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Ayre SK, White MJ, Harris HA, Jansen E, Byrne RA. The feeding siblings questionnaire (FSQ): Development of a self-report tool for parents with children aged 2-5 years. Appetite 2024; 198:107363. [PMID: 38636669 DOI: 10.1016/j.appet.2024.107363] [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: 07/26/2023] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
Over the last decade, there have been repeated calls to expand the operationalisation of food parenting practices. The conceptualisation and measurement of these practices has been based primarily on research with parent-child dyads. One unexplored dimension of food parenting pertains to the evaluation of practices specific to feeding siblings. This study describes the development and validation of the Feeding Siblings Questionnaire (FSQ) - a tool designed to measure practices in which siblings are positioned as mediators in parents' attempts to prompt or persuade a child to eat. Item development was guided by a conceptual model derived from mixed-methods research and refined through expert reviews and cognitive interviews. These interviews were conducted in two phases, where parents responded to the questionnaire primarily to test i) the readability and relevance of each item, and ii) its overall feasibility. The instrument was completed by 330 parents (96.1% mothers) in Australia with two children aged 2-5 years, and repeated by 133 parents (40.3%) two weeks later. Exploratory factor analysis was performed on baseline data. Internal consistency and test re-test reliability of the subsequent subscales were examined. Construct validity was assessed through comparisons with existing measures of food parenting practices and child eating behaviours. The final FSQ scale included 22 items, reflecting five food parenting practices: sibling competitiveness, active sibling influence, threatening unequal division of food, sibling role modelling, and vicarious operant conditioning. Internal consistency and test re-test reliability estimates were high, and there was some evidence of convergent construct validity. While its factor structure should be confirmed in a different sample, the FSQ offers a novel tool for assessing, monitoring, and evaluating feeding interactions beyond those confined to the parent-child dyad.
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Affiliation(s)
- Susannah K Ayre
- Woolworths Centre for Childhood Nutrition Research, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, 149 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
| | - Melanie J White
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, 149 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
| | - Holly A Harris
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062, PA, Rotterdam, the Netherlands.
| | - Elena Jansen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| | - Rebecca A Byrne
- Woolworths Centre for Childhood Nutrition Research, Queensland University of Technology, 62 Graham Street, South Brisbane, QLD, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, 149 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
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Fox K, Hart CN, Phelan S, Ventura AK, Wing R, Jelalian E. Maternal depressive symptom trajectories and associations with child feeding. BMC Public Health 2024; 24:1636. [PMID: 38898428 PMCID: PMC11186209 DOI: 10.1186/s12889-024-19110-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Responsive feeding, when caregivers attend to children's signals of hunger and satiation and respond in an emotionally supportive and developmentally appropriate way, is associated with the development of healthy eating behaviors, improved diet quality, and healthy weight status for children. However, gaps in the literature remain on how factors, such as maternal depressive symptoms and child temperament, influence feeding interactions. METHODS This longitudinal secondary data analysis explored the association between maternal depressive symptom trajectory and child temperament with maternal feeding practices in women with obesity who participated in a prenatal lifestyle intervention trial. Mothers self-reported depressive symptoms at baseline, 35 weeks gestation, and 6, 12, and 18 months postpartum. At 18- and 24-months postpartum, mothers completed self-reported assessments of feeding practices and child temperament and completed in-home video-recorded meals with their child, coded using the Responsiveness to Child Feeding Cues Scale. We used group-based trajectory modeling to identify distinct trajectories of depressive symptoms and generalized regressions to assess the association between symptom trajectory group and feeding. We also explored interactions between depressive symptoms and child temperament. RESULTS Three distinct trajectories of depressive symptoms were identified: No-Minimal and Decreasing, Mild-Moderate and Stable, and Moderate-Severe and Stable. At 18-months, when compared to the No-Minimal and Decreasing group, membership in the Moderate-Severe and Stable group was associated with higher observed responsiveness to child satiation cues ([Formula: see text] =2.3, 95%CI = 0.2, 4.4) and lower self-reported pressure to eat ([Formula: see text]=-0.4, 95%CI= -0.7, 0.0). When compared to the No-Minimal and Decreasing group, membership in the Mild-Moderate and Stable group was associated with higher self-reported restriction ([Formula: see text] =0.4, 95%CI = 0.0,0.7). The associations between trajectory group membership and feeding practices did not reach statistical significance at 24 months. Associations between depressive symptoms and restriction were moderated by child effortful control at 18 months [Formula: see text]) and surgency at 24 months [Formula: see text]). CONCLUSION A Moderate-Severe and Stable depressive symptom trajectory was associated with more responsive feeding practices and a Mild-Moderate and Stable trajectory was associated with higher restrictive feeding. Preliminary evidence suggests that depressive symptoms impact mothers' ability to match their use of restriction to the temperamental needs of their child.
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Affiliation(s)
- Katelyn Fox
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA.
- Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA.
| | - Chantelle N Hart
- Department of Social and Behavioral Sciences & Center for Obesity Research and Education, College of Public Health Temple University, 3223 North Broad Street, Suite 175, Philadelphia, PA, 19140, USA
| | - Suzanne Phelan
- Department of Kinesiology and Public Health & Center for Health Research Bailey College of Science and Mathematics, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA
| | - Alison K Ventura
- Department of Kinesiology and Public Health & Center for Health Research Bailey College of Science and Mathematics, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA
| | - Rena Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA
- Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Elissa Jelalian
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond Street, Providence, RI, 02903, USA
- Department of Psychology and Human Behavior, Alpert Medical School Brown University, 222 Richmond St, Providence, RI, 02903, USA
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Wright-Pedersen S, Vidgen H, Gallegos D. Children's descriptions of their involvement within everyday food practices. Appetite 2024; 200:107517. [PMID: 38815691 DOI: 10.1016/j.appet.2024.107517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND The way in which children interact with food has a profound impact on their health and wellbeing. However, most research, strategy and policy where food is the focus are derived from adult perspectives. There is limited understanding of children's perspectives of the nature of their everyday food practices, and their level of involvement and influence. This work garnered children's (8-12 years old) descriptions of, and involvement in, their everyday food practices. METHODS Forty-two children from 28 families from across Brisbane (Australia) participated in qualitative creative draw-and-tell interviews and 20 of these children (from 15 families) also completed Photovoice data collection. Data were abductively analysed through a social practice theory lens. RESULTS Children reported engaging in food planning, acquisition, preparation, consumption and tidy-up practices, to varying degrees of 'less involved', 'in partnership with adults or other children' or 'independently'. This was influenced largely by the willingness of adults to relinquish control and children's desire to participate, as well as other contextual factors. Children were more independent in consumption practices, as well as packing lunchboxes and preparing food spaces (as preparation practices). Partnerships were established more so within food acquisition and preparation practices, with less involvement described within planning and tidy-up practices. CONCLUSIONS The findings add new knowledge and depth and breadth to that already obtained from parents, teachers and adult researchers, highlighting the importance of privileging children's voices when investigating their food experiences. This work may be used to guide adults to invite and support children to be involved in food practices that they report being less involved in, as well as inform how best to work with and include children in future research and food and nutrition strategies and policies.
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Affiliation(s)
- Sophie Wright-Pedersen
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
| | - Helen Vidgen
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology (QUT), 62 Graham Street, South Brisbane, QLD, 4101, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), 149 Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.
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Milliren CE, Crowley M, Carmody JK, Bern EM, Eldredge O, Richmond TK. Pediatric hospital utilization for patients with avoidant restrictive food intake disorder. J Eat Disord 2024; 12:42. [PMID: 38528642 DOI: 10.1186/s40337-024-00996-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/12/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Avoidant restrictive food intake disorder (ARFID) is a relatively new feeding and eating disorder added to the DSM-5 in 2013 and ICD-10 in 2018. Few studies have examined hospital utilization for patients with ARFID specifically, and none to date have used large administrative cohorts. We examined inpatient admission volume over time and hospital utilization and 30-day readmissions for patients with ARFID at pediatric hospitals in the United States. METHODS Using data from the Pediatric Health Information System (PHIS), we identified inpatient admissions for patients with ARFID (by principal International Classification of Diseases, 10th Revision, ICD-10 diagnosis code) discharged October 2017-June 2022. We examined the change over time in ARFID volume and associations between patient-level factors (e.g., sociodemographic characteristics, co-morbid conditions including anxiety and depressive disorders and malnutrition), hospital ARFID volume, and hospital utilization including length of stay (LOS), costs, use of enteral tube feeding or GI imaging during admission, and 30-day readmissions. Adjusted regression models were used to examine associations between sociodemographic and clinical factors on LOS, costs, and 30-day readmissions. RESULTS Inpatient ARFID volume across n = 44 pediatric hospitals has increased over time (β = 0.36 per month; 95% CI 0.26-0.46; p < 0.001). Among N = 1288 inpatient admissions for patients with ARFID, median LOS was 7 days (IQR = 8) with median costs of $16,583 (IQR = $18,115). LOS and costs were highest in hospitals with higher volumes of ARFID patients. Younger age, co-morbid conditions, enteral feeding, and GI imaging were also associated with LOS. 8.5% of patients were readmitted within 30 days. In adjusted models, there were differences in the likelihood of readmission by age, insurance, malnutrition diagnosis at index visit, and GI imaging procedures during index visit. CONCLUSIONS Our results indicate that the volume of inpatient admissions for patients with ARFID has increased at pediatric hospitals in the U.S. since ARFID was added to ICD-10. Inpatient stays for ARFID are long and costly and associated with readmissions. It is important to identify effective and efficient treatment strategies for ARFID in the future.
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Affiliation(s)
- Carly E Milliren
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
| | - McGreggor Crowley
- Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Julia K Carmody
- Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Elana M Bern
- Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Olivia Eldredge
- Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, MA, USA
| | - Tracy K Richmond
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
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Eckert KF, Trew V, Serediuk E, Galvez A, Haines J. Transitioning to a Plant-Based Menu in Childcare: Identifying the Nutritional, Financial, and Logistical Considerations. CAN J DIET PRACT RES 2024; 85:20-24. [PMID: 37732547 DOI: 10.3148/cjdpr-2023-015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
International health organizations have called for a shift towards more plant-based foods as a way of promoting both individual health and environmental sustainability. Given the high percentage of children in Canada who attend childcare and the high volume of food provided in childcare, transitioning menus to incorporate plant-based foods could have important implications for both planetary and child health. The purpose of this case study is to describe a childcare centre's transition to a plant-based menu. A detailed nutritional analysis of the menu was conducted. The financial and logistical implications of the transitions to a plant-based menu were also assessed. Nutritional analysis revealed that the plant-based menu met or exceeded the daily nutrient requirement for all the key nutrients explored. Financially, the transition led to a 9% reduction in food costs. Logistically, the transition led to improved efficiency and safety with regard to food preparation, with substantially fewer tailored meals due to allergies and dietary restrictions required after the transition. These novel findings are relevant for food service administrators interested in transitioning to a plant-based menu as well as public health dietitians who could support the transition.
