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Werner LM, Mallan KM. Associations between restrictive feeding practices and children's dietary intake: Systematic review and meta-analyses. Appetite 2024; 200:107508. [PMID: 38795944 DOI: 10.1016/j.appet.2024.107508] [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: 02/15/2024] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Parents' attempt to limit or restrict children's intake of 'unhealthy' or discretionary foods has been widely considered as a counterproductive feeding practice associated with poorer dietary outcomes, but empirical evidence is varied. AIM The present systematic literature review aimed to investigate the association between parental restriction and children's dietary intake. METHOD Studies were identified through PsycInfo, MEDLINE, CINAHL, Web of Science, and Scopus databases on April 29th, 2022. Included were peer-reviewed, English-language articles published between 2001 and 2022, with an effect size between restriction and children's intake of foods that are 'healthy' (i.e., fruit, vegetables, other general healthy foods) or 'discretionary' (i.e., sweet or savoury energy-dense/nutrient poor foods, high-sugar foods, high-salt/fat foods, and high-energy/sugar-sweetened beverages), or overall diet quality. Risk of bias was assessed using a quality assessment checklist designed to evaluate survey studies. RESULTS Included studies (n = 44) were most often conducted in the USA, cross-sectional, and participants were mothers. Effect sizes (k = 59) from 21 studies were used in nine meta-analyses investigating various healthy and discretionary dietary intake variables. No meta-analytic effects were statistically significant. Qualitative synthesis of effect sizes ineligible for meta-analysis (k = 91) identified patterns of associations between restriction and increased intake of healthy foods, and decreased intake of discretionary foods. CONCLUSIONS Studies used a diverse selection of measures of restriction and dietary intake, limiting the ability of this review to make accurate cross-study comparisons. However, results suggest that instead of restriction being detrimental for children's dietary outcomes, it may be unrelated, or associated with more beneficial dietary outcomes. Research that utilises validated measures of restriction and dietary outcomes and a longitudinal design is needed to clarify this association.
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Affiliation(s)
- Lilly M Werner
- School of Behavioural and Health Sciences, Melbourne, Australian Catholic University, Australia
| | - Kimberley M Mallan
- School of Behavioural and Health Sciences, Brisbane, Australian Catholic University, Australia.
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2
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Pierce TB, Aragón MC, Auld G, Barale KV, Hughes SO, Power TG, Lanigan JD, Parker L, Baker SS. Parents Report Positive Changes in Parental Feeding Practices 12 Months After Intervention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:489-498. [PMID: 38661626 DOI: 10.1016/j.jneb.2024.03.012] [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: 09/27/2023] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE Determine self-reported parental feeding behavior changes and perspectives on parental feeding intervention at 12-month follow-up. METHODS Telephone focus groups using a 2 × 2 design (English/Spanish × in-class or online) with Expanded Food and Nutrition Education Program participants (n = 37) with children 2-8 years and high exposure to the Food, Feeding, and Your Family intervention (7 lessons). Researchers (n = 3) independently identified themes. RESULTS Parental behavior changes that (1) positively influenced children's diets, (2) involved children in food-related activities, (3) eased stressful situations around food, (4) led to healthier food choices, and (5) saved money when food shopping. Commonly implemented practices included establishing structured mealtime routines, introducing new foods multiple times, and encouraging children's eating competence. Online participants noted materials were easily accessible via text messages. CONCLUSIONS AND IMPLICATIONS Incorporating parental feeding content (in-class or online) into nutrition education interventions, such as the Expanded Food and Nutrition Education Program, supports developing positive parental feeding behaviors in families with low income.
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Affiliation(s)
- Theresa B Pierce
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | | | - Garry Auld
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Karen V Barale
- Washington State University Extension, Pierce County, Tacoma, WA
| | - Sheryl O Hughes
- US Department of Agriculture, Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA
| | - Jane D Lanigan
- Department of Human Development, Washington State University, Pullman, WA
| | | | - Susan S Baker
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO.
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3
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Xie Q, Yong C, Xiang C, Xi Y, Huo J, Liang J, Zou H, Pan Y, Wu M, Lin Q. The Impact of Caregiver Pressure to Eat on Food Neophobia in Children with Autism Spectrum Disorder: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:528. [PMID: 38790525 PMCID: PMC11119268 DOI: 10.3390/children11050528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/17/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
(1) Background: With autistic children's high pervasiveness of eating problems and inappropriate feeding behaviors by their caregivers, this study wanted to inspect the connection between caregivers' pressure to eat and food neophobia in these children. (2) Methods: Cross-sectional overview of 160 guardians of kids aged 2 to 7 years. After one-on-one questioning by the researcher, the collected information on the socio-demographic characteristics of the children with autism, caregiver feeding behavior, and new food neophobia (FN) scores was entered into the Questionnaire Star system. (3) Results: The mean FN score was 25.56 ± 6.46. The caregiver's pressure to eat positively related to children's FN (β = 0.164 95% CI, 0.078, 2.163). In these children, we found a negative correlation between FN score and the frequency of vegetable intake (p ≤ 0.001), fruit intake (p ≤ 0.05), aquatic product intake (p ≤ 0.05), and dietary diversity score (p ≤ 0.01), and positively correlated with the frequency of snack intake (p ≤ 0.05). (4) Conclusions: Caregiver pressure to eat was positively associated with high levels of FN in Chinese kids with ASD, which in turn negatively impacted dietary quality. To improve eating habits, caregivers should reconsider their feeding strategies and avoid using forceful methods to ease food neophobia in these children.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, 172 Tongzipo Road, Changsha 410031, China; (Q.X.); (C.Y.); (C.X.); (Y.X.); (J.H.); (J.L.); (H.Z.); (Y.P.); (M.W.)
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4
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Barton JM, McMath AL, Montgomery SP, Donovan SM, Fiese BH. Longitudinal changes in home food availability and concurrent associations with food and nutrient intake among children at 24-48 months. Public Health Nutr 2024; 27:e62. [PMID: 38305130 PMCID: PMC10897571 DOI: 10.1017/s1368980024000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 01/11/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES To describe changes in home food availability during early childhood, including modified, developmentally sensitive obesogenic scores, and to determine whether home food availability is associated with food and nutrient intakes of children concurrently, over time. DESIGN Data were drawn from the STRONG Kids 2 longitudinal, birth cohort to achieve the study objectives. Home food availability was assessed with the Home Food Inventory (HFI) and included fifteen food groups (e.g. fruit and vegetables) and three obesogenic scores (one original and two modified). Food and nutrient intakes were measured using the Block FFQ and included twenty-seven food groups and eighteen nutrients (e.g. vitamins A and C, protein). HFI and FFQ were completed by trained researchers or mothers, respectively, at 24, 36 and 48 months. Repeated-measures ANOVA and Spearman's correlations were used to achieve the study objectives. SETTING Central Illinois, USA. PARTICIPANTS Participants were 468 children at 24, 36 and 48 months of age. RESULTS Availability of less nutritious foods and obesogenic foods and beverages increased as children aged, and availability of both nutritious and less nutritious foods were associated with child food and nutrient intake. The three obesogenic scores demonstrated similar, positive associations with the intake of energy, saturated fat, added sugars and kilocalories from sweets. CONCLUSION These findings offer novel insight into changes in home food availability and associations with food and nutrient intake during early childhood. Additional attention is needed examining antecedents (e.g. built environments, purchasing behaviours) and consequences (e.g. child diet quality and weight) of home food availability.
