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Werner LM, Mallan KM. Associations between restrictive feeding practices and children's dietary intake: Systematic review and meta-analyses. Appetite 2024; 200:107508. [PMID: 38795944 DOI: 10.1016/j.appet.2024.107508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
BACKGROUND Parents' attempt to limit or restrict children's intake of 'unhealthy' or discretionary foods has been widely considered as a counterproductive feeding practice associated with poorer dietary outcomes, but empirical evidence is varied. AIM The present systematic literature review aimed to investigate the association between parental restriction and children's dietary intake. METHOD Studies were identified through PsycInfo, MEDLINE, CINAHL, Web of Science, and Scopus databases on April 29th, 2022. Included were peer-reviewed, English-language articles published between 2001 and 2022, with an effect size between restriction and children's intake of foods that are 'healthy' (i.e., fruit, vegetables, other general healthy foods) or 'discretionary' (i.e., sweet or savoury energy-dense/nutrient poor foods, high-sugar foods, high-salt/fat foods, and high-energy/sugar-sweetened beverages), or overall diet quality. Risk of bias was assessed using a quality assessment checklist designed to evaluate survey studies. RESULTS Included studies (n = 44) were most often conducted in the USA, cross-sectional, and participants were mothers. Effect sizes (k = 59) from 21 studies were used in nine meta-analyses investigating various healthy and discretionary dietary intake variables. No meta-analytic effects were statistically significant. Qualitative synthesis of effect sizes ineligible for meta-analysis (k = 91) identified patterns of associations between restriction and increased intake of healthy foods, and decreased intake of discretionary foods. CONCLUSIONS Studies used a diverse selection of measures of restriction and dietary intake, limiting the ability of this review to make accurate cross-study comparisons. However, results suggest that instead of restriction being detrimental for children's dietary outcomes, it may be unrelated, or associated with more beneficial dietary outcomes. Research that utilises validated measures of restriction and dietary outcomes and a longitudinal design is needed to clarify this association.
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Affiliation(s)
- Lilly M Werner
- School of Behavioural and Health Sciences, Melbourne, Australian Catholic University, Australia
| | - Kimberley M Mallan
- School of Behavioural and Health Sciences, Brisbane, Australian Catholic University, Australia.
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2
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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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3
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Surette VA, Smith‐Simpson S, Fries LR, Forde CG, Ross CF. Observations of feeding practices of US parents of young children with Down syndrome. MATERNAL & CHILD NUTRITION 2023; 19:e13548. [PMID: 37458153 PMCID: PMC10483950 DOI: 10.1111/mcn.13548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Parental behaviours influence food acceptance in young children, but few studies have measured these behaviours using observational methods, especially among children with Down syndrome (CWDS). The overall goal of this study was to understand parent feeding practices used during snack time with young CWDS (N = 111, aged 11-58 months). A coding scheme was developed to focus on feeding practices used by parents of CWDS from a structured home-use test involving tasting variously textured snack products. Behavioural coding was used to categorise parental feeding practices and quantify their frequencies (N = 212 video feeding sessions). A feeding prompt was coded as successful if the child ate the target food product or completed the prompt within 20 s of the prompt being given without a refusal behaviour. CWDS more frequently consumed the test foods and completed tasks in response to Autonomy-Supportive Prompts to Eat (49.3%), than to Coercive-Controlling Prompts to Eat (24.2%). By exploring the parent-CWDS relationship during feeding, we can identify potentially desirable parent practices to encourage successful feeding for CWDS. Future research should build upon the knowledge gained from this study to confirm longitudinal associations of parent practices with child behaviours during feeding.
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Affiliation(s)
| | - Sarah Smith‐Simpson
- Sensory and Consumer InsightsNestlé Nutrition North America (Gerber)FremontMichiganUSA
| | | | - Ciarán G. Forde
- Department of Agrotechnology and Food SciencesWageningen University & ResearchWageningenthe Netherlands
| | - Carolyn F. Ross
- School of Food ScienceWashington State UniversityPullmanWashingtonUSA
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Tournier C, Forde CG. Food oral processing and eating behavior from infancy to childhood: evidence on the role of food texture in the development of healthy eating behavior. Crit Rev Food Sci Nutr 2023:1-14. [PMID: 37267128 DOI: 10.1080/10408398.2023.2214227] [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: 06/04/2023]
Abstract
Eating behaviors develop in early life and refine during childhood, shaping long-term food choice and dietary habits, which underpin optimum growth and health. The development of Food Oral Processing (FOP) is of major importance in the establishment of eating behaviors at two scale levels: for the initial acceptance of food texture and for the longer-term development of eating behaviors associated to food intake. To date, both processes have been studied as independent topics and the current review proposes a parallel vision on their development from the onset of complementary feeding to later childhood. Individual factors affecting these FOP-related behaviors as they relate to food texture acceptance are discussed, alongside examples of interventions aiming at modifying them. Opportunity to better consider food textures when designing foods for children is addressed. Altogether, the review demonstrates the critical role of food texture in the development of a child's FOP skills, eating habits, and dietary patterns. These scientific knowledges need to be considered for the development of healthier eating behavior. We identify research gaps that need to be addressed and highlight the need to design foods that can support the development of healthy oral processing and eating behaviors among infants and children.
