The moderating role of parent gender on the relationship between restrictive feeding and a child's self–regulation in eating: Results from mother-only samples may not apply to both parents

Sex-Moderated Divergence between Adult Child and Parental Dietary Behavior Patterns in Relation to Body Mass Condition-Evaluating the Mediating Role of Physical Activity: A Cross-Sectional Study

The main objective of this study was to explore the dietary behaviors of parents and their adult children, focusing on patterns, potential intrinsic and extrinsic predictors of body mass, and determinants of becoming overweight. Non-probability, cross-sectional sampling was used to select participants from a university student population. Young adults (19-21 years of age, n = 144) and their parents were examined. The data of those family pairs with complete sets of results were used. Dietary patterns and physical activity were assessed with questionnaires (QEB and IPAQ), and body height, weight measurements, and body mass indexes were calculated. A cophylogenetic approach with tanglegrams and heatmaps was used to study patterns, while predictors of body mass index were identified using multiple linear regression, stepwise logistic regression, and mediation analysis procedures. Cophenetic statistics confirmed significant incongruence between fathers and sons, confirmed by Baker's Gamma correlation (rBG = 0.23, p = 0.021), and mothers and daughters (rBG = 0.26, p = 0.030). The relationships between the dietary patterns of the fathers and daughters, as well as mothers and sons, were of medium strength (rBG = 0.33, p = 0.032, rBG = 0.43, p = 0.031; respectively). Most of the patterns were mixed. Fast food, fried meals, alcoholic drinks, energy drinks, and sweetened beverages were associated significantly with being overweight. Significant intrinsic predictors of excessive weight in young adults were sex (b = 2.31, p < 0.001), PA (b = -0.02, p < 0.001), and eating fermented milk and curd cheese (b = -0.55, p = 0.024), while extrinsic (parental) predictors included eating fast food and fried meals (b = -0.44, p = 0.049). Both physical activity and dietary behaviors independently determined the sons' overweight status (b = -1.25, p = 0.008; b = -0.04, p < 0.001; respectively); while only PA did in daughters (b = -0.04, p < 0.001). No mediating effects of physical activity were observed. Adult children and parental dietary patterns were divergent, reflecting the influence of multiple factors on a child's dietary habits. However, this divergence is moderated by sex. Reciprocal interactions between dietary intake-particularly positive dyads such as fruits and vegetables, fermented milk, and curd cheese-and physical activity significantly impacted children's body mass index (BMI). The study of dietary patterns in conjunction with physical activity (both as independent determinants), particularly in relation to the link between overweight/obese children and overweight/obese parents, presents a separate challenge.

Research priorities and considerations for nutrition research: methods of sex and gender analysis for biomedical and nutrition research

For some 20 years, science funding bodies have been asking for the integration of sex- and gender-related factors into the content of research and innovation. The rationale for those requirements has been the accumulated evidence that sex and gender are important determinants of health and disease. The European Commission (EC) has been the first, since 2002, to seriously ask for the integration of sex and gender into research and innovation in the context of their multi-annual framework programmes. When introduced, this condition was not immediately applauded by the research community, who perhaps lacked training in methods for the integration of sex- and gender-related factors. The EC Expert Group on Gendered Innovations sought to fill this gap. This review describes the work of this international collaborative project which has resulted in the development of general and field-specific methods for sex and gender analysis and 38 case studies for various research domains (science, health and medicine, environment, engineering) to illustrate how, by applying methods of sex and gender analysis, new knowledge could be created. Since 2010, science funding bodies in Canada, the USA and several EU member states have followed the example of the EC issuing similar conditions. Although the effects of nutritional patterns on a range of (physiological and health) outcomes may differ for men and women, sex and gender analyses are rarely conducted in nutrition research. In this review, we provide examples of how gender is connected to dietary intake, and how advancing gender analysis may inform gender-sensitive policies and dietary recommendations.

