1
|
Fan JG, Kuehn M, Voegtline KM, Raghunathan RS, Hernandez RG, Johnson SB. Increasing Maternal Anxiety in the Pre- to Postpartum Transition Predicts Infant Feeding Practices and Beliefs. Acad Pediatr 2023:S1876-2859(23)00425-4. [PMID: 38042403 PMCID: PMC11136874 DOI: 10.1016/j.acap.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE Anxiety symptoms increase for some mothers in the perinatal period. Little is known about how increasing anxiety relates to infant feeding beliefs or weight-for-length. We examined relationships between clinically meaningful increases in maternal anxiety symptoms and perceptions of infant feeding behaviors and weight-for-length. METHODS Participants were 237 mothers with singleton pregnancies enrolled from obstetric care between 2015 and 2020 who completed the Infant Feeding Questionnaire (IFQ) at 6 months. Anxiety symptoms were measured during pregnancy (M = 24.6 weeks, SD = 6.3) and 6 weeks postpartum using the PROMIS-6A. Linear regression was used to test associations of prenatal, postpartum, or clinically meaningful increases in anxiety symptoms (ie, 3T-score increase) with two outcomes: IFQ (seven factors) and infant weight-for-length at age 6 months. RESULTS Prenatal symptoms were unrelated to IFQ factors. Postpartum symptoms predicted IFQ factors related to worry, such as concern for infant undereating/becoming underweight (B = 0.012, P = .02). Increasing symptoms predicted worry-related concerns as well as concern for infant hunger (B = 0.60, P ≤ .01) and greater preference for feeding on a schedule (B = 0.65, P ≤ .01). In a model including both increasing symptoms and postpartum symptoms, increasing anxiety symptoms drove associations with IFQ factors (eg, preference for feeding on a schedule, (B = 0.81, P = .01). Anxiety was unrelated to infant weight-for-length at 6 months. CONCLUSIONS Clinically meaningful increases in anxiety symptoms were associated with feeding beliefs related to worry. Increasing anxiety was a better predictor of feeding beliefs than the presence of pre- or postpartum symptoms alone. Mothers with increasing anxiety may benefit from support establishing health-promoting infant feeding practices.
Collapse
Affiliation(s)
- Juliana G Fan
- Johns Hopkins University School of Medicine (JG Fan), Baltimore, MD.
| | - Molly Kuehn
- Johns Hopkins University School of Medicine (M Kuehn, KM Voegtline, RG Hernandez, and SB Johnson), Department of Pediatrics, Baltimore, MD
| | - Kristin M Voegtline
- Johns Hopkins University School of Medicine (M Kuehn, KM Voegtline, RG Hernandez, and SB Johnson), Department of Pediatrics, Baltimore, MD; Johns Hopkins University Bloomberg School of Public Health (KM Voegtline, RS Raghunathan, and SB Johnson), Department of Population Family and Reproductive Health, Baltimore, MD
| | - Radhika S Raghunathan
- Johns Hopkins University Bloomberg School of Public Health (KM Voegtline, RS Raghunathan, and SB Johnson), Department of Population Family and Reproductive Health, Baltimore, MD; Johns Hopkins Bloomberg School of Public Health (RS Raghunathan and SB Johnson), Department of Mental Health, Baltimore, MD
| | - Raquel G Hernandez
- Johns Hopkins University School of Medicine (M Kuehn, KM Voegtline, RG Hernandez, and SB Johnson), Department of Pediatrics, Baltimore, MD; Department of Pediatrics, Johns Hopkins All Children's Hospital (RG Hernandez), St. Petersburg, FL
| | - Sara B Johnson
- Johns Hopkins University School of Medicine (M Kuehn, KM Voegtline, RG Hernandez, and SB Johnson), Department of Pediatrics, Baltimore, MD; Johns Hopkins University Bloomberg School of Public Health (KM Voegtline, RS Raghunathan, and SB Johnson), Department of Population Family and Reproductive Health, Baltimore, MD; Johns Hopkins Bloomberg School of Public Health (RS Raghunathan and SB Johnson), Department of Mental Health, Baltimore, MD
| |
Collapse
|
2
|
Carnell S, Thapaliya G, Jansen E, Chen L. Biobehavioral susceptibility for obesity in childhood: Behavioral, genetic and neuroimaging studies of appetite. Physiol Behav 2023; 271:114313. [PMID: 37544571 PMCID: PMC10591980 DOI: 10.1016/j.physbeh.2023.114313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/06/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
Modern food environments are conducive to overeating and weight gain, but not everyone develops obesity. One reason for this may be that individuals differ in appetitive characteristics, or traits, that manifest early in life and go on to influence their behavioral susceptibility to gain and maintain excess weight. Classic studies showing that eating behavior in children can be measured by behavioral paradigms such as tests of caloric compensation and eating in the absence of hunger inspired the development and validation of psychometric instruments to assess appetitive characteristics in children and infants. A large body of evidence now suggests that food approach traits increase obesity risk, while food avoidant traits, such as satiety responsiveness, decrease obesity risk. Twin studies and genetic association studies have demonstrated that appetitive characteristics are heritable, consistent with a biological etiology. However, family environment factors are also influential, with mounting evidence suggesting that genetic and environmental risk factors interact and correlate with consequences for child eating behavior and weight. Further, neuroimaging studies are revealing that individual differences in responses to visual food cues, as well as to small tastes and larger amounts of food, across a number of brain regions involved in reward/motivation, cognitive control and other functions, may contribute to individual variation in appetitive behavior. Growing evidence also suggests that variation on psychometric measures of appetite is associated with regional differences in brain structure, and differential patterns of resting state functional connectivity. Large prospective studies beginning in infancy promise to enrich our understanding of neural and other biological underpinnings of appetite and obesity development in early life, and how the interplay between genetic and environmental factors affects appetitive systems. The biobehavioral susceptibility model of obesity development and maintenance outlined in this narrative review has implications for prevention and treatment of obesity in childhood.