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Affiliation(s)
- Carole Tournier
- Centre des Sciences du Goût et de l'Alimentation, CNRS, INRAE, Institut Agro, Université de Bourgogne Franche-Comté, Dijon, France
- INRAE, PROBE Research Infrastructure, ChemoSens Facility, Dijon, France
| | - Ciaran G Forde
- Sensory Science and Eating Behaviour, Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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Dalal M, Cazorla-Lancaster Y, Chu CG, Agarwal N. Healthy From the Start—Lifestyle Interventions in Early Childhood. Am J Lifestyle Med 2022; 16:562-569. [DOI: 10.1177/15598276221087672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Lifestyle interventions are effective from the earliest years of childhood. To best promote health, lifestyle factors should be implemented for children and their families from birth. This includes introducing families to the benefits of a whole-food plant-based (WFPB) or plant-predominant diet, daily physical activity, positive family and peer social connections, avoidance of risky substances for caregivers, optimal sleep habits, and stress management and mindfulness for all family members. Through attention to these six pillars of lifestyle medicine, children and their families can succeed in initiating and maintaining optimal lifelong physical and mental health.
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Affiliation(s)
- Michelle Dalal
- Reliant Medical Group, University of Massachusetts Chan Medical School, Worcester, MA, USA
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Mazza M, Morseth M, Torheim LE. Association between parental feeding practices and children's dietary intake: a cross-sectional study in the Gardermoen Region, Norway. Food Nutr Res 2022; 66:8050. [PMID: 35382380 PMCID: PMC8941406 DOI: 10.29219/fnr.v66.8050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/30/2021] [Accepted: 02/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background Parental feeding practices may be important determinants for children's diets. In Norway, few studies have assessed this association and to our knowledge, no studies have included fish as an outcome. Objective The purpose of this study was to explore the association between multiple parental feeding practices and children's food intake. Design Parents (n = 111) of preschool children aged 1-5 years in the Gardermoen Region in Norway were recruited. The parents completed a web-based questionnaire regarding the use of 12 feeding practices measured by the Comprehensive Feeding Practices Questionnaire (CFPQ). Children's weekly food intake was measured using a food frequency questionnaire (FFQ). The association between parental feeding practices and food intake was assessed by logistic regression. Results The feeding practices involvement and environment increased the likelihood of children having a higher intake of fruit and berries (OR = 1.99, 95% CI = 1.15, 3.44 and OR = 2.10, 95% CI = 1.17, 3.78, respectively) when controlling for potential confounders. A positive association was found between the feeding practice environment and the children's intake of vegetables (OR = 2.94, CI = 1.55, 5.55), and between modeling and intake of vegetables (OR = 2.14, CI = 1.26, 3.63). Also, the feeding practice encourage balance and variety increased the likelihood of a higher consumption of vegetables (OR = 5.18, CI = 1.63, 16.5). Parents who more frequently encouraged the child to eat balanced and varied were more likely to have children with a higher consumption of fish (OR = 5.03, CI = 1.62, 15.7). If parents used more restriction for weight, the child was less likely to have a high SSB consumption (OR = 0.43, CI = 0.22, 0.83). Conclusion Findings suggest that children's intake of the favorite food item groups, fruit and berries, vegetables and fish, was associated with the use of positive feeding practices, such as involvement, environment, modeling and encouragement. For unfavorable food groups, only restriction for weight was negatively associated with SSB consumption. Findings should be interpreted carefully due to the relatively small sample size.
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Affiliation(s)
- Marlene Mazza
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Marianne Morseth
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Liv Elin Torheim
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Slapnicar C, Lear SA, Dehghan M, Gupta M, Rangarajan S, Punthakee Z. Relationship of parental feeding practices and diet with children's diet among South Asians in Canada. Appetite 2022; 173:105991. [PMID: 35271940 DOI: 10.1016/j.appet.2022.105991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/17/2022] [Accepted: 02/27/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND South Asian children's diets are considered unhealthy, yet the relationship with food parenting among South Asians is understudied. METHODS In a cross-sectional study, questionnaires were administered to dyads of Canadian South Asian elementary and high school children and a parent. Relationships between parental factors (perceived responsibility, restriction, pressure to eat, monitoring, home food environment, nutrition knowledge and intake of fruits and vegetables (FV), sugary beverages (SB) and sweets and fast foods (SWFF) and children's intake of FV, SB and SWFF were assessed by linear regression adjusted for sociodemographics. Subgroup differences by children's age and acculturation were explored by interaction analysis. RESULTS 291 children (age 9.8 ± 3.2 years) had mean daily intake frequencies of 3.1 ± 2.0 FV, 1.0 ± 0.9 SB and 2.1 ± 1.5 SWFF. Positive associations were found between parent and child intake of FV (standardized beta (ß) = 0.230, [95%CI 0.115, 0.345], p < 0.001), SB (β = 0.136 [0.019, 0.252], p = 0.02), and SWFF (β = 0.167 [0.052, 0.282], p = 0.005). Parental monitoring was associated with lower children's SWFF intake (ß = -0.131 [-0.248, -0.015], p = 0.03). Among those expressing less Western culture, parental SWFF intake was associated with child's SB intake (β = 0.255 [0.085, 0.425], p = 0.004). Among those expressing less traditional culture, positive home food environment was associated with lower child SWFF intake (β = -0.208 [-0.374, -0.042], p = 0.015). CONCLUSION South Asian children's diets have stronger relationships with their parents' diets than with food parenting practices or nutrition knowledge, though parental monitoring was associated with lower unhealthy food intake. However, with greater acculturation, the home food environment was more important for unhealthy food intake.
