Brief parent-report measure of slowness in eating is associated with weight status in children with cystic fibrosis over a 3-year follow-up

Objective: Eating behaviors are potential targets to improve outcomes including metabolic health in those with CF. We aimed to test whether slowness in eating was associated with weight status over 3 year follow-up in children with CF, using the slowness in eating subscale from the Child Eating Behavior Questionnaire (CEBQ), a brief parent-report instrument. Methods: Parents of 60 patients (mean age 7.7±3.2; 66.7% male) completed the CEBQ, including the 4-item subscale assessing slowness in eating (CEBQ-SE), during regular clinic hours, at study entry. Body Mass Index z-scores (BMIz) were calculated using anthropometric data collected at baseline and at 1, 2, and 3 year follow-up for use in Linear Mixed Models (LMM). Results: Children's CEBQ-SE scores were used to create 3 CEBQ-SE tertiles. Based on model estimates, at all time-points, the low CEBQ-SE tertile (fastest eaters) had a greater BMIz (Baseline: 0.46, Yr 1: 0.58; Yr 2: 0.64; Yr 3: 0.67) than both the medium CEBQ-SE tertile (Baseline: -0.09, Yr 1: -0.06, Yr 2: -0.03, Yr 3: -0.02) and high CEBQ-SE tertile (Baseline: -0.05, Yr 1: 0.08, Yr 2: 0.10, Yr 3: 0.01). Sensitivity analyses either omitting children who had ever used a gastric tube, or children who had never been on appetite-stimulating medication, demonstrated the utility of these interventions to promote reaching weight status goals, particularly for children with low BMIz and slow eating. Conclusion: Low slowness in eating at baseline was associated with high BMIz 1, 2, and 3 years later in children with CF. The CEBQ-SE subscale could identify children who could benefit from early intervention to optimize weight status and eating behavior.