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Affiliation(s)
- Katherine F Eckert
- Department of Family Relations and Applied Nutrition, University of Guelph, ON
| | - Valerie Trew
- Department of Family Relations and Applied Nutrition, University of Guelph, ON
- Child Care Operations, University of Guelph, ON
| | | | - Abby Galvez
- Department of Family Relations and Applied Nutrition, University of Guelph, ON
- Child Care Operations, University of Guelph, ON
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, ON
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Ayre SK, Harris HA, White MJ, Byrne RA. Food Parenting Practices and Child Eating Behaviors in Australian Families: A Cross-Sectional Sibling Design. J Acad Nutr Diet 2024; 124:42-57.e8. [PMID: 37661083 DOI: 10.1016/j.jand.2023.08.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Research on feeding in early childhood has focused primarily on parent-child dyadic interactions, despite parents enacting these practices within the complex dynamic of the family system. OBJECTIVE Using a sibling design, this study aimed to assess how parents may adapt their food parenting practices for siblings in response to differences in their eating behaviors. DESIGN A cross-sectional online survey was conducted between October and December 2022. PARTICIPANTS/SETTING Data were collected from parents (97.5% women) in Australia with 2 children aged 2 to 5 years (n = 336 parents and n = 672 children). MAIN OUTCOME MEASURES Survey items were completed for each sibling, and included four subscales of the Children's Eating Behaviour Questionnaire and seven subscales of the Feeding Practices and Structure Questionnaire-28. STATISTICAL ANALYSES PERFORMED Multiple linear regression models examined associations between within-sibling pair differences in child eating behaviors and food parenting practices, adjusting for differences in child body mass index z score, age, gender, and early feeding method. RESULTS Within-sibling pair differences in eating behaviors were associated with differences in some food parenting practices. For the fussier sibling, parents reported using more control-based practices, including persuasive feeding, reward for eating, and reward for behavior, and less of the structure-based practice, family meal settings (P values < 0.001). Similar directions of associations were found for persuasive feeding, reward for eating, and family meal settings with siblings who were slower eaters or more satiety responsive (P values < 0.007); however, no significant differences in reward for behavior were observed in relation to sibling differences in these eating behaviors. For the more food responsive sibling, parents reported using more control-based practices, including reward for behavior and overt restriction (P values < 0.002). CONCLUSIONS Within families, parents may adapt certain practices in response to differences in their children's eating behaviors. Interventions promoting responsive feeding should be designed to acknowledge the integral role of siblings in shaping parents' feeding decisions.
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Affiliation(s)
- Susannah K Ayre
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, Queensland, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
| | - Holly A Harris
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Melanie J White
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Rebecca A Byrne
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, Queensland, Australia; School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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Middleton G, Golley RK, Patterson KA, Coveney J. Barriers and enablers to the family meal across time; a grounded theory study comparing South Australian parents' perspectives. Appetite 2023; 191:107091. [PMID: 37865298 DOI: 10.1016/j.appet.2023.107091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 10/23/2023]
Abstract
Family meals are positively associated with numerous beneficial health and social outcomes. Current discourse however claims that parents are faced with numerous barriers when trying to bring the family together to share a meal. Solutions for overcoming barriers to a positive shared family meal are often individualistic and do not address the systemic pressures and burdens families have faced for decades. The aim of this study was to explore the systemic and novel barriers and enablers to shared family meals as experienced by families across time. To achieve this, a qualitative study informed by grounded theory was conducted. Parents of South Australian families were recruited and interviewed in the 1990s, and a new sample of parents were recruited and interviewed in 2020. Transcripts were analysed using grounded theory and comparative analysis methods. Thirty-two parents from 16 families were interviewed in the 1990s, and 22 parents from 10 families in 2020. Ten factors were identified presenting as either enablers or barriers to the family meal, depending on the context they were experienced. Barriers and enablers were largely consistent across time. Scheduling and flexibility, children's disruptions and children's independence, privileges required to have family meals and motivation and commitment to the family meal were identified as persistent enablers and barriers across time. These findings indicate that parents are faced with similar challenges they have been facing for decades and are still not being adequately supported to execute family meals regularly. Recognising that factors present as either barriers or enablers to the family meal provides us with opportunities to transform barriers to enablers and support families to have regular, meaningful family meals.
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Affiliation(s)
- Georgia Middleton
- Caring Futures Institute, Flinders University, Tarntanya, Adelaide, South Australia, Australia; College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia.
| | - Rebecca K Golley
- Caring Futures Institute, Flinders University, Tarntanya, Adelaide, South Australia, Australia; College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
| | - Karen A Patterson
- College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
| | - John Coveney
- Caring Futures Institute, Flinders University, Tarntanya, Adelaide, South Australia, Australia; College of Nursing and Health Sciences, Flinders University, Tarntanya, Adelaide, South Australia, Australia
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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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Sng QW, Chong FFM, Chan D, Tan KH, He HG. Evaluating the influence of low birth weight on food parenting practices in preschool children. Appetite 2023; 190:107031. [PMID: 37690619 DOI: 10.1016/j.appet.2023.107031] [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: 05/17/2023] [Revised: 08/05/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
Food parenting practices, especially Autonomy Support practices and Structure practices, have not been comprehensively studied among parents of children born with low birth weight in Asia. The aim of this study was to investigate food parenting practices among parents of preschoolers who were born with low (<2500 g) and normal birth weight (≥2500 g) in Singapore. We recruited 197 parents of pre-school children (aged 3-5 years) who completed a socio-demographic questionnaire and the HomeSTEAD questionnaire, which examined food parenting practices. Among parents, 98 (49.8%) and 99 (50.2%) had children who were normal (NBW) and low birth weight (LBW) respectively. Parents of children with LBW had lower scores in one Autonomy Support practice (Encouragement) and three Structure practices (Meal setting, Planning and preparation of healthy meals, Rules and limits around unhealthy foods), after controlling for ethnicity and parental education. Parents of children with LBW also scored higher in one Autonomy Support practice (Guided choices: when food is given). There were no significant differences in Coercive Control practices between parents of both groups. Healthcare professionals could use this information to assess parental needs when facilitating parents' positive food parenting practices, especially among children with low birth weight.
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Affiliation(s)
- Qian Wen Sng
- Department of Advancing Nursing Education, KK Women's and Children's Hospital, 229899, Singapore.
| | - Foong-Fong Mary Chong
- Saw Swee Hock School of Public Health, National University of Singapore, 117549, Singapore
| | - Daniel Chan
- Endocrinology Service, Paediatric Medicine, KK Women's and Children's Hospital, 229899, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 229899, Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, 117597, Singapore; National University Health System, 119228, Singapore
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Jones E, Burton AE. Exploring Vegan Mothers' Experiences of Making Food Choices for Infants and Young Children. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:624-633. [PMID: 37542483 DOI: 10.1016/j.jneb.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 08/07/2023]
Abstract
OBJECTIVE Our study aimed to explore vegan mothers' experiences and decision-making processes when feeding their children (up to 3 years old). METHODS We conducted a qualitative photo-elicitation interview study in the United Kingdom. Eight vegan mothers provided 5 photographs of food choices they had made for their children and completed online photo-elicitation interviews to discuss these images. Data were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS Five themes were developed: role modeling eating behavior, shared decision-making, nutritional guidance for vegan parents, fear of judgment for being vegan, and desire for convenience. CONCLUSIONS AND IMPLICATIONS Findings illustrate the complexity of the decision-making process and highlight the need for targeted resources for vegan parents. There is a need for awareness raising and training for health care professionals and the development of vegan-specific child-feeding resources to facilitate the provision of evidence-based nutritional guidance for vegan parents.
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Affiliation(s)
- Eliza Jones
- Centre for Psychological Research, School of Health, Science and Wellbeing, Staffordshire University, Staffordshire, United Kingdom
| | - Amy E Burton
- Centre for Psychological Research, School of Health, Science and Wellbeing, Staffordshire University, Staffordshire, United Kingdom.
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Gotow N, Nagai Y, Taguchi T, Kino Y, Ogino H, Kobayakawa T. Change in preference for vegetables and their perceptual attributes as a function of age and pickiness. Food Res Int 2023; 170:112967. [PMID: 37316010 DOI: 10.1016/j.foodres.2023.112967] [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: 09/08/2022] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 06/16/2023]
Abstract
Preference for vegetables is influenced by various factors, including demographic, psychological, socio-environmental, and genetic factors. This study confirmed that age, pickiness, and perceptual attributes were predictors of preference for vegetables and examined how preference for vegetables and their perceptual attributes varies with age and pickiness. Children (8-14 years, n = 420), youth (15-34 years, n = 569), middle-aged adults (35-64 years, n = 726), and older adults (65-85 years, n = 270) were asked which vegetables they liked (or disliked) and which perceptual attributes of each vegetable they liked (or disliked). On the basis of their responses, an overall preference score and a preference sub-score for each perceptual attribute were calculated. Participants in each age group were classified into four statuses (non-, mild, moderate, and severe) according to their pickiness scores. Multiple regression analysis revealed that age and preference sub-scores for eight perceptual attributes (sweetness, sourness, bitterness, umami, pungency, orthonasal aroma, texture, and appearance) were positive predictors of overall preference score and that pickiness score and four perceptual attributes (saltiness, astringency, retronasal aroma, and aftertaste) were negative predictors. In addition, overall preference score and preference sub-scores for perceptual attributes other than saltiness increased with increasing age group and decreasing picker status; however, preference sub-scores for at least one of the six perceptual attributes (bitterness, astringency, pungency, orthonasal aroma, retronasal aroma, and aftertaste) exhibited negative values in children, youth, and pickers (mild, moderate, and severe). The increase in preference for these perceptual attributes might be an indicator of the adultization of food perception and the expansion of food acceptance.
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Affiliation(s)
- Naomi Gotow
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba Central 6, 1-1-1, Higashi, Tsukuba, Ibaraki 305-8566, Japan.
| | - Yuko Nagai
- Kagome Co., Ltd., 17, Nishitomiyama, Nasushiobara-shi, Tochigi 329-2762, Japan.
| | - Taro Taguchi
- Kagome Co., Ltd., 17, Nishitomiyama, Nasushiobara-shi, Tochigi 329-2762, Japan.
| | - Yuko Kino
- Kagome Co., Ltd., 17, Nishitomiyama, Nasushiobara-shi, Tochigi 329-2762, Japan.
| | - Hiroyuki Ogino
- Kagome Co., Ltd., 17, Nishitomiyama, Nasushiobara-shi, Tochigi 329-2762, Japan.
| | - Tatsu Kobayakawa
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba Central 6, 1-1-1, Higashi, Tsukuba, Ibaraki 305-8566, Japan.
