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Fox K, Hart CN, Phelan S, Ventura AK, Wing R, Jelalian E. Maternal depressive symptom trajectories and associations with child feeding. BMC Public Health 2024; 24:1636. [PMID: 38898428 PMCID: PMC11186209 DOI: 10.1186/s12889-024-19110-8] [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: 04/11/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Responsive feeding, when caregivers attend to children's signals of hunger and satiation and respond in an emotionally supportive and developmentally appropriate way, is associated with the development of healthy eating behaviors, improved diet quality, and healthy weight status for children. However, gaps in the literature remain on how factors, such as maternal depressive symptoms and child temperament, influence feeding interactions. METHODS This longitudinal secondary data analysis explored the association between maternal depressive symptom trajectory and child temperament with maternal feeding practices in women with obesity who participated in a prenatal lifestyle intervention trial. Mothers self-reported depressive symptoms at baseline, 35 weeks gestation, and 6, 12, and 18 months postpartum. At 18- and 24-months postpartum, mothers completed self-reported assessments of feeding practices and child temperament and completed in-home video-recorded meals with their child, coded using the Responsiveness to Child Feeding Cues Scale. We used group-based trajectory modeling to identify distinct trajectories of depressive symptoms and generalized regressions to assess the association between symptom trajectory group and feeding. We also explored interactions between depressive symptoms and child temperament. RESULTS Three distinct trajectories of depressive symptoms were identified: No-Minimal and Decreasing, Mild-Moderate and Stable, and Moderate-Severe and Stable. At 18-months, when compared to the No-Minimal and Decreasing group, membership in the Moderate-Severe and Stable group was associated with higher observed responsiveness to child satiation cues ([Formula: see text] =2.3, 95%CI = 0.2, 4.4) and lower self-reported pressure to eat ([Formula: see text]=-0.4, 95%CI= -0.7, 0.0). When compared to the No-Minimal and Decreasing group, membership in the Mild-Moderate and Stable group was associated with higher self-reported restriction ([Formula: see text] =0.4, 95%CI = 0.0,0.7). The associations between trajectory group membership and feeding practices did not reach statistical significance at 24 months. Associations between depressive symptoms and restriction were moderated by child effortful control at 18 months [Formula: see text]) and surgency at 24 months [Formula: see text]). CONCLUSION A Moderate-Severe and Stable depressive symptom trajectory was associated with more responsive feeding practices and a Mild-Moderate and Stable trajectory was associated with higher restrictive feeding. Preliminary evidence suggests that depressive symptoms impact mothers' ability to match their use of restriction to the temperamental needs of their child.
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Affiliation(s)
- Katelyn Fox
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA.
- Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA.
| | - Chantelle N Hart
- Department of Social and Behavioral Sciences & Center for Obesity Research and Education, College of Public Health Temple University, 3223 North Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Suzanne Phelan
- Department of Kinesiology and Public Health & Center for Health Research Bailey College of Science and Mathematics, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA
| | - Alison K Ventura
- Department of Kinesiology and Public Health & Center for Health Research Bailey College of Science and Mathematics, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA
| | - Rena Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA
- Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA
- Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA
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Fox K, Melo Herrera Y, Abreu AM, Vadiveloo MK. Variety of High and Very Low-Energy Density Foods among Preschool-Aged Children and Associations with Food Intake, Diet Quality, and Weight Status. J Nutr 2024; 154:697-705. [PMID: 38135003 DOI: 10.1016/j.tjnut.2023.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Energy density (ED) and the variety of foods are 2 factors that may have a combined effect on preschool-aged children's ability to regulate food intake. However, little is known about the variety of foods consumed within different ED categories by children in the United States. OBJECTIVE Therefore, we explored the variety of high ED (HED, 4-9 kcal/g) and very low ED (VLED, <0.6 kcal/g) foods consumed by a nationally representative sample of children aged 2-5 y in the United States and the relationship between variety with food intake, diet quality, and weight status. METHODS ED, variety, and diet quality were assessed using two 24-h dietary recalls collected as part of the National Health And Nutrition Examination Survey 2011-2018 cycles (n = 1682). We assessed associations between HED and VLED varieties with energy intake, volume of food, diet quality, and weight status using multivariable linear and logistic regressions. RESULTS The HED variety was positively associated with energy intake (P < 0.0001). The VLED variety was positively associated with the volume of food (P < 0.0001) and diet quality (P < 0.0001). VLED was negatively associated with the odds of having obesity in minimally adjusted models [odds ratio (OR): 0.62; 95% confidence interval (CI): 0.31, 0.87]; however, the relationship was not significant in fully adjusted models. Patterns of variety intake were differently associated with energy, volume, and diet quality. Children consuming the high VLED variety and the low HED variety had lower odds of obesity [OR: 0.43; 95% CI: 0.21, 0.90]; however, this pattern was rare (10%). CONCLUSIONS These findings suggest that the variety of HED foods is associated with higher average energy intake per day, and the variety of VLED foods is associated with a higher volume of food consumed per day and diet quality in a nationally representative sample of preschool-aged children.
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Affiliation(s)
- Katelyn Fox
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, United States; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, United States
| | - Yarisbel Melo Herrera
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States
| | - Alyssa M Abreu
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States
| | - Maya K Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI, United States.
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Tauriello S, Moding K, Aronoff N, Kubiniec E, Anzman-Frasca S. Examining links between child temperament and feeding, eating, and weight outcomes: An updated systematic review of the literature. Eat Behav 2023; 49:101739. [PMID: 37209569 DOI: 10.1016/j.eatbeh.2023.101739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Weight outcomes have been associated with child temperament, defined as individual differences in reactivity and self-regulation. The current systematic review aims to provide an updated summary of the evidence linking temperamental negative reactivity, surgency, and regulation superfactors to early childhood feeding, eating, and weight outcomes. METHODS PubMed, PsycINFO and Embase databases, as well as scientific meeting programs, were searched using keywords and subject headings. Publication dates were limited to 2012-2019 as prior reviews were published in 2012 and 2014. Identified studies were eligible if they included children ages 0-5 years, a measure of child temperament, and a measure of parent/caregiver feeding, child eating, or child weight. 7113 studies were identified and 121 met inclusion criteria. RESULTS Feeding, eating, and weight outcomes were largely unrelated to overarching negative reactivity, surgency, and effortful control superfactors. Examination of individual temperament dimensions suggested difficult temperament was frequently linked to non-responsive feeding practices, whereas elevated emotionality and decreased self-regulation were linked to maladaptive eating behaviors, and lower inhibitory control to adiposity. Analyses with infants reported greater percentages of significant associations compared to children, and cross-sectional studies generally reported fewer significant associations than other study designs. CONCLUSIONS Difficult temperament, greater emotionality and lower self-regulation and inhibitory control were the aspects of temperament most consistently related to poorer early childhood feeding, eating, and weight outcomes. Associations tended to be stronger in infancy, and when examined within a non-cross-sectional study design. Findings can inform the development of tailored efforts to promote healthy eating and growth throughout childhood.
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Affiliation(s)
- Sara Tauriello
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America
| | - Kameron Moding
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States of America
| | - Nell Aronoff
- University Libraries, University at Buffalo, Buffalo, NY, United States of America
| | - Elizabeth Kubiniec
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, United States of America.
