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Baker LN, Fuglestad AJ. Parent's use of Coercive Control Practices with Food is associated with Poorer Emotion Regulation and Increased Emotional Overeating in Preschoolers. Appetite 2024:107608. [PMID: 39029529 DOI: 10.1016/j.appet.2024.107608] [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: 04/09/2024] [Revised: 06/17/2024] [Accepted: 07/17/2024] [Indexed: 07/21/2024]
Abstract
Emotional overeating is defined as eating in response to emotions. Around the preschool years, there is a shift from emotional undereating to overeating, which suggests environmental influences in the development of overeating. The use of food by parents to control their child's emotions, rather than to teach them appropriate emotion regulation strategies, may impact the child's ability to regulate their own emotions, resulting in emotional overeating. We hypothesized that such coercive control practices with food by parents would be associated with poorer ability of the child to regulate their own emotions, which in turn would lead to increased emotional overeating, but not emotional undereating. Mothers of four- and five-year-olds (N=221) were recruited through MTurk and Prolific to complete online questionnaires measuring food parenting practices (Comprehensive Feeding Style Questionnaire and Parent Feeding Style Questionnaire), child emotion regulation (Emotion Regulation Checklist), and child emotional eating (Child Eating Behavior Questionnaire). Several mediation models were tested. Parent's use of food to control emotions and behavior was associated with higher levels of emotional overeating, which was mediated by poorer child emotion regulation. However, child emotion regulation did not mediate the association between parent's use of food to control emotions and behavior and the child's emotional undereating. Taken together, these models suggest that parent's use of coercive control with food may lead to child emotional overeating, but not emotional undereating, by teaching children to regulate their emotions through eating rather than more adaptive regulation strategies. Future experimental and longitudinal studies are needed to directly test the nature and direction of these associations and whether coercive control with food teaches children to overeat in response to their emotions in lieu of using appropriate emotion regulation strategies.
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Affiliation(s)
- Lindsay N Baker
- Department of Psychology, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, United States
| | - Anita J Fuglestad
- Department of Psychology, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, United States.
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Berge JM, Hazzard VM, Trofholz A, Hochgraf A, Zak-Hunter L, Miller L. Reported Intergenerational Transmission of Parent Weight Talk and Links with Child Health and Wellbeing. J Pediatr 2024; 270:114012. [PMID: 38494088 PMCID: PMC11176000 DOI: 10.1016/j.jpeds.2024.114012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To examine if intergenerational transmission of parent weight talk occurs, the contextual factors prompting weight talk, and whether parent weight talk is associated with child weight, dietary intake, psychosocial outcomes, and food parenting practices. STUDY DESIGN Children aged 5-9 years and their families (n = 1307) from 6 racial and ethnic groups (African-American, Hispanic, Hmong, Native American, Somali/Ethiopian, White) were recruited for a longitudinal cohort study through primary care clinics in Minneapolis/St. Paul, Minnesota from 2016 through 2019. Parents filled out surveys at 2 time points, 18 months apart. Adjusted regression models examined associations of interest. RESULTS Intergenerational transmission of parent weight talk was observed. In addition, significant associations were found between parent engagement in weight talk and higher weight status and poorer psychosocial outcomes in children 18 months later. Parent engagement in weight talk was also associated with more restrictive food parenting practices 18 months later. CONCLUSIONS Parents' exposure to weight talk as children increased the likelihood of engaging in weight talk with their own children and had harmful associations over time with parent restrictive feeding practices, child weight, and psychosocial wellbeing in children. Health care providers may want to consider both modeling positive health-focused conversations and educating parents about the potential harmful and long-lasting consequences of engaging in weight talk with their children.
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Affiliation(s)
- Jerica M Berge
- Department of Family Medicine and Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Vivienne M Hazzard
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Anna Hochgraf
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN
| | - Lisa Zak-Hunter
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Laura Miller
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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Hatefnia E, Azizi P, Qorbani M, Safari-Moradabadi A. The role of maternal health beliefs in prevention of preschoolers' obesity. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:144. [PMID: 38784261 PMCID: PMC11114690 DOI: 10.4103/jehp.jehp_358_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/25/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Childhood obesity is one of the most serious global public health challenges of the 21st century, affecting every country in the world. Mothers' beliefs and perceptions about their children's obesity and overweight are key to obesity prevention. Given the importance of this issue, the present study aimed to determine perceptions and beliefs of mothers' nutritional behaviors related to overweight preschool children. MATERIALS AND METHODS This cross-sectional study was conducted on 350 mothers of preschool children with health records who were referred to child health assessment centers. The data collection tool was a researcher-made questionnaire based on the health belief model. SPSS19 was used for data analysis. P < 0.05 was considered significant. RESULTS The participants (350) included 52% 25-36 years old, and 57.3% live in rural areas. There was a significant difference in the mean perceived susceptibility between mothers with obese children and normal-weight children (P < 0.05). There was a significant positive relationship between severity and perceived benefits and a significant negative relationship with mothers' knowledge. There was also a significant negative relationship between self-efficacy and perceived barriers (P > 0.05). CONCLUSIONS The results of this study showed that maternal health beliefs were effective in the formation of obesity prevention behaviors in children. In this regard, educational interventions can play an important role in the proper practice of such behaviors.
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Affiliation(s)
- Effat Hatefnia
- Department of Health Education and Promotion, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Parvin Azizi
- Department of Health Education and Promotion, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Disease Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Ali Safari-Moradabadi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Rahmaty Z, Johantgen ME, Storr CL, Wang Y, Black MM. Preschoolers BMI: Associations with Patterns of Caregivers' Feeding Practices Using Structural Equation Models. Child Obes 2023; 19:169-178. [PMID: 35649202 PMCID: PMC10122251 DOI: 10.1089/chi.2022.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Childhood obesity is a major health concern. Caregivers' feeding practices are modifiable targets of obesity prevention. The study tested two hypotheses: (1) autonomy-promoting feeding practices are associated with lower BMI; and (2) diet mediates the association. We also explored examined whether feeding practices and BMI z-score (BMIz) associations are moderated by child sex, caregiver race, education, family poverty level, and food insecurity. Methods: Cross-sectional study of 437 preschoolers (44.4% girls, 38.2% Black/Other, mean age 48.1 months) and caregivers (90.2% female) from 50 child care centers. Feeding Practices were measured by Comprehensive Feeding Practices Questionnaire, child-size perception by preschooler silhouettes, temperament by the Behavior Rating Inventory of Executive Function, child diet by Young Children Food and Drink Questionnaire, and BMIz by measured weight and height. Latent profile analysis delineated feeding practice patterns. Structure equation modeling assessed the patterns in relationship to BMIz. Mediation and multiple-group analyses were used to assess mechanisms of feeding practice patterns and BMIz association. Results: From the three feeding practice patterns, Controlling, Balancing, and Regulating, Regulating was associated with lower child BMIz (b = -0.09) compared to Controlling. Higher difficult temperament (b = 0.09), higher caregiver BMIz (b = 0.26), and caregiver desire for thinner (b = 0.23) were associated with BMIz (p < 0.05). Evaluations of moderators and mediators were not significant. Conclusions: Comprehensive feeding practices support family factors related to child BMIz. Longitudinal research is needed to examine temporal associations between feeding practices and BMIz, with attention to autonomy-supporting practices, promotion of young children's self-regulation, and caregivers' perceptions of child temperament and size. Trial Registration: NCT03111264.
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Affiliation(s)
- Zahra Rahmaty
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
- Institute of Higher Education and Research in Healthcare (IUFRS), Department of Biology and Medicine, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Mary E. Johantgen
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L. Storr
- Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, MD, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Maureen M. Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
- RTI International, Research Triangle Park, NC, USA
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Chawner LR, Blundell-Birtill P, Hetherington MM. Parental intentions to implement vegetable feeding strategies at home: A cross sectional study. Appetite 2023; 181:106387. [PMID: 36427564 DOI: 10.1016/j.appet.2022.106387] [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: 06/27/2022] [Revised: 09/12/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022]
Abstract
In order to increase vegetable intake by children, parents are encouraged to implement strategies that promote trying and eating vegetables at mealtimes. Qualitative studies have previously highlighted barriers parents face in implementing healthy eating practices, such as time, monetary costs and child factors (e.g. fussy eaters). This study aimed to specify the relationships between child and parent factors and their effects on parental intentions to implement vegetable feeding strategies at mealtimes. Parental intentions to implement meal service (serving larger portions, offering variety, serving vegetables first) and experiential learning (repeated exposure, games, sensory play) strategies were examined. Parents (N = 302, 73 male, Mage = 33.5) also explained reasons why certain strategies may or may not work for their child (4-7y). For both types of strategy, higher food fussiness of the child predicted higher parental intentions to implement strategies at home. However, this was competitively mediated by low beliefs that the strategy would work for their child, resulting in weaker overall positive effects on intentions. In the meal service model, parental beliefs that healthy eating is important for their child had a positive, indirect effect on higher intentions, through involved parental feeding practices. However, this was not significant in the experiential learning strategies model. Written parental responses suggest that this may be due to meal service approaches being viewed as easier to implement, with little additional effort required. Increasing parental confidence to implement strategies successfully and managing expectations around successful outcomes of strategies (e.g. tasting, eating) may be important focuses of future interventions to support parents implementing vegetable feeding strategies at mealtimes.
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Affiliation(s)
- L R Chawner
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK.
| | | | - M M Hetherington
- School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
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Gray HL, Buro AW, Sinha S. Associations Among Parents' Eating Behaviors, Feeding Practices, and Children's Eating Behaviors. Matern Child Health J 2023; 27:202-209. [PMID: 36609937 DOI: 10.1007/s10995-022-03572-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023]
Abstract
Parental feeding practices influence children's eating behaviors, yet it is not well-understood whether parents' own eating behaviors are associated with their feeding practices. The purpose of this study was to examine associations among parents' eating behaviors, parental feeding practices, and children's eating behaviors. A cross-sectional study was conducted with 76 parents of children from an elementary school in Tampa, FL. Parents completed three questionnaires with topics related to parent eating behaviors, parental feeding practices, and children's eating behaviors. Multiple regression analysis was performed, controlling for demographic covariates. Parents who reported to eat more fruits per day (β = 0.15), eat more than one kind of fruit each day (β = 0.33), eat more than one kind of vegetable each day (β = 0.29), eat 2 or more vegetables at the main meal (β = 0.36), plan meals (β = 0.19), and keep vegetables ready for the child to eat (β = 0.25) indicated that they use more positive reinforcement feeding practices (all p ≤ 0.001). There were significantly positive associations between positive reinforcement and children's eating fruits or vegetables like apples, bananas or carrots as snacks (β = 1.03) and eating more than one kind of vegetable a day (β = 1.03; all p < 0.001). No other variables had any significant associations. Findings of this study indicate that there are potential associations among parent's own eating behaviors, feeding practices, and children's eating behaviors. Further research is needed to determine the mechanism of these relationships. Targeting these parental factors may be an effective way to maximize the impact of nutrition interventions on children's dietary behavior changes.
