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Ayre SK, Harris HA, White MJ, Byrne RA. Food Parenting Practices and Child Eating Behaviors in Australian Families: A Cross-Sectional Sibling Design. J Acad Nutr Diet 2024; 124:42-57.e8. [PMID: 37661083 DOI: 10.1016/j.jand.2023.08.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Research on feeding in early childhood has focused primarily on parent-child dyadic interactions, despite parents enacting these practices within the complex dynamic of the family system. OBJECTIVE Using a sibling design, this study aimed to assess how parents may adapt their food parenting practices for siblings in response to differences in their eating behaviors. DESIGN A cross-sectional online survey was conducted between October and December 2022. PARTICIPANTS/SETTING Data were collected from parents (97.5% women) in Australia with 2 children aged 2 to 5 years (n = 336 parents and n = 672 children). MAIN OUTCOME MEASURES Survey items were completed for each sibling, and included four subscales of the Children's Eating Behaviour Questionnaire and seven subscales of the Feeding Practices and Structure Questionnaire-28. STATISTICAL ANALYSES PERFORMED Multiple linear regression models examined associations between within-sibling pair differences in child eating behaviors and food parenting practices, adjusting for differences in child body mass index z score, age, gender, and early feeding method. RESULTS Within-sibling pair differences in eating behaviors were associated with differences in some food parenting practices. For the fussier sibling, parents reported using more control-based practices, including persuasive feeding, reward for eating, and reward for behavior, and less of the structure-based practice, family meal settings (P values < 0.001). Similar directions of associations were found for persuasive feeding, reward for eating, and family meal settings with siblings who were slower eaters or more satiety responsive (P values < 0.007); however, no significant differences in reward for behavior were observed in relation to sibling differences in these eating behaviors. For the more food responsive sibling, parents reported using more control-based practices, including reward for behavior and overt restriction (P values < 0.002). CONCLUSIONS Within families, parents may adapt certain practices in response to differences in their children's eating behaviors. Interventions promoting responsive feeding should be designed to acknowledge the integral role of siblings in shaping parents' feeding decisions.
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Affiliation(s)
- Susannah K Ayre
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, Queensland, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
| | - Holly A Harris
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Melanie J White
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Rebecca A Byrne
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, Queensland, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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Schratz LM, Larkin O, Dos Santos N, Martin C. Caregiver Influences on Eating Behaviors in Children: An Opportunity for Preventing Obesity. Curr Atheroscler Rep 2023; 25:1035-1045. [PMID: 38032429 DOI: 10.1007/s11883-023-01171-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE OF REVIEW This review seeks to define caregiver practices that impact childhood eating behaviors and identify ways to utilize these relationships to prevent childhood obesity. RECENT FINDINGS Childhood obesity, which correlates with adult obesity and increased cardiovascular risk, is increasing in prevalence and severity. Caregivers play a significant role in shaping a child's eating behaviors and their predisposition to obesity. Maternal influences during pregnancy and infancy impact a child's future food preferences. Caregiver feeding styles (authoritarian, authoritative, indulgent, and uninvolved) are associated with distinct effects on children's eating behaviors and self-regulation. Authoritative feeding styles promote child autonomy while setting boundaries in the feeding environment. Early caregiver education and coaching regarding nutrition and feeding practices is beneficial to establishing healthy eating behaviors for children. Various caregivers, including parents, grandparents, siblings, teachers, and others, influence a child's eating habits at different stages of development. These caregivers can both positively and negatively impact a child's diet. Comprehensive interventions involving these various caregivers to promote healthy eating practices in children is ideal. Such interventions should be sensitive to cultural and environmental factors. Childhood obesity is a complex issue with long-term health effects. Early intervention using comprehensive approaches including all caregivers, community support, and public policies to address the social determinants of health will be beneficial. Future research should focus on valid outcome measures and equitable interventions that encompass all aspects of a child's life.
