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Wan AWL, Chung KKH, Li JB, Xu SS, Chan DKC. An assessment tool for the international healthy eating report card for preschool-aged children: a cross-cultural validation across Australia, Hong Kong, Singapore, and the United States. Front Nutr 2024; 11:1340007. [PMID: 38562489 PMCID: PMC10982429 DOI: 10.3389/fnut.2024.1340007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
Objective This study aimed to develop and validate a globally applicable assessment tool of the 43-item International Healthy Eating Report Card Scale (IHERCS) which was designed to assess preschool-aged children's eating behaviours and family home food environments (FHFEs) across different cultural settings. In particular, we examined the factor structure, internal consistency and measurement invariance of the IHERCS across four cultural samples, including Australia, Hong Kong, Singapore, and the US. Convergent and discriminant validity were then conducted. Methods In this cross-cultural study, a total of 2059 parent-child dyads from these four regions were recruited, and the parents were asked to complete the IHERCS. An exploratory structural equational modelling approach was employed to examine two higher-order factor models of children's eating behaviours and FHFEs in the IHERCS and its cross-cultural measurement invariance. Results The findings demonstrated robust factor structures of the scales of children's eating behaviours and FHFEs in the IHERCS (i.e., CFI and TLI > 0.90; RMSEA and SRMR < 0.08) and an acceptable level of internal consistency (i.e., Cronbach's α = 0.55-0.84). Full configural invariance and metric invariance were established across the four cultural contexts, but full scalar invariance was not achieved. Partial scalar invariance was found only in the scale of FHFEs. The convergent validity and discriminant validity were supported. Conclusion Overall, the current findings provided preliminary support for the construct validity and measurement invariance of the IHERCS. It provides a reliable, valid and comprehensive assessment of eating behaviours and FHFEs among children in different cultural settings.
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Affiliation(s)
| | | | | | | | - Derwin King Chung Chan
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China
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2
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Chilman LB, Meredith PJ, Southon N, Kennedy-Behr A, Frakking T, Swanepoel L, Verdonck M. A qualitative inquiry of parents of extremely picky eaters: Experiences, strategies and future directions. Appetite 2023; 190:107022. [PMID: 37647989 DOI: 10.1016/j.appet.2023.107022] [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: 05/27/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND/AIM Picky eating is a common childhood phenomenon in younger children, impacting family relationships and mealtimes. Limited qualitative studies have explored parents' experiences of parenting an extremely picky eater. This study aimed to address this gap. METHODS This exploratory qualitative research design included participants who were Australian-based parents (n = 10) of children aged 2-6 years with a minimum picky eating score of 3.33, indicating extreme picky eating, on the Food Fussiness subscale of the Child Eating Behavior Questionnaire (CEBQ). Parents were interviewed online via Zoom using semi-structured interviews focused on their experiences of having a child who is a picky eater. Reflexive thematic analysis was used to analyze the data. RESULTS Five themes were identified: 1: The picky eating journey for parents. 2: Picky eating impacts families and mealtimes. 3: Parents have attempted multiple strategies to manage picky eating. 4: Emotions associated with parenting an extremely picky eater. 5: Parents of extremely picky eaters have a positive outlook for the future. CONCLUSION This qualitative study demonstrates that parents' experiences of parenting an extremely picky eater are varied. Parents desire health professionals who listen to their concerns and provide evidence-based knowledge around parent feeding practices to positively impact picky eating.
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Affiliation(s)
- Laine B Chilman
- School of Health, University of the Sunshine Coast, 4558, Australia.
| | - Pamela J Meredith
- School of Health, University of the Sunshine Coast, 4558, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, 4072, Australia
| | - Nicole Southon
- School of Health, University of the Sunshine Coast, 4558, Australia
| | - Ann Kennedy-Behr
- School of Health, University of the Sunshine Coast, 4558, Australia; School of Allied Health & Human Performance, University of South Australia, 5072, Australia
| | - Thuy Frakking
- School of Health, University of the Sunshine Coast, 4558, Australia; Research Development Unit, Caboolture Hospital, Metro North Hospital and Health Service, Queensland Health, 4029, Australia; Centre for Clinical Research, School of Medicine, The University of Queensland, Queensland, 4072, Australia; Speech Pathology Department, Gold Coast University Hospital, Gold Coast Hospital and Health Service, Queensland Health, 4215, Australia
| | - Libby Swanepoel
- School of Health, University of the Sunshine Coast, 4558, Australia; Australian Centre for Pacific Islands Research, School of Health, University of the Sunshine Coast, Queensland, 4558, Australia
| | - Michèle Verdonck
- School of Health, University of the Sunshine Coast, 4558, Australia
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Hasbani EC, Félix PV, Sauan PK, Maximino P, Machado RHV, Ferrari G, Fisberg M. How parents' feeding styles, attitudes, and multifactorial aspects are associated with feeding difficulties in children. BMC Pediatr 2023; 23:543. [PMID: 37898797 PMCID: PMC10612164 DOI: 10.1186/s12887-023-04369-4] [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: 05/09/2023] [Accepted: 10/15/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Parental complaints about feeding difficulties (FD) during childhood are frequent in pediatrics. Behavioral factors about children's feeding and parental aspects are fundamental in solving these problems, but research in this area lacks information considering the joint presence of fathers and mothers. Thus, this study aimed to investigate the features of children, parents and mealtime practices related to FD reported by fathers and mothers and to identify parenting styles, mealtime actions, practices and factors associated with FD in children. METHODS 323 parents (226 mothers and 97 fathers) of children aged 1 to 7 years were recruited in the emergency waiting room at Sabará Hospital Infantil, in São Paulo, Brazil, and self-completed electronic questionnaires on parenting style (Caregiver's Feeding Styles Questionnaire), parents' mealtime actions (Parent Mealtime Action Scale), socioeconomic information, personal and children's health data and routine meal practices. RESULTS The prevalence of FD in children was 26.6%. Indulgent parenting style was the most frequent (44.2%), followed by authoritarian (25.1%), authoritative (23.8%), and uninvolved (6.9%) styles. Most parents (75.8%) reported presence during meals, and 83.6% used distractions. Regression analyses after adjustments showed, as factors associated with FD, female children (OR: 2.06; 95%CI: 1.19-3.58), parents' FD history (OR: 3.16; 95%CI: 1.77-5.64), and greater frequency of parents' behavior of offering many food options (OR: 2.69; 95%CI: 1.18-6.14). Parents with indulgent styles had decreased chances of reporting FD in their children (OR: 0.13; 95%CI: 0.06-0.27). Furthermore, the practice of children sharing the family menu (OR: 0.43; 95%CI: 0.18-0.99) and higher frequency of parents' behavior of setting snack limits (OR: 0.44; 95%CI: 0.23-0.85) were inversely associated with FD. CONCLUSIONS This study reinforces the multifactorial aspects involved in the feeding difficulties context. It points out the importance of expanding knowledge of the individual role of fathers and mothers to compose a scenario that can guide future studies and interventions. TRIAL REGISTRATION CAAE #99221318.1.0000.5567 with registration number 2,961,598.
