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Werner LM, Mallan KM. Associations between restrictive feeding practices and children's dietary intake: Systematic review and meta-analyses. Appetite 2024; 200:107508. [PMID: 38795944 DOI: 10.1016/j.appet.2024.107508] [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: 02/15/2024] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Parents' attempt to limit or restrict children's intake of 'unhealthy' or discretionary foods has been widely considered as a counterproductive feeding practice associated with poorer dietary outcomes, but empirical evidence is varied. AIM The present systematic literature review aimed to investigate the association between parental restriction and children's dietary intake. METHOD Studies were identified through PsycInfo, MEDLINE, CINAHL, Web of Science, and Scopus databases on April 29th, 2022. Included were peer-reviewed, English-language articles published between 2001 and 2022, with an effect size between restriction and children's intake of foods that are 'healthy' (i.e., fruit, vegetables, other general healthy foods) or 'discretionary' (i.e., sweet or savoury energy-dense/nutrient poor foods, high-sugar foods, high-salt/fat foods, and high-energy/sugar-sweetened beverages), or overall diet quality. Risk of bias was assessed using a quality assessment checklist designed to evaluate survey studies. RESULTS Included studies (n = 44) were most often conducted in the USA, cross-sectional, and participants were mothers. Effect sizes (k = 59) from 21 studies were used in nine meta-analyses investigating various healthy and discretionary dietary intake variables. No meta-analytic effects were statistically significant. Qualitative synthesis of effect sizes ineligible for meta-analysis (k = 91) identified patterns of associations between restriction and increased intake of healthy foods, and decreased intake of discretionary foods. CONCLUSIONS Studies used a diverse selection of measures of restriction and dietary intake, limiting the ability of this review to make accurate cross-study comparisons. However, results suggest that instead of restriction being detrimental for children's dietary outcomes, it may be unrelated, or associated with more beneficial dietary outcomes. Research that utilises validated measures of restriction and dietary outcomes and a longitudinal design is needed to clarify this association.
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Affiliation(s)
- Lilly M Werner
- School of Behavioural and Health Sciences, Melbourne, Australian Catholic University, Australia
| | - Kimberley M Mallan
- School of Behavioural and Health Sciences, Brisbane, Australian Catholic University, Australia.
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2
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Carbonneau E, Dumas A, Lepage S, Dumas AA, Fontaine-Bisson B. A perinatal social nutrition approach to improve breastfeeding in a culturally diverse group of low-income women. Appl Physiol Nutr Metab 2024; 49:824-837. [PMID: 38387015 DOI: 10.1139/apnm-2023-0408] [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] [Indexed: 02/24/2024]
Abstract
Alima, Perinatal Social Nutrition Centre, is an established community organization that adopts a perinatal social nutrition approach to provide multidimensional support to women living in vulnerable conditions, particularly those with a precarious migratory status. This study aims to (i) determine which maternal characteristics, pregnancy-related variables, and structural features of the Alima intervention are associated with breastfeeding; and (ii) examine whether the association between attending breastfeeding workshops and breastfeeding characteristics differ according to maternal factors. The Alima digital database was used to analyze data from women who received the perinatal intervention between 2013 and 2020. Infant feeding data were retrieved at 2 weeks postpartum (T0, n = 2925), 2 months postpartum (T2, n = 1475), and 4 months postpartum (T4, n = 890). Logistic regressions were used to estimate the odds of overall and exclusive breastfeeding depending on sociodemographic characteristics, pregnancy-related variables, and features of the intervention. The prevalence of overall and exclusive breastfeeding was, respectively, 96.1% and 60.7% at T0; 93.0% and 58.5% at T2; 83.0% and 48.4% at T4. Higher education, previous breastfeeding experience, and recent immigration were associated with a higher likelihood of breastfeeding at each time point. Breastfeeding workshop attendance was associated with a greater likelihood of overall and exclusive breastfeeding at T2 and T4, with a stronger effect among women aged 35 or less, those with lower education, and those with excessive gestational weight gain. In conclusion, the Alima intervention is associated with positive breastfeeding outcomes, especially among vulnerable women living with precarious migratory status in Canada.
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Affiliation(s)
- Elise Carbonneau
- Centre de recherche Nutrition Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC G1V 0A6, Canada
- School of Nutrition, Faculty of Agriculture and Food Science, Université Laval, Québec, QC G1V 0A6, Canada
| | - Alex Dumas
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Institut du Savoir Montfort, Montfort Hospital, Ottawa, ON K1K 0T2, Canada
| | - Suzanne Lepage
- Alima, Perinatal Social Nutrition Centre, Montreal, QC H3H 1J3, Canada
| | - Audrée-Anne Dumas
- Centre de recherche Nutrition Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods, Université Laval, Québec, QC G1V 0A6, Canada
- School of Nutrition, Faculty of Agriculture and Food Science, Université Laval, Québec, QC G1V 0A6, Canada
| | - Bénédicte Fontaine-Bisson
- Alima, Perinatal Social Nutrition Centre, Montreal, QC H3H 1J3, Canada
- School of Nutrition Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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3
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Barton JM, McMath AL, Montgomery SP, Donovan SM, Fiese BH. Longitudinal changes in home food availability and concurrent associations with food and nutrient intake among children at 24-48 months. Public Health Nutr 2024; 27:e62. [PMID: 38305130 PMCID: PMC10897571 DOI: 10.1017/s1368980024000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 01/11/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES To describe changes in home food availability during early childhood, including modified, developmentally sensitive obesogenic scores, and to determine whether home food availability is associated with food and nutrient intakes of children concurrently, over time. DESIGN Data were drawn from the STRONG Kids 2 longitudinal, birth cohort to achieve the study objectives. Home food availability was assessed with the Home Food Inventory (HFI) and included fifteen food groups (e.g. fruit and vegetables) and three obesogenic scores (one original and two modified). Food and nutrient intakes were measured using the Block FFQ and included twenty-seven food groups and eighteen nutrients (e.g. vitamins A and C, protein). HFI and FFQ were completed by trained researchers or mothers, respectively, at 24, 36 and 48 months. Repeated-measures ANOVA and Spearman's correlations were used to achieve the study objectives. SETTING Central Illinois, USA. PARTICIPANTS Participants were 468 children at 24, 36 and 48 months of age. RESULTS Availability of less nutritious foods and obesogenic foods and beverages increased as children aged, and availability of both nutritious and less nutritious foods were associated with child food and nutrient intake. The three obesogenic scores demonstrated similar, positive associations with the intake of energy, saturated fat, added sugars and kilocalories from sweets. CONCLUSION These findings offer novel insight into changes in home food availability and associations with food and nutrient intake during early childhood. Additional attention is needed examining antecedents (e.g. built environments, purchasing behaviours) and consequences (e.g. child diet quality and weight) of home food availability.
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Affiliation(s)
- Jennifer M Barton
- Family Resiliency Center, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA, USA
| | - Arden L McMath
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Stewart P Montgomery
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, Urbana, IL, USA
- Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, Urbana, IL, USA
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign, Urbana, IL, USA
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Mason TB. Interactions of parental feeding characteristics and adolescent emotional eating in relation to unhealthful food and sugar-sweetened beverage intake among adolescents. Appetite 2024; 193:107125. [PMID: 37980952 PMCID: PMC10760998 DOI: 10.1016/j.appet.2023.107125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
The purpose of the current study was to examine main and interaction effects of parental feeding characteristics and adolescent emotional eating in relation to adolescents' unhealthful food and sugar-sweetened beverage intake. Data was used from the Family Life, Activity, Sun, Health, and Eating (FLASHE) study, which is an internet-administered cross-sectional study of adolescent-parent dyads. There were 1573 dyads who completed all study questionnaires. Adolescents completed measures of their emotional eating and dietary intake and parents completed items of parental feeding practices and legitimacy of parental authority. Adolescents with parents who reported higher instrumental feeding, higher limiting and legitimacy of authority, and lower role modeling and stimulus control had greater unhealthful eating and sugar-sweetened beverage intake. Elevated adolescent emotional eating strengthened the positive association between parental instrumental feeding and adolescent unhealthful food and sugar-sweetened beverage intake. Elevated adolescent emotional eating weakened the negative association between parental role modeling and stimulus control and adolescent sugar-sweetened beverage consumption. There was no interaction between parental role modeling and stimulus control and adolescent emotional eating for unhealthful food intake and no interaction between parental limiting and legitimacy of authority and adolescent emotional eating for unhealthful food or sugar-sweetened beverage intake. Given these findings, adolescent obesity and nutrition interventions and preventions should target both parental feeding characteristics and adolescent emotional eating.
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Affiliation(s)
- Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
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Pickard A, Croker H, Edwards K, Farrow C, Haycraft E, Herle M, Kininmonth AR, Llewellyn C, Blissett J. Identifying an avid eating profile in childhood: Associations with temperament, feeding practices and food insecurity. Appetite 2023; 191:107050. [PMID: 37793473 DOI: 10.1016/j.appet.2023.107050] [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: 06/26/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
This study aimed to identify distinct eating behaviour profiles in young children and examine how other key predictors of children's eating behaviour, including child temperament, the experience of food insecurity, or parental feeding practices, may vary by identified profiles. An online survey was conducted with 995 parents/carers living in England and Wales (N = 995, Mage = 35.4 years, 80% female, 88% White). Participants reported on their child's eating behaviour using the Child Eating Behaviour Questionnaire and completed measures of child temperament, household food security and parental feeding practices. Latent Profile Analysis (LPA) was carried out to identify distinct eating profiles amongst the children (36-72 months, Mage = 48.8 months, 52% female). Four eating profiles emerged from the sample of children: (a) avid eating, (b) avoidant eating, (c) happy eating, and (d) typical eating. Avid eating (21.9% of children) was characterised by higher levels of food responsiveness, enjoyment of food, and emotional over-eating in combination with lower satiety responsiveness, slowness in eating and food fussiness. Children with an avid eating profile were reported to be more surgent and experienced greater food insecurity than all other eating profiles. Parents of children belonging to the avid eating profile showed significantly greater use of food for emotional regulation, varied and balanced food provision, restriction of food for health, and restriction of food for weight feeding practices than the three other eating profiles.
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Affiliation(s)
- Abigail Pickard
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom.
| | - Helen Croker
- World Cancer Research Fund International, London, United Kingdom
| | - Katie Edwards
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Claire Farrow
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Moritz Herle
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Alice R Kininmonth
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Jacqueline Blissett
- School of Psychology & Institute of Health and Neurodevelopment, Aston University, Birmingham, United Kingdom
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Czarniecka-Skubina E, Gutkowska K, Hamulka J. The Family Environment as a Source for Creating the Dietary Attitudes of Primary School Students-A Focus Group Interview: The Junior-Edu-Żywienie (JEŻ) Project. Nutrients 2023; 15:4930. [PMID: 38068788 PMCID: PMC10708071 DOI: 10.3390/nu15234930] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/21/2023] [Accepted: 11/25/2023] [Indexed: 12/18/2023] Open
Abstract
The family environment plays a crucial role in creating the health behaviours of children and youth. This study aimed to explore the attitudes of parents with children aged 7-12 who represent an influential environment for creating the eating behaviours of children. A qualitative study was conducted using focus-group interviews (FGI) involving 101 parents from various socioeconomic backgrounds. Three categories of parents were identified based on their level of involvement and awareness of nutrition: 'aware', 'determined', and 'relaxed'. Among parents of 10-12-year-old students, an additional category, 'distanced' parents, was identified. The study revealed that parents require support in terms of providing compelling arguments and practical recommendations related to meals and reducing or eliminating their children's consumption of sweets, snacks, fast food, and, in the case of older students, energy drinks. Parents reported that their children had a moderate understanding of the principles of proper nutrition. The majority of respondents viewed this knowledge as primarily theoretical and expressed a need for practical guidance and activities, which they believe should be offered by schools. To achieve positive outcomes in educational activities related to food and nutrition, it is essential to involve children, parents, guardians, teachers, and other school staff in these efforts.
