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Dickin KL, Seim G. Adapting the Trials of Improved Practices (TIPs) approach to explore the acceptability and feasibility of nutrition and parenting recommendations: what works for low-income families? MATERNAL AND CHILD NUTRITION 2013; 11:897-914. [PMID: 24028083 DOI: 10.1111/mcn.12078] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Interventions to prevent childhood obesity must consider not only how child feeding behaviours are related to child weight status but also which behaviours parents are willing and able to change. This study adapted Trials of Improved Practices (TIPs) to assess acceptability and feasibility of nutrition and parenting recommendations, using in-depth interviews and household trials to explore families' experiences over time. A diverse sample of 23 low-income parents of 3-11-year-olds was recruited following participation in nutrition and parenting education. Parents chose nutrition and parenting practices to try at home and were interviewed 2 weeks and 4-6 months later about behaviour change efforts. Qualitative analysis identified emergent themes, and acceptability and feasibility were rated based on parents' willingness and ability to try new practices. The nutrition goal parents chose most frequently was increasing children's vegetable intake, followed by replacing sweetened beverages with water or milk, and limiting energy-dense foods. Parents were less inclined to reduce serving sizes. The parenting practices most often selected as applicable to nutrition goals were role-modelling; shaping home environments, often with other adults; involving children in decisions; and providing positive feedback. Most recommendations were viewed as acceptable by meaningful numbers of parents, many of whom tried and sustained new behaviours. Food preferences, habits and time were common barriers; family resistance or food costs also constrained some parents. Despite challenges, TIPs was successfully adapted to evaluate complex nutrition and parenting practices. Information on parents' willingness and ability to try practices provides valuable guidance for childhood obesity prevention programmes.
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Affiliation(s)
- Katherine L Dickin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Gretchen Seim
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
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Musher-Eizenman DR, Kiefner A. Food parenting: a selective review of current measurement and an empirical examination to inform future measurement. Child Obes 2013; 9 Suppl:S32-9. [PMID: 23944922 PMCID: PMC3746246 DOI: 10.1089/chi.2013.0030] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Interactions between parents and children in regard to food are an important part of the development of food preferences and intake patterns for children. The measurement of this complex and multidimensional construct is very challenging. METHODS This article examines the current status of measurement in this domain in a selective review, considers qualitative input from parents and adolescents in an empirical examination of the topic, and makes concrete recommendations for the future. RESULTS Qualitatively, there were important differences between what the adolescents reported that their parents did to impact their eating habits, what parents of younger children report they currently do, and what researchers typically measure in research on parental feeding practices. CONCLUSIONS On the basis of these empirical findings and our review of the literature, we recommend that food parenting be measured on three levels: Feeding styles (e.g., authoritative), food parenting practices (e.g., restriction), and specific feeding behaviors (e.g., putting food out of the child's reach). Specific recommendations for future study are given for each level of measurement.
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Affiliation(s)
| | - Allison Kiefner
- Department of Psychology, Bowling Green State University, Bowling Green, OH
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Hughes SO, Frankel LA, Beltran A, Hodges E, Hoerr S, Lumeng J, Tovar A, Kremers S. Food parenting measurement issues: working group consensus report. Child Obes 2013; 9 Suppl:S95-102. [PMID: 23944928 PMCID: PMC3746239 DOI: 10.1089/chi.2013.0032] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Childhood obesity is a growing problem. As more researchers become involved in the study of parenting influences on childhood obesity, there appears to be a lack of agreement regarding the most important parenting constructs of interest, definitions of those constructs, and measurement of those constructs in a consistent manner across studies. This article aims to summarize findings from a working group that convened specifically to discuss measurement issues related to parental influences on childhood obesity. Six subgroups were formed to address key measurement issues. The conceptualization subgroup proposed to define and distinguish constructs of general parenting styles, feeding styles, and food parenting practices with the goal of understanding interrelating levels of parental influence on child eating behaviors. The observational subgroup identified the need to map constructs for use in coding direct observations and create observational measures that can capture the bidirectional effects of parent-child interactions. The self-regulation subgroup proposed an operational definition of child self-regulation of energy intake and suggested future measures of self-regulation across different stages of development. The translational/community involvement subgroup proposed the involvement of community in the development of surveys so that measures adequately reflect cultural understanding and practices of the community. The qualitative methods subgroup proposed qualitative methods as a way to better understand the breadth of food parenting practices and motivations for the use of such practices. The longitudinal subgroup stressed the importance of food parenting measures sensitive to change for use in longitudinal studies. In the creation of new measures, it is important to consider cultural sensitivity and context-specific food parenting domains. Moderating variables such as child temperament and child food preferences should be considered in models.
