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Rathi N, Kansal S, Worsley A. Indian fathers' perceptions of young childcare and feeding - A qualitative study. Appetite 2024; 199:107404. [PMID: 38723669 DOI: 10.1016/j.appet.2024.107404] [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: 08/14/2023] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 06/01/2024]
Abstract
The role of parents in fostering children's healthy habits is a robust area of research. However, most of the existing literature predominantly focuses on mothers' parenting practices. Given the emergence of nuclear, dual earning families and the recent surge in maternal employment in urban India, fathers' engagement in child rearing and feeding warrants attention. The purpose of this research was to document the views of Indian fathers about paternal parenting practices, with an emphasis on children's diet among other health behaviors. Thirty-three fathers of children aged 6-59 months from Kolkata, India took part in semi-structured interviews conducted either face-to-face or over Zoom/telephone in Hindi, Bengali, and English. The interviews were audio recorded, transcribed verbatim, and translated to English. The transcribed data were subjected to thematic analysis informed by the Template Analysis technique. Themes were detected using the NVivo software program. Overall, these Indian fathers played an important role in early childhood care and feeding as reflected in the following seven themes: (i) Involvement of fathers in various childcare activities; (ii) Implementation of responsive and non-responsive feeding practices; (iii) Concerns regarding fussy and slow eating; (iv) Concerns regarding excessive screen time; (v) Paternal vs maternal parenting; (vi) Barriers to routine engagement of fathers in childcare; (vii) Desire for more nutrition and health knowledge. This enhanced understanding of paternal parenting behavior supports the inclusion of fathers in future family-focused lifestyle interventions aimed at improving children's health outcomes, including their dietary habits.
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Affiliation(s)
- Neha Rathi
- Department of Home Science, Mahila Maha Vidyalaya, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India.
| | - Sangeeta Kansal
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India.
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
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Quirke-McFarlane S, Carstairs SA, Cecil JE. 'You just eyeball it': Parent and nursery staff perceptions and influences on child portion size: A reflexive thematic analysis. Nutr Health 2024:2601060241245255. [PMID: 38623628 DOI: 10.1177/02601060241245255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Background: Childhood obesity is one of the most serious public health epidemics of the 21st century. Observational studies report that increases in portion size (PS) have occurred in parallel with levels of obesity. Increased PSs of high-energy-dense foods can promote overeating, and without compensatory behaviours, can contribute to childhood obesity. Caregivers make decisions about PSs for children in the home and nursery environment, thus are gatekeepers to child food intake. Understanding caregiver PS decisions can aid in the best practice of PS provision to young children. The aim of this study was to explore parent and nursery staff influences on child PS selection and their suggestions for useful tools/strategies in PS decisions. Methods: A qualitative design was employed using focus group discussions (FGDs) with parents and nursery staff of children aged 3-5 years. FGDs were employed given their ability to generate rich data, as well as permit the exploration of collective perceptions, attitudes, behaviours and experiences. Data were analysed using an inductive, semantic approach to reflexive thematic analysis. Results: Four FGDs were conducted: two with parents (n = 13), two with nursery staff (n = 17). Four overarching themes were derived: (i) awareness of PS guidelines; (ii) control over PS; (iii) social influences on children's eating behaviours; (iv) child-specific, social and external factors influencing parent and nursery staff PS decisions. Additionally, participants discussed tools/strategies they believe would be useful in PS decisions. Conclusion: Data from the themes suggest that caregiver control, social, child-specific and external factors are more influential than PS guidelines in both parent and nursery staff PS decisions for young children aged 3-5 years. These findings can inform future childhood obesity prevention initiatives focussed on improving parent and nursery staff provision/use of age-appropriate PSs.
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Affiliation(s)
- Sophia Quirke-McFarlane
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Sharon A Carstairs
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
| | - Joanne E Cecil
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews, UK
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Rathi N, Kansal S, Worsley A. Indian fathers are involved in nurturing healthy behaviours in adolescents: A qualitative inquiry. BMC Public Health 2024; 24:88. [PMID: 38178085 PMCID: PMC10768344 DOI: 10.1186/s12889-024-17634-7] [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: 08/31/2023] [Accepted: 01/01/2024] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Indian adolescents exhibit unhealthy food behaviours and inactive lifestyles which increase their risk of developing obesity and associated negative health consequences. The family food environment represents a vital setting to nurture healthy lifestyle behaviours in adolescents, with parents influencing their adolescents' dietary and physical activity behaviours. Yet, much of the existing evidence exploring parental influences predominantly focuses on mothers while fathers' engagement in instilling healthy dietary and physical activity behaviours is understudied, more so in the context of developing economies like India. Therefore, this qualitative study was designed to understand Indian fathers' views on instilling healthy behaviours in their children. METHODS Convenience sampling along with snowball sampling techniques were employed to recruit fathers of adolescents aged 10-19 years from Kolkata city, India. Informed by the research aim and review of literature, an interview guide was developed and pre-tested. Interviews were carried out either in person or virtually (Zoom/telephone) in English/Hindi/Bengali as per the preference of the participants. All interactions were audio recorded, transcribed verbatim, and translated to English for the purpose of data analysis. The transcripts were analysed thematically using NVivo software program. Themes were identified using both inductive and deductive approaches. RESULTS A total 36 fathers participated in the interviews. Seven main themes were identified: (i) Involvement of fathers in adolescent upbringing (i.e. engagement in meal preparation, food shopping, educational activities, physical activity); (ii) Family food environment (i.e. setting food rules, having meals with children, making food available); (iii) Challenges to instilling healthy behaviours in adolescents (i.e. adolescents' sedentary lifestyle and liking for unhealthy foods); (iv) Barriers to routine involvement in adolescent upbringing (i.e. time constraints due to paid employment, poor socio-economic status); (v) Adolescent nutrition education: (vi) Dual burden of malnutrition (i.e. awareness of malnutrition, no knowledge about government-led health programs for adolescents); (vii) Paternal knowledge. CONCLUSIONS The emerging themes reveal that Indian fathers played a crucial role in instilling healthy dietary and physical activity behaviour in their adolescents through various parenting practices such as purchasing nutritious food, enforcing food rules, disseminating nutrition-related knowledge, and encouraging adolescents to participate in moderate-to-vigorous intensity outdoor sports. This provides strong support for the inclusion of fathers in sustainable family-focused lifestyle interventions to maximise the nurturing care required by adolescents as well as assist in normalising the representation of fathers in health and welfare policies designed for adolescents.
