African-American and Hispanic children's beverage intake: Differences in associations with desire to drink, fathers' feeding practices, and weight concerns

Validation of a brief food parenting measure for fathers: A test of factorial validity, measurement invariance, internal reliability, and concurrent validity

Fathers are underrepresented in food parenting research partly due to the lack of succinct, theory-informed, and father-mother equivalent food parenting measurement tools. To address this, we 1) tested the factorial validity of a brief food parenting measure utilizing a subset of items from the Comprehensive Feeding Practices Questionnaire (CFPQ) to represent coercive control, structure, and autonomy support, 2) assessed the extent to which the brief tool works similarly in fathers and mothers (i.e., measurement invariance), and 3) evaluated its internal reliability and concurrent validity. Participants included 1071 fathers of children aged 2-6 years and 487 of their co-parents (mothers) from the Fathers & Families study. Fathers and mothers responded to 16 CFPQ items, and fathers reported on children's diets. Confirmatory factor analysis (CFA) was used to test factorial validity. Multi-group CFA was used to examine measurement invariance across fathers and mothers. Internal reliability was examined using Cronbach's alpha and the Spearman-Brown coefficient. Concurrent validity was assessed utilizing multiple logistic regressions to examine associations between the three food parenting factors and children's intakes of fruit, vegetables, sugar-sweetened beverages (SSBs), and fast food. CFA confirmed a three-factor model with 11 items, including coercive control (four items), structure (five items), and autonomy support (two items). Multi-group CFA indicated measurement invariance across fathers and mothers. Internal reliability was established. Concurrent validity was strong for structure, but weaker for coercive control and autonomy support. Further refinements are encouraged to enhance items' utility in characterizing fathers' food parenting practices, including in different social and cultural contexts.

Association between personality traits, eating behaviors, and the genetic polymorphisms FTO-rs9939609 and MAO-A 30 bp u-VNTR with obesity in Mexican Mayan children

Introduction

Genetic variants that control dopamine have been associated with obesity in children through loss of control of satiety and impulses, the manifestation of addictive eating behaviors, and specific personality traits. The variants include FTO-rs9939609 and the MAO-A 30 pb u-VNTR low-transcription alleles (LTA).

Objective

To evaluate the genetic association of FTO-rs9939609 and the MAO-A LTA, along with personality traits and eating behavior with obesity in Mayan children from Mexico.

Methods

We cross-sectionally evaluated 186 children (70 with obesity and 116 with normal weight) 6-12 years old from Yucatan, Mexico. Nutritional status was defined with body mass index (BMI) percentiles. Personality traits were evaluated with the Conners and TMCQ tests; eating behavior was evaluated with the CEBQ test. Genotyping with real-time PCR and TaqMan probes was used for FTO-rs9939609, whereas PCR amplification was used for MAO-A u-VNTR.

Results

High-intensity pleasure (p = 0.013) and moderate appetite (p = 0.032) differed according to nutritional status. Heterozygous FTO-rs9939609 T/A children showed higher mean scores of low-intensity pleasure (p = 0.002) and moderate appetite (p = 0.027) than homozygous T/T. Hemizygous boys having MAO-A LTA showed significantly higher mean scores of anxiety (p = 0.001) and impulsivity (p = 0.008). In multivariate models, only LTA alleles of MAO-A explained obesity in boys (OR = 4.44; 95% CI = 1.18-16.63).

Conclusion

In the present study, MAO-A u-VNTR alleles were associated with obesity in multivariate models only in boys. These alleles might also have a role in personality traits such as anxiety and impulsivity, which secondly contribute to developing obesity in Mayan boys.

Fathers Nutrition Knowledge and Child Feeding Practices Associated with Childhood Overweight and Obesity: A Scoping Review of Literature From 2000 to 2023

Objective. Childhood overweight/obesity is a serious global public health issue, demanding parental involvement to reverse trends. Despite fathers' crucial parenting roles, research on fathers and childhood overweight/obesity is limited. This scoping review examines the literature on fathers' nutrition knowledge and feeding practices with childhood overweight/obesity. Methods. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and Arksey and O'Malley (2005) framework, multiple databases were searched. Eligible father-child related studies focused on fathers' nutrition knowledge, feeding practices, and childhood overweight/obesity. Results. Of 26 eligible articles, 52% originated from the United States, and 44% focused on father-child dyads. Most studies were cross-sectional (64%) and survey-based (68%). Further, 11.5% assessed fathers' nutrition knowledge, and child feeding practices (53.4%). Conclusion. Literature on fathers' nutrition knowledge and feeding practices concerning childhood overweight/obesity is limited. Scaling-up fathers' inclusion in childhood nutrition research is encouraged for the design of holistic interventions.