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Affiliation(s)
- Sheryl O. Hughes
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Leslie A. Frankel
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Alicia Beltran
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Eric Hodges
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sharon Hoerr
- Department of Food Science & Human Nutrition, Michigan State University, East Lansing, MI
| | - Julie Lumeng
- Department of Pediatrics, University of Michigan Medical School; Human Nutrition Program, Department of Environmental Health Sciences, University of Michigan School of Public Health; and Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Alison Tovar
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingstown, RI
| | - Stef Kremers
- Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
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54
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Houldcroft L, Haycraft E, Farrow C. Peer and Friend Influences on Children's Eating. SOCIAL DEVELOPMENT 2013. [DOI: 10.1111/sode.12036] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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55
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Loth KA, MacLehose RF, Fulkerson JA, Crow S, Neumark-Sztainer D. Food-related parenting practices and adolescent weight status: a population-based study. Pediatrics 2013; 131:e1443-50. [PMID: 23610202 PMCID: PMC3639463 DOI: 10.1542/peds.2012-3073] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To examine food-related parenting practices (pressure-to-eat and food restriction) among mothers and fathers of adolescents and associations with adolescent weight status within a large population-based sample of racially/ethnically and socioeconomically diverse parent-adolescent pairs. METHODS Adolescents (N = 2231; 14.4 years old [SD = 2.0]) and their parents (N = 3431) participated in 2 coordinated population-based studies designed to examine factors associated with weight status and weight-related behaviors in adolescents. Adolescents completed anthropometric measurements and surveys at school. Parents (or other caregivers) completed questionnaires via mail or phone. RESULTS Findings suggest that the use of controlling food-related parenting practices, including pressure-to-eat and restriction, is common among parents of adolescents. Mean restriction levels were significantly higher among parents of overweight and obese adolescents compared with nonoverweight adolescents. However, levels of pressure-to-eat were significantly higher among nonoverweight adolescents. Results indicate that fathers are more likely than mothers to engage in pressure-to-eat behaviors and boys are more likely than girls to be on the receiving end of parental pressure-to-eat. Parental report of restriction did not differ significantly by parent or adolescent gender. No significant interactions by race/ethnicity or socioeconomic status were seen in the relationship between restriction or pressure-to-eat and adolescent weight status. CONCLUSIONS Given that there is accumulating evidence for the detrimental effects of controlling feeding practices on children's ability to self-regulate energy intake, these findings suggest that parents should be educated and empowered through anticipatory guidance to encourage moderation rather than overconsumption and emphasize healthful food choices rather than restrictive eating patterns.
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Affiliation(s)
- Katie A. Loth
- Division of Epidemiology and Community Health, School of Public Health
| | | | | | - Scott Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
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Clustering of diet- and activity-related parenting practices: cross-sectional findings of the INPACT study. Int J Behav Nutr Phys Act 2013; 10:36. [PMID: 23531232 PMCID: PMC3618009 DOI: 10.1186/1479-5868-10-36] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 03/19/2013] [Indexed: 12/02/2022] Open
Abstract
Background Various diet- and activity-related parenting practices are positive determinants of child dietary and activity behaviour, including home availability, parental modelling and parental policies. There is evidence that parenting practices cluster within the dietary domain and within the activity domain. This study explores whether diet- and activity-related parenting practices cluster across the dietary and activity domain. Also examined is whether the clusters are related to child and parental background characteristics. Finally, to indicate the relevance of the clusters in influencing child dietary and activity behaviour, we examined whether clusters of parenting practices are related to these behaviours. Methods Data were used from 1480 parent–child dyads participating in the Dutch IVO Nutrition and Physical Activity Child cohorT (INPACT). Parents of children aged 8–11 years completed questionnaires at home assessing their diet- and activity-related parenting practices, child and parental background characteristics, and child dietary and activity behaviours. Principal component analysis (PCA) was used to identify clusters of parenting practices. Backward regression analysis was used to examine the relationship between child and parental background characteristics with cluster scores, and partial correlations to examine associations between cluster scores and child dietary and activity behaviours. Results PCA revealed five clusters of parenting practices: 1) high visibility and accessibility of screens and unhealthy food, 2) diet- and activity-related rules, 3) low availability of unhealthy food, 4) diet- and activity-related positive modelling, and 5) positive modelling on sports and fruit. Low parental education was associated with unhealthy cluster 1, while high(er) education was associated with healthy clusters 2, 3 and 5. Separate clusters were related to both child dietary and activity behaviour in the hypothesized directions: healthy clusters were positively related to obesity-reducing behaviours and negatively to obesity-inducing behaviours. Conclusion Parenting practices cluster across the dietary and activity domain. Parental education can be seen as an indicator of a broader parental context in which clusters of parenting practices operate. Separate clusters are related to both child dietary and activity behaviour. Interventions that focus on clusters of parenting practices to assist parents (especially low-educated parents) in changing their child’s dietary and activity behaviour seems justified.
