A Longitudinal Study Of Eating Behavior Problems And Theirs Influential Factors Among Preschool Children In Some Rural Areas Of Anhui Province

Objective The preschool age is the key period of children’s growth and development,and also the key period of the formation of children’s eating behavior characteristics.In recent years,the problem of children’s eating behavior has been paid close attention by scholars at home and abroad.The increasing detection rate of children’s eating behavior problems warns us that if we do not take timely intervention measures,it will bring great harm to children’s growth and development.In this study,the longitudinal data of the survey on the eating behavior problems of preschool children in some rural areas of Anhui Province were used to understand the prevalence of eating behavior problems in this population,and to explore the changing trend and influencing factors of eating behavior problems.Methods According to the characteristics of geographical zoning in Anhui Province,this study adopted the convenient sampling method.A total of 26 kindergartens were selected as the research sites in Bowang District of Maanshan in the south,Feixi County and Changfeng County of Hefei in the middle,and Funan County of Funan City in the north of Anhui.The preschool children aged 3-6 years in the kindergartens were selected as the research subjects.The longitudinal study was adopted.Based on the baseline survey from September 2019 to January 2020,a follow-up survey was conducted from October 2020 to January 2021.The preschool children in junior class and middle class of kindergarten in the baseline survey were selected as the follow-up subjects.In the field survey,the method of self-filling or face-to-face interview of the caregivers of preschool children was used to investigate.The contents of structured questionnaire include children’s general situation,the feeding and rearing situation of children,parents’ work or business situation,sleep status,children’s eating behavior screening and evaluation questionnaire,children’s emotional behavior scale,children’s anxiety scale,family function scale,caregiver’s anxiety scale,etc.Epi Data 3.1 was used for data entry and SPSS 23.0 software was used for statistical analysis.χ2 test was used to analyze the differences of detection rate between groups based on different factors related to eating behavior problems among preschool children,and T-test was used to analyze the differences between groups about the scores of eating behavior problems among preschool children.The Generalized Estimating Equation(GEE)was used to explore the influencing factors of children’s dietary behavior problems during follow-up.Results After excluding children with missing critical information,a total of 1595 children of preschool age were included in the longitudinal study,including 870 boys and 725 girls.The detection rate of eating behavior problems in baseline survey was75.7%,and that in follow-up survey was 72.1%.The difference between the two surveys was statistically significant(X~2=5.272,P=0.022).Except for the dimension of Poor Appetite,there were significant differences in the detection rates of eating behavior problems between the results for the baseline and follow-up survey in other dimensions(P<0.05).The total score of eating behavior problems of preschool children increased from 69.0±11.7 points at baseline to 71.2 ±10.4 points at follow-up(P<0.05),and the total score of six dimensions of Poor Appetite,Food Preference,Poor Eating Habit,Parental Misperception,Fear of Feeding and Potential Organic Diseases showed an increasing trend in the follow-up survey(P<0.05).Stratification analysis was conducted according to different demographic characteristics of children to explore the changes in the scores of eating behavior problems in preschool children.The results showed that the overall scores of dietary behavior problems of preschool children at the follow-up visit were significantly higher than those of the baseline(P<0.05),except for the 5-year-old age group,overweight/obesity,birth asphyxia,low birth weight(<2500g)/oversized infants(>4000g),mother’s high school education level and children have sleep disorders.The results of GEE multivariate analysis showed that the birth weight was greater than 4000 g,the screen time was more than120 minutes,children have the experience of corporal punishment and sleep disorders,the existence of emotional behavior problems,the parents’ attitude of discipline was persuasion education and scolding when they did wrong,the symptoms of caregiver’s anxiety were significantly positively correlated with the eating behavior problems of preschool children.Caregiver was non-parents and left-behind experience of child were negatively associated with eating behavior problems in preschool children.Conclusion This longitudinal study shows that th e detection rate of eating behavior problems in preschool children is relatively high.Children’s eating behavior problems should arouse extensive attention,and targeted intervention measures should be developed.Preschool children may exhibit different dimensions of problems at different stages,and the scores of children’s eating behavior problems and all dimensions were upward during the follow-up period.From the perspective of longitudinal development,the age of children and caregiver was non-parents are the protective factors of eating behavior problems of preschool children.Excessive screen time,children have sleep disorders and emotional behavior problems,corporal punishment experience,the parents’ attitude of discipline was persuasion education and scolding when they did wrong,and the symptoms of caregiver’s anxiety are adverse factors for eating behavior problems of preschool children.It is necessary to fully understand the occurrence and influencing factors of children’s eating behavior problems,so as to formulate relevant intervention measures to promote children’s physical and mental health development.