Collapse
Affiliation(s)
- Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore MD, USA.
| | - Gita Thapaliya
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore MD, USA
| | - Elena Jansen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore MD, USA
| | - Liuyi Chen
- Division of Psychiatric Neuroimaging, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore MD, USA
| |
Collapse
|
3
|
Zhang X, Zhou Q, Vivor NK, Liu W, Cao J, Wang S. Sequential mediation of early temperament and eating behaviors in the pathways from feeding practices to childhood overweight and obesity. Front Public Health 2023; 11:1122645. [PMID: 37766743 PMCID: PMC10520502 DOI: 10.3389/fpubh.2023.1122645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Childhood eating behaviors and temperament may have important implication for constructing the pathways from maternal feeding practices to childhood overweight and obesity (OW/OB). Examining multiple feeding styles simultaneously to childhood OW/OB is critical through the mediators of early childhood temperament and eating behaviors. Methods This cross-sectional study recruited mothers mainly responsible for child care from two hospitals and two healthcare centers in eastern China. Sociodemographic characteristics, and data from the Infant Feeding Style Questionnaire (IFSQ), the short form of Children Behavior Questionnaire [Revised (IBQ-RSF)], and the Child Eating Behavior Questionnaire for toddler (CEBQ-T) were collected. Weight and recumbent length were measured to calculate the age- and sex-specific body mass index (BMI) z-scores (BMIz). The structural equation modeling (SEM) approach was used to examine direct and indirect pathways from five maternal feeding styles to childhood OW/OB through temperament and eating behaviors. Results A total of 486 children were recruited, 73 (15.02%) children were OW/OB; the age of the children was 14.55 (SD = 5.14) months, and the age of the mothers was 29.90 (SD = 3.63) years. The responsive feeding exerted significant direct (β = -0.098), indirect (β = -0.136) and total (β = -0.234) effects on childhood OW/OB. Restrictive feeding had significant direct (β = 0.222), indirect (β = 0.102) and total (β = 0.324) effects on childhood OW/OB. Indulgent feeding had significant direct (β = 0.220), indirect (β = 0.063), and total (β = 0.283) effects on childhood OW/OB. Pressuring feeding had significant direct (β = -0.116), indirect (β = -0.096) and total (β = -0.212) effects on childhood OW/OB. Discussion There was a direct effect of feeding practices on childhood OW/OB; feeding practices indirectly predicted childhood OW/OB through temperament and eating behaviors in children aged 6-23 months. This study could help governments agencies, policymakers, and healthcare workers to establish optimal intervention programs targeting feeding practices through childhood eating behaviors and temperament to prevent childhood OW/OB.
Collapse
Affiliation(s)
- Xiaoning Zhang
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
- Zhejiang Philosophy and Social Science Laboratory for Research in Early Development and Childcare, Hangzhou Normal University, Hangzhou, Zhejiang, China
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Qiong Zhou
- Department of Medical Nursing, Union Technical Institute, Lianyungang Subbranch of Traditional Chinese Medicine, Lianyungang, Jiangsu, China
| | | | - Wei Liu
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Junli Cao
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Sheng Wang
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| |
Collapse
|
4
|
Combs A, Garr K, Bolling C, Gates T, Mehl V, Adams T, Turner K, Odar Stough C. Maternal Feeding Beliefs and Behaviors Relate to Infant Diet and Appetite. Matern Child Health J 2023; 27:1089-1096. [PMID: 37010658 DOI: 10.1007/s10995-023-03646-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 04/04/2023]
Abstract
INTRODUCTION Maternal feeding practices may be linked to infant obesogenic outcomes, but research to date has focused primarily on infant growth as an outcome of maternal feeding practices rather than exploring additional obesogenic outcomes like infant appetite and diet. Therefore, the current study examined the association between maternal feeding practices and beliefs and infant growth, diet, and appetite simultaneously at a critical timepoint for obesity risk development (i.e., 3-months-old). METHODS Thirty-two 3-month-old infants and their mothers participated in this cross-sectional study. Infant anthropometrics were collected by trained staff and mothers completed questionnaires regarding maternal feeding practices and beliefs and infant diet and appetite. The data were analyzed by Spearman correlations. RESULTS Statistically significant correlations were identified between maternal feeding practices (e.g., using food to calm, concern about infant weight) and infant satiety, appetite, food responsiveness, slow eating, and kilocalories consumed. Infant weight-for-length was related to maternal concern about infant underweight and mother-infant social interaction during feeding. DISCUSSION These findings highlight the importance of the mother-infant feeding relationship and how these associations may influence responsive feeding practices and infant weight-related outcomes.
