Parenting style and child-feeding behaviour in predicting children's weight status change in Taiwan

How do mothers with young children perceive endocrine-disrupting chemicals?: an exploratory qualitative study

PURPOSE

Despite the health impacts of endocrine-disrupting chemicals (EDCs) beginning in the early stages of life, there is little research on the perception of EDCs among Korean mothers, who are primarily responsible for protecting children. This study aimed to explore how mothers with young children perceived EDCs for their concerns, the issues they faced, and the way they dealt with them.

METHODS

An exploratory qualitative design was utilized. Twelve mothers who were recruited from snowball sampling participated in voluntary interviews. Individual in-depth interviews lasting approximately 47 to 60 minutes were recorded and transcribed verbatim. The data were analyzed using qualitative content analysis as suggested by Graneheim and Lundman.

RESULTS

Four categories, 10 subcategories, and 25 condensed meaning units were identified by interpreting mothers' underlying meanings. The four categories were 'Knowledgeable yet contrasting ideas regarding EDCs,' 'Negative health impact, but more so for children,' 'Inaction or trying to minimize exposure,' and 'Need for early, reliable resources and social change.' Mothers were knowledgeable about EDCs and actively needed further education and support. While they tended to focus more on the health impact of EDCs on their children and were optimistic about their health risks, paying less attention to their preventive behaviors.

CONCLUSION

Healthcare professionals must consider mothers' perceptions of EDCs in future education and interventions regarding EDCs impact on women's life stages such as puberty, pregnancy, and childrearing. Also preventive strategies that can be applied to their daily lives are needed.

A scoping review of school-based anthropometric measurement

Though anthropometric measurement (AM) frequently occurs in school settings, it is not without risks to child wellbeing. The aim of this scoping review was to examine how AM in school settings takes place and is reported on to make recommendations on best practices. We identified and extracted data from 440 studies published since 2005 that conducted AM in school (pre-school through secondary/high school) settings. Privacy and sensitivity of AM were unclear in over 90% of studies. Thirty-one studies (7.0%) reported protecting student privacy, while nine (2.0%) reported public measurement. Only five studies reported sensitivity regarding AM (1.1%). Exactly who conducted AM was not specified in 201 studies (45.7%). Sixty-nine studies did not provide a weight status criteria citation (19.2%), and 10 used an incorrect citation (2.7%). In summary, serious shortcomings in the reporting of how AM is conducted and by whom, along with details concerning weight status classification, are evident. There is considerable room for improvement regarding the reporting of key methodological details. We propose best practices for AM in school settings, which also double as conditions that should be met before AM takes place in school settings.

Nonresponsive Parenting Feeding Styles and Practices and Risk of Overweight and Obesity among Chinese Children Living Outside Mainland China: An Integrative Review of the Literature

Chinese immigrants are a fast-growing population group in many parts of the world. Childhood obesity is increasingly a public health problem among Chinese living outside mainland China. Evidence suggests that parenting feeding styles and practices critically influence children's eating behaviors and risk of being overweight or obese. Therefore, the objectives of this review were to identify and synthesize the evidence from studies examining the associations between parenting feeding styles, feeding practices, and risk of overweight and obesity among children of Chinese parents outside mainland China. A systematic search of four electronic databases (CINAHL, Medline, PsycINFO, and PubMed) was conducted to identify peer-reviewed studies published in English between January 2000 and March 2022. Fifteen studies met the inclusion criteria and were included in the review. Findings of some of the reviewed studies showed that parenting feeding styles and practices varied according to children's age, gender, weight, and parents' acculturation levels. The two most identified parenting feeding styles were indulgent and authoritarian. Parents classified as having indulgent and/or authoritarian feeding styles reported using several feeding practices with unintended detrimental effects, such as pressuring children to eat and restricting or controlling child food intake (type and amount). Some of these feeding practices were associated with an increased risk of child overweight. The findings of this review provide important information that can inform the design interventions to address modifiable nonresponisve parental feeding practices such as pressuring, restricting, and controlling that meet the specific needs of Chinese parents and children outside mainland China.