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Affiliation(s)
- Jennifer M Barton
- Family Resiliency Center, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA, USA
| | - Arden L McMath
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Stewart P Montgomery
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign, Urbana, IL, USA
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Schratz LM, Larkin O, Dos Santos N, Martin C. Caregiver Influences on Eating Behaviors in Children: An Opportunity for Preventing Obesity. Curr Atheroscler Rep 2023; 25:1035-1045. [PMID: 38032429 DOI: 10.1007/s11883-023-01171-6] [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] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE OF REVIEW This review seeks to define caregiver practices that impact childhood eating behaviors and identify ways to utilize these relationships to prevent childhood obesity. RECENT FINDINGS Childhood obesity, which correlates with adult obesity and increased cardiovascular risk, is increasing in prevalence and severity. Caregivers play a significant role in shaping a child's eating behaviors and their predisposition to obesity. Maternal influences during pregnancy and infancy impact a child's future food preferences. Caregiver feeding styles (authoritarian, authoritative, indulgent, and uninvolved) are associated with distinct effects on children's eating behaviors and self-regulation. Authoritative feeding styles promote child autonomy while setting boundaries in the feeding environment. Early caregiver education and coaching regarding nutrition and feeding practices is beneficial to establishing healthy eating behaviors for children. Various caregivers, including parents, grandparents, siblings, teachers, and others, influence a child's eating habits at different stages of development. These caregivers can both positively and negatively impact a child's diet. Comprehensive interventions involving these various caregivers to promote healthy eating practices in children is ideal. Such interventions should be sensitive to cultural and environmental factors. Childhood obesity is a complex issue with long-term health effects. Early intervention using comprehensive approaches including all caregivers, community support, and public policies to address the social determinants of health will be beneficial. Future research should focus on valid outcome measures and equitable interventions that encompass all aspects of a child's life.
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Affiliation(s)
- Lorraine M Schratz
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA.
| | - Olivia Larkin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Nilse Dos Santos
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Christine Martin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
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Anderson H, Ferrante MJ, Tauriello S, Anzman-Frasca S. Differences in food parenting at home versus restaurants among parents of 3-to-8-year-old children. Appetite 2023; 183:106456. [PMID: 36640943 DOI: 10.1016/j.appet.2023.106456] [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: 09/09/2022] [Revised: 11/17/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
Indulgent parent feeding styles have been linked to less healthful eating behaviors and higher BMI among children. Restaurants are becoming a frequent eating environment for children. Frequent intake of food from restaurants has been associated with increased weight status, making restaurants a target for childhood obesity prevention efforts. Currently, little research has considered parent feeding styles in restaurants and how they might differ from the home setting. Given the increased frequency of children's restaurant consumption, examining parent feeding styles in restaurants may contribute to future research in this area. Therefore, the objective of this study was to examine parent feeding styles at home and in restaurants. Parents whose 3-to-8-year-old children dined out regularly completed a one-time, online survey in February/March 2022. The Caregiver's Feeding Style Questionnaire assessed parent feeding styles at home and in restaurants. Differences in feeding styles were examined across settings. Indulgent feeding styles were most common overall. Parents (n = 117; 92% mothers; 85% white; 61% reported household income > $75,000/year) reported higher demandingness at home (M = 2.6 ± 0.5) compared to restaurants (M = 2.4 ± 0.5; t(116) = 6.7, P < 0.001). Parents were more likely to use indulgent feeding styles (X2 = 11.6, P < 0.001) and less likely to use authoritarian feeding styles (X2 = 4.6, P < 0.05) in restaurants compared to the home, suggesting parent feeding styles are less structured in restaurants. Results may have implications for future healthy eating interventions in away-from-home contexts.
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Affiliation(s)
- Hannah Anderson
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Mackenzie J Ferrante
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Sara Tauriello
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, USA.
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Associations between Emotion Regulation, Feeding Practices, and Preschoolers' Food Consumption. Nutrients 2022; 14:nu14194184. [PMID: 36235837 PMCID: PMC9571169 DOI: 10.3390/nu14194184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/19/2022] [Accepted: 10/01/2022] [Indexed: 11/05/2022] Open
Abstract
Previous research identified emotion dysregulation, non-responsive feeding practices, and unhealthy food consumption as risk factors for childhood obesity. However, little is known about the relationships between these factors. This study examined associations between children’s emotion regulation, parental feeding practices, and children’s food consumption. The sample consisted of 163 mothers of children aged 3–5 years. Mothers completed the Emotion Regulation Checklist, the Child Feeding Questionnaire, and the Child Health Section from the Parent Interview of the Early Childhood Longitudinal Study-B to assess model variables. Results showed that healthy food consumption was associated with higher emotion regulation abilities, higher monitoring, and lower pressure to eat. For unhealthy food consumption, the associations were in opposite directions. Higher emotion regulation abilities were also associated with higher monitoring, lower pressure to eat, and lower restriction. For lability, the associations were in opposite directions. Regression analyses revealed that children’s lability, pressure to eat, and monitoring were significant predictors of children’s food consumption. These findings suggest that children’s emotion regulation and feeding practices are important determinants of children’s food consumption. Future longitudinal studies that examine bidirectional associations between children’s emotion regulation, parental feeding practices, children’s food consumption, and potential mechanisms accounting for these associations are needed.
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8
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Schnettler B, Miranda-Zapata E, Orellana L, Saracostti M, Poblete H, Lobos G, Adasme-Berríos C, Lapo M, Beroiza K, Grunert KG. Parents' Modeling During the COVID-19 Pandemic: Influences on Family Members' Diet Quality and Satisfaction With-Food-Related Life in Dual-Earner Parents With Adolescent Children. Front Nutr 2022; 9:902103. [PMID: 35662953 PMCID: PMC9158745 DOI: 10.3389/fnut.2022.902103] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Reciprocal family influences in the food domain have been little explored, particularly during the COVID-19 pandemic. To fill in this gap, this study explored actor and partner effects between parents' food modeling and parents' and their adolescent children's diet quality and satisfaction with food-related life (SWFoL); and the mediating role of diet quality between modeling and SWFoL. This study used a cross-sectional design. A sample of 430 different-sex dual-earner parents and one adolescent child were recruited in Rancagua, Chile, between March and June 2020. Parents answered the modeling dimension of the Comprehensive Feeding Practices Questionnaire. Parents and adolescents answered the Adapted Healthy Eating Index (AHEI) and the SWFoL Scale. Analyses were conducted using the Actor-Partner Interdependence Model and structural equation modeling. Results showed that one parent's modeling enhanced diet quality for themselves, their partner, and the adolescents. Parents' modeling was associated with their own SWFoL, directly and via their own diet quality. There were positive associations between mothers' modeling and adolescents' SWFoL; between mothers' diet quality and fathers' SWFoL; and between mothers' modeling and fathers' SWFoL via the fathers' diet quality. Parents' modeling can improve the three family members' diet quality, while mothers' modeling and diet quality showed to improve fathers' and adolescents' SWFoL.