Appetitive traits and food groups consumption in school-aged children: prospective associations from the Generation XXI birth cohort

PURPOSE

Appetite can influence children's dietary choices; however, this relationship in school-aged children is still unclear. We aimed to explore the prospective associations between child appetitive traits at age 7 and food consumption at 10 years of age.

METHODS

The study included 3860 children from the Generation XXI birth cohort, recruited in 2005/2006 in Porto, Portugal. The Children's Eating Behaviour Questionnaire was used to evaluate children's appetitive traits at 7 years. Food consumption was measured at 10 years through a validated Food Frequency Questionnaire. Logistic regression models were performed and adjusted for possible confounders.

RESULTS

Children with greater Enjoyment of Food at 7 years were 36% more likely to eat fruits ≥ 2 times/day and 54% more likely to eat vegetables > 2.5 times/day at 10 years compared to those with less frequent consumption. Children who ate more in response to negative emotions had higher odds of consuming energy-dense foods (OR = 1.33; 99% CI 1.13-1.58) and salty snacks (OR = 1.28; 99% CI 1.08-1.51) 3 years later. Those with less ability to adjust intake (higher Satiety Responsiveness) and more selective about foods (higher Food Fussiness) at 7 years were less likely to consume vegetables frequently, and were more likely to consume energy-dense foods and sugar-sweetened beverages.

CONCLUSIONS

Children's appetitive traits at 7 years were associated with the consumption of several food groups at 10 years of age. Eating more in response to negative emotions (Emotional Eating), with less ability to adjust intake (Satiety Responsiveness) and more food selectivity (Food Fussiness) were associated with worse dietary choices (in general, lower fruit and vegetables, and higher energy-dense foods and sugar-sweetened beverages consumption).

LEVEL OF EVIDENCE

Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

Ecological factors and childhood eating behaviours at 5 years of age: findings from the ROLO longitudinal birth cohort study

Background

Individual differences in children eating behaviours have been linked with childhood overweight and obesity. The determinants of childhood eating behaviours are influenced by a complex combination of hereditary and ecological factors. This study examines if key ecological predictors of childhood overweight; maternal socio-economic status (SES), children’s screen time, and childcare arrangements, are associated with eating behaviours in children aged 5-years-old.

Methods

This is secondary, cross-sectional analysis of the ROLO (Randomized COntrol Trial of LOw glycemic diet in pregnancy) study, using data from the 5-year follow-up (n = 306). Weight, height, and body mass index (BMI) were obtained from mothers and children at the 5-year follow-up. Children’s BMI z-scores were calculated. SES was determined using maternal education level and neighborhood deprivation score. Information on children’s screen time and childcare arrangements were collected using lifestyle questionnaires. Children’s eating behaviours were measured using the Children’s Eating Behaviour Questionnaire (CEBQ). Multiple linear regression, adjusted for potential confounders, assessed associations between maternal SES, screen time and children’s eating behaviours. One-way ANOVA, independent sample t-tests and Spearman’s correlation examined childcare exposure and children’s eating behaviour.

Results

Mothers in the lowest SES group had higher BMI and were younger than those in the highest SES group (p =  < 0.001, p = 0.03 respectively). In adjusted analysis, the lowest SES group was associated with a 0.463-point higher mean score for ‘Desire to Drink’ (95% CI = 0.054,0.870, p = 0.027) and higher ‘Slowness to Eat’ (B = 0.388, 95% CI = 0.044,0.733, p = 0.027) when compared with the highest SES group. Screen time (hours) was associated with higher ‘Food Fussiness’ (B = 0.032, 95% CI = 0.014,0.051, p = 0.001). Those who attended childcare had higher scores for ‘Desire to Drink’(p = 0.046). No relationship was observed between longer duration (years) spent in childcare and eating behaviours.