Collapse
Affiliation(s)
- Angela Combs
- Department of Psychology, University of Cincinnati, College of Arts and Sciences, P.O. Box 210376, Cincinnati, OH, 45221, United States
| | - Katlyn Garr
- Department of Psychology, University of Cincinnati, College of Arts and Sciences, P.O. Box 210376, Cincinnati, OH, 45221, United States
| | - Christopher Bolling
- Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, United States
| | - Taylor Gates
- Department of Psychology, University of Cincinnati, College of Arts and Sciences, P.O. Box 210376, Cincinnati, OH, 45221, United States
| | - Veronica Mehl
- Department of Psychology, University of Cincinnati, College of Arts and Sciences, P.O. Box 210376, Cincinnati, OH, 45221, United States
| | - Taylor Adams
- Department of Psychology, University of Cincinnati, College of Arts and Sciences, P.O. Box 210376, Cincinnati, OH, 45221, United States
| | - Krystin Turner
- Department of Occupational Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Cathleen Odar Stough
- Department of Psychology, University of Cincinnati, College of Arts and Sciences, P.O. Box 210376, Cincinnati, OH, 45221, United States.
| |
Collapse
|
5
|
Bergamini M, Simeone G, Verga MC, Doria M, Cuomo B, D’Antonio G, Dello Iacono I, Di Mauro G, Leonardi L, Miniello VL, Palma F, Scotese I, Tezza G, Caroli M, Vania A. Complementary Feeding Caregivers’ Practices and Growth, Risk of Overweight/Obesity, and Other Non-Communicable Diseases: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14132646. [PMID: 35807827 PMCID: PMC9268062 DOI: 10.3390/nu14132646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 12/07/2022] Open
Abstract
Several institutions propose responsive feeding (RF) as the caregivers’ relational standard when nurturing a child, from breast/formula feeding onwards. Previous systematic reviews (SRs) on caregivers’ feeding practices (CFPs) have included studies on populations from countries with different cultures, rates of malnutrition, and incomes, whereas this SR compares different CFPs only in healthy children (4–24 months) from industrialized countries. Clinical questions were about the influence of different CFPs on several important outcomes, namely growth, overweight/obesity, risk of choking, dental caries, type 2 diabetes (DM2), and hypertension. The literature review does not support any Baby Led Weaning’s or Baby-Led Introduction to SolidS’ (BLISS) positive influence on children’s weight–length gain, nor their preventive effect on future overweight/obesity. RF-CFPs can result in adequate weight gain and a lower incidence of overweight/obesity during the first two years of life, whereas restrictive styles and coercive styles, two kinds of non-RF in CF, can have a negative effect, favoring excess weight and lower weight, respectively. Choking risk: failure to supervise a child’s meals by an adult represents the most important risk factor; no cause–effect relation between BLW/BLISS/RF/NRCF and choking could be found. Risks of DM2, hypertension, and caries: different CFPs cannot be considered as a risky or preventive factor for developing these conditions later in life.
Collapse
Affiliation(s)
- Marcello Bergamini
- AUSL Ferrara, 44121 Ferrara, Italy
- Correspondence: ; Tel.: +39-338-929-0865
| | | | | | - Mattia Doria
- AULSS 3 Serenissima, 30015 Chioggia, Venice, Italy;
| | - Barbara Cuomo
- Department of Pediatrics, Belcolle Hospital, 01010 Viterbo, Italy;
| | | | | | | | - Lucia Leonardi
- Maternal Infantile and Urological Sciences Department, Sapienza University, 00161 Rome, Italy;
| | - Vito Leonardo Miniello
- Nutrition Unit, Department of Pediatrics, “Giovanni XXIII” Children Hospital, “Aldo Moro” University of Bari, 70126 Bari, Italy;
| | | | | | | | | | | |
Collapse
|
6
|
Shriver LH, Eagleton S, Lawless MC, Buehler C, Wideman L, Leerkes EM. Infant appetite and weight gain in early infancy: Moderating effects of controlling feeding styles. Appetite 2022; 176:106139. [PMID: 35718312 DOI: 10.1016/j.appet.2022.106139] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022]
Abstract
Excessive infant weight gain is a strong predictor of later obesity. While controlling feeding has been linked to negative weight outcomes, research has not considered associations between infant appetite and maternal feeding simultaneously in relation to infant weight. This longitudinal study examined infant food responsiveness and slowness in eating as predictors of infant weight outcomes and tested controlling feeding styles (restrictive and pressuring) as moderators. Data came from a diverse sample of mothers and their infants participating in an ongoing longitudinal study. Mothers (n = 159) reported infant appetite and feeding styles at 2 postnatal timepoints (2-month visits and 6-month visits). The infant weight outcomes included change in weight-for-age z-scores (WAZ-change) and rapid weight gain (RIWG; WAZ-change ≥ 0.67 SD) from birth to the second postnatal visit. Data were analyzed using hierarchical multiple and logistic regressions, controlling for birthweight, gestational age, maternal race/ethnicity, feeding mode, and residing with an intimate partner. Over 25% of infants exhibited RIWG. Greater infant food responsiveness predicted both greater infant weight gain and RIWG status. Infant food responsiveness and slowness in eating interacted with controlling feeding styles in a unique way. Infants with higher food responsiveness whose mothers were less restrictive had greater weight gain (b = 0.61, p < 0.001) and increased probability of RIWG (b = 2.71, p < 0.01) than infants with more restrictive mothers. Higher slowness in eating was associated with a lower RIWG probability among infants of mothers with lower pressuring feeding (b = -1.86, p < 0.05). For infants with a large appetite, some level of restrictive feeding may be beneficial for preventing excessive weight gain while pressuring may exacerbate the positive association between faster eating and RIWG.
