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Throm JK, Schilling D, Löchner J, Micali N, Dörsam AF, Giel KE. Parental verbal communication and modeling behavior during mealtimes shape offspring eating behavior - A systematic review with a focus on clinical implications for eating disorders. Appetite 2024; 200:107584. [PMID: 38944057 DOI: 10.1016/j.appet.2024.107584] [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: 01/26/2024] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE The aim of this review is to provide an overview of parental communication patterns during mealtimes, with a special emphasis being placed on the differences between families with and without a history of eating disorders. METHODS The systematic review was conducted according to the PRISMA statement. A systematic literature search was carried out in PubMed, PubPsych and PsycINFO and the results were assessed for eligibility by two independent raters using the PICOS criteria. Only studies that included a mealtime observation were considered suitable for analysis of both explicit and implicit parental communication. RESULTS The results of the review suggest that mothers communicate more, with more complexity, and with a greater variety of words with their children during mealtimes compared to fathers. The intention and type of communication is diverse and heterogeneous. In general, parents often tried to encourage their children to eat. Verbal modeling and co-eating appeared to be common behaviors. Mothers with a history of eating disorders expressed more negative emotions during eating than mothers without eating disorders. Findings regarding the use of positive comments and controlling speech are contradicting. DISCUSSION The review outlines major fields of parent-child communication and modeling behavior around family meals which might be relevant to investigate and integrate into models of intergenerational transmission of eating behavior and disordered eating.
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Affiliation(s)
- Jana Katharina Throm
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany.
| | - Denise Schilling
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany
| | - Johanna Löchner
- German Center for Mental Health (DZPG), Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tuebingen, Germany
| | - Nadia Micali
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Mental Health Services of the Capital Region of Denmark, Center for Eating and Feeding Disorders Research, Ballerup Psychiatric Centre, Copenhagen, Denmark
| | - Annica Franziska Dörsam
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany; Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tuebingen, Tuebingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany; Centre of Excellence for Eating Disorders Tuebingen (KOMET), University of Tuebingen, Germany; German Center for Mental Health (DZPG), Germany
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Mosli RH. Sibship Composition and BMI Z-Score Among Saudi Preschoolers: A Cross-Sectional Study. Cureus 2024; 16:e56485. [PMID: 38638783 PMCID: PMC11026033 DOI: 10.7759/cureus.56485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 04/20/2024] Open
Abstract
Background and objective The association between sibship composition and child body mass index (BMI) has not been investigated in any Arab/Middle Eastern populations. In light of this, this study aimed to examine the association of the number of siblings, number of older siblings, and number of younger siblings with child BMI z-score (BMIz) among preschoolers in the Kingdom of Saudi Arabia (KSA). Methods A total of 209 mothers and their children were recruited from preschools in Jeddah, KSA. Mothers reported their responses to the study questionnaire via telephone. Child anthropometry was objectively measured; BMIz was calculated based on age- and sex-specific World Health Organization (WHO) growth standards and reference data. We used hierarchical multiple linear regression to examine the association between sibship composition variables and child BMIz, independent of the effect of potential confounders, and to evaluate changes in model fit. Results The number of siblings was negatively associated with child BMIz [b = -0.18, 95% confidence interval (CI) = -0.35, -0.06, p<0.01, adjusted R2 = 0.16]. There was a negative association between the number of older siblings and child BMIz (b = -0.23, 95% CI = -0.38, -0.11, p<0.01, adjusted R2 = 0.21) as well as between the number of older sisters and child BMIz (b = -0.18, 95% CI = -0.52, -0.09, p<0.01, adjusted R2 = 0.19). However, there were no significant associations between the number of older brothers or the number of younger siblings and child BMIz. Conclusions Based on our findings, sibship composition was found to be associated with BMIz among a sample of preschoolers in KSA. More research is needed to further establish this association and to understand the underlying mechanism of the association of the greater number of older siblings and older sisters with lower BMIz.
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Affiliation(s)
- Rana H Mosli
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
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Ayre SK, Harris HA, White MJ, Byrne RA. Food Parenting Practices and Child Eating Behaviors in Australian Families: A Cross-Sectional Sibling Design. J Acad Nutr Diet 2024; 124:42-57.e8. [PMID: 37661083 DOI: 10.1016/j.jand.2023.08.131] [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: 06/06/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Research on feeding in early childhood has focused primarily on parent-child dyadic interactions, despite parents enacting these practices within the complex dynamic of the family system. OBJECTIVE Using a sibling design, this study aimed to assess how parents may adapt their food parenting practices for siblings in response to differences in their eating behaviors. DESIGN A cross-sectional online survey was conducted between October and December 2022. PARTICIPANTS/SETTING Data were collected from parents (97.5% women) in Australia with 2 children aged 2 to 5 years (n = 336 parents and n = 672 children). MAIN OUTCOME MEASURES Survey items were completed for each sibling, and included four subscales of the Children's Eating Behaviour Questionnaire and seven subscales of the Feeding Practices and Structure Questionnaire-28. STATISTICAL ANALYSES PERFORMED Multiple linear regression models examined associations between within-sibling pair differences in child eating behaviors and food parenting practices, adjusting for differences in child body mass index z score, age, gender, and early feeding method. RESULTS Within-sibling pair differences in eating behaviors were associated with differences in some food parenting practices. For the fussier sibling, parents reported using more control-based practices, including persuasive feeding, reward for eating, and reward for behavior, and less of the structure-based practice, family meal settings (P values < 0.001). Similar directions of associations were found for persuasive feeding, reward for eating, and family meal settings with siblings who were slower eaters or more satiety responsive (P values < 0.007); however, no significant differences in reward for behavior were observed in relation to sibling differences in these eating behaviors. For the more food responsive sibling, parents reported using more control-based practices, including reward for behavior and overt restriction (P values < 0.002). CONCLUSIONS Within families, parents may adapt certain practices in response to differences in their children's eating behaviors. Interventions promoting responsive feeding should be designed to acknowledge the integral role of siblings in shaping parents' feeding decisions.
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Affiliation(s)
- Susannah K Ayre
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, Queensland, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
| | - Holly A Harris
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Melanie J White
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Rebecca A Byrne
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, Queensland, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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Ruggiero CF, Moore AM, Savage JS. Direct Sibling Influence on Eating Behavior in Early Childhood: Siblings as Role Models and Caregivers. Acad Pediatr 2024; 24:119-123. [PMID: 37150478 PMCID: PMC10625651 DOI: 10.1016/j.acap.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/08/2023] [Accepted: 04/22/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVE Despite the majority of US children having at least 1 sibling, little is known about how siblings influence eating behavior and obesity risk. This qualitative study explored mothers' perceptions of older siblings' influences on younger siblings' eating behavior in the context of mealtimes in early childhood. METHODS A purposive subsample of mothers (n = 30) who participated in the Intervention Nurses Start Infants Growing on Healthy Trajectories and SIBSIGHT studies completed retrospective semi-structured interviews designed to explore the implications of sibling influences on maternal feeding practices during infancy and toddlerhood. Interviews were conducted by video conference with mothers between January and March 2021. All interviews were audio-recorded, transcribed, and a qualitative content analysis approach was used to code and identify themes. RESULTS Two main themes were identified related to the influence of older siblings on younger siblings during feeding interactions: 1) Older siblings as positive role models for younger siblings and 2) Older siblings acted as caregivers for younger siblings. Younger siblings received encouragement at mealtimes to try new foods. Older siblings assisted their mothers in caregiving and feeding tasks in developmentally appropriate ways. CONCLUSIONS Findings may help to elucidate the role of older siblings in shaping eating behavior and obesity risk of siblings in early childhood. Better understanding the role of siblings can aid in the development of novel interventions and anticipatory nutrition guidance in family-based clinical and community care.
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Affiliation(s)
- Cara F Ruggiero
- Center for Childhood Obesity Research (CF Ruggiero, AM Moore, and JS Savage), The Pennsylvania State University, University Park; Nutritional Sciences (CF Ruggiero and JS Savage), 110C Chandlee Laboratory, The Pennsylvania State University, University Park.
| | - Amy M Moore
- Center for Childhood Obesity Research (CF Ruggiero, AM Moore, and JS Savage), The Pennsylvania State University, University Park.
| | - Jennifer S Savage
- Center for Childhood Obesity Research (CF Ruggiero, AM Moore, and JS Savage), The Pennsylvania State University, University Park; Nutritional Sciences (CF Ruggiero and JS Savage), 110C Chandlee Laboratory, The Pennsylvania State University, University Park.