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Affiliation(s)
- Berta Schnettler
- Facultad de Ciencias Agropecuarias y Forestales, Universidad de La Frontera, Temuco, Chile
- Scientific and Technological Bioresource Nucleus (BIOREN-UFRO), Universidad de La Frontera, Temuco, Chile
- Centro de Excelencia en Psicología Económica y del Consumo, Núcleo de Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Edgardo Miranda-Zapata
- Facultad de Educación, Centro de Investigación Escolar y Desarrollo (Cied-UCT), Universidad Católica de Temuco, Temuco, Chile
- Universidad Autónoma de Chile, Temuco, Chile
| | - Ligia Orellana
- Centro de Excelencia en Psicología Económica y del Consumo, Núcleo de Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
| | - Mahia Saracostti
- Escuela de Trabajo Social, Universidad de Valparaíso, Valparaíso, Chile
| | - Héctor Poblete
- Centro de Excelencia en Psicología Económica y del Consumo, Núcleo de Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
| | - Germán Lobos
- Facultad de Economía y Negocios, Universidad de Talca, Talca, Chile
| | | | - María Lapo
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Katherine Beroiza
- Centro de Excelencia en Psicología Económica y del Consumo, Núcleo de Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
| | - Klaus G. Grunert
- MAPP Centre, Aarhus University, Aarhus, Denmark
- University of Vaasa, Vaasa, Finland
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9
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Trofholz A, Hersch D, Norderud K, Berge JM, Loth K. Changes to the home food environment and parent feeding practices during the COVID-19 pandemic: A qualitative exploration. Appetite 2022; 169:105806. [PMID: 34798223 PMCID: PMC8594079 DOI: 10.1016/j.appet.2021.105806] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 12/29/2022]
Abstract
The COVID-19 pandemic brought about many changes that potentially altered the home food environment, which has been associated with child eating patterns and dietary intake. There is also some evidence that changes due to the COVID-19 pandemic are associated with health behaviors in children, such as an increased intake of high-calorie snack food. The current study aimed to more deeply understand how the COVID-19 pandemic affected the home food environment of meal and snack time routines and parent feeding practices within families of young children. Data for this study are taken from the Kids EAT! Study, a racially/ethnically diverse cohort of families with 2-5 year old children. Qualitative interviews were conducted by phone and video conference with mothers (n = 25) during August/September 2020 and were coded using a hybrid deductive/inductive analysis approach. This allowed coders to identify themes using the interview questions as an organizational template (deductive) while also allowing unique themes to emerge from the qualitative data (inductive). Three overarching themes emerged with multiple sub-themes: 1) Mothers were more directive in the types of food and amounts of food eaten by children; 2) Mothers had less rules around mealtimes; 3) Mothers had increased meal responsibilities. When faced with a change in a structured schedule and increased stress-such as occurred with the COVID-19 pandemic, parents may benefit from advice on how to manage parent feeding practices, including tips on appropriate limit setting, establishing a schedule and routines, and improving accessibility of healthful snacks. Lessons learned during the COVID-19 pandemic may have relevance to other time periods when families face disruptions to routine and during other times of transition.
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Affiliation(s)
- Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Derek Hersch
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Kristin Norderud
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Katie Loth
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
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Othman SI, Fertig A, Trofholz A, Berge JM. How time in the US and race/ethnicity shape food parenting practices and child diet quality. Appetite 2021; 171:105870. [PMID: 34973995 DOI: 10.1016/j.appet.2021.105870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 12/07/2021] [Accepted: 12/12/2021] [Indexed: 11/17/2022]
Abstract
Childhood obesity prevalence is high among children from immigrant/refugee households who live in high-income countries. Poor child dietary intake is a critical risk factor for elevated obesity prevalence and food parenting practices have been found to be associated with child dietary intake and eating behaviors. The main aim of this study was to examine the associations between migrants'/refugees' food parenting practices, the length of residence time in the US, race/ethnicity, and child diet quality. The current study included 577 families from three racial/ethnic groups that include mostly foreign-born parents (Latino, Hmong, and Somali/Ethiopian), and a comparison group of 239 non-Hispanic White families. Results showed that for Latino and Hmong parents, some food parenting practices varied by how long they had lived in the US. For example, more recently moved parents engaged in more non-directive (e.g., avoid buying sweets) practices compared with US-born parents. In contrast, Somali/Ethiopian parents engaged in different food parenting practices than White parents, regardless of time in the US. Results also showed that diet quality among Hmong children was lower if their parents were US-born compared to foreign-born. Future researchers may want to consider studying why some food parenting practices change when parents move to the US and explore whether there is a combination of food parenting practices that are most useful in promoting a healthful child's diet and weight among immigrant and refugee families.
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Affiliation(s)
- Sally I Othman
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 425, Minneapolis, MN, 55414, USA.
| | - Angela Fertig
- University of Minnesota, Humphrey School of Public Affairs, USA
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 425, Minneapolis, MN, 55414, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware St SE, Suite 425, Minneapolis, MN, 55414, USA
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11
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L Deslippe A, M O'Connor T, Brussoni M, C Mâsse L. The association of food parenting practices with adolescents' dietary behaviors differ by youth gender, but not by parent gender. Appetite 2021; 169:105846. [PMID: 34871588 DOI: 10.1016/j.appet.2021.105846] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Parents affect their adolescents' dietary behaviors through food parenting practices both directly and indirectly through adolescents' cognitive factors (self-efficacy, intrinsic or extrinsic motivation). However, it is not known if mothers and fathers use of different food parenting practices similarly influences boys' and girls' dietary behaviors. This study investigated the direct and indirect associations between food parenting practices and adolescents' dietary behaviors (fruits/vegetables and sugar sweetened beverage (SSB)) and whether these associations differed by adolescents' or parents' gender. METHODS Data were obtained from the 2014 Family Life, Activity, Sun, Health, and Eating Study. A sample of 1633 American adolescent-parent dyads (73.7% mothers; 50.4% girls) completed the self-reported tools. Models were stratified by adolescents' gender and differences by parent gender were explored as a moderator. RESULTS Differences did not emerge based on gender of parents. However, associations between food parenting practices and adolescents' dietary behaviors differed by adolescents' gender. Direct associations between autonomy supportive food parenting practices and fruit/vegetable intake (β = 0.18, p < .05) and intrinsic motivations and SSB consumption (β = -0.13, p < .05) were detected only among boys. Direct associations, regardless of gender, were also found including structured food parenting practices and adolescent self-efficacy with their dietary behaviors; controlling food parenting practices with SSB intake; as well as intrinsic and extrinsic motivation with fruit/vegetable intake. Findings from the mediation analyses supported these trends with structured parenting practices displaying similar associations on boys' and girls' dietary behaviors were controlling and autonomy supportive parenting practices have significant indirect associations on boys' dietary behaviors through motivation pathways, but not girls. CONCLUSION Adolescent boys and girls appear to be affected differently by food parenting practices and accounting for these differences may contribute to more effective dietary interventions.
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Affiliation(s)
- Alysha L Deslippe
- School of Population and Public Health, University of British Columbia, 1985 West Mall, Vancouver, British Columbia, V6T 1Z2, Canada; BC Children's Hospital Research Institute, 4500 Oak St, Vancouver, British Columbia, V6H 3N1, Canada.
| | - Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, 1100 Bates St, Room: CNRC-2034, Houston, TX, 77030, United States.
| | - Mariana Brussoni
- School of Population and Public Health, University of British Columbia, 1985 West Mall, Vancouver, British Columbia, V6T 1Z2, Canada; BC Children's Hospital Research Institute, 4500 Oak St, Vancouver, British Columbia, V6H 3N1, Canada; Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.
| | - Louise C Mâsse
- School of Population and Public Health, University of British Columbia, 1985 West Mall, Vancouver, British Columbia, V6T 1Z2, Canada; BC Children's Hospital Research Institute, 4500 Oak St, Vancouver, British Columbia, V6H 3N1, Canada.