Collapse
Affiliation(s)
- Lenka H Shriver
- Nutrition, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Sally Eagleton
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Megan C Lawless
- School of Medicine, Pediatrics, University of Colorado-Anschutz Medical Campus, Aurora, CO, 80045, USA.
| | - Cheryl Buehler
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Laurie Wideman
- Kinesiology, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Esther M Leerkes
- Human Development and Family Studies, UNC Greensboro, PO Box 26170, Greensboro, NC, 27402-6170, USA.
| |
Collapse
|
7
|
Factors associated with feeding practices of black immigrant mothers of African and Caribbean origin living in Ottawa, Canada. Appetite 2021; 167:105641. [PMID: 34384808 DOI: 10.1016/j.appet.2021.105641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022]
Abstract
In Canada, Black immigrant women and their children are at higher risk of developing obesity. Factors that could influence children's weight status include parental feeding practices. Feeding practices such as monitoring, restriction and pressure to eat, are well studied among non-Hispanic White and Latinos groups, however, little is known about the feeding practices of Black immigrant parents of African and Caribbean origin. The aim of this study was to identify factors associated with feeding practices of Black immigrant mothers in Ottawa, Canada. The sample includes 188 Black mothers of African and Caribbean origin and their 6-12-year-old children. The Child Feeding Questionnaire was used to assess mothers' feeding practices. Demographic and socioeconomic data were collected using questionnaires. All participants' weight status was determined from measured weight and height. Pearson Chi-square tests and multivariate logistic regressions were performed. Results showed that mothers who felt responsible for feeding their children were more likely to monitor their children's food intake (p < 0.05). While mothers of children with underweight or normal weight were more like to use pressure to eat (p < 0.01), mothers of children with overweight or obesity were more like to use restriction (P < 0.05). Recent immigrant mothers were also more likely to use pressure to eat (P < 0.05). This study also provides evidence for associations between maternal feeding practices and mothers' weight status, household income and food security status. Findings build on previous research suggesting that parental feeding practices vary based on parents' and children's characteristics. Longitudinal studies are needed to assess the directionality of the association between mothers' feeding practices, and children's weight, diet quality and health in this population.
Collapse
|
8
|
Ballarotto G, Cerniglia L, Bozicevic L, Cimino S, Tambelli R. Mother-child interactions during feeding: A study on maternal sensitivity in dyads with underweight and normal weight toddlers. Appetite 2021; 166:105438. [PMID: 34090944 DOI: 10.1016/j.appet.2021.105438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
During the second year of life, mother's sensitivity in encouraging child autonomy supports children's emotional-affective individuation. In the feeding context, there is a clear transition from dependence on the mother to an emerging autonomy. Several studies have found an association between children's poor growth which is not related to organic pathologies, and maladaptive mother-child interactions that are characterized by poor maternal sensitivity. Despite this evidence, no studies have investigated maternal sensitivity to specific child's cues, such as demands for autonomy, during feeding interactions between mothers and their underweight children. This study aimed to assess how mothers' psychopathological risk and toddler's dysregulation profile are associated with mother-toddler interactional quality during feeding, with particular attention to mothers' sensitivity to child's specific cues (e.g. need of autonomy, requests for cooperation, request to stop the interaction, etc.). One hundred fifty mother-toddler dyads (N = 73 with underweight children and N = 77 with normal weight children) with children aged between 18 and 30 months, were recruited. Mother-toddlers feeding interactions were assessed through specific rating scales applied to the video-recorded interactions and mothers filled out questionnaires on children's emotional-behavioral functioning and their own psychopathological risk. Results showed a significant association between the quality of mother-toddler feeding interaction and children's weight. Underweight children showed less demand for autonomy and request for cooperation than normal weight children. Moreover, mothers of underweight children were less sensitive to toddler's cues of wanting to stop the interaction and demands for autonomy compared to mothers of normal weight children. Lower facilitations were associated with toddler's more dysregulated profile and with mother's higher psychopathological risk, and high toddler's dysregulation profile was associated with lower maternal sensitivity to child's cues of wanting to interrupt interactions and with worse mother's mood. Assessing maternal sensitivity in relation to toddler's specific cues might be particularly relevant in the feeding context. It might help to detect some dysfunctional interactive patterns and allow the implementation of prevention and treatment programs.
Collapse
Affiliation(s)
- Giulia Ballarotto
- Department of Dynamic and Clinical Psychology, University of Rome "La Sapienza", via degli Apuli 1, 00185, Rome, Italy.
| | - Luca Cerniglia
- Faculty of Psychology, Uninettuno Telematic International University, Corso Vittorio Emanuele II, 39, 00186, Rome, Italy.
| | - Laura Bozicevic
- Institute of Population Health, Department of Primary Care & Mental Health, Faculty of Health and Life Sciences, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Silvia Cimino
- Department of Dynamic and Clinical Psychology, University of Rome "La Sapienza", via degli Apuli 1, 00185, Rome, Italy.
| | - Renata Tambelli
- Department of Dynamic and Clinical Psychology, University of Rome "La Sapienza", via degli Apuli 1, 00185, Rome, Italy.