A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities

This study examined the longitudinal associations between parental feeding practices and child weight status, and their potential modification effects by child sex, age, and maternal and paternal educations among children. Data were collected from 2015 to 2017 of 2139 children aged 6−17 years and their parents in five Chinese mega-cities. Parental feeding practices were assessed using 11-items from Child Feeding Questionnaire. Waist-to-height ratio (WHtR), body mass index (BMI), and general and central obesity were measured and analyzed using a mixed-effects model. Three parental feeding patterns were identified by factor analysis including “concern”, “pressure to eat”, and “control”. Concern was associated with higher BMI z-score, WHtR (βs ranged from 0.01 to 0.16), and general obesity (ORs ranged from 1.29 to 6.41) among children aged ≤12 years and >12 years, regardless of child sex and parental educations. Pressure to eat was associated with lower BMI z-score (β = −0.08, p < 0.001), WHtR (β = −0.004, p < 0.01), and general (OR = 0.53, 95%CI = 0.42, 0.66) and central obesity (OR = 0.72, 95%CI = 0.58, 0.90) among children aged ≤12 years. Further analyses showed that significant associations were found for children with maternal or paternal education of college and above. Control was associated with increased risk of general and central obesity among children with maternal education of college and above, regardless of age. Our study indicates that higher concern and lower pressure to eat were associated with increased risk of obesity among children. Control was associated with increased risk of obesity among children with maternal education of college and above. Future childhood obesity preventions may optimize parental feeding practices.

Examining the Moderating Effect of Parenting Style and Parental Guidance on Children's Beliefs about Food: A Test of the Parenting Style-as-Context Model

Research examining the effect of parenting practices on child food consumption has often neglected the role in which global aspects of parenting - such as parenting style - play in shaping children's dietary behaviors. To address this gap, the parenting style-as-context model was used to examine the moderating effects of parenting style - defined as the perceived emotional climate communicated to children by their parents - on the association between parental guidance of food consumption and children's beliefs surrounding food. A cross-sectional survey of 1,113 child/adolescent participants between the ages of 9 and 18 was conducted to test the theoretical propositions derived from the parenting style-as-context model. Results suggest desirable relationships between different dimensions of parental guidance of food consumption on children's beliefs surrounding foods were stronger among children who were under an authoritative parenting style compared to other parenting styles. The results offer some support for the parenting style-as-context model and has theoretical and practical implications for research targeted at understanding the role parents play in inculcating healthy dietary habits among children.

The Role of General Parenting Style in Child Diet and Obesity Risk

PURPOSE OF REVIEW

The childhood obesity epidemic is widely considered to have reached pandemic proportions. Across the world, children with obesity are facing numerous psychological and physiological issues that follow them into adulthood, frequently leading to chronic illness and early death. In an effort to combat the compounding effects of childhood overweight, researchers are attempting to identify biological and environmental contributors to child weight. Parenting styles are one recognized influence on child diet and body mass index (BMI). This review is a comprehensive examination of the literature on the influence of parenting style on childhood diet and BMI over the past 5 years.

RECENT FINDINGS

Current research continues to support the use of traditional parenting style categories (i.e., authoritative, authoritarian, permissive, uninvolved/neglectful): however, newer subcategories of Baumrind's styles and the inclusion of previously underrepresented groups (e.g., fathers, cross cultural comparison studies) are shedding more light on the nuance of parenting's relationship with child weight. Parenting styles that focus on the balance of warmth and control (e.g., authoritative) in contrast to the styles dedicated to only one of these constructs (e.g., permissive, authoritarian) seem to promote the healthiest dietary habits and may be protective of child BMI.