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Affiliation(s)
- Heewon L Gray
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC 56, 33612, Tampa, FL, USA.
| | - Acadia W Buro
- H. Lee Moffitt Cancer Center and Research Institute, 12902 USF Magnolia Drive, 33612, Tampa, FL, USA
| | - Sweta Sinha
- Cedar Sinai Medical Center, 8700 Beverly Blvd, 90048, California, LA, USA
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Lappan SN, Harman T, Pavela G, Hendricks PS. Relationship Between Food Security Status in a Caregiver's Family of Origin and Current Feeding Practices Among Low-Income, Single, Female Primary Caregivers. FAMILY & COMMUNITY HEALTH 2022; 45:257-266. [PMID: 35985025 DOI: 10.1097/fch.0000000000000347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A child's familial environment is paramount to the formation and maintenance of their health behaviors. Factors that influence a child's health behaviors include parental modeling, types of available food, timing of food availability, and characteristics of the home environment. Previous research has demonstrated an association between a caregiver's current food security status and feeding practices, but no studies have explored the association between food security in the caregiver's childhood and their current feeding practices. This study investigates the relationship between parental food insecurity (both current and childhood) and child feeding practices. The US Household Food Security Survey and the Child Feeding Questionnaire were completed by 103 low-income, single, female primary caregivers. Results indicated that caregivers who reported current food insecurity expressed greater tendency to pressure their children to eat. Caregivers who reported food insecurity during their childhood also expressed greater tendency to pressure their children to eat and a greater concern about their child's weight. These findings can serve in both research and clinical efforts as an early screening tool to indicate families most in need of accessible resources. Findings also help to highlight the transgenerational nature of food insecurity, including its residual effects on health behaviors.
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Affiliation(s)
- Sara N Lappan
- Couple and Family Therapy Program, Alliant International University, Alhambra, California (Dr Lappan); and Departments of Nutrition Sciences (Ms Harman) and Health Behavior (Drs Pavela and Hendricks), University of Alabama at Birmingham, Birmingham, Alabama
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Tauriello S, Savage JS, Goldsmith J, Kubiniec E, Paul IM, Anzman-Frasca S. Effect of the INSIGHT Responsive Parenting Intervention on Parenting and Child Behavior at Ages 3 and 6 Years. J Pediatr 2022; 255:72-79. [PMID: 37081779 DOI: 10.1016/j.jpeds.2022.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To examine effects of the INSIGHT study responsive parenting (RP) intervention on reported and observed general parenting and child behavior during early and middle childhood. STUDY DESIGN Primiparous mother-newborn dyads (n = 279) were randomized to RP intervention or a safety control, with intervention content delivered at research nurse home visits at infant ages 3-4, 16, 28, and 40 weeks and research center visits at 1 and 2 years. At age 3 (n = 220) and 6 years (n = 171) parenting and child behavior were observed during dyadic interactions and coded using the Iowa Family Interaction Rating Scales. Mothers also reported on child behavior (age 3) and aspects of general parenting (age 6) via the Child Behavior Checklist and The Comprehensive General Parenting Questionnaire, respectively. RESULTS RP group children had fewer mother-reported externalizing (F = 8.69, P = .004) and problem behaviors at age 3 (F = 4.53, P = .03), and higher observed prosocial (F = 4.73, P = .03) and lower antisocial (ie, externalizing; F = 4.79, P = .03) behavior at age 6 vs controls. There were no study group differences in observed maternal sensitivity at age 3 or 6 years. At age 6, RP group mothers reported higher use of structure defined by establishing consistent rules and routines (F = 5.45, P = .02) and organization of their child's environment (F = 7.12, P = .008) compared with controls. CONCLUSIONS The INSIGHT RP intervention increased parental organization of the child's environment to facilitate competence, and had beneficial impacts on child behavior at 3 and 6 years. No impacts were found on maternal sensitivity in childhood. TRIAL REGISTRATION ClinicalTrials.gov: NCT01167270.
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Affiliation(s)
- Sara Tauriello
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Jennifer S Savage
- Department of Nutritional Sciences, Pennsylvania State University, University Park, PA; Center for Childhood Obesity Research, Pennsylvania State University, University Park, PA
| | - Juliana Goldsmith
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Elizabeth Kubiniec
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Ian M Paul
- Departments of Pediatrics & Public Health Sciences, Penn State College of Medicine, Hershey, PA
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY.
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Tarro S, Lahdenperä M, Vahtera J, Pentti J, Lagström H. Parental feeding practices and child eating behavior in different socioeconomic neighborhoods and their association with childhood weight. The STEPS study. Health Place 2022; 74:102745. [PMID: 35247796 DOI: 10.1016/j.healthplace.2022.102745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 12/28/2021] [Accepted: 01/21/2022] [Indexed: 12/20/2022]
Abstract
Child obesity risk, child eating behavior and parental feeding practices show a graded association with individual level socioeconomic status. However, their associations with neighborhood socioeconomic disadvantage are largely unknown. In this study (n = 682), we investigated how parental feeding practices and child eating behaviors were associated with body mass index and risk of overweight at preschool age in affluent and disadvantaged neighborhoods. We found that high food approach tendency in disadvantaged neighborhoods predicted higher body mass index and increased the risk of overweight at the age of 6 years compared with affluent neighborhoods. Our results suggest that children's eating habits may have stronger impact on overweight risk in disadvantaged than in affluent neighborhoods.
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Affiliation(s)
- Saija Tarro
- Department of Public Health, University of Turku and Turku Uniikversity Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | - Mirkka Lahdenperä
- Department of Public Health, University of Turku and Turku Uniikversity Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku Uniikversity Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | - Jaana Pentti
- Department of Public Health, University of Turku and Turku Uniikversity Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Hanna Lagström
- Department of Public Health, University of Turku and Turku Uniikversity Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
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Pérez L, Vizcarra M, Hughes SO, Papaioannou MA. Food Parenting Practices and Feeding Styles and Their Relations with Weight Status in Children in Latin America and the Caribbean. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042027. [PMID: 35206214 PMCID: PMC8871894 DOI: 10.3390/ijerph19042027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/21/2021] [Accepted: 12/29/2021] [Indexed: 12/22/2022]
Abstract
While a growing body of literature looks at the associations between food parenting practices, and feeding styles, and child’s weight status in developed countries, little is known for less developed countries, in general, and the Latin America and the Caribbean (LAC) region, in particular. This study systemically reviews and synthesizes existing evidence on the associations between child caregivers’ food parenting practices and feeding styles and 2 to 12-year-old child weight status. Keywords were used to search in PubMed, Web of Science, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature. Among the ten eligible articles, all of them reported significant associations between food parenting practices and feeding styles and child weight status. Existing studies have limitations, mainly related to cross-sectional convenience samples, which limit the generalization of the results. Additionally, small sample, heterogeneous feeding measures and weight related outcomes were other limitations. Future research is needed to understand caregiver–child interactions in the food situation and its link to child weight status in 2 to 12-year-old children in areas of LAC with diverse forms of malnutrition and contextual factors of countries.
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Affiliation(s)
- Luisa Pérez
- Carrera de Nutrición y Dietética, Facultad de Medicina—Clínica Alemana, Universidad del Desarrollo, Av. Plaza 680, Santiago 7610658, Chile;
| | - Marcela Vizcarra
- Food Behavior Research Center, School of Nutrition and Dietetics, College of Pharmacy, University of Valparaíso, Av. Gran Bretaña 1093, Valparaíso 2360102, Chile
- Correspondence:
| | - Sheryl O. Hughes
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Ave, Houston, TX 77030, USA; (S.O.H.); (M.A.P.)
| | - Maria A. Papaioannou
- USDA/ARS Children’s Nutrition Research Center, Baylor College of Medicine, 1100 Bates Ave, Houston, TX 77030, USA; (S.O.H.); (M.A.P.)
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Parental feeding and childhood genetic risk for obesity: exploring hypothetical interventions with causal inference methods. Int J Obes (Lond) 2022; 46:1271-1279. [PMID: 35306528 PMCID: PMC9239906 DOI: 10.1038/s41366-022-01106-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Parental-feeding behaviors are common intervention targets for childhood obesity, but often only deliver small changes. Childhood BMI is partly driven by genetic effects, and the extent to which parental-feeding interventions can mediate child genetic liability is not known. Here we aim to examine how potential interventions on parental-feeding behaviors can mitigate some of the association between child genetic liability and BMI in early adolescence, using causal inference methods. METHODS Data from the Avon Longitudinal Study of Parents and Children were used to estimate an interventional disparity measure for a child polygenic score for BMI (PGS-BMI) on BMI at 12 years. The approach compares counterfactual outcomes for different hypothetical interventions on parental-feeding styles applied when children are 10-11 years (n = 4248). Results are presented as adjusted total association (Adj-Ta) between genetic liability (PGS-BMI) and BMI at 12 years, versus the interventional disparity measure-direct effect (IDM-DE), which represents the association that would remain, had we intervened on parental-feeding under different scenarios. RESULTS For children in the top quintile of genetic liability, an intervention shifting parental feeding to the levels of children with lowest genetic risk, resulted in a difference of 0.81 kg/m2 in BMI at 12 years (Adj-Ta = 3.27, 95% CI: 3.04, 3.49; versus IDM-DE = 2.46, 95% CI: 2.24, 2.67). CONCLUSIONS Findings suggest that parental-feeding interventions have the potential to buffer some of the genetic liability for childhood obesity. Further, we highlight a novel way to analyze potential interventions for health conditions only using secondary data analyses, by combining methodology from statistical genetics and social epidemiology.
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12
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Rahmaty Z, Johantgen ME, Storr CL, Gilden R, Wang Y, Black MM. Patterns of caregivers' feeding practices and associated characteristics among preschool-age children in the United States. Appetite 2022; 168:105769. [PMID: 34710485 DOI: 10.1016/j.appet.2021.105769] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/06/2021] [Accepted: 10/19/2021] [Indexed: 01/22/2023]
Abstract
During early childhood, caregiver feeding practices (FP) influence children's diet and eating habits. Inconsistent methods of operationalizing FP have resulted in limited evidence regarding simultaneous FP patterns. This study examined the heterogeneity in FP among caregivers of preschoolers, along with the child, caregiver, and family characteristics associated with FP patterns. Caregivers of preschoolers (n = 437, 90% women) enrolled in 50 childcare centers across Maryland completed the Comprehensive Feeding Practices Questionnaire (CFPQ) and provided demographic information and perceptions of their child's size and temperament. Exploratory Factor Analysis of CFPQ identified 13 factors, and latent profile analysis (LPA) empirically identified three FP classes. Using multinomial structural equation models, we regressed FP classes on child sex, race, age, poverty level, food insecurity education, caregiver perception of child size and temperament. The most common FP pattern (69%) reflected high coercive and control with low autonomy and structural practices (Controlling Class). A second pattern (16%) had high coercive control with moderate structural and autonomy practices (Regulating Class). The third pattern (15%) reflected moderate levels of all practices (Balancing Class). Caregivers who desired their child to be heavier (aOR = 0.40, 95% CI = 0.22-0.72), were more financially secure (aOR = 0.80, 95%CI = 0.65-0.98), and were single (aOR = 0.38, 95% CI = 0.18-0.80) were less likely to be in the Balancing versus Controlling class. For each unit increase in child temperament t-score [higher = difficult], caregivers were more likely to be in the Balancing (aOR = 1.04, 95% CI = 1.01-1.07) or Regulating class (aOR = 1.04, 95% CI = 1.01-1.08) compared to the Controlling class. In this statewide sample, many caregivers endorsed controlling behaviors without endorsing empowering behaviors to help children become healthy eaters. Future studies should examine how caregiver feeding practices evolve and relate to children's eating habits, growth, and development over time.