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Affiliation(s)
- Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Krystyna Gutkowska
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland;
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland
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Searle B, Staton S, Littlewood R, Thorpe K. Mealtimes in the context of poverty: Comparison of ECEC services providing food and those requiring food provided from home. Child Care Health Dev 2023; 49:995-1005. [PMID: 36843189 DOI: 10.1111/cch.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND In developed economies, most children attend Early Childhood Education and Care (ECEC) services before school entry, many from early life and across long days. For this reason, ECEC services present significant potential to provide food environments that positively influence eating behaviours and food preferences with attendant effect on life course trajectories of health and wellbeing. Yet there is evidence that feeding practices that limit optimal ongoing nutrition, such as pressure and restriction, are amplified in ECEC services serving disadvantaged communities. We sought to identify underlying explanatory mechanisms through observation of children's feeding experiences and educator explanations comparing, family-provided and service-provided meals. METHOD This study used qualitative analyses of educator interviews and observation records from 55 mealtimes in 10 ECEC services: 5 providing food and 5 requiring family food provision. RESULTS High levels of concern drove educator's controlling feeding practices at mealtimes but presented differently across meal provision modes. In centres that provided food, educators' concern focused on food variety, manifesting in pressure to 'try' foods. In centres requiring family-provided food, concern focused on nutrition quantity and quality and manifested as control of order of food consumption and pacing of intake to ensure food lasted across the day. Interview data suggested that conflict aversion limited optimal nutrition. In centres providing food, this was seen in menus that prioritized child food preferences. In centres requiring family meal provision, conflict aversion was seen as reticence to discuss lunchbox contents with families. CONCLUSION The findings direct attention to public health intervention. Currently, ECEC face significant barriers to realizing their potential to support child nutrition and establish positive life course trajectories of nutrition. To do so requires targeted supports that enable sufficient supply and quality of food in the context of poverty.
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Affiliation(s)
- Bonnie Searle
- Australian Centre of Excellence for Children and Families across the Life Course, Brisbane, Queensland, Australia
- Institute for Social Science Research, University of Queensland, Brisbane, Queensland, Australia
| | - Sally Staton
- Australian Centre of Excellence for Children and Families across the Life Course, Brisbane, Queensland, Australia
| | - Robyn Littlewood
- Health and Wellbeing Queensland, Brisbane, Queensland, Australia
| | - Karen Thorpe
- Australian Centre of Excellence for Children and Families across the Life Course, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
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Burnett AJ, Russell CG, Lacy KE, Worsley A, Spence AC. Mothers' descriptions of their feeding strategies in response to fussy eating with children of different levels of trait fussiness. Appetite 2023; 187:106581. [PMID: 37120068 DOI: 10.1016/j.appet.2023.106581] [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: 11/10/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/01/2023]
Abstract
Parent feeding practices influence a child's dietary intake. Many studies examining how parents react to children's fussy eating behaviours have been limited to questionnaire measures, which assess a limited number of feeding practices. There is a lack of research exploring the range of strategies parents use when their child is being fussy and/or refusing to eat. Therefore, the aims of this study are to describe the strategies used by mothers when their child is being fussy or refusing to eat, and to assess differences in the strategies depending on the child's trait fussiness levels. In 2018, 1504 mothers of children aged 2-5 years completed an online survey. Trait fussiness was assessed using the Children's Eating Behaviour Questionnaire. Mothers were also asked the open-ended question "What are the strategies you use when your child is being fussy or refusing to eat?". Inductive thematic analysis was conducted using NVivo. Themes were compared by child trait fussiness levels. Seven main themes were identified: child-led feeding/trust in child's appetite, spectrum of pressure, home or family strategies, different types of food offerings, communication, avoid certain strategies, and never or rarely fussy. Mothers of children with severe trait fussiness levels reported more pressuring or persuasive strategies. This study provides novel information regarding the diverse range of feeding practices parents use in response to children's fussy eating behaviours. Mothers used more feeding strategies typically associated with unhealthy dietary intake for children of high levels of trait fussiness. It is important that future interventions tailor the information to provide support to parents of children with high levels of trait fussiness regarding the use of feeding practices recommended to support healthy dietary intake.
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Affiliation(s)
- Alissa J Burnett
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Catherine G Russell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Kathleen E Lacy
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Anthony Worsley
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Alison C Spence
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Jansen E, Naymik M, Thapaliya G, Huentelman M, Beauchemin J, D'Sa V, Lewis CR, Deoni S, Carnell S. Parent-reported child appetite moderates relationships between child genetic obesity risk and parental feeding practices. Front Nutr 2023; 10:1174441. [PMID: 37324730 PMCID: PMC10266414 DOI: 10.3389/fnut.2023.1174441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/25/2023] [Indexed: 06/17/2023] Open
Abstract
Background Food parenting practices are associated with child weight. Such associations may reflect the effects of parents' practices on children's food intake and weight. However, longitudinal, qualitative, and behavioral genetic evidence suggests these associations could, in some cases, reflect parents' response to children's genetic risk for obesity, an instance of gene-environment correlation. We tested for gene-environment correlations across multiple domains of food parenting practices and explored the role of parent-reported child appetite in these relationships. Materials and methods Data on relevant variables were available for N = 197 parent-child dyads (7.54 ± 2.67 years; 44.4% girls) participating in RESONANCE, an ongoing pediatric cohort study. Children's body mass index (BMI) polygenic risk score (PRS) were derived based on adult GWAS data. Parents reported on their feeding practices (Comprehensive Feeding Practices Questionnaire) and their child's eating behavior (Child Eating Behavior Questionnaire). Moderation effects of child eating behaviors on associations between child BMI PRS and parental feeding practices were examined, adjusting for relevant covariates. Results Of the 12 parental feeding practices, 2 were associated with child BMI PRS, namely, restriction for weight control (β = 0.182, p = 0.011) and teaching about nutrition (β = -0.217, p = 0.003). Moderation analyses demonstrated that when children had high genetic obesity risk and showed moderate/high (vs. low) food responsiveness, parents were more likely to restrict food intake to control weight. Conclusion Our results indicate that parents may adjust their feeding practices in response to a child's genetic propensity toward higher or lower bodyweight, and the adoption of food restriction to control weight may depend on parental perceptions of the child's appetite. Research using prospective data on child weight and appetite and food parenting from infancy is needed to further investigate how gene-environment relationships evolve through development.
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Affiliation(s)
- Elena Jansen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Marcus Naymik
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
| | - Gita Thapaliya
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Matt Huentelman
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
| | - Jennifer Beauchemin
- Advanced Baby Imaging Lab, Hasbro Children's Hospital, Rhode Island Hospital, Providence, RI, United States
| | - Viren D'Sa
- Advanced Baby Imaging Lab, Hasbro Children's Hospital, Rhode Island Hospital, Providence, RI, United States
| | - Candace R. Lewis
- Neurogenomics Division, The Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
- School of Life Sciences, Arizona State University, Phoenix, AZ, United States
| | - Sean Deoni
- Advanced Baby Imaging Lab, Hasbro Children's Hospital, Rhode Island Hospital, Providence, RI, United States
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, United States
- Maternal, Newborn and Child Health Discovery and Tools, Bill and Melinda Gates Foundation, Seattle, WA, United States
| | - Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
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Zarkogianni K, Chatzidaki E, Polychronaki N, Kalafatis E, Nicolaides NC, Voutetakis A, Chioti V, Kitani RA, Mitsis K, Perakis Κ, Athanasiou M, Antonopoulou D, Pervanidou P, Kanaka-Gantenbein C, Nikita K. The ENDORSE Feasibility Study: Exploring the Use of M-Health, Artificial Intelligence and Serious Games for the Management of Childhood Obesity. Nutrients 2023; 15:1451. [PMID: 36986180 PMCID: PMC10057317 DOI: 10.3390/nu15061451] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Childhood obesity constitutes a major risk factor for future adverse health conditions. Multicomponent parent-child interventions are considered effective in controlling weight. Τhe ENDORSE platform utilizes m-health technologies, Artificial Intelligence (AI), and serious games (SG) toward the creation of an innovative software ecosystem connecting healthcare professionals, children, and their parents in order to deliver coordinated services to combat childhood obesity. It consists of activity trackers, a mobile SG for children, and mobile apps for parents and healthcare professionals. The heterogeneous dataset gathered through the interaction of the end-users with the platform composes the unique user profile. Part of it feeds an AI-based model that enables personalized messages. A feasibility pilot trial was conducted involving 50 overweight and obese children (mean age 10.5 years, 52% girls, 58% pubertal, median baseline BMI z-score 2.85) in a 3-month intervention. Adherence was measured by means of frequency of usage based on the data records. Overall, a clinically and statistically significant BMI z-score reduction was achieved (mean BMI z-score reduction -0.21 ± 0.26, p-value < 0.001). A statistically significant correlation was revealed between the level of activity tracker usage and the improvement of BMI z-score (-0.355, p = 0.017), highlighting the potential of the ENDORSE platform.
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Affiliation(s)
- Konstantia Zarkogianni
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece (K.N.)
| | - Evi Chatzidaki
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (P.P.); (C.K.-G.)
| | - Nektaria Polychronaki
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (P.P.); (C.K.-G.)
| | - Eleftherios Kalafatis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece (K.N.)
| | - Nicolas C. Nicolaides
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (P.P.); (C.K.-G.)
| | - Antonis Voutetakis
- Department of Pediatrics, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Vassiliki Chioti
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (P.P.); (C.K.-G.)
| | - Rosa-Anna Kitani
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (P.P.); (C.K.-G.)
| | - Kostas Mitsis
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece (K.N.)
| | | | - Maria Athanasiou
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece (K.N.)
| | | | - Panagiota Pervanidou
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (P.P.); (C.K.-G.)
| | - Christina Kanaka-Gantenbein
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece; (E.C.); (P.P.); (C.K.-G.)
| | - Konstantina Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, 15780 Athens, Greece (K.N.)
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Gomes AI, Roberto MS, Pereira AI, Alves C, João P, Dias AR, Veríssimo J, Barros L. Development and Psychometric Characteristics of an Instrument to Assess Parental Feeding Practices to Promote Young Children's Eating Self-Regulation: Results with a Portuguese Sample. Nutrients 2022; 14:nu14234953. [PMID: 36500987 PMCID: PMC9736991 DOI: 10.3390/nu14234953] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022] Open
Abstract
A parental child-centered feeding approach is likely to keep children’s biological mechanisms activated while eating, protecting them in an obesogenic context. However, few feeding practice measures assess parents’ behaviors to guide and prompt children to identify and respond appropriately to their signs of hunger and satiety. We aimed to develop and study the reliability, validity, and measurement invariance of a new scale to assess parental feeding practices to promote children’s self-regulation of food intake. To pursue this aim, we conducted two descriptive, cross-sectional, online studies in Portugal in an online format; a total of 536 parents of 2- to 6-year-old children completed the evaluation protocol. Factorial analysis findings support the theoretical organization proposed for the scale. The confirmatory factorial analysis supported a first-order factor structure with two subscales, Prompting for eating self-regulation and Teaching about eating consequences, with eight items in total. Both scales presented good internal consistency and adequate temporal stability, with a significant, positive, and moderate relationship. The results showed metric invariance for the child’s sex. Both types of practices were positively correlated with the child’s enjoyment of food. Prompting for eating self-regulation showed negative associations with parents’ emotional lack of control, children’s satiety responsiveness, slowness in eating, and fussiness. Preliminary studies confirmed both the validity and reliability of the instrument and the adequacy of adopting a self-regulatory approach when assessing child-centered feeding practices. Combining this instrument with others that assess coercive practices can be beneficial to capture ineffective parents’ behaviors on children’s eating self-regulation.