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12
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Jones BL, Orton AL, Tindall SW, Christensen JT, Enosakhare O, Russell KA, Robins AM, Larriviere-McCarl A, Sandres J, Cox B, Thomas C, Reynolds C. Barriers to Healthy Family Dinners and Preventing Child Obesity: Focus Group Discussions with Parents of 5-to-8-Year-Old Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:952. [PMID: 37371184 DOI: 10.3390/children10060952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/24/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Although numerous physical and mental health benefits for children have been linked to family dinners, many families still do not have regular family meals together. This study sought to identify the barriers that keep families from having dinners together. METHODS We interviewed 42 parents of 5-to-8-year-old children in small focus groups to identify barriers and challenges that keep families from having healthy and consistent dinners together. RESULTS Parents reported the main barriers were time (e.g., time strain and overscheduling, mismatched schedules, long work hours, etc.), lack of meal planning or failure to follow plans, lack of skills (e.g., cooking skills or nutritional awareness), external factors (e.g., daycare, schools, or extended family, and competing with advertising), and food-related challenges (e.g., picky eating, food allergies). Parents also suggested potential solutions to overcome these barriers. CONCLUSIONS Overall, parents had a desire to have family dinners with their children, but they felt that there are many barriers keeping them from establishing or maintaining consistent family mealtimes. Future research, as well as child obesity prevention and intervention efforts, should consider these barriers and suggested solutions in efforts to promote healthy and consistent family meals as a means of lowering the prevalence of childhood obesity.
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Affiliation(s)
- Blake L Jones
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
| | - Adam L Orton
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
| | - Spencer W Tindall
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
| | | | | | - Keeley A Russell
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
| | - Anne-Marie Robins
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
| | | | - Joseph Sandres
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
| | - Braden Cox
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
| | - Connor Thomas
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
| | - Christina Reynolds
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA
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13
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Fox K, Vadiveloo M, McCurdy K, Risica PM, Gans KM, Tovar A. Control and Chaos: Caregiver's Basic Psychological Need Frustration is Associated With the Socioemotional Climate When Feeding. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:363-370. [PMID: 36898869 PMCID: PMC10351395 DOI: 10.1016/j.jneb.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/18/2023] [Accepted: 02/03/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE The socioemotional climate when feeding is a focus in childhood obesity prevention efforts. However, little is known about why caregivers create nonsupportive or supportive climates. This cross-sectional study used a Self-Determination Theory perspective to identify factors associated with the socioemotional climate when feeding in ethnically diverse families with low income. METHODS Caregivers of children aged 2-5 years (n = 66) completed the Parent Socioemotional Context of Feeding Questionnaire, the Basic Psychological Need (BPN) Satisfaction and Frustration Scale, and demographic surveys at baseline. Multivariable regressions assessed the association between BPN satisfaction/frustration with autonomy-supportive, structured, controlling, and chaotic feeding climates. RESULTS Participants were predominately Hispanic/Latinx (86.6%), women (92.5%), and born outside the US (60%). Their BPN frustration was positively associated with controlling (β = 0.96; SE = 0.26; P = 0.001) and chaotic (β = 0.79; SE = 0.27; P = 0.01) feeding. CONCLUSIONS AND IMPLICATIONS This analysis suggests that BPN frustration is associated with controlling and chaotic feeding and may be important to consider when encouraging responsive feeding.
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Affiliation(s)
- Katelyn Fox
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI; Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI.
| | - Maya Vadiveloo
- Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, RI
| | - Karen McCurdy
- Department of Human Development and Family Science, University of Rhode Island, Kingston, RI
| | - Patricia Markham Risica
- Department of Behavioral and Social Sciences, and Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - Kim M Gans
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT
| | - Alison Tovar
- Department of Behavioral and Social Sciences, and Department of Epidemiology, Brown University School of Public Health, Providence, RI
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14
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Mudholkar A, Korostenski L, Blackwell D, Lane AE. Factors associated with the early emergence of atypical feeding behaviours in infants and young children: A scoping review. Child Care Health Dev 2023; 49:1-19. [PMID: 35301737 PMCID: PMC10084441 DOI: 10.1111/cch.13005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 03/03/2022] [Accepted: 03/12/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Atypical feeding behaviours such as significantly limited food preferences, hypersensitivity to food textures or temperatures and pocketing food without swallowing are common concerns in child health. Current reports indicate an inter-relationship between early growth, feeding problems and developmental disorders, yet little is known about how these behaviours develop in early childhood. There is also a lack of consensus about clinical definitions for atypical feeding behaviours, diagnostic thresholds and the associated precursors. To date, there has been no synthesis of the extant literature about factors associated with the early onset of atypical feeding behaviours in young children. OBJECTIVE This scoping review aimed to characterize the factors associated with the early emergence of atypical feeding behaviours in typically developing young children. METHODS CINAHL, MEDLINE, PsycINFO and Scopus databases were searched. Studies published in the last 5 years were included if they examined factors associated with the development of atypical eating behaviours in infants and young children. Of the 2137 records obtained after the search strategy was applied, 202 full-text articles were retrieved for a more detailed examination and to ensure they met the inclusion criteria. This resulted in 54 studies being included in this scoping review. RESULTS Of the 54 studies, three studies analysed precursors responsible for atypical feeding behaviours, and 51 studies discussed the factors associated with the early emergence of feeding difficulties. Multiple factors, including genetic factors, breastfeeding, late introduction of solids and lumpy foods, complementary feeding techniques, parental mental health, prematurity and child factors including temperament, were identified. There is inconsistent evidence for the associations between breastfeeding exposure and feeding difficulties. CONCLUSIONS This study identified multiple factors potentially associated with the early onset of atypical feeding behaviours in young children; however, there is insufficient evidence at this time to support specific recommendations for early feeding practices in young children. More methodologically rigorous studies are needed to extend these findings.
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Affiliation(s)
- Asmita Mudholkar
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne.,School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs
| | - Larissa Korostenski
- Department of Neonatology, John Hunter Children's Hospital, Newcastle, Australia
| | - Dianne Blackwell
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne.,School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Alison E Lane
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne
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15
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Vidmar AP, Cáceres NA, Schneider-Worthington CR, Shirazipour C, Buman MP, de la Haye K, Salvy SJ. Integration of Time-Based Recommendations with Current Pediatric Health Behavior Guidelines: Implications for Obesity Prevention and Treatment in Youth. Curr Obes Rep 2022; 11:236-253. [PMID: 36348216 PMCID: PMC9742346 DOI: 10.1007/s13679-022-00491-z] [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] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW Youth-onset obesity is associated with negative health outcomes across the lifespan including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, dyslipidemias, asthma, and several cancers. Pediatric health guidelines have traditionally focused on the quality and quantity of dietary intake, physical activity, and sleep. RECENT FINDINGS Emerging evidence suggests that the timing (time of day when behavior occurs) and composition (proportion of time spent allocated to behavior) of food intake, movement (i.e., physical activity, sedentary time), and sleep may independently predict health trajectories and disease risks. Several theoretically driven interventions and conceptual frameworks feature behavior timing and composition (e.g., 24 h movement continuum, circadian science and chronobiology, intermittent fasting regimens, structured day hypothesis). These literatures are, however, disparate, with little crosstalk across disciplines. In this review, we examine dietary, sleep, and movement guidelines and recommendations for youths ages 0-18 in the context of theoretical models and empirical findings in support of time-based approaches. The review aims to inform a unifying framework of health behaviors and guide future research on the integration of time-based recommendations into current quantity and quality-based health guidelines for children and adolescents.
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Affiliation(s)
- Alaina P Vidmar
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA, 90027, USA.
| | - Nenette A Cáceres
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | | | - Celina Shirazipour
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Tempe, USA
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sarah-Jeanne Salvy
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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16
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Befort CA, Ross KM, Janicke DM, Perri MG. Parents of minor children lose less weight during a behavioral weight loss intervention: Findings from the Rural LEAP trial. Obes Sci Pract 2022; 8:728-734. [PMID: 36483125 PMCID: PMC9722455 DOI: 10.1002/osp4.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/11/2022] [Accepted: 03/27/2022] [Indexed: 11/10/2022] Open
Abstract
Objective The transition to parenthood is associated with worsening health behaviors, yet the impact of parental status on successful weight loss has rarely been examined. The purpose of this study was to examine the effect of parental status of minor children on weight loss and behavioral adherence in a rural community-based weight loss intervention. Methods Five hundred and twenty-eight adults (age 21-75 years, body mass index [BMI] 30-45 kg/m2) were enrolled in a group-based weight loss intervention consisting of 16 weekly sessions delivered in face-to-face group sessions at Cooperative Extension Service (CES) offices. Participants who were parents with at least one minor child (≤18 years old) in the home were compared to participants with no minor children in the home. Measures included percent weight loss, session attendance, adherence to self-monitoring, and achieving calorie and physical activity goals. Results Compared to participants without minor children, parents with minor children lost significantly less weight (7.5% vs. 6.2%, respectively; p = 0.01), and were less likely to lose ≥5% of baseline weight (59.2% vs. 70.2%, respectively; p = 0.02). In addition, parents with minor children attended significantly fewer sessions, had lower adherence to self-monitoring, and met calorie and step goals less often (all ps < 0.001). The association between parental status and percent weight loss was not significantly moderated by gender of the parent. Conclusions Parents of minor children had greater difficulty adhering to intervention goals and lost less weight than participants without minor children. Future research should investigate whether tailoring intervention to meet the unique needs of parents can enhance outcomes, especially given the large segment of the population represented by this group.
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Affiliation(s)
- Christie A. Befort
- Department of Population HealthUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Kathryn M. Ross
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
| | - David M. Janicke
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
| | - Michael G. Perri
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
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17
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Duong C, Jenkins M, Pyo E, Nguyen PH, Huynh T, Nguyen‐Viet H, Young MF, Ramakrishnan U. Understanding maternal food choice for preschool children across urban-rural settings in Vietnam. MATERNAL & CHILD NUTRITION 2022; 19:e13435. [PMID: 36346156 PMCID: PMC9749606 DOI: 10.1111/mcn.13435] [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: 12/31/2021] [Revised: 05/27/2022] [Accepted: 09/07/2022] [Indexed: 11/10/2022]
Abstract
Improving diet quality of preschool children is challenging in countries undergoing food environment and nutrition transition. However, few studies have sought to understand how mothers in these countries decide what and how to feed their children. This study aims to explore maternal experiences, perspectives and beliefs when making food choice decisions for preschool children in urban, peri-urban and rural areas in northern Vietnam. Two focus group discussions and 24 in-depth interviews were carried out and analysed using thematic analysis. The results showed that mothers across the urban-rural spectrum shared the intention to feed children safe, nutritious food for better health and weight gain while satisfying child food preferences to improve appetite and eating enjoyment. These food choice intentions were embedded within family food traditions, whereby mothers emphasised nutritious food and adopted strict feeding styles during lunch and dinner but were flexible and accommodating of child preferences during breakfast and side meals. These intentions were also embedded within the physical food environment, which provided a mix of healthy and unhealthy food through informal food retailers. Despite these intentions, mothers faced financial constraints and difficulties in managing children's refusal to chew, changes in eating mood and strong eating temperament. These findings support policies to limit the presence of unhealthy food in informal food retail and encourage meal-specific feeding strategies to help children enjoy nutritious food, transition from soft to textured food and become more cooperative during mealtime.