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Affiliation(s)
- Zahra Rahmaty
- The University of Maryland, School of Nursing, USA; Lausanne University Hospital and University of Lausanne, IUFRS, Switzerland.
| | | | | | - Robyn Gilden
- The University of Maryland, School of Nursing, USA
| | - Yan Wang
- The University of Maryland, School of Medicine, USA; George Washington University, Department of Prevention and Community Health, Milken Institute School of Public Health, USA
| | - Maureen M Black
- The University of Maryland, School of Medicine, USA; RTI International, USA
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Redsell SA, Slater V, Rose J, Olander EK, Matvienko-Sikar K. Barriers and enablers to caregivers' responsive feeding behaviour: A systematic review to inform childhood obesity prevention. Obes Rev 2021; 22:e13228. [PMID: 33779040 DOI: 10.1111/obr.13228] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/18/2021] [Accepted: 02/06/2021] [Indexed: 12/12/2022]
Abstract
Responsive infant feeding is a critical component of childhood obesity prevention. However, there is little guidance for caregivers on how to do this successfully. The first step to developing an intervention to promote responsive feeding is to systematically identify its barriers and enablers. Searches were conducted in CINAHL, Cochrane Library, Medline, Embase, PubMed, PsycINFO, Maternity, and Infant Care from inception to November 2020. All study designs were included if they reported a barrier or enabler to responsive feeding during the first 2 years of life. We used a "best fit" framework synthesis, with the Capacity, Opportunity, Motivation, and Behaviour (COM-B) model. The Mixed Method Appraisal Tool (MMAT) was used to assess study quality. Forty-three studies were included in the review. Barriers (n = 36) and enablers (n = 21) were identified across five COM-B domains: psychological capacity, physical and social opportunity, and reflective and automatic motivation. Enablers were recognition of infant feeding cues, feeding knowledge and family and friends. Caregiver attitude toward control of feeding was a barrier, together with health care professional advice about formula feeding and breastfeeding expectation. These barriers and enablers provide a comprehensive evidence base to guide intervention development to improve responsive feeding and prevent obesity across individual and population levels.
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Affiliation(s)
- Sarah A Redsell
- School of Health Sciences, University of Nottingham, B302, Medical School Building, Queens Medical Centre, Nottingham, NG7 2UH, UK
| | - Vicki Slater
- Faculty of Health Social Care, Education and Medicine, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK
| | - Jennie Rose
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK.,Ely Primary Care Networks, Staploe Medical Centre, Brewhouse Lane, Soham, UK
| | - Ellinor K Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, EC1V 0HB, UK
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14
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Schneider-Worthington CR, Berger PK, Goran MI, Salvy SJ. Learning to overeat in infancy: Concurrent and prospective relationships between maternal BMI, feeding practices and child eating response among Hispanic mothers and children. Pediatr Obes 2021; 16:e12756. [PMID: 33225624 PMCID: PMC8105266 DOI: 10.1111/ijpo.12756] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/05/2020] [Accepted: 11/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Parents play a key role in shaping children's eating behaviours and self-regulation. There is limited data on how maternal weight influences feeding practices in the first year of life. OBJECTIVE To examine the relationships between maternal BMI, feeding practices and infant eating behaviours related to self-regulation. METHODS Participants were 160 mother-infant dyads. A longitudinal design was used to examine concurrent and prospective associations between maternal 6-month postpartum BMI, mothers' feeding practices at 6 months (Infant Feeding Practices Questionnaire) and children's eating behaviours at 6 months (Baby Eating Behaviour Questionnaire) and 12 months (Child Eating Behaviour Questionnaire). RESULTS Higher maternal BMI was associated positively with mothers' use of restrictive feeding practices (β = 0.036, p = 0.033), and inversely with responsivity to infant satiety cues (Spearman partial r = -0.249, p = 0.002) at 6 months. Mother's restrictive feeding practices were associated with infant food responsiveness (β = 0.157, p = 0.009) and emotional overeating (β = 0.118, p = 0.005) at 12 months. Maternal use of responsive feeding practices was associated with lower infant food responsiveness at 6 months (Spearman partial r = -0.173, p = 0.031) and lower emotional overeating at 12 months (Spearman partial r = -0.183, p = 0.022). CONCLUSIONS Our findings add to studies suggesting that feeding practices can provide mechanistic pathways in the intergenerational transmission of obesity. Postpartum family-system approaches focusing on maternal health while integrating infant feeding guidance may confer benefits in improving maternal-child health.
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Affiliation(s)
| | - Paige K. Berger
- Department of Pediatrics, Children’s Hospital Los Angeles, The University of Southern California, Los Angeles, California
| | - Michael I. Goran
- Department of Pediatrics, Children’s Hospital Los Angeles, The University of Southern California, Los Angeles, California
| | - Sarah-Jeanne Salvy
- Research Center for Health Equity, Cedars-Sinai Medical Center, West Hollywood, California
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15
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van Vliet MS, Mesman J, Schultink JM, de Vries JHM, Vereijken CMJL, Rippe RCA, van der Veek SMC. Baby's first bites: Association between observed maternal feeding behavior and infant vegetable intake and liking. Appetite 2021; 165:105316. [PMID: 34023447 DOI: 10.1016/j.appet.2021.105316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/17/2021] [Accepted: 05/12/2021] [Indexed: 11/30/2022]
Abstract
Positive experiences with the introduction of solid food in infancy may lead to positive associations with feeding in both parent and infant. During this transitional period, parental feeding behavior and infant eating behavior might mutually reinforce each other. A feeding style that is found to be associated with positive child eating behavior, is sensitive feeding. In the present study we tested bidirectional prospective relations between mother and infant behavior in a cross-lagged model using observations of two feeds on two consecutive days on which the first bites of solid food were offered. The sample consisted of 246 first-time mothers and their infants, whose feeding interactions were videotaped during two home visits. Maternal sensitive feeding behavior (consisting of responsiveness to child feeding cues, general sensitivity and non-intrusiveness) and maternal positive and negative affect were coded. In addition, infant vegetable intake was weighed and vegetable liking was reported by mother. Results showed at least some stability of maternal feeding behavior and infant vegetable intake and liking from the first to the second feed. In addition, during the second feed maternal sensitive feeding and positive affect were associated with infant vegetable intake (r=.34 and r=.14) and liking (r=.33 and r=.39). These associations were mostly absent during the first feed. Finally, infant vegetable liking during the first feed positively predicted maternal sensitive feeding behavior during the second feed (β=.25), suggesting that the infant's first response might influence maternal behavior. Taken together, mother and infant seem more attuned during the second feed than during the first feed. Future studies might include multiple observations over a longer time period, or micro-coding. Such insights can inform prevention programs focusing on optimizing feeding experiences during the weaning period.
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Affiliation(s)
- M S van Vliet
- Leiden University, Institute of Education and Child Studies, P.O. Box 9555, 2300, RB, Leiden, the Netherlands.
| | - J Mesman
- Leiden University, Institute of Education and Child Studies, P.O. Box 9555, 2300, RB, Leiden, the Netherlands
| | - J M Schultink
- Wageningen University, Division of Human Nutrition and Health, P.O. Box 17, 6700, AA, Wageningen, the Netherlands
| | - J H M de Vries
- Wageningen University, Division of Human Nutrition and Health, P.O. Box 17, 6700, AA, Wageningen, the Netherlands
| | - C M J L Vereijken
- Danone Nutricia Research, Nutrition and Behaviour Science, P.O. Box 80141, 3508, TC, Utrecht, the Netherlands
| | - R C A Rippe
- Leiden University, Institute of Education and Child Studies, P.O. Box 9555, 2300, RB, Leiden, the Netherlands
| | - S M C van der Veek
- Leiden University, Institute of Education and Child Studies, P.O. Box 9555, 2300, RB, Leiden, the Netherlands
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16
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Kamody RC, Lydecker JA. Parental feeding practices and children's disordered eating among single parents and co-parents. Int J Eat Disord 2021; 54:812-820. [PMID: 33624860 PMCID: PMC8163105 DOI: 10.1002/eat.23490] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Some parental feeding practices are associated with pediatric disordered eating and weight status. Existing research, however, has focused on maternal feeding practices in co-parent households. Single parents and fathers are notably understudied in this area. The current study examined associations of parental feeding practices with child disordered eating behaviors and weight, and compared associations between single mothers and fathers with a matched sample of co-parenting mothers and fathers. METHOD Parents (N = 524) of youth between 5 and 16 years completed an online survey that included measures of parental feeding practices and unhealthy eating/weight-related parenting practices. Co-parents were matched to each single parent based on gender, race, ethnicity, education level, age, and BMI. RESULTS Single parents reported significantly greater concern about their child's weight, eating and shape, and reported engaging in more restraint and restriction of their child's eating, as well as having more perceived responsibility of their child's eating than caregivers in co-parent households. Children of single parents were significantly more likely to engage in secretive eating. DISCUSSION Associations between single parents' feeding practices and child weight and disordered eating parallel the broader literature. There were differences between single mothers and fathers and co-parenting mothers and fathers, particularly in their report of their unhealthy eating/weight-related parenting practices. Such differences may influence children's longer-term eating behaviors and weight status. Further research on single-parent households is needed, including longitudinal and epidemiological studies.
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Affiliation(s)
- Rebecca C. Kamody
- Department of Psychiatry, Yale School of Medicine, 301 Cedar Street, New Haven CT, 06519, USA
| | - Janet A. Lydecker
- Department of Psychiatry, Yale School of Medicine, 301 Cedar Street, New Haven CT, 06519, USA
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17
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Barnhart WR, Braden AL, Dial LA. Emotion Regulation Difficulties Strengthen Relationships Between Perceived Parental Feeding Practices and Emotional Eating: Findings from a Cross-Sectional Study. Int J Behav Med 2021; 28:647-663. [PMID: 33580875 DOI: 10.1007/s12529-021-09959-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND People with emotional eating (EE) may experience weight gain and obesity, eating disorder psychopathology, and emotion dysregulation. Limited research has examined experiences in childhood that may be associated with EE in adulthood. Perceived parental feeding practices and emotion regulation difficulties were examined as correlates of negative and positive EE in adulthood. METHODS A cross-sectional study using an online community sample of adults (N = 258) examined self-reported negative (Emotional Eating Scale-Revised; EE-anger/anxiety, EE-boredom, and EE-depression) and positive (Emotion Appetite Questionnaire; EE-positive) EE, perceived parental feeding practices (Child Feeding Questionnaire), and emotion regulation difficulties (Difficulties in Emotion Regulation Scale). RESULTS Moderation analyses calculated in PROCESS macro examined emotion regulation difficulties as a moderator of relationships between perceived parental feeding practices and EE. Across all models tested, age, BMI, and gender were entered as covariates. Higher perceptions of parental control (monitoring and restriction) of unhealthy eating behaviors and pressure to eat were more strongly associated with EE-anger/anxiety and EE-positive when emotion regulation difficulties were high. Higher perceptions of parental restriction of unhealthy eating behaviors and pressure to eat were more strongly associated with higher EE-boredom when emotion regulation difficulties were high. No significant interactions between perceived parental feeding practices and emotion regulation difficulties emerged in relation to EE-depression. CONCLUSIONS Perceived controlling parental feeding practices and emotion regulation difficulties may explain meaningful variance in negative and positive EE in adulthood.
