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Grazing in children: associations with child’s characteristics and parental feeding practices

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Grazing is a problematic eating behavior linked with poor weight loss outcomes, disordered eating psychopathology, and psychological distress in the adult population. However, no study assessed this behavior in children. Childhood is an important time frame for the development and maintenance of healthy eating habits, which can be influenced by children’s psychological state, eating habits, and parental practices. This study investigates the associations between grazing behavior in children and children’s psychological variables (anxiety, depression and withdrawn symptoms, body image dissatisfaction), children eating habits, and parental feeding practices.


In this cross-sectional study, 330 primary school students (6–10 years old) and their parents completed measures assessing children’s grazing, anxiety/depression and withdrawn symptoms, body image dissatisfaction, children eating habits and style, and parental feeding practices.


The path analysis tested showed that more restrictive parental feeding practices, inappropriate children eating habits, children’s anxiety/depression symptoms, and body image dissatisfaction were associated with increased grazing scores (CMIN = 12.679; DF = 11; p = 0.315; RMSEA = 0.025; CFI = 0.990; NFI = 0.935; TLI = 0.982; IFI = 0.991; SRMR = 0.045).


Grazing tends to occur in a context of children’s psychological distress, inappropriate children eating habits, and restrictive parental feeding practices. These variables should be addressed for the improvement of healthy eating habits and in weight-loss interventions for children.

Level of Evidence

Level V, cross-sectional descriptive study.

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Fig. 1


  1. 1.

    Conceição EM, Mitchell JE, Engel SG, Machado PPP, Lancaster K, Wonderlich SA (2014) What is “grazing”? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition. Surg Obes Relat Dis 10:973–982. https://doi.org/10.1016/j.soard.2014.05.002

  2. 2.

    Conceição EM, Mitchell JE, Machado PPP, Vaz AR, Pinto-Bastos A, Ramalho S et al (2017) Repetitive eating questionnaire [Rep(eat)-Q]: enlightening the concept of grazing and psychometric properties in a Portuguese sample. Appetite 117:351–358. https://doi.org/10.1016/j.appet.2017.07.012

  3. 3.

    Conceição EM, Pinto-bastos A, de Lourdes M, Vaz AR, Brandão I, Ramalho S (2018) Problematic eating behaviors and psychopathology in patients undergoing bariatric surgery: the mediating role of loss of control eating. Int J Eat Disord 51:507–517. https://doi.org/10.1002/eat.22862

  4. 4.

    Heriseanu AI, Hay P, Corbit L, Touyz S (2017) Grazing in adults with obesity and eating disorders: a systematic review of associated clinical features and meta-analysis of prevalence. Clin Psychol Rev 58:16–32. https://doi.org/10.1016/j.cpr.2017.09.004

  5. 5.

    Nicolau J, Ayala L, Rivera R, Speranskaya A, Sanchís P, Julian X et al (2015) Postoperative grazing as a risk factor for negative outcomes after bariatric surgery. Eat Behav 18:147–150. https://doi.org/10.1016/j.eatbeh.2015.05.008

  6. 6.

    Colles SL, Dixon JB, O’Brien PE (2008) Grazing and loss of control related to eating: two high-risk factors following bariatric surgery. Obesity 16:615–622. https://doi.org/10.1038/oby.2007.101

  7. 7.

    Goodpaster KPS, Marek RJ, Lavery ME, Ashton K, Rish JM, Heinberg LJ (2016) Graze eating among bariatric surgery candidates: prevalence and psychosocial correlates. Surg Obes Relat Dis 12:1091–1097. https://doi.org/10.1016/j.soard.2016.01.006

  8. 8.

    Poole NA, Atar AA, Kuhanendran D, Bidlake L, Fiennes A, McCluskey S et al (2005) Compliance with surgical after-care following bariatric surgery for morbid obesity: a retrospective study. Obes Surg 15:261–265. https://doi.org/10.1381/0960892053268499

  9. 9.

    Bonder R, Davis C, Kuk JL, Loxton NJ (2018) Compulsive “grazing” and addictive tendencies towards food. Eur Eat Disord Rev 26:569–573. https://doi.org/10.1002/erv.2642

  10. 10.

    Micanti F, Iasevoli F, Cucciniello C, Costabile R, Loiarro G, Pecoraro G et al (2016) The relationship between emotional regulation and eating behaviour: a multidimensional analysis of obesity psychopathology. Eat Weight Disord 22:105–115. https://doi.org/10.1007/s40519-016-0275-7

  11. 11.