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Affiliation(s)
- Calum Slapnicar
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada; Population Health Research Institute, Hamilton, ON, Canada
| | | | - Milan Gupta
- Canadian Collaborative Research Network, Brampton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Zubin Punthakee
- Population Health Research Institute, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada.
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Chan MJ, Tay GWN, Kembhavi G, Lim J, Rebello SA, Ng H, Lin C, Wang MC, Müller-Riemenschneider F, Chong MFF. Understanding children's perspectives of the influences on their dietary behaviours. Public Health Nutr 2022; 25:1-11. [PMID: 35184794 PMCID: PMC9991721 DOI: 10.1017/s1368980022000404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/05/2022] [Accepted: 02/16/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to examine the intrapersonal, interpersonal, environmental and macrosystem influences on dietary behaviours among primary school children in Singapore. DESIGN A qualitative interpretive approach was used in this study. Focus group discussions guided by the socio-ecological model (sem), of which transcripts were analysed deductively using the sem and inductively using thematic analysis to identify themes at each sem level. SETTING Two co-educational public primary schools in Singapore. PARTICIPANTS A total of 48 children (n 26 girls) took part in the semi-structured focus group discussions. Their mean age was 10·8 years (sd = 0·9, range 9-12 years), and the majority of the children were Chinese (n 36), along with some Indians (n 8) and Malays (n 4). RESULTS Children's knowledge of healthy eating did not necessarily translate into healthy dietary practices and concern for health was a low priority. Instead, food and taste preferences were pivotal influences in their food choices. Parents had a large influence on children with regards to their accessibility to food, their attitudes and values towards food. Parental food restriction led to some children eating in secrecy. Peer influence was not frequently reported by children. Competitions in school incentivised children to consume fruits and vegetables, but reinforcements from teachers were inconsistent. The proximity of fast-food chains in the neighbourhood provided children easy access to less healthy foods. Health advertisements on social media rather than posters worked better in drawing children's attention. CONCLUSIONS Findings highlighted important factors that should be considered in future nutrition interventions targeting children.
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Affiliation(s)
- Mei Jun Chan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | - Gabrielle Wann Nii Tay
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | | | - Jubilee Lim
- Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | - Hazyl Ng
- Health Promotion Board, Singapore, Singapore
| | - Congren Lin
- Health Promotion Board, Singapore, Singapore
| | - May C Wang
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, 117549 Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, 30 Medical Drive, 117609 Singapore, Singapore
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Helle C, Hillesund ER, Øverby NC. Associations between infant and maternal characteristics measured at child age 5 months and maternal feeding styles and practices up to child age two years. PLoS One 2022; 17:e0261222. [PMID: 34995296 PMCID: PMC8740973 DOI: 10.1371/journal.pone.0261222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 11/27/2021] [Indexed: 11/18/2022] Open
Abstract
Facilitating positive feeding practices from infancy may be an important strategy to prevent childhood overweight and obesity. Since the feeding situation early in life constitutes a bidirectional relationship, it is important to understand the impact of both maternal and infant characteristics on maternal feeding practices to intervene in a customized and tailored way. Few studies have concurrently examined associations between maternal and infant characteristics in relation to early maternal feeding practices. The aim of the present study was to explore potential associations between infant and maternal characteristics measured at child age five months, and maternal feeding styles and practices during the child’s first two years. Cross-sectional data from a Norwegian randomized controlled trial in which participants responded to questionnaires at child age 5 months (n = 474), 12 months (n = 293) and 24 months (n = 185) were used to explore potential associations. All maternal and child predictor variables were collected at child age five months. Maternal feeding styles and practices were mapped using subscales from the Infant Feeding Questionnaire at child age 5 and 12 months and the Child Feeding Questionnaire and the Parental Feeding Style Questionnaire at child age 24 months. The subscale-scores were split into roughly equal tertiles, and the upper or lower tertile for the outcome of interest were used to create binary outcome variables. Multivariable binary logistic regression models were conducted for each outcome. We found that maternal education and mental health symptoms as well as infant weight, temperament and feeding mode were associated with maternal feeding styles and practices over time. Our findings indicate that risk factors which may have long-term implications for child weight and health outcomes can be identified early. Larger, population-based studies with a longitudinal design are needed to further explore these pathways.
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Affiliation(s)
- Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- * E-mail:
| | - Elisabet R. Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Nina C. Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Associations of Childcare Arrangements with Adiposity Measures in a Multi-Ethnic Asian Cohort: The GUSTO Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212178. [PMID: 34831933 PMCID: PMC8622483 DOI: 10.3390/ijerph182212178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 01/02/2023]
Abstract
Childcare arrangements shape behavioural patterns that influence the risk of childhood obesity. However, little is known of its influence on childhood obesity in Singapore. We aim to examine the associations between childcare arrangements at the age of 5 years and childhood adiposity at age 6 years. Children from the GUSTO study were grouped into three childcare arrangements at age 5: full-time centre-based childcare (FC), partial centre-based with parental care (PCP), and partial centre-based with non-parents (grandparents and domestic helpers) as caregivers (PCN). Diet, physical activity and sedentary behaviour information were collected at age 5, while anthropometric measurements were collected at age 6. Associations were analysed using multivariable regression models. Among 540 children, those in PCN had higher BMI z-scores (β: 0.34; 95% CI: 0.01, 0.66), greater sum of skinfold thicknesses (mm) (β: 3.75; 95% CI: 0.53, 6.97) and were 3.55 times (95% CI: 1.78, 7.05) more likely to be overweight/obese than those in FC. Adiposity measures in PCP children did not differ from those in FC. PCN children were reported to have more screen time and greater fast-food intake. Children in PCN tended to have higher adiposity measures. Greater engagement of non-parental caregivers should be considered in interventions targeting child obesity.