Conclusions

In this cohort, the ecological factors examined had an influence on children’s eating behaviours aged 5-years-old. Our results illustrate the complexity of the relationship between the child’s environment, eating behaviour and children’s body composition. Being aware of the ecological factors that impact the development of eating behaviours, in the pre-school years is vital to promote optimal childhood appetitive traits, thus reducing the risk of issues with excess adiposity long-term.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-022-03423-x.

Contributing Factors of Sugar-Sweetened Beverage Intake in the Latinx Population: A Narrative Review Using the Social-Ecological Model

Sugar-sweetened beverage (SSB) consumption in the Latinx population has been a topic of increasing interest due to higher rates of consumption in this population, as well as higher prevalence of chronic health conditions, such as diabetes and obesity. SSB behaviors are influenced by multiple factors across the socio-ecological model. Understanding these factors can inform future intervention development and improve SSB consumption and overall health. Therefore, this narrative review identifies factors contributing to SSB consumption, as well as interventions conducted to address SSB consumption in the Latinx population residing in the United States. Contributing factors that are not currently addressed in published interventions are highlighted with the intent to inform the development of future comprehensive interventions.

The Associations between Caregivers' Emotional and Instrumental Feeding, Children's Emotional Eating, and Children's Consumption of Ultra-Processed Foods in China

High consumption of ultra-processed foods (UPF) increases the risks of non-communicable diseases and all-cause mortality in adulthood, and the risk of early childhood caries. Limited evidence about factors influencing children's consumption of UPF exists. This study was conducted to assess the prevalence of UPF consumption among children less than three years of age, and identify its associations with caregivers' emotional and instrumental feeding, and children's emotional eating. A cross-sectional study was conducted in Shijiazhuang, Hebei Province, China. Caregivers caring for children aged 6-36 months (n = 408) were recruited. Caregivers' emotional and instrumental feeding practices and children's emotional eating were assessed by the Parents' Feeding Practices Scale for Infant and Young Child and Children's Eating Behaviour Questionnaire, respectively. Children's UPF consumption was assessed by a validated Food Frequency Questionnaire. Of the children, 86.8% consumed UPF. The highest percentage of UPF consumed was pastries (63.5%), followed by solid or semi-solid dairy products (58.8%), and reconstituted meat products (56.4%). Caregivers' emotional and instrumental feeding was positively associated with children's consumption of UPF (OR = 1.59, 95%CI: 1.01, 2.49), a higher frequency of UPF consumption weekly (OR = 1.80, 95%CI: 1.35, 2.39), and a larger amount of UPF consumption weekly (OR = 1.85, 95% CI: 1.38, 2.49). Children's higher frequency of emotional undereating was associated with their UPF consumption (OR = 1.61, 95%CI: 1.07, 2.42) and a higher frequency of UPF consumption weekly (OR = 1.33, 95%CI: 1.03, 1.73). Children's emotional undereating significantly mediated the associations between caregivers' emotional and instrumental feeding and children's consumption of reconstituted meat products. Caregivers should be educated to avoid emotional and instrumental feeding practices, and cultivate children's good eating habits to improve children's diet quality.

Influences on the dietary intakes of preschool children: a systematic scoping review

BACKGROUND

Better diet quality of preschool children is associated with many important health outcomes, but there is significant room for improvement in many children's dietary intakes. The determinants of children's dietary intakes are complex and whole systems approaches may be effective tools for changing dietary intake. Collation of all the evidence available on determinants of preschool children's dietary intake is necessary to 'map' the whole system of influence. Therefore, this systematic scoping review of available literature on determinants of dietary intakes in preschool children was undertaken.

METHODS

The Joanna Briggs Institute methods for conducting a systematic scoping review were followed. Articles published since 2000 which assessed influences on the dietary intakes of preschool children were identified, yielding a total of 246 papers. Studies of children with clinical conditions (excluding obesity), or those conducted in middle and low-income countries were excluded, due to the different systems of influence in these populations. Data were extracted and information synthesised based on ecological level (child, parent, household, childcare, or wider determinants).

RESULTS

Most articles focused on influences at the parental level (n = 118, 48%), followed by those at the child level (n = 73, 30%). Most of the studies were of cross-sectional design (n = 109, 44%). Whilst many studies considered influences at multiple ecological levels (n = 63, 26%) few analyses determined interactions between factors in their relationship with children's dietary intakes, which is needed going forward using systems methods.