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The correlation between different operationalisations of parental restrictive feeding practices and children's eating behaviours: Systematic review and meta-analyses. Appetite 2023; 180:106320. [PMID: 36210017 DOI: 10.1016/j.appet.2022.106320] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/05/2022] [Accepted: 09/23/2022] [Indexed: 12/12/2022]
Abstract
Strategies used by parents to restrict children's access to highly palatable but unhealthy foods have been described collectively as restrictive feeding practices. Ironically, evidence shows these practices may foster maladaptive eating behaviours and increase children's risk of obesity. This systematic review and series of meta-analyses aim to estimate the relationships between different operationalisations of parental restrictive feeding practices and children's eating behaviours measured by either the Children's Eating Behaviour Questionnaire (Wardle et al., 2001) or eating in the absence of hunger paradigm. PsycINFO, Medline Complete, CINAHL, Scopus and Web of Science databases were searched on April 22nd 2021 for terms relating to restrictive feeding practices, children and eating behaviours. Eligible studies (n = 24) reported a correlation between restrictive feeding and children's (2-12-years) eating behaviours. Meta-analyses were conducted on different operationalisations of restrictive feeding practices and different eating behaviours where there were three or more effects to analyse. Studies that were not meta-analysed were synthesised qualitatively. All studies were quality assessed using a standard checklist. Restrictive feeding (Child Feeding Questionnaire; Birch et al., 2001), was significantly correlated with higher food responsiveness, food fussiness, emotional overeating, and lower slowness in eating. Overt restriction (Feeding Practices and Structure Questionnaire, E. Jansen et al., 2014) was significantly correlated with higher food responsiveness. The qualitative synthesis suggests overt restriction is related to maladaptive eating behaviours, but that other operationalisations of restrictive feeding, especially covert restriction, are not. Future research should examine whether covert restriction provides an alternative, non-harmful approach to restriction, by which parents can control children's diet quality without negatively impacting their eating behaviours.
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Martín-Rodríguez A, Bustamante-Sánchez Á, Martínez-Guardado I, Navarro-Jiménez E, Plata-SanJuan E, Tornero-Aguilera JF, Clemente-Suárez VJ. Infancy Dietary Patterns, Development, and Health: An Extensive Narrative Review. CHILDREN 2022; 9:children9071072. [PMID: 35884056 PMCID: PMC9319947 DOI: 10.3390/children9071072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/03/2022] [Accepted: 07/16/2022] [Indexed: 11/27/2022]
Abstract
Correct dietary patterns are important for a child’s health from birth to adulthood. Understanding a child’s health as a state of entire physical, mental, and social well-being is essential. However, reaching adulthood in a complete health proper state is determined by feeding and dietary habits during preconception, pregnancy, or children infancy. Different factors, such as the mother’s lifestyle, culture, or socioeconomic status, are crucial during all these phases. In this review, we aimed to assess the long-term associations between infancy dietary patterns and health and their influence on development and growth. To reach this objective, a consensus critical review was carried out using primary sources such as scientific articles, and secondary bibliographic indexes, databases, and web pages. PubMed, SciELO, and Google Scholar were the tools used to complete this research. We found that high-income countries promote high-calorie foods and, consequently, obesity problems among children are rising. However, undernutrition is a global health issue concerning children in low- and middle-income countries; thus, parental socioeconomic status in early life is essential to children’s health and development, showing that biological, social, and environmental influences are increased risk factors for chronic diseases. This narrative review is aimed to collect evidence for early nutritional intervention and future disease prevention.
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Affiliation(s)
| | - Álvaro Bustamante-Sánchez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Correspondence: (Á.B.-S.); (J.F.T.-A.); Fax: +34-911-413-585 (J.F.T.-A.)
| | | | | | | | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Correspondence: (Á.B.-S.); (J.F.T.-A.); Fax: +34-911-413-585 (J.F.T.-A.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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Bjørklund O, Wichstrøm L, Llewellyn C, Steinsbekk S. The prospective relation between eating behaviors and BMI from middle childhood to adolescence: A 5-wave community study. Prev Med Rep 2022; 27:101795. [PMID: 35656230 PMCID: PMC9152788 DOI: 10.1016/j.pmedr.2022.101795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 03/31/2022] [Accepted: 04/17/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Oda Bjørklund
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll 7491 Trondheim, Norway
- St Olav University Hospital, 7030 Trondheim, Norway
- Corresponding author at: Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll 7491 Trondheim, Norway.
| | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll 7491 Trondheim, Norway
- St Olav University Hospital, 7030 Trondheim, Norway
| | - Clare Llewellyn
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll 7491 Trondheim, Norway
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Wang J, Zhu B, Wu R, Chang YS, Cao Y, Zhu D. Bidirectional Associations between Parental Non-Responsive Feeding Practices and Child Eating Behaviors: A Systematic Review and Meta-Analysis of Longitudinal Prospective Studies. Nutrients 2022; 14:nu14091896. [PMID: 35565862 PMCID: PMC9103127 DOI: 10.3390/nu14091896] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/22/2022] [Accepted: 04/28/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Parental non-responsive feeding practices and child eating behaviors both play significant roles in childhood obesity. However, their longitudinal relationships are less clear. This systematic review aimed to examine their bidirectional associations. Methods: A systematic search of five databases was conducted from inception to February 2022. Data synthesis was performed using a semi-quantitative and quantitative approach. Results: A total of 14 studies with 15348 respondents were included. A total of 94 longitudinal effects from 14 studies of parental non-responsive feeding practices on child eating behaviors were investigated, and 19 statistically significant effects were discovered. Seventy-seven longitudinal effects from nine studies of child eating behaviors on parental feeding practices were examined, with fifteen being statistically significant. The pooled results of meta-analysis showed five statistically significant associations: parental restrictive feeding positively predicted child enjoyment of food (β = 0.044; 95% CI: 0.004, 0.085); use of food as a reward positively predicted child emotional eating (β = 0.09; 95% CI: 0.04, 0.15); child food responsiveness positively predicted restrictive feeding (β = 0.04; 95% CI: 0.02, 0.06); use food as a reward (β = 0.06; 95% CI: 0.03, 0.10). In addition, the pooled effects showed that child satiety responsiveness negatively predicted restrictive feeding (β = −0.05; 95% CI: −0.08, −0.01). Conclusions: The bidirectional relationships between parental non-responsive feeding practices and child eating behaviors are inconsistent and a few showed statistical significance. Theory-driven longitudinal studies using validated instruments and controlling for potential confounders are needed to unveil their relationships and provide evidence for obesity prevention interventions.
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Affiliation(s)
- Jian Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (B.Z.); (R.W.)
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK;
| | - Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (B.Z.); (R.W.)
| | - Ruxing Wu
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (B.Z.); (R.W.)
| | - Yan-Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London SE1 8WA, UK;
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden
- Correspondence: (Y.C.); (D.Z.); Tel.: +86-021-63846590 (D.Z.)
| | - Daqiao Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai 200025, China; (J.W.); (B.Z.); (R.W.)
- Correspondence: (Y.C.); (D.Z.); Tel.: +86-021-63846590 (D.Z.)