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Guo S, Wang Y, Fries LR, Li Y, Zhang N, Zhang H, Wei H, Jiang X, Shang L. Infant and preschooler feeding behaviors in Chinese families: A systematic review. Appetite 2021; 168:105768. [PMID: 34688731 DOI: 10.1016/j.appet.2021.105768] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/02/2022]
Abstract
A systematic review was conducted on the literature on feeding behaviors in Chinese families of children under 6 years old. Forty relevant publications were identified, of which 33 were published in Chinese, 7 in English. All studies were questionnaire-based and used a cross-sectional research design. Approximately half of the studies reported a score for each feeding practice/style, based on a Likert scale; the other half dichotomized these scores into a percentage of the population that reported frequent use of the behaviors. The most commonly reported feeding style of Chinese caregivers was a locally defined "active response" style that somewhat resembled authoritative parenting. The most commonly reported feeding practices were praise, encouraging trying new foods, encouragement of balanced diet and encouragement of healthy eating. Some behaviors showed a great deal of variance in prevalence between studies, which may be at least partially due to differences in methodology and how behaviors were defined. Some feeding behaviors varied in frequency depending on the child's age, although longitudinal studies are needed to better understand how these evolve over time. Child body composition was also associated with feeding behaviors use, although the direction of the association cannot be determined due to the cross-sectional nature of the research. There is still an important gap in the literature regarding the feeding behaviors of non-maternal caregivers, as grandparents often play an important role in childcare in China.
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Affiliation(s)
- Shibo Guo
- Department of Pediatric, Tangdu Hospital, The Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Yue Wang
- Department of Health Statistics, The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, The Fourth Military Medical University, Changle West Road 169#, Xi'an, Shaanxi, 710032, China.
| | | | - Yilin Li
- Nestlé Research, Beijing, China.
| | - Nini Zhang
- Department of Pediatric, Tangdu Hospital, The Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Haiyue Zhang
- Department of Health Statistics, The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, The Fourth Military Medical University, Changle West Road 169#, Xi'an, Shaanxi, 710032, China.
| | - Haixia Wei
- Department of Pediatric, Tangdu Hospital, The Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Xun Jiang
- Department of Pediatric, Tangdu Hospital, The Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Lei Shang
- Department of Health Statistics, The Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, The Fourth Military Medical University, Changle West Road 169#, Xi'an, Shaanxi, 710032, China.
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12
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Toh JY, Quah PL, Wong CH, Lun Yuan W, Aris IM, McCrickerd K, Godfrey KM, Chong YS, Shek LP, Tan KH, Yap F, Meaney MJ, Forde CG, Lee YS, Broekman BFP, Chong MFF. Evaluation of a child food reward task and its association with maternal feeding practices. PLoS One 2021; 16:e0254773. [PMID: 34288967 PMCID: PMC8294516 DOI: 10.1371/journal.pone.0254773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/04/2021] [Indexed: 11/18/2022] Open
Abstract
Food reward is defined as the momentary value of a food to the individual at the time of ingestion and is characterised by two psychological processes-"liking" and "wanting". We aimed to validate an age-appropriate food reward task to quantify implicit wanting of children from the GUSTO cohort (n = 430). At age 5 years, child appetitive traits and maternal feeding practices were reported by mothers via questionnaires. At age 6, a write-for-food task based on the child's preference for food or toy rewards was undertaken in laboratory conditions. Child BMI and skinfold measurements were taken at age 7. Convergent validity of the food reward task was assessed by associating with child appetitive traits, where enjoyment of food/food responsiveness (OR: 1.51; 95% CI: 1.06, 2.15) and emotional overeating (OR: 1.64; 95% CI: 1.09, 2.48) were positively associated with high food reward in children. Criterion validity was tested by associating with child BMI, however no significant relationships were observed. Multivariable logistic regression analysis with maternal feeding practices revealed that children whose mother tend to restrict unhealthy food (OR: 1.37; 95% CI: 1.03, 1.82) and girls whose mothers taught them about nutrition (OR: 2.09; 95% CI: 1.19, 3.67) were more likely to have high food reward. No further significant associations were observed between food reward, other appetitive traits and feeding practices. Despite the lack of association with child weight status, this study demonstrated the value of the write-for-food task to assess food reward in children and presented sex-specific associations with maternal feeding practices.