CONCLUSION

A wealth of evidence exists examining influences on the dietary intakes of preschool children and this information would benefit from analysis using a systems thinking approach in order to assess effective levers for intervention and what works, for whom, under what circumstances.

Associations of preschoolers' dietary patterns with eating behaviors and parental feeding practices at a 12-month follow-up of obesity treatment

Although dietary patterns are key to the management of childhood obesity, they are rarely assessed and thus poorly understood. This study examines preschoolers' dietary patterns and correlates 12 months after the start of obesity treatment (n = 99, mean age 5.2 years, 52% girls). A food frequency questionnaire (FFQ), the Child Eating Behavior Questionnaire (CEBQ), Child Feeding Questionnaire (CFQ) and Lifestyle Behavior Checklist (LBC) were answered by parents to assess children's food intake, eating behaviors, parental feeding practices, and obesity-related behaviors, respectively. Principal component analysis identified dietary patterns based on FFQ data. Through multiple linear regressions we examined correlations between a healthy (HD) and a less healthy (LHD) dietary pattern and mean scores of the CEBQ, CFQ, LBC scales as well as BMI z-scores. The reported intake of items in the LHD decreased after treatment while no differences were found for the HD. Children's eating behaviors, in particular food fussiness, showed consistent associations with diet (b = -0.39, 95% CI -0.63, -0.14 for HD and b = 0.41, 95% CI 0.15, 0.66 for LHD). Feeding practices and obesity-related behaviours were weakly associated with the dietary patterns (HD and Monitoring: b = 0.36, 95% CI 0.09, 0.62; LHD and Screen time b = 0.08, 95% CI 0.01, 0.15). Among the measured variables, eating behaviors had the largest impact on children's dietary patterns. The LHD was associated with a higher BMI z-score but no associations were found between changes in LHD intake and changes in BMI z-scores. Our findings suggest that decreasing food fussiness in children with obesity is key to positive dietary changes. Assessment of children's eating behaviors can help tailor dietary advice and provide support for families of children with obesity.

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

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.

Associations between family and home-related factors and child's snack consumption in a multi-ethnic population

BACKGROUND

Energy-dense snacks are considered unhealthy due to their high concentrations of fat and sugar and low concentrations of micronutrients. The present study aimed to evaluate associations between family and home-related factors and children's snack consumption. We explored associations within subgroups based on ethnic background of the child.

METHODS

Cross-sectional data of 644 primary school children (mean age: 9.4 years, 53% girls) from the population-based 'Water Campaign' study conducted in the Netherlands were used. Logistic regression analyses were used to evaluate the associations between family and home-related factors and child's snack intake.

RESULTS

Of the children, 28.7% consumed more than one snack per day. Children of parents who expressed more restrictive parenting practices towards the child's snack consumption (odds ratio (OR) = 2.5, P < 0.001), and who modelled snack eating less often (OR = 2.2, P < 0.001) had lower snack intake. Restrictive parenting practices and parental modelling of healthy snacking were significant for children with a Dutch or Moroccan/Turkish ethnic background, but not for children with a Surinamese/Antillean ethnic background.

CONCLUSIONS

We observed that parenting practices and parental modelling were independently associated with the child's snack intake. Also, the relationships between these factors and the child's snack consumption differed for children with distinct ethnic backgrounds.

The Obesity Parenting Intervention Scale: Factorial Validity and Invariance Among Head Start Parents

INTRODUCTION

Obesity affects 15.7% of U.S. preschoolers, with higher rates among low-income and Spanish-speaking populations. Food, physical activity, and sleep parenting practices, referred to collectively as obesity-related parenting practices, are linked with children's risk of obesity and are a common target in family-based obesity interventions. Yet, there is no brief, validated measure of obesity-related parenting practices that is appropriate for use in intervention studies and for diverse audiences. This study tests the factorial validity of a brief measure of obesity-related parenting and measurement invariance of the English and Spanish versions of the scale, as well as among mothers and fathers.

METHODS

Parents of children enrolled in Head Start (n=578; 500 mothers and 78 fathers) completed a brief survey of food (7 items), physical activity (5 items), and sleep parenting (3 items) in fall of 2017 and 2018. Scale items were drawn from existing measures and the evidence base, initially drafted in English, and then translated to Spanish. One parent per family completed the scale independently in English (n=448) or Spanish (n=130). A confirmatory factor analysis framework was adopted to test a 3-factor model for the total sample. Multi-group structural equation modeling was used to assess measurement invariance of the scale by the language of administration (English or Spanish) and among mothers and fathers separately.