    Reas DL, Wisting L, Kapstad H, Lask B (2012) Nibbling: Frequency and relationship to BMI, pattern of eating, and shape, weight, and eating concerns among university women. Eat Behav 13:65–66. https://doi.org/10.1016/j.eatbeh.2011.10.005

  12. 12.

    Heriseanu AI, Hay P, Touyz S (2019) Grazing behaviour and associations with obesity, eating disorders, and health-related quality of life in the Australian population. Appetite 143:1–9. https://doi.org/10.1016/j.appet.2019.104396

  13. 13.

    Conceição EM, Crosby R, Mitchell JE, Engel SG, Wonderlich SA, Simonich HK et al (2013) Picking or nibbling: frequency and associated clinical features in bulimia nervosa, anorexia nervosa, and binge eating disorder. Int J Eat Disord 46:815–818. https://doi.org/10.1002/eat.22167

  14. 14.

    Kass A, Accurso E, Goldschmidt A, Anam S, Byrne C, Kinasz K et al (2015) Picking and nibbling in children and adolescents with eating disorders. Int J Eat Disord 48:1102–1105. https://doi.org/10.1002/eat.22444

  15. 15.

    World Health Organization (2018) Fact sheets: healthy diet. Heal diet. https://www.who.int/news-room/fact-sheets/detail/h

  16. 16.

    Tanofsky-Kraff M, Shomaker L, Olsen C, Roza C, Wolkoff L, Columbo K et al (2011) A prospective study of pediatric loss of control eating and psychological outcomes. J Abnorm Psychol 120:108–118. https://doi.org/10.1037/a0021406

  17. 17.

    Sonneville KR, Horton NJ, Micali N, Crosby RD, Swanson SA, Solmi F et al (2013) Longitudinal associations between binge eating and overeating and adverse outcomes among adolescents and young adults. JAMA Pediatr 167:149–155. https://doi.org/10.1001/2013.jamapediatrics.12

  18. 18.

    Rhee KE, Boutelle KN, Jelalian E, Barnes R, Dickstein S, Wing RR (2015) Firm maternal parenting associated with decreased risk of excessive snacking in overweight children. Eat Weight Disord 20:195–203. https://doi.org/10.1007/s40519-014-0164-x

  19. 19.

    Nicklas TA, Baranowski T, Cullen KW, Berenson G (2001) Eating patterns, dietary quality and obesity. J Am Coll Nutr 20:599–608

  20. 20.

    Kelishadi R, Mozafarian N, Qorbani M, Motlagh ME, Safiri S, Ardalan G et al (2017) Is snack consumption associated with meal skipping in children and adolescents? The CASPIAN-IV study. Eat Weight Disord 22:321–328. https://doi.org/10.1007/s40519-017-0370-4

  21. 21.

    Theim KR, Tanofsky-kraff M, Salaita CG, Haynos AF, Mirch MC, Ranzenhofer LM et al (2007) Children’s descriptions of the foods consumed during loss of control eating episodes. Eat Behav 8:258–265. https://doi.org/10.1016/j.eatbeh.2006.10.001

  22. 22.

    Morgan CM, Yanovski SZ, Nguyen TT, McDuffie J, Sebring NG, Jorge MR et al (2002) Loss of control over eating, adiposity, and psychopathology in overweight children. Int J Eat Disord 31:430–441. https://doi.org/10.1002/eat.10038

  23. 23.

    Czaja J, Rief W, Hilbert A (2009) Emotion regulation and binge eating in children. Int J Eat Disord 42:356–362. https://doi.org/10.1002/eat.20630

  24. 24.

    Kelly NR, Tanofsky-kraff M, Vannucci A, Ranzenhofer LM, Altschul AM, Schvey NA et al (2016) Emotion dysregulation and loss-of-control eating in children and adolescents. Heal Psychol 35:1110–1119

  25. 25.

    Salvy S, Kieffer E, Epstein LH (2008) Effects of social context on overweight and normal-weight children’s food selection. Eat Disord 9:190–196. https://doi.org/10.1016/j.eatbeh.2007.08.001

  26. 26.

    Ventura AK, Birch LL (2008) Does parenting affect children’s eating and weight status? Int J Behav Nutr Phys Act 2008:5. https://doi.org/10.1186/1479-5868-5-15

  27. 27.

