An investigation of maternal food intake and maternal food talk as predictors of child food intake

Associations between social support and proactive health behaviours among Chinese adolescents: the mediating role of self-efficacy and peer relationships

BACKGROUND

Proactive health behaviours are crucial for enhancing adolescent health. However, there is limited evidence on the potential pathways through which social support influences adolescents' proactive health behaviours. This cross-sectional study aimed to examine the relationships between social support, self-efficacy, peer relationships and proactive health behaviours in Chinese adolescents.

METHODS

From October to December 2023, we recruited 6075 adolescents from Shandong Province, China. They completed self-report questionnaires on social support, self-efficacy, peer relationships and proactive health behaviours.

RESULTS

Linear regression analysis indicated that social support was positively associated with proactive health behaviours among adolescents (β = 0.571, 95% CI = 0.542, 0.600). Further mediation analyses revealed that self-efficacy (β = 0.085, 95% CI = 0.069,0.101) and peer relationships (β = 0.156, 95% CI = 0.136,0.177) mediated this relationship.

CONCLUSIONS

Increased social support was associated with better proactive health behaviours in Chinese adolescents. Additionally, higher self-efficacy and positive peer relationships enhanced this association. Our findings emphasised the significance of providing supportive environments at home and at school to promote proactive health behaviours in adolescents.

The invisible connection of mothers' BMI, emotional appetite, and food choices with childhood obesity

BACKGROUND

This study examined the effects of mothers' body mass index (BMI), emotional appetite, and food choices on children's growth curves and adiposity.

METHODS

Data was collected from 492 mothers. The demographic characteristics and anthropometric measurements were obtained using a questionnaire. The mothers' food choices and emotional appetites were assessed using scales. BMI for age Z score and tripoderal index (TMI) were used in the evaluation of children's anthropometric measurements and adiposity.

RESULTS

The mean age of mothers' was 39.10 ± 0.26 and BMI was 25.08 ± 0.21. Among the mothers, 54.5% were classified as normal, 28.4% as pre-obese, and 14.7% as obese. Among the children, 31.5% were overweight or obese. There was a strong positive correlation between the mean BMI of the mothers and the mean TMI and BMI of the children (p < 0.001). The "convenience" food choice factor of mothers had negative correlation with childiren's BMI for age (p < 0.005).

CONCLUSIONS

This study emphasizes the invisible connection between mothers' emotional appetite and food choices and children's BMI and TMI and highlights the importance of paying attention to mothers' eating habits for children's health outcomes. These findings will be informative in the formulation of future health policies.

IMPACT

This research revealed the relationship between mothers' food choices and emotional appetites, and their children's growth curves and adiposity. The study proposes the Triponderal Index as an alternative approach to evaluating growth, introducing a novel perspective in growth monitoring. By highlighting the impact of mothers' emotional appetites and food choices on children's dietary habits and weight status, the research emphasizes the significance of family eating habits. The findings support the promotion of healthy dietary practices within families as a crucial measure in preventing and managing childhood obesity, conveying a significant message to parents and healthcare professionals for a healthier future.

Associations between parental adherence to healthy lifestyles and cognitive performance in offspring: A prospective cohort study in China

BACKGROUND

Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring's cognitive development during early childhood. This study aimed to investigate the prospective associations between overall parental lifestyle and offspring's cognitive performance during adolescence and young adulthood in China.

METHODS

We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies. A healthy parental lifestyle score (ranged 0-5) was constructed based on the following five modifiable lifestyle factors: Smoking, drinking, exercise, sleep, and diet. Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring's fluid and crystallized intelligence in subsequent years (2012, 2014, 2016, and 2018).

RESULTS

Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence (multivariable-adjusted β = 0.53, 95% confidence interval [CI]: 0.29-0.77) and overall crystallized intelligence (multivariable-adjusted β = 0.35, 95% CI: 0.16-0.54) than those in the bottom tertile of parental healthy lifestyle scores. The results were similar after further adjustment for the offspring's healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status. Additionally, maternal and paternal healthy lifestyle scores were independently associated with better offspring's cognitive performance, with significant contribution observed for paternal never-smoking, weekly exercise, and diversified diet. When both parents and offspring adhered to a healthier lifestyle, we observed the highest level of the offspring's overall crystallized intelligence.

CONCLUSIONS

Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring's cognitive performance during adolescence and early adulthood, regardless of socioeconomic status. These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.