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Affiliation(s)
- Wesley R Barnhart
- Department of Psychology, Bowling Green State University, 822 East Merry Avenue, Bowling Green, OH, USA.
| | - Abby L Braden
- Department of Psychology, Bowling Green State University, 822 East Merry Avenue, Bowling Green, OH, USA
| | - Lauren A Dial
- Department of Psychology, Bowling Green State University, 822 East Merry Avenue, Bowling Green, OH, USA
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18
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Duraccio KM, Zaugg KK, Nottingham K, Jensen CD. Maternal self-efficacy is associated with mother-child feeding practices in middle childhood. Eat Behav 2021; 40:101475. [PMID: 33517024 DOI: 10.1016/j.eatbeh.2021.101475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 12/22/2020] [Accepted: 01/05/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Maternal self-efficacy (MSE) is a well-established correlate of health outcomes in young children, though little is known about this association in older children. The purpose of this cross-sectional study was to examine how MSE relates to mother-child feeding practices in middle childhood. METHODS A total of 306 children ages 8-12 (Mean age = 9.72, SD = 0.91, 52.9% female) and their mothers participated in this study. Mothers completed the New General Self-Efficacy Scale and the Child Feeding Questionnaire. A series of hierarchical regression models were used to examine how MSE related to maternal food restriction, maternal pressure to eat, and maternal food monitoring. RESULTS After accounting for maternal Body Mass Index (BMI), education, and age, and child Body Mass Index Percentile (BMI%ile) and age within the first step of each regression model, MSE emerged as a significant predictor for maternal restriction of foods (p = .024) and maternal food monitoring (p = .048). MSE was not significantly related to maternal pressure to eat. CONCLUSIONS This study is the first to establish that higher MSE is significantly related to healthier mother-child feeding practices in middle childhood, providing preliminary justification for enhancing MSE within comprehensive family interventions to support child weight-related health.
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Affiliation(s)
- Kara M Duraccio
- Department of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Kelsey K Zaugg
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Katy Nottingham
- Department of Psychology, Brigham Young University, Provo, UT, USA
| | - Chad D Jensen
- Department of Psychology, Brigham Young University, Provo, UT, USA
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19
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Gingras V, Switkowski KM, Rifas-Shiman SL, Faleschini S, Oken E, Hivert MF. Associations of Early Parental Concerns and Feeding Behaviors with Child's Diet Quality through Mid-Childhood. Nutrients 2020; 12:nu12113231. [PMID: 33105682 PMCID: PMC7690442 DOI: 10.3390/nu12113231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/02/2020] [Accepted: 10/16/2020] [Indexed: 12/23/2022] Open
Abstract
Parental feeding practices have been associated with children's dietary intakes, yet the directionality of these associations remains unclear. Among 1172 mother-child pairs from Project Viva, we aimed to examine associations of parental concerns and feeding behaviors at 2 years (behaviors dichotomized as yes vs. no), with diet quality (Youth Healthy Eating Index; YHEI) in early (mean 3.2, SD 0.3 years; n = 1076) and mid-childhood (mean 7.8, SD 0.7 years; n = 993). We used multivariable linear regression models adjusted for sociodemographic characteristics, parental body mass index (BMI), maternal diet quality in pregnancy, and child's BMI z-score and diet quality at 2 years. Early parental concerns about their child becoming overweight (15%) was associated with lower YHEI (β -1.54 points; 95%CI -2.75, -0.33; fully adjusted model) in early childhood. Early parental concerns about their child becoming underweight (7%) was associated with lower YHEI (-2.19 points; -4.31, -0.07) in early childhood, but the association was attenuated after adjustment for child's BMI z-score and diet quality at 2 years. We did not find associations of parental restrictive feeding (8%) and parental pressure to eat (47%) with child's YHEI through mid-childhood. In conclusion, we found no evidence that early parental concerns and feeding behaviors independently contribute to child's diet quality through childhood.
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Affiliation(s)
- Véronique Gingras
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (V.G.); (K.M.S.); (S.L.R.-S.); (S.F.); (E.O.)
| | - Karen M. Switkowski
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (V.G.); (K.M.S.); (S.L.R.-S.); (S.F.); (E.O.)
| | - Sheryl L. Rifas-Shiman
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (V.G.); (K.M.S.); (S.L.R.-S.); (S.F.); (E.O.)
| | - Sabrina Faleschini
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (V.G.); (K.M.S.); (S.L.R.-S.); (S.F.); (E.O.)
- School of Psychology, Laval University, Quebec City, QC G1V0A6, Canada
| | - Emily Oken
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (V.G.); (K.M.S.); (S.L.R.-S.); (S.F.); (E.O.)
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA; (V.G.); (K.M.S.); (S.L.R.-S.); (S.F.); (E.O.)
- Diabetes Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Correspondence: ; Tel.: +1-617-867-4505
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20
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Bektas G, Boelsma F, Baur VE, Seidell JC, Dijkstra SC. Parental Perspectives and Experiences in Relation to Lifestyle-Related Practices in the First Two Years of a Child's Life: A Qualitative Study in a Disadvantaged Neighborhood in The Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165838. [PMID: 32806644 PMCID: PMC7460357 DOI: 10.3390/ijerph17165838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023]
Abstract
The first two years of a child's life are a critical period in preventing several lifestyle-related health problems. A qualitative study was conducted to explore parental experiences and perspectives in relation to lifestyle-related child-rearing practices in order to minimize risk factors at an early stage. Data were collected through interviews (n = 25) and focus groups (n = 4) with parents of children aged 0-2 years, in a disadvantaged neighborhood in Amsterdam, the Netherlands. Results showed that parents were often uncertain about a number of lifestyle-related practices. Ambiguity also appeared regarding the parents' intentions to engage in certain practices and what they were able to achieve in everyday life. In addition, parents experienced strong sociocultural influences from their family, which interfered with their ability to make their own decisions on lifestyle-related practices. Parents also expressed a need for peer-support and confirmation of their practices. Future studies should focus on supporting parents in their parental practices during the first two years of their child's life. Any such study should take into account the specific sociocultural context accompanying lifestyle-related parental practices.
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Affiliation(s)
- Gülcan Bektas
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands; (F.B.); (J.C.S.)
- Correspondence: (G.B.); (S.C.D.); Tel.: +31-20-598-28-02 (G.B.); +31-20-598-61-28 (S.C.D.)
| | - Femke Boelsma
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands; (F.B.); (J.C.S.)
| | - Vivianne E. Baur
- Department of Care Ethics, University of Humanistic Studies, Kromme Nieuwegracht 29, 3512 HD Utrecht, The Netherlands;
| | - Jacob C. Seidell
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands; (F.B.); (J.C.S.)
| | - S. Coosje Dijkstra
- Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands; (F.B.); (J.C.S.)
- Correspondence: (G.B.); (S.C.D.); Tel.: +31-20-598-28-02 (G.B.); +31-20-598-61-28 (S.C.D.)
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21
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Gouveia MJ, Canavarro MC, Moreira H. The role of mindful parenting and children's weight in mothers' child-feeding practices. Eat Weight Disord 2020; 25:427-435. [PMID: 30430466 DOI: 10.1007/s40519-018-0615-x] [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: 04/12/2018] [Accepted: 11/07/2018] [Indexed: 10/27/2022] Open
Abstract
PURPOSE This study explores whether mindful parenting dimensions and children's body mass index (BMI) z-scores are associated with mothers' concern about child weight and child-feeding practices (i.e., responsibility for child feeding, pressure to eat, restriction, food reward, and monitoring). METHODS The sample included 576 mothers of children/adolescents (7-18 years old) with normal weight (BMI = 3-85th percentiles) and 490 mothers of children/adolescents with overweight/obesity (BMI ≥ 85th percentile; 59% undergoing nutritional treatment). Mothers completed the Portuguese versions of the Interpersonal Mindfulness on Parenting Scale and the Child Feeding Questionnaire. RESULTS Mothers of children with overweight/obesity undergoing nutritional treatment presented lower levels of emotional awareness of the child, nonjudgmental acceptance of parental functioning, and pressure to eat and higher levels of concern about child weight, restriction and monitoring than the other groups presented. Almost all mindful parenting dimensions and children's zBMI were significantly associated with mothers' concern and child-feeding practices. CONCLUSIONS Mindful parenting dimensions and children's weight seem to be important predictors of mothers' child-feeding practices and of their concern about child weight, which suggests that a mindful approach in parenting might help mothers adopt more adaptive and weight-adapted child-feeding practices. LEVEL OF EVIDENCE Level III, case-control analytic study.
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Affiliation(s)
- M J Gouveia
- Research Group "Relationships, Development and Health", Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3030-115, Coimbra, Portugal.
| | - M C Canavarro
- Research Group "Relationships, Development and Health", Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3030-115, Coimbra, Portugal
| | - H Moreira
- Research Group "Relationships, Development and Health", Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3030-115, Coimbra, Portugal
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22
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Reale S, Simpson RM, Marr C, Carstairs SA, Cecil JE, Hetherington MM, Caton SJ. Snack Portion Sizes for Preschool Children Are Predicted by Caregiver Portion Size, Caregiver Feeding Practices and Children's Eating Traits. Nutrients 2019; 11:E3020. [PMID: 31835571 PMCID: PMC6950396 DOI: 10.3390/nu11123020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/28/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022] Open
Abstract
Caregivers are mostly responsible for the foods young children consume; however, it is unknown how caregivers determine what portion sizes to serve. This study examined factors which predict smaller or larger than recommended snack portion sizes in an online survey. Caregivers of children aged 2 to 4 years were presented with 10 snack images, each photographed in six portion sizes. Caregivers (n = 659) selected the portion they would usually serve themselves and their child for an afternoon snack. Information on child eating traits, parental feeding practices and demographics were provided by caregivers. Most caregivers selected portions in line with recommended amounts for preschool children, demonstrating their ability to match portion sizes to their child's energy requirements. However, 16% of caregivers selected smaller than recommended low energy-dense (LED, e.g., fruits and vegetables) snacks for their child which was associated with smaller caregiver's own portion size, reduced child food liking and increased satiety responsiveness. In contrast, 28% of caregivers selected larger than recommended amounts of high energy-dense (HED, e.g., cookies, crisps) snacks for their child which were associated with larger caregiver's own portion size, greater frequency of consumption, higher child body mass index (BMI), greater pressure to eat and lower child food liking. These findings suggest that most caregivers in this study select portions adjusted to suit their child's age and stage of development. Future interventions could provide support to caregivers regarding the energy and nutrient density of foods given the relatively small portion sizes of LED and large portions of HED snacks offered to some children.
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Affiliation(s)
- Sophie Reale
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
| | - Rebecca M. Simpson
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
| | - Colette Marr
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
| | - Sharon A. Carstairs
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (S.A.C.); (J.E.C.)
| | - Joanne E. Cecil
- Population and Behavioural Sciences, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; (S.A.C.); (J.E.C.)
| | | | - Samantha J. Caton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield S1 4DA, UK; (S.R.); (R.M.S.); (C.M.)
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23
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Jansen PW, Derks IPM, Batenburg A, Jaddoe VWV, Franco OH, Verhulst FC, Tiemeier H. Using Food to Soothe in Infancy is Prospectively Associated with Childhood BMI in a Population-Based Cohort. J Nutr 2019; 149:788-794. [PMID: 30989177 DOI: 10.1093/jn/nxy277] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 07/30/2018] [Accepted: 10/10/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Feeding practices have been implicated in childhood overweight, but the long-term effects of using food to comfort a distressed child remain unknown. OBJECTIVE This study examined whether the use of food to soothe in infancy was associated with later body composition, and whether children's eating behaviors mediate this relation. METHODS Participants were 3960 children of Generation R, a population-based birth cohort in the Netherlands. Parents reported on the use of food to soothe when infants were 6 mo old and on child eating behavior (food responsiveness, emotional eating) at ages 4 and 10 y. Body mass index (BMI), fat mass, and fat-free mass were measured at ages 6 and 10 y. Linear regression and mediation analyses were conducted, accounting for various potential confounding factors. RESULTS The use of food to soothe when infants were 6 mo old predicted a higher BMI from age 6 y onwards, independently of infant weight, maternal BMI, and other confounders. Specifically, frequent use was associated with a BMI z score 0.13 higher at age 10 y (95% CI: 0.03, 0.22) as compared with never use. Children's emotional eating mediated this association (indirect effect B = 0.04; 95% CI: 0.02, 0.06). The feeding-body composition association was most evident for fat mass (P for trend = 0.014) and somewhat less for fat-free mass (P for trend = 0.079). CONCLUSIONS The use of food to comfort a distressed infant was consistently associated with obesogenic eating behaviors and an unhealthy body composition throughout middle and late childhood. As our design precludes conclusions on causal associations, we recommend further studies with precise, repeated assessments of infant feeding practices. Such research can help ascertain the direction of effect, which is needed for establishing evidence-based guidelines for parents regarding the use of food to soothe early in life.