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Affiliation(s)
- Ana Isabel Gomes
- Research Center for Psychological Science (CICPSI), Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Correspondence:
| | - Magda Sofia Roberto
- Research Center for Psychological Science (CICPSI), Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Ana Isabel Pereira
- Research Center for Psychological Science (CICPSI), Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Cátia Alves
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Patrícia João
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Ana Rita Dias
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - João Veríssimo
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
| | - Luísa Barros
- Research Center for Psychological Science (CICPSI), Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
- Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisboa, Portugal
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12
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Wang Q, Cui S, Barnhart WR, Liu Y, Yu Y, Cui T, He J. Relationships between retrospective parental feeding practices and Chinese university students' current appetitive traits, weight status, and satisfaction with food-related life. Appetite 2022; 175:106061. [PMID: 35469996 DOI: 10.1016/j.appet.2022.106061] [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: 02/05/2022] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 11/02/2022]
Abstract
Accumulating evidence suggests that parental feeding practices during childhood are related to adults' eating behaviors and weight status, but research exploring these relationships is largely conducted in Western contexts. However, China, a country that holds the largest world population, has distinct patterns of eating habits and food culture from Western countries. Therefore, the present study aimed to examine relationships between retrospective parental feeding practices (e.g., concern, monitoring, pressure to eat, and restriction) and current body mass index (BMI) and satisfaction with food-related life in a sample of 476 Chinese university students (195 men; Mage = 19.78 years, SD = 1.23). We also examined whether appetitive traits mediated these associations. Retrospective parental feeding practices were significantly related with participants' current BMI (concern: r = 0.26, p < .001; pressure to eat: r = -0.15, p < .001) and satisfaction with food-related life (concern: r = 0.15, p < .001; monitoring: r = 0.12, p = .009; pressure to eat: r = 0.13, p = .006; restriction: r = 0.16, p < .001). Relationships were partially mediated by young adults' current appetitive traits (e.g., enjoyment of food, emotional overeating, satiety responsiveness, slowness in eating). These findings suggest that retrospective parental feeding practices are important correlates of young adults' current weight status and satisfaction with food-related life, and that appetitive traits partially explain these relationships in the Chinese context.
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Affiliation(s)
- Qingyang Wang
- School of Management and Economics, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Shuqi Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Wesley R Barnhart
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Yutian Liu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Yiman Yu
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China
| | - Tianxiang Cui
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China; Department of Psychology, University of Macau, Macao, China
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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13
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Jansen E, Smith K, Thapaliya G, Sadler J, Aghababian A, Carnell S. Associations of mothers' and fathers' structure-related food parenting practices and child food approach eating behaviors during the COVID pandemic. Physiol Behav 2022; 252:113837. [PMID: 35513084 PMCID: PMC9059343 DOI: 10.1016/j.physbeh.2022.113837] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/19/2022] [Accepted: 04/30/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, many mothers and fathers have spent more time at home with their children, warranting consideration of parenting practices around food during the pandemic as influences on obesogenic eating behaviors among children. Structure-related feeding practices, particularly around snacking, may be particularly challenging yet influential in the pandemic setting. Parent sex and levels of feeding-related co-operation among parents (co-feeding) are understudied potential influences on parent-child feeding relationships. METHODS We investigated relationships between structure-related parent feeding and child food approach behaviors during the COVID-19 pandemic, while considering potential moderating influences of parent sex and co-feeding levels. An online survey was completed by 318 parents (206 mothers and 112 fathers) of 2-12-year-olds who were living in states with statewide or regional lockdowns in May/June 2020 within the US. Mothers and fathers were drawn from different families, with each survey corresponding to a unique parent-child dyad. Parental stress/mental health, co-feeding (Feeding Coparenting Scale), structure-related food and snack parenting (Feeding Practices and Structure Questionnaire and Parenting around SNAcking Questionnaire), and child eating behaviors (Child Eating Behaviour Questionnaire) were assessed. Relationships of parents' structure-related food and snack parenting practices with their child's emotional overeating and food responsiveness behaviors were examined using structural equation modelling. Further, we investigated whether these relations were moderated by parent sex or level of co-feeding. RESULTS Parent sex differences were seen in parental stress, mental health, and co-feeding, but not in structure-related food and snack parenting or child food approach eating behaviors. Structure-related food parenting was negatively associated with emotional overeating. However, structure-related snack parenting was positively associated with emotional overeating and food responsiveness. While regression paths varied between mothers vs. fathers, as well as by co-feeding levels, neither parent sex nor co-feeding levels significantly moderated relationships between parent feeding and child eating variables. CONCLUSIONS Future studies of food and snack parenting and co-operation in relation to feeding among mothers and fathers within a familial unit may be critical to identify intervention strategies that draw on all family resources to better navigate future disruptive events such as the COVID-19 pandemic.
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Affiliation(s)
- Elena Jansen
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA.
| | - Kimberly Smith
- Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Gita Thapaliya
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Jennifer Sadler
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Anahys Aghababian
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Susan Carnell
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
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14
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Patel C, Walasek L, Karasouli E, Meyer C. Content and Validity of Claims Made about Food Parenting Practices in United Kingdom Online News Articles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095053. [PMID: 35564446 PMCID: PMC9105157 DOI: 10.3390/ijerph19095053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023]
Abstract
The objective of this study was to qualitatively summarise the content of online news articles pertaining to food parenting practices and determine whether this content is substantiated by the scientific literature. News article data were identified and collected from United Kingdom online news published during 2010–2017 period using the News on the Web corpus. A coding framework was used to categorise the content of news articles to identify information related to food parenting practices. Then, claims made about food parenting practices were extracted from relevant news articles. Each claim was evaluated to determine the extent to which any claims were supported by the available scientific research evidence. The study identified ten claims across thirty-two relevant online news articles. Claims made across the news articles reported on the following food parenting practices: food restrictions, food-based threats and bribes, pressure to eat, use of food to control negative emotions, food availability, food preparation, and meal and snack routines. Eight out of the ten claims identified did not refer to scientific research evidence. News articles frequently lacked detail and information to explain to readers why and how the use of certain food parenting practices could have a lasting impact on children’s health outcomes. Considering the influence that news media has on parents, the reporting of food parenting practices in news articles should aim to provide a balanced view of the published scientific evidence and recognise the difficulties and barriers that prevent the use of helpful and healthy food parenting practices. The study results in this paper could be used to aid and structure of the dissemination of food parenting practice research findings in the media, inform public health education to influence perceptions of unhelpful food parenting practices, and promote parental use of responsive food parenting practices.
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Affiliation(s)
- Chloe Patel
- Warwick Manufacturting Group, Behaviour and Wellbeing Science, University of Warwick, Coventry CV4 7AL, UK;
- Correspondence:
| | - Lukasz Walasek
- Department of Psychology, University of Warwick, Coventry CV4 7AL, UK;
| | - Eleni Karasouli
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK;
| | - Caroline Meyer
- Warwick Manufacturting Group, Behaviour and Wellbeing Science, University of Warwick, Coventry CV4 7AL, UK;
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15
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Slapnicar C, Lear SA, Dehghan M, Gupta M, Rangarajan S, Punthakee Z. Relationship of parental feeding practices and diet with children's diet among South Asians in Canada. Appetite 2022; 173:105991. [PMID: 35271940 DOI: 10.1016/j.appet.2022.105991] [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: 11/04/2021] [Revised: 02/17/2022] [Accepted: 02/27/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND South Asian children's diets are considered unhealthy, yet the relationship with food parenting among South Asians is understudied. METHODS In a cross-sectional study, questionnaires were administered to dyads of Canadian South Asian elementary and high school children and a parent. Relationships between parental factors (perceived responsibility, restriction, pressure to eat, monitoring, home food environment, nutrition knowledge and intake of fruits and vegetables (FV), sugary beverages (SB) and sweets and fast foods (SWFF) and children's intake of FV, SB and SWFF were assessed by linear regression adjusted for sociodemographics. Subgroup differences by children's age and acculturation were explored by interaction analysis. RESULTS 291 children (age 9.8 ± 3.2 years) had mean daily intake frequencies of 3.1 ± 2.0 FV, 1.0 ± 0.9 SB and 2.1 ± 1.5 SWFF. Positive associations were found between parent and child intake of FV (standardized beta (ß) = 0.230, [95%CI 0.115, 0.345], p < 0.001), SB (β = 0.136 [0.019, 0.252], p = 0.02), and SWFF (β = 0.167 [0.052, 0.282], p = 0.005). Parental monitoring was associated with lower children's SWFF intake (ß = -0.131 [-0.248, -0.015], p = 0.03). Among those expressing less Western culture, parental SWFF intake was associated with child's SB intake (β = 0.255 [0.085, 0.425], p = 0.004). Among those expressing less traditional culture, positive home food environment was associated with lower child SWFF intake (β = -0.208 [-0.374, -0.042], p = 0.015). CONCLUSION South Asian children's diets have stronger relationships with their parents' diets than with food parenting practices or nutrition knowledge, though parental monitoring was associated with lower unhealthy food intake. However, with greater acculturation, the home food environment was more important for unhealthy food intake.
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Affiliation(s)
- Calum Slapnicar
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada; Population Health Research Institute, Hamilton, ON, Canada
| | | | - Milan Gupta
- Canadian Collaborative Research Network, Brampton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Zubin Punthakee
- Population Health Research Institute, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
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16
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Chan MJ, Tay GWN, Kembhavi G, Lim J, Rebello SA, Ng H, Lin C, Wang MC, Müller-Riemenschneider F, Chong MFF. Understanding children's perspectives of the influences on their dietary behaviours. Public Health Nutr 2022; 25:1-11. [PMID: 35184794 PMCID: PMC9991721 DOI: 10.1017/s1368980022000404] [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: 08/05/2021] [Revised: 02/05/2022] [Accepted: 02/16/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to examine the intrapersonal, interpersonal, environmental and macrosystem influences on dietary behaviours among primary school children in Singapore. DESIGN A qualitative interpretive approach was used in this study. Focus group discussions guided by the socio-ecological model (sem), of which transcripts were analysed deductively using the sem and inductively using thematic analysis to identify themes at each sem level. SETTING Two co-educational public primary schools in Singapore. PARTICIPANTS A total of 48 children (n 26 girls) took part in the semi-structured focus group discussions. Their mean age was 10·8 years (sd = 0·9, range 9-12 years), and the majority of the children were Chinese (n 36), along with some Indians (n 8) and Malays (n 4). RESULTS Children's knowledge of healthy eating did not necessarily translate into healthy dietary practices and concern for health was a low priority. Instead, food and taste preferences were pivotal influences in their food choices. Parents had a large influence on children with regards to their accessibility to food, their attitudes and values towards food. Parental food restriction led to some children eating in secrecy. Peer influence was not frequently reported by children. Competitions in school incentivised children to consume fruits and vegetables, but reinforcements from teachers were inconsistent. The proximity of fast-food chains in the neighbourhood provided children easy access to less healthy foods. Health advertisements on social media rather than posters worked better in drawing children's attention. CONCLUSIONS Findings highlighted important factors that should be considered in future nutrition interventions targeting children.