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Affiliation(s)
- Lorraine M Schratz
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA.
| | - Olivia Larkin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Nilse Dos Santos
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
| | - Christine Martin
- Division of Pediatric Cardiology, Department of Pediatrics, Massachusetts General Hospital for Children and Harvard Medical School, 175 Cambridge Street, 5Th Floor , Boston, MA, USA
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Killion K, Harris JL, Duffy VB. Caregiver perceptions of snacks for young children: A thematic synthesis of qualitative research. Appetite 2023:106628. [PMID: 37328005 DOI: 10.1016/j.appet.2023.106628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/26/2023] [Accepted: 06/05/2023] [Indexed: 06/18/2023]
Abstract
Snacks are inconsistently defined in nutrition research and dietary guidelines for young children, challenging efforts to improve diet quality. Although some guidelines suggest that snacks include at least two food groups and fit into an overall health promoting dietary pattern, snacks high in added sugars and sodium are highly marketed and frequently consumed. Understanding how caregivers perceive "snacks" for young children may aid in development of effective nutrition communications and behaviourally-informed dietary interventions for obesity prevention. We aimed to synthesize caregivers' perceptions of snacks for young children across qualitative studies. Four databases were searched for peer-reviewed qualitative articles including caregiver perceptions of "snacks" for children ≤5 years. We conducted thematic synthesis of study findings, concluding with the development of analytical themes. Data synthesis of fifteen articles from ten studies, conducted in the U.S., Europe, and Australia, revealed six analytical themes that captured food type, hedonic value, purpose, location, portion size, and time. Caregivers perceived snacks as both "healthy" and "unhealthy" foods. Less healthy snacks were described as highly liked foods, which required restriction and were consumed outside the home. Caregivers used snacks to manage behavior and curb hunger. Snack portions were described as "small", although caregivers reported various methods to estimate child portion size. Caregivers' perceptions of snacks revealed opportunities for targeted nutrition messaging, especially supporting responsive feeding and nutrient-dense food choices. In high-income countries, expert recommendations should consider caregivers' perceptions of snacks, more clearly defining nutrient-dense snacks that are enjoyable, achieve dietary requirements, reduce hunger, and promote healthy weight.
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Affiliation(s)
- Kate Killion
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Storrs, CT 06269-2101, USA.
| | - Jennifer L Harris
- Rudd Center for Food Policy and Health, University of Connecticut, 1 Constitution Plaza, Suite 600, Hartford, CT 06103, USA.
| | - Valerie B Duffy
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Box U-101 Storrs, CT 06269-2101, USA.
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Ayre SK, White MJ, Harris HA, Byrne RA. 'I'm having jelly because you've been bad!': A grounded theory study of mealtimes with siblings in Australian families. MATERNAL & CHILD NUTRITION 2023; 19:e13484. [PMID: 36808876 PMCID: PMC10019066 DOI: 10.1111/mcn.13484] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/11/2023] [Accepted: 01/23/2023] [Indexed: 02/22/2023]
Abstract
Obesity prevention interventions have been designed to promote responsive feeding in early childhood. However, existing interventions primarily target first-time mothers without considering the complexities of feeding multiple children within a family unit. By applying principles of Constructivist Grounded Theory (CGT), this study aimed to explore how mealtimes are enacted in families with more than one child. A mixed-methods study was conducted with parent-sibling triads (n = 18 families) in South East Queensland, Australia. Data included direct mealtime observations, semistructured interviews, field notes, and memos. Data were analysed using open and focused coding, during which constant comparative analysis was applied. The sample comprised of two-parent families with children ranging in age from 12 to 70 months (median sibling age difference = 24 months). A conceptual model was developed to map sibling-related processes integral to the enactment of mealtimes in families. Notably, this model captured feeding practices used by siblings, such as pressure to eat and overt restriction, that previously had only been described in parents. It also documented feeding practices used by parents that may occur only in the presence of a sibling, such as leveraging sibling competitiveness and rewarding a child to vicariously condition their sibling's behaviour. The conceptual model demonstrates complexities in feeding that give shape to the overall family food environment. Findings from this study can inform the design of early feeding interventions that support parents to remain responsive, particularly when their perceptions and expectations of siblings differ.