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Psychophysiological Regulation and Classroom Climate Influence First and Second Graders' Well-Being: The Role of Body Mass Index. Eur J Investig Health Psychol Educ 2021; 11:1581-1598. [PMID: 34940390 PMCID: PMC8700215 DOI: 10.3390/ejihpe11040112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022] Open
Abstract
This study examines the associations between physical and emotional well-being and classroom climate, cardiac vagal response, and body mass index (BMI) in a sample of 6- to-8-year-olds. Specifically, we expected a direct link between classroom climate, vagal withdrawal, BMI and children's physical and emotional comfort. Furthermore, we explored whether these individual and environmental characteristics influenced well-being in an interactive fashion. Participants were 142 (63 boys, 44%) first and second graders living in the North of Italy who were interviewed on their emotional and physical comfort. Heart rate and a measure of vagal influence on the heart (cardiac vagal tone) were recorded at rest and during an oral academic test. Height and weight were collected. Classroom climate was positively linked with physical well-being, whereas emotional well-being was negatively related with BMI. In addition, an inverted U-shaped effect of cardiac vagal withdrawal (i.e., cardiac vagal tone during stress minus resting vagal tone) on emotional well-being was found. Two regression models highlighted the role played by BMI when interacting with vagal withdrawal in predicting children's physical and emotional well-being. The interplay between BMI and cardiac vagal withdrawal played an important role in primary school children's well-being. From a clinical perspective, preventive training to improve autonomic regulation in concert with interventions promoting healthy eating attitudes might be critical for supporting primary school children's emotional and physical health.
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Kininmonth A, Smith A, Carnell S, Steinsbekk S, Fildes A, Llewellyn C. The association between childhood adiposity and appetite assessed using the Child Eating Behavior Questionnaire and Baby Eating Behavior Questionnaire: A systematic review and meta-analysis. Obes Rev 2021; 22:e13169. [PMID: 33554425 DOI: 10.1111/obr.13169] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 12/21/2022]
Abstract
This systematic review and meta-analysis aimed to quantify associations between Child Eating Behavior Questionnaire (CEBQ) and Baby Eating Behavior Questionnaire (BEBQ) appetitive traits (food approach: Food Responsiveness [FR], Enjoyment of Food [EF], Emotional Overeating [EOE], and Desire to Drink [DD]; food avoidant: Satiety Responsiveness [SR], Slowness in Eating [SE], Emotional Undereating [EUE], Food Fussiness [FF]) and measures of child adiposity. Searches of six databases up to February 2019 identified 72 studies (CEBQ, n = 67; BEBQ, n = 5), and 27 met the meta-analysis criteria. For cross-sectional studies reporting unadjusted correlations with body mass index z-scores (BMIz) (n = 19), all traits were associated with BMIz in expected directions (positive: FR, EF, EOE, and DD; negative: SR, SE, EUE, and FF). Pooled estimates ranged from r = 0.22 (FR) to r = -0.21 (SR). For cross-sectional studies reporting regression coefficients (n = 10), three traits (FR, EF, and EOE) associated positively, and three traits (SR, SE, and EUE) negatively, with BMIz (β = -0.31 [SR] to β = 0.22 [FR]). Eleven studies reported prospective relationships from appetite to adiposity measures for six scales (positive: FR, EF, EOE, and DD; negative: SR and SE). Five studies reported relationships from adiposity measures to appetite for five traits (positive: FR, EF, and EOE; negative: SR). All BEBQ traits were consistently cross-sectionally associated with adiposity measures. Overall, CEBQ/BEBQ-assessed appetitive traits show consistent cross-sectional relationships with measures of child adiposity.
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Affiliation(s)
- Alice Kininmonth
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Andrea Smith
- Obesity Group, Research Department of Behavioural Science and Health, University College London, London, UK
| | - Susan Carnell
- Department of Psychiatry and Behavioural Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Silje Steinsbekk
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Alison Fildes
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Clare Llewellyn
- Obesity Group, Research Department of Behavioural Science and Health, University College London, London, UK
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Abstract
PURPOSE OF REVIEW The childhood obesity epidemic is widely considered to have reached pandemic proportions. Across the world, children with obesity are facing numerous psychological and physiological issues that follow them into adulthood, frequently leading to chronic illness and early death. In an effort to combat the compounding effects of childhood overweight, researchers are attempting to identify biological and environmental contributors to child weight. Parenting styles are one recognized influence on child diet and body mass index (BMI). This review is a comprehensive examination of the literature on the influence of parenting style on childhood diet and BMI over the past 5 years. RECENT FINDINGS Current research continues to support the use of traditional parenting style categories (i.e., authoritative, authoritarian, permissive, uninvolved/neglectful): however, newer subcategories of Baumrind's styles and the inclusion of previously underrepresented groups (e.g., fathers, cross cultural comparison studies) are shedding more light on the nuance of parenting's relationship with child weight. Parenting styles that focus on the balance of warmth and control (e.g., authoritative) in contrast to the styles dedicated to only one of these constructs (e.g., permissive, authoritarian) seem to promote the healthiest dietary habits and may be protective of child BMI.
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Beckers D, Karssen LT, Vink JM, Burk WJ, Larsen JK. Food parenting practices and children's weight outcomes: A systematic review of prospective studies. Appetite 2020; 158:105010. [PMID: 33075443 DOI: 10.1016/j.appet.2020.105010] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 09/19/2020] [Accepted: 10/11/2020] [Indexed: 01/10/2023]
Abstract
This systematic review is the first to provide an overview of the prospective links between food parenting practices and children's weight outcomes. Three databases were searched. All titles, abstracts and full-texts were double screened by two independent reviewers. Peer-reviewed journal articles published after 1990 assessing the prospective association between food parenting practices and weight outcomes of children aged 2-18 years were eligible. A total of 38 eligible studies were identified, focusing on 12 separate food parenting practices. Restriction, pressure to eat, and monitoring were generally not associated with children's weight over time, but higher quality studies suggest that pressure to eat was associated with lower weight outcomes over time. Most studies on food availability and accessibility found null-findings as well. Instrumental-but not emotional-feeding was associated with higher weight over time, but higher quality studies are needed to confirm this link. Results involving the link between frequency of mealtime and child weight were mixed. Autonomy supporting and other structure-related food parenting practices were understudied. In conclusion, food parenting practices receiving the most attention within prospective studies (i.e., restriction, pressure to eat, monitoring) were generally not associated with children's weight outcomes over time. Future high quality studies should focus more on other food parenting practices, further unravel bidirectional links between food parenting and children's eating behaviors and weight outcomes, and examine the mediating role of dietary intake.