Food parenting practices and children's weight outcomes: A systematic review of prospective studies

This systematic review is the first to provide an overview of the prospective links between food parenting practices and children's weight outcomes. Three databases were searched. All titles, abstracts and full-texts were double screened by two independent reviewers. Peer-reviewed journal articles published after 1990 assessing the prospective association between food parenting practices and weight outcomes of children aged 2-18 years were eligible. A total of 38 eligible studies were identified, focusing on 12 separate food parenting practices. Restriction, pressure to eat, and monitoring were generally not associated with children's weight over time, but higher quality studies suggest that pressure to eat was associated with lower weight outcomes over time. Most studies on food availability and accessibility found null-findings as well. Instrumental-but not emotional-feeding was associated with higher weight over time, but higher quality studies are needed to confirm this link. Results involving the link between frequency of mealtime and child weight were mixed. Autonomy supporting and other structure-related food parenting practices were understudied. In conclusion, food parenting practices receiving the most attention within prospective studies (i.e., restriction, pressure to eat, monitoring) were generally not associated with children's weight outcomes over time. Future high quality studies should focus more on other food parenting practices, further unravel bidirectional links between food parenting and children's eating behaviors and weight outcomes, and examine the mediating role of dietary intake.

Predicting dietary intake among children classified as overweight or at risk for overweight: Independent and interactive effects of parenting practices and styles

Using baseline data from a randomized controlled pediatric obesity prevention trial, this study sought to examine general parenting style as a potential moderator of the association between feeding-specific parenting practices and child dietary intake. Four hundred and twenty-one parent-child dyads served as participants (49% girls and 93% mothers). Children were, on average, 6.6 years old and either overweight or at-risk for overweight (mean BMI percentile = 84.9). Data were collected in participants' homes. Study staff measured children's height and weight. Parents completed questionnaires designed to assess general parenting styles (authoritative, authoritarian and permissive) and child feeding practices (restriction and monitoring). Child dietary intake was assessed using a 24-h recall system. Outcomes were daily servings of fruits and vegetables, sugar-sweetened beverages (SSB), and unhealthy snacks. Results were as follows: Permissive parenting was inversely associated with fruit and vegetable consumption, and parental monitoring was inversely associated with SSB consumption. There were no other main effects of parenting style or feeding practice on child dietary consumption. Authoritarian parenting moderated the association between restriction and SSB intake (a marginally significant effect after correcting for multiple comparisons). Restriction was inversely associated with SSB consumption when authoritarianism was high but unassociated with SSB consumption when authoritarianism was low. Findings indicate that the parenting practice of monitoring child dietary intake was associated with more healthful consumption regardless of parenting style; interventions may thus benefit from encouraging parental monitoring. The parenting strategy of restricting child dietary intake, in contrast, was associated with lower SSB intake in the context of higher parental authoritarianism but inconsequential in the context of lower parental authoritarianism. This exploratory finding warrants further investigation.

Alternatives to restrictive feeding practices to promote self-regulation in childhood: a developmental perspective

Intake of energy-dense snack foods is high among US children. Although the use of restrictive feeding practices has been shown to be counterproductive, there is very limited evidence for effective alternatives to restriction that help children moderate their intake of these foods and that facilitate the development of self-regulation in childhood. The developmental literature on parenting and child outcomes may provide insights into alternatives to restrictive feeding practices. This review paper uses a model of parental control from the child development and parenting literatures to (i) operationally define restrictive feeding practices; (ii) summarize current evidence for antecedents and effects of parental restriction use on children's eating behaviours and weight status, and (iii) highlight alternative feeding practices that may facilitate the development of children's self-regulation and moderate children's intake of palatable snack foods. We also discuss recent empirical evidence highlighting the role of child temperament and food motivation related behaviours as factors that prompt parents to use restrictive feeding practices and, yet, may increase children's dysregulated intake of forbidden foods.

Implementation of parental feeding practices: does parenting style matter?

OBJECTIVES

To combat childhood obesity, researchers have focused on parental feeding practices that promote child health. The current study investigated how parenting style relates to twelve parental feeding practices.

DESIGN

Data on parenting style and parental feeding practices were obtained for a correlational study from users of Amazon's Mechanical Turk, an online survey system.

SETTING

USA.

SUBJECTS

Mothers of children aged 7-11 years (n 193).

RESULTS

Parenting style related differentially to eleven out of the twelve measured practices. Authoritative mothers displayed more feeding practices that promote child health and fewer practices that impede child health. Authoritarian and permissive mothers displayed more unhealthy practices than authoritative mothers, but differed from each other on the practices they employed.