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12
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Fiorentino R, Chiarelli F. Treatment of Dyslipidaemia in Children. Biomedicines 2021; 9:1078. [PMID: 34572264 PMCID: PMC8470054 DOI: 10.3390/biomedicines9091078] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/07/2021] [Accepted: 08/21/2021] [Indexed: 01/14/2023] Open
Abstract
Childhood dyslipidaemia is one of the main traditional cardiovascular risk factors that initiate and exacerbate the atherosclerotic process. Healthcare providers may play a key role in the management of children with lipid abnormalities; however, they have to properly evaluate the normal lipid values and know the available treatment options in children and adolescents. Current guidelines recommend healthy behaviours as the first-line treatment for childhood dyslipidaemia. The therapeutic lifestyle changes should focus on dietary modifications, daily physical activity, reduction in body weight and tobacco smoking cessation. Parents play a key role in promoting their children's healthy habits. In children with more severe forms of lipid abnormalities and in those who do not benefit from healthy behaviours, pharmacological therapy should be considered. Safe and effective medications are already available for children and adolescents. Statins represent the first-line pharmacological option, while ezetimibe and bile acid sequestrants are usually used as second-line drugs. Despite their limited use in children, other lipid-lowering agents (already approved for adults) are currently available or under study for certain categories of paediatric patients (e.g., familial hypercholesterolemia). Further studies are needed to evaluate the long-term efficacy, safety and tolerability of novel lipid-lowering drugs, especially in children.
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13
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Koning M, Vink J, Notten N, Gevers D, Eisinga R, Larsen J. Development and preliminary validation of the Adolescent Food Parenting Questionnaire: Parent and adolescent version. Appetite 2021; 167:105618. [PMID: 34348166 DOI: 10.1016/j.appet.2021.105618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 01/03/2023]
Abstract
Suitable instruments for measuring Food Parenting Practices (FPP) among adolescents and their parents that also measure the perception of adolescents about their parent's FPP are rare. The current study describes the development and preliminary testing of a short 16-item Adolescent Food Parenting Questionnaire (AFPQ) for parents (AFPQ-p) and adolescents (AFPQ-a) that may enable future large-scale research on potentially eminent parent-child FPP discrepancy. Participants included 381 parents (73.8 % mothers; Mage 45.9, 26.2% fathers; Mage 49.1) and their adolescent children (aged 12-16) who participated in the Dutch "G(F)OOD together" study. Most parents finished higher professional education (mothers: 44.3 %; fathers: 34.4 %) and performed a paid job of 32 h per week or more (mothers: 22.1 %; fathers: 60.0 %). The theoretical framework of Vaughn (2016) was leading in the development of the AFPQ. Exploratory factor analysis (EFA) was performed on a random split sample of parent-adolescent dyads and confirmatory factor analysis (CFA) was performed on the other half. The EFA in both parent and adolescent samples resulted in a clear 5 factor solution explaining 61.6 % (AFPQ-p) and 64.2 % (AFPQ-a) of the variance respectively, representing the factors Autonomy Support (α = 0.79/.82), Coercive Control (α = 0.85/.83), Snack Structure (α = 0.79/75), Healthy Structure (α = 0.78/74) and Modelling (α = 0.69/85). CFA confirmed good model fit for the AFPQ-p and the AFPQ-a. Associations with adolescent self-reported food intake were in the expected direction, confirming the preliminary convergent validity of the instrument among a moderate to highly educated group of parent-adolescent dyads. Although the AFPQ provides a promising short instrument, future research in more diverse samples is needed to build evidence on the instrument's psychometric characteristics in other groups.
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Affiliation(s)
- Maaike Koning
- Department of Healthy Society, Knowledge Centre for Health and Social Work, Windesheim University of Applied Sciences, Zwolle, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
| | - Jacqueline Vink
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
| | - Natascha Notten
- Department of Healthy Society, Knowledge Centre for Health and Social Work, Windesheim University of Applied Sciences, Zwolle, the Netherlands.
| | - Dorus Gevers
- Maastricht University, Maastricht, the Netherlands.
| | - Rob Eisinga
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
| | - Junilla Larsen
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
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14
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Koning M, Vink JM, Renders C, Notten N, Eisinga R, Larsen JK. Is the Prospective Link between Parental Stress and Adolescent Snack Intake or Weight Outcome Mediated by Food Parenting Practices? Nutrients 2021; 13:nu13082485. [PMID: 34444649 PMCID: PMC8401057 DOI: 10.3390/nu13082485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 01/09/2023] Open
Abstract
Parental stress may influence adolescents’ food intake and weight development over time, however, it is largely unknown why this is the case. This study examines whether the link between parental stress and adolescents’ snack intake and weight outcome is mediated by food parenting practices (FPPs). Participants included 400 parents and their adolescent children (aged 12–16) who completed questionnaires. The Perceived Stress Scale (PSS) was used to assess parental general stress levels and the Adolescent Food Parenting Questionnaire (AFPQ) to assess FPPs. Multiple mediation analyses with parallel mediators were performed, with parental general stress as an independent variable and adolescent snack intake and zBMI as dependent variables. FPPs (autonomy support, coercive control, modeling, healthy structure, snack structure) were entered as mediators in the model, adjusted for covariates. Autonomy support mediated the link between parental general stress and adolescent savory snack and sweet snack intake at follow-up. Parents who reported higher stress levels provided less autonomy support, which resulted in more adolescent snacking. None of the other FPPs mediated any link between parental stress and intake or weight outcome, and no significant indirect effects were observed with zBMI as an outcome variable. Further research should replicate this finding and may further examine underlying mechanisms.
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Affiliation(s)
- Maaike Koning
- Knowledge Centre for Health and Social Work, Department of Healthy Society, Windesheim University of Applied Sciences, P.O. Box 10090, 8000 GB Zwolle, The Netherlands;
- Behavioural Science Institute, Radboud University, P.O. BOX 9104, 6500 HE Nijmegen, The Netherlands; (J.M.V.); (R.E.); (J.K.L.)
- Correspondence:
| | - Jacqueline M. Vink
- Behavioural Science Institute, Radboud University, P.O. BOX 9104, 6500 HE Nijmegen, The Netherlands; (J.M.V.); (R.E.); (J.K.L.)
| | - Carry Renders
- Department of Health Sciences, Vrije Universiteit, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands;
| | - Natascha Notten
- Knowledge Centre for Health and Social Work, Department of Healthy Society, Windesheim University of Applied Sciences, P.O. Box 10090, 8000 GB Zwolle, The Netherlands;
| | - Rob Eisinga
- Behavioural Science Institute, Radboud University, P.O. BOX 9104, 6500 HE Nijmegen, The Netherlands; (J.M.V.); (R.E.); (J.K.L.)
| | - Junilla K. Larsen
- Behavioural Science Institute, Radboud University, P.O. BOX 9104, 6500 HE Nijmegen, The Netherlands; (J.M.V.); (R.E.); (J.K.L.)