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Affiliation(s)
- Evelin Czarny Hasbani
- Sciences Applied to Pediatrics Postgraduate Program, Federal University of São Paulo, Rua Botucatu, 598, Vila Clementino, São Paulo, 04023-062, SP, Brazil.
| | - Paula Victória Félix
- School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, São Paulo, 01246-904, SP, Brazil
| | - Patricia Kawai Sauan
- Consulting and Training, Rua José Maria Lisboa, 586, São Paulo, 01423-000, SP, Brazil
| | - Priscila Maximino
- CENDA (Excellency Center for Nutrition and Feeding Difficulties), Instituto PENSI-Jose Luiz E. Setubal Foundation, Av Angelica 2071, CEP 01227-200, São Paulo, Brazil
| | | | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia, Chile
| | - Mauro Fisberg
- Sciences Applied to Pediatrics Postgraduate Program, Federal University of São Paulo, Rua Botucatu, 598, Vila Clementino, São Paulo, 04023-062, SP, Brazil
- CENDA (Excellency Center for Nutrition and Feeding Difficulties), Instituto PENSI-Jose Luiz E. Setubal Foundation, Av Angelica 2071, CEP 01227-200, São Paulo, Brazil
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Acolatse L, Pourshahidi LK, Logue C, McCann MT, Kerr MA. Child food portion sizes in the home environment: how do parents decide? Proc Nutr Soc 2023; 82:386-393. [PMID: 36866645 DOI: 10.1017/s0029665123000071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The consumption of larger portion sizes (PS) of food has been implicated in the increased prevalence of childhood obesity. The home is usually the first place children learn about food, however, little is known about how parents determine child PS in the home environment. This narrative review aimed to explore parental beliefs, decisions, strategies and barriers to the provision of appropriate food PS for children in the home environment. Results indicate that parental decisions on child food PS are based on the amounts they serve themselves, personal intuition and knowledge of child appetite. Owing to the habitual nature of food provision, parental decisions on child PS may be taken without conscious thought and/or could be part of a complex decision-making process influenced by several interlinked factors, including parental childhood mealtime experiences, other family members and child weight status. Strategies to determine child-appropriate PS include modelling the desired PS behaviour, use of unit-based food packaging and PS estimation aids, and providing the child with a degree of autonomy to rely on their own appetite cues. A lack of knowledge/awareness of PS guidance is a key barrier identified by parents to the provision of age-appropriate PS, warranting the inclusion of salient child-appropriate PS guidance within national dietary recommendations. Further home-based interventions to improve the provision of appropriate child PS are required, leveraged on parental strategies already in use, as outlined in this review.
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Affiliation(s)
- Lena Acolatse
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - L Kirsty Pourshahidi
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Caomhan Logue
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Mary T McCann
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Maeve A Kerr
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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Wiggins S. How infant food likes become established as knowledge: Parental food assessments during infant mealtimes in the home. Appetite 2023; 184:106489. [PMID: 36792035 DOI: 10.1016/j.appet.2023.106489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/18/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023]
Abstract
Early infancy is a critical period for the development of food likes and dislikes, but very little is known about the role of the social context and parent-child interaction within this process, and even less about what happens in the home environment. The current paper addresses this issue by examining how and when parents utter food assessments about their infants' eating practices during mealtimes in the home, and the practices through which infant likes become established as knowledge. A data corpus of 77 video-recorded infant mealtimes from six infants (aged 5-9 months) and their parents was analysed using discursive psychology, with a specific focus on the use of object-side and subject-side assessments. Data were recorded in English-speaking family homes in Scotland and Sweden. The analysis highlights three key findings: (1) infants' interactional rights to assess food are invoked during first tastes, (2) infants' food likes are established through anchoring in family food preferences and as shared knowledge among family members, and (3) infants' potential food dislikes are challenged by parents using object-side assessments and claims about previous likes. Parents thus play a crucial role in the establishment of infant food likes through the formulation of subject-side category assessments during early infant mealtimes. The research suggests that more focus should be placed on examining infant eating practices as collaborative and interactional events in everyday contexts.
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Affiliation(s)
- Sally Wiggins
- Dept of Behavioural Sciences and Learning, Linköping University, Campus Valla, Linköping, 58 183, Sweden.
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6
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Costa A, Oliveira A. Parental Feeding Practices and Children's Eating Behaviours: An Overview of Their Complex Relationship. Healthcare (Basel) 2023; 11:healthcare11030400. [PMID: 36766975 PMCID: PMC9914567 DOI: 10.3390/healthcare11030400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
Several studies have found an association between eating behaviours and weight status and obesity risk in childhood. Children's eating behaviours arise from a combination of genetic and environmental factors. Parents appear to play a central role in their development as the main responsible for shaping children's feeding environment and eating experiences. The purpose of this paper is to review the literature on parental influences on eating behaviours across childhood, mainly focusing on parental feeding practices. The associations between parental feeding practices and children's eating behaviours have been extensively studied. However, most of the findings come from cross-sectional studies, so the possibility of reverse causality cannot be ruled out (i.e., children's behaviours influencing parents). Most recently, a few longitudinal studies with a cross-lagged design have shown that the relationship between children's eating behaviours and parental feeding practices seems to be bidirectional, where it is not straightforward whether parental feeding practices are a predictor or a consequence of children's eating behaviours. Children's eating behaviours influence parents to adopt certain feeding practices, but these practices also influence children's behaviours over time. Parental feeding practices may have the potential to shape children's eating behaviours and should be targeted to promote the development of non-obesogenic traits. However, parent-child interactions are complex and therefore both parent and child characteristics and the family dynamics should be considered.