CONCLUSIONS

Parenting style may relate to more aspects of feeding than previously realized. The inclusion of numerous healthy feeding practices along with unhealthy practices in the current study provides suggestions for the application of healthy feeding behaviours. Instruction on feeding behaviours and parenting style should be a focus of future educational programmes.

Psychological and physiological correlates of childhood obesity in Taiwan

Evidence of associations between psychopathology and obesity in childhood remains inconsistent, and most studies have been conducted in Western countries. This study investigated psychological and physiological correlates of obesity in a community sample of children in Taiwan. In total, 302 children (157 overweight/obese and 145 healthy-weight children) were selected from first- and fourth-grade schoolchildren in eight elementary schools in 2009. These children participated in a comprehensive health examination, including a physical examination, blood sample analysis, and questionnaire administration. We found that regarding physiological characteristics, compared with the healthy-weight children, the overweight/obese children had significantly higher values for body fat estimated using the bioelectrical impedance method (p < 0.001), systolic blood pressure (p < 0.001), and diastolic blood pressure (p = 0.001); lower values for high-density lipoprotein (p < 0.001); and worse values for glutamic-pyruvic transaminase (p < 0.001), triglycerides (p < 0.001), and fasting blood glucose (p = 0.049). In logistic models adjusted for parental and child traits and physiological characteristics, children’s overweight/obesity was significantly associated with lower self-concept (odds ratio [OR] = 0.96, 95% confidence interval [CI] = 0.93–0.99) and less disruptive behavior (OR = 0.96, 95% CI = 0.92–0.99). Less disruptive behavior and the lack of a higher prevalence of anxiety and depression in childhood obesity appear to be a unique pattern in Taiwan that warrants further investigation.

The Role of Food Parenting Skills and the Home Food Environment in Children's Weight Gain and Obesity

This paper presents an overview to provide readers with an update on the literature about the relation between parental influences (general parenting and food parenting practices) and children's weight-related outcomes. It first summarizes the evidence regarding the role of food parenting practices in shaping and maintaining children's nutritional and weight status. It then describes empirical evidence on the relation between general parenting and children's weight status. This evidence is less convincing, possibly because general parenting has a different, more distal role in influencing child behavior than parenting practices. General parenting may moderate the impact of food parenting practices on children's nutrition behaviors. Finally, we discuss studies on interventions targeting childhood overweight and obesity. There is no consensus on the optimal intervention targets (i.e., general parenting and/or food parenting practices). Based on the overview, we offer suggestions for future research.

Correlates of food patterns in young Latino children at high risk of obesity

OBJECTIVE

The present paper examines the influence of age and gender on food patterns of Latino children.

DESIGN

Data are from baseline of a 5-year, quasi-experimental obesity prevention study: Niños Sanos, Familia Sana (NSFS; Healthy Children, Healthy Families). In 2012, the researchers interviewed Latino parents, using a thirty-item questionnaire to ask about their children's food consumption and feeding practices. Statistical tests included t tests and ANCOVA.

SETTING

Rural communities in California's Central Valley, USA.

SUBJECTS

Two hundred and seventeen parents (87-89% born in Mexico) and their children (aged 2-8 years).

RESULTS

Fifty-one per cent of the children were overweight or obese (≥85th percentile of BMI for age and gender). Mean BMI Z-scores were not significantly different in boys (1·10 (SD 1·07)) and girls (0·92 (SD 1·04); P=0·12). In bivariate analysis, children aged 2-4 years consumed fast and convenience foods less often (P=0·04) and WIC (Supplemental Nutrition Program for Women, Infants, and Children)-allowable foods more often than children aged 5-8 years (P=0·01). In ANCOVA, neither age nor gender was significantly related to food patterns. Mother's acculturation level was positively related to children's consumption of fast and convenience foods (P=0·0002) and negatively related to consumption of WIC foods (P=0·01). Providing role modelling and structure in scheduling meals and snacks had a positive effect on the vegetable pattern (P=0·0007), whereas meal skipping was associated with more frequent fast and convenience food consumption (P=0·04).

CONCLUSIONS

Acculturation and child feeding practices jointly influence food patterns in Latino immigrant children and indicate a need for interventions that maintain diet quality as children transition to school.