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Affiliation(s)
- Cam Duong
- Nutrition and Health Sciences Program, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
| | - Mica Jenkins
- Nutrition and Health Sciences Program, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
| | - Euisun Pyo
- Nutrition and Health Sciences Program, Laney Graduate SchoolEmory UniversityAtlantaGeorgiaUSA
| | - Phuong Hong Nguyen
- International Food Policy Research InstituteWashingtonDistrict ColumbiaUSA
| | - Tuyen Huynh
- Alliance Bioversity International and CIATAsia HubHanoiVietnam
| | - Hung Nguyen‐Viet
- Animal and Human Health ProgramInternational Livestock Research InstituteNairobiKenya
| | - Melissa F. Young
- Hubert Department of Global HealthEmory UniversityAtlantaGeorgiaUSA
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18
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Nagge KA, Finch S, Rossiter MD. Family Feeding Practices of Parents on Prince Edward Island: A Focus on Responsive Feeding. CAN J DIET PRACT RES 2022; 83:198-202. [PMID: 36004725 DOI: 10.3148/cjdpr-2022-015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The home environment and parental influence are strong predictors of eating behaviours in young children and can influence healthy development. The objective of this study was to describe the feeding practices of a sample of families on Prince Edward Island. Eleven parent participants were recruited, one-on-one interviews were held, and a thematic analysis was conducted. Conversations with parents revealed that the family feeding environment is influenced by a multitude of factors that change daily and need to be navigated based on the age of the child. Parents saw family meals as time together and an opportunity to model healthy eating behaviours; however, they faced several challenges at mealtimes, including perceived picky eating. Parents recognized their children's hunger and satiety cues, although they respected satiety signals more often if children ate what they perceived as a lot of food. Many parents used food as a reward to encourage their children to eat more but recognized that it could lead to the development of undesirable habits. Despite the complex factors that influence feeding, dietitians can work with families to foster a responsive feeding environment by encouraging family meals, recognizing and respecting hunger and satiety cues, and understanding typical changes in eating behaviours as children age.
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Affiliation(s)
- Katrina A Nagge
- Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island
| | - Sarah Finch
- Assistant Professor, Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island
| | - Melissa D Rossiter
- Associate Professor Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island
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19
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White HJ, Meyer C, Palfreyman Z, Haycraft E. Family mealtime emotions and food parenting practices among mothers of young children: Development of the Mealtime Emotions Measure for Parents (MEM‐P). MATERNAL & CHILD NUTRITION 2022; 18:e13346. [PMID: 35294102 PMCID: PMC9218312 DOI: 10.1111/mcn.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
Family mealtimes can be important for supporting children's healthy development, yet the emotional context of mealtimes can vary considerably, likely impacting their overall success and enjoyment. Yet, despite having an important role, little is known about how parents emotionally experience mealtimes with their family. The first aim of the current study was to assess the factor structure of a novel self‐report measure to assess parents’ emotional responses experienced during family mealtimes (Mealtime Emotions Measure for Parents; MEM‐P). The second aim was to examine relationships between maternal mealtime emotions and their food parenting practices. Mothers of children aged between 1.5 and 6 years participated in this study. Mothers were invited to complete an online questionnaire measuring family mealtime emotions, anxiety, depression and food parenting practices. Exploratory factor analysis produced a three‐factor solution comprising both positive and negative emotion subscales: MEM‐P Efficacy; MEM‐P Anxiety; MEM‐P Stress and Anger. Mothers' positive mealtime emotions (mealtime efficacy) were related to greater use of practices promoting autonomy, providing a healthy home food environment, and modelling healthy eating. Higher anxiety about mealtimes was related to greater reports of child control over eating, and mealtime stress and anger was associated with greater use of food to regulate emotions. These findings highlight novel relationships between how mothers emotionally experience family mealtimes and the food parenting practices they use with their children. It is important to develop resources to help promote positive maternal experiences of family mealtimes and food‐based interactions. Mothers of young children experience a range of positive and negative emotions around family mealtimes. Mothers' mealtime emotions are related to the food parenting practices they report using with their children. Mothers with more positive emotional experiences of family mealtimes (i.e., greater mealtime efficacy) also reported higher use of food parenting practices which promote autonomy in children (e.g., involvement, balance and variety, teaching about nutrition) and which provide feeding structure (e.g., healthy food environment; modelling healthy eating). Some parents may benefit from further support to help them promote more positive mealtime experiences and food‐based interactions.
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Affiliation(s)
- Hannah J. White
- School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
| | - Caroline Meyer
- WMG and Warwick Medical School University of Warwick Coventry UK
- University Hospitals Coventry and Warwickshire NHS Trust Coventry UK
| | - Zoe Palfreyman
- Division of Psychology De Montfort University Leicester UK
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
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20
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Rossiter MD, Richard B, Whitfield KC, Mann L, McIsaac JLD. Responsive feeding values and practices among families across the Canadian Maritime provinces. Appl Physiol Nutr Metab 2022; 47:495-501. [PMID: 35113682 DOI: 10.1139/apnm-2021-0692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Children benefit from responsive feeding practices where their internal signals of hunger and satiety are valued and met with prompt, emotionally supportive, and developmentally appropriate responses. Using an online survey, this study describes responsive feeding values and practices among parents of young children (0-5 years) (n = 1039) across 3 Canadian Maritime provinces. Independent-samples t-tests and 1-way ANOVA were performed to determine the differences in survey questions related to the responsive feeding practices and values. First-time parents and parents with younger children report implementing more consistently some of the challenging responsive feeding practices, such as avoiding pressuring their children to eat, compared with parents with multiple children and parents with children ages 3-5 years. Parents often have well-intended reasons to encourage their children to eat; however, these can coincide with non-responsive practices with food such as pressuring, rewarding, and restriction. These coercive practices may be ineffective and counterproductive as they reinforce reasons to eat unrelated to appetite and self-regulation. Preschool and early feeding interventions that support parents in understanding normal child development, including typical eating behaviours and self-regulation, could help to equip them for challenging feeding experiences and encourage long-term responsive feeding practices. Novelty: First-time parents and parents with younger children report more consistently avoiding pressuring their children to eat, compared with parents with multiple children and parents with children ages 3-5 years. Parents often have well-intended reasons to encourage their children to eat; however, these can coincide with non-responsive practices such as pressuring, rewarding, and restriction.
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Affiliation(s)
- Melissa D Rossiter
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Brenna Richard
- Department of Child & Youth Study, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Kyly C Whitfield
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Linda Mann
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Jessie-Lee D McIsaac
- Department of Child & Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.,Healthy Populations Institute, Halifax, Nova Scotia, Canada
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21
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‘Fussy eating’ and feeding dynamics: School children's perceptions, experiences, and strategies. Appetite 2022; 173:106000. [DOI: 10.1016/j.appet.2022.106000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/30/2022] [Accepted: 03/04/2022] [Indexed: 11/02/2022]
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22
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The Picky Eating Questionnaire and Child-reported Food Preference Questionnaire: Pilot validation in Australian-Indian mothers and children 7-12 years old. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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23
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Walton K, McGee M, Sato J, Law N, Hopperton KE, Bando N, Kiss A, Unger S, O'Connor DL. Social-Emotional Functioning and Dietary Intake among Children Born with a Very Low Birth Weight. Appl Physiol Nutr Metab 2022; 47:737-748. [PMID: 35196153 DOI: 10.1139/apnm-2021-0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Very low birth weight infants (VLBW, <1500g) are at elevated risk of neurodevelopmental disorders, later obesity and cardiometabolic disease; if and how neurodevelopmental disorders impact chronic disease risk is poorly understood. The most common neurodevelopmental disorders experienced by VLBW children are those of social-emotional functioning. We compared dietary patterns and body composition between VLBW children with poor vs. typical social-emotional functioning using linear mixed models adjusted for sex, gestational age, cognitive impairment, parental education and BMI. VLBW children (n=158) attending the Donor Milk for Improved Neurodevelopmental Outcomes trial 5.5-year follow-up participated. Poor social-emotional functioning was based on standardized parent-rated questionnaires and/or parent-reported physician diagnosis of autism spectrum or attention-deficit/hyperactivity disorders. Most children had diets categorized as 'needs improvement' (67%) or 'poor' (27%) and 29% of children exhibited poor social-emotional functioning. Poor social-emotional functioning was positively associated with 100% fruit juice (β=0.3 cup equivalents/day; 95% CI 0.1, 0.5) and energy intake (β=118.1 kcals/day; 95% CI 0.9, 235.2). Children with poor social-emotional functioning were more likely to have a limited food repertoire (p=0.02), but less likely to exceed dietary fat recommendations (p=0.04). No differences in overall diet quality or body composition were observed. Diet counselling and research are essential to improving the nutrition of VLBW children to mitigate chronic disease risk. Novelty: • Overall diet quality and body composition did not differ between VLBW children with poor vs. typical social-emotional functioning. • Most had diets "needing improvement" or "poor" according to the HEI 2010. • Diet counselling may help mitigate chronic disease risk in this vulnerable population.
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Affiliation(s)
- Kathryn Walton
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada;
| | - Meghan McGee
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada.,University of Toronto Dalla Lana School of Public Health, 274071, Toronto, Ontario, Canada.,University of Toronto Temerty Faculty of Medicine, 12366, Nutritional Sciences, Toronto, Ontario, Canada;
| | - Julie Sato
- The Hospital for Sick Children, 7979, Neurosciences & Mental Health, Toronto, Ontario, Canada.,The Hospital for Sick Children, 7979, Diagnostic Imaging , Toronto, Ontario, Canada.,University of Toronto, 7938, Psychology, Toronto, Ontario, Canada;
| | - Nicole Law
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada;
| | - Kathryn E Hopperton
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada;
| | - Nicole Bando
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada.,University of Toronto Temerty Faculty of Medicine, 12366, Nutritional Sciences, Toronto, Ontario, Canada;
| | - Alex Kiss
- University of Toronto Institute of Health Policy Management and Evaluation, 206712, Toronto, Ontario, Canada.,Sunnybrook Research Institute, 282299, Evaluative and Clinical Sciences, Toronto, Ontario, Canada;
| | - Sharon Unger
- Sinai Health System, 518775, Department of Paediatrics, Toronto, Ontario, Canada.,University of Toronto Temerty Faculty of Medicine, 12366, Department of Pediatrics, Toronto, Ontario, Canada.,The Hospital for Sick Children, 7979, Neonatology, Toronto, Ontario, Canada;
| | - Deborah L O'Connor
- The Hospital for Sick Children, 7979, Translational Medicine, Toronto, Ontario, Canada.,University of Toronto Temerty Faculty of Medicine, 12366, Nutritional Sciences, Toronto, Ontario, Canada.,Sinai Health System, 518775, Paediatrics, Toronto, Ontario, Canada;
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Walton K, Daniel AI, Mahood Q, Vaz S, Law N, Unger SL, O'Connor DL. Eating Behaviors, Caregiver Feeding Interactions, and Dietary Patterns of Children Born Preterm: A Systematic Review and Meta-Analysis. Adv Nutr 2022; 13:875-912. [PMID: 35157009 PMCID: PMC9156386 DOI: 10.1093/advances/nmac017] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/26/2022] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Infants born preterm (<37 weeks of gestation) often experience feeding problems during hospitalization. Whether difficulties persist or have long-term sequelae on childhood eating is unclear. We aimed to describe the oromotor eating skills (e.g., chewing/swallowing), eating behaviors (e.g., food neophobia), food parenting practices (e.g., pressure to eat), and dietary patterns of preterm children during late infancy (6-12 mo) and early childhood (>12 mo-7 y) and to determine whether these differed from those of term-born peers. We identified 67 articles (57 unique studies) for inclusion. We used random-effects meta-analysis of proportions to examine the prevalence of oromotor eating skill and eating behavior challenges among preterm children, standard meta-analysis for comparisons with term-born peers, and the Grading of Recommendations, Assessment, Development and Evaluation approach to assess the certainty of evidence. Forty-three percent (95% CI: 24%, 62%) of infants and 25% (95% CI: 17%, 33%) of children born preterm experienced oromotor eating difficulties and 16% (95% CI: 4%, 27%) and 20% (95% CI: 11%, 28%), respectively, exhibited challenging eating behaviors. During late infancy and early childhood, oromotor eating difficulties (OR: 2.86; 95% CI: 1.71, 4.77; I2 = 67.8%) and challenging eating behaviors (OR: 1.52; 95% CI: 1.11, 2.10; I2 = 0.0%) were more common in those born preterm than in those born term: however, the certainty of evidence was very low. Owing to the low number and heterogeneity of studies, we narratively reviewed literature on food parenting and dietary patterns. Mothers of preterm infants appeared to have heightened anxiety while feeding and utilized coercive food parenting practices; their infants reportedly received less human milk, started solid foods earlier, and had poorer diet quality than term-born peers. In conclusion, meta-analyses show preterm children experience frequent oromotor eating difficulties and challenging eating behaviors throughout the early years. Given preterm birth increases risk of later obesity and diet-related chronic disease, research examining the effects of caregiver-child interactions on subsequent diet is warranted. This review was registered at www.crd.york.ac.uk/prospero/ as CRD42020176063.