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Affiliation(s)
- Neha Rathi
- Department of Home Science, Mahila Maha Vidyalaya, Banaras Hindu University, 221005, Varanasi, Uttar Pradesh, India.
| | - Sangeeta Kansal
- Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, 221005, Varanasi, Uttar Pradesh, India
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, 3220, Geelong, VIC, Australia
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Kielb EI, Moding KJ, Kimiecik C, Klenosky DB. Parents' food choice for their preschool-aged children: A means-end investigation. Child Care Health Dev 2024; 50:e13172. [PMID: 37699702 DOI: 10.1111/cch.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/26/2023] [Accepted: 08/22/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Despite the growing literature on the importance of parental feeding practices, the factors that influence how parents make decisions regarding the foods they offer to their young children are not fully understood. Means-end theory and its associated methodology known as laddering provide a useful framework for characterizing the relationships between the attributes of a choice option (e.g., a food item), the consequences (i.e., the benefits or costs/risks) associated with those attributes and the personal values (i.e., enduring beliefs) those consequences help reinforce. The present research uses this means-end perspective to enrich our understanding of how parents make food choices for their preschool-aged children. METHODS Interviews were conducted with parents (N = 33) of 3- to 5-year-old children to explore the factors underlying parents' decisions regarding the foods they recently offered, prefer to offer and avoid offering to their preschooler. The resulting data were transcribed, content analysed and summarized in a series of summary diagrams known as hierarchical value maps (HVMs). RESULTS Study results indicate that although most parents reported trying to make food decisions because they want their child to be healthy, factors such as avoiding fights/battles and low perceived likelihood their child would eat a food may be barriers to offering certain foods. CONCLUSIONS Taken together, these study findings enhance our understanding of the range of meanings underlying parents' food choice decisions and suggest opportunities for interventions to improve the quality of foods that parents offer to their children at home.
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Taquet J, Verbeken S, Goossens L. Examining the whole plate: The role of the family context in the understanding of children's food refusal behaviors. Eat Behav 2024; 52:101828. [PMID: 38006775 DOI: 10.1016/j.eatbeh.2023.101828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/06/2023] [Accepted: 11/16/2023] [Indexed: 11/27/2023]
Abstract
INTRODUCTION In the context of understanding children's food refusal behaviors, such as food fussiness and food neophobia, research has predominantly focused on the role of parental feeding strategies. However, little is known about which general family context variables add to the understanding of children's food refusal behaviors. The purpose of this study was to examine the relation between 1) parents' own use of maladaptive emotion regulation strategies when they are anxious, 2) parents' reactions towards their children's emotions in stressful situations, and 3) parenting styles on the one hand, and children's food refusal behaviors on the other. METHODS Mothers and fathers (N = 157) of young children (M = 4.64, SD = 1.7) completed a series of self- and parent-report questionnaires. RESULTS The model examining the role of parenting styles was found to be significantly related to food refusal behaviors in children. More specifically, the current findings demonstrate that higher levels of a coercive parenting style were associated with higher levels of both food fussiness and food neophobia in children. Furthermore, higher levels of a chaotic parenting styles were associated with higher levels of food neophobia in children. The models examining parents' maladjusted emotion regulation strategies when anxious and parents' reactions towards their children's emotions during stressful situations were not found to be significant. CONCLUSIONS Factors related to the parenting style appear to be important for understanding food refusal behaviors in children. Replication of the findings using longitudinal and observational designs is needed.
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Affiliation(s)
- Juliette Taquet
- Ghent University, Department of Developmental, Personality and Social Psychology, Henri Dunantlaan 2, 9000 Ghent, Belgium.
| | - Sandra Verbeken
- Ghent University, Department of Developmental, Personality and Social Psychology, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Lien Goossens
- Ghent University, Department of Developmental, Personality and Social Psychology, Henri Dunantlaan 2, 9000 Ghent, Belgium
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Capasso M, Califano G, Caracciolo F, Caso D. Only the best for my kids: An extended TPB model to understand mothers' use of food labels. Appetite 2023; 191:107040. [PMID: 37730151 DOI: 10.1016/j.appet.2023.107040] [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: 01/26/2023] [Revised: 07/21/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
Despite the evidence that mothers' food purchasing behavior impacts the quality of children's diet, few studies have explored psycho-social factors influencing how mothers choose the food to buy for their children. To fill this gap, this study tested an extended Theory of Planned Behavior (TPB) model to predict mothers' tendency to seek information on food labels before purchasing food for children. Participants included 311 Italian mothers who completed a self-report questionnaire measuring their information-seeking behavior, TPB variables, anticipated regret and healthy-eater identity. Results from a Multiple Correspondence Analysis showed that mothers' information-seeking behavior involved a continuum of choices ranging from selecting conventional or prepackaged foods to choosing to read the food label before making a purchase. Besides, a Partial Least Squares-Structural Equation Modeling analysis showed that information-seeking behavior was positively predicted by intention (β = 0.309, p < 0.001) and healthy-eater identity (β = 0.195, p < 0.001). In turn, intention was positively affected by attitude (β = 0.208, p < 0.001), subjective norms (β = 0.155, p < 0.01), perceived behavioral control (β = 0.124, p < 0.05), anticipated regret (β = 0.193, p < 0.001), and healthy-eater identity (β = 0.191, p < 0.001). These findings emphasize that future initiatives could usefully target attitude, anticipated regret and self-identity to encourage mothers' informed food choices for their children.
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Affiliation(s)
- Miriam Capasso
- Department of Humanities, University of Naples Federico II, Naples, Italy
| | | | - Francesco Caracciolo
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Daniela Caso
- Department of Humanities, University of Naples Federico II, Naples, Italy.
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Chilman LB, Meredith PJ, Southon N, Kennedy-Behr A, Frakking T, Swanepoel L, Verdonck M. A qualitative inquiry of parents of extremely picky eaters: Experiences, strategies and future directions. Appetite 2023; 190:107022. [PMID: 37647989 DOI: 10.1016/j.appet.2023.107022] [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: 05/27/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND/AIM Picky eating is a common childhood phenomenon in younger children, impacting family relationships and mealtimes. Limited qualitative studies have explored parents' experiences of parenting an extremely picky eater. This study aimed to address this gap. METHODS This exploratory qualitative research design included participants who were Australian-based parents (n = 10) of children aged 2-6 years with a minimum picky eating score of 3.33, indicating extreme picky eating, on the Food Fussiness subscale of the Child Eating Behavior Questionnaire (CEBQ). Parents were interviewed online via Zoom using semi-structured interviews focused on their experiences of having a child who is a picky eater. Reflexive thematic analysis was used to analyze the data. RESULTS Five themes were identified: 1: The picky eating journey for parents. 2: Picky eating impacts families and mealtimes. 3: Parents have attempted multiple strategies to manage picky eating. 4: Emotions associated with parenting an extremely picky eater. 5: Parents of extremely picky eaters have a positive outlook for the future. CONCLUSION This qualitative study demonstrates that parents' experiences of parenting an extremely picky eater are varied. Parents desire health professionals who listen to their concerns and provide evidence-based knowledge around parent feeding practices to positively impact picky eating.