| |
Collapse
|
9
|
Thompson AL, Wasser H, Nulty A, Bentley ME. Feeding style profiles are associated with maternal and infant characteristics and infant feeding practices and weight outcomes in African American mothers and infants. Appetite 2021; 160:105084. [PMID: 33359466 PMCID: PMC7878353 DOI: 10.1016/j.appet.2020.105084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/17/2020] [Accepted: 12/18/2020] [Indexed: 12/11/2022]
Abstract
Much literature links individual feeding styles to infant feeding practices and growth; however, parents' feeding styles are not discrete and may vary by context. We use latent profile analysis (LPA) as a person-centered approach to categorize infant feeding style patterns, test factors predicting profile membership, and examine if profiles are associated with infant feeding and weight. Additionally, we test the impact of a responsive feeding intervention on profile membership and stability. Data come from 270 African-American women and infants participating in the Mothers and Others Study, an early life obesity prevention intervention. LPA was used to categorize mothers across five constructs (laissez-faire, pressuring, restrictive, responsive and indulgent) measured at 28-weeks gestation and 3- and 15-months postpartum. Adjusted multinomial regression and regression models test the characteristics associated with profile membership and the associations between profile membership and breastfeeding and infant weight-for-age z-score (WAZ). We identified two groups (Positive and Less Responsive) prenatally, an additional group (High Controlling) at 3 months and a fourth group (High Indulgent) at 15 months. Several characteristics differed between the groups, including maternal age, income and depressive symptoms, infant sex and temperament, and treatment group. Mothers in the Positive group were more likely to breastfeed at 3 months. Infants with mothers in the High Controlling group had higher WAZ at 15 months. The intervention was associated with more Positive feeding practices at 15 months and a greater likelihood of remaining in the Positive group across the study. LPA identified profiles that are associated with maternal and infant characteristics and treatment group and with better feeding practices and growth outcomes, providing preliminary evidence that early intervention promoting more responsive feeding profiles may improve infant outcomes.
Collapse
Affiliation(s)
- Amanda L Thompson
- Department of Anthropology, University of North Carolina at Chapel Hill, USA; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA; Carolina Population Center, University of North Carolina at Chapel Hill, USA.
| | - Heather Wasser
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA
| | - Alison Nulty
- Department of Anthropology, University of North Carolina at Chapel Hill, USA
| | - Margaret E Bentley
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, USA; Carolina Population Center, University of North Carolina at Chapel Hill, USA
| |
Collapse
|
10
|
Complementary Feeding Practices and Parental Pressure to Eat among Spanish Infants and Toddlers: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041982. [PMID: 33670769 PMCID: PMC7922078 DOI: 10.3390/ijerph18041982] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 02/07/2023]
Abstract
The introduction of complementary foods is a crucial stage in the development and determination of infants’ health status in both the short and longer-term. This study describes complementary feeding practices among infants and toddlers in Spain. Also, relationships among sample characteristics (both parents and their child), feeding practices (timing, type of complementary food), and parental pressure to eat were explored. Cognitive interviewing with 18 parents was used to refine the survey questions. Responses from a national random sample of 630 parents, who were responsible for feeding their infants and toddlers aged 3–18 months, were obtained. Solids, often cereals and/or fruits first, were introduced at a median age of five months. Fish and eggs were introduced around the age of nine and ten months. Almost all children were fed with home-prepared foods at least once per week (93%), and in 36% of the cases, salt was added. Interestingly, higher levels of parental pressure to eat were found in female infants, younger parents, parents with a full-time job, the southern regions of Spain, and in infants who were not fed with home-prepared foods. Our insights underline the importance of clear feeding recommendations that can support health care professionals in promoting effective strategies to improve parental feeding practices.
Collapse
|
11
|
Bushaw A, Lutenbacher M, Karp S, Dietrich M, Graf M. Infant feeding beliefs and practices: Effects of maternal personal characteristics. J SPEC PEDIATR NURS 2020; 25:e12294. [PMID: 32441875 DOI: 10.1111/jspn.12294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/06/2020] [Accepted: 05/04/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Information is limited about how mothers make food decisions on behalf of their children. Eating practices are established early in life and are difficult to change, so it is imperative to focus on the caregiver who influences a young child's food preferences and eating behaviors. The purpose of this secondary data analysis was to examine the relationship between maternal characteristics and infant feeding beliefs and practices in a sample of multiparous mothers with a history of a prior preterm infant birth. DESIGN AND METHODS Secondary analysis of a subset of data (n = 112) collected from women who participated in a randomized clinical trial (RCT) assessing the efficacy of a home-based intervention to improve maternal and child outcomes. Inclusion criteria for the RCT: women ≥18 years of age at enrollment with a prior preterm live birth >20 and <37 weeks gestation, <24 weeks gestation at enrollment, spoke/read English, and received prenatal care at a regional medical center. Criteria for the subset included: completed the Infant Feeding Questionnaire at 5 months postpartum and had reported a prenatal body mass index (BMI). Univariate correlations and multiple linear regression analyses were used to assess the associations between maternal personal characteristics and infant feeding practices. RESULTS Median age of the mothers was 27 years (interquartile range [IQR]: 23-32) with median education of 12 years (IQR: 12-16). More than two-thirds (68%) of the women breastfed their last baby. These women were less likely to be concerned about their infant's hunger (r = -.20; p = .035). After controlling for education, maternal BMI, breastfed last baby, self-esteem, locus of control, and depressive symptoms, decreased maternal age (β = -.35; p < .001) and higher levels of stress (β = .19; p = .042) were associated with greater concern about their infant's hunger. Maternal demographic and psychosocial variables were not found to be statistically significantly associated with either concern about infant overeating and becoming overweight or an awareness of infant's hunger and satiety cues. PRACTICE IMPLICATIONS Differences in maternal psychosocial variables and attitudes toward infant feeding may contribute to long term eating habits and weight outcomes in children. A better understanding of maternal variables that influence infant feeding attitudes and practices could improve the design of future intervention studies aimed at mothers at risk for having poor infant feeding practices.