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Affiliation(s)
- Desi Beckers
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, the Netherlands.
| | - Levie T Karssen
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, the Netherlands
| | - Jacqueline M Vink
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, the Netherlands
| | - William J Burk
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, the Netherlands
| | - Junilla K Larsen
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, the Netherlands
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12
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Steinsbekk S, Bjørklund O, Llewellyn C, Wichstrøm L. Temperament as a predictor of eating behavior in middle childhood – A fixed effects approach. Appetite 2020; 150:104640. [DOI: 10.1016/j.appet.2020.104640] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 02/21/2020] [Accepted: 02/21/2020] [Indexed: 12/30/2022]
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13
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Smith JD, Fu E, Kobayashi MA. Prevention and Management of Childhood Obesity and Its Psychological and Health Comorbidities. Annu Rev Clin Psychol 2020; 16:351-378. [PMID: 32097572 PMCID: PMC7259820 DOI: 10.1146/annurev-clinpsy-100219-060201] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Childhood obesity has become a global pandemic in developed countries, leading to a host of medical conditions that contribute to increased morbidity and premature death. The causes of obesity in childhood and adolescence are complex and multifaceted, presenting researchers and clinicians with myriad challenges in preventing and managing the problem. This article reviews the state of the science for understanding the etiology of childhood obesity, the preventive interventions and treatment options for overweight and obesity, and the medical complications and co-occurring psychological conditions that result from excess adiposity, such as hypertension, nonalcoholic fatty liver disease, and depression. Interventions across the developmental span, varying risk levels, and service contexts (e.g.,community, school, home, health care systems) are reviewed. Future directions for research are offered with an emphasis on translational issues for taking evidence-based interventions to scale in a manner that will reduce the public health burden of the childhood obesity pandemic.
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Affiliation(s)
- Justin D Smith
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA; ,
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA
| | - Emily Fu
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA; ,
| | - Marissa A Kobayashi
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida 33136, USA;
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14
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Searle BRE, Harris HA, Thorpe K, Jansen E. What children bring to the table: The association of temperament and child fussy eating with maternal and paternal mealtime structure. Appetite 2020; 151:104680. [PMID: 32222402 DOI: 10.1016/j.appet.2020.104680] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 01/10/2023]
Abstract
Fussy eating is a nuanced, mealtime-specific behaviour associated with difficult temperament but has been rarely examined within the context of mealtime structure. The aim of this study was to a) examine associations between child temperament, and mothers' and fathers' structure-related feeding practices and b) explore whether these associations were mediated by child fussy eating. Cohabiting mother-father pairs (N = 205) of children aged between 2- to 5-years residing in a socioeconomically disadvantaged Australian city completed self-reported, validated measures of child temperament, food fussiness and structure-related feeding practices (structured meal timing, structured meal setting and family meal setting). Child temperament was associated with maternal and paternal structure-related feeding practices, such that more difficult temperament was associated with less mealtime structure. Mothers' perception of child food fussiness mediated the relationship between difficult temperament and increased provision of alternative meals to the child from the rest of the family. Additionally, mothers' and fathers' perception of child food fussiness mediated the relationship between difficult child temperament and lower frequency of sitting at a table together for family meals. Therefore, perceptions of child food fussiness may explain why mothers and fathers use less structure at mealtimes with children who have more difficult temperaments. These results suggests that similar intervention approaches can be used for both mothers and fathers from socioeconomically disadvantaged families to target fussy eating and structure the mealtime environment. Promoting mealtime structure to facilitate parents' appropriate responses to food refusal or difficult behaviour at mealtimes is indicated.
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Affiliation(s)
- Bonnie-Ria E Searle
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Holly A Harris
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Karen Thorpe
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Elena Jansen
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
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15
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Trude ACB, Black MM, Surkan PJ, Hurley KM, Wang Y. Maternal anxiety and diet quality among mothers and toddlers from low-income households. MATERNAL AND CHILD NUTRITION 2020; 16:e12992. [PMID: 32147951 PMCID: PMC7507505 DOI: 10.1111/mcn.12992] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/24/2020] [Accepted: 02/18/2020] [Indexed: 01/23/2023]
Abstract
We evaluated the association between maternal anxiety score and diet quality over time among mothers and toddlers in low‐income families. Longitudinal data were collected from 267 mother–toddler dyads in an obesity prevention trial. Participants were recruited from the Special Supplemental Nutrition Program for Women, Infants and Children and paediatric clinics between 2007 and 2010. Dyads were assessed at study enrolment (Time 1), 6‐month (Time 2), and 12‐month follow‐up (Time 3). On the basis of a 1‐day 24‐hr dietary recall, we estimated maternal and toddler diet quality using the Healthy Eating Index 2015. Anxiety, a time‐varying variable, was assessed via the State–Trait Anxiety Inventory. Associations between maternal anxiety score and maternal and toddler diet quality over time were assessed in adjusted mixed models. Maternal and toddler diet quality were positively correlated (r = .48, p < .001). Higher maternal anxiety scores were related to lower toddler Healthy Eating Index scores (b = −0.51, 95% confidence interval, CI [−0.87, −0.15]) with no significant variation over time. The relation between maternal diet quality and anxiety score varied over time (b = 0.28, p = .03, for time–anxiety interaction). Higher maternal anxiety scores were associated with lower maternal diet quality at Time 1 (b = −0.71, 95% CI [−1.09, 0.34]) and at Time 2 (b = −0.51, 95% CI [−0.97, −0.05]), but not at Time 3 (b = −0.14, 95% CI [−0.54, 0.26]). Findings suggest that mothers and toddlers exhibited similar low‐quality dietary patterns and that lower diet quality was associated with higher maternal anxiety scores. Approaches to enhance diet quality may consider incorporating anxiety‐reducing strategies into maternal and toddler care and feeding behaviour guidelines.
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Affiliation(s)
- Angela C B Trude
- Growth and Nutrition Division, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Maureen M Black
- Growth and Nutrition Division, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA.,RTI International, Research Triangle Park, North Carolina, USA
| | - Pamela J Surkan
- Social and Behavioral Intervention Program, International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kristen M Hurley
- Center for Human Nutrition, International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yan Wang
- Growth and Nutrition Division, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
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16
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Russell CG, Russell A. A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research. Obes Rev 2019; 20:725-749. [PMID: 30768750 DOI: 10.1111/obr.12838] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 12/16/2018] [Accepted: 01/07/2019] [Indexed: 12/12/2022]
Abstract
Childhood obesity has reached alarming proportions in many countries. There is consensus that both biological (especially genetic) and environmental (including psychosocial) factors contribute to weight gain and obesity in childhood. Research has identified extensive risk or predictive factors for childhood obesity from both of these domains. There is less consensus about the developmental processes or pathways showing how these risk factors lead to overweigh/obesity (OW/OB) in childhood. We outline a biopsychosocial process model of the development of OW/OB in childhood. The model and associated scholarship from developmental theory and research guide an analysis of research on OW/OB in childhood. The model incorporates biological factors such as genetic predispositions or susceptibility genes, temperament, and homeostatic and allostatic processes with the psychosocial and behavioral factors of parenting, parental feeding practices, child appetitive traits, food liking, food intakes, and energy expenditure. There is an emphasis on bidirectional and transactional processes linking child biology and behavior with psychosocial processes and environment. Insights from developmental theory and research include implications for conceptualization, measurement, research design, and possible multiple pathways to OW/OB. Understanding the developmental processes and pathways involved in childhood OW/OB should contribute to more targeted prevention and intervention strategies in childhood.
