Background

There is growing evidence that highly processed (HP) foods may trigger an addictive-like process, including experiences of withdrawal. Withdrawal is marked by physically (e.g., headaches) and psychologically (e.g., irritability, cravings) aversive symptoms that could be an obstacle to successful dietary change. The aim of this study was to develop a developmentally appropriate and psychometrically sound measure (ProWS-C) to assess for signs of HP food withdrawal in children.

Methods

304 parents who had recently attempted to reduce their 3-11-year old children’s HP food consumption (56.9% female) were recruited through Amazon Mechanical Turk. The ProWS-C was adapted from the adult version to reflect parents’ observations of child behavior rather than the child’s subjective experience. Internal consistency and validity were evaluated.

Results

Exploratory factor analysis revealed a one-factor structure with 21 items (α=0.94). The ProWS-C demonstrated convergent validity with higher child addictive-like eating (r=.55, p<.001), larger child body size (r=.24, p<.001), and subscales of the Child Eating Behavior Questionnaire that may be implicated in reward-driven eating, and discriminant validity with child food neophobia (r=-.10, p=.08). The ProWS-C was associated with parental addictive-like eating (r=.49, p<.001) and weight cycling (r=.13, p=.025). The ProWS-C explained 7% of variance (p<.001) in lower parent-reported overall success in reducing HP foods and 3.1% of variance (p=.001) in a shorter length of successful diet change beyond child addictive-like eating and body size.

Conclusions

The ProWS-C provides preliminary evidence for a withdrawal-like syndrome in children when HP food intake is reduced and appears to be a psychometrically sound tool for assessing parent-reported withdrawal-like symptoms in children. Illuminating the specific challenges parents and children face when trying to reduce HP foods may improve parents’ ability to help their children make sustainable dietary changes.