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Affiliation(s)
- Alexandra Costa
- EPIUnit—Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Correspondence:
| | - Andreia Oliveira
- EPIUnit—Instituto de Saúde Pública da Universidade do Porto, 4050-600 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, 4050-600 Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal
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7
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Food Fussiness in Children. TOP CLIN NUTR 2023. [DOI: 10.1097/tin.0000000000000301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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8
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Di Nucci A, Scognamiglio U, Grant F, Rossi L. The impact of COVID-19 pandemic on food habits and neophobia in children in the framework of the family context and parents' behaviors: A study in an Italian central region. Front Nutr 2022; 9:1070388. [PMID: 36570161 PMCID: PMC9772991 DOI: 10.3389/fnut.2022.1070388] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022] Open
Abstract
Objective This paper aims to evaluate whether changes in lifestyle and eating habits resulting from the Covid-19 emergency have influenced the post-pandemic level of food neophobia and in children living in an Italian central region. Methods A sample of 99 children took part in a retrospective assessment carried out with a self-administrated questionnaire. Pre and post-pandemic evaluation of eating habits, physical activity, and lifestyle indicators was carried out. Food neophobia was evaluated following the Child Food Neophobia Scale (CFNS). Descriptive statistics were produced. A contingency analysis was performed to check associations between variables. Results For a large part of the sample (97%) the selective food refusal did not change during the pandemic period. About 70% of participants did not change their eating habits, with some subgroups reporting an increase in the consumption of fruits (22.2%), vegetables (19.2%), and legumes (21.2%). Relevantly the impact of the pandemic on the sedentary attitude passed from 25.3 to 70.7%. Neophobia was not associated with ponderal status (p-value 0.5). However, in normal-weight children, a high prevalence of intermediate-level neophobia (78.4%) was found. 39.4% of the studied children were involved in meal preparation during social isolation, with an increase in the proportion of children that shared all meals with their family (32.3% vs. 78.8%). Non-coercive parent behaviors in reaction to food refusal were associated with low levels of neophobia (p-value < 0.05). Discussion In this sample, for the effect of parents' attitudes, the pandemic positively affected children's food habits and, consequently, the level of neophobia after the social restrictions. The main implication of the study is the importance of capitalizing on the period of restrictions in order to involve children in meal sharing and food preparation.
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9
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Jansen E, Smith K, Thapaliya G, Sadler J, Aghababian A, Carnell S. Associations of mothers' and fathers' structure-related food parenting practices and child food approach eating behaviors during the COVID pandemic. Physiol Behav 2022; 252:113837. [PMID: 35513084 PMCID: PMC9059343 DOI: 10.1016/j.physbeh.2022.113837] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/19/2022] [Accepted: 04/30/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, many mothers and fathers have spent more time at home with their children, warranting consideration of parenting practices around food during the pandemic as influences on obesogenic eating behaviors among children. Structure-related feeding practices, particularly around snacking, may be particularly challenging yet influential in the pandemic setting. Parent sex and levels of feeding-related co-operation among parents (co-feeding) are understudied potential influences on parent-child feeding relationships. METHODS We investigated relationships between structure-related parent feeding and child food approach behaviors during the COVID-19 pandemic, while considering potential moderating influences of parent sex and co-feeding levels. An online survey was completed by 318 parents (206 mothers and 112 fathers) of 2-12-year-olds who were living in states with statewide or regional lockdowns in May/June 2020 within the US. Mothers and fathers were drawn from different families, with each survey corresponding to a unique parent-child dyad. Parental stress/mental health, co-feeding (Feeding Coparenting Scale), structure-related food and snack parenting (Feeding Practices and Structure Questionnaire and Parenting around SNAcking Questionnaire), and child eating behaviors (Child Eating Behaviour Questionnaire) were assessed. Relationships of parents' structure-related food and snack parenting practices with their child's emotional overeating and food responsiveness behaviors were examined using structural equation modelling. Further, we investigated whether these relations were moderated by parent sex or level of co-feeding. RESULTS Parent sex differences were seen in parental stress, mental health, and co-feeding, but not in structure-related food and snack parenting or child food approach eating behaviors. Structure-related food parenting was negatively associated with emotional overeating. However, structure-related snack parenting was positively associated with emotional overeating and food responsiveness. While regression paths varied between mothers vs. fathers, as well as by co-feeding levels, neither parent sex nor co-feeding levels significantly moderated relationships between parent feeding and child eating variables. CONCLUSIONS Future studies of food and snack parenting and co-operation in relation to feeding among mothers and fathers within a familial unit may be critical to identify intervention strategies that draw on all family resources to better navigate future disruptive events such as the COVID-19 pandemic.
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Affiliation(s)
- Elena Jansen
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA.
| | - Kimberly Smith
- Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Gita Thapaliya
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Jennifer Sadler
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Anahys Aghababian
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
| | - Susan Carnell
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD, USA
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Ju S, Iwinski S, Fiese BH, McBride BA, Bost KK. Infant temperament and mealtime distractions as predictors of preschool Children's bite speed during family mealtime. Appetite 2022; 177:106157. [PMID: 35780936 DOI: 10.1016/j.appet.2022.106157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022]
Abstract
Eating behaviors are shaped at an early age, persist into adulthood, and are implicated in the development of physical health outcomes, including obesity. Faster bite speed has been identified as an obesogenic eating behavior, prompting researchers to examine child and family factors associated with children's variability in bite speed. Child temperament, involving phenotypes of reactivity and regulation, and distractions in family food contexts are fruitful areas of investigation, but few studies have examined the interplay among these factors and their associations with bite speed. To address the gap in the literature, we examined relations between early child temperament, family mealtime distractions, and children's observed bite speed. Caregiver report of child temperament at 3 months was measured using the Infant Behavior Questionnaire Very Short Form - Revised. Child mealtime distractions and bite speed were assessed using family mealtime videos that were collected during home visits when children were 18-24 months of age (n = 109). Results revealed that children who were reported to be higher on orienting/regulation at 3 months, and who were more distracted during mealtimes at 18-24 months, had relatively slower bite speeds. No significant interactions were found. The findings from this correlational study inform further investigations into the implications of early temperament and food contexts for the development of eating behaviors implicated in obesity risk.
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Affiliation(s)
- Sehyun Ju
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA.
| | - Samantha Iwinski
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA.
| | - Barbara H Fiese
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA; Family Resiliency Center, University of Illinois, Urbana, IL, USA.
| | - Brent A McBride
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA; Family Resiliency Center, University of Illinois, Urbana, IL, USA; Child Development Laboratory, University of Illinois, Urbana, IL, USA; Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA.
| | - Kelly K Bost
- Department of Human Development and Family Studies, University of Illinois, Urbana, IL, USA; Family Resiliency Center, University of Illinois, Urbana, IL, USA.