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Affiliation(s)
- Pauline W Jansen
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands.,Departments of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Ivonne P M Derks
- Departments of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands.,The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Amber Batenburg
- Departments of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Vincent W V Jaddoe
- Departments of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands.,Departments of Pediatrics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Oscar H Franco
- Departments of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Frank C Verhulst
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Henning Tiemeier
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands.,Departments of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands.,Departments of Psychiatry, Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands
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Mian A, Jansen PW, Nguyen AN, Bowling A, Renders CM, Voortman T. Children's Attention-Deficit/Hyperactivity Disorder Symptoms Predict Lower Diet Quality but Not Vice Versa: Results from Bidirectional Analyses in a Population-Based Cohort. J Nutr 2019; 149:642-648. [PMID: 30915449 DOI: 10.1093/jn/nxy273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/07/2018] [Accepted: 10/05/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND As an adjuvant for medication, dietary changes focused on specific nutrients have been proposed to prevent or reduce attention-deficit/hyperactivity disorder (ADHD) symptoms. However, whether an overall healthy dietary pattern is associated with ADHD symptom severity during childhood remains unclear. Furthermore, it is not clear what the direction of this association is. OBJECTIVES We aimed to examine the association between dietary patterns and ADHD symptoms in school-aged children. In addition, we aimed to identify the temporal direction of this association-that is, whether dietary patterns predict ADHD symptoms or vice versa. METHODS We analyzed data from 3680 children participating in the Generation R Study, a prospective cohort in Rotterdam, Netherlands. ADHD symptoms were assessed with parent-report questionnaires at ages 6 and 10 y using the Child Behavior Checklist. Dietary intake was assessed at the age of 8 y with a validated food-frequency questionnaire. We computed a diet quality score reflecting adherence to dietary guidelines. We examined bidirectional associations of diet quality with ADHD symptom scores using multivariable linear regression analysis and cross-lagged modeling. RESULTS Linear regressions showed that more ADHD symptoms at age 6 y were associated with a lower diet quality score at age 8 y (SD score = -0.08; 95% CI: -0.11, -0.05) but that diet quality at age 8 y was not associated with ADHD symptoms at age 10 y. Cross-lagged models confirmed a unidirectional relation from ADHD symptoms to diet quality but not vice versa. Associations did not differ by overweight status or between boys and girls. CONCLUSION Our study suggests that children with more ADHD symptoms may be at higher risk of an unhealthy diet but that overall diet quality does not affect ADHD risk.
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Affiliation(s)
- Annemiek Mian
- Departments of Epidemiology, Rotterdam, Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Pauline W Jansen
- Departments of Child and Adolescent Psychiatry/Psychology, Rotterdam, Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University, Rotterdam, Netherlands
| | - Anh N Nguyen
- Departments of Epidemiology, Rotterdam, Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, Netherlands
| | - April Bowling
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA.,Department of Health Sciences, Merrimack College, North Andover, MA
| | - Carry M Renders
- Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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25
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Gouveia MJ, Canavarro MC, Moreira H. How can mindful parenting be related to emotional eating and overeating in childhood and adolescence? The mediating role of parenting stress and parental child-feeding practices. Appetite 2019; 138:102-114. [PMID: 30917939 DOI: 10.1016/j.appet.2019.03.021] [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: 09/22/2018] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 01/30/2023]
Abstract
To explore whether the association between mindful parenting and children/adolescents' disordered eating behaviors (i.e., emotional eating and overeating) may be mediated by parenting stress and parental child-feeding practices. The sample comprised 726 family dyads composed of a mother (79.8%) or a father (20.2%) and their child (7-18 years old), of which 362 children/adolescents had normal weight (BMI = 5-85th percentile) and 364 had overweight or obesity (BMI ≥ 85th percentile) according to the WHO Child Growth Standards. Parents completed self-report measures of mindful parenting, parenting stress, and child-feeding practices, and children/adolescents completed measures of emotional eating and overeating. The path model was estimated in AMOS. Mindful parenting was negatively associated with children's emotional eating through lower levels of parenting stress followed by less frequent use of food as a reward and through less frequent use of food as a reward only. Mindful parenting was linked to children's overeating through lower levels of parenting stress. Moreover, mindful parenting was associated with less frequent use of food as a reward, pressuring to eat and monitoring through lower levels of parenting stress, among parents of girls, mostly from the early stage of adolescence. Additionally, higher levels of parenting stress were associated with using food as a reward and, consequently, with higher levels of emotional eating among girls, and with more restriction and, consequently, with more overeating among early-stage adolescents. A comprehensive model suggesting that mindful parenting can help children/adolescents engage less in disordered eating behaviors through lower levels of parenting stress and the adoption of more adaptive child-feeding practices is proposed. Parental practices, particularly mindful parenting, may have an important role in promoting healthier eating behaviors among children/adolescents.
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Affiliation(s)
- M J Gouveia
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.
| | - M C Canavarro
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - H Moreira
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
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26
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Bahreynian M, Mozafarian N, Motlagh ME, Qorbani M, Heshmat R, Kelishadi R. Association between parental feeding practices and later body mass index in children and adolescents: The Weight disorder survey of the CASPIAN-IV Study. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2019. [DOI: 10.3233/mnm-180242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Maryam Bahreynian
- Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nafiseh Mozafarian
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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27
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The effect of food type on the portion size effect in children aged 2-12 years: A systematic review and meta-analysis. Appetite 2019; 137:47-61. [PMID: 30779929 DOI: 10.1016/j.appet.2019.01.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 01/21/2019] [Accepted: 01/28/2019] [Indexed: 01/13/2023]
Abstract
Visual cues such as plate size, amount of food served and packaging are known to influence the effects of portion size on food intake. Unit bias is a well characterised heuristic and helps to determine consumption norms. In an obesogenic environment where large portions are common place, the unit or segmentation bias may be overridden promoting overconsumption of both amorphous or unit foods. The aim of this review was to investigate the impact of offering unit or amorphous food on the portion size effect (PSE) in children aged 2-12 years. A systematic search for literature was conducted in Medline, PsycInfo and Web of Science in February 2018. A total of 1197 papers were retrieved following the searches. Twenty-one papers were included in the systematic review, of which 15 provided requisite statistical information for inclusion in a random effects meta-analysis. Increasing children's food portion size by 51-100% led to a significant increase in intake (SMD = 0.47, 95% CI: 0.39-0.55). There was no evidence to suggest that increases in consumption were related to food type (p = 0.33), child age (p = 0.47) or initial portion size served (p=0.14). Residual heterogeneity was not significant (p=0.24). The PSE was demonstrated in children aged 2-12 years when offered both unit and amorphous food items. The effect was not restricted by food type, child age or influenced by initial portion size served. Of the studies included in the meta-analysis between study heterogeneity was low suggesting minimal variation in treatment effects between studies, however, more research is required to understand the mechanisms of the PSE in preschool children. Future research should determine feasible methods to downsize portion sizes served to children.
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28
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Warkentin S, Mais LA, Latorre MDRDDO, Carnell S, Taddei JADAC. Parents Matter: Associations of Parental BMI and Feeding Behaviors With Child BMI in Brazilian Preschool and School-Aged Children. Front Nutr 2018; 5:69. [PMID: 30148134 PMCID: PMC6096004 DOI: 10.3389/fnut.2018.00069] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/19/2018] [Indexed: 12/19/2022] Open
Abstract
Background: Brazil is undergoing nutritional transition and rates of obesity in preschool and school-aged children are increasing. Excess weight in the first years of life could predict excess weight in adulthood, making it essential to study risk factors in this population. Objective: Our goal was to investigate associations of parent feeding behaviors, as well as more distal familial influences including family SES and maternal and paternal weight, with BMI z-score in preschool and school-aged children in a Brazilian sample. Methods: Cross-sectional study. Data were collected in 14 Brazilian private schools. Parents of children aged 2–8 years (n = 1,071) completed a questionnaire assessing parent feeding behaviors, as well as sociodemographic and anthropometric information. Hierarchical linear regression models were fitted to investigate relationships between parent and child characteristics and child BMI z-score in preschool (2–5 years, n = 397) and school-aged (6–8 years, n = 618) children. Results: Final models indicated that higher maternal BMI and “restriction for weight control” were associated with higher child BMI z-score in both age groups (excessive weight, i.e., BMI ≥ +1 z-score, in preschoolers and school-aged children: 24.4 and 35.9%, respectively). In preschoolers only, “healthy eating guidance” and “pressure” were associated with lower child BMI z-score. For school-aged children, male sex, higher father BMI, and “restriction for health” were associated with higher child BMI z-score. Conclusions: Parent feeding behaviors and parent weight, as well as child sex, are associated with child BMI z-score, with evidence for differential relationships in preschool and school-aged children. Optimal obesity prevention and treatment strategies may differ by child age.
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Affiliation(s)
- Sarah Warkentin
- Discipline of Nutrology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Laís A Mais
- Discipline of Nutrology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | | | - Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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29
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Yang WY, Burrows T, MacDonald-Wicks L, Williams LT, Collins CE, Chee WSS. Parent-child feeding practices in a developing country: Findings from the Family Diet Study. Appetite 2018; 125:90-97. [DOI: 10.1016/j.appet.2018.01.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 12/15/2017] [Accepted: 01/30/2018] [Indexed: 11/16/2022]
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30
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Njardvik U, Klar EK, Thorsdottir F. The factor structure of the Children's Eating Behaviour Questionnaire: A comparison of four models using confirmatory factor analysis. Health Sci Rep 2018; 1:e28. [PMID: 30623064 PMCID: PMC6266355 DOI: 10.1002/hsr2.28] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 12/19/2017] [Accepted: 01/15/2018] [Indexed: 12/15/2022] Open
Abstract
AIMS The Child Eating Behavior Questionnaire (CEBQ) consists of 8 subscales measuring different aspects of eating behavior and is a widely used instrument in pediatric settings, both in relation to eating disorders and overweight/obesity. However, despite its widespread usage, research results have, to this date, been inconsistent in regard to the factor structure of the CEBQ, with several factorial models suggested. The purpose of this study was to systematically compare the 4 factor structures commonly reported in the literature on the 35-item CEBQ, using confirmatory factor analysis in the same sample. METHODS AND RESULTS In total, parents of 560 children aged 5 to 12 years old completed the CEBQ; 70 questionnaires were incomplete, resulting in a final sample of 490. Confirmatory factor analyses tested the 4 competing models: a 6-factor model, 2 seven-factor models, and an 8-factor model. The 8-factor model provided an acceptable fit to the data and turned out to be the best fitting model. Correlation coefficients between the 8 factors never exceeded r = .77, supporting the construct uniqueness of the 8 subscales. Results also indicated that the CEBQ subscales have good factorial validity and internal reliability (α ≥ .75). CONCLUSION In summary, this study of Icelandic children supports the appropriateness of using the CEBQ as a measure of 8 distinct dimensions of eating behavior style in school-aged children.