Collapse
Affiliation(s)
- Andrea Bushaw
- Gillette Children's Specialty Healthcare, Nursing Administration, St. Paul, Minnesota
| | | | - Sharon Karp
- Vanderbilt University, School of Nursing, Nashville, Tennessee
| | - Mary Dietrich
- Statistics and Measurement, Vanderbilt University, School of Nursing, Nashville, Tennessee
| | - Michelle Graf
- Vanderbilt University, School of Nursing, Nashville, Tennessee
| |
Collapse
|
12
|
Costarelli V, Michou M, Panagiotakos DB, Lionis C. Adherence to the Mediterranean diet and weight status in children: the role of parental feeding practices. Int J Food Sci Nutr 2020; 72:112-122. [PMID: 32458711 DOI: 10.1080/09637486.2020.1765151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The study examines Parental Feeding Practices (PFP) in relation to adherence to the Mediterranean Diet (MD) and children's weight status. It's a cross-sectional study of 402 parents (68.4% mothers), with children aged 2-12 years. Parents completed the Comprehensive Parental Feeding Questionnaire and the Mediterranean Diet Quality Index for children and adolescents (KIDMED), evaluating children's adherence to the MD. Logistic regression showed that in children aged 2-<6 years, "emotion regulation/food as reward" and "pressure" decrease MD adherence (OR = 0.186, p < 0.0001 and OR = 0.496, p = 0.004), and "monitoring" decrease excess body weight (OR = 0.284, p = 0.009). In older children (6-12 years), "healthy eating guidance" and "monitoring" increase MD adherence (OR = 3.262, p = 0.001 and OR = 3.147, p < 0.0001), "child control" decreases MD adherence (OR = 0.587, p = 0.049), "pressure" decrease excess body weight (OR = 0.495, p < 0.0001) and "restriction" increase excess body weight (OR = 1.784, p = 0.015). "Healthy eating guidance" and "monitoring" seem to be the best PFP employed, in terms of children's MD adherence and weight status.
Collapse
Affiliation(s)
- Vassiliki Costarelli
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
| | - Maria Michou
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Heraklion, Greece
| |
Collapse
|
13
|
Michou M, Panagiotakos DB, Mamalaki E, Yannakoulia M, Costarelli V. Development and validation of the Greek version of the comprehensive parental feeding questionnaire. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2019. [DOI: 10.3233/mnm-180275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Maria Michou
- Department of Home Economics and Ecology, Human Ecology Laboratory, Harokopio University, Athens, Greece
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Maria Yannakoulia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Vassiliki Costarelli
- Department of Home Economics and Ecology, Human Ecology Laboratory, Harokopio University, Athens, Greece
| |
Collapse
|
14
|
Spill MK, Callahan EH, Shapiro MJ, Spahn JM, Wong YP, Benjamin-Neelon SE, Birch L, Black MM, Cook JT, Faith MS, Mennella JA, Casavale KO. Caregiver feeding practices and child weight outcomes: a systematic review. Am J Clin Nutr 2019; 109:990S-1002S. [PMID: 30982865 DOI: 10.1093/ajcn/nqy276] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND As part of the USDA-Department of Health and Human Services Pregnancy and Birth to 24 Months Project, we conducted systematic reviews (SRs) on topics important for health and nutrition of young children. OBJECTIVES The purpose of the present SR was to examine the relation between caregiver feeding practices in children from birth to 24 mo and child weight gain, size, and body composition. METHODS A search of articles published from January 1980 to January 2017 in 4 databases identified 8739 references. Nutrition Evidence Systematic Review (NESR) analysts used the Nutrition Evidence Library Risk of Bias Assessment Tool to assess potential bias in the studies, and a Technical Expert Collaborative graded the body of evidence using the NESR grading rubric. RESULTS Twenty-seven articles were included in this review (8 controlled trials, 19 longitudinal cohort studies). Moderate evidence from randomized controlled trials suggests that providing responsive feeding guidance to teach mothers to recognize and respond appropriately to children's hunger and satiety cues can lead to "normal" weight gain and/or "normal" weight status in children aged ≤2 y compared with children whose mothers did not receive responsive feeding guidance. Moderate evidence from longitudinal cohort studies indicates an association between maternal feeding practices and the child's weight status and/or weight gain, but the direction of effect has not been adequately studied. Restrictive feeding practices are associated with increased weight gain and higher weight status, and pressuring feeding practices are associated with decreased weight gain and lower weight status. Evidence suggests that a mother's feeding practices are related to concerns about her child's body weight. CONCLUSIONS This review highlights the importance of the interaction between caregivers and infants and toddlers related to child feeding practices on children's weight outcomes. Research is needed on more diverse populations with consistent methodological app-roaches and objective measures.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Maureen M Black
- University of Maryland School of Medicine, Baltimore, MD.,RTI International, Baltimore, MD
| | | | | | | | - Kellie O Casavale
- US Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Rockville, MD
| |
Collapse
|
15
|
Warkentin S, Mais LA, Latorre MDRDDO, Carnell S, de Aguiar CarrazedoTaddei JA. Relationships between parent feeding behaviors and parent and child characteristics in Brazilian preschoolers: a cross-sectional study. BMC Public Health 2018; 18:704. [PMID: 29880038 PMCID: PMC5992628 DOI: 10.1186/s12889-018-5593-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 05/23/2018] [Indexed: 01/28/2023] Open
Abstract