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11
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Teekavanich S, Rukprayoon H, Sutchritpongsa S, Rojmahamongkol P. Electronic media use and food intake in Thai toddlers. Appetite 2022; 176:106121. [PMID: 35671917 DOI: 10.1016/j.appet.2022.106121] [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: 03/05/2022] [Revised: 05/23/2022] [Accepted: 06/01/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVES Viewing electronic media at mealtime is a common coping strategy for feeding difficulties, but its impact on food consumption is not known. We studied the prevalence of electronic media use at mealtime, its association with food intake, and associated factors. METHODS 138 healthy 18- to 30-month-old children were classified according to the presence of feeding difficulties using the Thai language version of the Montreal Children's Hospital Feeding Scale. Electronic media use and 3-day food intake history were collected. Each child's mean energy intake and time spent eating were compared between meals consumed with and without electronic media. RESULTS 58% of children watched electronic media while eating. Children with feeding difficulties ingested significantly more energy per meal when they watched media (184.0 ± 104.0 vs 152.7 ± 67.0, p = 0.04). Children without feeding difficulties spent significantly more minutes per meal when watching media (29.9 ± 10.1 vs 26.2 ± 7.6, p = 0.001). Longer total daily screen time (p < 0.001) and presence of feeding difficulties (p = 0.006) were associated with regular media use. Children who regularly used media at mealtime were significantly more likely to have a BMI-for-age z score classification as obese (16.7% VS 0.9%, p < 0.001). CONCLUSION Media use during feeding is associated with greater energy intake and longer meal duration. Thai children who regularly use media at mealtime were significantly more likely to be obese. Children with longer total daily screen time, and those with feeding difficulties are more likely to regularly use media at mealtime.
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Affiliation(s)
- Sineenat Teekavanich
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Hathaichanok Rukprayoon
- Division of Nutrition, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Sureelak Sutchritpongsa
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Pat Rojmahamongkol
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.
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12
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Warkentin S, Severo M, Fildes A, Oliveira A. Genetic and environmental contributions to variations on appetitive traits at 10 years of age: a twin study within the Generation XXI birth cohort. Eat Weight Disord 2022; 27:1799-1807. [PMID: 34741756 PMCID: PMC9123061 DOI: 10.1007/s40519-021-01322-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/13/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Given the variability in adiposity despite ubiquitous exposure to obesogenic food environments, it has been suggested that individuals respond in divergent ways to the environment they live in. The food environment becomes more 'permissive' as children age; therefore, genetic predisposition for a more avid appetite can be better expressed, influencing dietary quality, energy intake and weight gain. Our aim was to explore the genetic and environmental contribution of variations on appetitive traits in a sample of 10-year-old Portuguese children. METHODS Participants were twins enrolled in the Generation XXI birth cohort (n = 86 pairs). Parents reported twin's zygosity and child appetitive traits at 10 years of age through the Children's Eating Behavior Questionnaire. Intra-class correlations (ICCs) for all appetitive traits were calculated for monozygotic and dizygotic twins separately to examine patterns of resemblance, and structural equation modeling was conducted aiming to estimate the genetic (A), shared (C) and non-shared (E) environmental variances. RESULTS Moderate to strong heritability were found for child appetitive traits, with higher ICCs among monozygotic twin pairs. For all appetitive traits, with the exception of emotional undereating, genetic and non-shared environmental effects contributed to appetite variability. For emotional undereating, environmental effects seem to be more important than genetic effects (C: 0.81; 95% CI 0.71; 0.88 and E: 0.19; 95% CI 0.12; 0.29). CONCLUSION There was a significant genetic contribution, followed by non-shared environmental contribution, towards variation in appetitive traits in school-age children. Variation in emotional undereating was primarily explained by shared and non-shared environmental factors. LEVEL OF EVIDENCE Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Sarah Warkentin
- EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal.
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Milton Severo
- EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, England
| | - Andreia Oliveira
- EPIUnit, Institute of Public Health, University of Porto, Rua das Taipas, 135-139, 4050-600, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
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13
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Chawner LR, Blundell-Birtill P, Hetherington MM. An online study examining children's selection of vegetables at mealtimes: The role of meal contexts, variety and liking. Appetite 2021; 169:105803. [PMID: 34774967 DOI: 10.1016/j.appet.2021.105803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/25/2021] [Accepted: 11/09/2021] [Indexed: 01/02/2023]
Abstract
Associative learning predicts that children expect to eat vegetables together with foods high in carbohydrate and protein at mealtimes. However, choosing to eat and consume vegetables may be less likely if they are presented alongside more palatable, competing foods. This study examined food choices of children (N = 180, 8-11 years, 84 female) in a mealtime context. During an online task, children chose one food for a meal, from a choice of vegetables and either a food high in carbohydrate or protein. Preference was assessed with and without a partial meal stimulus, to test the effect of other foods on the plate. Vegetables were selected more often with a meal stimulus, especially when it consisted of carbohydrate and protein foods, meaning that the vegetable option added nutritional variety to the meal. This effect was moderated by the difference in liking between the food options available. Vegetables were selected more if they were better liked than the competing food option, although it was not necessary that vegetables were better liked if they added nutritional variety to the meal. Food fussy children were less likely to select vegetables, but no other effects of child appetitive traits or parental practices were found on children's food choices. Children may be more likely to select vegetables if they add nutritional variety to a meal and are similarly or better liked than competing food options. Future research could test specific meal configurations which promote children's selection and intake of vegetables at mealtimes.
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Affiliation(s)
- L R Chawner
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK.
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14
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Chilman L, Kennedy-Behr A, Frakking T, Swanepoel L, Verdonck M. Picky Eating in Children: A Scoping Review to Examine Its Intrinsic and Extrinsic Features and How They Relate to Identification. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9067. [PMID: 34501656 PMCID: PMC8431657 DOI: 10.3390/ijerph18179067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 11/16/2022]
Abstract
The health benefits and importance of family mealtimes have been extensively documented. Picky eating can impact this complex activity and has numerous extrinsic (or external) and intrinsic (or internal) features. Occupational therapists work with children and their families by looking at both intrinsic and extrinsic influences and are therefore well-placed to work within this context. This scoping review comprises a comprehensive search of key health industry databases using pre-determined search terms. A robust screening process took place using the authors pre-agreed inclusion and exclusion criteria. There were 80 studies that met the inclusion criteria, which were then mapped using content analysis. The most common assessments used to identify picky eating relied on parental reports and recall. Often additional assessments were included in studies to identify both the intrinsic and extrinsic features and presentation. The most common reported intrinsic features of the child who is a picky eater included increased sensitivity particularly to taste and smell and the child's personality. Extrinsic features which appear to increase the likelihood of picky eating are authoritarian parenting, rewards for eating, and pressuring the child to eat. Most commonly reported extrinsic features that decrease the likelihood of picky eating are family meals, responsive parents, and involving the child in the preparation of food. In conclusion, there is a lack of published papers addressing the role of occupational therapists in the assessment and identification of picky eating in children. There appears to be a complex interplay between intrinsic and extrinsic features which impact caregiver responses and therefore on the picky eater.