    Blaine RE, Kachurak A, Davison KK, Klabunde R, Fisher JO (2017) Food parenting and child snacking: a systematic review. Int J Behav Nutr Phys Act 14:146. https://doi.org/10.1186/s12966-017-0593-9

  28. 28.

    Booth SL, Sallis JF, Ritenbaugh C, Hill JO, Birch LL, Frank LD et al (2001) Environmental and societal factors affect food choice and physical activity: rationale, influences, and leverage points. Nutr Rev 59:21–39

  29. 29.

    Haines J, Haycraft E, Lytle L, Nicklaus S, Kok FJ, Merdji M et al (2019) Nurturing children’s healthy eating: position statement. Appetite 137:124–133. https://doi.org/10.1016/j.appet.2019.02.007

  30. 30.

    Couch SC, Glanz K, Zhou C, Sallis JF, Saelens BE (2014) Home Food environment in relation to children’s diet quality and weight status. J Acad Nutr Diet 114:1569–1580. https://doi.org/10.1016/j.jand.2014.05.015

  31. 31.

    Larsen JK, Hermans, Roel CJ, Sleddnes EFC, Engels RCME, Fisher JO, Kremers SPJ. How parental dietary behavior and food parenting practices affect children’s dietary behavior Interacting sources of influence ? Appetite 2015;89:246–57. Doi: 10.1016/j.appet.2015.02.012.

  32. 32.

    Liang J, Matheson BE, Rhee KE, Peterson CB, Rydell S, Boutelle KN (2016) Parental control and overconsumption of snack foods in overweight and obese children. Appetite 100:181–188. https://doi.org/10.1016/j.appet.2016.02.030

  33. 33.

    Loth KA (2016) Associations between food restriction and pressure-to-eat parenting practices and dietary intake in children: a selective review of the recent literature. Diet Patterns Behav 5:61–67. https://doi.org/10.1007/s13668-016-0154-x

  34. 34.

    Rodenburg G, Kremers SP, Oenema A, Van De Mheen D (2014) Associations of parental feeding styles with child snacking behaviour and weight in the context of general parenting. Public Health Nutr 17:960–969. https://doi.org/10.1017/S1368980013000712

  35. 35.

    Shloim N, Edelson LR, Martin N, Hetherington MM (2015) Parenting styles, feeding styles, feeding practices, and weight status in 4–12 year-old children: a systematic review of the literature. Front Psychol 6:4–12. https://doi.org/10.3389/fpsyg.2015.01849

  36. 36.

    Brown KA, Ogden J, Vögele C, Gibson EL (2008) The role of parental control practices in explaining children’s diet and BMI. Appetite 50:252–259. https://doi.org/10.1016/j.appet.2007.07.010

  37. 37.

    Matheson CC, Peterson C, Rhee K, Rydell S, Zucker N et al (2015) The relationship between parent feeding styles and general parenting with loss of control eating in treatment-seeking overweight and obese children. Int J Eat Disord 48:1047–1055. https://doi.org/10.1002/eat.22440

  38. 38.

    World Health Organization (2009) WHO AnthroPlus for personal computers Manual: software for assessing growth of the world’s children and adolescents

  39. 39.

    Achenbach T, Rescorla L, Dias P, Ramalho V, Lima V, Machado B et al (2014) Manual do sistema de avaliação empiricamente validado (ASEBA) para o período pré-escolar e escolar: um sistema integrado de avaliação com múltiplos informadores. In: 1a edição. Braga: Psiquilíbrios Edições

  40. 40.

    Achenbach T, Rescorla L (2003) Manual for the ASEBA school-age forms & profiles: an integrated system of multi-informant assessment. Burlington, VT

  41. 41.

    Golan M, Weizman A (1998) Reliability and validity of the family eating and activity habits questionnaire. Eur J Clin Nutr 52:771–777

  42. 42.

    Viana V, Franco T, Morais C, Almeida P, Silva D, Guerra A (2012) Controlo alimentar materno e estado ponderal: resultados do questionário alimentar para crianças. Psicol Saúde Doenças 13:298–310

  43. 43.

    Birch LL, Fisher JO, Grimm-thomas K, Markey CN, Sawyer R, Johnson SL (2001) Confirmatory factor analysis of the child feeding questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite 36:201–210. https://doi.org/10.1006/appe.2001.0398

  44. 44.

    Simões A (2014) Avaliação da (in)satisfação com a Imagem Corporal: Estudo de validação da Escala de Silhuetas de Collins para crianças e adolescentes Portugueses. Universidade de Coimbra

  45. 45.