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Affiliation(s)
- Catherine G Russell
- Faculty of Health, School of Exercise and Nutrition Sciences, Centre for Advanced Sensory Science, Deakin University, Burwood, Australia
| | - Alan Russell
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia
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17
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Early maternal perceived stress and children's BMI: longitudinal impact and influencing factors. BMC Public Health 2018; 18:1211. [PMID: 30376822 PMCID: PMC6208039 DOI: 10.1186/s12889-018-6110-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal perceived stress has been discussed to contribute to the development of childhood overweight. Our aim was to investigate the longitudinal relationship of early maternal perceived stress and BMI z-scores in preschool children (≤ five years). METHODS A longitudinal analysis was conducted in 498 mother-child pairs of the German prospective birth cohort LINA with information on maternal perceived stress during pregnancy, one and two years after birth. BMI z-scores were based on annual measurements of children's weight/height and calculated based on WHO reference data. General estimation equations were applied to evaluate the impact of maternal stress on children's longitudinal BMI z-scores. Potential stressors contributing to the perceived stress of the mother were assessed by linear regression models. Using mediation analyses we evaluated the relationship between stressors, maternal perceived stress, and children's BMI z-score development. RESULTS Postnatal maternal stress during the first year after birth had a positive longitudinal relationship with children's BMI z-scores up to the age of five years. Gender-stratified analyses revealed that only girls showed this positive association while boy's BMI z-scores were unaffected by maternal stress. We identified three neighborhood strains and two socio-demographic factors, which contributed to the maternal perceived stress level. Stressors themselves did not directly affect girl's BMI z-scores but rather mediated their effect through the perceived stress level. CONCLUSIONS While different stressors contribute to maternal stress, the perceived stress level - rather than the stressors themselves - is strongly positively associated with BMI z-score development in girls.
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18
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Smith JD, Egan KN, Montaño Z, Dawson-McClure S, Jake-Schoffman DE, Larson M, St. George SM. A developmental cascade perspective of paediatric obesity: a conceptual model and scoping review. Health Psychol Rev 2018; 12:271-293. [PMID: 29583070 PMCID: PMC6324843 DOI: 10.1080/17437199.2018.1457450] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/22/2018] [Indexed: 12/12/2022]
Abstract
Considering the immense challenge of preventing obesity, the time has come to reconceptualise the way we study the obesity development in childhood. The developmental cascade model offers a longitudinal framework to elucidate the way cumulative consequences and spreading effects of risk and protective factors, across and within biopsychosocial spheres and phases of development, can propel individuals towards obesity. In this article, we use a theory-driven model-building approach and a scoping review that included 310 published studies to propose a developmental cascade model of paediatric obesity. The proposed model provides a basis for testing hypothesised cascades with multiple intervening variables and complex longitudinal processes. Moreover, the model informs future research by resolving seemingly contradictory findings on pathways to obesity previously thought to be distinct (low self-esteem, consuming sugary foods, and poor sleep cause obesity) that are actually processes working together over time (low self-esteem causes consumption of sugary foods which disrupts sleep quality and contributes to obesity). The findings of such inquiries can aid in identifying the timing and specific targets of preventive interventions across and within developmental phases. The implications of such a cascade model of paediatric obesity for health psychology and developmental and prevention sciences are discussed.
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Affiliation(s)
- Justin D. Smith
- Department of Psychiatry and Behavioral Sciences, Department of Preventive Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA, (312)503-4041.
| | - Kaitlyn N. Egan
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA, (619)733-3977.
| | - Zorash Montaño
- Children’s Hospital of Los Angeles, University of Southern California, Los Angeles, California, USA, (323)804-6666.
| | - Spring Dawson-McClure
- Center for Early Childhood Health & Development, New York University Langone Medical Center, New York, New York, USA, (919)930-7240.
| | - Danielle E. Jake-Schoffman
- Division of Preventive & Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA, (508)856-6517.
| | - Madeline Larson
- Department of Psychology and Neuroscience, Baylor University, Waco, Texas, USA, (253)225-0119.
| | - Sara M. St. George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA, (305)243-0726.
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19
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Harris HA, Jansen E, Mallan KM, Daniels L, Thorpe K. Concern Explaining Nonresponsive Feeding: A Study of Mothers' and Fathers' Response to Their Child's Fussy Eating. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:757-764. [PMID: 30196882 DOI: 10.1016/j.jneb.2018.05.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/27/2018] [Accepted: 05/29/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine the role of parent concern in explaining nonresponsive feeding practices in response to child fussy eating in socioeconomically disadvantaged families. DESIGN Mediation analysis of cross-sectional survey data. SETTING Socioeconomically disadvantaged urban community in Queensland, Australia. PARTICIPANTS Cohabiting mother-father pairs (n = 208) with children aged 2-5 years. MAIN OUTCOME MEASURE(S) Two validated measures of nonresponsive feeding: persuasive feeding and reward for eating. ANALYSIS Mediation analysis tested concern as a mediator of the relationship between child food fussiness (independent variable) and parent nonresponsive feeding practices (dependent variables), adjusted for significant covariates and modeled separately for mothers and fathers. RESULTS Maternal concern fully mediated the relationship between child food fussiness and persuasive feeding (indirect effect: B [SE] = 0.10 [0.05]; 95% confidence interval [CI], 0.01-0.20). Concern also fully mediated the relationship between child food fussiness and reward for eating for mothers (indirect effect: B [SE] = 0.17 [0.07]; CI, 0.04-0.31) and fathers (indirect effect: B [SE] = 0.14 [0.05]; CI, 0.04-0.24) CONCLUSIONS AND IMPLICATIONS: Concern for fussy eating behaviors may explain mothers' and fathers' nonresponsive feeding practices. In addition to providing education and behavioral support, health professionals working with socioeconomically disadvantaged families can incorporate strategies that aim to alleviate parents' concerns about fussy eating.
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Affiliation(s)
- Holly A Harris
- Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, Australia.
| | - Elena Jansen
- Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Kimberley M Mallan
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, Australia; School of Psychology, Australian Catholic University, Banyo, Brisbane, Australia
| | - Lynne Daniels
- Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Karen Thorpe
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Brisbane, Australia
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20
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Steinsbekk S, Bonneville-Roussy A, Fildes A, Llewellyn CH, Wichstrøm L. Child and parent predictors of picky eating from preschool to school age. Int J Behav Nutr Phys Act 2017; 14:87. [PMID: 28679411 PMCID: PMC5498871 DOI: 10.1186/s12966-017-0542-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 06/27/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Picky eating is prevalent in childhood. Because pickiness concerns parents and is associated with nutrient deficiency and psychological problems, the antecedents of pickiness need to be identified. We propose an etiological model of picky eating involving child temperament, sensory sensitivity and parent-child interaction. METHODS Two cohorts of 4-year olds (born 2003 or 2004) in Trondheim, Norway were invited to participate (97.2% attendance; 82.0% consent rate, n = 2475) and a screen-stratified subsample of 1250 children was recruited. We interviewed 997 parents about their child's pickiness and sensory sensitivity using the Preschool Age Psychiatric Assessment (PAPA). Two years later, 795 of the parents completed the interview. The Children's Behavior Questionnaire (CBQ) was used to assess children's temperament. Parent- child interactions were videotaped and parental sensitivity (i.e., parental awareness and appropriate responsiveness to children's verbal and nonverbal cues) and structuring were rated using the Emotional Availability Scales (EAS). RESULTS At both measurement times, 26% of the children were categorized as picky eaters. Pickiness was moderately stable from preschool to school age (OR = 5.92, CI = 3.95, 8.86), and about half of those who displayed pickiness at age 4 were also picky eaters two years later. While accounting for pickiness at age 4, sensory sensitivity at age 4 predicted pickiness at age 6 (OR = 1.25, CI = 1.08, 2.23), whereas temperamental surgency (OR = 0.88, CI = 0.64, 1.22) and negative affectivity (OR = 1.17, CI = 0.75, 1.84) did not. Parental structuring was found to reduce the risk of children's picky eating two years later (OR = 0.90, CI = 0.82, 0.99), whereas parental sensitivity increased the odds for pickiness (OR = 1.10, CI = 1.00, 1.21). CONCLUSIONS Although pickiness is stable from preschool to school age, children who are more sensory sensitive are at higher risk for pickiness two years later, as are children whose parents display relatively higher levels of sensitivity and lower levels of structuring. Our findings suggest that interventions targeting children's sensory sensitivity, as well as parental sensitivity and structuring, might reduce the risk of childhood pickiness. Health care providers should support parents of picky eaters in repeatedly offering unfamiliar and rejected foods to their children without pressure and acknowledging child autonomy.