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Affiliation(s)
- Laine Chilman
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Locked Bag 4 Maroochydore, Maroochydore DC, Sunshine Coast, QLD 4558, Australia ; (A.K.-B.); (L.S.); (M.V.)
| | - Ann Kennedy-Behr
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Locked Bag 4 Maroochydore, Maroochydore DC, Sunshine Coast, QLD 4558, Australia ; (A.K.-B.); (L.S.); (M.V.)
- School of Allied Health & Human Performance, University of South Australia, Adelaide, SA 5000, Australia
| | - Thuy Frakking
- Research Development Unit, Caboolture Hospital, Metro North Hospital & Health Service, Herston, QLD 4510, Australia;
- Centre for Clinical Research, School of Medicine, The University of Queensland, Herston, QLD 4029, Australia
| | - Libby Swanepoel
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Locked Bag 4 Maroochydore, Maroochydore DC, Sunshine Coast, QLD 4558, Australia ; (A.K.-B.); (L.S.); (M.V.)
| | - Michele Verdonck
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Locked Bag 4 Maroochydore, Maroochydore DC, Sunshine Coast, QLD 4558, Australia ; (A.K.-B.); (L.S.); (M.V.)
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15
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Screen Time Parenting Practices and Associations with Preschool Children's TV Viewing and Weight-Related Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147359. [PMID: 34299807 PMCID: PMC8303526 DOI: 10.3390/ijerph18147359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/30/2021] [Accepted: 07/03/2021] [Indexed: 12/25/2022]
Abstract
The purpose of this study was to examine associations between screen time (ST) parenting practices and 2–5-year-old children’s TV viewing and weight status. Data were collected from 252 parent–child dyads enrolled in a randomized parent-focused childhood obesity prevention trial from 2009–2012. ST parenting practices were assessed at baseline using a validated parent-reported survey. Parent-reported child TV viewing and objectively measured anthropometrics were assessed at baseline, post-intervention (35 weeks), and follow-up (59 weeks). Marginal effect models were developed to test the association between baseline ST parenting practices and children’s TV viewing, BMI z-score, and waist circumference across all time points. Limiting/monitoring ST was associated with decreased weekly TV viewing (β = −1.79, 95% CI: −2.61; −0.95), while exposure to TV was associated with more weekly TV viewing over 59 weeks (β = 1.23, 95% CI: 0.71; 1.75). Greater parent use of ST as a reward was associated with increased child BMI z-score (β = 0.15, 95% CI: 0.03; 0.27), while limiting/monitoring ST was associated with decreased BMI z-score (β = −0.16, 95% CI: −0.30; −0.01) and smaller waist circumference (β = −0.55, 95% CI: −1.04; −0.06) over the study period. These findings suggest that modifying parent ST practices may be an important strategy to reduce ST and promote healthy weight in young children.
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Zhang L, Zhang Y, Qiu L, Yang G, Jiang H, Zheng M, Wang J. Parental feeding knowledge, practices and Chinese children and adolescents’ weight status. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1919112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Li Zhang
- Sociology, China University of Political Science and Law, Beijing, China
| | - Yaorong Zhang
- Social Work, China University of Political Science and Law, Beijing, China
| | - Liya Qiu
- Sociology, Peking University, Beijing, China
| | | | - Haiyan Jiang
- Sociology, China University of Political Science and Law, Beijing, China
- Social Work, China University of Political Science and Law, Beijing, China
| | - Mengyi Zheng
- Sociology, China University of Political Science and Law, Beijing, China
- Social Work, China University of Political Science and Law, Beijing, China
| | - Jie Wang
- Sociology, School of Law, Anhui Normal University, Anhui, China
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Sdravou K, Emmanouilidou-Fotoulaki E, Printza A, Andreoulakis E, Beropouli S, Makris G, Fotoulaki M. Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases. Healthcare (Basel) 2021; 9:healthcare9060741. [PMID: 34204179 PMCID: PMC8234215 DOI: 10.3390/healthcare9060741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/26/2022] Open
Abstract
Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
- Correspondence:
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
| | - Athanasia Printza
- 1st Otolaryngology Department, School of Medicine, University Hospital AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece;
| | - Elias Andreoulakis
- Hellenic Centre for Mental Health and Research, Department of Thessaloniki, Adult Psychiatric Unit, 36 Kaftatzoglou Str, 55337 Thessaloniki, Greece;
| | - Stavroula Beropouli
- Department of Pediatrics, General Hospital of Kozani (Mamatseio), 1 K. Mamatsiou, 50100 Kozani, Greece;
| | - Giorgos Makris
- Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 2400 Kalamata, Greece;
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (M.F.)
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18
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Thompson DA, Bekelman TA, Ferrante MJ, McCloskey ML, Johnson SL, Bellows LL. Picture Perfect: How Attaining the Ideal Meal is Not So Easy for Parents of Young Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:290-298. [PMID: 33558158 DOI: 10.1016/j.jneb.2021.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/23/2020] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore parental perspectives on the ideals and realities of family mealtimes. DESIGN Mini-focus groups (n = 7). SETTING Rural Colorado, US. PARTICIPANTS Parents (n = 30) were recruited at Head Start/preschool centers. PHENOMENON OF INTEREST Parent perspectives on mealtimes with preschool-aged children. ANALYSIS Transcripts were analyzed using thematic analysis. RESULTS Three categories of themes emerged: participant conceptions of ideal family meals, challenges to achieving their ideal family meal, and parental solutions. The theme of participant conceptions of ideal family meals composed family togetherness, children liking and eating the prepared food, healthfulness of food, and a nonchaotic mealtime. Challenges to achieving their ideal family meal included work schedules, disruptive child behaviors, child pickiness, snacking, and negative role-modeling. Finally, parental solutions to challenges incorporated having flexible meal timings, considering child preferences in premeal preparations, role-modeling, and numerous other parenting strategies. CONCLUSIONS AND IMPLICATIONS While parents valued many aspects of a version of the ideal meal rooted in historical standards, families faced many challenges in trying to attain that ideal. Although parents employed various strategies to combat mealtime challenges, parental expectations for preschool-aged children's mealtime behaviors may be unrealistic for the developmental stage of early childhood. Future interventions could help parents develop age-appropriate mealtime expectations.