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Mosli RH, Kutbi HA. The association of early feeding practices with eating behaviors and maternal indulgent feeding behaviors among Saudi preschoolers. Front Psychol 2023; 14:1126687. [PMID: 37593653 PMCID: PMC10427779 DOI: 10.3389/fpsyg.2023.1126687] [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: 03/12/2023] [Accepted: 07/03/2023] [Indexed: 08/19/2023] Open
Abstract
Evidence from previous work suggest that feeding practices during the first years of life may influence the development of eating behaviors later in childhood. Early feeding practices may also predict later maternal feeding behaviors. Mothers from an Arab/Middle Eastern background may adopt unique early feeding practices. The objective of this study was to examine the association of offering fruit juice and date syrup-milk mixture in a baby bottle during infancy with: 1) Child eating behaviors during preschool years; 2) Maternal indulgent feeding practices during preschool years. Mothers of preschoolers (n = 115) completed questions adopted from the Children's Eating Behavior Questionnaire (CEBQ), Child Feeding Questionnaire-Arabic (CFQ-A), as well as questions assessing early feeding practices and demographic characteristics. Unadjusted and adjusted logistic regression models were tested to examine the association of early feeding practices with child eating behaviors and maternal indulgent feeding behaviors. Odds ratios (ORs) and respective 95% confidence intervals (CI) were derived. Adjusting for covariates, children who were ever offered fruit juice in a baby bottle as infants were more likely to have high food responsiveness at preschool, compared to children who were not (OR = 2.93, 95% CI = 1.16, 7.42). Mothers who reported ever offering fruit juice in a baby bottle when their children were infants were more likely to adopt greater use of food as a reward when their children were at preschool (OR = 3.25, 95% CI = 1.22, 8.68). Early feeding practices are associated with child eating and maternal feeding behaviors later in childhood. Future longitudinal studies are needed to further establish these associations. Findings from this study can help inform community awareness and education programs to prevent maladaptive feeding practices and promote appropriate feeding strategies throughout childhood.
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Zheng M, Hesketh KD, Vuillermin P, Dodd J, Wen LM, Baur LA, Taylor R, Byrne R, Mihrshahi S, Burgner D, Tang MLK, Campbell KJ. Understanding the pathways between prenatal and postnatal factors and overweight outcomes in early childhood: a pooled analysis of seven cohorts. Int J Obes (Lond) 2023:10.1038/s41366-023-01301-9. [PMID: 37012427 DOI: 10.1038/s41366-023-01301-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND/OBJECTIVES Childhood overweight and obesity are influenced by a range of prenatal and postnatal factors. Few studies have explored the integrative pathways linking these factors and childhood overweight. This study aimed to elucidate the integrative pathways through which maternal pre-pregnancy body mass index (BMI), infant birth weight, breastfeeding duration, and rapid weight gain (RWG) during infancy are associated with overweight outcomes in early childhood from ages 3 to 5 years. SUBJECTS/METHODS Pooled data from seven Australian and New Zealand cohorts were used (n = 3572). Generalized structural equation modelling was used to examine direct and indirect associations of maternal pre-pregnancy BMI, infant birth weight, breastfeeding duration, and RWG during infancy with child overweight outcomes (BMI z-score and overweight status). RESULTS Maternal pre-pregnancy BMI was directly associated with infant birth weight (β 0.01, 95%CI 0.01, 0.02), breastfeeding duration ≥6 months (OR 0.92, 95%CI 0.90, 0.93), child BMI z-score (β 0.03, 95%CI 0.03, 0.04) and overweight status (OR 1.07, 95%CI 1.06, 1.09) at ages 3-5 years. The association between maternal pre-pregnancy BMI and child overweight outcomes was partially mediated by infant birth weight, but not RWG. RWG in infancy exhibited the strongest direct association with child overweight outcomes (BMI z-score: β 0.72, 95%CI 0.65, 0.79; overweight status: OR 4.49, 95%CI 3.61, 5.59). Infant birth weight was implicated in the indirect pathways of maternal pre-pregnancy BMI with RWG in infancy, breastfeeding duration, and child overweight outcomes. The associations between breastfeeding duration (≥6 months) and lower child overweight outcomes were fully mediated by RWG in infancy. CONCLUSIONS Maternal pre-pregnancy BMI, infant birth weight, breastfeeding duration and RWG in infancy act in concert to influence early childhood overweight. Future overweight prevention interventions should target RWG in infancy, which showed the strongest association with childhood overweight; and maternal pre-pregnancy BMI, which was implicated in several pathways leading to childhood overweight.
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Affiliation(s)
- Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | | | - Jodie Dodd
- Discipline of Obstetrics and Gynaecology, The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Li Ming Wen
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Louise A Baur
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Rebecca Byrne
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, Australia
| | - Seema Mihrshahi
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - David Burgner
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Mimi L K Tang
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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Ayre SK, White MJ, Harris HA, Byrne RA. 'I'm having jelly because you've been bad!': A grounded theory study of mealtimes with siblings in Australian families. MATERNAL & CHILD NUTRITION 2023; 19:e13484. [PMID: 36808876 PMCID: PMC10019066 DOI: 10.1111/mcn.13484] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/11/2023] [Accepted: 01/23/2023] [Indexed: 02/22/2023]
Abstract
Obesity prevention interventions have been designed to promote responsive feeding in early childhood. However, existing interventions primarily target first-time mothers without considering the complexities of feeding multiple children within a family unit. By applying principles of Constructivist Grounded Theory (CGT), this study aimed to explore how mealtimes are enacted in families with more than one child. A mixed-methods study was conducted with parent-sibling triads (n = 18 families) in South East Queensland, Australia. Data included direct mealtime observations, semistructured interviews, field notes, and memos. Data were analysed using open and focused coding, during which constant comparative analysis was applied. The sample comprised of two-parent families with children ranging in age from 12 to 70 months (median sibling age difference = 24 months). A conceptual model was developed to map sibling-related processes integral to the enactment of mealtimes in families. Notably, this model captured feeding practices used by siblings, such as pressure to eat and overt restriction, that previously had only been described in parents. It also documented feeding practices used by parents that may occur only in the presence of a sibling, such as leveraging sibling competitiveness and rewarding a child to vicariously condition their sibling's behaviour. The conceptual model demonstrates complexities in feeding that give shape to the overall family food environment. Findings from this study can inform the design of early feeding interventions that support parents to remain responsive, particularly when their perceptions and expectations of siblings differ.
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Affiliation(s)
- Susannah K. Ayre
- Woolworths Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologySouth BrisbaneQueenslandAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Melanie J. White
- School of Psychology & Counselling, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Holly A. Harris
- Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
| | - Rebecca A. Byrne
- Woolworths Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologySouth BrisbaneQueenslandAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
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Liu J, Wu Y, Ma Q, Wang X, Chen M, Ma T, Cui M, Li Y, Gao D, Ma Y, Chen L, Zhang Y, Yuan W, Guo T, Ma J, Dong Y. The joint associations of high birth weight and not having siblings with metabolic obesity phenotype among school-aged children and adolescents: A National Survey in China. Pediatr Obes 2023; 18:e13021. [PMID: 36912164 DOI: 10.1111/ijpo.13021] [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: 12/31/2022] [Revised: 01/29/2023] [Accepted: 02/20/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Birth weight (BW) and sibling's status are two important indicators of early intrauterine environment and subsequent living environment, but no evidence has emerged on their joint associations on metabolic obesity phenotype. To determine the joint associations between BW and single-child status with childhood metabolic obesity phenotype was our purpose. METHODS A cross-sectional assessment of children and adolescents aged 7-18 years was performed in Chinese seven provinces in 2013. We obtained anthropometric, blood pressure and biochemical measurements, and distributed questionnaires covering demographic, neonatal and lifestyle characteristics. The metabolic obesity phenotype was defined by 2018 consensus-based criteria. Logistic regression and restricted cubic spline models were applied to evaluate the associations of BW and metabolic obesity phenotype, and estimate the multiplicative interactions and the combined associations of BW and single-child status with metabolic obesity phenotype. RESULTS Of enrolled 12 346 children and adolescents, the prevalence of metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) was 1.96% and 3.03%. There were 8.95% and 4.03% children with high BW or low BW, and 67.55% did not have siblings. High BW was positively associated with MHO (OR = 1.94, 95%CI = 1.28-2.94). Single-child also had increased odds of MHO and MUO (p < 0.05), and it had joint associations with high BW showing 0.85- to 2.58-fold higher odds of MUO and MHO. CONCLUSIONS High BW and single-child status have joint positive associations with the subsequent odds of MHO and MUO, which should be jointly prevented through earlier screening and subsequent preventive strategies.
