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Purpose Given the variability in adiposity despite ubiquitous exposure to obesogenic food environments, it has been suggested that individuals respond in divergent ways to the environment they live in. The food environment becomes more ‘permissive’ as children age; therefore, genetic predisposition for a more avid appetite can be better expressed, influencing dietary quality, energy intake and weight gain. Our aim was to explore the genetic and environmental contribution of variations on appetitive traits in a sample of 10-year-old Portuguese children. Methods Participants were twins enrolled in the Generation XXI birth cohort (n = 86 pairs). Parents reported twin’s zygosity and child appetitive traits at 10 years of age through the Children’s Eating Behavior Questionnaire. Intra-class correlations (ICCs) for all appetitive traits were calculated for monozygotic and dizygotic twins separately to examine patterns of resemblance, and structural equation modeling was conducted aiming to estimate the genetic (A), shared (C) and non-shared (E) environmental variances. Results Moderate to strong heritability were found for child appetitive traits, with higher ICCs among monozygotic twin pairs. For all appetitive traits, with the exception of emotional undereating, genetic and non-shared environmental effects contributed to appetite variability. For emotional undereating, environmental effects seem to be more important than genetic effects (C: 0.81; 95% CI 0.71; 0.88 and E: 0.19; 95% CI 0.12; 0.29). Conclusion There was a significant genetic contribution, followed by non-shared environmental contribution, towards variation in appetitive traits in school-age children. Variation in emotional undereating was primarily explained by shared and non-shared environmental factors. Level of evidence Evidence obtained from well-designed cohort or case–control analytic studies.

Evidence on the association between children's food insecurity (FI) and dietary patterns (DPs) is scarce. This study assessed the association between children's FI and a priori and a posteriori-defined DPs in a Portuguese population-based sample of children. A cross-sectional study including 2800 children from the ten-year-old follow-up of the Generation XXI birth cohort was performed. Data on food security status, assessed by the Self-administered Food Security Survey Module for children (SAFSSMC), dietary intake and socio-demographics were collected. A previously developed Healthy Eating Index (HEI) was adapted for this study. Using the HEI score and its food groups, linear and logistic regression models were performed. Using latent class analysis, five a posteriori-defined DPs were identified. The DPs names considered an overall picture of the DP. Food security status as a categorical (food security/FI) and continuous variable (SAFSSMC raw score: higher scores representing higher FI) was used. Multinomial logistic regression models were used to assess the association between food security status and DPs. Children's FI (9.4%) was inversely associated with the HEI score (β=-0.695;95%CI:-1.154;-0.235), representing worse diet quality. A higher SAFSSMC raw score was associated with low fruit and vegetables (OR=1.089;95%CI:1.023;1.159) and seafood and eggs consumption (OR=1.073;95%CI:1.009-1.142), high consumption of meat and meat products (OR=1.091;95%CI:1.026;1.160), salty snacks (OR=1.067;95%CI:1.003-1.136) and soft drinks (OR=1.097;95%CI:1.031;1.168). The SAFSSMC raw score was positively associated with "Low consumption" (OR=1.119;95%CI:1.016;1.232), "Energy-dense foods" (OR=1.155;95%CI:1.028;1.298) and "Snacking" (OR=1.119;95%CI:1.006;1.245) DPs. FI was associated with worse dietary choices. Intervention strategies targeting food insecure children should be developed to promote healthy dietary habits. 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). This study was funded by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Science, Technology and Higher Education), under the project “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; Ref: info:eu-repo/grantAgreement/FCT/9471 - RIDTI/info:eu-repo/grantAgreement/FCT/9471 - RIDTI/PTDC/SAU-PUB/29567/2017/PT017/PT) and the project “Appetite regulation and obesity in childhood: a comprehensive approach towards understanding genetic and behavioural influences” (PTDC/SAU-EPI/30334/2017/ POCI-01-0145- FEDER-030334). This research was also financed by Portuguese Funds through FCT - Foundation for Science and Technology, I.P., under the project info:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB/04750/2020/PT [Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (EPIUnit)], and by the Calouste Gulbenkian Foundation. Isabel Maia holds a PhD Grant (Ref.SFRH/BD/117371/2016), co-funded by the FCT and the POCH/FSE Program. Ana Cristina Santos (info:eu-repo/grantAgreement/FCT/Investigador FCT/IF/01060/2015/CP1319/CT0001/PT) and Andreia Oliveira (IF/01350/2015) hold an FCT Investigator contracts.