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Affiliation(s)
- Kathryn Walton
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Allison I Daniel
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada,Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada,Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Quenby Mahood
- Hospital Library & Archives, Learning Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Simone Vaz
- Department of Pediatrics, William Osler Health System, Brampton, Ontario, Canada
| | - Nicole Law
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sharon L Unger
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada,Paediatrics, Sinai Health, Toronto, Ontario, Canada,Division of Neonatology, The Hospital for Sick Children, Toronto, Ontario, Canada
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25
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Harris HA, Moore AM, Ruggiero CF, Bailey-Davis L, Savage JS. Infant Food Responsiveness in the Context of Temperament and Mothers' Use of Food to Soothe. Front Nutr 2022; 8:781861. [PMID: 35087856 PMCID: PMC8786708 DOI: 10.3389/fnut.2021.781861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/17/2021] [Indexed: 12/15/2022] Open
Abstract
Parents' use of food to soothe an infants' non-hunger related distress may impair an infants' development of appetite self-regulation. Parents tend to use food to soothe if their infant has more ‘difficult' temperamental tendencies. However, the role of infant appetite in this association is unclear. This study investigates the moderating effect of infant food responsiveness on cross-sectional and prospective associations between infant temperament and mothers' use of food to soothe. Mothers (n = 200) from low-income households reported their infants' temperament (i.e., surgency, negative affect and regulation) and food responsiveness at age 4 months, and their use of food to soothe at age 4 and 6 months. Temperament × food responsiveness interactions on mothers' use of food to soothe were examined using general linear models, adjusting for covariates. Cross-sectional associations showed that mothers used more food to soothe at 4 months for infants who were lower in negative affect and higher in food responsiveness (negative affect × food responsiveness interaction: p = 0.03). Prospective associations showed that mothers used more food to soothe at 6 months for infants who were lower in regulation and higher in food responsiveness (infant regulation × food responsiveness interaction: p = 0.009). Other interactions were not significant. Infant food responsiveness was consistently associated with mothers' use of food to soothe, independent of some temperamental dimensions. The findings highlight the salience of infant food responsiveness, both independent of and in association with temperament, on mothers' use of food to soothe.
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Affiliation(s)
- Holly A Harris
- Generation R Study Group, Erasmus MC, University Medical Center, Department of Child and Adolescent Psychiatry/Psychology, Rotterdam, Netherlands
| | - Amy M Moore
- Department of Human Health and Development, Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, United States
| | - Cara F Ruggiero
- Department of Human Health and Development, Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, United States
| | - Lisa Bailey-Davis
- Population Health Sciences, Obesity Institute Geisinger, Danville, PA, United States
| | - Jennifer S Savage
- Department of Human Health and Development, Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, United States
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26
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Campbell N, Verdonck M, Swanepoel L, Chilman L. The Lived Experiences of Fathers in Mealtimes: A Thematic Synthesis of Qualitative Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19021008. [PMID: 35055825 PMCID: PMC8775529 DOI: 10.3390/ijerph19021008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 02/04/2023]
Abstract
The paternal experience of family mealtimes is an emerging field within qualitative literature. Previous quantitative studies suggest that differences exist between fathers’ and mothers’ mealtime behaviours, particularly in response to fussy eating. However, qualitative research has not yet focused exclusively on fathers’ fussy eating experiences. This metasynthesis aimed to provide insights into the general paternal experience, inclusive of their fussy eating responses. Thematic synthesis methodology was adopted to achieve this process and consisted of a systematic search resulting in the inclusion of 16 studies (18 papers). The direct quotations presented within each study were subjected to three stages of analysis to produce three analytical themes, supported by eight descriptive themes. The analytical themes presented were: (1) environmental influences on fathers’ mealtime experiences; (2) attitudes and emotions of fathers during mealtimes; and (3) observable behaviours of fathers during mealtimes. These themes highlighted the complexity of the mealtime experience from a paternal perspective. Multidirectional relationships were identified between each mealtime component (i.e., the environment, attitudes, emotions and behaviours) as evidenced by the paternal commentary presented. The findings also provided insights into fathers’ fussy eating experiences, recognising that fathers should be considered as individuals in the presence of mealtime intervention.
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Špindler N, Cilar Budler L, Klanjšek P, Kegl B. Vpliv izbirčnosti v prehrani na prehranjenost otrok. OBZORNIK ZDRAVSTVENE NEGE 2021. [DOI: 10.14528/snr.2021.55.4.3070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: Vse pogosteje zaznavamo različne težave z načinom prehranjevanja pri otrocih. Otroci med 10. in 14. letom intenzivno rastejo in se razvijajo. Namen raziskave je bil ugotoviti vpliv izbirčnosti v prehrani otrok na njihovo prehranjenost v omenjeni starosti.Metode: Uporabljena je bila presečna opisna raziskava. Zajet je bil priložnostni vzorec osnovnošolcev zadnjega triletja. V raziskavi je sodelovalo 62 (49,2 %) učencev moškega in 64 (50,8 %) učencev ženskega spola zadnjega triletja ene izmed osnovnih šol v Sloveniji. Za zbiranje podatkov smo uporabili anketni vprašalnik, pridobili pa smo tudi podatke o telesni masi in višini. Uporabili smo opisno in sklepno statistiko (dvostranski test ANOVA).Rezultati: 37 (53,6 %) deklet in 28 (44,4 %) fantov je trdilo, da so izbirčni. Z dvostranskim testom ANOVA smo ugotovili, da obstaja povezava med izbirčnostjo in prehranjenostjo (p = 0,014). Pri dekletih je vidno večje odstopanje od prehranjenosti kot pri fantih.Diskusija in zaključek: Izbirčno prehranjevanje je v današnjem času zelo pogost problem, saj se je v njem prepoznala skoraj polovica vključenih učencev. Izbirčnost ima lahko negativne posledice v odrasli dobi. V starosti 10–14 let se ustvarjajo prehranjevalne navade, ki so lahko prisotne celotno življenje, zato je bistveno, da delujemo preventivno in s tem preprečimo negativne posledice. V prihodnosti bi bilo treba raziskovanje usmeriti v preventivne dejavnosti in promocijo zdravega prehranjevanja.
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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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29
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Fraser K, Markides BR, Barrett N, Laws R. Fussy eating in toddlers: A content analysis of parents' online support seeking. MATERNAL & CHILD NUTRITION 2021; 17:e13171. [PMID: 33739624 PMCID: PMC8189205 DOI: 10.1111/mcn.13171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 01/02/2023]
Abstract
The development of healthy eating habits in childhood is essential to reducing later risk of obesity. However, many parents manage fussy eating in toddlerhood with ineffective feeding practices that limit children's dietary variety and reinforce obesogenic eating behaviours. Understanding parents' feeding concerns and support needs may assist in the development of feeding interventions designed to support parents' uptake of responsive feeding practices. A total of 130 original posts by parents of toddlers (12-36 months) were extracted from the online website Reddit's 'r/Toddlers' community discussion forum over a 12-month period. Qualitative content analysis was used to categorise the fussy eating topics that parents were most concerned about and the types of support they were seeking from online peers. The most frequently raised fussy eating concerns were refusal to eat foods offered, inadequate intake (quantity and quality), problematic mealtime behaviours and changes in eating patterns. Parents were primarily seeking practical support (69.2%) to manage emergent fussy eating behaviours. This consisted of requests for practical feeding advice and strategies or meal ideas. Nearly half of parents sought emotional support (47.7%) to normalise their child's eating behaviour and seek reassurance from people with lived experience. Informational support about feeding was sought to a lesser extent (16.2%). Fussy eating poses a barrier to children's dietary variety and establishing healthy eating habits. These results suggest parents require greater knowledge and skills on 'how to feed' children and support to manage feeding expectations. Health professionals and child feeding interventions should focus on providing parents with practical feeding strategies to manage fussy eating. Supporting parents to adopt and maintain responsive feeding practices is vital to developing healthy eating habits during toddlerhood that will continue throughout adulthood.
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Affiliation(s)
- Kylie Fraser
- School of Health and Social DevelopmentDeakin UniversityVictoriaAustralia
| | - Brittany Reese Markides
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityVictoriaAustralia
| | - Norma Barrett
- School of Health and Social DevelopmentDeakin UniversityVictoriaAustralia
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition SciencesDeakin UniversityVictoriaAustralia
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30
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Lim PS, Balistreri KA, Silverman AH, Davies WH. Disrupted mealtime interactions are associated with stress and internalizing symptoms in caregivers of school-age children. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1928499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Paulina S. Lim
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Kathryn A. Balistreri
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Alan H. Silverman
- Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - W. Hobart Davies
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
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31
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Prasetyo YB, Dewi YS, Arifin H, Kamel AD. The Effect of Learning Module Program on Mothers’ Ability to Adapt to New Foods, Feeding Styles, and Self-efficacy to Their Children with Avoidant Restrictive Food Intake Disorder. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The education to improve a mother’s knowledge is deemed to be important because it may improve children’s nutritional status.
AIM: The aim of this study was to examine the effects of learning module program on the mothers’ ability to adapt to new foods, feeding styles, and self-efficacy to their children with avoidant restrictive food intake disorder (ARFID).
METHODS: Quasi-experimental design was used to evaluate the effectiveness of learning module program. Fifteen mothers of experimental group were given four meetings within 4 weeks. Each meeting ran about 50 min. Fifteen mothers of control group were conducted home visit and received twice education about the health principals of feeding children. Both experimental group and control group had pre-test and post-test. The data were analyzed using Chi-square test, Fisher’s exact test, and Mann–Whitney U-test.
RESULTS: The participants of the experimental group have shown bigger surge of new foods adaptation (t = –2.973, p < 0.003), feeding style (t = –4.646, p < 0.001), self-efficacy (t = –3.652, p = 0.001) than the control group has.