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Affiliation(s)
- Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Chun Hong Wong
- Department of Food Science and Technology, National University of Singapore, Singapore, Singapore
| | - Wen Lun Yuan
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Izzuddin M. Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States of America
| | - Keri McCrickerd
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore, Singapore
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit and National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lynette P. Shek
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Divisions of Paediatric Allergy, Immunology, and Rheumatology, Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
| | - Fabian Yap
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore
- Departments of Paediatrics, KK Women’s and Children’s Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Michael J. Meaney
- Integrative Neurosciences, Singapore Institute for Clinical Sciences, Agency for Science and Technology, Brenner Centre for Molecular Medicine, Singapore, Singapore
- Department of Psychiatry, McGill University, Montréal, QC, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, Montréal, QC, Canada
| | - Ciarán G. Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children’s Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Birit F. P. Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Department of Psychiatry, OLVG and AmsterdamUMC, VU University, Amsterdam, Netherlands
| | - Mary F. F. Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- * E-mail:
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13
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Jalali-Farahani S, Amiri P, Lashkari B, Cheraghi L, Hosseinpanah F, Azizi F. Prognostic value of different maternal obesity phenotypes in predicting offspring obesity in a family-based cohort study. BMC Public Health 2021; 21:885. [PMID: 33964905 PMCID: PMC8106828 DOI: 10.1186/s12889-021-10932-4] [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: 11/11/2020] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
Background Parental weight is studied as an important determinant of childhood obesity; however, obesity-related metabolic abnormalities have been less considered as determinants of childhood obesity. This study aimed to investigate the association between maternal obesity phenotypes and incidence of obesity in their offspring. Methods This longitudinal study was conducted within the framework of the Tehran Lipid and Glucose Study. A total of 2151 non-obese children who had complete parental information were followed for incidence of obesity over a mean of 148.7 ± 34.7 months. Obesity in children was defined using the World Health Organization criteria. Maternal body mass index (BMI) was classified into three categories: normal weight, overweight and obese. Dysmetabolic status was considered as having metabolic syndrome or diabetes. Metabolic syndrome and diabetes were defined according to the Joint Interim Statement and American diabetes association criteria, respectively. Considering maternal BMI categories and metabolic status, six obesity phenotypes were defined as followed: 1) normal weight and normal metabolic status, 2) overweight and normal metabolic status, 3) obese and normal metabolic status, 4) normal weight and dysmetabolic status, 5) overweight and dysmetabolic status, and 6) obese and dysmetabolic status. The association between maternal obesity phenotypes and incidence of obesity in children was studied using Cox proportional regression hazard model. Results In male offspring, the risk of incidence of obesity significantly increased in those with maternal obesity phenotypes including overweight/normal metabolic: 1.75(95% CI: 1.10–2.79), obese/normal metabolic: 2.60(95%CI: 1.51–4.48), overweight/dysmetabolic: 2.34(95%CI: 1.35–4.03) and obese/dysmetabolic: 3.21(95%CI: 1.94–5.03) compared to the normal weight/normal metabolic phenotype. Similarly, in girls, the risk of incidence of obesity significantly increased in offspring with maternal obesity phenotypes including overweight/normal metabolic: 2.39(95%CI: 1.46–3.90), obese/normal metabolic: 3.55(95%CI: 1.94–6.46), overweight/dysmetabolic: 1.92(95%CI: 1.04–3.52) and obese/dysmetabolic: 3.89(95%CI: 2.28–6.64) compared to normal weight/normal metabolic phenotype. However, maternal normal weight/dysmetabolic phenotype did not significantly change the risk of obesity in both male and female offspring. Conclusion Except for normal weight/dysmetabolic phenotype, all maternal obesity phenotypes had significant prognostic values for incidence of offspring obesity with the highest risk for obese/dysmetabolic phenotype. This study provides valuable findings for identifying the first line target groups for planning interventions to prevent childhood obesity. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10932-4.
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Affiliation(s)
- Sara Jalali-Farahani
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran.,Students' Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran.
| | - Bita Lashkari
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Leila Cheraghi
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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14
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Kininmonth AR, Smith AD, Llewellyn CH, Dye L, Lawton CL, Fildes A. The relationship between the home environment and child adiposity: a systematic review. Int J Behav Nutr Phys Act 2021; 18:4. [PMID: 33407598 PMCID: PMC7788808 DOI: 10.1186/s12966-020-01073-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/14/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Extensive research has demonstrated the role of the Home Environment (HE) in shaping children's energy balance behaviours. Less is known about direct relationships with bodyweight. This review examines associations between the social and physical aspects of three pre-defined Home Environment domains (food, physical activity and media) and adiposity measures in children ≤12 years. METHODS Six electronic databases (PubMed, Medline, EBSCO CINAHL, EMBASE, Web of Science, PsycInfo) were systematically searched up to October 2020. Studies reporting at least one physical and/or social aspect of the food, physical activity and/or media domains of the Home Environment in relation to child adiposity outcomes were included (n = 62). RESULTS Most studies examined one (n = 41) or two domains (n = 16). Only five studies assessed all three domains of the Home Environment. Most consistent relationships were observed for physical aspects of the home media environment; with greater availability of electronic devices associated with higher child adiposity (21/29 studies). Findings were less consistent for the smaller number of studies examining physical aspects of the home food or physical activity environments. 8/15 studies examining physical food environments reported null associations with adiposity. Findings were similarly mixed for physical activity environments; with 4/7 reporting null associations, 2/7 reporting negative associations and 1/7 reporting positive associations between access to physical activity equipment/garden space and adiposity. Fewer studies assessed social aspects (e.g. caregiver modelling or limit setting) of the Home Environment in relation to child adiposity and findings were again mixed; 9/16 media environment, 7/11 food environment and 9/13 physical activity environment studies reported null associations with child adiposity outcomes. CONCLUSIONS The home media environment was most consistently associated with adiposity in childhood. Findings were less consistent for the home food and physical activity environments. Greater agreement on definitions and the measurement of the obesogenic home environment is required in order to clarify the strength and direction of relationships with child adiposity. Robust longitudinal research using comprehensive measures of the holistic home environment is needed to better identify which aspects contribute to excess weight gain in childhood. TRIAL REGISTRATION PROSPERO Systematic review registration number: CRD42018115139 .