Children's perception of food parenting practices: adaptation and validation of the comprehensive feeding practices questionnaire in Chilean adolescents

Introduction

Assessment of the Comprehensive Feeding Practices Questionnaire in adolescents (CFPQ-Teen) is still limited, with no evaluation of the measurement invariance. The participants comprised 473 Chilean adolescents of both sexes from dual-income nuclear families. The aims of this study were: (1) to adapt to Spanish and validate a model of five-factor version the CFPQ-Teen; (2) to examine the psychometric properties, (3) to evaluate the measurement invariance according to the adolescents' gender; and (4) to compare the scores of each factor between female and male adolescents.

Methods

The instrument was translated, back-translated, and adapted from the CFPQ-Teen, confirming the equivalence, conceptual, and face validity in a pilot sample of 40 adolescents. An exploratory factor analysis was performed on the five-factor model of the CFPQ-Teen: Monitoring, Adolescent Control, Restriction for weight control, Parental Modeling, and Environment. The Environment factor was eliminated as a result.

Results

The confirmatory factor analysis presented good reliability, convergent, discriminant, and concurrent validity values. In addition, medium to high goodness-of-fit levels were obtained by eliminating an item from the Adolescent Control factor. These results confirm a final 20-item model representing four factors. The multigroup invariance analysis of the measurement model verified configural, metric, scalar, and partial strict invariance. No significant differences were found between females and males in the scores on the four factors.

Discussion

These results enable comparisons by sex on the perceptions of Food Parenting Practices from the analyzed factors, primarily within the context of the Chilean sample.

Measurement invariance of the comprehensive feeding practices questionnaire in dual-earner parents with adolescent children in Chile

The Comprehensive Feeding Practices Questionnaire (CFPQ) has been evaluated in international studies, but the evaluation of its psychometric properties in Spanish, and in particular for parents of adolescents is still limited, and the invariance of measurement according to gender has not been evaluated. Therefore, the objectives of this study were: (1) To adapt the five-factor model of the CFPQ instrument to Spanish; (2) To examine the psychometric properties of this adaptation; and (3) To evaluate the measurement invariance of the model to verify the equivalence of measurement of the perceptions of food parenting practices between mothers and fathers belonging to nuclear, dual-earner families with adolescent children. Participants were 946 mothers and fathers from Southern Chile. Results showed that the conceptual equivalence for the CFPQ was achieved. An exploratory factor analysis was performed for a five-factor model: Monitoring, Child control, Restriction for weight control, Modeling and Environment. Horn's parallel analysis identified four factors, while factor loading analysis determined the removal of the environment factor. Confirmatory factor analysis presented good reliability values. Convergent and discriminant validity was confirmed, and medium-to-high levels of goodness of fit were obtained, eliminating two items. Results supported a final model of four factors and 19 items. Multigroup analysis of the measurement model verified the configural and metric invariance between fathers and mothers, while the scalar and strict partial invariance was verified. These findings are a relevant guide to measure factorial scores in the four-factor model of the CFPQ, establishing a characterization of feeding practices of parents and adolescents.

The correlation between different operationalisations of parental restrictive feeding practices and children's eating behaviours: Systematic review and meta-analyses

Strategies used by parents to restrict children's access to highly palatable but unhealthy foods have been described collectively as restrictive feeding practices. Ironically, evidence shows these practices may foster maladaptive eating behaviours and increase children's risk of obesity. This systematic review and series of meta-analyses aim to estimate the relationships between different operationalisations of parental restrictive feeding practices and children's eating behaviours measured by either the Children's Eating Behaviour Questionnaire (Wardle et al., 2001) or eating in the absence of hunger paradigm. PsycINFO, Medline Complete, CINAHL, Scopus and Web of Science databases were searched on April 22nd 2021 for terms relating to restrictive feeding practices, children and eating behaviours. Eligible studies (n = 24) reported a correlation between restrictive feeding and children's (2-12-years) eating behaviours. Meta-analyses were conducted on different operationalisations of restrictive feeding practices and different eating behaviours where there were three or more effects to analyse. Studies that were not meta-analysed were synthesised qualitatively. All studies were quality assessed using a standard checklist. Restrictive feeding (Child Feeding Questionnaire; Birch et al., 2001), was significantly correlated with higher food responsiveness, food fussiness, emotional overeating, and lower slowness in eating. Overt restriction (Feeding Practices and Structure Questionnaire, E. Jansen et al., 2014) was significantly correlated with higher food responsiveness. The qualitative synthesis suggests overt restriction is related to maladaptive eating behaviours, but that other operationalisations of restrictive feeding, especially covert restriction, are not. Future research should examine whether covert restriction provides an alternative, non-harmful approach to restriction, by which parents can control children's diet quality without negatively impacting their eating behaviours.