RESULTS

Results supported a 3-factor model of obesity parenting with a single factor each for food, physical activity, and sleep parenting. There was statistically significant measurement invariance across all groups (p<0.05). Internal consistency was adequate across factors (α=0.65-0.80).

CONCLUSIONS

This brief obesity-parenting scale demonstrates adequate factorial validity in English and Spanish and among mothers and fathers. This measure has been integrated into an intervention, and future work will test sensitivity to change.

Fathers' attachment representations and infant feeding practices

This study examined how fathers' adult attachment representations, assessed before the birth of their first child, predict feeding practices with their 8-month-old infants. Fathers have been underrepresented in child feeding research, particularly in longitudinal and observational studies. Feeding is a key parenting task of infancy and a growing number of studies have begun to explore the connection between attachment and parental feeding practices and behavior, revealing a clear link between mothers' adult attachment and how they feed their children. This is the first longitudinal examination of attachment as a prenatal predictor of fathers' infant feeding behavior. Participants were 118 first-time fathers and their infants. Adult Attachment Interviews were conducted in the third trimester of pregnancy, and father-infant feeding interactions were observed at home when the infant was 8-months-old. Videotaped feedings were coded using Chatoor's Feeding Scale (1997). Compared to other fathers, (1) those with secure attachment representations were more attuned to their infants during feeding, (2) those with dismissing representations were less attuned, and (3) those with unresolved trauma displayed more controlling behaviors. Fathers were more controlling with their sons than their daughters across all attachment representations. Study results suggest that father's infant feeding behaviors may influence by their own attachment representations. The links to fathers' controlling feeding practices are noteworthy because of the negative implications controlling parental feeding practices can have on child outcomes. The prediction of paternal feeding behaviors from assessments conducted prenatally has important intervention implications.

Factors associated with water consumption among children: a systematic review

BACKGROUND

Water is recommended as the main beverage for daily fluid intake. Previous systematic reviews have studied the consumption of sugar-sweetened beverages (SSBs) among children, but none have focused on water consumption. Insight into factors that are associated with children's water intake is needed to inform the development of interventions aimed at the promotion of water consumption. The objective of this review was therefore to summarize the current evidence on factors associated with water consumption among children aged 2 to 12 years.

METHODS

A systematic literature search in seven electronic databases was conducted in May, 2018 and retrieved 17,850 unique records. Two additional studies were identified by hand-searching references of included articles. Studies were selected if they had a cross-sectional or longitudinal study design, focused on children aged 2-12 years and published in an English language peer-reviewed journal. Participants from clinical populations, studies that included data of < 10 participants and non-human studies were excluded.

RESULTS

A total of 63 articles met inclusion criteria and were included in the analysis. We identified 76 factors that were investigated in these studies; 17/76 were investigated in a longitudinal study. There was evidence of positive associations between water consumption and child's self-efficacy, parental education level, parental self-efficacy, use of feeding practices such as restriction or encouraging healthy eating and study year. Evidence was inconsistent (< 60% of studies reported an association) for child's age, sex, BMI, consumption of SSBs and ethnic background of the parent. There was no evidence (≤33% of studies reported an association) of associations between consumption of milk or juice, parental emotional-, modelling- or instrumental feeding practices, eating school lunch or outside temperature and water consumption. The remaining 54 factors were investigated in fewer than three studies.

CONCLUSIONS

There is some evidence for an association between potentially modifiable parental and child-related factors and water consumption. However, most factors identified in this review were only studied by one or two studies and most studies were cross-sectional. More longitudinal research is necessary to investigate environmental, parental and child-related factors associated with water consumption that are currently under-studied and could further inform intervention strategies.

TRIAL REGISTRATION

PROSPERO ID# CRD42018093362 , registered May 22, 2018.

Engaging Latino Fathers in Children's Eating and Other Obesity-Related Behaviors: a Review

PURPOSE OF REVIEW

There is a growing evidence of the important role that fathers play in influencing their children's eating and other weight-related behaviors. Latino children are at high risk for obesity and associated medical conditions. Engaging Latino fathers is a potentially important and unique way to help promote healthy lifestyles for Latino children, but doing so requires a culturally sensitive understanding both of fathers' current role and the family perceptions of this role.