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Affiliation(s)
- Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yu Wu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Qi Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Xinxin Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Mengjie Cui
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yanhui Li
- School of Nursing, Peking University, Beijing, China
| | - Di Gao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Ying Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Wen Yuan
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Tongjun Guo
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China
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Papaioannou MA, Power TG, O’Connor TM, Fisher JO, Micheli NE, Hughes SO. Child Weight Status: The Role of Feeding Styles and Highly Motivated Eating in Children. CHILDREN 2023; 10:children10030507. [PMID: 36980065 PMCID: PMC10047856 DOI: 10.3390/children10030507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/26/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023]
Abstract
Although parental feeding plays an important role in child eating and weight status, high food motivation among children may also be a factor shaping how feeding impacts child weight. This study explored whether individual differences in preschool children’s food motivation interacted with mothers’ feeding styles in predicting subsequent child weight status. Participants included 129 Hispanic Head Start mother/child dyads. Data were collected at ages 4–5 years (Time 1) and 7–9 (Time 3). Staff measured heights/weights and observed children in an eating in the absence of hunger task. Mothers reported on feeding styles/practices and children’s eating behaviors. A principal components analysis derived a measure of highly motivated eating in children. Multiple regressions predicted Time 3 child BMI z-scores. Time 3 BMI z-scores were positively predicted by authoritative and indulgent feeding styles and negatively predicted by monitoring. Since feeding style interacted with highly motivated eating, separate regressions were run for high and low food motivation in children. Unexpectedly, results showed that authoritative feeding positively predicted Time 3 child BMI z-scores only for children showing low levels of food motivation. Characterizing differential parental feeding and child eating phenotypes may assist in tailoring childhood obesity prevention programs for the target populations.
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Affiliation(s)
- Maria A. Papaioannou
- Department of Pediatrics, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Thomas G. Power
- Department of Human Development, Washington State University, Pullman, WA 99164, USA
| | - Teresia M. O’Connor
- Department of Pediatrics, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jennifer O. Fisher
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, PA 19122, USA
| | - Nilda E. Micheli
- Department of Pediatrics, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sheryl O. Hughes
- Department of Pediatrics, USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA
- Correspondence: ; Tel.: +1-713-798-7017
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Keenan K, Barclay K, Goisis A. Health outcomes of only children across the life course: An investigation using Swedish register data. POPULATION STUDIES 2023; 77:71-90. [PMID: 35102810 DOI: 10.1080/00324728.2021.2020886] [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] [Indexed: 10/19/2022]
Abstract
Only children (with no full biological siblings) are a growing subgroup in many high-income settings. Previous studies have largely focused on the short-term developmental outcomes of only children, but there is limited evidence on their health outcomes. Using Swedish population register data for cohorts born 1940-75, we compare the health of only children with that of children from multi-child sibling groups, taking into account birth order, family size, and presence of half-siblings. Only children showed lower height and fitness scores, were more likely to be overweight/obese in late adolescence, and experienced higher later-life mortality than those with one or two siblings. However, only children without half-siblings were consistently healthier than those with half-siblings, suggesting that parental disruption confers additional disadvantages. The health disadvantage was attenuated but not fully explained by adjustment for parental characteristics and after using within-family maternal cousin comparison designs.
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Affiliation(s)
| | - Kieron Barclay
- Max Planck Institute for Demographic Research.,Stockholm University.,Swedish Collegium for Advanced Study
| | - Alice Goisis
- Max Planck Institute for Demographic Research.,University College London
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Chanfreau J, Barclay K, Keenan K, Goisis A. Sibling group size and BMI over the life course: Evidence from four British cohort studies. ADVANCES IN LIFE COURSE RESEARCH 2022; 53:100493. [PMID: 36652211 DOI: 10.1016/j.alcr.2022.100493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/06/2022] [Accepted: 06/07/2022] [Indexed: 06/17/2023]
Abstract
Only children, here defined as individuals growing up without siblings, are a small but growing demographic subgroup. Existing research has consistently shown that, on average, only children have higher body mass index (BMI) than individuals who grow up with siblings. How this difference develops with age is unclear and existing evidence is inconclusive regarding the underlying mechanisms. We investigate BMI trajectories for only children and those with siblings up to late adolescence for four British birth cohorts and across adulthood for three cohorts. We use data on BMI from ages 2-63 years (cohort born 1946); 7-55 years (born 1958); 10-46 (born 1970) and 3-17 years (born 2000-2002). Using mixed effects regression separately for each cohort, we estimate the change in BMI by age comparing only children and those with siblings. The results show higher average BMI among only children in each cohort, yet the difference is substantively small and limited to school age and adolescence. The association between sibling status and BMI at age 10/11 is not explained by differential health behaviours (physical activity, inactivity and diet) or individual or family background characteristics in any of the cohorts. Although persistent across cohorts, and despite the underlying mechanism remaining unexplained, the substantively small magnitude of the observed difference and the convergence of the trajectories by early adulthood in all cohorts raises doubts about whether the difference in BMI between only children and siblings in the UK context should be of research or clinical concern. Future research could usefully be directed more at whether only children experience elevated rates of disease, for which high BMI is a risk factor, at different stages of the life course and across contexts.
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Affiliation(s)
- Jenny Chanfreau
- UCL Social Research Institute, University College London, London WC1H 0AA, UK.
| | | | | | - Alice Goisis
- UCL Social Research Institute, University College London, London WC1H 0AA, UK
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12
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Review and meta-analysis for the caregiver's feeding styles questionnaire administered to low-income families. Eat Behav 2022; 46:101659. [PMID: 35964363 DOI: 10.1016/j.eatbeh.2022.101659] [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: 02/15/2022] [Revised: 06/29/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022]
Abstract
The Caregiver's Feeding Styles Questionnaire (CFSQ) is a well-established measure which uses scores along two dimensions of demandingness and responsiveness to classify low-income parents into one of four feeding style typologies (authoritative, authoritarian, indulgent, and uninvolved; Hughes, et al., 2005). The measure is widely used by researchers to explore the relationship between feeding style and child weight status but has not been evaluated comprehensively in a review or meta-analysis. The aims of this study were to 1) compare established median cutoffs for responsiveness and demandingness in parent feeding (k = 5; see Hughes et al., 2012) to current median splits along these two dimensions for a larger sample of articles (k = 19) and 2) evaluate the relation between children's BMI, demandingness and responsiveness, and parent feeding style categories. Results indicated that the cutoffs for responsiveness and demandingness initially established based on five studies of low-income families did not differ significantly with the addition of 19 studies. Child BMI z-scores (k = 8) were above average for all four parent feeding style categories and highest for indulgent parents, which was consistent with the literature outlining low-income children at higher risk for obesity and children of indulgent parents being particularly at risk. While heterogeneity of samples should be considered, study results suggested that the CFSQ distribution for responsiveness and demandingness was relatively generalizable across low-income samples, though heterogeneity was higher among caregiver's feeding style categories. Furthermore, the study confirmed that parent feeding styles were related to child weight status in a meaningful way, but all children in these low-income samples, on average, were heavier than their same-aged peers across all parent feeding styles.
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How Parenting and Family Characteristics Predict the Use of Feeding Practices among Parents of Preschoolers: A Cross-Sectional Study in Beijing, China. Nutrients 2022; 14:nu14153109. [PMID: 35956286 PMCID: PMC9370555 DOI: 10.3390/nu14153109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 02/01/2023] Open
Abstract
Parental coercive and structured feeding practices are linked with children’s weight gain. Thus, identifying their predictors will assist in childhood obesity prevention. We explored how parents’ concerns and perceptions of children’s weight, parenting stress, parenting competence, parents’ family roles, and only child status (of both parent and child) predict the use of restriction, pressure to eat, and monitoring practices among parents of preschoolers. Parent–child dyads (n = 2990) were recruited in Beijing in 2019. Parenting competence, parents’ weight perceptions and feeding practices were assessed using the Chinese version of Parenting Sense of Competence Scale and Child Feeding Questionnaire (CFQ), respectively. Parenting stress and other variables were collected through self-administered questionnaires. Multivariate linear associations between parents’ weight perceptions and feeding practices were significant among normal-weight children. Parents’ concerns about children being overweight were positively associated with restriction and monitoring, and negatively associated with pressure to eat. Higher levels of parenting stress and parenting competence significantly improved the adoption of restriction and pressure to eat. Parents’ only child status and that of children had an impact on parents’ feeding practices. The fathers’ feeding preferences were substantially different from what mothers preferred. In conclusion, such parenting and family characteristics significantly influenced feeding practices of preschoolers’ parents. These were long neglected in China.