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Affiliation(s)
- Susannah K. Ayre
- Woolworths Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologySouth BrisbaneQueenslandAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Melanie J. White
- School of Psychology & Counselling, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Holly A. Harris
- Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
| | - Rebecca A. Byrne
- Woolworths Centre for Childhood Nutrition Research, Faculty of HealthQueensland University of TechnologySouth BrisbaneQueenslandAustralia
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
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Bohn C, Vogel M, Poulain T, Hiemisch A, Kiess W, Körner A. Having siblings promotes a more healthy weight status—Whereas only children are at greater risk for higher BMI in later childhood. PLoS One 2022; 17:e0271676. [PMID: 35853023 PMCID: PMC9295960 DOI: 10.1371/journal.pone.0271676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background Birth order and having at least one sibling are known to be associated with an increased risk for development of overweight. However, there are no studies assessing pre- and postnatal factors for developing overweight within families. Therefore, the present study aimed to analyse the association of the mother’s weight gain during pregnancy, prepregnancy BMI, mother’s age at birth, breastfeeding, age gap between siblings, and physical activity together with sibling-related characteristics on the development of overweight in children and adolescents. Methods Data were obtained from the longitudinal LIFE Child cohort. The study sample included n = 1932 children, stratified into first-born (n = 578), second-born (n = 608), third-or-later-born single-born siblings (n = 162), only children (n = 526), and twin children (n = 58). Children with chronic or syndromic diseases, born prematurely or from mothers with gestational diabetes were excluded. Data were adjusted for multiple children per family using mixed models. Pregnancy weight gain, prepregnancy BMI and mother’s age were considered prenatal co-variates. Postnatal factors included the duration of breastfeeding and the children’s physical activity level. Results Particularly until the onset of puberty, the BMI-SDS differed between single-born siblings, only children and twins, and increased with birth order. Compared to children with siblings, only children exhibited a strong increase in BMI-SDS starting at age nine. A higher age gap between siblings was associated with a higher BMI-SDS in second- and third-or-later-born children. Single-born siblings had the highest rate and duration of breastfeeding. Physical activity was highest in twins and third-or-later-born children and lowest in only children. In a multivariate model, being an only child showed a highly significant association with BMI-SDS. Conclusion The present study demonstrated that siblings had a lower BMI-SDS than only children did. For single-born siblings, the association between birth order and increased BMI-SDS seemed to persist only up to 11 years of age.
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Affiliation(s)
- Claudia Bohn
- Medical Faculty, LIFE Child (Leipzig Research Centre for Civilization Diseases), Leipzig University, Leipzig, Germany
| | - Mandy Vogel
- Medical Faculty, LIFE Child (Leipzig Research Centre for Civilization Diseases), Leipzig University, Leipzig, Germany
| | - Tanja Poulain
- Medical Faculty, LIFE Child (Leipzig Research Centre for Civilization Diseases), Leipzig University, Leipzig, Germany
| | - Andreas Hiemisch
- Medical Faculty, LIFE Child (Leipzig Research Centre for Civilization Diseases), Leipzig University, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Centre for Paediatric Research (CPL), Medical Faculty, Leipzig University, Leipzig, Germany
| | - Wieland Kiess
- Medical Faculty, LIFE Child (Leipzig Research Centre for Civilization Diseases), Leipzig University, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Centre for Paediatric Research (CPL), Medical Faculty, Leipzig University, Leipzig, Germany
| | - Antje Körner
- Medical Faculty, LIFE Child (Leipzig Research Centre for Civilization Diseases), Leipzig University, Leipzig, Germany
- Department of Women and Child Health, Hospital for Children and Adolescents and Centre for Paediatric Research (CPL), Medical Faculty, Leipzig University, Leipzig, Germany
- * E-mail:
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Food-related parenting practices and styles in households with sibling children: A scoping review. Appetite 2022; 174:106045. [DOI: 10.1016/j.appet.2022.106045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/30/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022]
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Damen FW, Luning PA, Fogliano V, Steenbekkers BL. Mothers choose a snack for their 2–3-year-old children based on different health perceptions. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Damen FWM, Steenbekkers BLPA. Added value of physical food products as a stimulus during interviewing. Appetite 2021; 169:105819. [PMID: 34808272 DOI: 10.1016/j.appet.2021.105819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/17/2021] [Accepted: 11/18/2021] [Indexed: 12/31/2022]
Abstract
Semi-structured interviews are an often-used method for researching consumer perceptions of food products. However, understanding detailed and in-depth how consumers perceive food products is challenging for researchers because it could be difficult for consumers to express their motives and perceptions. In our previous studies using semi-structured interviews, this difficulty to express perceptions was also recognized, especially when concepts like naturalness, sustainability and healthiness were discussed. However, in both studies physical food products were used as stimuli and there was an indication that there might be differences in the number and type of answers given before and after the use of these stimuli products. Therefore, the current research aimed at showing effects and the possible value of using physical food stimuli products during semi-structured interviews. Two different studies were used to reach this aim, one study about the health perception of mothers and the other study about the naturalness, sustainability and healthiness perception of adolescents, both using snack products as physical stimuli. In both studies, the use of physical stimuli products appeared to be effective and useful. The comparison of the answers with and without stimuli products showed that using stimuli products provides more, and more detailed answers on the perception of the products. Therefore, the results of this study could serve as a guideline on the use of food stimuli products during semi-structured interviews.