RECENT FINDINGS

Here, we review recent data and argue that there are subtle but important differences between the qualitative and quantitative research conducted regarding the role Latino fathers may play in promoting healthy eating and physical activity for their children. We suggest how to synthesize these findings and also present qualitative results for ways to best engage Latino fathers in research studies with a focus on physical activity. Results from the review support that Latino fathers are important potential targets for child obesity prevention, but our findings stress the importance of considering cultural values when trying to recruit, engage and retain Latino fathers for such research.

Home Food Environment Factors Associated With Hispanic Preschoolers' Intake of Fruits and Vegetables

The purpose of this study was to evaluate the relationship of home fruit and vegetable (F&V) availability and maternal feeding practices with Hispanic preschoolers' F&V intake (N = 238). "Availability' of total fruit" (P < .0001) and "modeling" (P < .020) increased the odds of consuming 1 or more cups of fruit. "Pressure" (P < .009) and the child being female (P < .028) increased the odds of consuming 1 or more cups of vegetables, while having a greater number of children in the home (P < .037) reduced the odds of consuming 1 or more cups of vegetables. To increase preschoolers' intake of F&V, interventions should target specific environmental factors in the home and maternal monitoring practices.

Longitudinal associations between eating and drinking engagement during mealtime and eating in the absence of hunger in low income toddlers

To develop effective obesity-related interventions during early life, it is important to identify predictors of eating in the absence of hunger during toddlerhood. Hence, this study examined longitudinal associations between child eating and drinking engagement at 27 months of age and child eating in the absence of hunger (EAH) at 33 months of age (N = 91 children; 57.1% boys). At 27 months of age, we coded child eating and drinking engagement during a videotaped naturalistic lunch meal at home. We also obtained mothers' reports of their child's food responsiveness (FR), satiety responsiveness (SR), and desire to drink (DD) using the Child Eating Behavior Questionnaire (CEBQ). Children participated in a standard EAH protocol at 27 and 33 months of age where they were presented with palatable foods and the amount of food eaten was assessed (calculated as total kilocalories consumed). Correlational analyses showed that EAH at 27 months of age was positively related to EAH at 33 months of age and that neither mother-reported child FR or SR were associated with child eating engagement. Mother-reported child DD was associated with child drinking engagement. To predict EAH at 33 months, a regression analysis was conducted in which EAH at 27 months, mother-reported and observed child eating and drinking engagement at 27 months were entered as predictors, controlling for child demographics (i.e., age, sex, race/ethnicity and weight-for-length z-score (WLZ). Findings were that children who were observed to engage in more drinking at 27 months of age consumed more energy (measured as kcal) in the EAH at 33 months of age. Implications for understanding eating, and drinking, behaviors in toddlerhood are discussed.

A qualitative study conducted in the USA exploring Latino fathers' beliefs, attitudes and practices related to their young children's eating, physical activity and sedentary behaviours

OBJECTIVE

Increasing evidence documents fathers' influential role in their children's eating, physical activity (PA) and sedentary behaviours (SB). We aimed to expand limited existing research examining fathers' influence in these areas by exploring Latino fathers' beliefs, attitudes and practices related to eating, PA and SB of their young children.

DESIGN

Seven focus group discussions were conducted in Spanish with Latino fathers (n 28) of children aged 2-8 years. Audio recordings were transcribed and translated verbatim without identifiers. Data were analysed using thematic analysis to identify key concepts and themes using NVivo 11 software.

RESULTS

Fathers expressed positive beliefs and attitudes about the importance of healthy eating for their young children, themselves and their families. Nevertheless, the majority reported familial practices including eating out, getting take-out, etc. that have been linked to increased obesity risk among Latino children. Fathers were more involved and engaged in children's PA than eating and feeding. However, several fathers reported engaging predominantly in sedentary activities with their children, appeared permissive of children's sedentary habits and struggled to set limits on children's screen-time.