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Affiliation(s)
- Laine B Chilman
- School of Health, University of the Sunshine Coast, 4558, Australia.
| | - Pamela J Meredith
- School of Health, University of the Sunshine Coast, 4558, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, 4072, Australia
| | - Nicole Southon
- School of Health, University of the Sunshine Coast, 4558, Australia
| | - Ann Kennedy-Behr
- School of Health, University of the Sunshine Coast, 4558, Australia; School of Allied Health & Human Performance, University of South Australia, 5072, Australia
| | - Thuy Frakking
- School of Health, University of the Sunshine Coast, 4558, Australia; Research Development Unit, Caboolture Hospital, Metro North Hospital and Health Service, Queensland Health, 4029, Australia; Centre for Clinical Research, School of Medicine, The University of Queensland, Queensland, 4072, Australia; Speech Pathology Department, Gold Coast University Hospital, Gold Coast Hospital and Health Service, Queensland Health, 4215, Australia
| | - Libby Swanepoel
- School of Health, University of the Sunshine Coast, 4558, Australia; Australian Centre for Pacific Islands Research, School of Health, University of the Sunshine Coast, Queensland, 4558, Australia
| | - Michèle Verdonck
- School of Health, University of the Sunshine Coast, 4558, Australia
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Acolatse L, Pourshahidi LK, Logue C, McCann MT, Kerr MA. Child food portion sizes in the home environment: how do parents decide? Proc Nutr Soc 2023; 82:386-393. [PMID: 36866645 DOI: 10.1017/s0029665123000071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The consumption of larger portion sizes (PS) of food has been implicated in the increased prevalence of childhood obesity. The home is usually the first place children learn about food, however, little is known about how parents determine child PS in the home environment. This narrative review aimed to explore parental beliefs, decisions, strategies and barriers to the provision of appropriate food PS for children in the home environment. Results indicate that parental decisions on child food PS are based on the amounts they serve themselves, personal intuition and knowledge of child appetite. Owing to the habitual nature of food provision, parental decisions on child PS may be taken without conscious thought and/or could be part of a complex decision-making process influenced by several interlinked factors, including parental childhood mealtime experiences, other family members and child weight status. Strategies to determine child-appropriate PS include modelling the desired PS behaviour, use of unit-based food packaging and PS estimation aids, and providing the child with a degree of autonomy to rely on their own appetite cues. A lack of knowledge/awareness of PS guidance is a key barrier identified by parents to the provision of age-appropriate PS, warranting the inclusion of salient child-appropriate PS guidance within national dietary recommendations. Further home-based interventions to improve the provision of appropriate child PS are required, leveraged on parental strategies already in use, as outlined in this review.
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Affiliation(s)
- Lena Acolatse
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - L Kirsty Pourshahidi
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Caomhan Logue
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Mary T McCann
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Maeve A Kerr
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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Tang T, Chawner LR, Chu R, Nekitsing C, Hetherington MM. Downsizing by design – Investigating acceptance, choice and willingness to pay for portion control design concepts. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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The foodscapes of children and adolescents attending schools in Lima, Peru. Appetite 2021; 168:105738. [PMID: 34634374 DOI: 10.1016/j.appet.2021.105738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/03/2021] [Accepted: 10/05/2021] [Indexed: 11/21/2022]
Abstract
Foodscapes are the sum of all places where food and eating are actualized, as well as the institutional arrangements, discourses, cultural practices, trends and meanings that shape the relationship between individuals and food. However, limited research is available on how the different elements of foodscapes (physical, social, institutional) interact to influence children's and adolescents' eating behaviors. The aim of this study was to identify and characterize the factors influencing Peruvian children's and adolescents' practices around food, focusing on the systemic and complex nature of eating. We conducted non-participant observations inside and around two schools-one public and one private-located in Lima, Peru, for an entire school-week, and interviewed 44 parents/caregivers of children and adolescents, ages 6-16. Qualitative content analysis was developed, as its iterative and reflective nature allowed for evolving understandings of the data. Results showed that individual attributes (SES, age and gender) interact with individual agency, the physical environment, parental and peer influence, to determine differentiated food-related outcomes of children and adolescents. Moreover, the state-wide law aiming to protect children's and adolescents' health and nutrition seemed to partially influence the eating practices of parents and children at school and at home. This study is unique in its kind, as existent research has mainly focused on the effects of foodscapes on children and adolescents in Western countries, while research in the Global South, such as Peru, remains mostly underdeveloped. Moreover, this study, unlike previous ones, intends to systematically understand how foodscapes shape children's and adolescents' eating practices.
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Philippe K, Issanchou S, Roger A, Feyen V, Monnery-Patris S. How Do French Parents Determine Portion Sizes for Their Pre-Schooler? A Qualitative Exploration of the Parent-Child Division of Responsibility and Influencing Factors. Nutrients 2021; 13:nu13082769. [PMID: 34444929 PMCID: PMC8399289 DOI: 10.3390/nu13082769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 07/28/2021] [Accepted: 08/09/2021] [Indexed: 01/28/2023] Open
Abstract
Large portion sizes can make children overeat, alter their self-regulation abilities and induce weight gain. However, little is known about how parents determine portion sizes for their children. Using semi-structured interviews with 5 fathers and 32 mothers of pre-schoolers, this study examined French parents' food portioning practices. The division of responsibility between parent and child in deciding portion sizes was explored, as well as the influencing factors and possible sources of information. Parents described a wide range of practices. For most, determining portion sizes is an intuitive action that depends on habits and mainly arises from experiences with feeding their child and his/her appetitive traits. Few parents grant autonomy to their child for portioning and serving food, especially for the first serving. Many influencing factors were identified, including child-related (e.g., appetite, food preferences), parent-related (e.g., avoiding food waste), and external factors (e.g., influence of siblings, French food culture). Most parents do not search for information/recommendations to guide their practices. Stimulating optimal self-regulation of eating in children is important and parents can play a crucial role in this. This study identified barriers and facilitators to guide parents in providing appropriate portion sizes and help include children in this decision process.
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McNally J, Hugh-Jones S, Hetherington MM. “An invisible map” - maternal perceptions of hunger, satiation and ‘enough’ in the context of baby led and traditional complementary feeding practices. Appetite 2020; 148:104608. [DOI: 10.1016/j.appet.2020.104608] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 10/25/2022]
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Baloch FA, Jogezai NA, Mohamed Ismail SAM. Food and cultural norms: rural mothers' selection of nutrition intake for their young children. HEALTH EDUCATION 2020. [DOI: 10.1108/he-09-2019-0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study aimed at exploring food related cultural norms that influence rural mothers' food selection for their primary school aged children (aged 4–7 years).Design/methodology/approachThis is a qualitative study conducted in northern parts of Balochistan province of Pakistan. The Theory of Planned Behaviour (TPB) was applied as the theoretical framework of the study. Within a qualitative research method four focused group interviews with 30 rural mothers were employed to generate data.FindingsThe study found that mothers’ food selection for their children was heavily influenced by certain cultural norms that have become taboos with the passage of time. It is evident through findings that subjective norms have a greater influence on mothers' behaviour than their attitude and perceived behavioural control (PBC).Originality/valueWe ensure originality of this research paper as fewer researches have been conducted to further elaborate the link between socio-cultural norms and food selection. In particular, the influence of this close relationship on child health has been of limited consideration in a developing context. This paper has neither been published elsewhere, nor it is currently under consideration for publication in any other journal.