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Affiliation(s)
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Clare H Llewellyn
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Louise Dye
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Clare L Lawton
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
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15
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Feeding practices demonstrated by parents of toddlers: An observational analysis of breakfast, lunch, dinner, and snacks. Appetite 2020; 155:104825. [PMID: 32777244 DOI: 10.1016/j.appet.2020.104825] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 07/31/2020] [Accepted: 08/05/2020] [Indexed: 12/26/2022]
Abstract
The aims of the current study were to compare feeding practices and the eating environment (other people present, other people eating, and screen use) observed in families of toddlers across breakfast, lunch, dinner, and snacks. 60 families with toddlers (12-36 months; M = 24.7 months) video recorded all occasions over the course of a day when the toddler ate or drank. Videos were coded for a variety of feeding practices (e.g., prompts to eat, restriction), other people present and eating, and screen use. Prompts to eat were grouped into autonomy-supportive prompts (ASP) and coercive-controlling prompts (CCP). Results of the study showed different patterns of consistency between meals and snacks depending on the feeding practice examined. CCP were correlated across all eating occasions, including meals and snacks, but ASP, interference, and instruction were only correlated across the primary meals (all p-values < .05). ASP and praise were also more frequently demonstrated during the primary meals compared to snacks (p-values < .05). Parents also used more interference at dinner compared to both breakfast and snacks. Furthermore, mothers and siblings commonly ate with the toddler, especially during lunch and dinner, but family members infrequently ate with the child during snacks. The percentage of families using a screen was similar for breakfast (38%), lunch (39%), and dinner (33%), but slightly higher for snacks (47%). Together, the results of this study demonstrate notable differences in feeding practices and environmental factors during meals compared to snacks.
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16
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Yuniar WP, Khomsan A, Dewi M, Ekawidyani KR, Mauludyani AVR. Hubungan antara Perilaku Gizi dan Perilaku Hidup Bersih dan Sehat (PHBS) dengan Status Gizi Baduta Di Kabupaten Cirebon. AMERTA NUTRITION 2020. [DOI: 10.20473/amnt.v4i2.2020.155-164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Cirebon Regency is one of the priority areas that becomes the locus in efforts to accelerate the reduction of stunting in 2018.Objective: This study aims to analyze the relationship between feeding parenting pattern with nutrient intake of under two-years infants and the relationship between nutritional behavior and clean and healthy lifestyle behavior (CHLB) with nutritional status of under two-years infants in Cirebon Regency.Methods: This study used a cross-sectional study design using secondary data from previous studies conducted at the same two locations in Cirebon Regency. The data processing was carried out in November to December 2019. The subjects involved were 70 mothers who had infants aged 0-24 months. Analysis of the relationship between variables using the Rank Spearman test.Results: The results of the correlation test showed that there was no significant relationship (p> 0.05) between feeding parenting pattern with nutritional intake. In addition, maternal nutritional behavior also did not have a significant relationship (p> 0.05) with nutritional status. This study found that there was a significant relationship between clean and healthy living behavior on the indicators of a smoke-free home environment with the nutritional status using HAZ index.Conclusion: Imbalance between knowledge and socio-economic factors of income can lead to inequality in the application of feeding parenting pattern, nutritional behavior, and CHLB to the nutritional status of under two years. Therefore, a continuous monitoring and evaluation system is needed to ensure that the stunting acceleration program runs effectively and efficiently.ABSTRAK Latar belakang: Kabupaten Cirebon merupakan salah satu daerah prioritas yang menjadi lokus dalam upaya percepatan penurunan stunting pada tahun 2018.Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan antara pola asuh makan dengan asupan zat gizi baduta serta hubungan antara perilaku gizi dan perilaku hidup bersih dan sehat dengan status gizi baduta di Kabupaten Cirebon.Metode: Penelitian ini menggunakan desain studi cross-sectional dengan menggunakan data sekunder dari penelitian sebelumnya yang dilakukan pada dua lokasi yang sama di Kabupaten Cirebon. Proses pengolahan data dilakukan pada bulan November hingga Desember 2019. Subjek yang terlibat adalah 70 orang ibu baduta yang memiliki bayi berusia 0-24 bulan. Analisis hubungan antar variabel menggunakan uji Rank Spearman.Hasil: Hasil uji korelasi menunjukkan bahwa tidak terdapat hubungan yang signifikan (p >0,05) antara pola asuh makan dengan asupan zat gizi. Selain itu, perilaku gizi ibu juga tidak memilki hubungan yang signifikan (p>0,05) dengan status gizi. Penelitian ini menemukan bahwa terdapat hubungan yang signifikan antara perilaku hidup bersih dan sehat pada indikator lingkungan rumah bebas asap rokok terhadap status gizi baduta.Kesimpulan: Ketidakseimbangan antara pengetahuan dengan faktor sosio-ekonomi penghasilan dapat mengakibatkan terjadinya ketimpangan dalam penerapan pola asuh makan, perilaku gizi, dan PHBS terhadap status gizi baduta. Oleh karena itu, diperlukan sistem monitoring dan evaluasi secara kontinu untuk memastikan bahwa program percepatan stunting berjalan secara efektif dan efisien.