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Affiliation(s)
- Mei Jun Chan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | - Gabrielle Wann Nii Tay
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | | | - Jubilee Lim
- Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | - Hazyl Ng
- Health Promotion Board, Singapore, Singapore
| | - Congren Lin
- Health Promotion Board, Singapore, Singapore
| | - May C Wang
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609 Singapore, Singapore
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17
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De-Jongh González O, Ojeda García A, Turnbull B, Cruz Torres CE, León Elizalde MA, Escalante Izeta EI. Don't take the context out of the picture: Contextually shaped parents' and children's obesogenic behaviors in a marginalized area of Mexico City. Appetite 2022; 171:105915. [PMID: 35007664 DOI: 10.1016/j.appet.2022.105915] [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: 08/02/2021] [Revised: 12/21/2021] [Accepted: 01/05/2022] [Indexed: 11/26/2022]
Abstract
Santa Fe Gully zone is a marginalized area of Mexico City where nearly 39% of children live with either overweight or obesity. Despite the extensive research on obesogenic behaviors, studies frequently overlook the contexts where such behaviors occur. This qualitative study described individual and familial obesogenic behaviors among children with obesity from Santa Fe Gully, and explained how these behaviors might be contextually shaped. We used a grounded theory approach to investigate the process of development/maintenance of obesity in our sample. Fifteen participants (seven 10-year-olds with overweight or obesity and their parents) participated in nine art-based focus groups, and parents completed individual semi-structured interviews. Data were analyzed using a structured thematic content analysis. Results showed children's weight status was part of their identity, providing children with a familial 'fitting' sense while increasing psychosocial difficulties, leading to emotional overeating as a coping strategy. Parents' use of controlling and low-structured parenting practices reinforced children's emotional overeating and failed to regulate children's dietary and physical activity behaviors. Some low-structured parenting practices were guilt-motivated or fostered by socioeconomic and cultural factors (e.g., limited food access, unhealthy food exposure, community unsafety). Future interventions in Santa Fe Gully aimed at modifying obesogenic behaviors should incorporate systemic and ecological approaches to help participants navigate through contextual obstacles, as their behaviors should be analized considering the context where they occur.
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Affiliation(s)
- Olivia De-Jongh González
- Psychology Department, Universidad Iberoamericana of Mexico City, 880 Prolongación Paseo de la Reforma, Lomas de Santa Fe, Álvaro Obregón, Mexico City, CP 01219, Mexico; School of Population and Public Health, University of British Columbia, BC Children's Hospital Research Institute, F514-4490 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.
| | - Angélica Ojeda García
- Psychology Department, Universidad Iberoamericana of Mexico City, 880 Prolongación Paseo de la Reforma, Lomas de Santa Fe, Álvaro Obregón, Mexico City, CP 01219, Mexico.
| | - Bernardo Turnbull
- Psychology Department, Universidad Iberoamericana of Mexico City, 880 Prolongación Paseo de la Reforma, Lomas de Santa Fe, Álvaro Obregón, Mexico City, CP 01219, Mexico.
| | - Christian E Cruz Torres
- Psychology Department, Universidad de Guanajuato Campus León, Blvd. Puente Milenio No. 1001 Fracción del Predio San Carlos, CP 37670, Guanajuato, México.
| | - M Angélica León Elizalde
- School of Population and Public Health, University of British Columbia, BC Children's Hospital Research Institute, F514-4490 Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.
| | - Ericka I Escalante Izeta
- Health Department, Universidad Iberoamericana of Puebla. 2901 Blvd. del Niño Poblano, Reserva Territorial Atlixcáyotl, San Andrés Cholula, Puebla, CP 72820, Mexico.
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18
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Philippe K, Chabanet C, Issanchou S, Monnery-Patris S. Young Children's Eating in the Absence of Hunger: Links With Child Inhibitory Control, Child BMI, and Maternal Controlling Feeding Practices. Front Psychol 2021; 12:653408. [PMID: 34867571 PMCID: PMC8635239 DOI: 10.3389/fpsyg.2021.653408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 10/19/2021] [Indexed: 12/05/2022] Open
Abstract
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.
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Affiliation(s)
- Kaat Philippe
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Claire Chabanet
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Sylvie Issanchou
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
| | - Sandrine Monnery-Patris
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, Dijon, France
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19
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Penilla C, Tschann JM, Pasch LA, Flores E, Deardorff J, Martinez SM, Butte NF, Greenspan LC. Style of meal service and feeding practices among Mexican American fathers and mothers: An analysis of video-recorded children's evening mealtime at home. Appetite 2021; 169:105851. [PMID: 34883137 DOI: 10.1016/j.appet.2021.105851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/18/2022]
Abstract
The aim of this study was to examine video-recorded observations of evening family mealtime at home among Mexican American children to help elucidate style of meal service, fathers' and mothers' feeding practices and child's eating behavior. Consistent with guidelines for coding behaviors, we analyzed observational data of evening mealtimes of 71 Mexican American children aged eight to 10 years. Regarding style of meal service, in almost all cases (96%), parents plated the child's food, with more available on the table or counter in 40% of the observations. Mothers almost always served the child (94%). Regarding parental feeding practices, parents used positive involvement in meals (80%), pressure to eat (42%) and restriction of food (9%). Using food as a reward to control behavior was never used by either parent. The majority (75%) of children requested or negotiated to eat less food, or only eat certain items. In Mexican American families, both mothers and fathers play a role in family mealtimes and both use positive involvement in child's meals, and to a lesser extent pressure to eat, with their children aged eight to 10 years. To help reduce the obesity epidemic, intervention strategies are needed, which integrate the family, a plating style of meal and parental feeding practices that promote healthy eating in the home. To reduce obesity among Mexican American children, interventions that focus on parental positive involvement in child's meal and maintenance of home cooked meals could have a positive impact on the entire family.
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Affiliation(s)
- Carlos Penilla
- Division of Adolescent and Young Adult Medicine, University of California, San Francisco, Box 0503, San Francisco, CA, 94118-0503, USA.
| | - Jeanne M Tschann
- Department of Psychiatry, University of California, San Francisco, Box 0848, San Francisco, CA, 94143-0848, USA.
| | - Lauri A Pasch
- Department of Psychiatry, University of California, San Francisco, Box 0848, San Francisco, CA, 94143-0848, USA.
| | - Elena Flores
- Department of Counseling Psychology, University of San Francisco, 2130 Fulton St, San Francisco, CA, 94118, USA.
| | - Julianna Deardorff
- School of Public Health, University of California, Berkeley, 2121 Berkeley Way West, Berkeley, CA, 94720-7360, USA.
| | - Suzanna M Martinez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, 550 16th St, San Francisco, CA, 94158, USA.
| | - Nancy F Butte
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, 1100 Bates St, Houston, TX, 77030-2600, USA.
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20
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Jackson K, Rosenberg J, Jansen E, Mallan KM. Qualitative Exploration of Dimensions of Restrictive Feeding With Australian Mothers of 6-Year-Olds. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:858-869. [PMID: 34257029 DOI: 10.1016/j.jneb.2021.04.465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 04/18/2021] [Accepted: 04/24/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Explore the nature and dimensions of restrictive feeding with mothers of 6-year-olds. DESIGN Semistructured interviews with mothers. Conversations were audio-recorded and transcribed verbatim. SETTING Brisbane and Adelaide, Australia. PARTICIPANTS Twenty-nine mothers of 6-year-olds. PHENOMENON OF INTEREST Mothers' restrictive feeding practices. ANALYSIS Qualitative thematic analysis. RESULTS This study revealed 6 key themes relating to the restrictive feeding phenomenon: restriction of specific foods and drinks; restrictive feeding practices; mothers' motivation; mothers' preferences for restricted foods; patterns over time; and relationships with other controlling feeding practices. Parents' restrictive feeding practices are likely to be inherently inconsistent, with mothers reportedly varying their practices across different restricted foods, contexts, day to day, and as children age. Mothers intended to either totally restrict or restrict a food/drink in moderation, and these intentions presented qualitatively distinct characteristics across themes. Mothers commonly referred to foods/drinks restricted in moderation as treats, and their liking for these restricted foods/drinks was related to higher child access. CONCLUSIONS AND IMPLICATIONS This study provides insights into the nature and dimensions of restrictive feeding. Further research is proposed to clarify these findings and examine the effects of child access, types of restrictive feeding practices, and parent communication on child preferences for restricted foods and drinks across a range of cultural groups.
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Affiliation(s)
- Kim Jackson
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - John Rosenberg
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Elena Jansen
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kimberley M Mallan
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
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21
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Somaraki M, Ek A, Eli K, Ljung S, Mildton V, Sandvik P, Nowicka P. Parenting and childhood obesity: Validation of a new questionnaire and evaluation of treatment effects during the preschool years. PLoS One 2021; 16:e0257187. [PMID: 34555050 PMCID: PMC8459975 DOI: 10.1371/journal.pone.0257187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 08/24/2021] [Indexed: 11/19/2022] Open
Abstract
Objectives Parenting is an integral component of obesity treatment in early childhood. However, the link between specific parenting practices and treatment effectiveness remains unclear. This paper introduces and validates a new parenting questionnaire and evaluates mothers’ and fathers’ parenting practices in relation to child weight status during a 12-month childhood obesity treatment trial. Methods First, a merged school/clinical sample (n = 558, 82% mothers) was used for the factorial and construct validation of the new parenting questionnaire. Second, changes in parenting were evaluated using clinical data from the More and Less Study, a randomized controlled trial (RCT) with 174 children (mean age = 5 years, mean Body Mass Index Standard Deviation Score (BMI SDS) = 3.0) comparing a parent support program (with and without booster sessions) and standard treatment. Data were collected at four time points over 12 months. We used linear mixed models and mediation models to investigate associations between changes in parenting practices and treatment effects. Findings The validation of the questionnaire (9 items; responses on a 5-point Likert scale) revealed two dimensions of parenting (Cronbach’s alpha ≥0.7): setting limits to the child and regulating one’s own emotions when interacting with the child, both of which correlated with feeding practices and parental self-efficacy. We administered the questionnaire to the RCT participants. Fathers in standard treatment increased their emotional regulation compared to fathers in the parenting program (p = 0.03). Mothers increased their limit-setting regardless of treatment allocation (p = 0.01). No treatment effect was found on child weight status through changes in parenting practices. Conclusion Taken together, the findings demonstrate that the new questionnaire assessing parenting practices proved valid in a 12-month childhood obesity trial. During treatment, paternal and maternal parenting practices followed different trajectories, though they did not mediate treatment effects on child weight status. Future research should address the pathways whereby maternal and paternal parenting practices affect treatment outcomes, such as child eating behaviors and weight status.