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Affiliation(s)
- Urdur Njardvik
- Department of PsychologyUniversity of IcelandReykjavikIceland
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31
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Roach E, Viechnicki GB, Retzloff LB, Davis-Kean P, Lumeng JC, Miller AL. Family food talk, child eating behavior, and maternal feeding practices. Appetite 2017; 117:40-50. [PMID: 28587941 DOI: 10.1016/j.appet.2017.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/28/2017] [Accepted: 06/02/2017] [Indexed: 01/04/2023]
Abstract
Families discuss food and eating in many ways that may shape child eating habits. Researchers studying how families talk about food have examined this process during meals. Little work has examined parent-child food-related interactions outside of mealtime. We assessed family food talk at home outside of mealtime and tested whether food talk was associated with obesogenic child eating behaviors, maternal feeding practices, or child weight. Preschool and school-aged mother-child dyads (n = 61) participated in naturalistic voice recording using a LENA (Language ENvironment Analysis) recorder. A coding scheme was developed to reliably characterize different types of food talk from LENA transcripts. Mothers completed the Children's Eating Behavior Questionnaire (CEBQ) and Child Feeding Questionnaire (CFQ) to assess child eating behaviors and maternal feeding practices. Child weight and height were measured and body mass index z-score (BMIz) calculated. Bivariate associations among food talk types, as a proportion of total speech, were examined and multivariate regression models used to test associations between food talk and child eating behaviors, maternal feeding practices, and child BMIz. Proportion of child Overall Food Talk and Food Explanations were positively associated with CEBQ Food Responsiveness and Enjoyment of Food (p's < 0.05). Child food Desire/Need and child Prep/Planning talk were positively associated with CEBQ Enjoyment of Food (p < 0.05). Child Food Enjoyment talk and mother Overt Restriction talk were positively associated with CEBQ Emotional Over-Eating (p < 0.05). Mother Monitoring talk was positively associated with CFQ Restriction (p < 0.05). Mother Prep/Planning talk was negatively associated with child BMIz. Food talk outside of mealtimes related to child obesogenic eating behaviors and feeding practices in expected ways; examining food talk outside of meals is a novel way to consider feeding practices and child eating behavior.
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Affiliation(s)
- Elizabeth Roach
- Center for Human Growth and Development, University of Michigan, USA; Department of Nutritional Sciences, University of Michigan School of Public Health, USA
| | | | - Lauren B Retzloff
- Center for Human Growth and Development, University of Michigan, USA
| | - Pamela Davis-Kean
- Center for Human Growth and Development, University of Michigan, USA; Institute for Social Research, University of Michigan, USA; Department of Psychology, University of Michigan, USA
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, USA; Department of Nutritional Sciences, University of Michigan School of Public Health, USA; Department of Pediatrics, University of Michigan Medical School, USA
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, USA; Department of Health Behavior and Health Education, University of Michigan School of Public Health, USA.
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Steinsbekk S, Barker ED, Llewellyn C, Fildes A, Wichstrøm L. Emotional Feeding and Emotional Eating: Reciprocal Processes and the Influence of Negative Affectivity. Child Dev 2017; 89:1234-1246. [PMID: 28439888 DOI: 10.1111/cdev.12756] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Emotional eating, that is, eating more in response to negative mood, is often seen in children. But the origins of emotional eating remain unclear. In a representative community sample of Norwegian 4-year-olds followed up at ages 6, 8, and 10 years (analysis sample: n = 801), one potential developmental pathway was examined: a reciprocal relation between parental emotional feeding and child emotional eating. The results revealed that higher levels of emotional feeding predicted higher levels of emotional eating and vice versa, adjusting for body mass index and initial levels of feeding and eating. Higher levels of temperamental negative affectivity (at age 4) increased the risk for future emotional eating and feeding.
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Affiliation(s)
| | | | | | | | - Lars Wichstrøm
- Norwegian University of Science and Technology.,NTNU Social Science
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33
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Tabak RG, Schwarz CD, Haire‐Joshu DL. Associations between feeding practices and maternal and child weight among mothers who do and do not correctly identify their child's weight status. Obes Sci Pract 2017; 3:51-58. [PMID: 31516723 PMCID: PMC6727840 DOI: 10.1002/osp4.88] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 11/01/2016] [Accepted: 11/08/2016] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE This study aimed to explore factors associated with accuracy of maternal weight perception and determine if maternal feeding practices are associated with weight status. METHODS Overweight/obese mothers reported demographics and perception of their child's weight and completed a modified preschooler feeding questionnaire. Mother's and child's height and weight were measured. Logistic regression was used to explore associations between demographic factors and accuracy. Correlations between the preschooler feeding questionnaire scales and mom's body mass index (BMI) and child's BMI-percentile were explored for the total sample and accurate and underestimating moms. RESULTS Among mothers whose child was overweight or obese, only 20% of mothers correctly identified the child as overweight. Forty percent of moms were underestimaters. There was a positive correlation between concern the child was overweight/overeating and the child's BMI-percentile among underestimating moms; in the total sample (r = 0.32, p < .001) and accurate moms (r = 0.52, p < .001). In underestimaters only, there was a negative relationship between child BMI-percentile and pressure to eat (r = -0.30, p < .001) and concern about child underweight (r = -0.47, p < .001). CONCLUSIONS This study identified different associations between child weight and mother's feeding practices in mothers accurately and inaccurately perceiving her child's weight. Intervention studies should explore targeting education on feeding practices based on these perceptions.
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Affiliation(s)
- R. G. Tabak
- Washington University in St. LouisThe Brown School of Social Work and Public Health, and The School of MedicineSt. LouisMOUSA
| | - C. D. Schwarz
- Washington University in St. LouisThe Brown School of Social Work and Public Health, and The School of MedicineSt. LouisMOUSA
| | - D. L. Haire‐Joshu
- Washington University in St. LouisThe Brown School of Social Work and Public Health, and The School of MedicineSt. LouisMOUSA
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Gerards SMPL, Niermann C, Gevers DWM, Eussen N, Kremers SPJ. Context matters! The relationship between mother-reported family nutrition climate, general parenting, food parenting practices and children's BMI. BMC Public Health 2016; 16:1018. [PMID: 27677380 PMCID: PMC5039910 DOI: 10.1186/s12889-016-3683-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/19/2016] [Indexed: 12/15/2022] Open
Abstract
Background Efforts to explain children’s nutrition behavior or weight often involve investigating the parent-child relationship, typically studying the associations between food parenting practices (FPPs) and child outcomes. However, these behaviors are embedded in a broader system: general parenting (GP, the general emotional climate at home), and the family health climate (an aspect of the broader family system in the context of health). In the current study, we combined the parent-child measures of parenting (FPPs and GP) and the nutritional dimension of the family health climate (family nutrition climate, FNC) to get a broader view of how these concepts are interrelated. The current study had two aims: predicting FPPs using GP and FNC as predictor variables, and investigating the relationship between FPPs and children’s weight in different groups of parents, based on low and high GP and FNC scores. Methods We collected cross-sectional data via an online survey panel. Mothers of 267 children aged 5–12 years filled out a questionnaire assessing demographics (e.g., children’s weight and height), GP, FPPs, and FNC. Bivariate correlation coefficients were calculated between all constructs. Structural equation modeling was performed to test the hypothesized relationships between GP, FNC and FPPs. Hereafter, different groups of parents were identified, using median split, based on a low or high score on GP or a low or high score on FNC. Bivariate correlation coefficients were calculated between FPPs and children’s BMI z-score for these different groups. Results GP and FNC were consistently positively correlated (all r’s ≥.177), and both concepts were positively associated with healthy FPPs (all r’s ≥.214). In families with a positive context (i.e. scoring high on GP and on FNC), healthy FPPs were associated with lower BMI z-scores of the children (r -.229). This association was not found for children with a more negative family context. Conclusions FNC and GP are valuable additional concepts to investigate relationships between FPPs and child outcomes. We recommend that more studies, next to investigating the parent-child system, include a measure of the broader family system, in order to get a broader view of the mechanisms explaining child health behaviors and weight status.
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Affiliation(s)
- Sanne M P L Gerards
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
| | - Christina Niermann
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.,Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Dorus W M Gevers
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Nadine Eussen
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
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Warkentin S, Mais LA, Latorre MDRDDO, Carnell S, Taddei JADAC. Validation of the comprehensive feeding practices questionnaire in parents of preschool children in Brazil. BMC Public Health 2016; 16:603. [PMID: 27435192 PMCID: PMC4952239 DOI: 10.1186/s12889-016-3282-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 06/28/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Recent national surveys in Brazil have demonstrated a decrease in the consumption of traditional food and a parallel increase in the consumption of ultra-processed food, which has contributed to a rise in obesity prevalence in all age groups. Environmental factors, especially familial factors, have a strong influence on the food intake of preschool children, and this has led to the development of psychometric scales to measure parents' feeding practices. The aim of this study was to test the validity of a translated and adapted Comprehensive Feeding Practices Questionnaire in a sample of Brazilian preschool-aged children enrolled in private schools. METHODS A transcultural adaptation process was performed in order to develop a modified questionnaire (43 items). After piloting, the questionnaire was sent to parents, along with additional questions about family characteristics. Test-retest reliability was assessed in one of the schools. Factor analysis with oblique rotation was performed. Internal reliability was tested using Cronbach's alpha and correlations between factors, discriminant validity using marker variables of child's food intake, and convergent validity via correlations with parental perceptions of perceived responsibility for feeding and concern about the child's weight were also performed. RESULTS The final sample consisted of 402 preschool children. Factor analysis resulted in a final questionnaire of 43 items distributed over 6 factors. Cronbach alpha values were adequate (0.74 to 0.88), between-factor correlations were low, and discriminant validity and convergent validity were acceptable. CONCLUSIONS The modified CFPQ demonstrated significant internal reliability in this urban Brazilian sample. Scale validation within different cultures is essential for a more comprehensive understanding of parental feeding practices for preschoolers.
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Affiliation(s)
- Sarah Warkentin
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP), Rua Loefgreen, 1647, CEP: 04040-032, São Paulo, SP, Brazil.
| | - Laís Amaral Mais
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP), Rua Loefgreen, 1647, CEP: 04040-032, São Paulo, SP, Brazil
| | | | - Susan Carnell
- Department of Psychiatry and Behavioral Sciences, Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Eating Behaviours of Preadolescent Children over Time: Stability, Continuity and the Moderating Role of Perceived Parental Feeding Practices. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:437. [PMID: 27104552 PMCID: PMC4847099 DOI: 10.3390/ijerph13040437] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/10/2016] [Accepted: 04/14/2016] [Indexed: 11/17/2022]
Abstract
The links between childhood eating behaviours and parental feeding practices are well-established in younger children, but there is a lack of research examining these variables in a preadolescent age group, particularly from the child's perspective, and longitudinally. This study firstly aimed to examine the continuity and stability of preadolescent perceptions of their parents' controlling feeding practices (pressure to eat and restriction) over a 12 month period. The second aim was to explore if perceptions of parental feeding practices moderated the relationship between preadolescents' eating behaviours longitudinally. Two hundred and twenty nine preadolescents (mean age at recruitment 8.73 years) completed questionnaires assessing their eating behaviours and their perceptions of parental feeding practices at two time points, 12 months apart (T1 and T2). Preadolescents' perceptions of their parental feeding practices remained stable. Perceptions of restriction and pressure to eat were continuous. Perceptions of parental pressure to eat and restriction significantly moderated the relationships between eating behaviours at T1 and T2. The findings from this study suggest that in a preadolescent population, perceptions of parental pressure to eat and restriction of food may exacerbate the development of problematic eating behaviours.