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Affiliation(s)
- Darcy A Thompson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Traci A Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Mackenzie J Ferrante
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Morgan L McCloskey
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
| | - Susan L Johnson
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Laura L Bellows
- Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO
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Sdravou K, Emmanouilidou-Fotoulaki E, Printza A, Andreoulakis E, Evangeliou A, Fotoulaki M. Mealtime Environment and Control of Food Intake in Healthy Children and in Children with Gastrointestinal Diseases. CHILDREN-BASEL 2021; 8:children8020077. [PMID: 33498758 PMCID: PMC7912501 DOI: 10.3390/children8020077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/14/2021] [Accepted: 01/20/2021] [Indexed: 12/15/2022]
Abstract
Parental feeding practices and mealtime routine significantly influence a child’s eating behavior. The aim of this study was to investigate the mealtime environment in healthy children and children with gastrointestinal diseases. We conducted a cross-sectional case–control study among 787 healthy, typically developing children and 141 children with gastrointestinal diseases, aged two to seven years. Parents were asked to provide data on demographics and describe their mealtime environment by answering to 24 closed-ended questions. It was found that the majority of the children had the same number of meals every day and at the same hour. Parents of both groups exerted considerable control on the child’s food intake by deciding both when and what their child eats. Almost one third of the parents also decided how much their child eats. The two groups differed significantly in nine of the 24 questions. The study showed that both groups provided structured and consistent mealtime environments. However, a significant proportion of children did not control how much they eat which might impede their ability to self-regulate eating. The presence of a gastrointestinal disease was found to be associated with reduced child autonomy, hampered hunger cues and frequent use of distractions during meals.
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Affiliation(s)
- Katerina Sdravou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
- Correspondence:
| | - Elpida Emmanouilidou-Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
| | - Athanasia Printza
- 1st E.N.T. Department, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Elias Andreoulakis
- Hellenic Centre for Mental Health and Research, Adult Psychiatric Unit, Department of Thessaloniki, 55337 Thessaloniki, Greece;
| | - Athanasios Evangeliou
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
| | - Maria Fotoulaki
- 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; (E.E.-F.); (A.E.); (M.F.)
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20
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An M, Zhou Q, Younger KM, Liu X, Kearney JM. Are Maternal Feeding Practices and Mealtime Emotions Associated with Toddlers' Food Neophobia? A Follow-Up to the DIT-Coombe Hospital Birth Cohort in Ireland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228401. [PMID: 33202792 PMCID: PMC7696543 DOI: 10.3390/ijerph17228401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/06/2020] [Accepted: 11/11/2020] [Indexed: 11/23/2022]
Abstract
This study was conducted to explore the associations between maternal feeding practices, mealtime emotions, as well as maternal food neophobia and toddlers’ food neophobia in Ireland. A follow-up to the Technological University Dublin (DIT)-Coombe Hospital birth cohort was conducted. Mothers in the original cohort were invited to the present study by telephone calls. Postal questionnaires with stamped addressed envelopes were distributed to those who agreed to participate in the study. Toddler food neophobia was assessed by the modified version of the Child Food Neophobia Scale (CFNS). There were 205 participants included in this study, with a median score of child food neophobia of 12. A higher degree of child food neophobia (score > 12) was positively associated with the maternal practice of coaxing the children to eat at refusal (OR (Odds Ratio) = 2.279, 95% CI: 1.048–4.955), unpleasant emotions at mealtime (e.g., stressful or hectic for mothers, or tearful for children) (OR ranged between 1.618 and 1.952), and mothers’ own degree of food neophobia (OR = 1.036, 95% CI: 1.001–1.072). Mothers who were not worried when confronted with child’s food refusal was negatively associated with toddlers’ food neophobia (OR = 0.251, 95% CI: 0.114–0.556). This study suggests the maternal practices of responsive feeding, being calm and patient with the toddlers, and creating a positive atmosphere at mealtime.
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Affiliation(s)
- Meijing An
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (M.A.); (X.L.)
| | - Qianling Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (M.A.); (X.L.)
- Correspondence: ; Tel.: +86-010-82801222-105
| | - Katherine M. Younger
- School of Biological Sciences, Technological University Dublin, Kevin Street Dublin 8, D08 X622 Dublin, Ireland; (K.M.Y.); (J.M.K.)
| | - Xiyao Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; (M.A.); (X.L.)
| | - John M. Kearney
- School of Biological Sciences, Technological University Dublin, Kevin Street Dublin 8, D08 X622 Dublin, Ireland; (K.M.Y.); (J.M.K.)
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Bassul C, A. Corish C, M. Kearney J. Associations between the Home Environment, Feeding Practices and Children's Intakes of Fruit, Vegetables and Confectionary/Sugar-Sweetened Beverages. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134837. [PMID: 32635599 PMCID: PMC7370037 DOI: 10.3390/ijerph17134837] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/20/2022]
Abstract
Within the home environment, parents influence their children’s dietary intakes through their parenting and dietary practices, and the foods they make available/accessible. The aim of this cross-sectional study was to examine the associations between home environmental characteristics and children’s dietary intakes. Three hundred and thirty-two children aged three–five years and their parents participated in the study. Home environmental characteristics, including parental control feeding practices, were explored using validated and standardized questionnaires such as the Child Feeding Questionnaire (CFQ), the Physical and Nutritional Home Environment Inventory (PNHEI) and the Healthy Home Survey (HHS). Parent and child food consumption was also measured. Pressure to eat from parents was associated with lower fruit intake in children (OR 0.67, 95% CI 0.47–0.96, p = 0.032). Greater variety of fruit available in the home increased the likelihood of fruit consumption in children (OR 1.35 95% CI 1.09–1.68, p = 0.005). Watching television for ≥1 h per day was associated with a decreased probability of children eating vegetables daily (OR 0.38, 95% CI 0.20–0.72, p = 0.003) and doubled their likelihood of consuming confectionary/sugar-sweetened beverages more than once weekly (OR 2.15, 95% CI 1.06–4.38, p = 0.034). Children whose parents had lower vegetable consumption were 59% less likely to eat vegetables daily. This study demonstrates that modifiable home environmental characteristics are significantly associated with children’s dietary intakes.
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Affiliation(s)
- Carolina Bassul
- School of Biological and Health Sciences, Technological University Dublin, City Campus, Kevin Street, Dublin 8, Ireland
- Correspondence: (C.B.); (J.M.K.); Tel.: +353-(0)-1-402-2837 (C.B.); +353-(0)-1-402-2837 (J.M.K.)
| | - Clare A. Corish
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland;
| | - John M. Kearney
- School of Biological and Health Sciences, Technological University Dublin, City Campus, Kevin Street, Dublin 8, Ireland
- Correspondence: (C.B.); (J.M.K.); Tel.: +353-(0)-1-402-2837 (C.B.); +353-(0)-1-402-2837 (J.M.K.)