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Fisher JO, Birch LL, Zhang J, Grusak MA, Hughes SO. External influences on children's self-served portions at meals. Int J Obes (Lond) 2013; 37:954-60. [PMID: 23295501 DOI: 10.1038/ijo.2012.216] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 10/25/2012] [Accepted: 11/09/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Large portions promote intake among children, but little is known about the external influences of the eating environment on children's self-selected portion sizes. This research experimentally tested effects of the amount of entree available and serving spoon size on children's self-served entree portions and intakes at dinner meals. A secondary objective was to identify child and family predictors of self-served entree portion sizes. DESIGN A 2 × 2 within-subjects design was used, in which the amount of a pasta entree available for self-serving (275 vs 550 g) and the serving spoon size (teaspoon vs tablespoon) were systematically varied. The serving bowl size and portion sizes of all other foods offered were held constant across conditions. Conditions were spaced 1 week apart and randomly assigned. Weighed self-served entree portions and food intakes as well as demographics, maternal feeding styles and child/maternal anthropometrics were measured. SUBJECTS Participants were 60 ethnically diverse children aged 4-6 years and their mothers. RESULTS Mixed models revealed that children served themselves 40% more entree when the amount available was doubled (P<0.0001) and 13% more when the serving spoon size was tripled (P<0.05). Serving spoon size and the amount of entree available indirectly influenced children's intake, with larger self-served portion sizes related to greater entree intakes (P<0.0001). Greater self-served portions and energy intakes at the meal were seen among those children whose mothers reported indulgent or authoritarian feeding styles (P<0.001). CONCLUSION Children's self-served portion sizes at meals are influenced by size-related facets of the eating environment and reflect maternal feeding styles.
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Affiliation(s)
- J O Fisher
- Department of Public Health, Center for Obesity Research and Education, Temple University, Philadelphia, PA 19140, USA.
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58
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Sleddens EFC, Kremers SPJ, Hughes SO, Cross MB, Thijs C, De Vries NK, O'Connor TM. Physical activity parenting: a systematic review of questionnaires and their associations with child activity levels. Obes Rev 2012; 13:1015-33. [PMID: 22845791 DOI: 10.1111/j.1467-789x.2012.01018.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Insufficient physical activity (PA) is considered a critical contributor to childhood overweight. Parents are a key in influencing their child's PA through various mechanisms of PA parenting, including support, restriction of PA and facilitation of enrolment in PA classes or activities. However, study findings are difficult to compare because instruments vary in terms of constructs, psychometric assessment and type of PA assessed. The goal of the current review was to identify existing PA parenting questionnaires and report on the validation of these measures through findings of their psychometric performance and correlation to youth's PA. The search of eligible studies was restricted to instruments with multiple items. Eleven unique PA parenting questionnaires were identified, and 46 studies that used these instruments were included. Extracted data include sample characteristics, as well as type and assessment methods of parental influence and PA. Findings highlight the tremendous variation in the conceptualization and measurement of PA parenting, common use of non-validated instruments and lack of comprehensive measures. The development of theory-based PA parenting measures (preferably multidimensional) should be prioritized to guide the study of the parental role in promoting child's PA as well as the design of family-based PA interventions.