Daily variability in mothers' and fathers' feeding practices and associations with children's eating behaviors

The current study explores daily variability in maternal and paternal pressuring, restrictive, and structure-related feeding practices and their associations with child energy regulation and food refusal. Multilevel models were run separately for mothers and fathers to understand these associations, as well as within a dyadic framework to account for the interdependence of partners. One hundred families with at least one child between 3- to 5-years old participated by completing seven days of daily diaries. Results suggest there is daily variability in feeding practices for mothers and fathers and children's energy regulation and food refusal. Mothers' daily reports (within family variability) suggested that on days when mothers used more pressure and less structure than usual, children showed more food refusal. Fathers' daily reports suggested that on days when fathers used more pressure or less structure, children showed less energy regulation. On average across the week (between family variability), maternal pressure and restriction was related to child energy regulation. Dyadic multilevel models suggested that fathers' daily feeding behavior was associated with child eating behavior, while mothers' pressure and restrictive feeding on average across the week was a better predictor of between family variability in child eating behavior. For provision of support or structure during feeding, maternal structure was related to less father-reported energy regulation and paternal structure was related to more father-reported energy regulation. The results highlight the necessity of considering both mothers' and fathers' behaviors from day-to-day to get a more authentic picture of the family feeding relationship.

Young Children's Eating in the Absence of Hunger: Links With Child Inhibitory Control, Child BMI, and Maternal Controlling Feeding Practices

This study aimed to gain a better understanding of the associations between young children’s eating in the absence of hunger (EAH), inhibitory control, body mass index (BMI) and several maternal controlling feeding practices (food as reward, restriction for health, restriction for weight control). In addition, to more properly assess the relationship between children’s and maternal variables, the link between EAH and restriction was explored separately in two directionalities: “child to parent” or “parent to child.” To do this, mothers of 621 children aged 2.00–6.97years (51% boys, M=4.11years, SD=1.34) filled in a questionnaire with items from validated questionnaires. Structural equation modeling (SEM) was used to analyze the data. The results showed, whatever the directionality considered, a positive association between children’s eating in the absence of hunger and their BMI z-scores. Restriction for health and restriction for weight control were differently linked to EAH and to children’s BMI z-scores. Namely, low child inhibitory control, food as reward and restriction for health were identified as risk factors for EAH. Restriction for weight control was not linked to EAH, but was predicted by child BMI z-scores. Interventions aiming to improve children’s abilities to self-regulate food intake could consider training children’s general self-regulation, their self-regulation of intake, and/or promoting adaptive parental feeding practices.

Sex Differences in Maternal Restrictive Feeding Practices in the Intervention Nurses Start Infants Growing on Healthy Trajectories Study

BACKGROUND

Intervention Nurses Start Infants Growing on Healthy Trajectories tested an early life responsive parenting (RP) intervention designed for obesity prevention. Body mass index z-score at age 3 years was lower for the RP group versus controls with a larger effect for girls than boys. We sought to determine if child sex was associated with differing maternal feeding practices and whether sex moderated intervention effects on feeding.

DESIGN/METHODS

Mothers (N = 279) completed the Infant Feeding Styles Questionnaire (IFSQ) at 28 weeks, the Structure and Control in Parent Feeding (SCPF) at 1, 2, and 3 years, and the Child Feeding Questionnaire (CFQ) at 3 years. Study aims were tested using 2-way analysis of variance and repeated measures.

RESULTS

Mothers reported greater restriction (limiting food quantity) for boys at 28 weeks (IFSQ: 3.0 ± 1.1 vs 2.8 ± 1.0, P = .07) and across annual measurements from age 1 to 3 years (SCPF: P = .04). At age 3, the intervention group effect on restriction differed by sex (CFQ: P = .047) such that higher restriction was reported by RP group mothers of boys versus girls (3.4 ± 0.7 vs 3.0 ± 0.9, P = .002) with no control group sex difference (3.4 ± 0.8 vs 3.3 ± 0.9, P = .79). There were no sex differences or sex by intervention group interactions in other reported feeding practices at any assessment (ie, structure-based feeding, pressure).