Simply Dinner: A Randomized Controlled Trial of Home Meal Delivery

OBJECTIVE

To determine the effect of a bundled intervention (home meal delivery and provision of cooking/serving resources) on preschoolers' body mass index z-score (BMIz), dietary quality, and family meal frequency.

METHODS

Participants (299 families; mean child age 4.4 years, 47% male, 55% White, 18% Black, 27% Hispanic or other race and ethnicity, and 25% were overweight or obese) were randomized to a control group or to provision of cooking/serving resources plus home meal delivery for 12 weeks (meals provided by Meals on Wheels [MOW cohort, n = 83] or a commercial service [COM cohort, n = 216]). Outcomes were child dietary quality, family meal frequency, and child BMIz.

RESULTS

The intervention increased dinnertime intake of red and orange vegetables in the full sample (MOW cohort+COM cohort) (0.10 pre- to 0.15 cup equivalents (CE) post-in the intervention group vs 0.10 pre- to 0.09 post- in the control group; P = .01) and the COM cohort (0.11 pre- to 0.17 CE post- vs 0.11 pre- to 0.09 post-; P = .002), and typical daily dietary intake of fruit and fruit juice in the MOW cohort (1.50 CE pre- to 1.66 post- vs 1.48 pre- to 1.19 post-; P = .05). The intervention did not change meal frequency or BMIz.

CONCLUSIONS

Short-term home meal delivery with provision of cooking/serving resources improved dietary quality among preschool-aged children but did not change meal frequency or BMIz. Expansion of Meals on Wheels programs to preschool-aged children may be a promising intervention to improve dietary quality. Family meals, when already frequent, are not further increased by reducing the burden of meal preparation.

Examining the feasibility of a brief parent intervention designed to promote positive food communication with infants

BACKGROUND

Few prevention interventions exist focusing on supporting parents to use positive food communication at mealtimes, for the prevention of disordered eating. "Mealtime chatter matters (MCM)" is a brief intervention designed for parents of infants. The intervention was designed in collaboration with child health nurses (CHNs) to be embedded into usual care. The overall aim of this study was to test the feasibility of the intervention through examining the acceptability of the MCM content and resources and the potential impact of the intervention on parents.

METHODS

This pilot study utilised a mixed methods approach and took place within a regional child health service in Queensland, Australia (October 2021 to June 2022). Participants were parents of infants attending child health education groups and CHNs. The intervention consisted of a brief education session (including accompanying resources), facilitated by a Paediatric Dietitian. The acceptability of MCM content and resources was assessed by both parents and CHNs via self-reported questionnaires and the potential impact on parents assessed via pre-/post-self-reported questionnaires.

RESULTS

Forty-six parents of infants (aged < 8 months) and six CHNs who hosted the intervention and observed the program's delivery participated in the study. MCM content and resources were highly acceptable to parents and CHNs, as both qualitative and quantitative data concurred. How the program may have potentially impacted parenting practices was unclear from the survey results and further investigation is required to better understand these. Tangible lessons and opportunities to further test this intervention were clear from current results.

CONCLUSION

Overall, MCM was acceptable to both parents and CHNs, with the content and resources both being highly valued. Parents reported the content to be informative and engaging and CHNs were keen to have such an intervention available in the future. However, further modification and testing is required of MCM. This feasibility study is an essential first step in supporting parents and CHNs to access an evidence-based intervention with the aim of preventing disordered eating.

TRIAL REGISTRATION

Griffith University Human Research Ethics Committee (2021/577) and Gold Coast Hospital and Health Service Human Research Ethics Committee (QGC/76618).

Cultural influences on infant and toddler feeding among low-income Latinx mothers

Latinx infants and toddlers experience higher obesity rates than their black or white counterparts, increasing chronic disease risk later in life. Infant and toddler feeding (ITF) interventions are shown to improve dietary behaviours, but few studies target Latinx populations. Culturally tailoring such interventions is imperative, but cultural influences on Latinx ITF practices remain unclear. The purpose of this study was to characterize how culture influences ITF practices among Latinx mothers of low income. A brief survey and semistructured interview informed by the theory of planned behaviour (TPB) were conducted on Zoom with New York City-based Latinx mothers of children 4 to 24 months old. A directed content analysis approach was used to identify themes using TPB theoretical codes and inductive codes. Transcripts were coded independently by two researchers using NVivo 12. Survey data were analyzed using descriptive statistics in Excel. Participants (n = 19) were of Dominican, Mexican and Central and South American origin, had low acculturation scores and mean child age was 16.7 months (range: 5-24 months old). The central theme identified was that participants balanced cultural information with evidence-based health information to determine which ITF practices were most beneficial to infant/toddler health. This resulted in the adoption of evidence-based ITF recommendations, adoption of cultural practices that aligned with evidence-based recommendations and dismissal or postponement of cultural ITF practices that contradicted evidence-based recommendations. The present results can be applied to culturally relevant ITF education as follows: emphasizing the benefits of desirable ITF practices on children's health and promoting healthy cultural ITF practices.