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Affiliation(s)
- E F C Sleddens
- Department of Health Promotion, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University Medical Center, Maastricht, The Netherlands.
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59
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Jansen PW, Roza SJ, Jaddoe VW, Mackenbach JD, Raat H, Hofman A, Verhulst FC, Tiemeier H. Children's eating behavior, feeding practices of parents and weight problems in early childhood: results from the population-based Generation R Study. Int J Behav Nutr Phys Act 2012; 9:130. [PMID: 23110748 PMCID: PMC3543222 DOI: 10.1186/1479-5868-9-130] [Citation(s) in RCA: 216] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 10/24/2012] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Weight problems that arise in the first years of life tend to persist. Behavioral research in this period can provide information on the modifiable etiology of unhealthy weight. The present study aimed to replicate findings from previous small-scale studies by examining whether different aspects of preschooler's eating behavior and parental feeding practices are associated with body mass index (BMI) and weight status -including underweight, overweight and obesity- in a population sample of preschool children. METHODS Cross-sectional data on the Child Eating Behaviour Questionnaire, Child Feeding Questionnaire and objectively measured BMI was available for 4987 four-year-olds participating in a population-based cohort in the Netherlands. RESULTS Thirteen percent of the preschoolers had underweight, 8% overweight, and 2% obesity. Higher levels of children's Food Responsiveness, Enjoyment of Food and parental Restriction were associated with a higher mean BMI independent of measured confounders. Emotional Undereating, Satiety Responsiveness and Fussiness of children as well as parents' Pressure to Eat were negatively related with children's BMI. Similar trends were found with BMI categorized into underweight, normal weight, overweight and obesity. Part of the association between children's eating behaviors and BMI was accounted for by parental feeding practices (changes in effect estimates: 20-43%), while children's eating behaviors in turn explained part of the relation between parental feeding and child BMI (changes in effect estimates: 33-47%). CONCLUSIONS This study provides important information by showing how young children's eating behaviors and parental feeding patterns differ between children with normal weight, underweight and overweight. The high prevalence of under- and overweight among preschoolers suggest prevention interventions targeting unhealthy weights should start early in life. Although longitudinal studies are necessary to ascertain causal directions, efforts to prevent or treat unhealthy child weight might benefit from a focus on changing the behaviors of both children and their parents.
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Affiliation(s)
- Pauline W Jansen
- The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands.
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A Review of Methods to Assess Parental Feeding Practices and Preschool Children's Eating Behavior: The Need for Further Development of Tools. J Acad Nutr Diet 2012; 112:1578-602, 1602.e1-8. [DOI: 10.1016/j.jand.2012.06.356] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 06/07/2012] [Indexed: 11/24/2022]
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61
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MOROSHKO I, BRENNAN L. Maternal controlling feeding behaviours and child eating in preschool-aged children. Nutr Diet 2012. [DOI: 10.1111/j.1747-0080.2012.01631.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rigal N, Chabanet C, Issanchou S, Monnery-Patris S. Links between maternal feeding practices and children’s eating difficulties. Validation of French tools. Appetite 2012; 58:629-37. [DOI: 10.1016/j.appet.2011.12.016] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Revised: 12/20/2011] [Accepted: 12/23/2011] [Indexed: 10/14/2022]
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Hendy HM, Williams KE. Mother's feeding practices for children 3-10 years of age and their associations with child demographics. Appetite 2012; 58:710-6. [PMID: 22269792 DOI: 10.1016/j.appet.2012.01.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 01/05/2012] [Accepted: 01/07/2012] [Indexed: 11/18/2022]
Abstract
The present study examined relationships between mothers' feeding practices and child demographics such as gender, age, weight status, and family income. This cross-sectional analysis was conducted using data from 2259 children between 3 and 10 years of age who were sampled for the development of the Parent Mealtime Action Scale. No child gender differences were found in mothers' feeding practices. Older children received more Fat Reduction and Many Food Choices, but less Positive Persuasion, Use of Rewards, Insistence on Eating, and Special Meals, with differences in these feeding practices being most notable from before to after school age. Overweight children received less Insistence on Eating and more Fat Reduction than underweight or normal weight children. Children with the lowest family incomes received less Fat Reduction, less Daily FV Availability, more Use of Rewards. Results suggest that mothers respond to changing conditions, possibly including feedback from school nurses, increases in children's weight status, and availability of financial resources.