CONCLUSIONS

We provide new information on Latino fathers' beliefs and child feeding and PA practices that may provide important targets for interventions aimed at promoting healthful eating and PA behaviours of Latino children. Future research should further quantify the influence of Latino fathers' parenting styles and practices on development of children's eating, PA and SB. This information is needed to identify risk factors amenable to interventions and to design culturally appropriate parenting and family-based interventions targeting Latino children's home environment and designed to meet this ethnic group's specific needs.

Mothers' self-reported grocery shopping behaviours with their 2- to 7-year-old children: relationship between feeding practices and mothers' willingness to purchase child-requested nutrient-poor, marketed foods, and fruits and vegetables

OBJECTIVE

To assess relationships between mothers' feeding practices (food as a reward, food for emotion regulation, modelling of healthy eating) and mothers' willingness to purchase child-marketed foods and fruits/vegetables (F&V) requested by their children during grocery co-shopping.

DESIGN

Cross-sectional. Mothers completed an online survey that included questions about feeding practices and willingness (i.e. intentions) to purchase child-requested foods during grocery co-shopping. Feeding practices scores were dichotomized at the median. Foods were grouped as nutrient-poor or nutrient-dense (F&V) based on national nutrition guidelines. Regression models compared mothers with above-the-median v. at-or-below-the-median feeding practices scores on their willingness to purchase child-requested food groupings, adjusting for demographic covariates.

SETTING

Participants completed an online survey generated at a public university in the USA.

SUBJECTS

Mothers (n 318) of 2- to 7-year-old children.

RESULTS

Mothers who scored above-the-median on using food as a reward were more willing to purchase nutrient-poor foods (β=0·60, P<0·0001), mothers who scored above-the-median on use of food for emotion regulation were more willing to purchase nutrient-poor foods (β=0·29, P<0·0031) and mothers who scored above-the-median on modelling of healthy eating were more willing to purchase nutrient-dense foods (β=0·22, P<0·001) than were mothers with at-or-below-the-median scores, adjusting for demographic covariates.

CONCLUSIONS

Mothers who reported using food to control children's behaviour were more willing to purchase child-requested, nutrient-poor foods. Parental feeding practices may facilitate or limit children's foods requested in grocery stores. Parent-child food consumer behaviours should be investigated as a route that may contribute to children's eating patterns.

The Influence of Fathers on Children's Physical Activity and Dietary Behaviors: Insights, Recommendations and Future Directions

PURPOSE OF REVIEW

Although fathers have an important influence on their children's well-being, their unique influence on child lifestyle behaviors has been largely overlooked in the literature. To inform and encourage future research, this paper provides an overview of existing studies that have examined the influence of fathers on the physical activity and dietary behaviors of their children.

RECENT FINDINGS

While the available data indicate that fathers' behaviors and parenting practices likely play an important role in promoting healthy behaviors in children, the evidence base is limited by a reliance on observational designs and small, ungeneralizable samples. This paper also provides a summary of the methods, research findings, and experiential insights we have gained while conducting the "Healthy Dads, Healthy Kids" randomized controlled trials, which tested the efficacy and effectiveness of a socio-culturally targeted program that engages fathers to improve their own health and the health of their children. The paper concludes with a series of recommendations for recruiting and engaging fathers and a summary of directions for future research.

Feeding styles, parenting styles and snacking behaviour in children attending primary schools in multiethnic neighbourhoods: a cross-sectional study

OBJECTIVE

The aim of the present study was to investigate whether feeding styles and parenting styles are associated with children's unhealthy snacking behaviour and whether the associations differ according to children's ethnic background.

METHOD

Cross-sectional data from the population-based 'Water Campaign' study were used. Parents (n=644) of primary school children (6-13 years) completed a questionnaire covering sociodemographic characteristics, feeding style dimensions ('control over eating', 'emotional feeding', 'encouragement to eat' and 'instrumental feeding'), parenting style dimensions ('involvement' and 'strictness') and children's unhealthy snacking behaviour. Logistic regression analyses were performed to determine whether feeding styles and parenting styles were associated with children's unhealthy snacking behaviour.