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Hodgins K, Parizeau K. Farm-to-fork… and beyond? A call to incorporate food waste into food systems research. FOOD AND FOODWAYS 2020. [DOI: 10.1080/07409710.2020.1718280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kelly Hodgins
- Department of Geography, Environment and Geomatics, University of Guelph, Guelph, Ontario,Canada
| | - Kate Parizeau
- Department of Geography, Environment and Geomatics, University of Guelph, Guelph, Ontario,Canada
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Reale S, Simpson RM, Marr C, Carstairs SA, Cecil JE, Hetherington MM, Caton SJ. Snack Portion Sizes for Preschool Children Are Predicted by Caregiver Portion Size, Caregiver Feeding Practices and Children's Eating Traits. Nutrients 2019; 11:E3020. [PMID: 31835571 PMCID: PMC6950396 DOI: 10.3390/nu11123020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022] Open
Abstract
Caregivers are mostly responsible for the foods young children consume; however, it is unknown how caregivers determine what portion sizes to serve. This study examined factors which predict smaller or larger than recommended snack portion sizes in an online survey. Caregivers of children aged 2 to 4 years were presented with 10 snack images, each photographed in six portion sizes. Caregivers (n = 659) selected the portion they would usually serve themselves and their child for an afternoon snack. Information on child eating traits, parental feeding practices and demographics were provided by caregivers. Most caregivers selected portions in line with recommended amounts for preschool children, demonstrating their ability to match portion sizes to their child's energy requirements. However, 16% of caregivers selected smaller than recommended low energy-dense (LED, e.g., fruits and vegetables) snacks for their child which was associated with smaller caregiver's own portion size, reduced child food liking and increased satiety responsiveness. In contrast, 28% of caregivers selected larger than recommended amounts of high energy-dense (HED, e.g., cookies, crisps) snacks for their child which were associated with larger caregiver's own portion size, greater frequency of consumption, higher child body mass index (BMI), greater pressure to eat and lower child food liking. These findings suggest that most caregivers in this study select portions adjusted to suit their child's age and stage of development. Future interventions could provide support to caregivers regarding the energy and nutrient density of foods given the relatively small portion sizes of LED and large portions of HED snacks offered to some children.
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Affiliation(s)
- Sophie Reale
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
| | - Rebecca M. Simpson
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
| | - Colette Marr
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
| | - Sharon A. Carstairs
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (S.A.C.); (J.E.C.)
| | - Joanne E. Cecil
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (S.A.C.); (J.E.C.)
| | | | - Samantha J. Caton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
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Maternal Decisions on Portion Size and Portion Control Strategies for Snacks in Preschool Children. Nutrients 2019; 11:nu11123009. [PMID: 31835341 PMCID: PMC6950145 DOI: 10.3390/nu11123009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/29/2019] [Accepted: 12/04/2019] [Indexed: 11/17/2022] Open
Abstract
Caregivers are responsible for the type and amount of food young children are served. However, it remains unclear what considerations caregivers make when serving snacks to children. The aim of the study was to explore mothers' decisions and portion control strategies during snack preparation in the home environment. Forty mothers of children aged 24-48 months participated in the study. Mothers prepared five snack foods for themselves and their child whilst verbalizing their actions and thoughts. Mothers were then asked about their portion size decisions in a semi-structured interview. Transcripts were imported into NVivo and analyzed thematically. Three key themes were identified: (1) portion size considerations, (2) portion control methods, and (3) awareness and use of portion size recommendations. Transient, food-related situational influences influenced mothers and disrupted planning and portion control. Food packaging and dishware size were used as visual cues for portion control; however, these vary widely in their size, thus emphasizing mothers' uncertainty regarding appropriate portion sizes. Mothers called for portion size information to be accessible, child-centered, and simple. These findings reveal multiple considerations when deciding on the correct snack portion sizes for children. These decisions are complex and vary across situations and time, and according to the types of snacks offered.
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Katzow M, Canfield C, Gross RS, Messito MJ, Cates CB, Weisleder A, Johnson SB, Mendelsohn AL. Maternal Depressive Symptoms and Perceived Picky Eating in a Low-Income, Primarily Hispanic Sample. J Dev Behav Pediatr 2019; 40:706-715. [PMID: 31415306 PMCID: PMC6878153 DOI: 10.1097/dbp.0000000000000715] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Feeding concerns are common in the first 2 years of life and typically reflect maternal perceptions occurring within the larger context of the parent-child relationship. We aimed to determine whether (1) maternal depressive systems predicted perceived picky eating, mediated by maternal negative perceptions; (2) receipt of the Video Interaction Project (VIP) parenting intervention impacted perceived picky eating through this pathway; and (3) perceived picky eating was associated with child growth or subsequent dietary patterns. METHODS We performed a partial longitudinal analysis of 187 low-income, predominantly Hispanic mother-child dyads enrolled in a randomized controlled trial of the VIP. Mother-infant dyads were enrolled postpartum in an urban public hospital. Participants randomized to the VIP met with an interventionist on days of well-child visits; sessions were designed to facilitate interactions in play and shared reading through provision of learning materials and review of videotaped parent-child interaction; the curriculum did not contain feeding-specific elements. We used structural equation modeling to determine direct, indirect, and total effects of maternal depressive symptoms, maternal negative perceptions, and the VIP on perceived picky eating. We then tested associations between perceived picky eating and (1) child growth, using multivariable linear regression and multilevel modeling; and (2) subsequent child dietary consumption, using multivariable multinomial logistic regression. RESULTS Maternal depressive symptoms had significant total effects on negative maternal perceptions (β = 0.32, p < 0.001) and perceived picky eating (β = 0.21, p < 0.01) after controlling for potential confounders. This effect was partially mediated by maternal negative perceptions (indirect effect: β = 0.06, p = 0.04). When used in the model as the predictor, the VIP had a significant total effect on perceived picky eating (β = -0.16, p = 0.02), which was partially mediated by maternal depressive symptoms and negative perceptions (indirect effect: β = -0.05, p = 0.02). Perceived picky eating was not associated with child diet at age 2 years or adiposity from 6 months to 3 years. CONCLUSION Maternal concerns about picky eating may reflect deeper depressive symptoms and negative perceptions of her child's behavior. Interventions designed to facilitate positive parenting in general may lessen feeding-specific concerns, such as picky eating. Although reassurance about growth and nutritional outcomes for children perceived as picky eaters is appropriate, clinicians should also consider probing for underlying symptoms of depression that could lead to eating concerns.