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Affiliation(s)
- Helen M Hendy
- Penn State University, Schuylkill Campus, 200 University Drive, Schuylkill Haven, PA 17972, USA.
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64
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Frankel LA, Hughes SO, O'Connor TM, Power TG, Fisher JO, Hazen NL. Parental Influences on Children's Self-Regulation of Energy Intake: Insights from Developmental Literature on Emotion Regulation. J Obes 2012; 2012:327259. [PMID: 22545206 PMCID: PMC3321464 DOI: 10.1155/2012/327259] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 01/11/2012] [Indexed: 01/02/2023] Open
Abstract
The following article examines the role of parents in the development of children's self-regulation of energy intake. Various paths of parental influence are offered based on the literature on parental influences on children's emotion self-regulation. The parental paths include modeling, responses to children's behavior, assistance in helping children self-regulate, and motivating children through rewards and punishments. Additionally, sources of variation in parental influences on regulation are examined, including parenting style, child temperament, and child-parent attachment security. Parallels in the nature of parents' role in socializing children's regulation of emotions and energy intake are examined. Implications for future research are discussed.
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Affiliation(s)
- Leslie A. Frankel
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
- *Leslie A. Frankel:
| | - Sheryl O. Hughes
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Teresia M. O'Connor
- Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Thomas G. Power
- Department of Human Development, Washington State University, Pullman, WA 99164, USA
| | - Jennifer O. Fisher
- Department of Public Health, Temple University, Philadelphia, PA 19140, USA
| | - Nancy L. Hazen
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, TX 78712, USA
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Sleddens EFC, Gerards SMPL, Thijs C, de Vries NK, Kremers SPJ. General parenting, childhood overweight and obesity-inducing behaviors: a review. ACTA ACUST UNITED AC 2011; 6:e12-27. [DOI: 10.3109/17477166.2011.566339] [Citation(s) in RCA: 312] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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66
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Gubbels JS, Kremers SPJ, Stafleu A, de Vries SI, Goldbohm RA, Dagnelie PC, de Vries NK, van Buuren S, Thijs C. Association between parenting practices and children's dietary intake, activity behavior and development of body mass index: the KOALA Birth Cohort Study. Int J Behav Nutr Phys Act 2011; 8:18. [PMID: 21401954 PMCID: PMC3065396 DOI: 10.1186/1479-5868-8-18] [Citation(s) in RCA: 138] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 03/14/2011] [Indexed: 11/15/2022] Open
Abstract
Background Insights into the effects of energy balance-related parenting practices on children's diet and activity behavior at an early age is warranted to determine which practices should be recommended and to whom. The purpose of this study was to examine child and parent background correlates of energy balance-related parenting practices at age 5, as well as the associations of these practices with children's diet, activity behavior, and body mass index (BMI) development. Methods Questionnaire data originated from the KOALA Birth Cohort Study for ages 5 (N = 2026) and 7 (N = 1819). Linear regression analyses were used to examine the association of child and parent background characteristics with parenting practices (i.e., diet- and activity-related restriction, monitoring and stimulation), and to examine the associations between these parenting practices and children's diet (in terms of energy intake, dietary fiber intake, and added sugar intake) and activity behavior (i.e., physical activity and sedentary time) at age 5, as well as BMI development from age 5 to age 7. Moderation analyses were used to examine whether the associations between the parenting practices and child behavior depended on child characteristics. Results Several child and parent background characteristics were associated with the parenting practices. Dietary monitoring, stimulation of healthy intake and stimulation of physical activity were associated with desirable energy balance-related behaviors (i.e., dietary intake and/or activity behavior) and desirable BMI development, whereas restriction of sedentary time showed associations with undesirable behaviors and BMI development. Child eating style and weight status, but not child gender or activity style, moderated the associations between parenting practices and behavior. Dietary restriction and monitoring showed weaker, or even undesirable associations for children with a deviant eating style, whereas these practices showed associations with desirable behavior for normal eaters. By contrast, stimulation to eat healthy worked particularly well for children with a deviant eating style or a high BMI. Conclusion Although most energy balance-related parenting practices were associated with desirable behaviors, some practices showed associations with undesirable child behavior and weight outcomes. Only parental stimulation showed desirable associations with regard to both diet and activity behavior. The interaction between parenting and child characteristics in the association with behavior calls for parenting that is tailored to the individual child.