RESULT

Overall, children whose parents had a higher extent of 'control over eating' had a lower odds of eating unhealthy snacks more than once per day (OR, 0.57; 95% CI 0.42 to 0.76). Further stratified analysis showed that 'control over eating' was associated with less unhealthy snacking behaviour only in children with a Dutch (OR, 0.37; 95% CI 0.20 to 0.68) or a Moroccan/Turkish (OR, 0.44; 95% CI 0.25 to 0.77) ethnic background. 'Encouragement to eat' was associated with a lower odds of eating unhealthy snacks every day in children with a Dutch ethnic background only (OR, 0.48; 95% CI 0.25 to 0.90). 'Instrumental feeding' was associated with a higher odds of eating unhealthy snacks more than once a day in children with a Moroccan/Turkish ethnic background only (OR, 1.43; 95% CI 1.01 to 2.04).

CONCLUSION

Our results suggest that 'control over eating' may be associated with less unhealthy snack consumption in children. The associations of feeding styles and parenting styles with children's unhealthy snacking behaviour differed between children with different ethnic backgrounds.

Fathers' feeding practices and children's weight status in Mexican American families

Mothers' feeding practices are associated with their children's weight status, but little is known about the associations between fathers' feeding practices and children's weight status. Moreover, there is a dearth of research on Latino fathers' feeding practices and children's weight status, even though Latino children suffer some of the highest obesity rates in the U.S. We examined the associations between fathers' feeding practices and child weight status, conditional on mothers' feeding practices, within 174 Mexican American families with children aged 8-10 years. Parents completed the Parental Feeding Practices Questionnaire, which consists of four subscales: positive involvement in child eating, pressure to eat, use of food to control behavior, and restriction of amount of food. To assess child weight status, body mass index (BMI) was calculated and converted to age- and gender-specific percentile scores (BMI z-score). We fit four sets of regression models, one set for each of the four parental feeding practices subscales, with child BMI z-score as the outcome variable. Fathers' pressure to eat (b = -0.20, p = 0.04; 95% CI: -0.39, -0.01) and use of food to control behavior (b = -0.36, p = 0.02; 95% CI: -0.65, -0.07) were associated with lower child BMI z-score, and restriction of amount of food (b = 0.56, p < 0.001; 95% CI: 0.27, 0.84) was associated with higher child BMI z-score, after accounting for mothers' feeding practices. Fathers' positive involvement in child eating was not associated with child BMI z-score. These findings provide empirical evidence that fathers' feeding practices are independently associated with children's weight status, even when mothers' feeding practices are taken into account, and suggest that fathers' feeding practices also matter in regard to children's weight status.

Hispanic Mothers' Views of the Fathers' Role in Promoting Healthy Behaviors at Home: Focus Group Findings

BACKGROUND

Overweight and obesity prevention interventions rarely take into account the unique role of fathers in promoting healthy home environments.

OBJECTIVE

To use qualitative methodology to examine the views of Hispanic mothers of children aged 2 to 5 years regarding fathers' roles in promoting healthy behaviors at home.

DESIGN

Nine focus groups were conducted in Spanish with Hispanic mothers of preschool-aged children (N=55) from October to December 2015.

PARTICIPANTS/SETTINGS

Hispanic mothers were recruited from churches, community agencies, and preschools located in five Zip codes in the southwest part of Oklahoma City, OK.

ANALYSIS

Questions examined the views of Hispanic mothers regarding fathers' roles in promoting healthy behaviors at home. Focus groups were audiorecorded, transcribed in Spanish, translated into English, and coded and analyzed for themes by two coders using NVivo version 10 software.

RESULTS

Four themes were identified: fathers' disagreement with mothers about food preferences and preparation, fathers' support for child's healthy eating, fathers' support for child's physical activity, and fathers' lack of support for a healthy home food environment. Fathers' traditional expectations about the type of foods and portion sizes adults should eat conflicted with mothers' meal preparations. Mothers reported that, although they favored eating low-calorie meals, the meals fathers preferred eating were high-calorie meals (eg, quesadillas). In general, fathers supported healthy eating and physical activity behaviors for their children. Supportive behaviors for children included preparing healthy meals, using healthier cooking methods, grocery shopping with their children for healthy foods, and asking the child to participate in household chores and/or play sports. Fathers' unsupportive behaviors included bringing high-calorie foods, such as pizza, and sugary drinks into the home, using sweets and savory foods for emotion regulation, and displaying an indulgent parental feeding style.

CONCLUSIONS

Mothers' views of fathers' perceived roles in child eating and physical activity, and maintaining a healthy eating environment, have important implications for the success of promoting healthy behaviors in the homes of Hispanic families.