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Affiliation(s)
- Michelle Katzow
- Division of General Pediatrics, Department of Pediatrics,
New York University School of Medicine, New York, New York
| | - Caitlin Canfield
- Division of Developmental-Behavioral Pediatrics, Department
of Pediatrics, New York University School of Medicine, New York, New York
| | - Rachel S. Gross
- Division of General Pediatrics, Department of Pediatrics,
New York University School of Medicine, New York, New York
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics,
New York University School of Medicine, New York, New York
| | | | - Adriana Weisleder
- Department of Communication Sciences and Disorders,
Northwestern University, Evanstan, Illinois
| | - Samantha Berkule Johnson
- Division of Developmental-Behavioral Pediatrics, Department
of Pediatrics, New York University School of Medicine, New York, New York
| | - Alan L. Mendelsohn
- Division of Developmental-Behavioral Pediatrics, Department
of Pediatrics, New York University School of Medicine, New York, New York
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18
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Bekelman TA, Bellows LL, McCloskey ML, Martin CK, Johnson SL. Assessing dinner meals offered at home among preschoolers from low-income families with the Remote Food Photography Method. Pediatr Obes 2019; 14:e12558. [PMID: 31347302 PMCID: PMC6991120 DOI: 10.1111/ijpo.12558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/18/2019] [Accepted: 05/29/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND The high prevalence of obesity among preschoolers may be partially explained by the type and quantity of foods offered by parents and left unconsumed by preschoolers. OBJECTIVES (a) To compare foods offered and consumed at dinner to the Dietary Guidelines for Americans (DGAs) and the Child and Adult Care Food Program (CACFP) standards and (b) to examine the types, quantities, and nutrient composition of foods offered to and consumed by preschoolers and their plate waste. METHODS Participants were recruited from six Head Start/preschool centres. The Remote Food Photography Method was used to document dinner meals over 1 week (n = 153 meals). Energy and nutrients for foods offered, consumed, and plate waste were calculated. Foods offered and consumed were compared with the DGAs and CACFP standards. RESULTS Foods and beverages offered at dinner equaled 506 kcal, which is 36% of the DGA-recommended total daily energy intake. Meals offered and consumed were high in fat and sodium and low in fibre. Adherence to CACFP standards was low for fruits (25%) and milk (2%) and moderate for vegetables (63%). Mean plate waste (29%) was similar across food types. CONCLUSIONS Opportunities exist to improve preschoolers' adherence to the DGAs and CACFP standards by enhancing the quality of dinner meals offered to them.
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Affiliation(s)
- Traci A Bekelman
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Laura L Bellows
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado
| | - Morgan L McCloskey
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado
| | - Corby K Martin
- Pennington Biomedical Research Center, Ingestive Behavior, Weight Management & Health Promotion Laboratory, Baton Rouge, Louisiana
| | - Susan L Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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19
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Abstract
PURPOSE OF REVIEW This review provides an approach for resolving a variety of feeding difficulties in children, ranging from normal eating behavior that is misperceived as a problem to substantial feeding disorders. RECENT FINDINGS Criteria to identify pediatric feeding disorders have been thoroughly addressed in the newly established designations of avoidant restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD). These diagnostic criteria improve the accuracy of identifying, classifying, and managing significant feeding disorders in young children. While recent definitions of feeding difficulties are particularly appropriate in multidisciplinary settings, in this paper, we advocate for a progressive approach of managing feeding problems in all clinical settings. It begins by identifying red flags indicative of serious threats to the child, screening for oral motor dysfunction, stabilizing nutrient intake, and eliminating aversive feeding practices. The next step, if eating behavior does not improve, involves strategies that target specific eating behaviors and parental feeding styles. In severe or resistant cases, referral to specialists or interdisciplinary feeding teams is advised.
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Affiliation(s)
- Kim Milano
- College of Health & Human Sciences, Northern Illinois University, DeKalb, IL, 60115-2828, USA
| | - Irene Chatoor
- Department of Psychiatry, Children's National Medical Health System, The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - Benny Kerzner
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Children's National Medical Health System, Professor of Pediatrics, The George Washington School of Medicine and Health Sciences, 111 Michigan Ave. NW., Washington, DC, 20010, USA.
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20
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Mothers' Vegetable Consumption Behaviors and Preferences as Factors Limiting the Possibility of Increasing Vegetable Consumption in Children in a National Sample of Polish and Romanian Respondents. Nutrients 2019; 11:nu11051078. [PMID: 31096620 PMCID: PMC6566701 DOI: 10.3390/nu11051078] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/04/2019] [Accepted: 05/10/2019] [Indexed: 12/18/2022] Open
Abstract
Increasing the insufficient intake of vegetables in children may be difficult, due to the influence of parents and at-home accessibility. The aim of this study was to analyze the association between self-reported vegetable consumption behaviors and preferences of mothers and the behaviors and preferences of their children, as declared by them. The nationally representative Polish (n = 1200) and Romanian (n = 1157) samples of mothers of children aged 3-10 were obtained using the random quota sampling method, and interviewed for their and their children's general frequency of consumption and preferences of vegetables in years 2012-2014. A 24 h dietary recall of vegetable consumption was conducted for mothers and their children. Associations were observed for general number of servings consumed per day by mother-child pairs (p < 0.0001; R = 0.6522, R = 0.6573 for Polish and Romanian samples, respectively) and number of types indicated as preferred (p < 0.0001; R = 0.5418, R = 0.5433). The share of children consuming specific vegetables was 33.1-75.3% and 42.6-75.7% while their mothers also consumed, but 0.1-43.2% and 1.2-22.9% while their mothers did not. The share of children preferring specific vegetables was 16.7-74.1% and 15.2-100% when their mother shared the preference, but 1.3-46.9% and 0-38.3% when their mother did not. The mothers' vegetable consumption behaviors and preferences may be a factor limiting the possibility of increasing vegetable consumption in their children.
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21
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Wolstenholme H, Heary C, Kelly C. Fussy eating behaviours: Response patterns in families of school-aged children. Appetite 2019; 136:93-102. [PMID: 30668966 DOI: 10.1016/j.appet.2019.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/23/2018] [Accepted: 01/09/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fussy eating is the unwillingness to eat both familiar and novel foods. Childhood fussy eating can be a barrier to a healthful diet and is associated with mealtime stress and conflict. Research has primarily focused on parenting practices in response to fussy eating in pre-schoolers. Less is known about parenting practices and family processes such as setting goals and managing emotions in relation to fussy eating in older children. This research aims to explore how families respond to fussy eating behaviours in school-aged children and based on parents' retrospective accounts, to investigate how responses change over time. METHODS 16 parents from 14 families of school-aged children (6-10 years) participated in semi-structured qualitative interviews. Interviews were analysed using inductive thematic analysis. RESULTS Three family process themes were identified which explain how families respond to fussy eating behaviours: 1) Dynamic and Evolving Feeding Goals, 2) Managing Negative Emotions and 3) Parenting Practices: Figuring out What Works. Three distinct patterns were identified regarding how parent responses change over time: 1) Resistance-to-Acceptance Response, 2) Fluctuating Response and 3) Consistent Response. DISCUSSION The family response to fussy eating behaviours is complex, dynamic and contextual. This has implications for the design and interpretation of quantitative studies, and for the development of guidelines and interventions.
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Affiliation(s)
- Hazel Wolstenholme
- School of Psychology, National University of Ireland Galway, University Road, Galway, Ireland.
| | - Caroline Heary
- School of Psychology, National University of Ireland Galway, University Road, Galway, Ireland.
| | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland Galway, University Road, Galway, Ireland.