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Affiliation(s)
- Jessica S Gubbels
- Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, the Netherlands
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Corsini N, Wilson C, Kettler L, Danthiir V. Development and preliminary validation of the Toddler Snack Food Feeding Questionnaire. Appetite 2010; 54:570-8. [PMID: 20211670 DOI: 10.1016/j.appet.2010.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 02/25/2010] [Accepted: 03/01/2010] [Indexed: 11/24/2022]
Abstract
This study describes the development of a measure of parental influences on toddlers' intake of snack foods, the Toddler Snack Food Feeding Questionnaire (TSFFQ), and presents evidence for the factor structure, test-retest reliability, convergent, discriminant and concurrent validity of the instrument. Exploratory factor analysis (EFA) was conducted in two samples (parents of toddlers stating current practices; parents of preschoolers recalling past practices). EFA identified five meaningful and interpretable factors: Rules, Flexibility, Allow Access, Self-efficacy and Child's Attraction. Allow Access, Flexibility, and Child's Attraction were positively correlated with frequency of toddlers' snack food consumption. In the preschool sample only, not-overweight and overweight parents both had significantly lower scores than obese parents on Allow Access. No significant correlations were found between parents' recall of past feeding and BMI z-scores at preschool age. The TSFFQ strengthens our understanding of how parents control their children's intake of snack foods and could be used along with other measures of parental feeding control to investigate parental influences on children's eating behaviour, food preferences, energy balance and weight status.
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Affiliation(s)
- Nadia Corsini
- CSIRO Food and Nutritional Sciences, P.O. Box 10041, Adelaide 5000, SA, Australia.
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68
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Santos JL, Kain J, Dominguez-Vásquez P, Lera L, Galván M, Corvalán C, Uauy R. Maternal anthropometry and feeding behavior toward preschool children: association with childhood body mass index in an observational study of Chilean families. Int J Behav Nutr Phys Act 2009; 6:93. [PMID: 20040107 PMCID: PMC2809038 DOI: 10.1186/1479-5868-6-93] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Accepted: 12/29/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A better understanding of the link between eating behavior and maternal feeding practices with childhood and maternal weight status is of great interest. OBJECTIVE To assess the association between childhood anthropometric measures with mothers' Body Mass Index (BMI) and their feeding practices toward preschool children in Chile. METHODS 1029 children (504 boys, 4.3 +/- 0.3 years) and their mothers were selected from public nurseries located in low income neighborhoods in Santiago. Mothers' BMI, children's BMI and waist-to-height ratios were registered. Maternal feeding practices towards their children's nutritional habits were measured using an adapted version of the Child Feeding Questionnaire (CFQ). RESULTS We found a direct correlation (p < 0.001) between children's BMI z-score and their mothers' BMI, both in boys (Spearman rho = 0.26) and girls (rho = 0.30). A direct association was also found between children's BMI z-score with scores of the subscale "concern for child's weight" (Spearman rho = 0.26 in boys and rho = 0.37 in girls; p < 0.001) and "food restriction" (rho = 0.19 in boys and rho = 0.27 in girls; p < 0.001). A reverse significant association was found between children's BMI z-score with scores of "pressure to eat" (rho = -0.30 in boys and rho = -0.36 in girls; p < 0.001). Analyses of the combined categories of childhood obesity and/or maternal obesity showed an important influence of children's weight status on CFQ scores. CONCLUSION Mothers' BMI and children's BMI z-scores are highly correlated. We found significant associations between mothers' behaviour subscales and children's BMI z-score. It is not possible to establish a causal link between mother's CFQ scores and children's nutritional status, given the cross-sectional nature of this study and the bidirectional influences that exist between mothers and their children.