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Affiliation(s)
- Maria Somaraki
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Karin Eli
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | | | - Veronica Mildton
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Pernilla Sandvik
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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Abstract
Objective: Feeding practices used by educators in Early Childhood Education and Care (ECEC) settings can influence the diet quality of young children. However, Australian data is scarce and limited to describing barriers to responsive feeding. This study describes the use of feeding practices amongst a group of Australian educators. Design: Direct observation of feeding practices and assessment of centre policy were conducted using the ‘Environment and Policy Assessment and Observation’ tool. Self-reported feeding practices and demographic data were collected via online survey using the Childcare Food and Activity Practices Questionnaire. Setting: Ten centre-based ECEC services in South East Queensland, Australia. Participants: Educators working in ECEC. Results: A total of 120 meals were observed and 88 educators provided self-report data (n 84 female). Centre policy supported the use of responsive feeding practices, and this was reflected in the high frequency with which children could decide what and how much to eat, across both observed and self-report data as well as low levels of pressure to eat and use of food as a reward (observed at 19·9 % and 0 % of meals). The only apparent discrepancy was regarding modelling. Median score for self-reported role-modelling was 5·0 (4·3–5·0) and educators were observed to sit with children at 75 % of meals, however observed occasions of enthusiastic role modelling was only 22 % (0–33·3) of meals. Conclusions: Research addressing how educators conceptualise feeding practices, as well under what circumstances they are used, particularly in centres with different models of food provision, may shed light on why modelling is rarely implemented in practice.
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23
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Hyczko AV, Ruggiero CF, Hohman EE, Anzman-Frasca S, Savage JS, Birch LL, Paul IM. Sex Differences in Maternal Restrictive Feeding Practices in the Intervention Nurses Start Infants Growing on Healthy Trajectories Study. Acad Pediatr 2021; 21:1070-1076. [PMID: 34020105 PMCID: PMC8349795 DOI: 10.1016/j.acap.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
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.
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Affiliation(s)
- Alexis V. Hyczko
- Penn State College of Medicine, 500 University Dr., Hershey, PA, USA 17033
| | - Cara F. Ruggiero
- Penn State University, Center for Childhood Obesity Research, 129 Noll Laboratory, University Park, PA, USA 16802
| | - Emily E. Hohman
- Penn State University, Center for Childhood Obesity Research, 129 Noll Laboratory, University Park, PA, USA 16802
| | - Stephanie Anzman-Frasca
- University at Buffalo, Department of Pediatrics, G56 Farber Hall, South Campus, Buffalo, NY, USA 14214-8001
| | - Jennifer S. Savage
- Penn State University, Center for Childhood Obesity Research, 129 Noll Laboratory, University Park, PA, USA 16802
| | - Leann L. Birch
- University of Georgia, Department of Foods and Nutrition, 176 Dawson Hall, Athens, GA, USA 30602-3632
| | - Ian M. Paul
- Penn State College of Medicine, 500 University Dr., Hershey, PA, USA 17033,Departments of Pediatrics & Public Health Sciences, 500 University Dr., Hershey, PA, USA 17033
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24
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Koning M, Vink J, Notten N, Gevers D, Eisinga R, Larsen J. Development and preliminary validation of the Adolescent Food Parenting Questionnaire: Parent and adolescent version. Appetite 2021; 167:105618. [PMID: 34348166 DOI: 10.1016/j.appet.2021.105618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 01/03/2023]
Abstract
Suitable instruments for measuring Food Parenting Practices (FPP) among adolescents and their parents that also measure the perception of adolescents about their parent's FPP are rare. The current study describes the development and preliminary testing of a short 16-item Adolescent Food Parenting Questionnaire (AFPQ) for parents (AFPQ-p) and adolescents (AFPQ-a) that may enable future large-scale research on potentially eminent parent-child FPP discrepancy. Participants included 381 parents (73.8 % mothers; Mage 45.9, 26.2% fathers; Mage 49.1) and their adolescent children (aged 12-16) who participated in the Dutch "G(F)OOD together" study. Most parents finished higher professional education (mothers: 44.3 %; fathers: 34.4 %) and performed a paid job of 32 h per week or more (mothers: 22.1 %; fathers: 60.0 %). The theoretical framework of Vaughn (2016) was leading in the development of the AFPQ. Exploratory factor analysis (EFA) was performed on a random split sample of parent-adolescent dyads and confirmatory factor analysis (CFA) was performed on the other half. The EFA in both parent and adolescent samples resulted in a clear 5 factor solution explaining 61.6 % (AFPQ-p) and 64.2 % (AFPQ-a) of the variance respectively, representing the factors Autonomy Support (α = 0.79/.82), Coercive Control (α = 0.85/.83), Snack Structure (α = 0.79/75), Healthy Structure (α = 0.78/74) and Modelling (α = 0.69/85). CFA confirmed good model fit for the AFPQ-p and the AFPQ-a. Associations with adolescent self-reported food intake were in the expected direction, confirming the preliminary convergent validity of the instrument among a moderate to highly educated group of parent-adolescent dyads. Although the AFPQ provides a promising short instrument, future research in more diverse samples is needed to build evidence on the instrument's psychometric characteristics in other groups.
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Affiliation(s)
- Maaike Koning
- Department of Healthy Society, Knowledge Centre for Health and Social Work, Windesheim University of Applied Sciences, Zwolle, the Netherlands; Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
| | - Jacqueline Vink
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
| | - Natascha Notten
- Department of Healthy Society, Knowledge Centre for Health and Social Work, Windesheim University of Applied Sciences, Zwolle, the Netherlands.
| | - Dorus Gevers
- Maastricht University, Maastricht, the Netherlands.
| | - Rob Eisinga
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
| | - Junilla Larsen
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands.
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Giuliani NR, Harrington EM, Trevino SD. Intergenerational transmission of appetite self-regulation. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2021; 76:101330. [PMID: 36911419 PMCID: PMC10003670 DOI: 10.1016/j.appdev.2021.101330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Parents and other primary caregivers affect the development of children's self-regulation in myriad ways, including via the parent's own self-regulation abilities. Ample evidence supports the association between mother and child self-regulation, yet this has never been experimentally assessed with regard to appetite self-regulation, the self-regulation of food intake. This study sought to explicitly test the associations between mother and child self-regulation across 3 domains: (1) appetite, (2) attentional control, and (3) inhibitory control. A community sample of 88 mother-preschooler dyads (ages 3-5) participated in this cross-sectional, experimental study. Results demonstrated that maternal self-regulation was significantly positively associated with child self-regulation in the appetite domain, b = 0.52, t(63.54) = 2.39, p = .020, but not for attentional or inhibitory control. These results add to the literature on parental influences on self-regulation development in early childhood and suggest that patterns of mother-child associations may vary across domains of self-regulation.
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Affiliation(s)
- Nicole R. Giuliani
- Special Education and Clinical Sciences, University of Oregon, United States of America
| | - Ellie M. Harrington
- Special Education and Clinical Sciences, University of Oregon, United States of America
| | - Shaina D. Trevino
- Counseling Psychology and Human Services, University of Oregon, United States of America
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26
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Bayless AK, Wyatt TH, Raynor H. Self-Regulation in Pediatric Nursing Literature: An Evolutionary Concept Exploration. Res Theory Nurs Pract 2021; 35:RTNP-D-20-00084. [PMID: 34162760 DOI: 10.1891/rtnp-d-20-00084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The concept of self-regulation appears frequently in nursing literature. Although the concept is well developed in nonnursing theories, its application in nursing has not been explored adequately. Most nursing authors address self-regulation in one of two ways. Some publish findings without a strong theoretical understanding of self-regulation. Others publish studies using a conglomeration of theorists' self-regulatory explanations without properly contextualizing the theoretical elements for nursing practice. For this concept exploration, the authors used Rodgers, B. L. (2005). Developing nursing knowledge: Philosophical traditions and influences Lippincott, Williams & Wilkins, evolutionary concept analysis method to determine the current use of self-regulation in pediatric nursing literature and trace the concept's recent development, changes, and expansion. This work provides a representation of self-regulation based on existing healthcare studies and suggests steps for concept clarification that could promote accurate use of the concept in future research.
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Affiliation(s)
| | - Tami H Wyatt
- College of Nursing, University of Tennessee, Knoxville, TN
| | - Hollie Raynor
- College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN
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Effectiveness of an Innovative Sensory Approach to Improve Children's Nutritional Choices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126462. [PMID: 34203732 PMCID: PMC8296279 DOI: 10.3390/ijerph18126462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/10/2021] [Accepted: 06/12/2021] [Indexed: 12/03/2022]
Abstract
A case-control study was conducted to investigate the effectiveness of the Edueat® Method, through experiential workshops focused on the use of all 5 senses. In two different primary schools in the same city, questionnaires were administered in two months with a follow-up one year later. Participants: 119 children (age 8.2–9.0) chosen randomly; control group 66 (55.5%). Seven lessons of 2 h each were held in the schools by experts of the Edueat® method and seven extra lessons by the teachers. The main outcome measures were the children’s changes in their approach and attitude towards their eating habits. The answers were grouped with factor analysis and summarized through scores. Repeated-measures analysis of variance was conducted in order to identify the relationships between scores and treatment over time. At the end of treatment, the intervention group showed a significant appreciation towards healthy foods (+4.15 vs. −0.05, p = 0.02) and a greater capacity in identifying foods which are very good for the health (+15.6 vs. +14.4, p = 0.02). In conclusion, the Edueat® method was found to be particularly promising in transmitting knowledge of those foods which are healthy. Greater involvement of teachers and parents is crucial.
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28
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Gomes AI, Pereira AI, Roberto MS, Boraska K, Barros L. Changing parental feeding practices through web-based interventions: A systematic review and meta-analysis. PLoS One 2021; 16:e0250231. [PMID: 33909666 PMCID: PMC8081248 DOI: 10.1371/journal.pone.0250231] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/03/2021] [Indexed: 11/18/2022] Open
Abstract
Web-based parent interventions designed to promote children’s healthy eating patterns can enhance parents’ engagement and facilitate behavior change. However, it is still unclear how much the existing programs focus on changing parental feeding practices, and if so, which behavioral methodologies are used and how effective these interventions are in changing these parental behaviors. This systematic review and meta-analysis studied randomized controlled trials of web-based interventions targeting parents of 0-12-year-old children, aiming to promote children’s healthy diet or prevent nutrition-related problems and reporting parental feeding behaviors as one of the outcomes. We conducted an electronic search in four databases from the earliest publication date until February 2020. Of the 1271 records found, we retained twelve studies about nine programs, comprising 1766 parents that completed the baseline evaluation. We found recent interventions, mainly directed to parents of young children, with small, non-clinical samples, and mostly theory-based. The programs were heterogeneous regarding the type of intervention delivered and its duration. The most assessed parental feeding practices were Restriction, Pressure to eat, and Food availability/accessibility. The behavior change techniques Instruction on how to perform the behavior, Demonstration of the behavior, and Identification of self as role model were frequently used. Meta-analytic results indicated that most programs’ effects were small for the evaluated parental practices, except for Food availability/accessibility that benefited the intervention group only when all follow-up measurements were considered. The development of high-quality and controlled trials with larger samples is needed to determine with greater certainty the interventions’ impact on parental feeding behaviors. The more frequent inclusion of measures to evaluate parental practices to support children’s autonomy and of self-regulatory strategies as intervention components should be considered when designing programs.
