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Research Article: Associations between early childhood appetitive traits and dietary diversity in school-age children: a two-year longitudinal follow-up study

Date Published: 2026-07-21

Abstract:
Dietary diversity reflects diet quality and is critical for children’s growth and long-term health. Appetitive traits affect dietary habits and long-term food choices. However, few studies have explored the associations between early childhood appetitive traits and dietary diversity in school-age children using standardized and validated tools. We recruited 208 kindergarten children aged 5–6?years, with 194 completing the two-year longitudinal follow-up. Appetitive traits were evaluated at age 5–6 using the Child Eating Behavior Questionnaire (CEBQ). Dietary diversity was assessed 2 years later via the Dietary Diversity Score (DDS). Binary logistic regressions were carried out to assess the associations between early childhood appetitive traits and dietary diversity. Inverse probability weighting (IPW) was conducted in complete cases to test the robustness of the main results. Higher food fussiness at 5–6?years was significantly associated with a lower likelihood of high DDS 2 years later (OR?=?0.521, 95% CI: 0.327–0.830). No significant sex interactions were observed for these associations. Food fussiness at 5–6?years was associated with dietary diversity in school-age children. These findings underscore the relevance of early appetitive traits to dietary diversity and provide evidence-based insights for promoting children’s nutrition.

Introduction:
Dietary diversity reflects diet quality and is critical for children’s growth and long-term health. Appetitive traits affect dietary habits and long-term food choices. However, few studies have explored the associations between early childhood appetitive traits and dietary diversity in school-age children using standardized and validated tools.

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