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Food-related parenting practices and styles in households with sibling children: A scoping review. Appetite 2022; 174:106045. [DOI: 10.1016/j.appet.2022.106045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/30/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022]
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Papaioannou MA, Micheli N, Power TG, O'Connor TM, Fisher JO, Hughes SO. Maternal Feeding Styles and Child Appetitive Traits: Direction of Effects in Hispanic Families With Low Incomes. Front Public Health 2022; 10:871923. [PMID: 35719648 PMCID: PMC9201210 DOI: 10.3389/fpubh.2022.871923] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/06/2022] [Indexed: 01/27/2023] Open
Abstract
Feeding styles of parents have been associated with dietary quality/intake and weight outcomes; however, much of the research to date has been cross sectional and the direction of influence unclear. This prospective longitudinal study evaluated the direction of effects between feeding styles and child appetitive traits over time in a sample of 129 Hispanic parent/child dyads that participated in a larger study. Data analyzed for the current study were collected when the children were 4–5 years old and again at ages 7–9 years. Parents (all mothers) reported on their feeding styles and children's appetitive traits using well-established questionnaires. Cross-lagged panel analyses were used to examine the direction of effects. Fully adjusted models revealed that a number of children's appetitive traits at baseline predicted later feeding styles. A bi-directional relationship was found between authoritarian feeding and satiety responsiveness such that higher satiety responsiveness was associated with authoritarian feeding and vice versa. Lower satiety responsiveness was associated with indulgent feeding, whereas higher food responsiveness was associated with authoritarian feeding. Results show preliminary evidence that children's appetitive traits may shape mothers' approach to child feeding. There is also preliminary support for the protective role of an authoritarian feeding style in the self-regulatory processes around child appetitive traits among this population of Hispanic families with low-income levels. These results warrant continued research given that other studies have shown beneficial outcomes for authoritarian feeding among ethnically diverse families with low incomes.
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Affiliation(s)
- Maria A Papaioannou
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Nilda Micheli
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA, United States
| | - Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Jennifer Orlet Fisher
- Center for Obesity Research and Education, Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
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Mosli RH, Kutbi HA. The Association between Sibship Composition and Child Eating Behaviors. Behav Med 2022; 49:130-136. [PMID: 35156545 DOI: 10.1080/08964289.2021.1997892] [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] [Indexed: 11/02/2022]
Abstract
Development of eating habits and patterns during childhood can have life-long effects on weight and health status. Family structure, functioning, and interactions during mealtimes may influence the development of eating behaviors among children. The objective of this study was to examine the association between sibship composition and child eating behaviors among preschoolers in Saudi Arabia. One hundred and fifteen mothers were recruited through various preschools around the city of Jeddah, Saudi Arabia. A previously validated Arabic version of the Children's Eating Behavior Questionnaire (CEBQ) was completed over the telephone along with questions assessing sibship composition and demographic characteristics. Spearman correlations and adjusted linear regression models were examined to assess the association between sibship composition and child eating behaviors. Adjusting for covariates, number of older siblings was positively associated with emotional over eating, food responsiveness, and the desire to drink. Number of older sisters was positively associated with the desire to drink but negatively associated with food fussiness. Having a greater number of older (rather than younger) siblings may be associated with food-approach eating behaviors. Having a greater number of older sisters may be associated with less food fussiness. Focusing on older siblings in encouraging healthy eating habits and appropriate food choices may be beneficial in promoting adaptive eating behaviors and prevention of excessive energy intake and weight gain. Future longitudinal and mixed-methods research studies with larger sample sizes are needed in order to better understand the underlying mechanisms for the associations between sibship composition and child eating behaviors.
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Affiliation(s)
- Rana H Mosli
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hebah A Kutbi
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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Katagiri A, Nawa N, Fujiwara T. Association Between Length of Only-Child Period During Early Childhood and Overweight at Age 8-A Population-Based Longitudinal Study in Japan. Front Pediatr 2022; 10:782940. [PMID: 35774097 PMCID: PMC9237356 DOI: 10.3389/fped.2022.782940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Prior studies have shown that children who are the only child are more likely to be overweight compared to their peers with siblings, regardless of whether they are the oldest, in the middle, or youngest. The study objective was to clarify whether there is an association between the length of the only-child period and the risk of overweight in firstborns who experienced an only-child period during early childhood before their siblings were born. METHODS A total of 7,576 first-born boys and 7,229 first-born girls were examined from a nationwide longitudinal survey in Japan. The length of the only-child period was determined by "birth interval"; i.e., the interval between the birth of the index child and the birth of the second child. It was categorized as short (<1.5 years), moderate (between 1.5 and 4 years), long (between 4 and 8 years), and only-child (the second baby was not born for 8 years). Overweight was defined as body mass index (BMI) z-score 1 standard deviation or more at age 8. Logistic regression was used to examine the association between length of only-child period and childhood overweight, adjusting for covariates. RESULTS Moderate birth interval was inversely associated with being overweight in comparison with only-child in both boys (odds ratio (OR): 0.83, 95% CI, 0.72-0.96) and girls (OR: 0.75, 95% CI, 0.63-0.88). Long birth interval also showed inverse association in boys (OR: 0.78, 95% CI, 0.62-0.97), and marginal inverse association in girls (OR: 0.80, 95% CI, 0.62-1.04). CONCLUSION First-born children who experienced short birth intervals did not show a different overweight risk from only-child. First-born children who experienced 1.5-8 years of the birth interval had a lower risk of childhood overweight compared with only-child.
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Affiliation(s)
- Aomi Katagiri
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobutoshi Nawa
- Department of Medical Education Research and Development, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
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Sibling Inequalities in Overweight and the Role of Mother’s Education: Evidence From the Indonesian Family Life Survey. Food Nutr Bull 2021. [PMCID: PMC8293756 DOI: 10.1177/0379572120976250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Previous studies have shown that sibling inequalities in overweight vary across contexts. Furthermore, research on the extent to which parental factors such as mother’s education can compensate for or reinforce such disparities is considerably rare. Objective: This study analyzes to what extent and how the chances of overweight among children (0-19 years of age) vary systematically by gender, birth order, and number of siblings. We also look at whether mother’s education buffers or aggravates sibling inequalities in overweight. Methods: Data were from the fifth wave of the Indonesian Family Life Survey-5 2014/2015, which comprised 6723 children born in 4784 families. We applied within-family centered birth order dummies to disentangle the effects of birth order from those of number of siblings. Cluster-robust logistic regressions were conducted. Results: Overweight occurred more in eldest and youngest children, and in children of smaller families. Mother’s education amplified sibling inequalities. Odds of overweight in children increased along with more years of education the mothers had. This was greater for boys and eldest children. Further analyses indicated that boys whose mothers spent more years in school consumed high-calorie foods more often. Conclusion: The overall results indicate that mother’s education aggravates sibling inequalities in overweight. Nutrition interventions to reduce overweight in children should target the eldest and the youngest children and children of smaller families. Mothers who had more school years, and particularly their sons, should also be in the target group. Boys should be advised to consume high-calorie foods less often.
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Ruggiero CF, McHale SM, Paul IM, Savage JS. Learned Experience and Resource Dilution: Conceptualizing Sibling Influences on Parents' Feeding Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115739. [PMID: 34071852 PMCID: PMC8199493 DOI: 10.3390/ijerph18115739] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022]
Abstract
Studies from diverse cultures report mixed results in the relationship between birth order and risk for obesity. Explanations may thus lie in the postnatal period when growth is shaped by the family environment, including parental feeding practices, which may be affected by siblings. Consistent with a family systems perspective, we describe two processes that may explain birth order effects on parental feeding practices and child outcomes: learned experience and resource dilution. Parents learn from experience when earlier-born children influence their parents’ knowledge, expectations, and behavior toward later-born siblings through their behaviors and characteristics—which can have both positive and negative implications. Resource dilution is a process whereby the birth of each child limits the time, attention and other resources parents have to devote to any one of their children. The goal of this review is to provide a theoretical basis for examining potential sibling influences on parental responsive feeding toward developing recommendations for future research and practice aimed at preventing obesity throughout family systems.