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15
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Sdravou K, Emmanouilidou-Fotoulaki E, Printza A, Andreoulakis E, Beropouli S, Makris G, Fotoulaki M. Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases. Healthcare (Basel) 2021; 9:healthcare9060741. [PMID: 34204179 PMCID: PMC8234215 DOI: 10.3390/healthcare9060741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022] Open
Abstract
Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
- Correspondence:
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
| | - Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, University Hospital AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Elias Andreoulakis
- Hellenic Centre for Mental Health and Research, Department of Thessaloniki, Adult Psychiatric Unit, 36 Kaftatzoglou Str, 55337 Thessaloniki, Greece;
| | - Stavroula Beropouli
- Department of Pediatrics, General Hospital of Kozani (Mamatseio), 1 K. Mamatsiou, 50100 Kozani, Greece;
| | - Giorgos Makris
- Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 2400 Kalamata, Greece;
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
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16
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Koning M, Vink J, Visscher TLS, Larsen J. Maternal stress and depressive symptoms and adolescents' body mass index: a prospective study. BMC Public Health 2021; 21:675. [PMID: 33827481 PMCID: PMC8028230 DOI: 10.1186/s12889-021-10721-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 03/28/2021] [Indexed: 11/28/2022] Open
Abstract
Background Growing evidence suggests that maternal mental health issues are associated with (young) children’s weight outcomes. However, most studies have been limited by cross-sectional designs and have been aimed at (younger) children. The current prospective study focuses on the link between maternal mental health (i.e., psychological stress and depressive symptoms) and adolescents’ zBMI development. Methods The participants in the present study were part of wave 1 and 2 of a longitudinal study on Dutch adolescents’ and their parents’ health behavior. Adolescents (aged 10–14) and their parents were recruited through six secondary schools in the South and the East of the Netherlands. For this study, we only included biological mothers and their adolescent children who participated in both waves, with data on the main measures in both waves, leaving a final sample of 336 biological mother-child dyads. Adolescents height and weight were measured, and both parents and adolescents filled in validated questionnaires on perceived stress and depressive symptoms and answered additional questions concerning domain-specific stress. Regression analyses were performed in R to examine longitudinal links between maternal stress and depressive symptoms at baseline (T1) and adolescents’ BMI standard deviation scores (zBMI) 6 months later (T2), corrected for baseline zBMI and covariates. Results Maternal general perceived stress (β = .20, p = .002) at T1 preceded higher adolescents’ zBMI at T2, after controlling for baseline zBMI and other covariates, whereas maternal depressive symptoms at T1 (β = −.05, p = .44) and other domain-specific stress did not (maternal financial stress, maternal stress at work, maternal stress at home). Additionally, lower educational level among adolescents (β = .16, p = .001) and adolescent depressive symptoms (β = .16, p = .001) was associated with a higher zBMI at T2. Conclusions Results suggest that maternal general stress, but not depressive symptoms, may influence adolescents’ weight development. Our findings warrant future investigation on whether and how general stress among mothers may predict weight increases of their adolescent offspring.
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Affiliation(s)
- Maaike Koning
- Developmental Psychology, Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands. .,Department of Healthy Society, Knowledge Centre for Health and Social work, Windesheim University of Applied Sciences, Zwolle, The Netherlands.
| | - Jacqueline Vink
- Developmental Psychology, Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands
| | | | - Junilla Larsen
- Developmental Psychology, Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands
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17
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Mâsse LC, Tu AW, Watts A, Hughes SO, O'Connor TM. What parenting practices do US and Canadian parents use to encourage or discourage healthy eating among their 5-12 year-old children? Prev Med Rep 2020; 20:101234. [PMID: 33294311 PMCID: PMC7689546 DOI: 10.1016/j.pmedr.2020.101234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 09/11/2020] [Accepted: 10/20/2020] [Indexed: 11/15/2022] Open
Abstract
This study explored the parenting practices that parents of 5-12 year-old children report using to encourage or discourage children's healthy eating and examined sex differences in parent's responses. A stratified sample of 135 parents in the US and Canada completed a semi-qualitative online survey (Jan-Feb 2014) (stratified by parents' sex, income, and ethnicity of each country). Parents provided short answers to questions regarding the strategies they or other parents used to encourage or discourage their children's healthy eating (5-12 year-old). The 2389 parent responses were coded by two coders with discrepancies triangulated. Data was qualitatively reviewed and log-linear analysis assessed whether responses varied by types of encouragement (encourage, discourage), sex of parent (male, female), and six dimensions of parenting practices (autonomy promotion, structure of the food environment, behavioral and educational, control, responsiveness, and consistency of the food environment). Parenting practices that were controlling or promoted structure were predominantly mentioned as a way to regulate children's eating behavior. Strategies that support children's self-regulatory processes, such as autonomy promotion and responsiveness, were infrequently mentioned. Sex differences in parenting practices emerged. Mothers mentioned autonomy promoting practices more often than fathers did. Fathers mentioned controlling practices more often than mothers did as a practice that discouraged healthy eating among children. The findings highlighted that parents need to gain a greater understanding of the practices that nurture healthy eating in children, such as autonomy supportive and responsive parenting practices, to better support children as they grow.
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Affiliation(s)
- Louise C Mâsse
- BC Children's Hospital Research Institute / School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - Allison Watts
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis-St. Paul, MN, United States
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Teresia M O'Connor
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
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18
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Pesch MH, Julian MM, Lo SL, Wu Y, Miller AL, Appugliese D, Lumeng JC. Phenotypes of controlling feeding behaviours in mothers of toddlers: A mixed methods study. Pediatr Obes 2020; 15:e12639. [PMID: 32379402 DOI: 10.1111/ijpo.12639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/17/2020] [Accepted: 03/25/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Maternal feeding behaviours, in particular controlling behaviours, are associated with risk of childhood obesity. OBJECTIVES To qualitatively examine patterns of mothers' beliefs and behaviours around controlling feeding through a semi-structured interview and to examine associations of those patterns with participant demographic characteristics and classical child feeding instruments. METHODS A convenience sample of mothers (N = 35) of toddlers (mean age 25 months) participated in a semi-structured interview about their child feeding beliefs and behaviours. Anthropometrics were measured. Transcripts were analyzed using narrative analysis for patterns from which two emerged, known as phenotypes. A coding scheme was created and reliably applied. Bivariate correlates of the phenotypes with participant child characteristics and mother self-reported feeding behaviours were examined. RESULTS The phenotypes were High Covert Control (n = 12) and Shared Control (n = 23). High Covert Control phenotype membership was correlated with higher child and mother BMI (body mass index) and child female sex. Shared Control phenotype membership was correlated with lower child and mother BMI and greater pressure to eat. CONCLUSIONS Two controlling feeding phenotypes emerged among mothers of toddlers, which were associated with participant characteristics including BMI, but did not map onto classical child feeding instruments.
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Affiliation(s)
- Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA
| | - Megan M Julian
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Sharon L Lo
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Yue Wu
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA
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19
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Wood AC, Blissett JM, Brunstrom JM, Carnell S, Faith MS, Fisher JO, Hayman LL, Khalsa AS, Hughes SO, Miller AL, Momin SR, Welsh JA, Woo JG, Haycraft E. Caregiver Influences on Eating Behaviors in Young Children: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2020; 9:e014520. [PMID: 32389066 PMCID: PMC7660848 DOI: 10.1161/jaha.119.014520] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A substantial body of research suggests that efforts to prevent pediatric obesity may benefit from targeting not just what a child eats, but how they eat. Specifically, child obesity prevention should include a component that addresses reasons why children have differing abilities to start and stop eating in response to internal cues of hunger and satiety, a construct known as eating self‐regulation. This review summarizes current knowledge regarding how caregivers can be an important influence on children's eating self‐regulation during early childhood. First, we discuss the evidence supporting an association between caregiver feeding and child eating self‐regulation. Second, we discuss what implications the current evidence has for actions caregivers may be able to take to support children's eating self‐regulation. Finally, we consider the broader social, economic, and cultural context around the feeding environment relationship and how this intersects with the implementation of any actions. As far as we are aware, this is the first American Heart Association (AHA) scientific statement to focus on a psychobehavioral approach to reducing obesity risk in young children. It is anticipated that the timely information provided in this review can be used not only by caregivers within the immediate and extended family but also by a broad range of community‐based care providers.