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Affiliation(s)
- Silje Steinsbekk
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll, 7491, Trondheim, Norway.
| | | | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Clare H Llewellyn
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Lars Wichstrøm
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Dragvoll, 7491, Trondheim, Norway.,NTNU Social Research, 7491, Trondheim, Norway
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21
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Sokol RL, Qin B, Poti JM. Parenting styles and body mass index: a systematic review of prospective studies among children. Obes Rev 2017; 18:281-292. [PMID: 28086262 PMCID: PMC5436909 DOI: 10.1111/obr.12497] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parenting style may be an important determinant of an individual's future weight status. However, reviews that evaluate the relationship between parenting style and weight-related outcomes have not focused on prospective studies. METHODS We systematically searched PubMed, Embase and PsychInfo for studies published between 1995 and 2016 that evaluated the prospective relationship between parenting style experienced in childhood and subsequent weight outcomes. RESULTS We identified 11 prospective cohort studies. Among the eight studies that categorized parenting style into distinct groups (i.e. authoritative, authoritarian, permissive and neglectful), five provided evidence that authoritative parenting was associated with lower body mass index gains. Among the six highest quality studies, four suggested a protective role of authoritative parenting style against adverse weight-related outcomes. However, only one study controlled for a comprehensive set of confounders, and the small number of studies conducted within certain age groups precluded our ability to ascertain critical periods when parenting style is most strongly related to child weight. CONCLUSIONS The present literature supports the idea that authoritative parenting may be protective against later overweight and obesity, although findings are mixed. More prospective cohort studies of longer durations, with more sophisticated methods that examine age-varying relationships, and that control for a comprehensive set of confounders, are needed.
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Affiliation(s)
- Rebeccah L Sokol
- Department of Health Behavior, University of North Carolina at Chapel Hill, 135 Dauer Drive, 302 Rosenau Hall, CB #7440, Chapel Hill, NC 27599-7440
| | - Bo Qin
- Population Science, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08903
| | - Jennifer M Poti
- Department of Nutrition, University of North Carolina at Chapel Hill, 137 East Franklin Street, Carolina Population Center, CB #8120, Chapel Hill, NC 27599
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22
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Associations between maternal sense of coherence and controlling feeding practices: The importance of resilience and support in families of preschoolers. Appetite 2016; 105:134-43. [DOI: 10.1016/j.appet.2016.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/07/2016] [Accepted: 05/13/2016] [Indexed: 11/17/2022]
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Personality and Body-Mass-Index in School-Age Children: An Exploration of Mediating and Moderating Variables. PLoS One 2016; 11:e0158353. [PMID: 27486752 PMCID: PMC4972344 DOI: 10.1371/journal.pone.0158353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 06/14/2016] [Indexed: 02/07/2023] Open
Abstract
This study explored longitudinal associations between personality and body-mass-index (BMI) in school-age children, including the potential mediating role of screen time and physical activity, and the potential moderating roles of child demographics and neighbourhood socioeconomic position. Participants were the parents (and teachers) of 3857 ten-year-old children, who completed questionnaires at baseline with a two-year follow-up. After controlling for child demographics (e.g., sex, pubertal status), we found that personality was unimportant for concurrent BMI, but was important for subsequent BMI and change in BMI over two years. Low levels of introversion and persistence at baseline, and decreases in persistence over time, were associated with a higher BMI at follow-up and a greater increase in BMI over time. Moderator analyses showed that introversion was more strongly related to subsequent BMI for children listed as aboriginal or Torres Strait Islander. The relationship between personality and change in BMI was mediated by screen time, but not by physical activity. To conclude, findings demonstrate that personality is important for change in body mass in Australian children (particularly indigenous children), and that screen-based sedentary behaviour features an important role in this association.
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Harris HA, Fildes A, Mallan KM, Llewellyn CH. Maternal feeding practices and fussy eating in toddlerhood: a discordant twin analysis. Int J Behav Nutr Phys Act 2016; 13:81. [PMID: 27412445 PMCID: PMC4944306 DOI: 10.1186/s12966-016-0408-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/30/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Parental feeding practices are thought to play a causal role in shaping a child's fussiness; however, a child-responsive model suggests that feeding practices may develop in response to a child's emerging appetitive characteristics. We used a novel twin study design to test the hypothesis that mothers vary their feeding practices for twin children who differ in their 'food fussiness', in support of a child-responsive model. METHODS Participants were mothers and their 16 month old twin children (n = 2026) from Gemini, a British twin birth cohort of children born in 2007. Standardized psychometric measures of maternal 'pressure to eat', 'restriction' and 'instrumental feeding', as well as child 'food fussiness', were completed by mothers. Within-family analyses examined if twin-pair differences in 'food fussiness' were associated with differences in feeding practices using linear regression models. In a subset of twins (n = 247 pairs) who were the most discordant (highest quartile) on 'food fussiness' (difference score ≥ .50), Paired Samples T-test were used to explore the magnitude of differences in feeding practices between twins. Between-family analyses used Complex Samples General Linear Models to examine associations between feeding practices and 'food fussiness'. RESULTS Within-pair differences in 'food fussiness' were associated with differential 'pressure to eat' and 'instrumental feeding' (ps < .001), but not with 'restriction'. In the subset of twins most discordant on 'food fussiness', mothers used more pressure (p < .001) and food rewards (p < .05) with the fussier twin. Between-family analyses indicated that 'pressure to eat' and 'instrumental feeding' were positively associated with 'food fussiness', while 'restriction' was negatively associated with 'food fussiness' (ps < .001). CONCLUSIONS Mothers appear to subtly adjust their feeding practices according to their perceptions of their toddler's emerging fussy eating behavior. Specifically, the fussier toddler is pressured more than their less fussy co-twin, and is more likely to be offered food rewards. Guiding parents on how to respond to fussy eating may be an important aspect of promoting feeding practices that encourage food acceptance.
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Affiliation(s)
- Holly A Harris
- Centre for Children's Health Research, Queensland University of Technology, South Brisbane, 4101, Australia.,School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, 4059, Australia.,Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK
| | - Alison Fildes
- Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK
| | - Kimberley M Mallan
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, 4059, Australia.,School of Psychology, Australian Catholic University, Brisbane, 4014, Australia
| | - Clare H Llewellyn
- Health Behaviour Research Centre, University College London, London, WC1E 6BT, UK. .,University College of London, Gower Street, London, WC1E 6BT, UK.