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17
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Argueza BR, Sokal-Gutierrez K, Madsen KA. Obesity and Obesogenic Behaviors in Asian American Children with Immigrant and US-Born Mothers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1786. [PMID: 32164148 PMCID: PMC7084370 DOI: 10.3390/ijerph17051786] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/02/2020] [Accepted: 03/07/2020] [Indexed: 01/01/2023]
Abstract
Child obesity is understudied in Asian Americans, which include a growing population of recent immigrants. We examined the relationship between maternal nativity and time in the US, and obesity and obesogenic behaviors among Asian American children. We analyzed public-use data from the 2013-2016 California Health Interview Survey for Asian American children ages 2 to 11 years. We used logistic regression to determine the odds of obesity and obesogenic behaviors associated with maternal nativity and time in the US. This study included n = 609 children. Children of US-born mothers had lower odds of obesity (adjusted odds ratio, AOR, 0.12; 95% CI 0.02 to 0.91) and lower fruit intake (AOR 0.15, 95% CI 0.03 to 0.81) than children of recent immigrants (< 5 years in the US). Asian American children with recent immigrant mothers are more likely to be obese and eat less fruit than children with US-born mothers. Efforts to prevent obesity and increase fruit consumption are particularly important for this vulnerable population of children of recent immigrants.
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Affiliation(s)
- Bianca R. Argueza
- California Department of Public Health Preventive Medicine Residency Program, Sacramento, CA 95899, USA
- Berkeley School of Public Health, University of California, Berkeley, CA 94720, USA; (K.S.-G.); (K.A.M.)
| | - Karen Sokal-Gutierrez
- Berkeley School of Public Health, University of California, Berkeley, CA 94720, USA; (K.S.-G.); (K.A.M.)
| | - Kristine A. Madsen
- Berkeley School of Public Health, University of California, Berkeley, CA 94720, USA; (K.S.-G.); (K.A.M.)
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18
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Estimating and differentiating maternal feeding practices in a country ranked first in childhood obesity. Public Health Nutr 2019; 23:620-630. [PMID: 31747985 DOI: 10.1017/s1368980019003173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Mexico ranks first in childhood obesity worldwide. However, little is known about the factors influencing maternal feeding practices. The present study aimed to estimate the prevalence of feeding practices and explore associations between weight concern, weight perception, sociodemographic characteristics and those feeding practices. DESIGN Cross-sectional. SETTING North-eastern Mexico. PARTICIPANTS Mothers aged ≥18 years who were in charge of feeding a singleton child aged 2-6 years with no endocrine disease or visible genetic malformations (n 507). Information on six maternal feeding practices, concern and perception of the child's weight and demographics were collected by interview. The mother's and child's height and weight were measured. The feeding practices questionnaire was subject to content, construct and convergent validity analysis. Then, mean feeding scores were obtained and prevalence and 95 % CI were determined for scores ≥3; multivariate logistic regression was performed. RESULTS Not modelling (63·5 %; 95 % CI 59·2, 67·8 %) and pressuring to eat (55·6 %; 95 % CI 51·2, 60·0 %) were the most frequent feeding practices, followed by easy access to unhealthy foods (45·4 %; 95 % CI 40·9, 49·8 %) and child control (43·2 %; 95 % CI 38·8, 47·6 %). They prevailed despite concern about the child's excess weight or a perception of the child as overweight/obese. Education was associated with the highest number of practices (educated mothers used more pressuring to eat, less regulation and less easy access; or monitoring was less absent). CONCLUSIONS The frequency of certain feeding practices needs to be improved. Emphasis on the child's weight concern, obesity perception and maternal education is essential for optimizing intervention planning.
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19
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Fries LR, Chan MJ, Quah PL, Toh JY, Fogel A, Goh AT, Aris IM, Broekman BFP, Cai S, Tint MT, Chong YS, Shek LP, Lee YS, Yap F, Tan KH, Gluckman PD, Godfrey KM, Silva Zolezzi I, Forde CG, Chong MFF. Maternal feeding practices and children's food intake during an ad libitum buffet meal: Results from the GUSTO cohort. Appetite 2019; 142:104371. [PMID: 31323246 PMCID: PMC6682493 DOI: 10.1016/j.appet.2019.104371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 12/16/2022]
Abstract
Parents' feeding practices have been shown to be associated with children's food intake and weight status, but little is known about feeding practices in Asian countries. This study used behavioral observation to explore the feeding practices of 201 mothers of 4.5 year-old children in Singapore during an ad libitum buffet lunch. Feeding practices were coded from videos, focusing on behaviors used to prompt the child to eat more food (autonomy-supportive and coercive-controlling prompts to eat, suggesting items from buffet), those to reduce intake (restriction, questioning food choice), and those related to eating rate (hurrying or slowing child eating). Child outcome measures included energy consumed, variety of food items selected, and BMI. Maternal restriction and trying to slow child eating rate were associated with higher energy consumed by the child (r = 0.19 and 0.13, respectively; p < 0.05). Maternal autonomy-supportive prompts and restriction were associated with a greater variety of items selected by children (r = 0.19 and 0.15, respectively; p < 0.05). The frequency of maternal feeding practice use differed across ethnic groups, with Malay mothers using the most prompts to eat (p < 0.05), Chinese mothers most likely to question a child's food choice (p < 0.01), and Indian mothers the last likely to tell the child to eat faster (p < 0.001). There were no differences between ethnic groups for other feeding practices. No associations were found between feeding practices and child BMI. It is possible that feeding practices related to restriction and slowing child eating are adopted in response to children who consume larger portions, although longitudinal or intervention studies are needed to confirm the direction of this relationship and create local recommendations.