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Affiliation(s)
- José Luis Santos
- Departamento de Nutrición, Diabetes y Metabolismo. Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Olstad DL, McCargar L. Prevention of overweight and obesity in children under the age of 6 years. Appl Physiol Nutr Metab 2009; 34:551-70. [PMID: 19767789 DOI: 10.1139/h09-016] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Although obesity was rarely observed among children 30 years ago, it is now evident among Canadian children of all ages. Currently, 15.2% of 2- to 5-year-old children are overweight, whereas 6.3% are obese. Limited data suggest that poor dietary and physical activity patterns are increasing obesity risk among these young children. Body weight and lifestyle behaviours are known to track from childhood to adulthood, thereby increasing the risk for obesity and other chronic diseases later in life. Intrauterine life, infancy, and the preschool years may all include critical periods that program the long-term regulation of energy balance, and therefore obesity-prevention strategies should be initiated in utero and continue throughout childhood and adolescence. Although single-strategy obesity-prevention initiatives have had limited success, programs that target multiple behaviours may help reduce body weight and body fat among young children. Parental involvement is key to the success of obesity-prevention programs at a young age, as parents have primary control over their children's food and activity environments. Accordingly, parental obesity is the best predictor of childhood obesity. Parents should be encouraged to teach and role model healthy lifestyle behaviours for their young children. Health professionals can also be involved in obesity prevention, as they are ideally placed to identify young children at risk for obesity. By calculating and plotting the body mass index for all children, and initiating obesity-prevention strategies in utero, health professionals can help curb the rise in overweight and obesity among young children.
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Affiliation(s)
- Dana Lee Olstad
- Alberta Institute for Human Nutrition, University of Alberta, Edmonton, AB T6G 2P5, Canada
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Saxton J, Carnell S, van Jaarsveld CHM, Wardle J. Maternal education is associated with feeding style. ACTA ACUST UNITED AC 2009; 109:894-8. [PMID: 19394477 DOI: 10.1016/j.jada.2009.02.010] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Accepted: 09/19/2008] [Indexed: 12/20/2022]
Abstract
Maternal feeding styles may be influenced by maternal education, with implications for children's dietary quality and adiposity. One-hundred and eighty mothers completed the Parental Feeding Style Questionnaire, which includes scales assessing four aspects of feeding style, ie, control over feeding, emotional feeding, instrumental feeding, and encouragement/prompting to eat. Mothers with higher education had significantly higher scores on control over feeding [F(1,177)=8.79; P=0.003] and significantly lower emotional feeding scores [F(1,177)=7.26; P=0.008] than those with lower education. There were no differences for instrumental feeding or encouragement/prompting to eat (P>0.05). These findings suggest modest but potentially important differences in maternal control and emotional feeding styles by maternal education. Should these feeding characteristics prove salient to childhood diet and weight, this could inform appropriately targeted parental feeding advice.
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Affiliation(s)
- Jennifer Saxton
- Department of Epidemiology and Public Health University College London, Gower St, London. WC1E 6BT UK
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Rossi A, Moreira EAM, Rauen MS. Determinantes do comportamento alimentar: uma revisão com enfoque na família. REV NUTR 2008. [DOI: 10.1590/s1415-52732008000600012] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
O comportamento alimentar ocupa atualmente um papel central na prevenção e no tratamento de doenças. A alimentação durante a infância, ao mesmo tempo em que é importante para o crescimento e desenvolvimento, pode também representar um dos principais fatores de prevenção de algumas doenças na fase adulta. Freqüentemente a família, os fatores sociais e os ambientais podem influenciar o padrão alimentar das crianças. O objetivo desta revisão foi abordar os diversos fatores ambientais envolvidos na aquisição de hábitos alimentares na infância. Os artigos selecionados foram pesquisados nas bases de dados Medline e SciELO considerando o período de 1978 a 2007. Foram utilizados os termos em ingles: children's eating patterns, children's dietary quality, determinants of children's eating patterns e em português. São apresentados os resultados de algumas investigações mais relevantes nesta área. Embora alguns desses fatores sejam inatos e, por isso, necessitem de um controle mais rigoroso, ressalta-se o papel determinante da família na formação dos hábitos alimentares saudáveis, pois a modificação de um hábito alimentar durante a fase adulta tem, em geral, alta taxa de insucesso. Além disso, outros fatores, como a escola, a rede social, as condições socioeconômicas e culturais, são potencialmente modificáveis e influenciam no processo de construção dos hábitos alimentares da criança e, conseqüentemente, do indivíduo adulto.
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