Impact of mothers' distress and emotional eating on calories served to themselves and their young children: An experimental study

BACKGROUND

Parents play a significant role in children's eating behaviours and food environment. Emotional eating (i.e., eating due to/to cope with emotions regardless of hunger) can contribute to excess energy consumption and subsequent weight gain. Yet, there is a paucity of research examining mothers' feeding and eating behaviours in the presence of their young children during times of acute distress.

OBJECTIVE

The current study examined whether manipulated maternal mood impacted subsequent eating and parental-feeding in mothers with overweight or obesity with their preschool aged children in a laboratory-based experiment.

METHODS

Mothers (n = 47) with overweight or obesity and their preschool aged children were randomized to either an acute distress or control group. After completing a task which manipulated mothers' moods, respectively, dyads were offered a buffet of snack foods. Measures of mothers' reported emotional eating and distress were collected, and calories served and consumed were objectively measured.

RESULTS

There were no between-group differences regarding calories served or consumed. Mothers across both groups who reported higher emotional eating served themselves (p = 0.014) and their children (p = 0.007) less food, and mothers consumed less food (p = 0.045). Mothers who reported higher emotional eating and increased acute distress fed their children less food (p = 0.02) and both children and mothers ate less food (p < 0.05).

CONCLUSIONS

Results suggest that mothers who report emotional eating tendencies may feed their children less food during periods of acute distress.

Parents’ Communication with Teachers about Food and Nutrition Issues of Primary School Students

Parents and teachers have a major influence in the formation of primary school children’s eating behaviours. Although the cooperation of parents and teachers has frequently been recommended in the promotion of healthy eating habits among primary school children, little is known about the communication between these two groups regarding food- and nutrition-related issues. This paper reports findings from semi-structured interviews with primary school parents (n = 19) and primary teachers (n = 17), as well as findings from a survey of 787 parents in Australia. Audio-recorded interviews were analysed using NVivo and descriptive statistics were calculated for the survey questions. The results indicated that their communications involved various topics, including allergies, lunchbox content, and supervision requests, through diverse communication channels. The risk of offending each other and time scarcity were reported as communication barriers. Parents mainly expected teachers to ensure that their children were given enough time to eat their lunch, teach healthy eating, and be good role models of healthy eating. This study highlights the need to overcome communication barriers between parents and teachers and support teachers in their multifaceted professional roles.

Parental Food Communication and Child Eating Behaviours: A Systematic Literature Review

AIM

To review current evidence for parental food communication practices and their association with child eating behaviours.

METHODS

The PRISMA framework guided the reporting of the review; registered with Prospero in July 2020 (blinded for peer review). Eligible studies were critically appraised using the Joanna Briggs Institute tools. Only quantitative studies that included a parental measure of food communication and a child measure of eating behaviour were included.

RESULTS

From 11063 articles 23 were eligible for synthesis. The vast majority (82%) of studies used observational cross-sectional designs. Three involved observing parent-child dyads, with the remainder using questionnaires. Two quasi-experimental designs tested interventions and two randomised control trial were reported. The majority of measures assessing parental food communication were subscales of larger questionnaires. The Caregiver's Feeding Style Questionnaire (CFSQ) was the most direct and relevant measure of parental food communication. Findings of reviewed studies highlighted that "how" parents communicate about food appears to impact child eating behaviours. Using child-centred communication provided promising outcomes for positive child eating behaviours, while parental "diet" communication was found to be associated with poorer dietary outcomes in children.

CONCLUSIONS

Food communication research is in its infancy. However, evidence for the importance of parents' child-focused food communication is emerging, providing a focus for future research and interventions. SO WHAT?: Given the gaps in our understanding about prevention of disordered eating, there is a significant opportunity to explore what food communication strategies may assist parents to communicate about food in a positive way.

