Health-related quality of life, temperament, and eating behavior among formula-fed infants in the Philippines: a pilot study

Sheri Volger, Elvira M Estorninos, Maria R Capeding, Jowena Lebumfacil, Diane Rigassio Radler, J Scott Parrott, Pamela Rothpletz-Puglia, Sheri Volger, Elvira M Estorninos, Maria R Capeding, Jowena Lebumfacil, Diane Rigassio Radler, J Scott Parrott, Pamela Rothpletz-Puglia

Abstract

Background: The rising prevalence of childhood obesity in Asia has led to interest in potential risk factors such as infant health-related quality of life (HRQoL), temperament and eating behaviors. This pilot study evaluated the utility of administering parent-reported outcome measures (PROMs) to explore these factors in Filipino infants and examined the relationships between these factors and infant sex, formula intake and weight, over time.

Methods: Forty healthy, 4-week-old, formula-fed infants (n = 20 males) were enrolled in this 6-week, prospective, uncontrolled study during which infants were exclusively fed a standard term infant formula enriched with alpha-lactalbumin. On Day-1 and 42, anthropometrics were measured and mothers completed a 97-item measure of HRQoL [Infant Toddler Quality of Life Questionnaire (ITQOL)] covering 6 infant-focused and 3 parent-focused concepts and a 24-item measure of infant temperament [Infant Characteristics Questionnaire (ICQ)]. At Day-42, mothers also completed an 18-item measure of infant appetite [Baby Eating Behaviour Questionnaire (BEBQ)]. A 3-day formula intake diary was completed before Day-42. Nonparametric statistics were used to evaluate correlations among outcomes and compare outcomes by visit and sex.

Results: Thirty-nine infants completed the study; similar results were observed in males and females. Completion of PROMs was 100% with no missing responses, but Cronbach's α was low for many concept scales scores. ITQOL scores [range 0 (worst)-100 (best)] were generally high (median ≥ 80) except for Day-1 and Day-42 Temperament and Mood and Day-1 General Health Perceptions scores. ITQOL but not ICQ temperament scores improved significantly between Day-1 and Day-42 (P < 0.01). Mean ± standard deviation BEBQ scores (range 1-5) were high for Enjoyment of Food (4.59 ± 0.60) and Food Responsiveness (3.53 ± 0.81), and low for Satiety Responsiveness (2.50 ± 0.73) and Slowness in Eating (1.71 ± 0.60). Better HRQoL scores were significantly (P < 0.05) associated with high General Appetite scores (3 ITQOL concepts, r = 0.32 to 0.54), greater Enjoyment of Food (4 ITQOL concepts, r = 0.35 to 0.42) and low levels of Slowness in Eating (7 ITQOL concepts, r = - 0.32 to - 0.47).

Conclusion: Findings demonstrated the utility of the ITQOL, ICQ and BEBQ for measuring HRQoL, temperament and eating behavior, and the need for further adaptations for use in Filipino infants.

Trial registration: ClinicalTrials.gov identifier NCT02431377; Registered May 1, 2015.

Keywords: Baby eating behaviour questionnaire; HRQoL; Health-related quality of life; Infant characteristics questionnaire; Infant eating behavior; Infant quality of life; Infant temperament; The infant toddler quality of life questionnaire.

Conflict of interest statement

Ethics approval and consent to participate

The study was conducted in accordance with the Declaration of Helsinki and Good Clinical Practices and was approved by the Institutional Review Board and the Philippines Food and Drug Administration. All parent(s) or legally acceptable representative(s) (henceforth “parents” or “mothers”) provided informed consent prior to any trial related procedure in accordance with applicable regulatory requirements. The informed consent process was fully documented.

Competing interests

SV is an employee of Nestlé Nutrition and a PhD student at Rutgers University School of Health Professions; the work was done in part to fulfill a requirement for the degree. JL is an employee of Wyeth Nutrition Philippines. EE and MC received grant / research support from Nestlé Nutrition. PRP, DRR and JSP have no competing interests to report.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Disposition of study participants

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