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20
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Poulsen MN, Bailey-Davis L, Pollak J, Hirsch AG, Schwartz BS. Household Food Insecurity and Home Food Availability in Relation to Youth Diet, Body Mass Index, and Adiposity. J Acad Nutr Diet 2019; 119:1666-1675. [PMID: 30858071 PMCID: PMC6732246 DOI: 10.1016/j.jand.2019.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 12/28/2018] [Accepted: 01/02/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Food security status is related to food types available in the home, which may shape youth dietary patterns, with implications for obesity. OBJECTIVE Investigate whether household food insecurity and home food availability (HFA) are associated with youth fruit and vegetable (F/V) consumption and anthropometric outcomes. DESIGN Cross-sectional study. Youth and parents completed questionnaires during in-home visits (2013-2014). Research staff obtained anthropometric measures. PARTICIPANTS/SETTING Medical record data for 10- to 15-year-old Pennsylvania youths were used to identify 434 parent-youth dyads, with 408 evaluated after excluding missing data. MAIN OUTCOME MEASURES Parent-reported household food security was assessed with the six-item US Department of Agriculture Food Security Scale (dichotomized as high vs low). Healthy and obesogenic HFA scales assessed parent report of how frequently particular foods were present in the home. Youth self-reported daily average F/V consumption. Anthropometric outcomes included age- and sex-standardized z scores for body mass index (BMIz), waist circumference (WCz), and percent body fat (PBFz). STATISTICAL ANALYSES Associations were evaluated with multivariable linear regression adjusted for youth age, sex, and race or ethnicity, and parent age and income. RESULTS Compared with food secure counterparts, youth from food insecure households had higher mean (beta [standard error]) BMIz (.30 [.15]), WCz (.27 [.12]), and PBFz (.43 [.16]). Food insecure households had lower mean healthy HFA scores (-1.23 [.54]); there was no evidence obesogenic HFA differed between food secure and insecure households. Youth from lower healthy HFA or higher obesogenic HFA households reported fewer mean daily F/V servings (healthy HFA: .08 [.02]; obesogenic HFA: -.06 [.02]). Food security status was not associated with F/V consumption, nor was there evidence HFA modified associations between food insecurity and anthropometric outcomes. CONCLUSIONS Despite an observed association between healthy HFA and youth F/V consumption, this study did not provide evidence that HFA explained associations between food insecurity and youth anthropometric outcomes.
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21
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Westen SC, Mitchell TB, Mayer-Brown S, Resmini Rawlinson A, Ding K, Janicke DM. Mother and Father Controlling Feeding Behaviors and Associations With Observed Mealtime Family Functioning. J Pediatr Psychol 2019; 44:1174-1183. [DOI: 10.1093/jpepsy/jsz060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/29/2019] [Accepted: 06/29/2019] [Indexed: 12/23/2022] Open
Abstract
Abstract
Objective
Mealtime family functioning is important in shaping health behaviors associated with overweight/obesity, particularly for preschool-aged children. Parental controlling feeding behaviors (i.e., restriction and pressure to eat), may impact mealtime family functioning and thus be targets of prevention and intervention efforts. The current study aimed to address literature gaps by examining both mother and father self-reports of controlling feeding behaviors, and the discrepancies between parents’ reports. Further, the study examined the associations among controlling feeding behaviors and objective mealtime family functioning in a community sample of preschool-aged children.
Methods
The sample included 27 children between 2 and 6 years of age and their immediate family members. Two mealtimes were videotaped for each family and coded for family functioning using the Mealtime Interaction Coding System, and self-reports of feeding practices were collected using the Child Feeding Questionnaire.
Results
Mother controlling feeding behaviors were not significantly related to any mealtime family functioning domain. Father controlling feeding behaviors were only significantly related to interpersonal involvement. However, discrepancies in the use of controlling feeding behaviors accounted for nearly one fourth of the variance in overall family functioning and affect management, with greater discrepancies being related to poorer family functioning.
Conclusions
Interventions may be designed to reduce parental discrepancies in the use of controlling feeding behaviors. Future research should consider longitudinal design, using larger, more representative samples, to better understand the impact of parental controlling feeding behaviors, particularly the impact of parental discrepancies in these areas, on mealtime family functioning and subsequent health outcomes.
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Affiliation(s)
- Sarah C Westen
- Department of Clinical and Health Psychology, University of Florida
| | | | - Sarah Mayer-Brown
- Department of Pediatrics/Division of Gastroenterology, Hepatology & Nutrition/Center for GI Motility, The Children's Hospital of Philadelphia
- Department of Child & Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia
| | | | - Ke Ding
- Department of Clinical and Health Psychology, University of Florida
| | - David M Janicke
- Department of Clinical and Health Psychology, University of Florida
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22
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Bekelman TA, Bellows LL, Clark L, Thompson DA, Kemper G, McCloskey ML, Johnson SL. An Ecocultural Perspective on Eating-Related Routines Among Low-Income Families With Preschool-Aged Children. QUALITATIVE HEALTH RESEARCH 2019; 29:1345-1357. [PMID: 30499371 PMCID: PMC6538438 DOI: 10.1177/1049732318814540] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Eating-related routines, such as regular mealtimes, can protect against obesity. Little is known about eating-related routines among preschoolers or the factors that shape those routines. Ecocultural Theory and qualitative interviews with 30 caregivers of preschoolers in Colorado were used to describe eating-related routines at home and parents' perspectives on the factors that shape routines. Qualitative content analysis was used to analyze and interpret data. Consistent with clinical recommendations, parents' goals included dinner meals where adults and preschoolers eat the same food, in the same place, at the same time. However, parents' employment schedules and challenges in managing preschoolers' behavior prevented parents from consistently enacting recommended routines. Educating parents alone may not be sufficient to ensure optimal eating-related routines among preschoolers, and the household context needs to be considered. Families organized routines according to cultural values and available resources.
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Affiliation(s)
- Traci A Bekelman
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Lauren Clark
- 3 The University of Utah, Salt Lake City, Utah, USA
| | - Darcy A Thompson
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Geri Kemper
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Susan L Johnson
- 1 University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Elkins C, Fruh S, Jones L, Bydalek K. Clinical Practice Recommendations for Pediatric Dyslipidemia. J Pediatr Health Care 2019; 33:494-504. [PMID: 31227123 DOI: 10.1016/j.pedhc.2019.02.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 12/29/2022]
Abstract
The leading cause of mortality in the United States is atherosclerotic cardiovascular disease (ASCVD). Atherosclerotic lesions begin during childhood and can place individuals at greater risk for ASCVD. Providers play an active role in preventing the progression of risk factors and future ASCVD events through appropriate clinical management of genetic and acquired dyslipidemias in the pediatric population. Health care providers need to be aware of current recommendations related to screening for dyslipidemia, lifestyle modification strategies, pharmacologic treatment, and guidelines for ongoing monitoring. Most patients with mild to moderate dyslipidemia can be managed by a primary care provider. It is imperative that providers understand the pathophysiology, screening methods, and available treatment options to effectively manage the condition. Frequent reassessment of family history and adherence to lifestyle modifications and pharmacologic interventions is essential for effective treatment.