Caregiver Perceptions of Child Diet Quality: What Influenced Their Judgment

This study aimed at assessing the correctness of a caregiver’s perception of their child’s diet status and to determine the factors which may influence their judgment. 815 child-caregiver pairs were recruited from two primary schools. 3-day 24-h recall was used to evaluate children’s dietary intake, Chinese Children Dietary Index (CCDI) was used to evaluate the dietary quality. Multivariate logistic regression models were used to explore the factors that could influence the correctness of caregiver’s perception. In the current study, 371 (62.1%) children with “high diet quality” and 35 (16.1%) children with “poor diet quality” were correctly perceived by their caregivers. Children who were correctly perceived as having “poor diet quality” consumed less fruits and more snacks and beverages than those who were not correctly perceived (p < 0.05). Obese children were more likely to be correctly identified as having “poor diet quality” (OR = 3.532, p = 0.040), and less likely to be perceived as having “high diet quality”, even when they had a balanced diet (OR = 0.318, p = 0.020). Caregivers with a high level of education were more likely to correctly perceive children’s diet quality (OR = 3.532, p = 0.042). Caregivers in this study were shown to lack the ability to correctly identify their children’s diet quality, especially amongst children with a “poor diet quality”. Obesity, significantly low consumption of fruits or high consumption of snacks can raise caregivers’ awareness of “poor diet quality”.

Studying Children's Eating at Home: Using Synchronous Videoconference Sessions to Adapt to COVID-19 and Beyond

The COVID-19 pandemic has disrupted many facets of developmental research, including research that measures children's eating behavior. Here, children's food intake is often measured by weighing foods that children are offered before and after in-person testing sessions. Many studies also examine children's food ratings (the extent to which they like or dislike a food), assessed via picture categorization tasks or hedonic scales. This paper reviews existing research on different methods for characterizing children's eating behavior (with a focus on food intake, preferences, and concepts) and presents a feasibility study that examined whether children's eating behaviors at home (including their food intake and ratings) can be measured via live video-chat sessions. The feasibility analyses revealed that an observational feeding paradigm at home yielded a majority (more than 70%) of video-chat recordings that had a sufficient view of the child and adequate sound and picture quality required for observational coding for the majority of the session's duration. Such positioning would enable behavioral coding of child food intake, parent food talk, and meal characteristics. Moreover, children were able to answer questions to stories and express their preferences via researcher screen-share methods (which can assess children's self-reported food preferences and beliefs) with low rates of exclusion across studies. The article ends with a discussion on the opportunities and challenges of using online platforms to conduct studies on children's eating behaviors in their home environments during the COVID-19 pandemic and beyond.

Show or tell: Children's learning about food from action vs verbal testimony

BACKGROUND

Childhood obesity continues to be a critical health concern in the United States. Nonetheless, interventions that focus on delivering verbal lessons about food and health to children in preschool classrooms have had only modest effects.

OBJECTIVES

The present study examines the relative effectiveness of showing vs telling children about food to promote healthy eating, with a focus on unfamiliar foods and vegetables.

METHODS

Three- to six-year-old children (n = 71) were tested in a laboratory study in which they watched videos of two people eating apple-broccoli puree. One person took five bites of the food; the other said they liked the food.

RESULTS

Children did not differentiate between the food they saw someone eat and the food they heard someone talk about. Children's food intake was negatively associated with parent reports of children's eating behavior on the Food Fussiness subscale of the Child Eating Behavior Questionnaire. We found similar patterns in an analogous toy task. In an unfamiliar object task, children selected the action demonstration as the right way to use the object.

CONCLUSIONS

We find no evidence that action vs verbal testimony is more persuasive in guiding children's food choices, but action testimony may be persuasive in other domains. The associations between children's food intake and pickiness provide growing evidence of alignment between parent assessments of their children's typical eating behavior and children's food choices in laboratory studies.

Evaluating and communicating about the healthiness of foods: Predictors of parents' judgments and parent-child conversations

Parents are typically in charge of purchasing the food that their children eat, but little is known about how parents decide if particular foods are healthy for their children and how their beliefs about nutrition influence their children's beliefs. In two studies, we investigated how parents of children ages 4 to 12 (N = 826) make decisions about the healthiness of foods, when presented with different representations of the same nutritional information. Providing parents with nutritional information did not influence their ratings of how healthy food items are, compared to when they are shown only pictures of the foods. Parents reported talking with their children about nutrition, believed they are the best source of information for children about nutrition, and believed their nutrition beliefs influence their child's beliefs. Our findings highlight the role of prior knowledge in food cognition and how beliefs about foods are transmitted from parents to children.