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Affiliation(s)
- Cara F. Ruggiero
- The Center for Childhood Obesity Research, Penn State University, University Park, State College, PA 16802, USA;
- Department of Nutritional Sciences, Penn State University, University Park, State College, PA 16802, USA
- Correspondence:
| | - Susan M. McHale
- Department of Human Development and Family Studies, Penn State University, University Park, State College, PA 16802, USA;
| | - Ian M. Paul
- Pediatrics and Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - Jennifer S. Savage
- The Center for Childhood Obesity Research, Penn State University, University Park, State College, PA 16802, USA;
- Department of Nutritional Sciences, Penn State University, University Park, State College, PA 16802, USA
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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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Hughes SO, Power TG, O’Connor TM, Fisher JO, Micheli NE, Papaioannou MA. Maternal feeding style and child weight status among Hispanic families with low-income levels: a longitudinal study of the direction of effects. Int J Behav Nutr Phys Act 2021; 18:30. [PMID: 33588844 PMCID: PMC7885249 DOI: 10.1186/s12966-021-01094-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 01/27/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The home environment is a central and modifiable influence on the development of childhood obesity. Evidence supports the central role of parents in shaping problematic child eating behaviors and excess weight. Most studies of feeding emphasize parent-driven influences without taking into account the child's role in eating interactions. Few studies have addressed the bi-directional nature of feeding dynamics in studies of young children. METHODS The goals of this study were: 1) to examine if parental feeding styles during preschool (4-5 years) predict child weight status at 7-9 years, and 2) to examine the direction of effects between parental feeding styles and child weight status over time. Participants were part of a larger longitudinal study of Hispanic Head Start families living in the West South Central United States. Data from mother/child dyads were collected at three time points: Time 1 (ages 4-5), Time 2 (ages 5 ½-6 ½), and at Time 3 (ages 7-9). Only data from the Times 1 and 3 were used in the current analyses. A total of 128 mothers and their children had data on all variables needed for the analyses. Assessments included parent-reported feeding styles, feeding practices, acculturation, child eating behaviors, and child height and weight. Hierarchical regression was used to examine the first aim; a cross-lagged panel analysis examined the second aim. RESULTS An indulgent parental feeding style at ages 4-5 was associated with increased child BMI z-score at ages 7-9. Indulgent feeding significantly contributed to child BMI z-score beyond demographics, baseline child BMI z-score, parental acculturation, and child eating behaviors. Regarding the direction of effects in parental feeding interactions, the cross-lagged analyses showed that both indulgent feeding style and authoritative feeding style at Time 1 positively predicted child BMI z-scores at Time 3. Child effects were significant as well. Child BMI z-score at Time 1 positively predicted indulgent feeding and negatively predicted authoritarian feeding at Time 3. CONCLUSIONS Indulgent feeding should be addressed in future family-focused childhood obesity initiatives focused on young children and their parents.
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Affiliation(s)
- Sheryl O. Hughes
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030 USA
| | - Thomas G. Power
- Department of Human Development, Washington State University, PO Box 644852, Pullman, WA 99164 USA
| | - Teresia M. O’Connor
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030 USA
| | - Jennifer O. Fisher
- Department of Social and Behavioral Sciences, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA 19140 USA
| | - Nilda E. Micheli
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030 USA
| | - Maria A. Papaioannou
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX 77030 USA
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Power TG, Beck AD, Fisher JO, Micheli N, O'Connor TM, Hughes SO. Observations of Maternal Feeding Practices and Styles and Young Children's Obesity Risk: A Longitudinal Study of Hispanic Mothers with Low Incomes. Child Obes 2021; 17:16-25. [PMID: 33253009 PMCID: PMC7815060 DOI: 10.1089/chi.2020.0178] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: Maternal feeding practices and styles are well-established correlates of children's BMI z-scores in the preschool years. Most studies, however, are cross-sectional, using maternal self-reports to examine feeding. This study examined, over a 3½-year period, the relationship between observed and self-reported feeding practices/styles and children's BMI z-scores in a sample of Hispanic mothers with low incomes and their preschool children. Methods: One hundred eighty-seven mothers were observed feeding their 4- to 5-year old during a buffet meal in a laboratory setting and completed self-report measures on their feeding practices and styles. Children's BMI z-scores were assessed at this visit and 3½ years later. Results: Consistent with previous research, observed and self-reported pressure to eat and/or authoritarian feeding were negatively associated with children's BMI z-scores at the first time point; observed discouraging eating was positively associated. However, children's BMI z-scores 3½ years later, controlling for Time 1 BMI z-scores, were positively associated with observed pressure to eat. Observed maternal reasoning and self-reported monitoring of children's eating behavior at Time 1 were negatively associated with later BMI z-scores. Only self-reported feeding styles predicted later children's BMI z-scores, with indulgent and authoritative styles positively associated with children's BMI z-scores at the third time point. Conclusions: These findings demonstrate that mothers who ignore their children's fullness cues and pressure them to eat have children who are at greater risk for the development of later obesity. Implications for the development of family-focused childhood obesity prevention programs are discussed.
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Affiliation(s)
- Thomas G. Power
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Ashley D. Beck
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Jennifer O. Fisher
- Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| | - Nilda Micheli
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Teresia M. O'Connor
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Sheryl O. Hughes
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA.,Address correspondence to: Sheryl O. Hughes, PhD, Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates, Houston, TX 77030-2600, USA
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Sources and Determinants of Wholegrain Intake in a Cohort of Australian Children Aged 12-14 Months. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249229. [PMID: 33321930 PMCID: PMC7764788 DOI: 10.3390/ijerph17249229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 11/17/2022]
Abstract
In the first two years of life, exposure to wholegrain foods may help establish life‑long consumption patterns associated with reduced risk of chronic disease, yet intake data are lacking for this age group. This cross‑sectional analysis aimed to determine intakes and food sources of wholegrains in a cohort of 828 Australian children aged 12–14 months, and to identify determinants of wholegrain intake. Three non‑consecutive days of dietary intake data were collected using a 24‑h recall and 2‑day estimated food record. The multiple source method was used to estimate usual wholegrain intake, and the multivariable general linear model procedure used to identify associations between usual wholegrain intake and socio‑demographic determinants. The mean wholegrain intake was 19.5 (±14) g/day, and the major food sources were ready to eat breakfast cereals (40%) breads and bread rolls (26.6%), flours and other cereal grains (9.4%), and commercial infant foods (8.3%). Lower wholegrain intakes were observed for children whose mothers were born in China (p < 0.001) and other Asian countries (p < 0.001), with the exception of India (p = 0.193); those with mothers aged less than 25 years (p = 0.001) and those with two or more siblings (p = 0.013). This study adds to the weight of global evidence highlighting the need to increase children’s intake of foods high in wholegrain, including in the first few years of life.
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Tian X, von Cramon-Taubadel S. Are only children in China more likely to be obese/overweight than their counterparts with siblings? ECONOMICS AND HUMAN BIOLOGY 2020; 37:100847. [PMID: 31981790 DOI: 10.1016/j.ehb.2020.100847] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/01/2019] [Accepted: 01/04/2020] [Indexed: 06/10/2023]
Abstract
Family planning policy in China has resulted in a large number of one-child families. According to Becker's "quantity-quality trade-off" theory there is an inverse relationship between the number of children in a family, and spending per child. We test whether this has led to significant differences in the height, weight and BMI of only-children compared with children with siblings in China using 4414 observations derived from four recent waves (2004, 2006, 2009, and 2011) of the China Health and Nutrition Survey. We use propensity score matching and instrumental variables to control for the possible endogeneity of the number of siblings. Results show that only-children are significantly heavier (1.88 %-3.86 %), and have higher BMI (2.59 %-3.50 %). Moreover, they are more likely to be obese than children with siblings (2.33 %-3.00 %). Further analysis shows that these differences in health outcomes might be attributable to higher consumption of animal-source food (23.90-27.13 g), a higher frequency of eating western fast food (0.48-0.70 times/3-month) and drinking sweetened soft drinks (0.29-0.36 times/month), a higher share of meals eaten away from home (4.67 %-5.31 %), and more sedentary activity (20.04-34.35 minutes/week) by only children. Our study indicates that the growing share of only children due to China's family planning policies also contributes to the increasing prevalence of overweight and obesity in China. This policy has been eased in recent years, which might slow the increase in the prevalence of overweight and obesity and thus reduce the corresponding health burden for Chinese society as a whole.
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Affiliation(s)
- Xu Tian
- China Center for Food Security Studies, Nanjing Agricultural University, 1# Weigang, Xuanwu District, Nanjing, China.
| | - Stephan von Cramon-Taubadel
- Department of Agricultural Economics and Rural Development, University of Göttingen, Wilhelm-Weber-Str. 2, Goettingen, 37073, Germany.