Background Eating habits formed in early childhood are influenced by parental feeding behaviors, warranting investigation of predictors and correlates of parent feeding. We aimed to describe relationships between parental feeding practices and parent and child characteristics in a sample of Brazilian preschoolers. Methods Four hundred and two parents of preschoolers enrolled in private schools of São Paulo and Campinas, Brazil, completed a Brazilian version of the Comprehensive Feeding Practices Questionnaire, as well as questions about parental attitudes, child food intake, other obesity-associated behaviors, and socioeconomic and demographic characteristics. We ran bivariate logistic regression models examining associations between independent variables and each feeding practice. Next, we ran multiple logistic regression models predicting each parental feeding practice. Results Greater ‘Restriction for Weight Control’ and ‘Restriction for Health’ were associated with lower maternal education (OR = 2.42 (CI 95% 1.07–5.48) and 2.79 (CI 95% 1.25–6.22), respectively), and with higher concern about child overweight (OR = 2.46, CI 95% 1.64–3.69 for ‘Restriction for Weight Control’, only), while greater ‘Pressure’ was associated with greater concern about child underweight (OR = 2.30, CI 95% 1.53–3.47) and lower maternal BMI (OR = 0.94, CI 95% 0.88–1.00). Greater use of ‘Emotion Regulation/ Food as Reward’ was associated with lower maternal education (OR = 2.22, CI 95% 1.05–4.71). In analyses of positive feeding practices, lesser use of ‘Healthy Eating Guidance’ and ‘Monitoring’ was associated with greater intake of less healthy foods in children (OR = 1.53 (CI 95% 1.01–2.32) and OR = 1.94 (CI 95% 1.27–2.97), respectively), and greater use of screen devices (OR = 1.59 (CI 95% 1.04–2.44) and OR = 1.57 (CI 95% 1.03–2.39), respectively). Lesser use of ‘Healthy Eating Guidance’ was additionally associated with higher maternal BMI (OR = 1.09, CI 95% 1.03–1.16), and lesser use of ‘Monitoring’ with lesser perceived parent responsibility for child feeding (OR = 1.68, CI 95% 1.12–2.52). Conclusions Our results demonstrate diverse socioeconomic, anthropometric and behavioral correlates of parent feeding in a large Brazilian sample of parents of preschoolers.
Collapse
Affiliation(s)
- Sarah Warkentin
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP), Rua Loefgreen, 1647, São Paulo, SP, CEP: 04040-032, Brazil.
| | - Laís Amaral Mais
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP), Rua Loefgreen, 1647, São Paulo, SP, CEP: 04040-032, Brazil
| | | | - Susan Carnell
- Department of Psychiatry and Behavioral Sciences, Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - José Augusto de Aguiar CarrazedoTaddei
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP), Rua Loefgreen, 1647, São Paulo, SP, CEP: 04040-032, Brazil
| |
Collapse
|
16
|
Russell CG, Denney-Wilson E, Laws RA, Abbott G, Zheng M, Lymer SJ, Taki S, Litterbach EKV, Ong KL, Campbell KJ. Impact of the Growing Healthy mHealth Program on Maternal Feeding Practices, Infant Food Preferences, and Satiety Responsiveness: Quasi-Experimental Study. JMIR Mhealth Uhealth 2018; 6:e77. [PMID: 29695373 PMCID: PMC5943630 DOI: 10.2196/mhealth.9303] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 12/22/2017] [Accepted: 12/22/2017] [Indexed: 01/22/2023] Open
Abstract
Background Infancy is an important life stage for obesity prevention efforts. Parents’ infant feeding practices influence the development of infants’ food preferences and eating behaviors and subsequently diet and weight. Mobile health (mHealth) may provide a feasible medium through which to deliver programs to promote healthy infant feeding as it allows low cost and easy access to tailored content. Objective The objective of this study was to describe the effects of an mHealth intervention on parental feeding practices, infant food preferences, and infant satiety responsiveness. Methods A quasi-experimental study was conducted with an mHealth intervention group (Growing Healthy) and a nonrandomized comparison group (“Baby's First Food"). The intervention group received access to a free app with age-appropriate push notifications, a website, and an online forum that provided them with evidence-based advice on infant feeding for healthy growth from birth until 9 months of age. Behavior change techniques were selected using the Behaviour Change Wheel framework. Participants in both groups completed three Web-based surveys, first when their infants were less than 3 months old (baseline, T1), then at 6 months (time 2, T2), and 9 months of age (time 3, T3). Surveys included questions on infant feeding practices and beliefs (Infant Feeding Questionnaire, IFQ), satiety responsiveness (Baby Eating Behaviour Questionnaire), and infant’s food exposure and liking. Multivariate linear regression models, estimated using maximum likelihood with bootstrapped standard errors, were fitted to compare continuous outcomes between the intervention groups, with adjustment for relevant covariates. Multivariate logistic regression adjusting for the same covariates was performed for categorical outcomes. Results A total of 645 parents (Growing Healthy: n=301, Baby's First Food: n=344) met the eligibility criteria and were included in the study, reducing to a sample size of 546 (Growing Healthy: n=234, Baby's First Food: n=312) at T2 and a sample size of 518 (Growing Healthy: n=225, Baby's First Food: n=293) at T3. There were approximately equal numbers of boy and girl infants, and infants were aged less than 3 months at baseline (Growing Healthy: mean 7.0, SD 3.7 weeks; Baby's First Food: mean 7.9, SD 3.8 weeks), with Growing Healthy infants being slightly younger than Baby's First Food infants (P=.001). All but one (IFQ subscale “concerns about infant overeating or becoming overweight” at T2) of the measured outcomes did not differ between Growing Healthy and Baby's First Food. Conclusions Although mHealth can be effective in promoting some health behaviors and offers many advantages in health promotion, the results of this study suggest that design and delivery characteristics needed to maximize the impact of mHealth interventions on infant feeding are uncertain. The sensitivity of available measurement tools and differences in baseline characteristics of participants may have also affected the results.