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A cultural adaptation and validation of a child eating behaviour measure in a low- and middle-income country. Public Health Nutr 2020; 23:1931-1938. [PMID: 32383413 DOI: 10.1017/s136898001900510x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The Child Eating Behaviour Questionnaire (CEBQ), a widely used instrument that has been validated mostly in high-income countries, has limitations in its factorial validity when used among different cultures. This study examines whether the CEBQ instrument is culturally appropriate and valid to be used in a low- and middle-income country (LMIC) in a setting where child undernutrition remains prevalent. DESIGN The study employed a qualitative process to validate the content of items relative to the culture and setting, which was followed by a survey to test the psychometric properties of the instrument. Tests of factorial validity, convergent validity and reliability were performed. SETTING Three different socio-economic settings of Yogyakarta, Indonesia. PARTICIPANTS The participants of this study were mothers of children aged 25-60 months. In-depth interviews were conducted with twenty-four mothers and the questionnaire validation process involved 238 mothers in the survey. RESULTS A Confirmatory Factor Analysis model with eight subscales provided the best fit (root-mean-square error of approximation = 0·048 (90 % CI 0·040, 0·057); Comparative Fit Index = 0·95 and Tucker Lewis Index = 0·95) after three new items and eight items from the original CEBQ were removed. Convergent validity with child's weight was found for two subscales, slowness in eating and satiety responsiveness. Reliability measured using Cronbach's alpha provided values between 0·62 and 0·78. CONCLUSION The original eight-factor structure of the CEBQ showed adequate content validity and provided factorial, discriminant and convergent validity with mothers of preschool children living in a LMIC where child nutrition remains a significant public health issue.
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Wedde S, Haines J, Ma D, Duncan A, Darlington G. Associations between Family Meal Context and Diet Quality among Preschool-Aged Children in the Guelph Family Health Study. CAN J DIET PRACT RES 2020; 81:21-27. [PMID: 31512491 DOI: 10.3148/cjdpr-2019-022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To explore the associations between family meal context and overall diet quality of Canadian preschool-aged children. Methods: Cross-sectional analysis of 95 preschool-aged children from 72 families. Measures about health behaviours and the family meal environment were drawn from selected questionnaire items. Three-day food records for children were assessed using the Healthy Eating Index 2010 (HEI-2010). Linear regression was used to explore the associations between the family meal variables and children's HEI-2010 scores. Results: In analyses adjusted for child age, sex, and household income, child involvement in meal preparation (β = 4.34; 95% CI: 0.56-8.12) and time spent preparing the evening meal (β = 3.77; 95% CI: 0.42-7.12) were associated with higher HEI-2010 scores. Serving fast food (β = -2.90; 95% CI: -4.79 to -1.02) and using screen-based devices during meals (β = -3.80; 95% CI: -7.38 to -0.21) were associated with lower HEI-2010 scores. Family meal frequency and serving prepared foods, sugar-sweetened beverages, and vegetables at meals were not significantly associated with preschoolers' diet quality. Conclusions: The context in which family meals take place influences child diet quality. Taking the time to include children in family meal preparation may benefit children's dietary intake.
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Affiliation(s)
- Sarah Wedde
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON
| | - David Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Alison Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON
| | - Gerarda Darlington
- Department of Mathematics and Statistics, University of Guelph, Guelph, ON
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A comparison of maternal feeding responses to child fussy eating in low-income food secure and food insecure households. Appetite 2019; 137:259-266. [PMID: 30858067 DOI: 10.1016/j.appet.2019.03.005] [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: 11/12/2018] [Revised: 02/12/2019] [Accepted: 03/02/2019] [Indexed: 11/23/2022]
Abstract
Children learn to like a wide variety of healthy foods through exposure in their early feeding environment. While some children may reject foods during this learning process, parents may perceive persistent refusal as 'fussy' or 'picky' eating. Low-income parents may provide fussy children with a narrow range of foods that they will like and accept to avoid food and economic waste; inadvertently limiting children's exposure to a variety of healthy foods. This 'risk aversion' to food rejection may be particularly salient in food insecure households where resources are further constrained. We aimed to examine if food insecurity modifies the relationship between child fussy eating and parents' food provision and feeding with respect to exposure to a variety of healthy foods. Australian mothers residing in a low-income community (N = 260) completed a cross-sectional survey on their preschool-aged child's 'food fussiness', household food insecurity and food exposure practices. Food exposure practices included the home availability of fruit and vegetables, and children's tasting of a variety of fruit and vegetables (food provision); and whether parents prepared alternative meals for their child (feeding). Mothers reporting food insecurity (11%) were less likely to have fruit frequently available in the home compared to mothers reporting food security. Food insecurity moderated the relationship between fussy eating and food exposure practices insofar that food secure mothers were more likely to prepare alternative meals for fussier children. Family resources and child fussy eating behaviours are identified as important contextual factors in food provision and feeding. Findings from the current study suggest that health professionals, researchers and policymakers tailor interventions to consider both the needs of families and child eating characteristics.
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Cole NC, Musaad SM, Lee SY, Donovan SM. Home feeding environment and picky eating behavior in preschool-aged children: A prospective analysis. Eat Behav 2018; 30:76-82. [PMID: 29894927 DOI: 10.1016/j.eatbeh.2018.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 04/06/2018] [Accepted: 06/06/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Picky eating is prevalent in young children and is associated with poor dietary quality and nutrient deficiencies. Identifying predictors of picky eating could inform the development of anticipatory feeding guidance for parents and caregivers of young children. This study identified the association between factors of the home feeding environment with picky eating behavior in a cohort of preschool-aged children. METHODS Parents of preschool-aged children (n = 497) completed questionnaires including measures of the home feeding environment (i.e., television during mealtime, family mealtime routines, and feeding practices) and child picky eating behavior. The questionnaire was repeated one year later, in which 326 parent-child dyads participated. Logistic regression was used to determine the cross-sectional and prospective associations between home feeding environment measures and child picky eating behavior outcomes. RESULTS Child control over feeding and watching television during mealtime were associated with higher odds of picky eating behavior in both cross-sectional and prospective analyses. A higher sense of positive climate during family meals and mealtime ritualization was associated with lower odds of picky eating behavior one year later. CONCLUSION The home feeding environment plays a role in the development of young children's picky eating behavior. Avoiding the television and maintaining parent control of food choices during mealtimes could lead to improvements in children's food preferences and dietary intake.
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Affiliation(s)
- Natasha Chong Cole
- Division of Nutritional Sciences, University of Illinois, Urbana, IL 61801, USA.
| | - Salma M Musaad
- Family Resiliency Center, University of Illinois, Urbana, IL 61801, USA.
| | - Soo-Yeun Lee
- Division of Nutritional Sciences, University of Illinois, Urbana, IL 61801, USA; Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL 61801, USA.
| | - Sharon M Donovan
- Division of Nutritional Sciences, University of Illinois, Urbana, IL 61801, USA; Department of Food Science and Human Nutrition, University of Illinois, Urbana, IL 61801, USA.