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Damen FWM, Steenbekkers BLPA, Fogliano V, Luning PA. Youngest versus oldest child: why does mothers' snack choice differ? Appetite 2020; 144:104455. [PMID: 31521767 DOI: 10.1016/j.appet.2019.104455] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 11/28/2022]
Abstract
Young children frequently consume energy dense snacks, which is one of the factors contributing to childhood overweight. The consumption of more healthy snacks could help in meeting the dietary intake requirements of children. Previous research suggested that mothers of first children showed more health-conscious food behavior compared to mothers of not-first children. However, what is missing from earlier research is an in-depth exploration of differences in considerations to choose a snack and the reasons connected. Therefore, this study aims to characterize differences in mothers' snack choice for their youngest child at 2-3 years and their oldest child when he/she was of the same age. Moreover, this study aims to identify reasons for these differences. A grounded theory approach was used for data collection and analysis. Semi-structured interviews were carried out with 17 Dutch mothers with two or three children. All mothers indicated differences between snacks provided to their youngest child (2-3 years) and their oldest child when it was of the same age. Most frequently mentioned differences were youngest children receive unhealthy snacks at a younger age, the structure regarding snack providing is more fixed, and that youngest children receive less age-specific snacks. Most frequently mentioned reasons for these differences were role-modelling, novelty of the first-born, availability of other types of snacks at home, and school hours of the oldest child. The study provided insights into the possible role of siblings in shaping snack consumption. Results might be relevant for the development of intervention strategies to increase mothers' awareness and to help to meet children's dietary requirements.
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Affiliation(s)
- Femke W M Damen
- Food Quality and Design Group, Department of Agrotechnology and Food Sciences, Wageningen University & Research, P.O. Box 17, Wageningen, Netherlands.
| | - Bea L P A Steenbekkers
- Food Quality and Design Group, Department of Agrotechnology and Food Sciences, Wageningen University & Research, P.O. Box 17, Wageningen, Netherlands
| | - Vincenzo Fogliano
- Food Quality and Design Group, Department of Agrotechnology and Food Sciences, Wageningen University & Research, P.O. Box 17, Wageningen, Netherlands
| | - Pieternel A Luning
- Food Quality and Design Group, Department of Agrotechnology and Food Sciences, Wageningen University & Research, P.O. Box 17, Wageningen, Netherlands
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Tian X, Wang H. The Impact of Having One Parent Absent on Children' Food Consumption and Nutrition in China. Nutrients 2019; 11:E3077. [PMID: 31861207 PMCID: PMC6950458 DOI: 10.3390/nu11123077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 11/21/2022] Open
Abstract
The rapid economic and social development in the past decades has greatly increased the societal acceptance of divorce and non-marital pregnancies in China, which leads to a soaring number of single-parent children. This paper aimed to investigate the impact of having one parent absent on children' food consumption and nutrition status. We extracted 1114 children from a longitudinal household survey data in China, all of which were observed twice. Using the Propensity Score Matching and Difference-in-Difference methods, we found that being raised by one parent does not have a negative effect on children's food consumption and nutrition intake. On the contrary, single-parent families tend to provide more food to their children as a compensation for the absence of one parent and this compensation effect offsets the negative impact caused by declined family income. Particularly, urban, rich families had stronger compensation effect than other families with low and middle incomes.
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Affiliation(s)
- Xu Tian
- China Center for Food Security Studies & College of Economics and Management, Nanjing Agricultural University, Nanjing 210095, China;
| | - Hui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 210095, China
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Abstract
OBJECTIVE To identify whether picky eating during childhood is associated with dietary intake, weight status and disordered eating behaviour during young adulthood. DESIGN A population-based study using data from young adults who responded online or by mail to the third wave of the Project EAT (Eating and Activity in Teens and Young Adults) study in 2008-2009. Participants retrospectively reported the extent to which they were a picky eater in childhood, sociodemographic characteristics, disordered eating behaviours, usual dietary intake, and weight and height. SETTING Participants were initially recruited in the Minneapolis/St. Paul metropolitan area of Minnesota, USA, in 1998-1999. PARTICIPANTS The analytic sample included 2275 young adults (55 % female, 48 % non-Hispanic White, mean age 25·3 (sd 1·6) years). RESULTS Young adults who reported picky eating in childhood were found to currently have lower intakes of fruit, vegetables and whole grains, and more frequent intakes of snack foods, sugar-sweetened beverages and foods from fast-food restaurants. No associations were observed between picky eating in childhood and young adults' weight status, use of weight-control strategies or report of binge eating. CONCLUSIONS While young adults who report picky eating during childhood are not at higher risk for disordered eating, those who were picky eaters tend to have less healthy dietary intake. Food preferences and dietary habits established by picky eaters during childhood may persist into adulthood.
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Chen BB, Zhou N. The Weight Status of Only Children in China: The Role of Marital Satisfaction and Maternal Warmth. JOURNAL OF CHILD AND FAMILY STUDIES 2019; 28:2754-2761. [DOI: 10.1007/s10826-019-01455-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Griauzde DH, Lumeng JC, Shah PE, Kaciroti N. Lower Body Mass Index Z-Score Trajectory During Early Childhood After the Birth of a Younger Sibling. Acad Pediatr 2019; 19:51-57. [PMID: 29920332 DOI: 10.1016/j.acap.2018.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 06/06/2018] [Accepted: 06/09/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The objectives of this study were to examine differences in body mass index z-score (BMIZ) trajectory during early childhood among children with a younger sibling compared with those without and to test potential mediators. METHODS This longitudinal cohort study included 6050 participants of the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). Focal children's weight, height, sibship status, screen time, active play time, family dinner frequency, and diet quality were assessed at 9 months, 24 months, preschool, and kindergarten when available. A piecewise linear regression model was used to examine the association between sibling birth and focal child's subsequent BMIZ trajectory to kindergarten. Mediation by screen time, active play time, family dinner frequency, and diet quality was tested. RESULTS BMIZ trajectory was lower among children who had a new sibling join the family before kindergarten compared to children who did not have a new sibling join the family by kindergarten. The association was strongest when new sibship occurred when the focal child was 48 to 66 months (b = -0.026, P = .044). The association was not mediated by screen time, active play time, family dinner frequency, or diet quality. CONCLUSION Among a nationally representative cohort of US children, new sibship before kindergarten was associated with a lower BMIZ trajectory. Several common obesogenic risk factors did not explain the association.
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Affiliation(s)
- Dina H Griauzde
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System; Department of Internal Medicine.
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich.; Department of Pediatrics and Communicable Diseases (JC Lumeng and PE Shah), Medical School, University of Michigan, Center for Human Growth and Development , University of Michigan; Department of Nutritional Sciences (JC Lumeng)
| | - Prachi E Shah
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich.; Department of Pediatrics and Communicable Diseases (JC Lumeng and PE Shah), Medical School, University of Michigan, Center for Human Growth and Development , University of Michigan
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Mich.; Department of Biostatistics , School of Public Health, University of Michigan, Ann Arbor, Mich
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Kracht CL, Swyden KJ, Weedn AE, Salvatore AL, Terry RA, Sisson SB. A Structural Equation Modelling Approach to Understanding Influences of Maternal and Family Characteristics on Feeding Practices in Young Children. Curr Dev Nutr 2018; 2:nzy061. [PMID: 30283915 PMCID: PMC6163107 DOI: 10.1093/cdn/nzy061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/11/2018] [Accepted: 07/09/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The family environment is influential for a child's healthy development through parent and sibling influences on feeding practices. Multiple-child households may protect against unhealthy feeding practices, but additional children contribute to higher maternal stress. Households of married parents may decrease maternal stress by sharing parental demands. OBJECTIVE We aimed to evaluate the collective influence of maternal stress, marital status, and number of children on feeding practices. METHODS Mothers of 2- to 5-y-old children (n = 278) were recruited mainly on a university campus and completed an online survey to examine associations between maternal stress (Depression, Anxiety, Stress Scale), number of children, marital status, and feeding practices (restriction and pressure to eat; Child Feeding Questionnaire). Relationships were examined through the use of multivariate regression and structural equation modelling. RESULTS A mainly married (85%) and Caucasian (73%) sample participated, with most mothers reporting multiple children [2 children (45%) or ≥3 children (24%)]. Marital status was not associated with either feeding practice, i.e., restriction and pressure to eat (P < 0.05). In adjusted models, maternal stress (β = 0.04, SE = 0.01, P = 0.003) and number of children (β = 0.24, SE = 0.08, P = 0.003) in the household individually contributed to higher feeding restriction; their interaction resulted in lower feeding restriction (β = -0.01, SE = 0.05, P = 0.005). In stratified models, maternal stress was associated with restriction in single-child households (β = -0.03, SE = 0.009, P = 0.002), but not multiple-child households (β = -0.004, SE = 0.005, P = 0.40). CONCLUSIONS Number of children had no effect on feeding practices individually, but may contribute to a less restrictive feeding environment. Additional investigation into creating less stressful and more positive feeding environments for all mothers can lead to healthier mothers and families.
