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Development of Eating Behaviors Among Children and Adolescents

Birch LL, Fisher JO
Pediatrics
January 1, 1998

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Pediatrics. 1998;101(Suppl 2):539-549

This article is part of a 1998 supplement to the journal Pediatrics “The Causes and Health Consequences of Obesity in Children and Adolescents.”

Abstract: The prevalence of obesity among children is high and increasing. We know that obesity runs in the families, with children of obese parents at greater risk of developing obesity than children of thin parents. Research on genetic factors in obesity has provided us with estimates of the proportion of the variance in a population accounted for by genetic factors. However, this research does not provide information regarding individual development. To design effective preventive interventions, research is needed to delineate how genetics and environmental factors interact in the etiology of childhood obesity. Addressing this question is especially challenging because parents provide both genes and environment for children.

An enormous amount of learning about food and eating occurs during the transition from the exclusive milk diet of infancy to the omnivore’s diet consumed by early childhood. This early learning is constrained by children’s genetic predispositions, which include the unlearned preference for sweet tastes, salty tastes, and the rejection of sour and bitter tastes. Children also are predisposed to reject new foods and to learn associations between foods’ flavors and their postingestive consequences of eating. Evidence suggest that children can respond to the energy density of a diet and that although intake at individual meals is erratic, 24-hour energy intake is relatively well regulated. There are individual differences in the regulation of energy intake as early as the preschool period. These differences in self-regulation are associated with differences in child-feeding practices and with children’s adiposity. This suggests that child-feeding practices have the potential to affect children’s energy balance via altering patterns of intake. Initial evidence indicates that imposition of stringent parental controls can potentiate preferences for high-fat, energy-dense foods, limit children’s acceptance of a variety of foods, and disrupt children’s regulation of energy intake by altering children’s responsiveness to internal cues of hunger and satiety. This can occur when well-intended but concerned parents assume that children need help in determining what, when, and how much to eat and when parents impose child-feeding practices that provide children with few opportunities for self-control. Implications of these findings for preventative interventions are discussed.

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