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Affiliation(s)
- Ana Isabel Gomes
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
- * E-mail:
| | - Ana Isabel Pereira
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
| | - Magda Sofia Roberto
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
| | - Klara Boraska
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
- Department of Psychology, Catholic University of Croatia, Zagreb, Republic of Croatia
| | - Luisa Barros
- Faculty of Psychology, Research Center for Psychological Science (CICPSI), University of Lisbon, Lisbon, Portugal
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Appetite self-regulation declines across childhood while general self-regulation improves: A narrative review of the origins and development of appetite self-regulation. Appetite 2021; 162:105178. [PMID: 33639246 DOI: 10.1016/j.appet.2021.105178] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 02/07/2023]
Abstract
This narrative review discusses the origins and development of appetite self-regulation (ASR) in childhood (from infancy to age 6 or 7 years). The origins, or foundations, are the biological infrastructure associated with appetite regulation and appetite self-regulation. Homeostatic regulation in infancy is examined and then evidence about developmental change in components of ASR. The main ASR-related components covered are: delay-of-gratification, caloric compensation, eating in the absence of hunger, food responsiveness/hedonics and fussy eating. The research included behavioral measures, parent-reports of appetitive traits and fMRI studies. There were two main trends in the evidence: a decline across childhood in the components of ASR associated with food approach (and therefore an increase in disinhibited eating), and wide individual differences. The decline in ASR contrasts with general self-regulation (GSR) where the evidence is of an improvement across childhood. For many children, bottom-up automatic reactive processes via food reward/hedonics or food avoidance as in fussy eating, appear not to be matched by improvements in top-down regulatory capacities. The prominence of bottom-up processes in ASR could be the main factor in possible differences in developmental paths for GSR and ASR. GSR research is situated in developmental science with its focus on developmental processes, theory and methodology. In contrast, the development of ASR at present does not have a strong developmental tradition to access and there is no unifying model of ASR and its development. We concluded (1) outside of mean-level or normative changes in the components of ASR, individual differences are prominent, and (2) there is a need to formulate models of developmental change in ASR together with appropriate measurement, research designs and data analysis strategies.
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Graf MD, Karp SM, Lutenbacher M, Wasser H, Bushaw A, Dietrich MS. Clinical strategies for addressing obesity in infants and toddlers. Nurse Pract 2021; 46:28-33. [PMID: 33475327 DOI: 10.1097/01.npr.0000731552.88748.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Babies' earliest food experiences have a lifelong impact on eating preferences and dietary habits, laying the foundation for obesity risk. NPs have the opportunity to provide education about healthy infant feeding practices before the growth trajectory becomes abnormal and focus intensive education on at-risk families.
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James-Martin G, Baird DL, Hendrie GA. Strategies to Reduce Consumption of Unhealthy Foods and Beverages: Scenario Modeling to Estimate the Impact on the Australian Population's Energy and Nutrient Intakes. J Acad Nutr Diet 2021; 121:1463-1483. [PMID: 33495107 DOI: 10.1016/j.jand.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 11/12/2020] [Accepted: 12/03/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Overconsumption of energy-dense, nutrient-poor "discretionary" foods and beverages can indicate poor diet quality, which is a risk factor for obesity and chronic disease. With 60% of Australians exceeding the recommended intake of discretionary foods, there is a need for interventions to reduce their consumption. OBJECTIVE The objective was to model the impact of 26 specific scenarios to limit discretionary food intake on energy and nutrient intake. DESIGN The scenario modeling analysis was based on reduction strategies targeting portion size, frequency, or variety of discretionary food and beverage items consumed. PARTICIPANTS/SETTING Data from 12,153 respondents aged 2 to 85 years from the 2011-12 Australian National Nutrition and Physical Activity Survey were used. OUTCOME MEASURES The outcome measures were change in servings of discretionary foods and key nutrients (energy, total fat, saturated fat, sugar, alcohol, sodium, trans fat) for the population, and by sex, age group, weight status, and socioeconomic status. STATISTICAL ANALYSES PERFORMED Descriptive and inferential statistical analysis were conducted. RESULTS Scenarios reduced total energy intake by up to 26% across the population as a whole. The removal of discretionary foods (not beverages) resulted in the greatest reduction in servings and energy (74.8% and 25.6%, respectively), followed by the removal of discretionary items in portions greater than 143 kcal (59.1% and 24.3%) and not consuming discretionary items at main meals (51.2% and 17.8%). Targeting single categories of discretionary foods reduced energy intake by an average of 5.6% for the removal of cakes and biscuits, 4.4% for alcohol, and 3.9% for sugar-sweetened beverages. Strategies reduced total fat, saturated fat, and sugar by up to 35%, 38%, and 40% respectively. CONCLUSIONS Strategies that are specific to discretionary food and beverage intake targeting reductions in portion size, frequency, or variety have the potential to reduce energy intake and improve diet quality. These findings have implications for designing interventions with potential to tailor messages to current dietary habits. Exploration of how these strategies could be effectively implemented will be the focus of further research.
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Jansen E, Russell CG, Appleton J, Byrne R, Daniels LA, Fowler C, Rossiter C, Mallan KM. The Feeding Practices and Structure Questionnaire: development and validation of age appropriate versions for infants and toddlers. Int J Behav Nutr Phys Act 2021; 18:13. [PMID: 33468156 PMCID: PMC7814443 DOI: 10.1186/s12966-021-01079-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/05/2021] [Indexed: 01/22/2023] Open
Abstract
Background In order to measure and understand trajectories of parental feeding practices and their relationship with child eating and weight, it is desirable to perform assessment from infancy and across time, in age-appropriate ways. While many feeding practices questionnaires exist, none is presently available that enables tracking of feeding practices from infancy through childhood. The aim of the study was to develop a version of the Feeding Practices and Structure Questionnaire (FPSQ) for parents with infants and toddlers (< 2 years) to be used in conjunction with the original FPSQ for older children (≥2 years) to measure feeding practices related to non-responsiveness and structure across childhood. Methods Constructs and items for the FPSQ for infants and toddlers were derived from the existing and validated FPSQ for older children and supplemented by a review of the literature on infant feeding questionnaires. Following expert review, two versions of the questionnaire were developed, one for milk feeding parents and one for solid feeding parents. Data from two studies were combined (child ages 0–24 months) to test the derived constructs with Confirmatory Factor Analysis for the milk feeding (N = 731) and solid feeding (N = 611) versions. Results The milk feeding version consisted of four factors (18 items) and showed acceptable model fit and good internal reliability: ‘feeding on demand vs. feeding routine’ (α = 0.87), ‘using food to calm’ (α = 0.87), ‘persuasive feeding’ (α = 0.71), ‘parent-led feeding’ (α = 0.79). The same four factors showed acceptable model fit for the solid feeding version (21 items), likewise with good internal reliability (α = 0.74, 0.86, 0.85, 0.84 respectively). Two additional factors (13 items) were developed for the solid feeding version that appeared developmentally appropriate only for children aged 12 months or older: ‘family meal environment’ (α = 0.81) and ‘using (non-)food rewards’ (α = 0.92). The majority of factor-factor correlations were in line with those of the original FPSQ. Conclusions The FPSQ milk and solid feeding versions are the first measures specifically developed as precursors to the FPSQ to measure parental feeding practices in children < 2 years, particularly practices related to non-responsiveness and structure. Further validation in more diverse samples is required. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01079-x.
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Affiliation(s)
- E Jansen
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD, 4059, Australia. .,Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - C G Russell
- CASS Food Research Centre, Faculty of Health, School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - J Appleton
- Susan Wakil School of Nursing and Midwifery, University of Sydney, 88 Mallett St, Camperdown, NSW, 2050, Australia.,Tresillian Family Care Centres, McKenzie Street, Belmore, Sydney, NSW, 2192, Australia
| | - R Byrne
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD, 4059, Australia.,Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, 62 Graham St, South Brisbane, QLD, 4101, Australia
| | - L A Daniels
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD, 4059, Australia
| | - C Fowler
- Tresillian Family Care Centres, McKenzie Street, Belmore, Sydney, NSW, 2192, Australia.,School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia
| | - C Rossiter
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia
| | - K M Mallan
- School of Behavioural and Health Sciences, Australian Catholic University, 1100 Nudgee Rd, Banyo, QLD, 4014, Australia
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Spielvogel I, Naderer B, Binder A, Matthes J. The Forbidden Reward. The Emergence of Parent-Child Conflicts About Food Over Time and the Influence of Parents' Communication Strategies and Feeding Practices. Front Public Health 2021; 8:604702. [PMID: 33537278 PMCID: PMC7848163 DOI: 10.3389/fpubh.2020.604702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/14/2020] [Indexed: 11/24/2022] Open
Abstract
One of the most critical arenas for conflicts between parents and their children relates to food. Although parent-child conflicts about food are a real occurrence, this form of parent-child interaction has been rarely examined. Given the special role of parents in shaping children's diet, we especially focus on the impact of parental measures. This study investigates how parental communication strategies (i.e., active vs. restrictive) and feeding practices (i.e., overt control vs. covert control) affect the emergence of parent-child conflicts about food over time. Based on previous research, we assessed overt control through parents' use of food as a reward and restriction of their children's access to specific food types. We explored the impact of our predictors on both conflicts about unhealthy and healthy food with a two-wave panel study including parents and their children (N = 541; children aged between 5 and 11) in Austria between fall 2018 and spring 2019. Results of two multiple linear regressions indicated that predominantly parents' use of unhealthy food as a reward is connected to both healthy and unhealthy food conflicts. Furthermore, inconsistent parental educational styles increased the respective conflict potential. Active food-related mediation and covert control did not relate to food-related conflicts about unhealthy and healthy food. Parents' increased use of overtly controlling and restrictive feeding practices might not be only counterproductive for children's diet but also for food-related parent-child interactions. Instead, a “health discourse” (i.e., active food-related mediation) might prevent food-related conflicts and foster a healthy growth in the future.
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Affiliation(s)
- Ines Spielvogel
- Department of Communication, Advertising and Media Effects Research Group (AdME), University of Vienna, Vienna, Austria
| | - Brigitte Naderer
- Department of Media and Communication, Ludwig Maximilian University of Munich, Munich, Germany
| | - Alice Binder
- Department of Communication, Advertising and Media Effects Research Group (AdME), University of Vienna, Vienna, Austria
| | - Jörg Matthes
- Department of Communication, Advertising and Media Effects Research Group (AdME), University of Vienna, Vienna, Austria
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Abstract
PURPOSE OF REVIEW The goal of the current paper is to review the literature on the neural and behavioral factors involved in food decision-making in youth. RECENT FINDINGS Recent neuroimaging studies that employ passive viewing paradigms have found that exposure to food-related cues activate reward, motor planning, and attentional salience signals in children. Greater activations of reward signals and/or lower activations of control signals are associated with overeating and weight gain. Neuroimaging studies with decision-making paradigms have found the reward network in the brain activates during food choices, while control network activates less strongly. Findings suggest that exposure to food cues activates reward/valuation network, but activation of control network tends to be relatively weaker in children. Hedonic aspects of foods are predominantly considered in children's food choices, and their dietary self-control is not matured yet. The increased activation in reward network and the decreased activation in control network are associated with risk of developing obesity.
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Affiliation(s)
- Oh-Ryeong Ha
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry St, Kansas City, MO, 64110, USA
| | - Seung-Lark Lim
- Department of Psychology, University of Missouri-Kansas City, 5030 Cherry St, Kansas City, MO, 64110, USA
| | - Amanda S Bruce
- Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
- Center for Children's Healthy Lifestyles and Nutrition; Children's Mercy Hospital, Kansas City, MO, USA.