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22
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Kairey L, Matvienko-Sikar K, Kelly C, McKinley MC, O'Connor EM, Kearney PM, Woodside JV, Harrington JM. Plating up appropriate portion sizes for children: a systematic review of parental food and beverage portioning practices. Obes Rev 2018; 19:1667-1678. [PMID: 30160009 DOI: 10.1111/obr.12727] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/10/2018] [Accepted: 06/04/2018] [Indexed: 12/20/2022]
Abstract
Consumption of larger portion sizes is associated with higher energy intake and weight status in children. As parents play a pivotal role in child feeding, we synthesized literature on 'parental portioning practices' using a mixed methods systematic design to inform future strategies addressing portion sizes served to children. Electronic databases PubMed, EMBASE, SCOPUS, PsycINFO and CINAHL Plus were searched. Two reviewers independently screened 385 abstracts and assessed 71 full-text articles against eligibility criteria: studies assessing portioning of foods or beverages by parent(s) with ≥1 child aged 2-12 years. Narrative synthesis of 14 quantitative studies found that portion sizes parents serve vary substantially and are influenced by amounts parents serve themselves, perceived child hunger and parent and child body size. Thematic synthesis of 14 qualitative studies found that parents serve the portion sizes they learn to be appropriate for their child to be fed. Portioning is influenced by parents' desires for a healthy child with a balanced diet. Future guidance on appropriate portion sizes for children would ideally present recommended portion sizes for first serving, incremental with age. Future research is however needed to assess the adoption and efficacy of providing such guidance to families.
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Affiliation(s)
- L Kairey
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - K Matvienko-Sikar
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - C Kelly
- Health Promotion Research Centre, School of Health Sciences, NUI Galway, Galway, Ireland
| | - M C McKinley
- Northern Ireland Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - E M O'Connor
- Department of Biological Sciences, and Health Research Institute, University of Limerick, Limerick, Ireland
| | - P M Kearney
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
| | - J V Woodside
- Northern Ireland Centre of Excellence for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
| | - J M Harrington
- HRB Centre for Health and Diet Research, School of Public Health, University College Cork, Cork, Ireland
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23
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McCrickerd K. Cultivating self-regulatory eating behaviours during childhood: The evidence and opportunities. NUTR BULL 2018. [DOI: 10.1111/nbu.12355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- K. McCrickerd
- Clinical Nutrition Research Centre (CNRC); Singapore Institute for Clinical Sciences (SICS); Agency of Science, Technology and Research (A*STAR); Singapore
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24
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Raggio L, Gámbaro A. Study of the reasons for the consumption of each type of vegetable within a population of school-aged children. BMC Public Health 2018; 18:1163. [PMID: 30290788 PMCID: PMC6173934 DOI: 10.1186/s12889-018-6067-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 09/24/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Several studies have evaluated the existence of factors that influence the consumption of vegetables in children, such as family environment, daily exposure to one or several vegetables, parents' consumption and consumption pattern and the way in which vegetables are prepared in the household, among others. The objective of this study was to investigate the reasons for consumption associated with each vegetable in school-aged children through a survey designed to be answered by the parents. METHODS A preliminary study with 162 parents was carried out on the consumption of vegetables in children aged 6 to 12 years. Based on the information obtained, a survey was designed with 14 phrases to investigate the reasons for the low consumption of each type of vegetable among school-aged children, which was answered online by 419 parents. RESULTS The results obtained allowed us to categorise the vegetables into 6 groups. Group A consisted of tomatoes, corn, pumpkin and carrots as the vegetables that children like to eat most. Group B contains the vegetables that are consumed mostly camouflaged in other preparations, such as onions and red peppers. Group C contains only cauliflower, which was negatively associated with senses, such as colour, smell and taste. This vegetable was never offered to children by a high percentage of parents. Group D consists of green vegetables: zucchini, spinach, chard and peas. Vegetables of this group are added to other foods and the child usually ingests them camouflaged or obliged. Group E consists of beetroot, lettuce and broccoli. Beetroot and lettuce were the vegetables parents reported were most often rejected by their children. This rejection, they stated, was due to sensory aspects, such as colour, texture and taste. CONCLUSIONS The reasons for consumption among school-aged children depend on each type of vegetable and cannot be generalized. The sensory characteristics of the vegetable (mainly colour and flavour) and the habits of consumption in the family environment play a major role in children's acceptance or rejection of vegetables.
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Affiliation(s)
- Laura Raggio
- Food Department, Escuela de Nutrición (School of Nutrition), Universidad de la República, Montevideo, Uruguay
| | - Adriana Gámbaro
- Sensory Evaluation Area, Food Department, Facultad de Química (School of Chemistry), Universidad de la República, Montevideo, Uruguay
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25
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Fogel A, Fries LR, McCrickerd K, Goh AT, Chan MJ, Toh JY, Chong YS, Tan KH, Yap F, Shek LP, Meaney MJ, Broekman BFP, Lee YS, Godfrey KM, Chong MFF, Forde CG. Prospective associations between parental feeding practices and children's oral processing behaviours. MATERNAL AND CHILD NUTRITION 2018; 15:e12635. [PMID: 30051652 DOI: 10.1111/mcn.12635] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 04/10/2018] [Accepted: 05/22/2018] [Indexed: 12/18/2022]
Abstract
Previous research demonstrated that faster eating rates are linked with increased intake of energy during a meal. Here, we examined whether within-meal parental feeding practices show cross-sectional and prospective associations with children's oral processing behaviours and whether the previously demonstrated association between faster eating rates and higher energy intakes varies by parental feeding practices. A subset (n = 155) of children and their mothers from the Growing Up in Singapore Towards healthy Outcomes cohort participated in an ad libitum meal at age 4.5 years. Children's oral processing behaviours (eating rate, bite size, chews per gram, oral exposure time, and meal duration) and parental feeding practices (autonomy-supporting and coercive prompts, restrictions, hurrying, and slowing) were recorded during the meal. Subsequently, 94 of the children participated in a follow-up meal without their mothers at age 6 years. Parental feeding practices were not consistently associated with child oral processing behaviours overall. However, exploratory post hoc analyses revealed some sex differences. The mothers of girls with faster eating rates, larger bite sizes, and fewer chews were more likely to use hurrying, slowing, and restrictions, but similar associations were not observed among boys. Children who had the most problematic eating style and were eating fast and for long experienced more restrictions, instructions to slow down, and prompts. Faster eating rates were linked with the highest energy intakes if children were additionally prompted to eat. Prospective analyses showed that children who were more often prompted using coercive techniques and less frequently hurried at age 4.5 years had faster eating rates at 6 years and a larger increase in eating rates between ages 4.5 and 6 years but did not consume more energy. Although the direction of these associations cannot be assumed, these exploratory analyses suggest sex differences in the associations between feeding practices and oral processing behaviours and highlight the potential role of parents in the development of children's oral processing behaviours.
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Affiliation(s)
- Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | | | - Keri McCrickerd
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, A*STAR, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Fabian Yap
- KK Women's and Children's Hospital, Singapore
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael J Meaney
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.,Douglas Mental Health University Institute, McGill University, Montréal, Québec, Canada
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.,Department of Psychiatry, VU Medical Centre, VU University, Amsterdam, The Netherlands
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, A*STAR, Singapore.,Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mary Foong Fong Chong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ciarán G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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26
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Factors Influencing Children's Eating Behaviours. Nutrients 2018; 10:nu10060706. [PMID: 29857549 PMCID: PMC6024598 DOI: 10.3390/nu10060706] [Citation(s) in RCA: 516] [Impact Index Per Article: 86.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/28/2018] [Accepted: 05/30/2018] [Indexed: 12/31/2022] Open
Abstract
Relevant factors involved in the creation of some children’s food preferences and eating behaviours have been examined in order to highlight the topic and give paediatricians practical instruments to understand the background behind eating behaviour and to manage children’s nutrition for preventive purposes. Electronic databases were searched to locate and appraise relevant studies. We carried out a search to identify papers published in English on factors that influence children’s feeding behaviours. The family system that surrounds a child’s domestic life will have an active role in establishing and promoting behaviours that will persist throughout his or her life. Early-life experiences with various tastes and flavours have a role in promoting healthy eating in future life. The nature of a narrative review makes it difficult to integrate complex interactions when large sets of studies are involved. In the current analysis, parental food habits and feeding strategies are the most dominant determinants of a child’s eating behaviour and food choices. Parents should expose their offspring to a range of good food choices while acting as positive role models. Prevention programmes should be addressed to them, taking into account socioeconomic aspects and education.
