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Nutrition during the early life cycle

Are problematic eating behaviors from 4- to 7-year-old explained by genetic, shared factors or individual characteristics? A longitudinal twin study


Studies based on twins are ideal to disentangle the relative contribution of different factors in the development of eating behaviors. This study aims to evaluate if changes in problematic eating behaviors from 4 to 7 years old are more influenced by the genetics, the shared environment of twins, or by individual characteristics of each twin. A total of 86 caregivers (mostly mothers) of twins from the Generation XXI birth cohort provided information on eating behaviors at 4 and 7 years of age. A score of problematic eating behaviors was developed. The Common fate model and the ACE model were used to estimate the effect of shared, individual, and genetic characteristics on changes in eating behaviors. At the dyadic level (shared), the eating behavior score at 4 years old was significantly and positively associated with the eating behavior at 7 years of age (β = 0.402, 95% CI 0.063;0.657). At the individual level, no significant association was observed (β = 0.020, 95% CI −0.078;0.125). The ACE model also showed the shared environment as the major responsible for the changes in eating behaviors from 4 to 7 years old. It also showed that genetic characteristics decreased their relevance overtime. This study supports that changes in eating behaviors from 4 to 7 years of age are mostly associated with the shared environment rather than individual characteristics of each twin. These results are important to improve future strategies to promote healthy environments.

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Fig. 1
Fig. 2: Dyadic and individual associations (95% confidence intervals) between twins’ eating behaviors at 4 and 7 years old obtained from a common fate model analysis.
Fig. 3: Cross-sectional and longitudinal ACE twin models.

Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.


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The authors gratefully acknowledge the families enrolled in Generation XXI for their kindness, all members of the research team for their enthusiasm and perseverance and the participating hospitals and their staff for their help and support. Generation XXI was funded by Programa Operacional de Saúde – Saúde XXI, Quadro Comunitário de Apoio III and Administração Regional de Saúde Norte (Regional Department of Ministry of Health). It has support from the Portuguese Foundation for Science and Technology and from the Calouste Gulbenkian Foundation.


This study was supported through FEDER from the Operational Programme Factors of Competitiveness – COMPETE and through national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Education and Science) under the projects “Appetite regulation and obesity in childhood: a comprehensive approach towards understanding genetic and behavioral influences” (POCI-01-0145-FEDER-030334); “Appetite and adiposity - evidence for gene-environment interplay in children” (IF/01350/2015); Reference: PTDC/SAU-PUB/29567/2017); “HIneC: when do health inequalities start? Understanding the impact of childhood social adversity on health trajectories from birth to early adolescence” (POCI-01-0145-FEDER-029567; Reference: PTDC/SAU-PUB/29567/2017), and through Investigator Contract (IF/01350/2015 - AO). It was also funded by the European Community’s Seventh Framework Programme under Grant Agreement No. 603946 (FP7-2013, HEALS project) and by the PhD Grant PD/BD/135,925/2018 (Cláudia Ribeiro) funded by FCT. In addition, this research was also supported by the Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit) trought FCT UIDB/04750/2020 and LA/P/0064/2020.

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All the authors have read and approved the paper and it has not been published previously nor is it being considered by any other peer-reviewed journal. CR: investigation, writing- original draft preparation; MS: formal analysis, methodology; AO: writing – review & editing; HB: writing – review & editing; ER: conceptualization; writing – review & editing, supervision; project administration, funding acquisition.

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Correspondence to Cláudia Ribeiro.

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Ribeiro, C., Severo, M., Oliveira, A. et al. Are problematic eating behaviors from 4- to 7-year-old explained by genetic, shared factors or individual characteristics? A longitudinal twin study. Eur J Clin Nutr (2022).

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