Factorial validation analysis of the Baby and Children's Eating Behavior Questionnaires in Samoa.

Survey instruments for assessing eating behaviors in infancy and early childhood have yet to be validated among Pacific Islanders, among whom the prevalence of pediatric obesity is steadily increasing. This study aimed to evaluate Baby Eating Behavior Questionnaire (BEBQ) and Children's Eating Behavior Questionnaire (CEBQ) factor structures against data collected from mother-infant dyads in Samoa. The BEBQ was administered across two time points: approximately 2 months (mean = 2.37 [SD = 0.34]; N = 105) and 4 months postpartum (mean = 4.22 [SD = 0.44]; N = 117). The CEBQ was administered at approximately 21 months postpartum (mean = 21.45 [SD = 1.72]; N = 113). Both the original four-factor BEBQ and seven-factor CEBQ models failed to replicate in confirmatory factor analyses. BEBQ data from 2 and 4 months demonstrated acceptable fit to a nine-item, two factor model, generated by elimination of factors with low internal reliability. A series of exploratory factor analyses on CEBQ data from 21 months postpartum ultimately revealed 16-item, three-factor structure. There was little correlation between BEBQ and CEBQ scores, suggesting either that infant feeding behaviors before and after weaning are not strongly associated, or that the BEBQ and CEBQ function better in cross-sectional, rather than longitudinal analyses. Newly derived CEBQ factors raise concerns regarding whether original CEBQ items and factors were sufficiently theoretically distinct. Study results suggest that demographic and cultural differences may impact both BEBQ and CEBQ factor structure. Further qualitative research is necessary to address these issues.

A missense variant in CREBRF, rs373863828, is associated with fat-free mass, not fat mass in Samoan infants.

BACKGROUND/OBJECTIVES: In Samoa, where 80% of the adult population is living with obesity, understanding the determinants of adiposity and growth during infancy may inform prevention efforts. We examined the association of a missense variant, rs373863828, in the CREBRF gene with body composition in Samoan infants. Adults with one or more copies of the rs373863828 minor allele (A) have higher odds of obesity, based on body-mass index (BMI), but paradoxically decreased odds of diabetes compared to those without the allele. Our study may offer novel insight into the natural history and pathogenesis of this unexpected relationship. SUBJECTS/METHODS: In a prospective study, we measured body composition in early infancy, and at 2- and 4-months of age using anthropometry and dual-energy x-ray absorptiometry (DXA). We genotyped subjects at the CREBRF rs373863828 locus and compared infants with (AA/AG) and without (GG) the variant. In longitudinal analyses, we calculated the absolute change in each outcome from the early infant to the 4-month assessment, adjusting for baseline and other covariates. RESULTS: In cross-sectional analyses, there was no significant difference in infant BMI or fat mass by genotype. After adjusting for covariates, infants with the variant had 4.0 ± 1.8 g more bone mass (p = 0.026) and 210.9 ± 79.6 g more lean mass (p = 0.009) at 4-months and accumulated 176.9 ± 73.0 g more lean mass between the early infant and 4-month assessment (p = 0.017). CONCLUSIONS: The CREBRF rs373863828 minor allele (A) was not associated with increased BMI or adiposity in Samoan infants, but instead with increased lean and bone mass. Our findings suggest that lean (i.e., muscle) and bone mass accretion should be explored as pathways to explain the "protective" effect of the CREBRF variant against diabetes.