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Ensaff H, Bunting E, O'Mahony S. "That's His Choice Not Mine!" Parents' Perspectives on Providing a Packed Lunch for Their Children in Primary School. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:357-364.e1. [PMID: 29631705 DOI: 10.1016/j.jneb.2017.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 12/15/2017] [Accepted: 12/17/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine factors influencing parents' selection of packed lunches over a school lunch, their choices in food preparation, and the role of children within these. DESIGN A qualitative approach using semistructured focus group and individual interviews. SETTING Four primary schools in a UK local authority. PARTICIPANTS Twenty parents providing a packed lunch for their children (aged 5-11 years). ANALYSIS An inductive thematic approach was used to identify categories and themes. The researchers maintained rigor in the data analysis through internal discussion and review until consensus was reached. RESULTS Children emerged as active decision makers exerting substantial power particularly in the initial decision to have a packed lunch, and then in influencing the lunch's contents. The packed lunch could be a source of anxiety for some parents; however, ultimately parents' attitudes and perceptions revolved around the key requirement that the lunch was eaten. Providing a packed lunch was a means of achieving this. CONCLUSIONS This study highlights children's growing authority over everyday food decisions. Further research is needed to explore children's perceptions of their role in food provision. The study's findings have implications for school food, nutrition education, and school-based interventions. Frameworks that look to improve children's nutrition in this area should reflect children's growing status as food decision makers and consider how this can be employed to support and sustain positive changes.
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Affiliation(s)
- H Ensaff
- School of Food Science and Nutrition, University of Leeds, Leeds, UK; Department of Nutrition and Dietetics, Leeds Beckett University, Leeds, UK.
| | - E Bunting
- Department of Nutrition and Dietetics, Leeds Beckett University, Leeds, UK
| | - S O'Mahony
- Health and Wellbeing Service, Children and Families Service, Leeds City Council, Leeds, UK
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28
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“What can I do when he/she doesn't want to eat?”: Maternal strategies for ensure children's food consumption in early childhood. Appetite 2017; 116:575-583. [DOI: 10.1016/j.appet.2017.05.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 05/01/2017] [Accepted: 05/27/2017] [Indexed: 11/20/2022]
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29
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McCrickerd K, Leong C, Forde CG. Preschool children's sensitivity to teacher-served portion size is linked to age related differences in leftovers. Appetite 2017; 114:320-328. [DOI: 10.1016/j.appet.2017.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/24/2017] [Accepted: 04/03/2017] [Indexed: 01/12/2023]
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30
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Are Family Routines Modifiable Determinants of Preschool Children’s Eating, Dietary Intake, and Growth? A Review of Intervention Studies. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0207-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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31
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Developmental Readiness, Caregiver and Child Feeding Behaviors, and Sensory Science as a Framework for Feeding Young Children. ACTA ACUST UNITED AC 2017. [DOI: 10.1097/nt.0000000000000200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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32
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da Silva JPC, Sarubbi Junior V, Nascimento VG, Bertoli CJ, Gallo PR, Leone C. Mothers' conceptions about excess weight in infancy and the nutritional status of their children. Clinics (Sao Paulo) 2016; 71:500-5. [PMID: 27652830 PMCID: PMC5004579 DOI: 10.6061/clinics/2016(09)03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/06/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To analyze maternal conceptions about excess weight in infancy and the nutritional status of their preschool-aged children. METHODS A mixed, exploratory study was performed using semi-structured interviews. Two study groups were defined: a group of 16 mothers of children with excess weight and a group of 15 mothers of eutrophic children. The interviews were submitted to content analysis using CHIC software (Classification Hiérarchique Implicative et Cohésitive¯). RESULTS The mothers of children with excess weight tended to conceive thin children as malnourished, while those of normal weight children emphasized the influence of family and genetics as determinants of a child's nutritional status. Although there was a certain consensus among the mothers that an unhealthy diet contributes to the risk of a child developing excess weight, the concept of genetics as a determinant of a child's nutritional status was also present in the dialogue from the mothers of both groups. This result indicates a lack of clarity regarding the influence of eating behavior and family lifestyle on weight gain and the formation of a child's eating habits. Both groups indicated that the mother has a decisive role in the eating habits of her child; however, the mothers of children with excess weight did not seem to take ownership of this concept when addressing the care of their own children. CONCLUSION Differences in conceptions, including taking ownership of care, may contribute to the development of excess weight in preschool-aged children.
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Affiliation(s)
- Janaína Paula Costa da Silva
- Universidade de São Paulo, Departamento Saãde Materno-Infantil, São Paulo/SP, Brazil
- Faculdade de Ciências da Saúde do Trairi da Universidade Federal do Rio Grande do Norte/RN, BrazilBrazil
- E-mail:
| | | | | | - Ciro João Bertoli
- Universidade de Taubatã, Departamento de Medicina, Taubaté/SP, Brazil
| | - Paulo Rogério Gallo
- Universidade de São Paulo, Departamento Saãde Materno-Infantil, São Paulo/SP, Brazil
| | - Claudio Leone
- Universidade de São Paulo, Departamento Saãde Materno-Infantil, São Paulo/SP, Brazil
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Strategies Low-Income Parents Use to Overcome Their Children’s Food Refusal. Matern Child Health J 2016; 21:68-76. [DOI: 10.1007/s10995-016-2094-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Spence AC, Hesketh KD, Crawford DA, Campbell KJ. Mothers' perceptions of the influences on their child feeding practices - A qualitative study. Appetite 2016; 105:596-603. [PMID: 27352882 DOI: 10.1016/j.appet.2016.06.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/20/2016] [Accepted: 06/24/2016] [Indexed: 11/29/2022]
Abstract
Children's diets are important determinants of their health, but typically do not meet recommendations. Parents' feeding practices, such as pressure or restriction, are important influences on child diets, but reasons why parents use particular feeding practices, and malleability of such practices, are not well understood. This qualitative study aimed to explore mothers' perceptions of influences on their feeding practices, and assess whether an intervention promoting recommended feeding practices was perceived as influential. The Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program was a cluster-randomised controlled trial involving 542 families aiming to improve child diets. Following the trial, when children were two years old, 81 intervention arm mothers were invited to participate in qualitative interviews, and 26 accepted (32%). Thematic analysis of interview transcripts used a tabular thematic framework. Eight major themes were identified regarding perceived influences on child feeding practices. Broadly these encompassed: practical considerations, family setting, formal information sources, parents' own upbringing, learning from friends and family, learning from child and experiences, and parents' beliefs about food and feeding. Additionally, the Melbourne InFANT Program was perceived by most respondents as influential. In particular, many mothers reported being previously unaware of some recommended feeding practices, and that learning and adopting those practices made child feeding easier. These findings suggest that a variety of influences impact mothers' child feeding practices. Health practitioners should consider these factors in providing feeding advice to parents, and researchers should consider these factors in planning interventions.