CONCLUSION: The findings indicated that the learning module program was deemed to be effective to improve mothers’ ability to adapt to new foods, feeding styles, and self-efficacy to their children with ARFID.
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32
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Lebron CN, Agosto Y, Guzman T, Sutton D, Stoutenberg M, Messiah SE, George SMS. A qualitative study of cognitive, behavioral, and environmental influences on Hispanic mothers' early childhood feeding practices. Appetite 2021; 164:105268. [PMID: 33864860 DOI: 10.1016/j.appet.2021.105268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/12/2021] [Accepted: 04/09/2021] [Indexed: 10/21/2022]
Abstract
Young children's lifestyle behaviors are largely shaped by their parents. There are socioeconomic risk factors particular to Hispanic populations that influence the way parents feed their children. As obesity continues to be a public health issue with substantial inequities across race and ethnicity, it is critical to understand Hispanic parents' food choices and feeding practices. The objective of this qualitative study is to identify the behavioral, environmental, and cognitive factors that influence the parental food choices and feeding behaviors of Hispanic mothers of children ages 0-5 years. Snowball sampling was used to recruit participants from the community (n = 30) who were 1) female; 2) Hispanic; 3) over the age of 18; and 4) a mother to child(ren) between the ages zero and five. Each interview consisted of a brief demographic survey and a set of open-ended questions based on Social Cognitive Theory constructs. A thematic analysis using a combined deductive and inductive approach was used to analyze transcriptions. Results indicated that mothers' attitudes around breastfeeding were connected with their challenges, while their attitudes around solid foods were expressed in their feeding strategies. Mothers used strategies of modeling, repeated exposure, and practices of "sneaking" in healthy foods and bribing to promote healthy eating. Mothers were most likely to seek out information from (1) pediatricians, (2) female family members, and (3) the internet. Hispanic mothers actively seek out information from many different sources that impact how they feed their young children. Understanding their trusted sources and how it influences the SCT constructs is an important step in preventing early childhood obesity.
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Affiliation(s)
- Cynthia N Lebron
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.
| | - Yaray Agosto
- Florida International University, Robert Stempel College of Public Health & Social Work, Miami, FL, USA
| | - Tamisha Guzman
- Florida International University, Robert Stempel College of Public Health & Social Work, Miami, FL, USA
| | - Danielle Sutton
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mark Stoutenberg
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Sarah E Messiah
- University of Texas Health Science Center School of Public Health, Dallas Campus, Dallas, TX, USA; Center for Pediatric Population Health, Children's Health System of Texas and UTHealth School of Public Health, Dallas, TX, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Prasetyo YB, Nursalam N, Widyawati IY, Hargono R, Ahsan A, Kumboyono K. A belief-based parenting behavior model for promoting family's ability to care for children with avoidant restrictive food intake disorder (ARFID) in Indonesia. J Public Health Res 2021; 10:1964. [PMID: 33623776 PMCID: PMC7893318 DOI: 10.4081/jphr.2021.1964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Family's ability to care for children with avoidant restrictive food intake disorder (ARFID) is a central indicator in preventing the children from worse nutritional disorders. Environmental factor, child factor, caregiving behavioral systems, and beliefs can improve the family's ability to care for children. The aim of this research was to analyze the effect of environmental factor, child factor, caregiving behavioral systems, and beliefs on the family's ability to care for children with ARFID. Design and Methods: This cross-sectional research was carried out on 245 families with children suffering from ARFID in Malang Regency, in the working area of the Health Office of Malang Regency. The population of this research was families with children suffering from ARFID within the working area of the Health Office of Malang Regency. The research sample size was computed using the rule of thumb in structural equation modeling (SEM), the sample size used was 245. Results: Results showed that the family's ability to care for children with ARFID was highly influenced by the caregiver's belief (t = 21.796; β = 0.713). Caregiver's belief became a dominant factor in the promotion of the family's ability to care for children with ARFID. A caregiver's belief was influenced by his/her behavior. Conclusions: It was concluded that the caregiver's belief serves as a primary factor in the promotion of the family's ability to care for children with ARFID. A caregiver's behavior holds a prominent role in influencing his/her belief in providing care for children suffering from ARFID.
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Affiliation(s)
- Yoyok Bekti Prasetyo
- Community Department, Department of Nursing, Faculty of Health Sciences, University of Muhammadiyah Malang, Kota Malang, Jawa Timur
| | - Nursalam Nursalam
- Department of Health Sciences, Faculty of Public Health, Airlangga University, Surabaya
| | - Ika Yuni Widyawati
- Department of Health Sciences, Faculty of Public Health, Airlangga University, Surabaya
| | - Rahmat Hargono
- Department of Health Education and Behavioural Sciences, Faculty of Public Health, Airlangga University, Surabaya
| | - Ahsan Ahsan
- Department of Nursing, Faculty of Medicine, Brawijaya University, Kota Malang, Jawa Timur, Indonesia
| | - Kumboyono Kumboyono
- Department of Nursing, Faculty of Medicine, Brawijaya University, Kota Malang, Jawa Timur, Indonesia
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Patel MD, Donovan SM, Lee SY. Considering Nature and Nurture in the Etiology and Prevention of Picky Eating: A Narrative Review. Nutrients 2020; 12:nu12113409. [PMID: 33171966 PMCID: PMC7694604 DOI: 10.3390/nu12113409] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 12/25/2022] Open
Abstract
Children are often categorized as picky eaters by parents and caregivers for their rejection of foods, such as vegetables, and for exhibiting other difficult mealtime behaviors. However, there are several factors that contribute to these mealtime behaviors, including early feeding practices (i.e., breastfeeding, introduction to solid food), repeated exposure to novel foods, and genetic taste sensitivity to certain compounds. Using the online database of PubMed, a review of the literature on the development of picky eating in children, its outcomes, and intervention strategies was conducted. This review groups the developmental contributors to picky eating into the categories of nature and nurture and explores the interaction between the two. This paper will also summarize the potential outcomes of picky eating and the various strategies that are currently recommended to mitigate picky eating in young children. However, there is a lack of longitudinal work targeting consistent picky eating behaviors that have the potential to impact long-term food preferences and dietary variety. Future intervention strategies should address the factors that influence the development of picky eating on an individual level.
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Affiliation(s)
- Meera D. Patel
- Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA;
| | - Sharon M. Donovan
- Department of Food Science and Human Nutrition and Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA;
| | - Soo-Yeun Lee
- Department of Food Science and Human Nutrition and Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA;
- Correspondence: ; Tel.: +1-217-244-9435
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35
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Jansen PW, Derks IPM, Mou Y, van Rijen EHM, Gaillard R, Micali N, Voortman T, Hillegers MHJ. Associations of parents' use of food as reward with children's eating behaviour and BMI in a population-based cohort. Pediatr Obes 2020; 15:e12662. [PMID: 32548949 PMCID: PMC7583369 DOI: 10.1111/ijpo.12662] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Parents' use of food as reward has been linked to children's dietary intake, but the association with children's eating behaviour and overweight risk is less clear. OBJECTIVES To examine the temporal association of using food as reward with eating behaviour, body mass index (BMI) and weight status of children. METHODS Participants were 3642 children of the population-based Generation R Study in the Netherlands (8.3% overweight/obese). Repeated assessments were collected at child ages 4 and 9 years, including measured anthropometrics and parent reports on feeding practises and eating behaviour. RESULTS Linear regressions and cross-lagged models indicated that parents' use of food as reward at child age 4 years predicted Emotional Overeating and Picky Eating at age 9 years. Reversely, higher Emotional Overeating and Food Responsiveness scores were associated with more use of food as reward over time. Using food as reward was not associated with children's satiety response, BMI or overweight risk. CONCLUSIONS A vicious cycle may appear in which children who display food approach behaviour are rewarded with food by their parents, which in turn might contribute to the development of unhealthy eating habits (emotional eating, fussiness). These findings warrant further research, to facilitate evidence-based recommendations for parents.
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Affiliation(s)
- Pauline W. Jansen
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC‐University Medical Centre RotterdamRotterdamThe Netherlands,Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
| | - Ivonne P. M. Derks
- Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
| | - Yuchan Mou
- The Generation R Study GroupErasmus MC‐University Medical Centre RotterdamRotterdamThe Netherlands,Department of EpidemiologyErasmus MC‐University Medical Centre RotterdamRotterdamThe Netherlands
| | - Elisabeth H. M. van Rijen
- Department of Psychology, Education and Child StudiesErasmus University RotterdamRotterdamThe Netherlands
| | - Romy Gaillard
- Department of PaediatricsErasmus MC‐University Medical Centre RotterdamRotterdamThe Netherlands
| | - Nadia Micali
- Department of Psychiatry, Faculty of MedicineUniversity of GenevaGenevaSwitzerland,Department of PsychiatryIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA,Institute of Child Health, University College LondonLondonUK
| | - Trudy Voortman
- Department of EpidemiologyErasmus MC‐University Medical Centre RotterdamRotterdamThe Netherlands
| | - Manon H. J. Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC‐University Medical Centre RotterdamRotterdamThe Netherlands
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Marsh S, Taylor R, Galland B, Gerritsen S, Parag V, Maddison R. Results of the 3 Pillars Study (3PS), a relationship-based programme targeting parent-child interactions, healthy lifestyle behaviours, and the home environment in parents of preschool-aged children: A pilot randomised controlled trial. PLoS One 2020; 15:e0238977. [PMID: 32941530 PMCID: PMC7498059 DOI: 10.1371/journal.pone.0238977] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/26/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Early childhood is a critical period for the development of obesity, with new approaches to prevent obesity in this age group needed. We designed and piloted the 3 Pillars Study (3PS), a healthy lifestyle programme informed by attachment theory for parents of preschool-aged children. METHODS A 2-arm, randomised controlled pilot study was conducted to assess the effectiveness of 3PS, a 6-week programme involving a half-day workshop plus 6-week access to a study website. The programme was designed to promote routines around healthy lifestyle behaviours, including sleep, limited screen use, and family meals, within the context of positive, reciprocal parent-child interactions. Parents (n = 54) of children aged 2-4 years who regularly exceeded screen use recommendations (≥1 hour per day), were randomised to the 3PS programme (n = 27) or a wait-list control group (n = 27). Child screen time at 6 weeks was the primary endpoint. Frequency of family meals, parent feeding practices, diet quality, sleep, Child Routine Inventory (to assess predictability of commonly occurring routines), and household chaos were also assessed. Study data were collected online at baseline, 6 weeks, and 12 weeks via REDCap. RESULTS No group differences were observed for changes from baseline in screen time (primary endpoint), feeding behaviour scores, Child Routine Inventory scores, or total night time sleep duration at 6 and 12 weeks, although all measures improved in the hypothesised direction in the 3PS group. Compared with controls, the intervention group demonstrated significant improvements from baseline in household chaos scores (i.e. a reduction in chaos) and a number of measures of sleep outcomes, indicating improved sleep continuity. The programme was highly acceptable to parents. CONCLUSIONS AND RECOMMENDATIONS A relational approach appears promising as a novel way to promote healthy lifestyle behaviours associated with the prevention of childhood obesity in children aged 2-4 years. A larger study is warranted.