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Affiliation(s)
- Chelsea L Kracht
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Katheryn J Swyden
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Ashley E Weedn
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Alicia L Salvatore
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Robert A Terry
- Department of Psychology, University of Oklahoma, Norman, OK
| | - Susan B Sisson
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
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DeJesus JM, Gelman SA, Viechnicki GB, Appugliese DP, Miller AL, Rosenblum KL, Lumeng JC. An investigation of maternal food intake and maternal food talk as predictors of child food intake. Appetite 2018; 127:356-363. [PMID: 29758271 PMCID: PMC6768399 DOI: 10.1016/j.appet.2018.04.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 04/16/2018] [Accepted: 04/23/2018] [Indexed: 01/13/2023]
Abstract
Though parental modeling is thought to play a critical role in promoting children's healthy eating, little research has examined maternal food intake and maternal food talk as independent predictors of children's food intake. The present study examines maternal food talk during a structured eating protocol, in which mothers and their children had the opportunity to eat a series of familiar and unfamiliar vegetables and desserts. Several aspects of maternal talk during the protocol were coded, including overall food talk, directives, pronoun use, and questions. This study analyzed the predictors of maternal food talk and whether maternal food talk and maternal food intake predicted children's food intake during the protocol. Higher maternal body mass index (BMI) predicted lower amounts of food talk, pronoun use, and questions. Higher child BMI z-scores predicted more first person pronouns and more wh-questions within maternal food talk. Mothers of older children used fewer directives, fewer second person pronouns, and fewer yes/no questions. However, maternal food talk (overall and specific types of food talk) did not predict children's food intake. Instead, the most robust predictor of children's food intake during this protocol was the amount of food that mothers ate while sitting with their children. These findings emphasize the importance of modeling healthy eating through action and have implications for designing interventions to provide parents with more effective tools to promote their children's healthy eating.
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Affiliation(s)
- Jasmine M DeJesus
- Department of Psychology, University of Michigan, United States; Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, United States.
| | - Susan A Gelman
- Department of Psychology, University of Michigan, United States
| | | | | | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, United States
| | | | - Julie C Lumeng
- Department of Pediatrics and Communicable Diseases, School of Medicine, University of Michigan, United States; Department of Nutritional Sciences, School of Public Health, University of Michigan, United States
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Cai L, Lin L, Dai M, Chen Y, Li X, Ma J, Jing J. One-child policy, weight status, lifestyles and parental concerns in Chinese children: a nationwide cross-sectional survey. Eur J Clin Nutr 2018; 72:1150-1158. [DOI: 10.1038/s41430-018-0178-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 03/17/2018] [Accepted: 04/08/2018] [Indexed: 11/09/2022]
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Fernandez C, DeJesus JM, Miller AL, Appugliese DP, Rosenblum KL, Lumeng JC, Pesch MH. Selective eating behaviors in children: An observational validation of parental report measures. Appetite 2018; 127:163-170. [PMID: 29729326 DOI: 10.1016/j.appet.2018.04.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 04/24/2018] [Accepted: 04/30/2018] [Indexed: 01/13/2023]
Abstract
Selective eating in children is commonly measured by parental report questionnaires, yet it is unknown if parents accurately estimate their child's selective eating behavior. The objectives of this study were to test the validity and stability of two measures of selective eating using observed child behavior. Low-income mother-child dyads participated in a videotaped laboratory eating protocol at two time points (baseline: mean child age = 5.9 years; follow-up: mean child age = 8.6 years), during which they were presented with a familiar and an unfamiliar vegetable. Videos were reliably coded for child selective eating behaviors: amount consumed, child hedonic rating of vegetables, child compliance with maternal prompts to eat, latency to first bite, number of bites, and negative utterances. Mothers completed the Child Eating Behavior Questionnaire Food Fussiness (CEBQ FF) scale and the Food Neophobia Scale (FNS) at both time points. Questionnaire validity, stability of measured behaviors, and discriminant validity of questionnaires were examined in the full sample. CEBQ FF scores and FNS scores were both inversely correlated with the quantity consumed, child hedonic rating, and compliance with prompts to eat for both familiar and unfamiliar vegetables at baseline and at follow up. CEBQ FF and FNS scores were inversely correlated with number of bites (for both foods), positively correlated with latency to first bite (for both foods), and inversely correlated with child negative utterances (for the familiar food only). Notably, FNS scores correlated with observed behavior for both familiar and unfamiliar foods, rather than demonstrating a specific association with unfamiliar foods only. This study supports the validity of the CEBQ FF and FNS in low-income early school-aged children.
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Affiliation(s)
- Carmen Fernandez
- University of Michigan Medical School, M4101 Medical Science Building I - C Wing, 1301 Catherine Street, Ann Arbor, MI 48109-5624, USA.
| | - Jasmine M DeJesus
- Center for Human Growth and Development, University of Michigan, Department of Pediatrics and Communicable Diseases, University of Michigan, and the Department of Psychology, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109-0406, USA.
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, and the Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, Ann Arbor, MI 48109-0406, USA.
| | | | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, and Department of Psychiatry, Medical School, University of Michigan, 4250 Plymouth Road, Rachel Upjohn Building, Ann Arbor, MI 48109, USA.
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Department of Nutritional Sciences, School of Public Health, University of Michigan, and Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, University of Michigan, 300 N. Ingalls Street, 10th Floor, Ann Arbor, MI 48109, USA.
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics and Communicable Diseases, University of Michigan, and Center for Human Growth and Development, University of Michigan, 300 N. Ingalls Street, 1109 SE, Ann Arbor, MI 48109-5456, USA.
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Min J, Xue H, Wang VHC, Li M, Wang Y. Are single children more likely to be overweight or obese than those with siblings? The influence of China's one-child policy on childhood obesity. Prev Med 2017; 103:8-13. [PMID: 28739490 DOI: 10.1016/j.ypmed.2017.07.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 06/06/2017] [Accepted: 07/14/2017] [Indexed: 11/17/2022]
Abstract
China's one-child policy (1979-2015) has affected Chinese parenting practices and children's health behaviors and also may have contributed to increased childhood obesity. However, very limited research has investigated the association between one-child policy and childhood obesity. We examined characteristics of single-child families and the influence of one-child policy (indicated by single-child status) on children's weight status and related health behaviors. Data from children aged 6-18years old in the 2011 (n=1580) and 2000 (n=2317) China Health and Nutrition Survey were cross-sectionally analyzed with multilevel models. From 2000 to 2011, the rates about doubled for being a single-child (30.1% to 57.0%) and being overweight or obese (OWB, 6.6% to 16.5%) along with urbanization (27.5% to 37.1%). Single-child families had higher levels of parental education, household income and urban residence than families with ≥ two children (p<0.05). Compared to the children with siblings, single children were more likely to be OWB; the association became stronger over time (OR=4.5 (1.7-12.4) in 2011 and 1.7 (1.0-2.8) in 2000). Also, single children had less recreational screen time, but similar physical activity levels; however single urban children were more likely to have excess total energy intake (OR=5.70 (1.58-20.60)) than those with siblings. Being single-child is about four times more likely to be overweight/obesity than those having siblings, and the association became stronger over time in China. China's one-child policy might have contributed to its rising childhood obesity rates. Obesity intervention programs may need to account for the influence of the one-child policy in China.
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Affiliation(s)
- Jungwon Min
- Systems-oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, USA; Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Hong Xue
- Systems-oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, USA; Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Vivian H C Wang
- Wagner School of Public Service, New York University, USA; Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Miao Li
- Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Youfa Wang
- Systems-oriented Global Childhood Obesity Intervention Program, Fisher Institute of Health and Well-being, College of Health, Ball State University, USA; Systems-oriented Global Childhood Obesity Intervention Program, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY, USA; Department of Nutrition and Health Sciences, College of Health, Ball State Universty, USA.
