Adaptation, validation and reliability of the Spanish version of eating pattern inventory for children EPIC-C in a sample of Mexican adolescents

Patricia Trujano, Manuel De Gracia, Carlos Nava, Mónica Thomas


Background: Eating behavior represents an important public health issue. This study shows the results of the adaptation and validation of the questionnaire eating pattern inventory for children (EPI-C) in the Spanish version, what can be very useful in Spanish-speaking contexts.

Methods: The adaptation and validation of the questionnaire was carried out with a statistically representative sample of 417 adolescents of Mexico City. Different statistical analysis were applied.

Results: The analysis of the adapted version reproduced the same factorial structure and psychometric properties as the original questionnaire. The adapted inventory consisted of 20 items, formed by 4 subscales dietary restraint (8 items), external eating (6 items), parental pressure to eat (3 items), and emotional eating (3 items) which explained the 68,8% of the total variable.

Conclusions: The scores of the subscales were associated with the body weight of the adolescents with normal weight and overweight-obesity, with the level of the anxiety state, with the emotional eating and with the dietary restraints which suggests initial evidence of its validity and utility in Spanish speaking countries.


Adaptation, Adolescents, Eating behavior, Questionnaire EPI-C, Validity

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Faith MS. Development and modification of child food preferences and eating patterns: behavior genetics strategies. Int J Obes. 2005;29(6):549-56.

Pérez Herrera A. Current situation of childhood obesity in Mexico. Nutr Hosp. 2019;36(2):463-9.

Whitaker RC, Deeks CM, Baughcum AE, Specker BL. The relationship of childhood adiposity to parent body mass index and eating behavior. Obes Res. 2000;8(3):234-40.

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766-81.

National Survey of Health and Nutrition 2018. 2019. Available at: contenidos/ programas/ensanut/2018/doc/ensanut_2018_presentacion_resultados.pdf. Accessed on 20 November, 2019

García LI, Ledezma JC. Obesity, a true persistent public health problem in Mexico. J Negative No Positive Results. 2018;3(8):643-54.

Schacht M, Richter-Appelt H, Schulte-Markwort M, Hebebrand J, Schimmelmann BG. Eating pattern inventory for children: A new self-rating questionnaire for preadolescents. J Clin Psychol. 2006;62(10):1259-73.

Diehl JM. Attitude to eating and body weight by 11- to 16-year-old adolescents. Schweiz Med Wochenschr. 1999;129(5):162-75.

Munkholm A, Bjorner JB, Petersen J, Micali N, Olsen EM, Skovgaard AM. Validation of the eating pattern inventory for children in a general population sample of 11- to 12-year-old children. Assessment. 2017;24(6):810-9.

Maloney MJ, McGUIRE JB, Daniels SR. Reliability testing of a children’s version of the eating attitude test. J Am Acad Child Adolesc Psychiatr. 1988;27(5):541-3.

Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med. 1982;12(4):871-8.

de Gracia M, Marcó M, Trujano P. Factors associated with eating behavior in pre-adolescents. Psicothema. 2007;19(4):646-53.

Kovacs, M. Children’s depression inventory (CDI). Technical manual update. North Tonawanda, NY: Multi-Health Systems; 2003.

Ahlen J, Ghaderi A. Evaluation of the children’s depression inventory- short version (CDI-S). Psychol Assess. 2017;29(9):1157-66.

Allgaier AK, Frühe B, Pietsch K, Saravo B, Baethmann M, Schulte-Körne G. Is the children’s depression inventory short version a valid screening tool in pediatric care? A comparison to its full-length version. J Psychosom Res. 2012;73(5):369-74.

Miu AS, Yeager DS. Preventing symptoms of depression by teaching adolescents that people can change: effects of a brief incremental theory of personality intervention at 9-month follow-up. Clin Psychol Sci. 2015;3(5):726-43.

del Barrio V, Roa ML, Olmedo M, Colodrón F. First adaptation of the CDI-S to the Spanish population. Rev Accion Psicológica. 2002;1(3):263-72.

Spielberger CD, Edwards CD. Preliminary Test Manual for the State-trait Anxiety Inventory for Children: (“How-I-feel Questionnaire”). Consulting Psychologists Press; 1973.

Buela-Casal G, Guillén-Riquelme A, Seisdedos N. STAI, state-trait anxiety questionnaire. Spanish adaptation. 8th edn. Madrid: TEA; 2011.

Cole TJ. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240.

Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007;335(7612):194.

Cohen J. Statistical power analysis. Curr Dir Psychol Sci. 1992;1(3):98-101.

Timmerman ME, Lorenzo-Seva U. Dimensionality assessment of ordered polytomous items with parallel analysis. Psychol Methods. 2011;16(2):209-20.

Lorenzo-Seva U, Ferrando PJ. Robust Promin: A method for diagonally weighted factor rotation. Lib Rev Peru Psicol. 2019;25(1):99-106.

Cheung GW, Rensvold RB. Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Model Multidiscip J. 2002;9(2):233-55.

Steiger JH. Structural model evaluation and modification: an interval estimation approach. Multivar Behav Res. 1990;25(2):173-80.

Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990;107(2):238-46.

Browne MW, Cudeck R. Alternative ways of assessing model fit. Sociol Methods Res. 1992;21(2):230-58.

Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model Multidiscip J. 1999;6(1):1-55.

Jöreskog KG, Sörbom D. LISREL 8: Structural equation modelling with the SIMPLIS command language. Hillsdale, NJ, US: Lawrence Erlbaum Associates, Inc; 1993:202.

Steiger JH. Understanding the limitations of global fit assessment in structural equation modelling. Personal Individ Differ. 2007;42(5):893-8.

Berra S, Rivadero L, Ponzo J, Osorio AG, Pasarín MI, Leyns C, et al. Linguistic acceptability in understanding health services assessment questionnaires in Latin America. Gac sanit. 2021;35(4):395-8.

Valdés A, Vera JA, Urias M. Particularities of the current Mexican family. Mexico: AM Editores; 2017.

McVey G. Dieting among preadolescent and young adolescent females. Can Med Assoc J. 2004;170(10):1559-61.

Racine SE, Burt SA, Iacono WG, McGue M, Klump KL. Dietary restraint moderates genetic risk for binge eating. J Abnorm Psychol. 2011;120(1):119-28.

Field D, Garland M, Williams K. Correlates of specific childhood feeding problems. J Paediatr Child Health. 2003;39(4):299-304.

Jones JM, Bennett S, Olmsted MP, Lawson ML, Rodin G. Disordered eating attitudes and behaviors in teenaged girls: a school-based study. Can Med Assoc J. 2001;165(5):547-52.

Lazarevich I, Irigoyen Camacho ME, Velázquez-Alva M del C, Zepeda Zepeda M. Relationship among obesity, depression, and emotional eating in young adults. Appetite. 2016;107:639-44.

Ahmed SP, Bittencourt-Hewitt A, Sebastian CL. Neurocognitive bases of emotion regulation development in adolescence. Dev Cogn Neurosci. 2015;15:11-25.

Peñate W, González-Loyola M, Oyanadel C. The predictive role of affectivity, self-esteem and social support in depression and anxiety in children and adolescents. Int J Environ Res Public Health. 2020;17(19):6984.