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Affiliation(s)
- Samantha Marsh
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Rachael Taylor
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Barbara Galland
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Sarah Gerritsen
- Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Varsha Parag
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Ralph Maddison
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
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37
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Haycraft E, Witcomb GL, Farrow C. The Child Feeding Guide: A digital health intervention for reducing controlling child feeding practices and maternal anxiety over time. NUTR BULL 2020. [DOI: 10.1111/nbu.12445] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- E. Haycraft
- School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
| | - G. L. Witcomb
- School of Sport, Exercise and Health Sciences Loughborough University Loughborough UK
| | - C. Farrow
- School of Life and Health Sciences Aston University Birmingham UK
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Cormack J, Rowell K, Postăvaru GI. Self-Determination Theory as a Theoretical Framework for a Responsive Approach to Child Feeding. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:646-651. [PMID: 32247759 DOI: 10.1016/j.jneb.2020.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/18/2020] [Accepted: 02/10/2020] [Indexed: 06/11/2023]
Abstract
Supporting positive childhood eating behaviors is a central and ongoing priority for health care providers, encompassing both health outcomes for typical eaters and best practice in relation to pediatric feeding challenges. Building on existing work, this perspective draws on literature from multiple fields to recommend the use of Self-Determination Theory as a framework for responsive feeding. Additionally, it contributes to the definition and conceptualization of responsive feeding. The 3 basic needs proposed by Self-Determination Theory (autonomy, relatedness and competence) have significant implications for both professional practice and the direction of future research.
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Affiliation(s)
- Johanna Cormack
- Department of Psychology, Bishop Grosseteste University, Lincoln, United Kingdomqry.
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Searle BRE, Harris HA, Thorpe K, Jansen E. What children bring to the table: The association of temperament and child fussy eating with maternal and paternal mealtime structure. Appetite 2020; 151:104680. [PMID: 32222402 DOI: 10.1016/j.appet.2020.104680] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 01/10/2023]
Abstract
Fussy eating is a nuanced, mealtime-specific behaviour associated with difficult temperament but has been rarely examined within the context of mealtime structure. The aim of this study was to a) examine associations between child temperament, and mothers' and fathers' structure-related feeding practices and b) explore whether these associations were mediated by child fussy eating. Cohabiting mother-father pairs (N = 205) of children aged between 2- to 5-years residing in a socioeconomically disadvantaged Australian city completed self-reported, validated measures of child temperament, food fussiness and structure-related feeding practices (structured meal timing, structured meal setting and family meal setting). Child temperament was associated with maternal and paternal structure-related feeding practices, such that more difficult temperament was associated with less mealtime structure. Mothers' perception of child food fussiness mediated the relationship between difficult temperament and increased provision of alternative meals to the child from the rest of the family. Additionally, mothers' and fathers' perception of child food fussiness mediated the relationship between difficult child temperament and lower frequency of sitting at a table together for family meals. Therefore, perceptions of child food fussiness may explain why mothers and fathers use less structure at mealtimes with children who have more difficult temperaments. These results suggests that similar intervention approaches can be used for both mothers and fathers from socioeconomically disadvantaged families to target fussy eating and structure the mealtime environment. Promoting mealtime structure to facilitate parents' appropriate responses to food refusal or difficult behaviour at mealtimes is indicated.
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Affiliation(s)
- Bonnie-Ria E Searle
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Holly A Harris
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Karen Thorpe
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
| | - Elena Jansen
- Centre for Children's Health Research, 62 Graham St, South Brisbane, QLD, 4101, Australia.
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The Environmental and Bitter Taste Endophenotype Determinants of Picky Eating in Australian School-Aged Children 7-12 years-A Cross-Sectional Pilot Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051573. [PMID: 32121357 PMCID: PMC7084323 DOI: 10.3390/ijerph17051573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 12/11/2022]
Abstract
Caregivers’ perceptions of children’s pickiness are relatively scarce in relation to the five core food groups and their importance in providing a nutritionally balanced diet. Furthermore, there is no validated questionnaire that examines child-reported food preferences in an age-appropriate manner, and the use of terms such as a “picky eater” can be attributed to environmental and genetic factors. Despite potential links between children’s food preferences and endophenotype bitter taste, associations between bitter taste sensitivity and picky eating is relatively unexplored. The proposed cross-sectional study aims to develop and validate a parent-reported core-food Picky Eating Questionnaire (PEQ) and child-reported Food Preference Questionnaire (C-FPQ) and simultaneously investigate environmental and phenotype determinants of picky eating. The study will be conducted in three stages: Phase 1, piloting PEQ and C-FPQ questionnaires (15–20 primary caregivers and their children aged 7–12 years); Phase 2 and 3, validating the revised questionnaires and evaluating the 6-n-propylthiouracil (PROP) bitter taste sensitivity to examine perception to bitter taste (369 primary caregivers and their children). Study findings will generate new validated tools (PEQ, C-FPQ) for use in evidence-based practice and research and explore picky eating as a behavioural issue via the potential genetic-phenotype basis of bitter taste sensitivity.
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Wolstenholme H, Kelly C, Hennessy M, Heary C. Childhood fussy/picky eating behaviours: a systematic review and synthesis of qualitative studies. Int J Behav Nutr Phys Act 2020; 17:2. [PMID: 31900163 PMCID: PMC6942299 DOI: 10.1186/s12966-019-0899-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 12/10/2019] [Indexed: 12/21/2022] Open
Abstract
Fussy/picky eating behaviours are common across childhood. Recent reviews of the fussy eating literature focus on quantitative research and do not adequately account for families' subjective experiences, perceptions and practices. This review aims to synthesise the increasing volume of qualitative work on fussy eating. A systematic search of relevant databases was carried out. Studies were included if they were qualitative, published since 2008, with a primary focus on families' experiences, perceptions and practices regarding fussy eating, food neophobia, or food refusal in children (aged one to young adult). Studies with clinical samples, or relating to children under one year were excluded. Ten studies were eligible for this review and were synthesised using meta-ethnography (developed by Noblit and Hare). This review provides a comprehensive description and definition of fussy eating behaviours. A conceptual model of the family experience of fussy eating was developed, illustrating relationships between child characteristics (including fussy eating behaviours), parent feeding beliefs, parent feeding practices, mealtime emotions and parent awareness of food preference development. Our synthesis identified two ways in which fussy eating relates to mealtime emotions (directly and via parent feeding practices) and three distinct categories of parent beliefs that relate to fussy eating (self-efficacy, attributions and beliefs about hunger regulation). The model proposes pathways which could be explored further in future qualitative and quantitative studies, and suggests that parent beliefs, emotions, and awareness should be targeted alongside parent feeding practices to increase effectiveness of interventions. The majority of studies included in this review focus on pre-school children and all report the parent perspective. Further research is required to understand the child's perspective, and experiences of fussy eating in later childhood. PROSPERO Registration: CRD42017055943.
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Affiliation(s)
| | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland, Galway, Ireland
| | - Marita Hennessy
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Caroline Heary
- School of Psychology, National University of Ireland, Galway, Ireland
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Parental Influence in Forming Preschool Children's Eating Behaviors-A Cross-Sectional Survey in Chongqing, China. Healthcare (Basel) 2019; 7:healthcare7040140. [PMID: 31703475 PMCID: PMC6955891 DOI: 10.3390/healthcare7040140] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/21/2019] [Accepted: 11/04/2019] [Indexed: 01/26/2023] Open
Abstract
Children’s eating habits are closely related to their health problems and the outlook for children’s nutritional statuses appears poor. A cross-sectional survey was conducted among parents of preschool children from December 2018 to January 2019. Sixteen representative kindergartens in 6 districts of Chongqing, China, were included in the study. We took 2200 samples and collected information by questionnaire and after screening, 1781 questionnaires were valid and finally included in the data analysis (n = 1781). Ordinal logistic regression analysis found that age, fathers’ education level, forced diet and perception of children’s body shape were factors associated with children’s eating behaviors (ordered logistic regression/three-level eating behavior; odds ratios p < 0.05). 80.24% of preschool children may have unhealthy eating behavior in this survey and 80.35% of parents had forced their children to eat. Eating behaviors of preschool children in Chongqing are closely related to family factors. This study provides important insight for parents and health care workers in China to improve preschool-aged children’s nutritional behaviors. Intervention programs should focus on parents with low income, low education levels, coercive dietary behaviors and deviated body shape perceptions to reduce children’s eating behavioral problems.
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Sandvik P, Ek A, Eli K, Somaraki M, Bottai M, Nowicka P. Picky eating in an obesity intervention for preschool-aged children - what role does it play, and does the measurement instrument matter? Int J Behav Nutr Phys Act 2019; 16:76. [PMID: 31481062 PMCID: PMC6724280 DOI: 10.1186/s12966-019-0845-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/27/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Research on picky eating in childhood obesity treatment is limited and inconsistent, with various instruments and questions used. This study examines the role of picky eating in a randomized controlled obesity intervention for preschoolers using subscales from two instruments: The Child Eating Behavior Questionnaire (CEBQ) and the Lifestyle Behavior Checklist (LBC). METHOD The study includes 130 children (mean age 5.2 years (SD 0.7), 54% girls, mean Body Mass Index (BMI) z-score 2.9 (SD 0.6)) and their parents (nearly 60% of non-Swedish background, 40% with university degree). Families were randomized to a parent-group treatment focusing on evidence-based parenting practices or to standard treatment focusing on lifestyle changes. The children's heights and weights (BMI z-score) were measured at baseline, and at 3, 6 and 12 months post baseline. At these time-points, picky eating was reported by parents using the CEBQ (Food Fussiness scale, 6 items) and 5 items from the LBC. Child food intake was reported with a Food Frequency Questionnaire (FFQ). Pearson correlation was used to study associations between baseline picky eating and baseline BMI z-scores and food intake. Mixed effects models were used to study associations between the two measurements of picky eating and changes in picky eating, to assess the effects of changes in picky eating on BMI z-scores, and to evaluate baseline picky eating as a predictor of changes in BMI z-scores. RESULTS Neither the standard treatment nor the parent-group treatment reduced the degree of picky eating (measured with CEBQ or LBC). Baseline picky eating measured with the CEBQ was associated with a lower BMI z-score and lower intake of vegetables. Children with a higher degree of picky eating at baseline (measured with the CEBQ) displayed a lower degree of weight loss. When degree of picky eating was examined, for 25% of the children, the CEBQ and the LBC yielded diverging results. CONCLUSIONS Baseline picky eating may weaken the effectiveness of obesity treatment, and assessments should be conducted before treatment to adjust the treatment approach. Different measurements of picky eating may lead to different results. The CEBQ seems more robust than the LBC in measuring picky eating. TRIAL REGISTRATION Clinicaltrials.gov , NCT01792531. Registered 15 February 2013 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01792531.