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26
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Muesbeck J, St John BM, Kant S, Ausderau KK. Use of Props During Mealtime for Children With Autism Spectrum Disorders: Self-Regulation and Reinforcement. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2018; 38:254-260. [PMID: 29911486 DOI: 10.1177/1539449218778558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Mealtime is an important family routine commonly affected for families with children with autism spectrum disorders (ASD). Limited research is available regarding strategies families incorporate to support mealtime engagement. The purpose of this study was to explore the frequency and characterize the purpose of Props used during mealtimes with children with ASD. A total of 12 families with a child(ren), N = 14, aged 2 to 7 years, with ASD and mealtime challenges or eating difficulties participated in video-recorded mealtimes in their home. Independent coders analyzed mealtimes for the frequency and purpose of Props (items used to support child participation during mealtime). Props were used by 75% of families ( n = 9); common Props included toys, electronics, and books. Props were used primarily as a self-regulation tool for the child and occasionally as positive reinforcement for specific behaviors. Overall, Props were used to support child engagement in mealtime. Occupational therapists should consider using Props as individualized, accessible, and supportive mealtime interventions for families and children.
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Costa S, Pinto A, Santos AC, Oliveira A. The association of problematic eating behaviours with food quality and body mass index at 7 years of age. Eur J Clin Nutr 2018; 73:549-557. [PMID: 29748660 DOI: 10.1038/s41430-018-0169-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 03/27/2018] [Accepted: 03/29/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES There is scarce evidence of how certain eating behaviours compromise the compliance with dietary guidelines and weight status in school-aged children. This study aims to evaluate the association of children's problematic eating behaviours with food quality and body mass index at 7 years of age. SUBJECTS/METHODS Participants were children aged 7 years old from a population-based cohort study from Porto, Portugal-Generation XXI. Children's quantity and speed of ingestion, food refusal at the table and food rewards requesting were evaluated by caregiver's perception. Food consumption was evaluated by a food frequency questionnaire and compared with age-appropriate guidelines. Children's weight status was assessed by objective measurements and parent's perceptions. Associations were estimated by logistic regressions (odds ratio (OR), 95% confidence intervals (95% CI)) adjusted for maternal age, education, smoking during pregnancy, birth type, child's sex, weight-for-gestational age and sports (n = 3801). RESULTS Children eating small amounts of food, refusing to eat at the table with the rest of the family during meals and asking for food rewards showed a higher consumption of energy-dense foods (OR = 1.51; 95% CI:1.23-1.86; OR = 1.58; 95% CI:1.16-2.16; OR = 1.56; 95% CI:1.14-2.12) and presented higher odds of consuming fruit and vegetables below recommendations (OR = 1.41; 95% CI:1.22-1.64; OR = 1.20; 95% CI:1.00-1.45; OR = 1.28; 95% CI:1.05-1.55). Children displaying these eating behaviours were less likely to be overweight/obese, hence their parents were less likely to show concern with their weight. Including food quality as covariate in the final models with obesity status did not change the associations. CONCLUSIONS Problematic eating behaviours were associated with poorer food quality (more energy-dense foods and low fruit and vegetables), but food quality does not seem to explain the association with obesity status. Parents were less likely to be concerned about their child's weight if the child ate slowly or poorly, and accordingly the odds of them being overweight or obese were lower.
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Affiliation(s)
- Sara Costa
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Andreia Pinto
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Ana Cristina Santos
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal.,Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Andreia Oliveira
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal. .,Department of Public Health and Forensic Sciences, and Medical Education, Unit of Epidemiology, Faculty of Medicine, University of Porto, Porto, Portugal.
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28
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What’s the fuss about? Parent presentations of fussy eating to a parenting support helpline. Public Health Nutr 2018; 21:1520-1528. [DOI: 10.1017/s1368980017004049] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo characterise parent presentations of fussy eating and mealtime interactions at a point of crisis, through analyses of real-time recordings of calls to a parenting helpline.DesignQualitative analysis included an inductive thematic approach to examine clinical parent presentations of fussy eating and derive underlying themes relating to mealtime interactions.SettingCalls made to the Child Health Line regarding feeding concerns were recorded and transcribed verbatim.SubjectsFrom a corpus of 723 calls made during a 4-week period in 2009, twelve were from parents of children aged 6–48 months.ResultsParents of infants (≤12 months, n 6) presented feeding concerns as learning challenges in the process of transitioning from a milk-based to a solid-based diet, while parents of toddlers (13–48 months, n 6) presented emotional accounts of feeding as an intractable problem. Parents presented their child’s eating behaviour as a battle (conflict), in which their children’s agency over limited intake and variety of foods (child control) was constructed as ‘bad’ or ‘wrong’. Escalating parent anxiety (parent concern) had evoked parent non-responsive feeding practices or provision of foods the child preferred.ConclusionsReal-time descriptions of young children’s fussy eating at a time of crisis that initiated parents’ call for help have captured the highly charged emotional underpinnings of mealtime interactions associated with fussy eating. Importantly, they show the child’s emerging assertion of food autonomy can escalate parents’ emotional distress that, in the short term, initiates non-responsive feeding practices. The current study identifies the importance of educational and emotional support for parents across the period of introducing solids.
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Powell F, Farrow C, Meyer C, Haycraft E. The importance of mealtime structure for reducing child food fussiness. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27062194 DOI: 10.1111/mcn.12296] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 12/10/2015] [Accepted: 01/04/2016] [Indexed: 11/28/2022]
Abstract
The aim of this study was to explore how the structure of mealtimes within the family setting is related to children's fussy eating behaviours. Seventy-five mothers of children aged between 2 and 4 years were observed during a typical mealtime at home. The mealtimes were coded to rate mealtime structure and environment as well as the child's eating behaviours (food refusal, difficulty to feed, eating speed, positive and negative vocalisations). Mealtime structure emerged as an important factor which significantly distinguished children with higher compared with lower levels of food fussiness. Children whose mothers ate with their child and ate the same food as their child were observed to refuse fewer foods and were easier to feed compared with children whose mothers did not. During mealtimes where no distractors were used (e.g. no TV, magazines or toys), or where children were allowed some input into food choice and portioning, children were also observed to demonstrate fewer fussy eating behaviours. Findings of this study suggest that it may be important for parents to strike a balance between structured mealtimes, where the family eats together and distractions are minimal, alongside allowing children some autonomy in terms of food choice and intake.
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Affiliation(s)
- Faye Powell
- School of Health and Social Sciences, University of Bedfordshire, UK
| | - Claire Farrow
- School of Life and Health and Sciences, Aston University, UK
| | - Caroline Meyer
- Institute for Digital Healthcare, The University of Warwick, UK.,Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, UK
| | - Emma Haycraft
- School of Sport Exercise and Health Sciences, Loughborough University, UK
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