Collapse
Affiliation(s)
- Catherine Georgina Russell
- Centre for Advanced Sensory Science, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Burwood, Australia.,Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia
| | - Elizabeth Denney-Wilson
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Sydney Nursing School, The University of Sydney, Sydney, Australia.,Sydney Local Health District, Sydney, Australia
| | - Rachel A Laws
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sharyn J Lymer
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,The Boden Institute of Obesity Nutrition Exercise & Eating Disorders, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Sarah Taki
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Health Promotion Unit, Sydney Local Health District, and University of Sydney, Sydney, Australia
| | - Eloise-Kate V Litterbach
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Kok-Leong Ong
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Department of Accounting and Data Analytics, La Trobe Business School, College of Arts, Social Sciences and Commerce, La Trobe University, Melbourne, Australia
| | - Karen J Campbell
- Centre for Obesity Management and Prevention Research Excellence in Primary Health Care, Sydney, Australia.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| |
Collapse
|
17
|
Kral TVE, Chittams J, Moore RH. Relationship between food insecurity, child weight status, and parent-reported child eating and snacking behaviors. J SPEC PEDIATR NURS 2017; 22:10.1111/jspn.12177. [PMID: 28321980 PMCID: PMC5398923 DOI: 10.1111/jspn.12177] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/27/2016] [Accepted: 02/07/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE Prior studies showed that food insecurity may increase the odds of obesity in children and adults. We still know very little about the familial aggregation of obesity in food-insecure households or the mechanisms by which food insecurity confers an increased risk of obesity to children. The purpose of this study was to compare children and mothers from food-insecure and food-secure households in their weight status, child eating patterns/behaviors, and maternal feeding practices. DESIGN AND METHODS Fifty mothers of 8-10-year-old children were asked to complete questionnaires, including the U.S. Household Food Security survey, and had their own and their children's heights and weights measured. RESULTS The odds of a child being obese were five times higher for children from food-insecure households compared with children from food-secure households (95% confidence interval 1.15-20.8). In univariate analyses, children from food-insecure households showed significantly greater external eating, both past satiation and in the absence of hunger (p < .03), and mothers from food-insecure households expressed significantly greater concern about their children's weight and used restrictive feeding practices to a greater extent (p < .03) when compared with families from food-secure households. A greater proportion of children from food-secure households consumed three to four snacks per day (45.9 vs. 15.4%), while a higher proportion of children from food-insecure households consumed five or more snacks per day (15.4 vs. 0%; p = .02). PRACTICE IMPLICATIONS These findings provide further support for an association between food insecurity and childhood obesity and suggest that differences in external eating, child snacking patterns, and select maternal feeding practices may be implicated in food-insecure children's overconsumption of calories. When caring for food-insecure children, healthcare providers should screen for problematic eating patterns and feeding practices.
Collapse
Affiliation(s)
- Tanja V E Kral
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Jesse Chittams
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Reneé H Moore
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|
18
|
Mais LA, Warkentin S, Latorre MDRDDO, Carnell S, Taddei JAADC. Parental Feeding Practices among Brazilian School-Aged Children: Associations with Parent and Child Characteristics. Front Nutr 2017; 4:6. [PMID: 28377921 PMCID: PMC5359473 DOI: 10.3389/fnut.2017.00006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/07/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Children's eating behavior, food intake, and weight status are highly influenced by parents, who shape their food environment via parental feeding practices. The aim of this study was to investigate associations between sociodemographic, anthropometric, and behavioral/attitudinal characteristics of parents and their 5- to 9-year-old children and a range of positive ("healthy eating guidance," "monitoring") and potentially negative ("restriction for weight control," "restriction for health," "emotion regulation/food as reward," and "pressure") parental feeding practices. METHODS Parents completed a questionnaire assessing parental and child characteristics. Parental feeding practices were measured using a Brazilian adaptation of the Comprehensive Feeding Practices Questionnaire. To test associations between parent and child characteristics and parental feeding practices, we ran bivariate logistic regression models with parent and child characteristics as independent variables and high (above median) scores on individual parental feeding practices as outcome variables. We then conducted multivariate logistic regression models containing all parent and child characteristics, controlling for child age and maternal education. RESULTS Lower parental perceived responsibility for child feeding, higher child use of screen devices, and higher child ultra-processed food intake were associated with lower scores on "healthy eating guidance" and "monitoring." Higher parental perceived responsibility for child feeding and concern about child overweight were associated with higher scores on "restriction for weight control" and "restriction for health." Parental perceptions of low weight and concern about child underweight, and higher perceived responsibility for child feeding, were associated with higher scores on "pressure." Greater intake of ultra-processed foods and lower maternal age were associated with higher scores on "emotion regulation/food as reward." CONCLUSION Parental concerns and perceptions relating to child weight were predictive of potentially negative feeding practices. Higher scores on potentially negative feeding practices, and lower scores on positive parent feeding practices, were associated with poorer child diet and higher use of screen devices. Parental engagement in the feeding interaction predicted greater adoption of both potentially negative and positive feeding practices. These results support the need for policies and programs to educate parents about child feeding and help motivated parents to promote healthy lifestyles in their children.
Collapse
Affiliation(s)
- Laís Amaral Mais
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Sarah Warkentin
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | | | - Susan Carnell
- Johns Hopkins School of Medicine , Baltimore, MD , USA
| | | |
Collapse
|