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Affiliation(s)
- Pernilla Sandvik
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden.
| | - Anna Ek
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
| | - Karin Eli
- Social Science and Systems in Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Warwick, England.,Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, England
| | - Maria Somaraki
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden
| | - Matteo Bottai
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, 751 22, Uppsala, Sweden.,Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
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Daniels L. Feeding Practices and Parenting: A Pathway to Child Health and Family Happiness. ANNALS OF NUTRITION AND METABOLISM 2019; 74 Suppl 2:29-42. [DOI: 10.1159/000499145] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Feeding and parenting are inextricably linked. The complex bidirectional interactions between parent feeding practices and child eating behaviour shape the early feeding environment which in turn interacts with genetic predispositions to lay the foundation for life-long eating habits and health outcomes. Parent feeding and child (and parent) eating are central to the fabric of family life and are strongly rooted in culture and tradition. Yet, many parents experience stress and anxiety related to this ubiquitous parenting task and perceive their child as a “fussy eater” or a “difficult feeder.” Parents commonly misinterpret heritable and developmentally “normal” child eating behaviour, such as food refusal, as cause for concern. In an effort to get their child to “eat well” they respond with coercive feeding practices, such as pressure, reward and restriction. Emotional feeding that uses food to comfort, distract, calm or shape behaviour is also common. Although well intentioned, these non-responsive, parent- rather than child-centred feeding practices are ineffective, even counterproductive. They teach children to eat for reasons unrelated to appetite and, hence, more than they need and fail to support development of healthy food preferences and appetite regulation. Early feeding interventions are needed that assist parents to understand normal child eating behaviour and promote responsive feeding practices and effective food parenting. The aim of this chapter is to review (1) “normal” eating behaviour of young children, (2) the range of feeding practices and strategies that parents use to respond to and try to shape these behaviours, (3) evidence for approaches to feeding young children that have potential to reduce conflict related to child feeding and promote life-long healthy eating patterns that are a key determinant of long-term health and well-being and (4) to provide an overview of an early feeding intervention, NOURISH, which demonstrated a positive impact on maternal feeding practices and potentially reduced parent anxiety and stress related to feeding.
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Wolstenholme H, Heary C, Kelly C. Fussy eating behaviours: Response patterns in families of school-aged children. Appetite 2019; 136:93-102. [PMID: 30668966 DOI: 10.1016/j.appet.2019.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/23/2018] [Accepted: 01/09/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fussy eating is the unwillingness to eat both familiar and novel foods. Childhood fussy eating can be a barrier to a healthful diet and is associated with mealtime stress and conflict. Research has primarily focused on parenting practices in response to fussy eating in pre-schoolers. Less is known about parenting practices and family processes such as setting goals and managing emotions in relation to fussy eating in older children. This research aims to explore how families respond to fussy eating behaviours in school-aged children and based on parents' retrospective accounts, to investigate how responses change over time. METHODS 16 parents from 14 families of school-aged children (6-10 years) participated in semi-structured qualitative interviews. Interviews were analysed using inductive thematic analysis. RESULTS Three family process themes were identified which explain how families respond to fussy eating behaviours: 1) Dynamic and Evolving Feeding Goals, 2) Managing Negative Emotions and 3) Parenting Practices: Figuring out What Works. Three distinct patterns were identified regarding how parent responses change over time: 1) Resistance-to-Acceptance Response, 2) Fluctuating Response and 3) Consistent Response. DISCUSSION The family response to fussy eating behaviours is complex, dynamic and contextual. This has implications for the design and interpretation of quantitative studies, and for the development of guidelines and interventions.
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Affiliation(s)
- Hazel Wolstenholme
- School of Psychology, National University of Ireland Galway, University Road, Galway, Ireland.
| | - Caroline Heary
- School of Psychology, National University of Ireland Galway, University Road, Galway, Ireland.
| | - Colette Kelly
- Health Promotion Research Centre, National University of Ireland Galway, University Road, Galway, Ireland.
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Harris HA, Jansen E, Mallan KM, Daniels L, Thorpe K. Concern Explaining Nonresponsive Feeding: A Study of Mothers' and Fathers' Response to Their Child's Fussy Eating. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:757-764. [PMID: 30196882 DOI: 10.1016/j.jneb.2018.05.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/27/2018] [Accepted: 05/29/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To examine the role of parent concern in explaining nonresponsive feeding practices in response to child fussy eating in socioeconomically disadvantaged families. DESIGN Mediation analysis of cross-sectional survey data. SETTING Socioeconomically disadvantaged urban community in Queensland, Australia. PARTICIPANTS Cohabiting mother-father pairs (n = 208) with children aged 2-5 years. MAIN OUTCOME MEASURE(S) Two validated measures of nonresponsive feeding: persuasive feeding and reward for eating. ANALYSIS Mediation analysis tested concern as a mediator of the relationship between child food fussiness (independent variable) and parent nonresponsive feeding practices (dependent variables), adjusted for significant covariates and modeled separately for mothers and fathers. RESULTS Maternal concern fully mediated the relationship between child food fussiness and persuasive feeding (indirect effect: B [SE] = 0.10 [0.05]; 95% confidence interval [CI], 0.01-0.20). Concern also fully mediated the relationship between child food fussiness and reward for eating for mothers (indirect effect: B [SE] = 0.17 [0.07]; CI, 0.04-0.31) and fathers (indirect effect: B [SE] = 0.14 [0.05]; CI, 0.04-0.24) CONCLUSIONS AND IMPLICATIONS: Concern for fussy eating behaviors may explain mothers' and fathers' nonresponsive feeding practices. In addition to providing education and behavioral support, health professionals working with socioeconomically disadvantaged families can incorporate strategies that aim to alleviate parents' concerns about fussy eating.
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Affiliation(s)
- Holly A Harris
- Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, Australia.
| | - Elena Jansen
- Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Kimberley M Mallan
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, Australia; School of Psychology, Australian Catholic University, Banyo, Brisbane, Australia
| | - Lynne Daniels
- Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Brisbane, Australia; School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
| | - Karen Thorpe
- Institute for Social Science Research, The University of Queensland, Indooroopilly, Brisbane, Australia
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Sandvik P, Ek A, Somaraki M, Hammar U, Eli K, Nowicka P. Picky eating in Swedish preschoolers of different weight status: application of two new screening cut-offs. Int J Behav Nutr Phys Act 2018; 15:74. [PMID: 30092802 PMCID: PMC6085619 DOI: 10.1186/s12966-018-0706-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/23/2018] [Indexed: 12/11/2022] Open
Abstract
Background Characteristics of picky eaters of different weight status have not been sufficiently investigated. We used two newly developed screening cut-offs for picky eating in the Food fussiness (FF) subscale of the Child Eating Behavior Questionnaire (CEBQ) to investigate the prevalence and characteristics of picky eaters in preschool-aged children with thinness, normal weight, overweight or obesity. Methods Data for 1272 preschoolers (mean age 4.9 years) were analyzed. The parent-reported FF subscale ranges from 1 to 5, and two screening cut-offs were applied to classify children as picky eaters (3.0 and 3.33). Structural Equation Modeling was used to study associations with other factors in the CEBQ, the Child Feeding Questionnaire (CFQ) and the Lifestyle Behavior Checklist (LBC). Scores were compared separately for each weight status group. Results Nearly half of the children were classified as moderate or severe picky eaters (cut-off 3.0) and 30% as severe (cut-off 3.33). For both cut-offs, prevalence was significantly lower in the obesity group. Still, one-third of children with obesity met the cut-off of 3.0 and 17% met the cut-off of 3.33. While picky eaters displayed similar patterns across weight status groups, some differences emerged. Food responsiveness was lower for picky eaters, but the difference was significant only among children with obesity. Slowness in eating was not as pronounced among picky eaters in the obesity group. In the overweight and obesity groups, parents of picky eaters did not report as high pressure to eat, as compared to the thinness or normal weight groups; in the obesity group, parents of picky eaters also perceived their children’s weight as lower. In all weight status groups, parents of picky eaters were more likely to report their children had too much screen time, complained about physical activity, and expressed negative affect toward food. Conclusions Picky eating was less common but still prevalent among children with obesity. Future studies should investigate the potential influence of picky eating on childhood overweight and obesity. Moreover, as children with picky eating display higher emotional sensitivity, further research is needed to understand how to create positive eating environments particularly for children with picky eating and obesity. Electronic supplementary material The online version of this article (10.1186/s12966-018-0706-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pernilla Sandvik
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
| | - Anna Ek
- Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Maria Somaraki
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Ulf Hammar
- Institute of Environmental Medicine, Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Karin Eli
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
| | - Paulina Nowicka
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.,Unit of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Mallan KM, Jansen E, Harris H, Llewellyn C, Fildes A, Daniels LA. Feeding a Fussy Eater: Examining Longitudinal Bidirectional Relationships Between Child Fussy Eating and Maternal Feeding Practices. J Pediatr Psychol 2018; 43:1138-1146. [DOI: 10.1093/jpepsy/jsy053] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/03/2018] [Indexed: 12/23/2022] Open
Affiliation(s)
- Kimberley M Mallan
- School of Psychology, Australian Catholic University
- School of Exercise and Nutrition Sciences, Queensland University of Technology
| | - Elena Jansen
- School of Exercise and Nutrition Sciences, Queensland University of Technology
- Centre for Children’s Health Research, Queensland, Australia
| | - Holly Harris
- School of Exercise and Nutrition Sciences, Queensland University of Technology
- Centre for Children’s Health Research, Queensland, Australia
- School of Public Health, The University of Queensland
| | - Clare Llewellyn
- Department of Behavioural Science and Health, University College London
| | - Alison Fildes
- Department of Behavioural Science and Health, University College London
- School of Psychology, University of Leeds, Woodhouse Lane
| | - Lynne A Daniels
- School of Exercise and Nutrition Sciences, Queensland University of Technology
- Centre for Children’s Health Research, Queensland, Australia
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Abstract
OBJECTIVE Few studies on child feeding have focused on family dynamics or disadvantaged families, yet feeding occurs in the complex social, economic, and relational context of the family. We examined how the level (high vs low) and concordance (concordant vs discordant) of nonresponsive feeding practices of mothers and fathers are associated with child fussy eating, in a socioeconomically disadvantaged Australian sample. METHODS Mother-father pairs (N = 208) of children aged 2 to 5 years old independently completed validated questionnaires reporting their "persuasive feeding," "reward for eating," "reward for behavior," and child's "food fussiness." The fussiness scores did not differ between mother-father pairs and were averaged to derive a single dependent variable. K-means cluster analyses were used to assign mother-father pairs to clusters for each feeding practice, based on mean scores. Three ANCOVAs, corresponding to each feeding practice, tested differences in child fussiness across clusters while controlling for covariates. RESULTS Four clusters were identified for each feeding practice-concordant: (1) high (MHi/FHi) for both parents and (2) low (MLo/FLo) for both parents; and discordant: (3) high for mother but low for father (MHi/FLo); and (4) low for mother but high for father (MLo/FHi). For "persuasive feeding," MLo/FLo reported lower levels of fussiness compared with MHi/FLo, MHi/FHi, and MLo/FHi (p values < 0.05). For "reward for eating," MLo/FLo reported lower levels of fussiness than did MHi/FHi (p < 0.05). Child fussiness did not differ across "reward for behavior" clusters. CONCLUSION In socioeconomically disadvantaged families, when parents are concordant in avoiding nonresponsive feeding practices, less child "food fussiness" is reported. Findings suggest that feeding interventions should consider inclusion of both parents in 2-parent households.
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50
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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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