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Mais LA, Warkentin S, Latorre MDRDDO, Carnell S, Taddei JADAC. Validation of the Comprehensive Feeding Practices Questionnaire among Brazilian Families of School-Aged Children. Front Nutr 2015; 2:35. [PMID: 26579525 PMCID: PMC4630658 DOI: 10.3389/fnut.2015.00035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/19/2015] [Indexed: 11/26/2022] Open
Abstract
Introduction Children’s eating behaviors are influenced by parents, who are the first nutritional educators. The comprehensive feeding practices questionnaire (CFPQ) was developed to measure feeding practices among parents, but has not yet been validated in Brazil, where child obesity rates are steeply increasing. The aim of the study was to test the validity of the CFPQ among Brazilian parents of school-aged children and propose a new version of the instrument. Methods Transcultural adaptation included translation into Portuguese, back translation, content validity, testing for semantic equivalence, and piloting. Questionnaire data were obtained for 659 parents of 5- to 9-year olds. Confirmatory and exploratory factor analyses and psychometric analyses (tests for internal consistency, factor correlations, item-discriminant and convergent validity, and test–retest reliability) were conducted. Results Confirmatory factor analysis demonstrated a poor fit of the data to the original 12-factor model. Exploratory factor analysis generated a 6-factor model composed of 42 items: healthy eating guidance, monitoring, restriction for weight control, restriction for health, emotion regulation/food as reward, and pressure. This factor solution was supported by internal consistency tests (α = 0.71–0.91) and factor correlations (ρ = −0.16 to 0.32). Item-discriminant and convergent validity tests showed that parents who used coercive practices had more overweight children and were more concerned about their child’s weight (ρ = 0.09–0.40). Test–retest reliability was acceptable (intraclass correlation coefficient = 0.45–0.77). Conclusion Since parental practices are highly culturally and age group sensitive, it is essential to conduct careful evaluations of questionnaires when introduced into specific age groups within new cultural settings. This modified six-factor model of the CFPQ is valid to measure parental feeding behaviors of school-aged children in urban Brazilian settings.
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Affiliation(s)
- Laís Amaral Mais
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Sarah Warkentin
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | | | - Susan Carnell
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine , Baltimore, MD , USA
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Restrictive rules of Dutch mothers regarding their children's dietary intake between meals. Eat Behav 2015; 18:62-5. [PMID: 25913009 DOI: 10.1016/j.eatbeh.2015.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 02/27/2015] [Accepted: 04/07/2015] [Indexed: 11/22/2022]
Abstract
The use of restrictive food rules by parents has been found to be associated with dietary intake in their children. The aim of this study was to explore the use of restrictive rules of Dutch mothers regarding their child's food intake between main meals in detail, to generate necessary input for setting priorities for further research and intervention development. A cross-sectional questionnaire study on nine restrictive rules was completed by 359 mothers of primary school children aged 4-12years. Mothers reported to use an average of 4.1 (SD 2.1) out of nine restrictive food rules and all rules measured in this study were used. The rules mother's reported to use most were not eating shortly before meals, not eating certain foods too often and not eating too much of certain foods. The rules varied according to different foods, but particularly applied to the intake of potato chips, nuts and savory snacks, candy and chocolate. Mothers of a younger age, lower educated mothers and mothers with a higher BMI were less likely to use (certain) restrictive rules. This study showed that mothers use a large variety of rules, particularly to restrict the intake of unhealthy foods and reported on several subgroups that were less likely to use (certain) rules. Our results direct further research and inform the development of interventions.
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How parental dietary behavior and food parenting practices affect children's dietary behavior. Interacting sources of influence? Appetite 2015; 89:246-57. [DOI: 10.1016/j.appet.2015.02.012] [Citation(s) in RCA: 220] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 01/27/2015] [Accepted: 02/08/2015] [Indexed: 01/16/2023]
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Abstract
This paper presents an overview to provide readers with an update on the literature about the relation between parental influences (general parenting and food parenting practices) and children's weight-related outcomes. It first summarizes the evidence regarding the role of food parenting practices in shaping and maintaining children's nutritional and weight status. It then describes empirical evidence on the relation between general parenting and children's weight status. This evidence is less convincing, possibly because general parenting has a different, more distal role in influencing child behavior than parenting practices. General parenting may moderate the impact of food parenting practices on children's nutrition behaviors. Finally, we discuss studies on interventions targeting childhood overweight and obesity. There is no consensus on the optimal intervention targets (i.e., general parenting and/or food parenting practices). Based on the overview, we offer suggestions for future research.
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Affiliation(s)
- S. M. P. L. Gerards
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - S. P. J. Kremers
- Department of Health Promotion, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands
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Blake CE, Fisher JO, Ganter C, Younginer N, Orloski A, Blaine RE, Bruton Y, Davison KK. A qualitative study of parents' perceptions and use of portion size strategies for preschool children's snacks. Appetite 2014; 88:17-23. [PMID: 25447008 DOI: 10.1016/j.appet.2014.11.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 09/23/2014] [Accepted: 11/03/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Increases in childhood obesity correspond with shifts in children's snacking behaviors and food portion sizes. This study examined parents' conceptualizations of portion size and the strategies they use to portion snacks in the context of preschool-aged children's snacking. METHODS Semi-structured qualitative interviews were conducted with non-Hispanic white (W), African American (AA), and Hispanic (H) low-income parents (n = 60) of preschool-aged children living in Philadelphia and Boston. The interview examined parents' child snacking definitions, purposes, contexts, and frequency. Verbatim transcripts were analyzed using a grounded theory approach. Coding matrices compared responses by race/ethnicity, parent education, and household food security status. RESULTS Parents' commonly referenced portion sizes when describing children's snacks with phrases like "something small." Snack portion sizes were guided by considerations including healthfulness, location, hunger, and timing. Six strategies for portioning snacks were presented including use of small containers, subdividing large portions, buying prepackaged snacks, use of hand measurement, measuring cups, scales, and letting children determine portion size. Differences in considerations and strategies were seen between race/ethnic groups and by household food security status. CONCLUSIONS Low-income parents of preschool-aged children described a diverse set of considerations and strategies related to portion sizes of snack foods offered to their children. Future studies should examine how these considerations and strategies influence child dietary quality.
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Affiliation(s)
- Christine E Blake
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Columbia, South Carolina 29208, United States.
| | - Jennifer Orlet Fisher
- Department of Public Health, Center for Obesity Research and Education, Temple University, 3223 N. Broad Street, Philadelphia, Pennsylvania 19140, United States
| | - Claudia Ganter
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
| | - Nicholas Younginer
- Department of Health Promotion, Education, and Behavior, University of South Carolina, 915 Greene Street, Columbia, South Carolina 29208, United States
| | - Alexandria Orloski
- Department of Public Health, Center for Obesity Research and Education, Temple University, 3223 N. Broad Street, Philadelphia, Pennsylvania 19140, United States
| | - Rachel E Blaine
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
| | - Yasmeen Bruton
- Department of Public Health, Center for Obesity Research and Education, Temple University, 3223 N. Broad Street, Philadelphia, Pennsylvania 19140, United States
| | - Kirsten K Davison
- Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
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Jansen PW, Tharner A, van der Ende J, Wake M, Raat H, Hofman A, Verhulst FC, van Ijzendoorn MH, Jaddoe VWV, Tiemeier H. Feeding practices and child weight: is the association bidirectional in preschool children? Am J Clin Nutr 2014; 100:1329-36. [PMID: 25332330 DOI: 10.3945/ajcn.114.088922] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Parental feeding practices are associated with children's body mass index (BMI). It has been generally assumed that parental feeding determines children's eating behaviors and weight gain, but feeding practices could equally be a parent's response to child weight. OBJECTIVE In longitudinal analyses, we assessed the directionality in the relation between selected controlling feeding practices and BMI in early childhood. DESIGN Participants were 4166 children from the population-based Generation R Study. BMI was measured at ages 2 and 6 y. With the use of the Child Feeding Questionnaire, parents reported on restriction, monitoring, and pressure to eat (child age: 4 y). BMI and feeding-behavior scales were transformed to SD scores. RESULTS With the use of linear regression analyses, there was an indication that a higher BMI at age 2 y predicted higher levels of parental restriction (adjusted β = 0.07; 95% CI: 0.04, 0.10) and lower levels of pressure to eat (adjusted β = -0.20; 95% CI: -0.23, -0.17) 2 y later. Restriction at age 4 y positively predicted child BMI at 6 y of age, although this association attenuated to statistical nonsignificance after accounting for BMI at age 4 y (β = 0.01; 95% CI: -0.01, 0.03). Pressure to eat predicted lower BMI independently of BMI at age 4 y (β = -0.02; 95% CI: -0.04, -0.01). For both restriction and pressure to eat, the relation from BMI to parenting was stronger than the reverse (Wald's test for comparison: P = 0.03 and < 0.001, respectively). Monitoring predicted a lower child BMI, but this relation was explained by confounding factors. CONCLUSIONS Although the feeding-BMI relation is bidirectional, the main direction of observed effects suggests that parents tend to adapt their controlling feeding practices in response to their child's BMI rather than the reverse. Therefore, some components of current programs aimed at preventing or treating unhealthy child weight may need to be carefully scrutinized, especially those targeting parental food-related restriction and pressure to eat.
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Affiliation(s)
- Pauline W Jansen
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
| | - Anne Tharner
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
| | - Jan van der Ende
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
| | - Melissa Wake
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
| | - Hein Raat
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
| | - Albert Hofman
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
| | - Frank C Verhulst
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
| | - Marinus H van Ijzendoorn
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
| | - Vincent W V Jaddoe
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
| | - Henning Tiemeier
- From the Departments of Child and Adolescent Psychiatry/Psychology (PWJ, JvdE, FCV, and HT) and Pediatrics (VWVJ), Erasmus University Medical Center (Erasmus MC)-Sophia, Rotterdam, Netherlands; The Generation R Study Group (PWJ, AT, and VWVJ) and Departments of Epidemiology (AT, AH, VWVJ, and HT), Public Health (HR), and Psychiatry (HT), Erasmus MC-University Medical Center Rotterdam, Rotterdam, Netherlands; the Institute of Psychology (PWJ) and School of Pedagogical and Educational Sciences (MHvI), Erasmus University Rotterdam, Rotterdam, Netherlands; the Murdoch Childrens Research Institute, Melbourne, Australia (MW); the Department of Pediatrics, University of Melbourne, Melbourne, Australia (MW); and the Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia (MW)
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Houldcroft L, Farrow C, Haycraft E. Perceptions of parental pressure to eat and eating behaviours in preadolescents: The mediating role of anxiety. Appetite 2014; 80:61-9. [DOI: 10.1016/j.appet.2014.05.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 04/30/2014] [Accepted: 05/02/2014] [Indexed: 12/29/2022]
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Kral TVE, Souders MC, Tompkins VH, Remiker AM, Eriksen WT, Pinto-Martin JA. Child Eating Behaviors and Caregiver Feeding Practices in Children with Autism Spectrum Disorders. Public Health Nurs 2014; 32:488-97. [PMID: 25112438 DOI: 10.1111/phn.12146] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This pilot study compared children with autism spectrum disorders (ASD) and typically developing children (TDC) on weight-related outcomes and caregiver-reported child eating behaviors and feeding practices. DESIGN AND SAMPLE Cross-sectional study. Caregivers of 25 children with ASD and 30 TDC, ages 4-6. METHODS Caregivers completed validated questionnaires that assessed child eating behaviors and feeding practices. Children's height, weight, and waist circumference were measured. RESULTS Children with ASD, when compared to TDC, showed significantly greater abdominal waist circumferences (p = .01) and waist-to-height ratios (p < .001). Children with ASD with atypical oral sensory sensitivity exhibited greater food avoidance behaviors, including reluctance to eat novel foods (p = .004), being selective about the range of foods they accept (p = .03), and undereating due to negative emotions (p = .02), than children with ASD with typical oral sensory sensitivity. Caregivers of children with ASD with atypical oral sensory sensitivity reported using food to regulate negative child emotions to a greater extent than caregivers of children with typical oral sensory sensitivity (p = .02). DISCUSSION Children with ASD, especially those with atypical oral sensory sensitivity, are at increased risk for food avoidance behaviors and may require additional support in several feeding domains.