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Hammad SS, Berry DC. The Child Obesity Epidemic in Saudi Arabia: A Review of the Literature. J Transcult Nurs 2016; 28:505-515. [PMID: 27655934 DOI: 10.1177/1043659616668398] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To examine prevalence, nutrition and activity, and overweight and obesity prevention and management in Saudi Arabia. DESIGN Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria, PubMed, Web of Science, PyschINFO, Global Health, Family Studies Worldwide, Middle Eastern Studies, and Sociological Abstracts was searched from January 1, 2003 to January 31, 2016. Inclusion criteria included peer-reviewed articles published in Arabic and English that focused on prevalence, overweight or obesity in children 2 to 20 years of age, body mass index percentile, and interventions. FINDINGS Three themes were identified: epidemiological features, where the eastern region had the highest prevalence of overweight and obesity, risk factors, which included higher parental education, and lifestyle factors, which included increased consumption of calorie-dense food and a sedentary lifestyle. CONCLUSION Childhood obesity is increasing in Saudi Arabia at an alarming rate. IMPLICATIONS FOR PRACTICE Practitioners need to consider the cultural influences of the increasing obesity epidemic in Saudi Arabia.
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Affiliation(s)
- Sama S Hammad
- 1 The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Diane C Berry
- 1 The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Brown CL, Vander Schaaf EB, Cohen GM, Irby MB, Skelton JA. Association of Picky Eating and Food Neophobia with Weight: A Systematic Review. Child Obes 2016; 12:247-62. [PMID: 27135525 PMCID: PMC4964761 DOI: 10.1089/chi.2015.0189] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Picky eating and food neophobia are common during childhood. Childhood eating behaviors are often predictive of adult eating behaviors. OBJECTIVES Determine if childhood picky eating or food neophobia is associated with childhood weight status, or with becoming underweight, overweight, or obese later in childhood. DATA SOURCES We identified relevant studies from searches of PubMed, PsycINFO, and NEOHAL, as well as citations from identified studies. Study Eligibility Criteria and Participants: Inclusion criteria were original research articles examining a relationship between picky eating and/or food neophobia with childhood weight status. We summarized definitions and prevalence of picky eating or food neophobia and association with weight status. STUDY APPRAISAL Two independent investigators assessed bias and confounding using the Agency for Healthcare Research and Quality's RTI Item Bank. RESULTS Forty-one studies met inclusion criteria. Picky eating was defined inconsistently, and a large variation in prevalence was found (5.8%-59%). Food neophobia was consistently defined as an unwillingness to try new foods, with a prevalence between 40% and 60%. No association existed between childhood weight status and food neophobia, and results were unclear for picky eating. LIMITATIONS Risk of bias and confounding were moderate. Parental report was commonly used to assess picky eating, height, and weight and parental weight, feeding styles, and community characteristics were infrequently considered. CONCLUSIONS AND IMPLICATIONS Heterogeneous definitions used for picky eating led to a wide range of reported prevalence and an unclear relationship with weight. Consistent definitions and an improved understanding of such a relationship could help clinicians provide appropriate anticipatory guidance.
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Affiliation(s)
- Callie L. Brown
- Department of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emily B. Vander Schaaf
- Department of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Gail M. Cohen
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC
| | - Megan B. Irby
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC
| | - Joseph A. Skelton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC.,Brenner FIT Program, Brenner Children's Hospital, Winston-Salem, NC.,Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
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Mosli RH, Kaciroti N, Corwyn RF, Bradley RH, Lumeng JC. Effect of Sibling Birth on BMI Trajectory in the First 6 Years of Life. Pediatrics 2016; 137:e20152456. [PMID: 26969271 PMCID: PMC4811309 DOI: 10.1542/peds.2015-2456] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE This study examined the longitudinal association between birth of a sibling and changes in body mass index z-score (BMIz) trajectory during the first 6 years of life. METHODS Children (n = 697) were recruited across 10 sites in the United States at the time of birth. Sibship composition was assessed every 3 months. Anthropometry was completed when the child was age 15 months, 24 months, 36 months, 54 months, and in first grade. Children were classified based on the timing of their sibling's birth. A piecewise quadratic regression model adjusted for potential confounders examined the association of the birth of a sibling with subsequent BMIz trajectory. RESULTS Children whose sibling was born when they were 24 to 36 months or 36 to 54 months old, compared with children who did not experience the birth of a sibling by first grade, had a lower subsequent BMIz trajectory and a significantly lower BMIz at first grade (0.27 vs 0.51, P value = 0.04 and 0.26 vs 0.51, P value = 0.03, respectively). Children who did not experience the birth of a sibling by the time they were in first grade had 2.94 greater odds of obesity (P value = 0.046) at first grade compared with children who experienced the birth of a sibling when they were between 36 to 54 months old. CONCLUSIONS A birth of a sibling when the child is 24 to 54 months old is associated with a healthier BMIz trajectory. Identifying the underlying mechanism of association can help inform intervention programs.
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Affiliation(s)
- Rana H Mosli
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA; Department of Nutritional Sciences, School of Public Health,
| | | | - Robert F Corwyn
- Department of Psychology, University of Arkansas at Little Rock, Little Rock, Arkansas
| | - Robert H Bradley
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Julie C Lumeng
- Department of Nutritional Sciences, School of Public Health, Center for Human Growth and Development, and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan
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Maternal encouragement and discouragement: Differences by food type and child weight status. Appetite 2016; 101:15-22. [PMID: 26924561 DOI: 10.1016/j.appet.2016.02.146] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 01/11/2016] [Accepted: 02/21/2016] [Indexed: 01/26/2023]
Abstract
Childhood obesity prevention practice guidelines recommend that parents encourage the intake of certain types of foods and discourage the intake of others. It is unknown if parents of children of different weight statuses encourage or discourage their child's intake differently based on food type. The objective of this study was to determine the association of child weight status with maternal encouragement and discouragement of for four different types of food. A total of 222 mother-child dyads were video-taped during the standardized, sequential presentation of four foods to both participants: cupcakes (familiar dessert), green beans (familiar vegetable), halva (unfamiliar dessert) and artichoke (unfamiliar vegetable). Mother's encouragements and discouragements of child intake were reliably coded for each food type. Poisson regression models were used to test the independent association of child weight status (normal weight, overweight and obese) with encouragement and discouragement for each food type. Mothers of an obese, vs. normal or overweight child, had lower rates of encouragement for a familiar dessert (p = 0.02), and a higher rates of discouragements for a familiar dessert (p = 0.001), a familiar vegetable (p = 0.01), and an unfamiliar vegetable (p = 0.001). There were no differences in encouragements or discouragements between mothers of an overweight, vs. obese child, for any of the 4 food types. Mothers of obese children may alter their feeding behavior differentially based on food type. Future work should examine how interventions promoting maternal encouragement or discouragement of different food types impact child weight status.
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Mosli RH, Miller AL, Peterson KE, Lumeng JC. Sibling feeding behavior: Mothers as role models during mealtimes. Appetite 2015; 96:617-620. [PMID: 26585632 DOI: 10.1016/j.appet.2015.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/30/2015] [Accepted: 11/06/2015] [Indexed: 11/29/2022]
Abstract
Siblings may act as caregivers and role models during mealtimes, and develop caregiving skills by observing and imitating the behavior of their mothers. The objective of this study was to examine the association between maternal feeding behaviors and encouragements to eat delivered from the sibling to the index child during mealtimes. Index children aged 4-8 years (n = 69) were videotaped while eating a routine evening meal at home with one sibling present. Encouragements to eat delivered from the sibling to the index child were coded from the videotapes. Mothers completed the Child Feeding Questionnaire and the Caregiver's Feeding Styles Questionnaire. Poisson regression was used to examine the association of maternal Pressure to Eat, Restriction, Monitoring, Verbal Direction, and Coercion with number of encouragements to eat delivered from the sibling to the index child. Models were adjusted for index child's age, sex, and race/ethnicity, and maternal education. Results showed that maternal Pressure to Eat (Rate Ratio (RR): 1.39, 95% confidence interval (CI): 1.19, 1.69), Restriction (RR: 1.31, 95% CI: 1.07, 1.60), Verbal Direction (RR: 2.04, 95% CI: 1.68, 2.47), and Coercion (RR: 1.58, 95% CI: 1.29, 1.92) were each positively associated with the number of encouragements to eat delivered from the sibling to the index child. Maternal Monitoring was not associated with the number of encouragements to eat delivered from the sibling to the index child (RR: 0.92, 97% CI: 0.78, 1.09). Findings suggest that maternal behavior during mealtimes may affect the index child indirectly by shaping the behavior of siblings. Since controlling feeding behaviors have been associated with greater child obesity risk, future studies may evaluate the compounded effect of experiencing controlling feeding behaviors from both mothers and siblings.
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Affiliation(s)
- Rana H Mosli
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA, Saudi Arabia.
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA.
| | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
| | - Julie C Lumeng
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA.
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