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Affiliation(s)
- Femke W M Damen
- Food Quality and Design Group, Department of Agrotechnology and Food Sciences, Wageningen University & Research, P.O. Box 17, Wageningen, Netherlands; Isi GmbH, Ascherberg, 2, 37124 Rosdorf, Gӧttingen, Germany.
| | - Bea L P A Steenbekkers
- Food Quality and Design Group, Department of Agrotechnology and Food Sciences, Wageningen University & Research, P.O. Box 17, Wageningen, Netherlands
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Healthy snacking in the school environment: Exploring children and mothers' perspective using projective techniques. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2020.104173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Damen FW, Luning PA, Pellegrini N, Vitaglione P, Hofstede GJ, Fogliano V, Steenbekkers BL. Mothers’ considerations in snack choice for their children: Differences between the North and the South of Italy. Food Qual Prefer 2020. [DOI: 10.1016/j.foodqual.2020.103965] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Damen FW, Steenbekkers BL, de Vaal MT, Kampen JK, Fogliano V, Luning PA. General parenting and mothers’ snack giving behavior to their children aged 2–7. Food Qual Prefer 2020. [DOI: 10.1016/j.foodqual.2020.103961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hepworth AD, Moding KJ, Stifter CA. A laboratory-based assessment of mother-child snack food selections and child snack food consumption: Associations with observed and maternal self-report of child feeding practices. Food Qual Prefer 2020; 83. [PMID: 32483400 DOI: 10.1016/j.foodqual.2020.103898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study explored how mothers' observed and self-reported child feeding practices (child control over food choices, encouragement of balance and variety, and teaching about nutrition) were associated with mother-child snack food selections and child snack food consumption in a laboratory setting. Mothers (N = 107) and their 4.5-year-old children (52% female) selected up to 5 snack foods (out of 9 snack foods: 6 higher-energy-density [ED] and 3 lower-ED) for optional child consumption throughout a one-hour laboratory visit. Mothers' in-the-moment child feeding practices during the snack food selection task were coded using observational coding schemes, and mothers' global child feeding practices (i.e., across meals and snacking occasions) were self-reported using the Comprehensive Feeding Practices Questionnaire (Musher-Eizenman & Holub, 2007). Results of multiple linear regression analyses with covariates showed that higher-ED snack food selections were positively associated with observed child control over food choices (B = 0.35, SE = 0.12, p = .006) and self-reported teaching about nutrition (B = 0.49, SE = 0.19, p = .010), and negatively associated with self-reported encouragement of balance and variety (B = -0.66, SE = 0.24, p = .007). Lower-ED snack food selections were positively associated with self-reported encouragement of balance and variety (B = 0.53, SE = 0.20, p = .008). Child consumption of higher-ED or lower-ED snack foods were not significantly associated with mothers' child feeding practices (observed or self-reported). We discuss the implications of these findings for future research on children's snack food selection and consumption.
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Affiliation(s)
- Allison D Hepworth
- University of Maryland School of Social Work, 525 West Redwood Street, Baltimore, MD 21201, USA
| | - Kameron J Moding
- Purdue University, Fowler Memorial House, 1200 West State Street, West Lafayette, IN, 47907, USA
| | - Cynthia A Stifter
- Pennsylvania State University, 236 Health and Human Development Building, University Park, PA 16802, USA
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