristol Medical School: Population Health Sciences, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom.
5
Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.
6
University Hospitals Bristol National Health Service Foundation Trust, National Institute for Health Research Bristol Biomedical Research Centre, University of Bristol, Bristol, United Kingdom.
7
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
8
Harvard Pilgrim Health Care Institute, Boston, Massachusetts.

Abstract

OBJECTIVE:

The Children's Eating Attitudes Test (ChEAT) is a self-report questionnaire that is conventionally summarized with a single score to identify "problematic" eating attitudes, masking informative variability in different eating attitude domains. This study evaluated the empirical support for single- versus multifactor models of the ChEAT. For validation, we compared how well the single- versus multifactor-based scores predicted body mass index (BMI).

METHOD:

Using data from 13,674 participants of the 11.5 year-follow-up of the Promotion of Breastfeeding Intervention Trial (PROBIT) in the Republic of Belarus, we conducted confirmatory factor analysis to evaluate the performance of 3- and 5-factor models, which were based on past studies, to a single-factor model representing the conventional summary of the ChEAT. We used cross-validated linear regression models and the reduction in mean squared error (MSE) to compare the prediction of BMI at 11.5 and 16 years by the conventional and confirmed factor-based ChEAT scores.

RESULTS:

The 5-factor model, based on 14 of the original 26 ChEAT items, had good fit to the data whereas the 3- and single-factor models did not. The MSE for concurrent (11.5 years) BMI regressed on the 5-factor ChEAT summary was 35% lower than that of the single-score models, which reduced the MSE from the null model by only 1%-5%. The MSE for BMI at 16 years was 20% lower.

DISCUSSION:

We found that a parsimonious 5-factor model of the ChEAT explained the data collected from healthy Belarusian children better than the conventional summary score and thus provides a more discriminating measure of eating attitudes.

KEYWORDS:

Republic of Belarus; adiposity; attitude; child; eating; factor analysis; psychology; statistical

PMID:
30825346
DOI:
10.1002/eat.23062

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