Breastfeeding and women's interest in specific food tastes

To determine whether breastfeeding alters women's interest in eating foods of different taste categories, we surveyed women at their 6-week post-partum check-up, asking them to rate their interest in eating various foods. Regardless of whether women responded in English or Spanish, they indicated greatest interest in eating sweet-tasting foods and least interest in eating sour-tasting foods, independent of whether they were breastfeeding. In general, the interest in eating foods of all taste qualities foods was increased in women who were breastfeeding; however, interest in eating salty and sour foods was not altered by breastfeeding in Spanish respondants. It is noteworthy that interest in eating foods of specific taste categories correlated with ratings of hunger in women who were not breastfeeding, but not in women who were breastfeeding. Thus, although breastfeeding women had a greater interest in eating foods of all taste categories, their interest does not appear to be driven solely by hunger. Finally, independent of breastfeeding, the interest in eating specific foods within taste categories differed between English and Spanish respondants, with Spanish respondants reporting greater interest in eating both nuts and bananas compared to English respondants. Together, these findings represent an initial approach to assess the impact of breastfeeding on interest in eating different types of food, and of how reproductive status and cultural differences may interact to affect food preferences and thereby to alter food choices.

A biopsychosocial approach to processes and pathways in the development of overweight and obesity in childhood: Insights from developmental theory and research

Childhood obesity has reached alarming proportions in many countries. There is consensus that both biological (especially genetic) and environmental (including psychosocial) factors contribute to weight gain and obesity in childhood. Research has identified extensive risk or predictive factors for childhood obesity from both of these domains. There is less consensus about the developmental processes or pathways showing how these risk factors lead to overweigh/obesity (OW/OB) in childhood. We outline a biopsychosocial process model of the development of OW/OB in childhood. The model and associated scholarship from developmental theory and research guide an analysis of research on OW/OB in childhood. The model incorporates biological factors such as genetic predispositions or susceptibility genes, temperament, and homeostatic and allostatic processes with the psychosocial and behavioral factors of parenting, parental feeding practices, child appetitive traits, food liking, food intakes, and energy expenditure. There is an emphasis on bidirectional and transactional processes linking child biology and behavior with psychosocial processes and environment. Insights from developmental theory and research include implications for conceptualization, measurement, research design, and possible multiple pathways to OW/OB. Understanding the developmental processes and pathways involved in childhood OW/OB should contribute to more targeted prevention and intervention strategies in childhood.

Feasibility and Acceptability of a Culturally Tailored Website to Increase Fruit and Vegetable Intake and Physical Activity Levels in African American Mother-Child Dyads: Observational Study

BACKGROUND

African American youth (aged 8-14 years) do not adhere to national dietary and physical activity guidelines. Nonadherence to these recommendations contributes to disproportionate rates of obesity compared with their white counterparts. Culturally tailored electronic health (eHealth) solutions are needed to communicate nutrition and physical activity messages that resonate with this target population.

OBJECTIVE

This study aimed to identify the impact of exposure to a website hosting culturally tailored cartoons to inspire fruit and vegetable uptake and physical activity levels in African American mother-child dyads.

METHODS

Statistical analysis included paired sample t tests to evaluate knowledge gains, self-efficacy, and readiness to change. Adapted items from Prochaska's Stages of Change toward the following 4 behaviors were assessed with pre- and posttest surveys: (1) fruit and vegetable selection on my plate, (2) meal preparation, (3) fruit and vegetable selection outside of home, and (4) physical activity. Open-ended comments on videos from mother-child dyads were used to determine user acceptance. Observations of repeated responses during content analysis informed coding and development of key themes.

RESULTS

A final sample size of 93 mother-child dyads completed the study. Mothers reported significant improvement from precontemplation or contemplation stages to preparation or action stages for (1) fruit and vegetable selection on her plate (P=.03), (2) meal preparation for her family (P=.01), (3) fruit and vegetable selection outside the home (P<.001), and (4) physical activity (P<.001). Significant improvements were found in knowledge, stage of change, and self-efficacy for the 4 target behaviors of interest (P<.001). Children's open-ended commentary reported vicarious learning and positive character identification with brown-skinned cartoons exhibiting healthful food and exercise behaviors. Mothers commented on the lack of accessible produce in their neighborhoods not depicted in the cartoon videos.

CONCLUSIONS

Culturally adapted cartoons that incorporate tailored preferences by African American families, such as race or demography, may help increase adherence to target health behaviors when developing eHealth behavior solutions.