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Affiliation(s)
- Lisa R Fries
- Nestlé Research, Vers-chez-les-Blanc, Case Postale 44, CH-1000, Lausanne, Switzerland.
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Anna Fogel
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore.
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore.
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore.
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Psychiatry, VU Medical Centre, Amsterdam, The Netherlands, Research & Innovation, Location GGZ InGeest, Oldenaller 1, 1081, HJ, Amsterdam, the Netherlands.
| | - Shirong Cai
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Mya Thway Tint
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore.
| | - Lynette P Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore.
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 12, 119228, Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 5 Lower Kent Ridge Road, 119074, Singapore.
| | - Fabian Yap
- Pediatric Endocrinology, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Duke-National University of Singapore Graduate Medical School, 8 College Road, 169857, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, 59 Nanyang Drive, 636921, Singapore.
| | - Kok Hian Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Experimental Medicine Building, 59 Nanyang Drive, 636921, Singapore; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Level 3, Singapore, 229899.
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Liggins Institute, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand.
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS FT, Tremona Road, SO16 6YD, Southampton, UK.
| | - Irma Silva Zolezzi
- Nestlé Research Singapore Hub, 21 Biopolis Road Nucleos (South Tower), #04-22/23, 138567, Singapore.
| | - Ciaran G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), 30 Medical Drive, 117609, Singapore; Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), National University Health System, 14 Medical Drive #07-02, MD 6 Building, Yong Loo Lin School of Medicine, 117599, Singapore; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10-01, 117549, Singapore.
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20
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Quah PL, Ng JC, Fries LR, Chan MJ, Aris IM, Lee YS, Yap F, Godfrey KM, Chong YS, Shek LP, Tan KH, Forde CG, Chong MFF. Longitudinal Analysis Between Maternal Feeding Practices and Body Mass Index (BMI): A Study in Asian Singaporean Preschoolers. Front Nutr 2019; 6:32. [PMID: 31001535 PMCID: PMC6454195 DOI: 10.3389/fnut.2019.00032] [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: 11/09/2018] [Accepted: 03/06/2019] [Indexed: 12/13/2022] Open
Abstract
Bidirectional studies between maternal feeding practices with subsequent child weight are limited, with no studies in Asian populations. In longitudinal analyses, we assessed the directionality of the associations between maternal feeding practices and body mass index (BMI) in preschoolers. Participants were 428 mother child dyads from the GUSTO (Growing Up in Singapore Toward healthy Outcomes) cohort. Feeding practices were assessed using the Comprehensive Feeding Practices Questionnaire (CFPQ) at age 5 y. Child BMI was measured at ages 4 and 6 y. BMI and maternal feeding practices subscales were transformed to SD scores and both directions of their associations examined with multivariable linear regression and pathway modeling. Higher BMI at age 4 was associated with lower encouragement of balance and variety (β = −0.33; 95%CI: −0.53, −0.13), lower pressure to eat (β = −0.49; −0.68, −0.29) and higher restriction (β = 1.10; 0.67, 1.52) at age 5, adjusting for confounders and baseline feeding practices at 3 years. In the reverse direction, only pressure and restriction at age 5 were associated with lower and higher child BMI at age 6 years, respectively. After the adjustment for baseline BMI at age 5, the association with pressure was attenuated to non-significance (β = 0.01 (−0.01, 0.03), while the association with restriction remained significant (β = 0.02; 0.002, 0.03). Overall, associations from child BMI to maternal restriction for weight control and pressure feeding practices was stronger than the association from these maternal feeding practices to child BMI (Wald's statistics = 24.3 and 19.5, respectively; p < 0.001). The strength and directionality suggests that the mothers in the Asian population were likely to adopt these feeding practices in response to their child's BMI, rather than the converse. Clinical Trial Registry Number and Website This study was registered at clinicaltrials.gov as NCT01174875 (www.clinicaltrials.gov, NCT01174875).
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Affiliation(s)
- Phaik Ling Quah
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Jing Chun Ng
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Lisa R Fries
- Nestlé Research, Vers-chez-les-Blanc, Lausanne, Switzerland
| | - Mei Jun Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore
| | - Izzuddin M Aris
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Paediatric Endocrinology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Fabian Yap
- Departments of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore.,Duke-National University of Singapore Graduate Medical School, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital, Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore, Singapore
| | - Lynette P Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Divisions of Pediatric Allergy, Immunology, and Rheumatology, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kok Hian Tan
- Duke-National University of Singapore Graduate Medical School, Singapore, Singapore.,Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ciaran G Forde
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Clinical Nutrition Research Center, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Mary F F Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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