CONCLUSIONS

Mothers of boys used more restrictive feeding through age 3. These findings may be partially explained by previously reported better self-soothing and self-regulation abilities of participating girls.

Comparing Maternal and Paternal Complementary Feeding Practices: Findings From an Online Survey

OBJECTIVE

To explore differences between mothers' and fathers' complementary feeding practices.

METHODS

An online survey of UK parents with a healthy child in complementary feeding age. Timing of introducing solid foods and adherence to feeding guidelines were assessed. Dietary quality was measured using the Complementary Feeding Utility Index.

RESULTS

In a sample of 60 mothers and fathers (nondyads), there were no differences between fathers and mothers in the timing of introduction of solid foods, compliance with complementary feeding guidelines, or dietary quality. Most fathers who participated had a male child, whereas mothers had an equal number of male and female children (P < 0.001). The proportion of mothers who followed baby-led weaning was higher compared with fathers (P = 0.02).

CONCLUSIONS AND IMPLICATIONS

Study findings reveal no gender differences in parental complementary feeding practices apart from the use of baby-led weaning. Future studies with bigger male samples are warranted to explore the paternal role during complementary feeding.

The relationship between parental food parenting practices & child eating behavior: A comparison of mothers and fathers

The objective of this study was to compare the relationships between food parenting practices and child eating behavior among mothers and fathers of young children. This cross-sectional study recruited mothers (n = 127) and fathers (n = 118) of children (4.2 ± 1.3 years old) to complete surveys (face-to-face and online). Each parent completed the Comprehensive Food Parenting Questionnaire, Children's Eating Behavior Questionnaire, and demographic questions. Linear regressions were used to compare the relationships between parental food parenting practices and children's eating behaviors with parent sex as a moderator. Child age and sex served as control variables in each regression. Parent sex was a significant moderator in several relationships between parent food parenting practices and child eating behavior. In the relationship between parental restriction for health (ß = -.14, p = .014) and monitoring (ß = -.13, p = .028) and child slowness in eating, the slope of the interaction was significantly higher for mothers, meaning that when mothers and fathers use the same level of restriction for health and monitoring, child slowness in eating is higher for children of mothers. When mothers and fathers used the same level of restriction for weight, child food responsiveness (ß = .13, p = .003) and emotional overeating (ß = .12, p = .046) was significantly higher for children of fathers. There may be differences in how mothers and fathers implement food parenting practices and/or differences in how these practices impact children. Specifically, for fathers, it seems that the use of restriction for weight is more detrimental for children's eating behaviors compared to when mothers use the same level of restriction for weight.

Fathers' food parenting: A scoping review of the literature from 1990 to 2019

BACKGROUND

While food parenting is a robust area of inquiry, studies have largely focused on mothers. Given the diversity of family structures today and increases in fathers' engagement in caregiving, fathers' food parenting warrants attention.

OBJECTIVE

We present a scoping review of research on fathers' food parenting (1990-2019). Eligible studies included peer-reviewed research published in English documenting fathers' food parenting and presenting results for fathers separate from mothers.

RESULTS

Seventy-seven eligible studies were identified. Most studies were based in the U.S (63.6%) and utilized a cross-sectional design (93.5%). Approximately half of studies used a validated measure of food parenting (54.5%) and slightly less than 30% utilized theory (28.6%). Many studies did not report information on fathers' residential status (37.7%) or their relationship to the target child (biological vs social) (63.6%). Content analysis of study findings showed that: fathers are involved in food parenting, but at lower levels than mothers; there are few consistent mother-father differences in food parenting practices; and fathers' controlling food parenting is linked with negative nutrition outcomes in children while responsive food parenting is linked with positive child outcomes.

CONCLUSION

To better inform family interventions to prevent childhood obesity, future food parenting research with fathers should recognize the diversity of family structures and utilize prospective, theory-based, designs.