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Affiliation(s)
- Tanja V E Kral
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Margaret C Souders
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Victoria H Tompkins
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Adriane M Remiker
- Department of Cell and Developmental Biology, Weill Cornell Medical College, New York, New York
| | - Whitney T Eriksen
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
| | - Jennifer A Pinto-Martin
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.,Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Sleddens EF, Kremers SP, Stafleu A, Dagnelie PC, De Vries NK, Thijs C. Food parenting practices and child dietary behavior. Prospective relations and the moderating role of general parenting. Appetite 2014; 79:42-50. [DOI: 10.1016/j.appet.2014.04.004] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 04/01/2014] [Accepted: 04/03/2014] [Indexed: 12/12/2022]
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Nowicka P, Sorjonen K, Pietrobelli A, Flodmark CE, Faith MS. Parental feeding practices and associations with child weight status. Swedish validation of the Child Feeding Questionnaire finds parents of 4-year-olds less restrictive. Appetite 2014; 81:232-41. [PMID: 24972134 DOI: 10.1016/j.appet.2014.06.027] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/17/2014] [Accepted: 06/20/2014] [Indexed: 12/12/2022]
Abstract
The Child Feeding Questionnaire (CFQ) assesses parental feeding attitudes, beliefs and practices concerned with child feeding and obesity proneness. The questionnaire has been developed in the U.S., and validation studies in other countries are limited. The aim of this study was to examine the psychometric properties of the CFQ in Sweden and the associations between parenting practices and children's weight status. Based on records from the Swedish population register, all mothers of 4-year-olds (n = 3007) from the third largest city in Sweden, Malmö, were contacted by mail. Those who returned the CFQ together with a background questionnaire (n = 876) received the CFQ again to enable test-retest evaluation; 564 mothers completed the CFQ twice. We used confirmatory factor analysis to test whether the original 7-factor model was supported. Good fit (CFI = 0.94, TLI = 0.95, RMSEA = 0.04, SRMR = 0.05) was obtained after minor modifications such as dropping 2 items on restriction and adding 3 error covariances. The internal reliability and the 2-week test-retest reliability were good. The scores on restriction were the lowest ever reported. When the influence of parenting practices on child BMI (dependent variable) was examined in a structural equation model (SEM), child BMI had a positive association with restriction and a negative association with pressure to eat. Restriction was positively influenced by concern about child weight. The second SEM treated parenting practices as dependent variables. Parental foreign origin and child BMI had direct effects on restriction, while pressure to eat was also influenced by parental education. While the results of the study support the usefulness of the CFQ in Sweden, carefully designed cross-cultural comparisons are needed to explain why the levels of restrictive feeding in Swedish families are the lowest reported.
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Affiliation(s)
- Paulina Nowicka
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), B62, Karolinska Institute, 141 86 Stockholm, Sweden.
| | - Kimmo Sorjonen
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institute, 171 65 Solna, Sweden
| | - Angelo Pietrobelli
- Pediatric Unit, Verona University Medical School, Policlinic GB. Rossi, P.le LA. Scuro, 1, 37134 Verona, Italy; Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Carl-Erik Flodmark
- Childhood Obesity Unit, Childhood Centre Malmö, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Myles S Faith
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 2211 McGavran Greenberg Hall, CB 7461, Chapel Hill, NC 27599-7461, USA
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Tung HJ, Yeh MC. Parenting style and child-feeding behaviour in predicting children's weight status change in Taiwan. Public Health Nutr 2014; 17:970-8. [PMID: 23332023 PMCID: PMC10282477 DOI: 10.1017/s1368980012005502] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 11/17/2012] [Accepted: 11/25/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The prevalence of overweight and obesity among children is on the rise worldwide. Prior studies find that parents' child-feeding practices are associated with child weight status and the efficacy of specific parental child-feeding practices can be moderated by parenting styles. In the current longitudinal study, we examined the associations between child-feeding practices and weight status changes over 1 year among a sample of school-aged children in Taiwan. DESIGN In autumn 2008, a child-feeding questionnaire and parenting-style questionnaire were administered to parents of the second and fourth graders in an elementary school in Taiwan. The weight and height of the students were measured by a trained school nurse in 2008 and again in 2009. SETTING An elementary school in central Taiwan. SUBJECTS A total of 465 parent-child pairs were included in the analysis. RESULTS Using a gender- and age-adjusted BMI classification scheme issued by the Taiwan Department of Health, 29·2 % of the students were considered overweight at the 2009 measurement. Controlling for 2008 weight status revealed moderating effects of parenting style on the relationship between child-feeding practices and child weight status. Both authoritative and authoritarian mothers might monitor their children's dietary intake; however, the effectiveness of this practice was better, in terms of weight status control, among the authoritative mothers. CONCLUSIONS Findings suggest that parenting styles have a moderating effect on specific parental child-feeding practices. Parenting styles and parent's feeding practices could be an important focus for future public health interventions addressing the rising childhood obesity epidemic.
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Affiliation(s)
- Ho-Jui Tung
- Department of Healthcare Administration, Asia University, 500 Lioufeng Road, Wufeng, Taichung 41354, Taiwan
| | - Ming-Chin Yeh
- Nutrition Program, CUNY School of Public Health at Hunter College, City University of New York, New York, NY, USA
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Loth K, Fulkerson JA, Neumark-Sztainer D. Food-related parenting practices and child and adolescent weight and weight-related behaviors. ACTA ACUST UNITED AC 2014; 11:207-220. [PMID: 26413263 DOI: 10.2217/cpr.14.5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The prevalence of overweight and obesity in children has reached a concerning plateau in the past three decades, with overweight or obesity impacting approximately one-third of youth. Unhealthy weight-related behaviors, including dieting, unhealthy weight control practices and binge eating, are also a great public health concern for young people given both their high prevalence and harmful consequences. Food-related parenting practices, including food restriction and pressure-to-eat, have been associated with higher weight status, as well as the use of unhealthy weight-related behaviors, in children and adolescents. Physicians and other health care providers who work with families should discourage parents from using food restriction and pressure-to-eat parenting practices with their child or adolescent. Alternatively, parents should be empowered to promote healthy eating by focusing on making nutritious food items readily available within their home and modeling healthy food choices for their child or adolescent.
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Affiliation(s)
- K Loth
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
| | | | - D Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota
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Sleddens EFC, O'Connor TM, Watson KB, Hughes SO, Power TG, Thijs C, De Vries NK, Kremers SPJ. Development of the Comprehensive General Parenting Questionnaire for caregivers of 5-13 year olds. Int J Behav Nutr Phys Act 2014; 11:15. [PMID: 24512450 PMCID: PMC3926334 DOI: 10.1186/1479-5868-11-15] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 02/06/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the large number of parenting questionnaires, considerable disagreement exists about how to best assess parenting. Most of the instruments only assess limited aspects of parenting. To overcome this shortcoming, the "Comprehensive General Parenting Questionnaire" (CGPQ) was systematically developed. Such a measure is frequently requested in the area of childhood overweight. METHODS First, an item bank of existing parenting measures was created assessing five key parenting constructs that have been identified across multiple theoretical approaches to parenting (Nurturance, Overprotection, Coercive control, Behavioral control, and Structure). Caregivers of 5- to 13-year-olds were asked to complete the online survey in the Netherlands (N = 821), Belgium (N = 435) and the United States (N = 241). In addition, a questionnaire regarding personality characteristics ("Big Five") of the caregiver was administered and parents were asked to report about their child's height and weight. Factor analyses and Item-Response Modeling (IRM) techniques were used to assess the underlying parenting constructs and for item reduction. Correlation analyses were performed to assess the relations between general parenting and personality of the caregivers, adjusting for socio-economic status (SES) indicators, to establish criterion validity. Multivariate linear regressions were performed to examine the associations of SES indicators and parenting with child BMI z-scores. Additionally, we assessed whether scores on the parenting constructs and child BMI z-scores differed depending on SES indicators. RESULTS The reduced questionnaire (62 items) revealed acceptable fit of our parenting model and acceptable IRM item fit statistics. Caregiver personality was related as hypothesized with the GCPQ parenting constructs. While correcting for SES, overprotection was positively related to child BMI. The negative relationship between structure and BMI was borderline significant. Parents with a high level of education were less likely to use overly forms of controlling parenting (i.e., coercive control and overprotection) and more likely to have children with lower BMI. Based on several author review meetings and cognitive interviews the questionnaire was further modified to an 85-item questionnaire. CONCLUSIONS The GCPQ may facilitate research exploring how parenting influences children's weight-related behaviors. The contextual influence of general parenting is likely to be more profound than its direct relationship with weight status.
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Affiliation(s)
- Ester F C Sleddens
- Maastricht University, Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center+, P,O, Box 616, 6200, MD Maastricht, The Netherlands.
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De Lepeleere S, DeSmet A, Verloigne M, Cardon G, De Bourdeaudhuij I. What practices do parents perceive as effective or ineffective in promoting a healthy diet, physical activity, and less sitting in children: parent focus groups. BMC Public Health 2013; 13:1067. [PMID: 24219513 PMCID: PMC3827002 DOI: 10.1186/1471-2458-13-1067] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/09/2013] [Indexed: 12/02/2022] Open
Abstract
Background To support parents in improving the health of their young children, examples of effective parenting practices for a healthy diet, physical activity (PA) and sedentary behavior (SB) are needed. This study explores perceived effective and ineffective parenting practices in difficult situations concerning raising healthy children and investigates their relationship with Self-Determination Theory (SDT) and Social Cognitive Theory (SCT). The current study is formative work to inform the content of a randomized controlled trial. Methods Four focus groups were conducted between June and October 2012 at worksites during lunch break. A total of 21 unrelated parents of primary schoolchildren (6 fathers, 15 mothers) participated. A short written questionnaire introduced typical difficult situations derived from parental anecdotal reports, concerning healthy diet, PA and SB. These situations formed the backbone for the subsequent focus group discussion. In October 2012, discussions were audio-recorded and analyzed in Nvivo to identify key response items using thematic analysis. Results Parents experienced explaining why the child should behave healthily, monitoring, being consistent, offering alternatives, reacting empathetically, modeling, motivating, increasing intrinsic value and availability, and using time-out as effective practices, whereas anger was considered ineffective. Opinions were mixed about the effectiveness of giving as much freedom as possible, obliging, rewarding and punishing, and setting rules and agreements. Parenting practices were consistent with principles from both SDT and SCT. Conclusions Parents identified numerous perceived effective practices to respond to their child’s health-related behavior. Since many of them coincide with the evidence base and the success of a parenting program depends upon the degree to which parents’ concerns and motivations are integrated into the program design, important opportunities are created for future intervention programs.
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Affiliation(s)
- Sara De Lepeleere
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium.
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