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Wilson TA, Liu Y, Adolph AL, Sacher PM, Barlow SE, Pont S, Sharma S, Byrd-Williams C, Hoelscher DM, Butte NF. Behavior Modification of Diet and Parent Feeding Practices in a Community- Vs Primary Care-Centered Intervention for Childhood Obesity. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:150-161.e1. [PMID: 30139562 DOI: 10.1016/j.jneb.2018.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 05/03/2018] [Accepted: 05/14/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate behavior modification of diet and parent feeding practices in childhood obesity interventions. DESIGN Secondary analysis of randomized, controlled trial comparing Mind, Exercise, Nutrition … Do It! (MEND2-5 and MEND/Coordinated Approach to Child Health [CATCH6-12]) vs Next Steps at baseline and 3 and 12 months. SETTING Austin and Houston, TX. PARTICIPANTS A total of 549 Hispanic and black children randomized to programs by age groups (2-5, 6-8, and 9-12 years) INTERVENTIONS: Twelve-month MEND2-5 and MEND/CATCH6-12 vs Next Steps. MAIN OUTCOME MEASURE(S) Diet (MEND-friendly/unfriendly food groups and Healthy Eating Index-2010) and parent feeding practices (parental overt control, discipline, limit setting, monitoring, reinforcement, modeling, and covert control; and food neophobia). ANALYSIS Mixed-effects linear regression. RESULTS Changes in diet quality, consumption of MEND-unfriendly foods, and parent feeding practices did not differ between programs. In both interventions, MEND-unfriendly vegetables, grains, dairy and protein, added fat and desserts/sugar-sweetened beverages declined in 2-5- and 6-8-year-olds (P < .001). Healthy Eating Index-2010 improved in 2-5- (treatment; P = .002) and 6-8-year-olds (P = .001). Parental overt control decreased and limit setting, discipline, monitoring, reinforcement, and covert control increased with both interventions in 2-5- and 6-8-year-olds (P < 0.01-0.001). CONCLUSIONS Diet quality, consumption of MEND-unfriendly foods, and parent feeding practices were altered constructively in 2 pediatric obesity interventions, especially in 2-5- and 6-8-year-olds.
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Affiliation(s)
- Theresa A Wilson
- US Department of Agriculture, Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Yan Liu
- US Department of Agriculture, Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Anne L Adolph
- US Department of Agriculture, Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Paul M Sacher
- Childhood Nutrition Research Centre, University College London, London, UK
| | - Sarah E Barlow
- Children's Health, GI Practice, University of Texas Southwestern Medical Center, Dallas, TX
| | - Stephen Pont
- Texas Center for the Prevention and Treatment of Childhood Obesity, Dell Children's Medical Center University of Texas at Austin Dell Medical School, Austin, TX
| | - Shreela Sharma
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health, Houston, TX
| | - Courtney Byrd-Williams
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, TX
| | - Deanna M Hoelscher
- Michael and Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health in Austin, Austin, TX.
| | - Nancy F Butte
- US Department of Agriculture, Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Lipsky LM, Haynie DL, Liu A, Nansel TR. Resemblance of Diet Quality in Families of Youth with Type 1 Diabetes Participating in a Randomized Controlled Behavioral Nutrition Intervention Trial in Boston, MA (2010-2013): A Secondary Data Analysis. J Acad Nutr Diet 2019; 119:98-105. [PMID: 30389377 PMCID: PMC7668210 DOI: 10.1016/j.jand.2018.07.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Parent-child diet quality resemblance is unknown in families of youth with type 1 diabetes, for whom nutrition is central to disease management. OBJECTIVE Examine diet quality resemblance in families of youth with type 1 diabetes participating in a behavioral nutrition intervention trial and investigate whether treatment assignment or family meal frequency modifies resemblance. DESIGN This is a secondary data analysis from an 18-month randomized controlled trial conducted August 2010 to May 2013. PARTICIPANTS/SETTING Parent-youth dyads (N=136, child age=12.3±2.5 years) were recruited from a northeast US diabetes center. MAIN OUTCOME MEASURES Parent and child Healthy Eating Index-2005 (HEI-2005, reflecting adherence to 2005 Dietary Guidelines for Americans) and whole plant food density (WPFD, reflecting intervention target foods) were calculated from 3-day food records collected every 6 months. STATISTICAL ANALYSIS Linear random effects models adjusting for demographics and disease characteristics investigated parent-child diet quality resemblance. Separate models examined whether treatment assignment or family meal frequency modified resemblance. Three-way interaction terms examined whether resemblance changed over time by treatment assignment. RESULTS Time-varying parent and child HEI-2005 and WPFD were positively associated (P<0.001), and there were no interactions with family meals. Parent-child HEI-2005 resemblance was similar across treatment groups; however, parent-child WPFD resemblance was stronger in the intervention (β±standard error [SE]=.30±.06) vs control families (β±SE=.12±.05). Parent-child HEI-2005 resemblance was similar over time by treatment assignment, whereas parent-child WPFD resemblance increased over time for families in the intervention group (three-way interaction term β±SE=.03±.01). CONCLUSIONS Parent and youth diet quality were positively correlated in families of youth with type 1 diabetes. Resemblance was stronger in the intervention group for target foods, but not for a general measure of diet quality. The lack of effect modification by family meal frequency suggests that family diet quality resemblance is not contingent on shared meals.
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Fill "half your child's plate with fruits and vegetables": Correlations with food-related practices and the home food environment. Appetite 2018; 133:77-82. [PMID: 30339784 DOI: 10.1016/j.appet.2018.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 09/25/2018] [Accepted: 10/12/2018] [Indexed: 02/03/2023]
Abstract
This study examined the prevalence of parental report of children's adherence to USDA's MyPlate guidelines of 'half of plate filled with fruits and vegetables (FV)' and associations with child and parent/guardian report of food-related practices and the home food environment. Data for this study represent the baseline assessment (n = 160 parent-child dyads) of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus study, a randomized controlled trial to prevent excess weight gain among 8-12 year-old children. Multiple logistic regression models examined associations between a newly created 'half plate FV' variable 'During the past seven days how many times was half of your child's plate filled with fruits and vegetables at dinner?" and personal and home food environmental factors, including food availability, child fruit/vegetable intake, and healthy eating index (HEI), adjusted for race and receipt of public assistance. Parents reported their children had half their plates filled with FV at dinner on average 2.7 times in the past week. With each reported child intake of FV, the odds of having half their plates filled with FV were almost one and a half times greater; there were significantly higher odds of children having half their plates filled with FV with greater children's HEI, parent and child cooking skills and self-efficacy to cook healthy meals, family meal frequency, and availability of more types of fruits and vegetables in the home. The findings demonstrate that the MyPlate campaign's message of "half the plate filled with FV" can be used in nutrition interventions focusing on improving the home food environment and increasing children's FV intake; the survey item used in the present study may be effective in capturing adherence to the MyPlate message.