    Collins ME (1991) Body figure perceptions and preferences among preadolescent children. Int J Eat Disord 10:199–208

  46. 46.

    Hu L, Bentler P (1999) Cutoff criteria for fit indexes in covariance structure analysis. Struct Equ Model 6:1–55

  47. 47.

    Reas DL, Dahlgren C, Wonderlich J, Syversen G, Kvalem I (2019) Confirmatory factor analysis and psychometric properties of the Norwegian version of the repetitive eating questionnaire: further evidence for two distinct subtypes of grazing behaviour. Eur Eat Disord Rev 27:205–211. https://doi.org/10.1002/erv.2631

  48. 48.

    Salvy S, Kieffer E, Epstein LH (2008) Effects of social context on overweight and normal-weight children’s food selection. Eat Behav 9:190–196. https://doi.org/10.1016/j.eatbeh.2007.08.001

  49. 49.

    OECD (2019) Health at a Glance 2019: OECD Indicators. Paris. https://doi.org/10.1787/4dd50c09-en

  50. 50.

    Schlüter N, Schmidt R, Kittel R, Tetzlaff A, Hilbert A (2016) Loss of control eating in adolescents from the community. Int J Eat Disord 49:413–420. https://doi.org/10.1002/eat.22488

  51. 51.

    Webber L, Hill C, Cooke L, Carnell S, Wardle J (2010) Associations between child weight and maternal feeding styles are mediated by maternal perceptions and concerns. Eur J Clin Nutr 64:259–265. https://doi.org/10.1038/ejcn.2009.146

  52. 52.

    Faith MS, Berkowitz RI, Stallings VA, Kerns J, Storey M, Stunkard AJ (2004) Parental feeding attitudes and styles and child body mass index: prospective analysis of a gene-environment interaction. Pediatrics 114:e429–e436. https://doi.org/10.1542/peds.2003-1075-L

  53. 53.

    Cin C, Ba T, Holub SC (2011) Children’s Self-regulation in eating: associations with inhibitory control and parents’ feeding behavior domain-specific and global self-regulatory abilities. J Pediatr Psychol 36:340–345. https://doi.org/10.1093/jpepsy/jsq089

  54. 54.

    Mantzios M, Egan H, Bahia H, Hussain M, Keyte R (2018) How does grazing relate to body mass index, self-compassion, mindfulness and mindful eating in a student population? Heal Psychol Open 5:1–7. https://doi.org/10.1177/2055102918762701

  55. 55.

    Kerr DCR, Lunkenheimer ES, Olson SL (2007) Assessment of child problem behaviors by multiple informants: a longitudinal study from preschool to school entry. J Child Psychol Pschiatry 48:967–975. https://doi.org/10.1111/j.1469-7610.2007.01776.x

  56. 56.

    Piazza-waggoner C, Driscoll KA, Gilman DK, Scott W (2008) A comparison using parent report and direct observation of mealtime behaviors in young children with cystic fibrosis: implications for practical and empirically based behavioral assessment in routine clinical care. Child Heal Care 37:38–48. https://doi.org/10.1080/02739610701766875

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This study was partially conducted at Psychology Research Centre (PSI/01662), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds, and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653), by the following grants to Eva Conceição (IF/01219/2014 and POCI-01-0145-FEDER-028209). The funding body had no role in the design, collection, analysis, and interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication.


This study was partially conducted at Psychology Research Centre (PSI/01662), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds, and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653), by the following grants to Eva Conceição (IF/01219/2014 and POCI-01-0145-FEDER-028209). The funding body had no role in the design, collection, analysis, and interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication.

Author information

EC, SG and JP contributed to the study conception and design. Material preparation, data collection were conducted by JP. Data analyses were performed by EC, JP, SR and SF. JP wrote a preliminary version in Portuguese. The first draft of the manuscript was written by EC and SF. SG and SR commented on and changed previous versions of the manuscript. All authors read and approved the final manuscript.

Correspondence to Eva M. Conceição.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Direcção Geral de Educação, Inquérito nº 0564400001) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Parents and their children willing to participate in the study signed a written informed consent form for themselves and their children.

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Conceição, E.M., Pinheiro, J., Félix, S. et al. Grazing in children: associations with child’s characteristics and parental feeding practices. Eat Weight Disord (2020). https://doi.org/10.1007/s40519-020-00866-y

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  • Grazing
  • Children
  • Parental feeding practices
  • Children eating habits
  • Psychological distress