Institute of Epidemiology & Health Care


The relationship between appetitive traits, dietary intake and weight gain in the Gemini cohort

Author H.N. Syrad
Author C.H. Llewellyn
Author A. Fildes
Author S.A. Jebb
Abstract This thesis uses data from the Gemini twin birth cohort to explore interrelationships between appetite, dietary intake, consumption patterns and weight during early childhood. Specifically it aims to: (i) describe the dietary intake of young children; (ii) explore associations between appetite, eating patterns, and dietary intake; (iii) identify associations between eating patterns and weight gain; (iv) examine the mediation of the appetite-weight relationship by eating patterns; and (v) assess the continuity and stability of appetite and eating patterns from early to middle childhood. Chapter 4 describes the dietary intake of children aged 21 months in relation to UK public health nutrition recommendations. At a population level, young children are exceeding recommended intakes of energy and protein but not meeting recommended intakes of Vitamin D or iron. Chapter 5 explored the role of appetite in dietary intake during the complementary feeding period. Children with lower appetitive avidity consumed more milk, and had lower food intake, than those with more avid appetites. Mothers reported supplementing their child's diet with formula milk due to 'picky' eating. Chapter 6 explored the role of appetite in how children eat and drink. Food Responsiveness was associated with higher 'meal frequency', and Satiety Responsiveness was associated with larger 'meal size'. Chapter 7 established that larger meals, but not more frequent eating, were associated with weight status at aged two, and weight gain from two to five years. These associations were replicated cross-sectionally in a nationally representative sample. Chapter 8 demonstrated that meal size partially mediated the relationship between Satiety Responsiveness and weight. Findings from Chapter 9 suggested that appetite and eating patterns track moderately from early to mid-childhood. Overall this thesis identifies behavioural pathways through which individual differences in appetite may result in weight gain.