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25
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Leung CY, Miller AL, Kaciroti NA, Chen YP, Rosenblum K, Lumeng JC. Low-income pre-schoolers with higher temperamental surgency enjoy and respond more to food, mediating the path to higher body mass index. Pediatr Obes 2016; 11:181-6. [PMID: 26083122 PMCID: PMC4683115 DOI: 10.1111/ijpo.12042] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 04/22/2015] [Accepted: 04/23/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Temperament is associated with obesity risk. However, the mechanisms linking temperament and eating behaviour to childhood adiposity are unclear. OBJECTIVES To examine whether three temperament dimensions (surgency, effortful control and negative lability) are uniquely associated with an increased BMI z score (BMIz) concurrently and an excessive rate of change in BMIz longitudinally through four eating behaviours (food responsiveness, enjoyment of food, emotional overeating and satiety responsiveness) among low-income pre-schoolers, independent of home environment quality. METHODS 379 pre-schoolers were recruited from Head Start in the Midwest region of the United States. Primary caregivers reported child temperament, eating behaviours and the level of chaos at home. Child BMIz was derived from weight and height measurements at ages 4, 5 and 6 years on average. RESULTS Path analyses revealed that higher levels of surgency predicted more food responsiveness and enjoyment of food, which was in turn associated with higher concurrent BMIz, independent of effortful control, negative lability and home chaos. CONCLUSION Low-income surgent pre-schoolers were more likely to have elevated BMIz as they were more inclined to eat in response to external cues and have a high appetitive drive. Obesity prevention programmes might target low-income children with surgent temperaments, and the identified eating behaviours.
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Affiliation(s)
- Christy Y.Y. Leung
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Alison L. Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Niko A. Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Yu Pu Chen
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
| | - Katherine Rosenblum
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Julie C. Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI,Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI,Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
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26
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de Barse LM, Cardona Cano S, Jansen PW, Jaddoe VVW, Verhulst FC, Franco OH, Tiemeier H, Tharner A. Are parents' anxiety and depression related to child fussy eating? Arch Dis Child 2016; 101:533-538. [PMID: 26916538 DOI: 10.1136/archdischild-2015-309101] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 01/09/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To examine the association between parental anxiety and depression with child fussy eating-that is, consistent rejection of particular food items. DESIGN This study was embedded in Generation R, a prospective cohort from fetal life onwards in the Netherlands. SETTING Population-based. PARTICIPANTS 4746 4-year-old children and their parents. EXPOSURE Parental internalising problems (ie, symptoms of anxiety and depression) were assessed with the Brief Symptoms Inventory during pregnancy and the preschool period (child age 3 years). MAIN OUTCOME MEASURE The food fussiness scale of the Children's Eating Behaviour Questionnaire. RESULTS Maternal anxiety during pregnancy and during the child's preschool period was related to higher food fussiness sum-scores in children. For instance, per point on the anxiety scale in pregnancy, children had on average a 1.02 higher sum-score (95% CI 0.59 to 1.46) on the food fussiness scale, after adjustment for confounders. Likewise, mothers' depressive symptoms at both time points were associated with fussy eating behaviour in their children (eg, in the antenatal period: per point on the depression scale, children had a 0.91 point higher sum-score on the food fussiness scale, 95% CI 0.49 to 1.33). We found largely similar associations between fathers' internalising problems and children's fussy eating. However, fathers' anxiety during the antenatal period was not related to child fussy eating. CONCLUSIONS Maternal and paternal internalising problems were prospectively associated with fussy eating in preschoolers. Healthcare practitioners should be aware that non-clinical symptoms of anxiety and depression in parents are risk factors for child fussy eating.
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Affiliation(s)
- Lisanne M de Barse
- The Generation R Study Group, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | | | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Vincent V W Jaddoe
- The Generation R Study Group, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Frank C Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Anne Tharner
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Psychology, University of Copenhagen, København K, Denmark
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27
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Skogheim TS, Vollrath ME. Associations of Child Temperament with Child Overweight and Breakfast Habits: A Population Study in Five-Year-Olds. Nutrients 2015; 7:10116-28. [PMID: 26633494 PMCID: PMC4690074 DOI: 10.3390/nu7125522] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 11/04/2015] [Accepted: 11/26/2015] [Indexed: 11/20/2022] Open
Abstract
This study examines the associations of child temperament with overweight/obesity and breakfast habits. Participants were 17,409 five-year-olds whose mothers partake in the Norwegian Mother and Child Cohort Study (MoBa), and completed a questionnaire at the child’s 5th birthday. Temperament was assessed as externalizing, internalizing and sociable temperament. Breakfast habits differentiated between “every day”, “4 to 6 times a week”, and “0 to 3 times a week”. The child’s weight status was determined by Body Mass Index-percentiles and categorized as normal weight versus overweight/obese. Children with externalizing temperament had higher odds of being overweight and higher odds of not eating breakfast daily. Children high in internalizing temperament had higher odds of not eating breakfast daily, but not of being overweight. Children with average scores of sociability were more prone to being overweight but had normal breakfast habits. All results were adjusted for key confounders. That five-year-olds high in externalizing temperament had a higher risk to be overweight adds important information to the literature. The association of externalizing temperament with child breakfast habits so early in life is intriguing, as parents mostly control eating patterns in children that young. Mechanisms mediating this association should be explored.
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Affiliation(s)
| | - Margarete Erika Vollrath
- Norwegian Institute of Public Health, Oslo 0403, Norway.
- Institute of Psychology, University of Oslo, Oslo 0373, Norway.
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28
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Jansen E, Mallan KM, Daniels LA. Extending the validity of the Feeding Practices and Structure Questionnaire. Int J Behav Nutr Phys Act 2015; 12:90. [PMID: 26123046 PMCID: PMC4487203 DOI: 10.1186/s12966-015-0253-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 06/24/2015] [Indexed: 01/15/2023] Open
Abstract
Background Feeding practices are commonly examined as potentially modifiable determinants of children’s eating behaviours and weight status. Although a variety of questionnaires exist to assess different feeding aspects, many lack thorough reliability and validity testing. The Feeding Practices and Structure Questionnaire (FPSQ) is a tool designed to measure early feeding practices related to non-responsive feeding and structure of the meal environment. Face validity, factorial validity, internal reliability and cross-sectional correlations with children’s eating behaviours have been established in mothers with 2-year-old children. The aim of the present study was to further extend the validity of the FPSQ by examining factorial, construct and predictive validity, and stability. Methods Participants were from the NOURISH randomised controlled trial which evaluated an intervention with first-time mothers designed to promote protective feeding practices. Maternal feeding practices (FP) and child eating behaviours were assessed when children were aged 2 years and 3.7 years (n = 388). Confirmatory Factor analysis, group differences, predictive relationships, and stability were tested. Results The original 9-factor structure was confirmed when children were aged 3.7 ± 0.3 years. Cronbach’s alpha was above the recommended 0.70 cut-off for all factors except Structured Meal Timing, Over Restriction and Distrust in Appetite which were 0.58, 0.67 and 0.66 respectively. Allocated group differences reflected behaviour consistent with intervention content and all feeding practices were stable across both time points (range of r = 0.45-0.70). There was some evidence for the predictive validity of factors with 2 FP showing expected relationships, 2 FP showing expected and unexpected relationships and 5 FP showing no relationship. Conclusions Reliability and validity was demonstrated for most subscales of the FPSQ. Future validation is warranted with culturally diverse samples and with fathers and other caregivers. The use of additional outcomes to further explore predictive validity is recommended as well as testing test-retest reliability of the questionnaire.