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Affiliation(s)
- Alison C Spence
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Australia.
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Australia.
| | - David A Crawford
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Australia.
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, Victoria, 3125, Australia.
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Younginer NA, Blake CE, Davison KK, Blaine RE, Ganter C, Orloski A, Fisher JO. "What do you think of when I say the word 'snack'?" Towards a cohesive definition among low-income caregivers of preschool-age children. Appetite 2016; 98:35-40. [PMID: 26689891 PMCID: PMC6657694 DOI: 10.1016/j.appet.2015.12.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/11/2015] [Accepted: 12/03/2015] [Indexed: 11/24/2022]
Abstract
Despite agreement that snacks contribute significant energy to children's diets, evidence of the effects of snacks on health, especially in children, is weak. Some of the lack of consistent evidence may be due to a non-standardized definition of snacks. Understanding how caregivers of preschool-aged children conceptualize and define child snacks could provide valuable insights on epidemiological findings, targets for anticipatory guidance, and prevention efforts. Participants were 59 ethnically-diverse (White, Hispanic, and African American), low-income urban caregivers of children age 3-5 years. Each caregiver completed a 60-90 min semi-structured in-depth interview to elicit their definitions of child snacks. Data were coded by two trained coders using theoretically-guided emergent coding techniques to derive key dimensions of caregivers' child snack definitions. Five interrelated dimensions of a child snack definition were identified: (1) types of food, (2) portion size, (3) time, (4) location, and (5) purpose. Based on these dimensions, an empirically-derived definition of caregivers' perceptions of child snacks is offered: A small portion of food that is given in-between meals, frequently with an intention of reducing or preventing hunger until the next mealtime. These findings suggest interrelated dimensions that capture the types of foods and eating episodes that are defined as snacks. Child nutrition studies and interventions that include a focus on child snacks should consider using an a priori multi-dimensional definition of child snacks.
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Affiliation(s)
- Nicholas A Younginer
- University of South Carolina, Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, 915 Greene St., Columbia, SC 29208, USA.
| | - Christine E Blake
- University of South Carolina, Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, 915 Greene St., Columbia, SC 29208, USA
| | - Kirsten K Davison
- Harvard T.H. Chan School of Public Health, Department of Nutrition, 665 Huntington Ave., Boston, MA 02445, USA
| | - Rachel E Blaine
- Harvard T.H. Chan School of Public Health, Department of Nutrition, 665 Huntington Ave., Boston, MA 02445, USA; California State University, Long Beach, Department of Family and Consumer Sciences, 1250 Bellflower Blvd, FCS FA-15, Long Beach, CA 90840, USA
| | - Claudia Ganter
- Harvard T.H. Chan School of Public Health, Department of Nutrition, 665 Huntington Ave., Boston, MA 02445, USA
| | - Alexandria Orloski
- Temple University, Center for Obesity Research and Education, 3323 N Broad St. Suite 175, Philadelphia, PA 19140, USA
| | - Jennifer Orlet Fisher
- Temple University, Center for Obesity Research and Education, 3323 N Broad St. Suite 175, Philadelphia, PA 19140, USA
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McCrickerd K, Forde CG. Parents, portions and potential distortions: Unpicking children's meal size. NUTR BULL 2016. [DOI: 10.1111/nbu.12190] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- K. McCrickerd
- Clinical Nutrition Research Centre; Centre for Translational Medicine; Yong Loo Lin School of Medicine; Singapore
- Singapore Institute for Clinical Sciences; Agency for Science Technology and Research (A*STAR); Singapore
| | - C. G. Forde
- Clinical Nutrition Research Centre; Centre for Translational Medicine; Yong Loo Lin School of Medicine; Singapore
- Singapore Institute for Clinical Sciences; Agency for Science Technology and Research (A*STAR); Singapore
- Department of Physiology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
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Johnson SL. Developmental and Environmental Influences on Young Children's Vegetable Preferences and Consumption. Adv Nutr 2016; 7:220S-231S. [PMID: 26773030 PMCID: PMC4717879 DOI: 10.3945/an.115.008706] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Food intake patterns begin to be shaped at the earliest points in life. Early exposures and experiences are critical for the acceptance of some foods, particularly healthful foods such as vegetables, which often have a bitter component in their flavor profiles. In addition to repeated exposure to these foods, the quality and emotional tone of parent-child interactions are important in facilitating children's acceptance of vegetables. During early childhood, parents are challenged by children's developmental characteristics related to eating, such as the emergence of child neophobia, and by individual characteristics of the child that are more biologically based, including genetic predispositions to bitter taste and sensory sensitivities. Experimental studies consistently show that repeated exposure to novel and rejected familiar foods is the most powerful method to improve acceptance. However, the manner and persistence with which these exposures are performed are critical. Research investigating influences on children's vegetable acceptance and ingestion has focused on associations among availability, parent intakes, child neophobia, and the parental feeding response to children's reluctance to try and consume vegetables. Because young children's dietary intakes are low and below dietary recommendations, investigations have focused more on factors that impede children's vegetable acceptance, such as controlling feeding practices, than on positive influences. Research that addresses the multifaceted nature of these interactions among different levels of social-ecological environment, individual traits, parental feeding styles and practices, and socioeconomic influences and that uses longitudinal designs and complex statistical approaches is called for to ascertain more effective methods to improve children's vegetable acceptance.
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Affiliation(s)
- Susan L Johnson
- University of Colorado Anschutz Medical Campus, Department of Pediatrics/Section of Nutrition, The Children's Eating Laboratory, Aurora, CO
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Abstract
PURPOSE OF REVIEW In this review, an overview of literature on picky eating is given, with the focus on recently published studies. RECENT FINDINGS Papers on picky eating published over the past 2 years broadly covered three themes: characterization of picky eating; factors contributing to the development of picky eating in children; and management of picky eating. Findings suggest that picky eating is a reasonably robust concept, comprising food neophobia, eating a limited variety of food, and other specific features related to food and eating (e.g. low enjoyment of food, slowness in eating, and higher satiety responsiveness). Picky eating has a higher prevalence in preschool children and seems to decrease thereafter. Studies investigating factors influencing the development of picky eating in childhood have examined a range of child factors, parent factors, and parent-child interactions. Only very limited guidance has emerged regarding the management of picky eating. SUMMARY Picky eating is a descriptive term with greater emerging clarity about its core characteristics and associations. Research remains limited with ongoing difficulties related to lack of standardized assessment measures, and poor ability to differentiate between normal and clinically significant picky eating.
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Affiliation(s)
- S Cardona Cano
- aParnassia Psychiatric Institute, The Hague bThe Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands cDepartment of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA dDepartment of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands eDepartment of Child and Adolescent Mental Health, Great Ormond Street Hospital for Children NHS Foundation Trust fUniversity College London, Institute of Child Health, London, UK
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