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Longitudinal factor analysis of the Comprehensive Feeding Practices Questionnaire among parents of preschool-aged children. Appetite 2018; 129:94-102. [DOI: 10.1016/j.appet.2018.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 06/17/2018] [Accepted: 07/04/2018] [Indexed: 02/07/2023]
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Loth KA, Nogueira de Brito J, Neumark-Sztainer D, Fisher JO, Berge JM. A Qualitative Exploration Into the Parent-Child Feeding Relationship: How Parents of Preschoolers Divide the Responsibilities of Feeding With Their Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:655-667. [PMID: 29628220 PMCID: PMC6062462 DOI: 10.1016/j.jneb.2018.03.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/01/2018] [Accepted: 03/02/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To explore the extent to which parents divide responsibilities of feeding (what, when, where, how much, and whether) with their children and the factors that influence parents' approach to feeding. DESIGN Individual interviews. PARTICIPANTS Parents (n = 40) of preschoolers. PHENOMENON OF INTEREST Division of feeding responsibilities; motivation for feeding approach; challenges to feeding. ANALYSIS Audio-recorded interviews were transcribed verbatim and coded using deductive and inductive content analysis. RESULTS Parent's approaches to feeding varied widely. A few parents followed the Division of Responsibility approach closely. Instead, many parents gave their child more than the recommended amount of influence over what foods were served and offered children less than the recommended amount of autonomy over the whether and how much of eating. Meals and snacks were approached differently; parents exhibited less control over the timing of snacks as well as the types and amounts of foods eaten during snacks, compared with the control exhibited during meals. CONCLUSIONS AND IMPLICATIONS These data support future research to understand the impact of this framework on child health outcomes when it is adhered to on all eating occasions, including snacks. Collaboration by researchers and clinicians to explore alternative frameworks that encourage parents to provide the structure and autonomy support may enhance positive outcomes in children.
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Affiliation(s)
- Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN.
| | - Junia Nogueira de Brito
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Jennifer Orlet Fisher
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
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Lopez NV, Schembre S, Belcher BR, O'Connor S, Maher JP, Arbel R, Margolin G, Dunton GF. Parenting styles, food-related parenting practices, and children's healthy eating: A mediation analysis to examine relationships between parenting and child diet. Appetite 2018; 128:205-213. [PMID: 29920321 DOI: 10.1016/j.appet.2018.06.021] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 01/01/2023]
Abstract
Parents exert a strong influence on their children's diet. While authoritative parenting style is linked to healthier weight and dietary outcomes in children, and authoritarian and permissive parenting styles with unhealthy eating, little is known about the mechanisms that mediate these relationships. Feeding styles are often examined in relation to child diet, but they do not consider the social and physical environmental contexts in which dietary behaviors occur. Therefore, this study examined whether parenting styles (authoritative, authoritarian, and permissive) were associated with three specific food-related parenting practices - mealtime structural practices (e.g., eating meals as a family), parent modeling of healthy food, and household food rules and whether these parenting practices mediated the association between parenting styles and children's diet. Participants were 174 mother-child dyads. Mothers (68% married, 58% college graduates, Mage = 41 years [SD = 6.2]) reported on their parenting practices using validated scales and parenting style using the Parenting Styles and Dimensions Questionnaire. Children (52% female, Mage = 10 years [SD = 0.9]) completed two telephone-based 24-hour dietary recalls. Dietary outcomes included the Healthy Eating Index (HEI)-2010 score, and fruit and vegetables and added sugar intake. Using PROCESS, multiple mediation cross-sectional analyses with parallel mediators using 10,000 bootstraps were performed. Significant indirect effects were observed with mealtime structure and the relationships between authoritative parenting and HEI-2010 score (b = 0.045, p < .05, CI = [0.006, 0.126]), authoritarian parenting and HEI-2010 score (b = -0.055, p < .05, CI = [-0.167, -0.001]), and permissive parenting and HEI-2010 score (b = -0.093, p < .05, CI = [-0.265, -0.008]). Child diet quality is affected by mealtime structural practices. Further examination of the features by which mealtime structural practices serve as a mechanism for parents to support healthy eating among their children may improve children's diet quality.
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Affiliation(s)
- Nanette V Lopez
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA, 90032, USA.
| | - Susan Schembre
- Department of Behavioral Science, Division of Cancer Prevention and Population Sciences, University of Texas, MD Anderson Cancer Center, 1155 Pressler Street, Houston, TX, 77030, USA.
| | - Britni R Belcher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA, 90032, USA.
| | - Sydney O'Connor
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA, 90032, USA.
| | - Jaclyn P Maher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA, 90032, USA; Department of Kinesiology, University of North Carolina at Greensboro, 1408 Walker Avenue, 237H Coleman Building, Greensboro, NC, 27412, USA.
| | - Reout Arbel
- Department of Psychology, University of Southern California, 3620 South McClintock Avenue, Los Angeles, CA, 90089, USA.
| | - Gayla Margolin
- Department of Psychology, University of Southern California, 3620 South McClintock Avenue, Los Angeles, CA, 90089, USA.
| | - Genevieve F Dunton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 North Soto Street, Los Angeles, CA, 90032, USA.
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Rose AM, Williams RA, Rengers B, Kennel JA, Gunther C. Determining attitudinal and behavioral factors concerning milk and dairy intake and their association with calcium intake in college students. Nutr Res Pract 2018; 12:143-148. [PMID: 29629031 PMCID: PMC5886966 DOI: 10.4162/nrp.2018.12.2.143] [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: 12/16/2017] [Revised: 02/28/2018] [Accepted: 03/02/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND/OBJECTIVES Average intake of calcium among college students is below the recommended intake, and knowledge surrounding the attitudinal and behavioral factors that influence milk and dairy intake, a primary food source of calcium, is limited. The purpose of this study was to evaluate college students' attitudes and behaviors concerning milk and dairy consumption and their association with calcium intake. SUBJECTS/METHODS Participants were 1,730 undergraduate students who completed an online survey (SurveyMonkey) as part of baseline data collection for a social marketing dairy campaign. The online survey assessed attitudes and behaviors concerning milk and dairy intake, and calcium intake. Questions about milk- and dairy-related attitudes and behaviors were grouped into 14 factors using factor analysis. Predictors of calcium intake were then evaluated. RESULTS Median calcium intake across all participants was 928.6 mg/day, with males consuming higher calcium intakes than females (P < 0.001). Adjusted for gender, calcium intakes were most strongly (and positively) correlated with associating milk with specific eating occasions and availability (i.e., storing calcium-rich foods in one's dorm or apartment) (both P < 0.001). Other correlates of calcium intake included: positive-viewing milk as healthy (P = 0.039), having family members who drink milk) (P = 0.039), and taking calcium supplements (P = 0.056); and negative-parent rules concerning milk (P = 0.031) and viewing milk in dining halls negatively (P = 0.05). CONCLUSIONS Calcium intakes among college students enrolled in the current study was below the recommended dietary allowance of 1,000 mg/day, reinforcing the need for dietary interventions in this target population, especially females. Practitioners and researchers should consider the factors found here to impact calcium intake, particularly associating milk with specific eating occasions (e.g., milk with breakfast) and having calcium-rich foods available in the dorm room or apartment, as intervention strategies in future efforts aimed at promoting milk and dairy foods and beverages for improved calcium intake in college students.
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Affiliation(s)
- Angela M Rose
- Department of Human Sciences, Ohio State University, Human Nutrition Program, 1787 Neil Ave, Columbus, OH 43210, USA
| | - Rachel A Williams
- Department of Human Sciences, Ohio State University, Human Nutrition Program, 1787 Neil Ave, Columbus, OH 43210, USA
| | - Brooke Rengers
- Department of Human Sciences, Ohio State University, Human Nutrition Program, 1787 Neil Ave, Columbus, OH 43210, USA
| | - Julie A Kennel
- Department of Human Sciences, Ohio State University, Human Nutrition Program, 1787 Neil Ave, Columbus, OH 43210, USA
| | - Carolyn Gunther
- Department of Human Sciences, Ohio State University, Human Nutrition Program, 1787 Neil Ave, Columbus, OH 43210, USA
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