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Affiliation(s)
- Elena Jansen
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.
| | - Kimberley M Mallan
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia.
| | - Lynne A Daniels
- Institute of Health and Biomedical Innovation, School of Exercise and Nutrition Sciences, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, 4059, Australia. .,Nutrition and Dietetics, Flinders University, Adelaide, SA, 5001, Australia.
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29
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Tate EB, Wood W, Liao Y, Dunton GF. Do stressed mothers have heavier children? A meta-analysis on the relationship between maternal stress and child body mass index. Obes Rev 2015; 16:351-61. [PMID: 25879393 PMCID: PMC4447110 DOI: 10.1111/obr.12262] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/09/2014] [Accepted: 12/12/2014] [Indexed: 02/06/2023]
Abstract
Child obesity continues to be a prevalent public health issue. This meta-analysis synthesized 17 studies investigating the association between levels of psychological stress experienced by mothers and the body mass index of their children. The overall standardized mean difference effect size was positive and significantly different from zero in cross-sectional d = 0.20 (k = 14, 95% confidence interval [CI]: 0.06, 0.34) and longitudinal studies d = 0.18 (k = 5, 95% CI: 0.00, 0.351) and had significant heterogeneity in both (cross-sectional, Q[13] = 193.00, P < 0.001; longitudinal, Q[4] = 29.46, P < 0.001). In longitudinal studies, effect sizes were larger when children also would have experienced the stressor, Q(6) = 4.68, P < 0.05, for toddlers than infants, Q(4) = 5.04, P < 0.05, and in higher quality studies, Q(4) = 14.58, P < 0.05. Results highlight the potential benefits of including a parent stress management component in childhood obesity prevention programmes.
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Affiliation(s)
- E B Tate
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
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30
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Bergmeier H, Skouteris H, Hetherington M. Systematic research review of observational approaches used to evaluate mother-child mealtime interactions during preschool years. Am J Clin Nutr 2015; 101:7-15. [PMID: 25527745 DOI: 10.3945/ajcn.114.092114] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The family meal and social interactions during the meal are important events in a child's life. Specifically, mealtime interactions have been linked to child weight status, the development of children's eating patterns, and socialization. Mealtime interactions may be observed and evaluated to provide insights into this important event beyond self-reported measurements. OBJECTIVE We aimed to identify, review, and examine studies in which mother-child mealtime behaviors were measured through observation. DESIGN MEDLINE Complete, PsycINFO, and PsycARTICLES were systematically searched by using sensitive search strategies. We included observational studies of mother-child eating and mealtimes and associations between mother-child interactions and preschool child eating or weight status published to March 2014. RESULTS Thirteen articles were included in our review. All studies but one were cross-sectional, and none of the studies evaluated how mutual dimensions (e.g., parent responsiveness to the child and child responsiveness to the parent) of dyadic interactions between mothers and children influence maternal feeding practices, children's eating, and weight. The parenting style was associated with maternal feeding practices but not directly with children's eating. Parental discouragements to eat and negative statements about food were associated with higher child weight status. Parental encouragement to eat was associated with higher child weight status as well as maternal body mass index. No associations were shown between maternal reports of feeding practices and observed maternal feeding practices. CONCLUSIONS Parents' overarching attitudes and approaches to parenting appear to be associated with their feeding practices or styles. Future studies should implement longitudinal observational methods with the capacity to measure levels of dimensions within bidirectional parent-child interactions and the extent to which these factors influence maternal practices, children's eating, and weight status.
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Affiliation(s)
- Heidi Bergmeier
- From the School of Psychology, Deakin University, Burwood, Australia (HB and HS), and the Institute of Psychological Sciences, University of Leeds, Leeds, United Kingdom (MH)
| | - Helen Skouteris
- From the School of Psychology, Deakin University, Burwood, Australia (HB and HS), and the Institute of Psychological Sciences, University of Leeds, Leeds, United Kingdom (MH)
| | - Marion Hetherington
- From the School of Psychology, Deakin University, Burwood, Australia (HB and HS), and the Institute of Psychological Sciences, University of Leeds, Leeds, United Kingdom (MH)
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31
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Nowicka P, Sorjonen K, Pietrobelli A, Flodmark CE, Faith MS. Parental feeding practices and associations with child weight status. Swedish validation of the Child Feeding Questionnaire finds parents of 4-year-olds less restrictive. Appetite 2014; 81:232-41. [PMID: 24972134 DOI: 10.1016/j.appet.2014.06.027] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/17/2014] [Accepted: 06/20/2014] [Indexed: 12/12/2022]
Abstract
The Child Feeding Questionnaire (CFQ) assesses parental feeding attitudes, beliefs and practices concerned with child feeding and obesity proneness. The questionnaire has been developed in the U.S., and validation studies in other countries are limited. The aim of this study was to examine the psychometric properties of the CFQ in Sweden and the associations between parenting practices and children's weight status. Based on records from the Swedish population register, all mothers of 4-year-olds (n = 3007) from the third largest city in Sweden, Malmö, were contacted by mail. Those who returned the CFQ together with a background questionnaire (n = 876) received the CFQ again to enable test-retest evaluation; 564 mothers completed the CFQ twice. We used confirmatory factor analysis to test whether the original 7-factor model was supported. Good fit (CFI = 0.94, TLI = 0.95, RMSEA = 0.04, SRMR = 0.05) was obtained after minor modifications such as dropping 2 items on restriction and adding 3 error covariances. The internal reliability and the 2-week test-retest reliability were good. The scores on restriction were the lowest ever reported. When the influence of parenting practices on child BMI (dependent variable) was examined in a structural equation model (SEM), child BMI had a positive association with restriction and a negative association with pressure to eat. Restriction was positively influenced by concern about child weight. The second SEM treated parenting practices as dependent variables. Parental foreign origin and child BMI had direct effects on restriction, while pressure to eat was also influenced by parental education. While the results of the study support the usefulness of the CFQ in Sweden, carefully designed cross-cultural comparisons are needed to explain why the levels of restrictive feeding in Swedish families are the lowest reported.
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Affiliation(s)
- Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), B62, Karolinska Institute, 141 86 Stockholm, Sweden.
| | - Kimmo Sorjonen
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institute, 171 65 Solna, Sweden
| | - Angelo Pietrobelli
- Pediatric Unit, Verona University Medical School, Policlinic GB. Rossi, P.le LA. Scuro, 1, 37134 Verona, Italy; Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Carl-Erik Flodmark
- Childhood Obesity Unit, Childhood Centre Malmö, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Myles S Faith
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 2211 McGavran Greenberg Hall, CB 7461, Chapel Hill, NC 27599-7461, USA
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