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Power TG, Beck AD, Fisher JO, Micheli N, O'Connor TM, Hughes SO. Observations of Maternal Feeding Practices and Styles and Young Children's Obesity Risk: A Longitudinal Study of Hispanic Mothers with Low Incomes. Child Obes 2021; 17:16-25. [PMID: 33253009 PMCID: PMC7815060 DOI: 10.1089/chi.2020.0178] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: Maternal feeding practices and styles are well-established correlates of children's BMI z-scores in the preschool years. Most studies, however, are cross-sectional, using maternal self-reports to examine feeding. This study examined, over a 3½-year period, the relationship between observed and self-reported feeding practices/styles and children's BMI z-scores in a sample of Hispanic mothers with low incomes and their preschool children. Methods: One hundred eighty-seven mothers were observed feeding their 4- to 5-year old during a buffet meal in a laboratory setting and completed self-report measures on their feeding practices and styles. Children's BMI z-scores were assessed at this visit and 3½ years later. Results: Consistent with previous research, observed and self-reported pressure to eat and/or authoritarian feeding were negatively associated with children's BMI z-scores at the first time point; observed discouraging eating was positively associated. However, children's BMI z-scores 3½ years later, controlling for Time 1 BMI z-scores, were positively associated with observed pressure to eat. Observed maternal reasoning and self-reported monitoring of children's eating behavior at Time 1 were negatively associated with later BMI z-scores. Only self-reported feeding styles predicted later children's BMI z-scores, with indulgent and authoritative styles positively associated with children's BMI z-scores at the third time point. Conclusions: These findings demonstrate that mothers who ignore their children's fullness cues and pressure them to eat have children who are at greater risk for the development of later obesity. Implications for the development of family-focused childhood obesity prevention programs are discussed.
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Affiliation(s)
- Thomas G. Power
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Ashley D. Beck
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Jennifer O. Fisher
- Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| | - Nilda Micheli
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Teresia M. O'Connor
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Sheryl O. Hughes
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA.,Address correspondence to: Sheryl O. Hughes, PhD, Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates, Houston, TX 77030-2600, USA
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36
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Loth KA, Mohamed N, Trofholz A, Tate A, Berge JM. Associations between parental perception of- and concern about-child weight and use of specific food-related parenting practices. Appetite 2020; 160:105068. [PMID: 33352291 DOI: 10.1016/j.appet.2020.105068] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 11/23/2020] [Accepted: 12/07/2020] [Indexed: 01/20/2023]
Abstract
Little is known about the association between parental perception of their child's weight as well as parent's current and future concerns regarding their child's weight and a broad range of food-related parenting practices. This study used the first wave of cross-sectional data from the longitudinal Family Matters study to examine the relationships between parental perception of child weight status, parent concern for child's current and future weight and parent use of different types of food-related practices. Parent/child dyads (n = 150) were recruited from primary care clinics. Multiple regression models were fit to examine cross-sectional relationships between parental perception and concern for their child's weight and food-related parenting practices (food restriction, pressure-to-eat, food control, food monitoring, nutrition education, and parent modeling). Parents who perceived their child to be underweight had lower scores for food restriction than parents who perceived their child to be overweight. Parents who reported concern about their child's current weight reported higher scores for food restriction and monitoring than parents who were not currently concerned. Parents who reported concern about their child's future weight status reported higher scores for pressure-to-eat and monitoring than parents who were not at all concerned about their child's future weight status. The relationship between parental perception of child's current weight status and parent use of food restriction, pressure-to-eat, and overall food control was modified by child sex. Overall, results suggest that parent's perceptions of and concerns about their child's current and future weight status were correlated with their feeding approaches. Health care providers may want to consider providing anticipatory guidance for parents that have concerns about their child's weight by teaching them about positive, evidence-based ways they can engage in healthy food-related parenting practices.
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Affiliation(s)
- Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Nabila Mohamed
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Allan Tate
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | - Jerica M Berge
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
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Savage JS, Adams EL, Rollins BY, Bleser JA, Marini ME. Teaching families to manage intake of candy in the home: Results from a feasibility study using multiphase optimization strategy (MOST). Obes Sci Pract 2020; 6:649-659. [PMID: 33354343 PMCID: PMC7746962 DOI: 10.1002/osp4.446] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/07/2020] [Accepted: 07/26/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Excess intake of desserts/sweets high in added sugars, such as candy, is linked with greater obesity risk. Parents often limit their childrens' intake of these sweet foods using controlling feeding practices, such as restriction; yet, restrictive feeding practices are counterproductive for childrens' self-regulation of energy intake. OBJECTIVE This study developed a family-based behavioural intervention that taught parents alternatives to restrictive feeding practices and encouraged children to consume candy in moderation. METHODS Using the multiphase optimization strategy (MOST), parent-child dyads (N = 37) were randomized into one of eight conditions that included a combination of intervention components delivered over 4 weeks: home supply, parent shared decision making, child mindfulness and child attention control strategies. RESULTS Retention rate at follow-up was high (95%). Among parents who received parent shared decision making, 86.4% reported the structured-based candy routine they set with their child was easy to follow. Most children reported child mindfulness (95%) and attention control (89.5%) strategies were easy to play. Children recalled 4.1 ± 1.8 of the six mindfulness strategies and 2.7 ± 1.6 of the five attention control strategies at follow-up. Eating in the absence of hunger tended to be lower for children who received parent shared decision making and child mindfulness components. CONCLUSION This intervention was feasible and well-implemented in the home environment. Findings will inform future, larger interventions designed to test similar strategies on childrens; eating behaviours and self-regulation.
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Affiliation(s)
- J. S. Savage
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
- Department of Nutritional SciencesPenn State UniversityUniversity ParkPennsylvaniaUSA
| | - E. L. Adams
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
- Department of Nutritional SciencesPenn State UniversityUniversity ParkPennsylvaniaUSA
| | - B. Y. Rollins
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
| | - J. A. Bleser
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
| | - M. E. Marini
- Center for Childhood Obesity ResearchPenn State UniversityUniversity ParkPennsylvaniaUSA
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Somaraki M, Eli K, Sorjonen K, Ek A, Sandvik P, Nowicka P. Changes in parental feeding practices and preschoolers’ food intake following a randomized controlled childhood obesity trial. Appetite 2020; 154:104746. [DOI: 10.1016/j.appet.2020.104746] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/03/2020] [Accepted: 05/16/2020] [Indexed: 12/14/2022]
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Armstrong B, Hepworth AD, Black MM. Hunger in the household: Food insecurity and associations with maternal eating and toddler feeding. Pediatr Obes 2020; 15:e12637. [PMID: 32294800 PMCID: PMC9132245 DOI: 10.1111/ijpo.12637] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/09/2020] [Accepted: 03/15/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Research is needed to identify how food insecurity affects maternal eating behavior and child feeding practices, factors that may pose intergenerational risks for obesity. OBJECTIVES This longitudinal study investigated whether maternal restrained eating mediated the association between household food insecurity and feeding practices. METHODS Participants included 277 WIC-eligible mothers (69% below the poverty line, 70% African American) and their toddlers (Mage = 20.11 months, SD = 5.50) participating in a childhood obesity prevention trial. Maternal reports of household food insecurity, restrained eating, and child feeding practices (restrictive and responsive) were collected at baseline, 6 and 12 months and analyzed using multilevel mediation. RESULTS Forty percent of mothers reported some degree of household food insecurity over 12 months. Within-person analyses showed that relative increases in household food insecurity were indirectly related to increases in restrictive and decreases in responsive child feeding practices, mediated through increases in mothers' own restrained eating. CONCLUSIONS Relative change in household food insecurity (rather than overall severity) appears to have indirect effects on toddler feeding practices, through mothers' own eating. Stable household food security without transient food insecurity may improve health and wellbeing for both mothers and children.
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Affiliation(s)
- Bridget Armstrong
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, US
| | - Allison D. Hepworth
- Department of Social Work, University of Maryland School of Social Work, Baltimore, Maryland, US
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, US,RTI International, Research Triangle Park, North Carolina, US
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40
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Bauer KW, Weeks HM, Shah K, Ludwig-Borycz E, Riley H, Lumeng JC, Miller AL. Observed restrictive feeding practices among low-income mothers of pre-adolescents. Pediatr Obes 2020; 15:e12666. [PMID: 32537901 DOI: 10.1111/ijpo.12666] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/25/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To describe verbal and non-verbal restrictive feeding practices used by low-income mothers with their pre-adolescent children during a laboratory-based protocol, and examine associations between mother/child anthropometrics, child appetitive traits and mothers' restrictive practices. METHODS Mothers and children (dyad n = 108, mean child age = 11.0 years [SD = 1.2]) were provided a standardized meal and then buffet of desserts. Sessions were video-recorded, and trained coders reliably identified positive and negative restrictive statements, non-verbal restrictive behaviours and redirection to healthier foods. Mother/child anthropometrics were measured by trained study staff and child appetitive traits reported by mothers using subscales of the Children's Eating Behaviours Questionnaire. Negative binomial regression was used to examine associations between mother/child characteristics and restrictive practices. RESULTS Nearly all mothers (89.8%) engaged in restrictive feeding during the dessert buffet. Positive restrictive statements were the most common form of restriction (mean statements/10 minutes = 3.2 [SD = 3.1]). No associations were observed between children's body mass index (BMI) or appetitive traits and mothers' restrictive feeding practices. Associations of small effect size were observed between mothers' BMI, use of positive restrictive statements (incidence rate ratio [IRR] = 0.98 [0.96-0.996]) and non-verbal restrictive behaviours (IRR = 0.96 [0.93-0.99]). CONCLUSIONS Laboratory-based feeding protocols can objectively assess nuances in restrictive feeding practices. Further research is needed to understand how specific approaches to restriction affect children's eating behaviours and weight.
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Affiliation(s)
- Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kinari Shah
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Elizabeth Ludwig-Borycz
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Hurley Riley
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Julie C Lumeng
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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42
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Examining child intake frequency, mothers’ own liking and child early exposure as potential predictors of child liking for restricted foods and drinks at 5 years old. Public Health Nutr 2020; 23:2355-2364. [DOI: 10.1017/s1368980020000312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To examine longitudinal patterns of child introduction to foods and drinks targeted for restriction by parents and associations between child intake frequency, mother’s own liking, child early exposure and child liking for restricted foods and drinks at 5 years old.Design:The study involved secondary analyses of longitudinal data from mothers and children participating in the NOURISH randomised controlled trial. Patterns of descriptive data were examined, and a binary logistic regression model tested for prediction of child liking of a selection of restricted foods and drinks.Setting:Brisbane and Adelaide, Australia.Participants:Two hundred and eleven mothers and their first born 5-year-old children.Results:The proportion of children who had tried the selected restricted foods and drinks progressively increased from 14 months to 5 years old. Mothers’ own high liking for both sweet and savoury restricted foods and drinks predicted child high liking for the same items at 5 years old. Child high intake frequency at 5 years old also predicted child high liking for sweet foods and drinks, but child early exposure did not predict child liking for the restricted items examined.Conclusions:These results challenge the belief that limiting children’s intake of foods high in sugar, fat and/or salt will increase their liking for them. Findings instead suggest that restricting children’s access to such foods may be beneficial. While further research is required, mothers should be made aware that their own food preferences may inadvertently influence their child’s liking for the very foods they are trying to restrict.
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Cormack J, Rowell K, Postăvaru GI. Self-Determination Theory as a Theoretical Framework for a Responsive Approach to Child Feeding. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:646-651. [PMID: 32247759 DOI: 10.1016/j.jneb.2020.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/18/2020] [Accepted: 02/10/2020] [Indexed: 06/11/2023]
Abstract
Supporting positive childhood eating behaviors is a central and ongoing priority for health care providers, encompassing both health outcomes for typical eaters and best practice in relation to pediatric feeding challenges. Building on existing work, this perspective draws on literature from multiple fields to recommend the use of Self-Determination Theory as a framework for responsive feeding. Additionally, it contributes to the definition and conceptualization of responsive feeding. The 3 basic needs proposed by Self-Determination Theory (autonomy, relatedness and competence) have significant implications for both professional practice and the direction of future research.
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Affiliation(s)
- Johanna Cormack
- Department of Psychology, Bishop Grosseteste University, Lincoln, United Kingdomqry.
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44
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The association of parenting practices with toddlers' dietary intake and BMI, and the moderating role of general parenting and child temperament. Public Health Nutr 2020; 23:2521-2529. [PMID: 32423508 PMCID: PMC7550897 DOI: 10.1017/s136898002000021x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: The objective was to examine the association between parenting practices, toddler’s dietary intake and BMI. In addition, potential moderation of these associations by general parenting and child temperament was examined. Design: The current cross-sectional study assessed parenting practices using the Comprehensive Feeding Practices Questionnaire, general parenting using the Comprehensive General Parenting Questionnaire, child temperament using the Child Behavior Check List, and children’s dietary intake through parental questionnaires. Children’s weight and length were objectively measured to determine BMI z-scores. Associations were examined using multiple linear regression analyses. Moderation was examined using interaction terms. Setting: Home setting. Participants: 393 Dutch toddlers (age 1–3 years) and their parents recruited through fifty childcare centres and preschools in the Netherlands. Results: Various practices were related to children’s diet and BMI. For instance, the availability of healthy foods is the most important predictor of healthy dietary intake (e.g. β = –0·35 for sweets; β = 0·18 for fruit). The association of availability with a healthier diet was strongest when parents scored low on the positive parenting style dimensions, including nurturance, structure and/or behavioural control. In addition, it seemed that a high availability of healthy foods and low availability of unhealthy foods is especially beneficial for children showing withdrawal/depressive, anxious or overactive behaviour, while encouraging balance and variety is not beneficial for these children. All other practices were related to children’s diet and/or BMI as well. Conclusions: The findings underline the importance of viewing the impact of parenting practices in the context of general parenting and child temperament.
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Mehdizadeh A, Nematy M, Vatanparast H, Khadem-Rezaiyan M, Emadzadeh M. Impact of Parent Engagement in Childhood Obesity Prevention Interventions on Anthropometric Indices among Preschool Children: A Systematic Review. Child Obes 2020; 16:3-19. [PMID: 31479311 DOI: 10.1089/chi.2019.0103] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Home environment, modeling of weight-related behaviors, and general parenting style are very important predictors of obesity in children. The effect of parent engagement in prevention of obesity in children is not clear. The main objective of this systematic review was to address the effects of parent engagement in obesity prevention interventions on anthropometric changes among preschool children. Methods: PubMed/Medline, Cochrane Library, ISI Web of Knowledge, Scopus, Science Direct, and Google Scholar were searched. Eligible studies were randomized controlled trials in last 10 years (from 2008 until February 14, 2018), which had a parent engagement in obesity prevention interventions (as an intervention) and children's anthropometric indices (as an outcome). Results: Twenty-six studies were included. Half of studies targeted both parents and children, and the rest targeted only parents. Types of interventions ranged from a simple motivational interviewing to professional skill training approaches. Studies that targeted overweight or obese children in their intervention containing training sessions followed by maintenance for parents and those that focused on individual support for overweight children and their parents, resulted in higher improvement in BMI and other outcomes. Conclusions: Anthropometric indices and BMI are not appropriate for reflecting the effectiveness of parent engagement in obesity prevention interventions. Having an individual component in the intervention and focusing more on parents vs. children in the intervention may result in improvement in anthropometric outcomes. Focusing on weight-related behaviors as the main outcome in both, children and parents, rather than anthropometric indices, is highly recommended for future reviews.
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Affiliation(s)
- Atieh Mehdizadeh
- Department of Clinical Nutrition, Qaem Educational, Research, and Treatment Center, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohsen Nematy
- Metabolic Syndrome Research Centers, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Majid Khadem-Rezaiyan
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Emadzadeh
- Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Zhou Z, Liew J, Yeh YC, Perez M. Appetitive Traits and Weight in Children: Evidence for Parents' Controlling Feeding Practices as Mediating Mechanisms. The Journal of Genetic Psychology 2019; 181:1-13. [PMID: 31684838 DOI: 10.1080/00221325.2019.1682506] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Children's food approach and food avoidance are appetitive traits with genetic or biological bases. Nonetheless, parents play a critical role in children's dietary intake through parenting and feeding practices. The present study tested parents' controlling feeding practices (i.e., restriction and pressure to eat) as mediating mechanisms between child appetitive traits and child BMI in an economically and ethnically diverse sample. Participants were 139 children aged 4 to 6 years (51.8% males, M = 4.77 years, SD = 0.84) and their parents. Results showed that restriction and pressure to eat mediated the relation between child food approach or food avoidance and child BMI. Mediation effects did not differ across poverty status or racial/ethnic groups. Also, the type of controlling feeding that parents exert related to children's weight status in diametrically different or opposite ways. Thus, food-related parenting appears to be a promising point of entry for childhood obesity prevention programs. Findings are consistent with a biopsychosocial model of the development of eating and weight in childhood which takes into account both parent and child behavior and characteristics and links child biology and behavior with psychosocial processes and environment.
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Affiliation(s)
- Zhiqing Zhou
- Texas A&M University, College Station, Texas, USA
| | - Jeffrey Liew
- Texas A&M University, College Station, Texas, USA
| | - Yu-Chen Yeh
- Texas A&M University, College Station, Texas, USA
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Eagleton SG, Brown CL, Moses MJ, Skelton JA. Restrictive feeding and excessive hunger in young children with obesity: A case series. Clin Case Rep 2019; 7:1962-1967. [PMID: 31624618 PMCID: PMC6787779 DOI: 10.1002/ccr3.2411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 08/03/2019] [Accepted: 08/07/2019] [Indexed: 11/24/2022] Open
Abstract
Treatment recommendations for childhood obesity include guidance to reduce portions and the consumption of high-energy-dense foods. These messages may unintentionally promote restrictive feeding among parents of children with obesity with excessive hunger. Clinical guidance may benefit from framing treatment messages to parents in the context of a nonrestrictive feeding style.
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Affiliation(s)
- Sally G. Eagleton
- Center for Childhood Obesity ResearchPenn State College of Health and Human DevelopmentUniversity ParkPA
- Department of Nutritional SciencesPenn State College of Health and Human DevelopmentUniversity ParkPA
| | - Callie L. Brown
- Department of PediatricsWake Forest School of MedicineWinston‐SalemNC
- Department of Epidemiology and PreventionWake Forest School of MedicineWinston‐SalemNC
| | - Melissa J. Moses
- Brenner FIT (Families In Training) ProgramBrenner Children's HospitalWake Forest Baptist HealthWinston‐SalemNC
| | - Joseph A. Skelton
- Department of PediatricsWake Forest School of MedicineWinston‐SalemNC
- Department of Epidemiology and PreventionWake Forest School of MedicineWinston‐SalemNC
- Brenner FIT (Families In Training) ProgramBrenner Children's HospitalWake Forest Baptist HealthWinston‐SalemNC
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Bergmeier H, Paxton SJ, Milgrom J, Anderson SE, Baur L, Hill B, Lim S, Green R, Skouteris H. Early mother-child dyadic pathways to childhood obesity risk: A conceptual model. Appetite 2019; 144:104459. [PMID: 31533059 DOI: 10.1016/j.appet.2019.104459] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/06/2019] [Accepted: 09/14/2019] [Indexed: 01/24/2023]
Abstract
Understanding the emotional quality of the mother-child dyadic relationship and parent-child feeding interactions may further clarify early developmental pathways to eating behaviours and obesity risk. The quality of parent-child relationships fosters all aspects of child development but has not yet been extensively examined in relation to childhood weight gain. The aim of this paper is to propose a conceptual model, which outlines early mother-child dyadic pathways linking parent-child feeding interactions to child body mass index, where parent-child relationships have a central role. It maps out individual and dyadic mother-child factors (i.e., attachment, child temperament and maternal mental health) that influence the nature and quality of parent-child feeding interactions from infancy to toddlerhood. Our model bridges the gap between research fields by bringing together key maternal and child factors implicated in child development. Understanding early parent-child feeding interactional patterns and their influence on child self-regulation and eating behaviours may be relevant to multidisciplinary approaches toward preventing childhood obesity. High quality quantitative and observational data capturing meaningful parent, child and dyadic level interactions around food contexts, attachment security, maternal mental health, child temperament and self-regulation will help to inform new, aetiologically important, targets for preventative intervention.
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Affiliation(s)
- Heidi Bergmeier
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Susan J Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jeannette Milgrom
- School of Psychological Sciences, Melbourne University, Melbourne, Australia; Parent-Infant Research Institute, Department of Clinical and Health, Psychology, Heidelberg Repatriation Hospital, Heidelberg West, Australia
| | - Sarah E Anderson
- Division of Epidemiology, School of Public Health, The Ohio State University, Columbus, OH, USA
| | - Louise Baur
- Discipline of Paediatrics and Child Health and Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Rachael Green
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
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Abstract
PURPOSE OF REVIEW Studies on obesogenic eating behaviors in young children have mainly focused on the roles of family environment and parental behaviors. However, intrapersonal characteristics, particularly executive functions, have recently gained more attention in the literature. Therefore, herein we review work on children's executive functions (EFs), particularly the roles of cold and hot executive functions on children's obesogenic eating behaviors. RECENT FINDINGS Most work examining the associations between EF and obesogenic eating among children has focused on the cool EF, particularly inhibitory control/impulsivity. Findings have consistently showed that deficits in inhibitory control/impulsivity are associated with overeating and food responsiveness. The roles of the other two cool EFs (attention control/shifting and working memory) and hot EF (delay of gratification and affective decision-making) in contributing to child obesogenic eating are less clear. For instance, the association between children's performance on delay of gratification tasks and obesogenic eating varies depending on whether food or non-food rewards were used; children with poorer delay of gratification in non-food tasks had more obesogenic eating, although children with poorer delay of gratification in food tasks had less obesogenic eating. Deficits in inhibitory control/impulsivity are associated with more obesogenic eating, suggesting that improving children's inhibition may reduce overeating and childhood obesity. The roles of other cool and hot components of EFs in contributing to obesogenic eating require further study.
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Bernard K, Frost A, Jelinek C, Dozier M. Secure attachment predicts lower body mass index in young children with histories of child protective services involvement. Pediatr Obes 2019; 14:e12510. [PMID: 30659782 DOI: 10.1111/ijpo.12510] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 11/04/2018] [Accepted: 12/08/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Children who experience early adversity are at risk for obesity; secure attachment may be a protective factor as it has been linked to reduced obesity risk. OBJECTIVE To evaluate whether (1) participation in a parenting intervention and (2) secure attachment were associated with body mass index (BMI) among young children with histories of child protective services (CPS) involvement. METHODS A total of 105 parent-child dyads referred following CPS involvement were randomly assigned to receive Attachment and Biobehavioral Catch-up (ABC), which was designed to increase parental sensitivity, or a control intervention. Attachment security was assessed during infancy, and BMI was assessed at annual follow-up visits until children were 4 years old. RESULTS Children in the ABC group were more likely to have secure attachments (52%) than children in the control intervention group (32%). Although the ABC intervention did not have a direct effect on children's BMI, secure attachment was associated with a steeper decline in BMI from age 2 to age 4, with secure children showing significantly lower BMI (M = 15.4, SD = 2.08; 16.6% overweight/obese) than insecure children (M = 17.6, SD = 3.81; 35.7% overweight/obese) at age 4. CONCLUSIONS Secure attachment was associated with reduced BMI among CPS-referred children; thus, secure attachment may be a novel target of early obesity prevention efforts.
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Affiliation(s)
- Kristin Bernard
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Allison Frost
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Caitlin Jelinek
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Mary Dozier
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
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