Food-related parenting practices and child and adolescent weight and weight-related behaviors

Fostering wellbeing and healthy lifestyles through conviviality and commensality: Underappreciated benefits of the Mediterranean Diet

Among the often-neglected features of healthy diets, such as the Mediterranean diet, is the preparation and sharing of food, which is (or was) done in a social environment governed by social rules rather than by time constraints. The act of eating is a daily human practice that is not limited to meeting nutritional and energy needs but also involves a constructed social dimension of sharing meals that is part of the process of human civilization and food cultures around the world. In this narrative review, we outline the importance of conviviality in steering part of the health effects of healthful diets, with special reference to the Mediterranean diet. Based on the available evidence, we suggest that public health initiatives (such as nudging to promote conviviality) to improve people's eating and living styles, reduce loneliness, and promote the sharing of meals could improve health. Interventions aimed at directly increasing/improving people's social relationships, networking, and conviviality can-directly and indirectly-improve both psychological well-being and general health.

Associations between parental engagement in disordered eating behaviors and use of specific food parenting practices within a racially, ethnically, and socioeconomically diverse sample

Parents influence their children's eating behaviors through their use of food parenting practices, or goal-directed behaviors that guide both what and how they feed their child. Prior research suggests that parents who engage in disordered eating behaviors are more likely to use coercive food parenting practices, which are known to be associated with the development of maladaptive eating behaviors in young people. The present study sought to extend our current understanding by examining the association between parental engagement in disordered eating behaviors and use of a broader range of food parenting practices in a socioeconomically and racially diverse, population-based sample (n = 1306 parents/child dyads). Parents self-reported their disordered eating behaviors, as well as use of coercive and structure-based food parenting practices. A series of separate linear regression models, adjusting for parent and child sociodemographic and anthropometric characteristics, revealed that parents engaging in restrictive disordered eating behaviors and binge eating reported significantly higher levels of coercive food parenting practices, including pressure-to-eat, restriction, threats and bribes, and using food to control negative emotions. Parental engagement in restrictive disordered eating behaviors was also associated with significantly higher use of food rules and limits. Overall, parental engagement in compensatory disordered eating behaviors was significantly associated with higher levels of restrictive and emotional feeding practices, as well as with lower levels of monitoring. Given prior research supporting a relationship between exposure to coercive control food parenting practices and the development of maladaptive eating behaviors in young people, results from the current study provide support for the role that food parenting practices might play in the intergenerational transmission of disordered eating behaviors.

Observations of parent-adolescent interactions relate to food parenting practices and adolescent disordered eating in adolescents at risk for adult obesity

Adolescent disordered eating and obesity are interrelated and adversely relate to mental and metabolic health. Parental feeding practices have been associated with adolescent disordered eating and obesity. Yet, observable interactions related to food parenting have not been well characterized. To address this gap, N = 30 adolescents (M ± SD 14 ± 2 year) at risk for adult obesity due to above-average body mass index (BMI ≥70th percentile) or parental obesity (BMI ≥30 kg/m2 ) participated in a video-recorded parent-adolescent task to discuss a food/eating-related disagreement. Interactions were coded for individual/dyadic affect/content using the Interactional Dimensions Coding System. We examined associations of interaction qualities with parent-reported food practices, adolescent disordered eating behaviors/attitudes, and insulin resistance. Reported parenting practices were correlated with multiple interaction qualities (p-values <0.05), with the most consistent correspondence between parent-reported pressure to eat (e.g., pressure to eat more healthy foods) and negative aspects of parent-adolescent interactions. Also, after accounting for adolescent age, sex, and BMI-standard score, parent-adolescent interaction qualities were associated with adolescents' disordered eating and insulin resistance. Specifically, greater adolescent problem-solving related to less adolescent global disordered eating, shape, and weight concern (p-values <0.05); adolescent autonomy related to less weight concern (p = 0.03). Better parent communication skills were associated with less adolescent eating concern (p = 0.04), and observed dyadic mutuality related to adolescents' lower insulin resistance (p = 0.03). Parent-adolescent interaction qualities during food/eating-related disagreements show associations with parent-reported food practices and adolescent disordered eating. This method may offer a tool for measuring the qualities of parent-adolescent food/eating-related interactions. A nuanced understanding of conversations about food/eating may inform family-based intervention in youth at-risk for adult obesity.

Leveraging ecological momentary assessment to understand variability in food parenting practices within a low-income racially/ethnically diverse sample of parents of preschoolers

Children's eating behaviors are shaped significantly by their home food environment, including exposure to food parenting practices. The current study leveraged ecological momentary assessment (EMA) to describe how food parenting practices used to feed preschoolers (n = 116) differed across contextual factors around eating, including type of eating occasion (i.e., meals vs. snacks), day of the week (i.e., weekend vs. weekday), who initiated the meal (parent vs. child), emotional climate of the eating occasion. Parent perceptions of how well the eating occasion went, including how well the child ate and whether the food parenting practices worked as intended were also explored. Parent use of specific food parenting practices, situated within four higher-order domains (i.e., structure, autonomy support, coercive control, indulgent), was found to differ by type of eating occasion; parents engaged in a higher proportion of structure practices at meals than at snacks. Use of specific food parenting practices differed by mealtime emotional climate; parent use of structure and autonomy support was associated with eating occasions described as relaxed, enjoyable, neutral, and fun. Finally, parent perception of how well the child ate differed by use of specific food parenting practices; during eating occasions when parent's felt their child ate "not enough", they used less autonomy support and more coercive control compared to eating occasions where the child ate "enough and a good balance." Leveraging EMA allowed for increased understanding of the variability in food parenting practices and contextual factors. Findings may be utilized to inform the development of larger-scale studies seeking to understand why parents choose specific approaches to feeding their children, as well as the impact of various approaches to child feeding on child health outcomes.

Weight and disordered eating among adolescents from low-income backgrounds

Disordered eating affects youth from varying socioeconomic backgrounds; however, representation of youth from low-income backgrounds within disordered eating research has been limited. The aim of the current study was to examine the association between adolescent weight and disordered eating among a sample of youth from a low-income background and to examine specific socioenvironmental factors that might moderate this association. Adolescents ages 12-17 (N = 73) from a low-income background and their parents/guardians completed self-report questionnaires. Adolescent height and weight were objectively measured to calculate BMI z-score. Adolescent weight was significantly positively associated with global disordered eating (95 % CI [0.26, 0.54]), after controlling for sex. Parental weight concern moderated the association between weight and global disordered eating, F(4, 68) = 18.44, p < .01, such that the relation between adolescent zBMI and disordered eating was no longer significant at low levels of parental weight concern. Structured family meals moderated the association between weight and global disordered eating, F(4, 68) = 11.99, p < .01, such that more frequent meals weakened the association between adolescent zBMI and disordered eating. Findings suggest that higher weight is associated with greater levels of disordered eating among adolescents from a low-income background. In addition, lower levels of parental weight concern and more frequent family meals significantly buffered the association between weight and disordered eating in this at-risk, yet understudied population. Both parental weight concern and family meals present as factors within the family environment that may serve as targets for intervention.

Barriers to Healthy Family Dinners and Preventing Child Obesity: Focus Group Discussions with Parents of 5-to-8-Year-Old Children

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.

Parental feeding practices as potential moderating or mediating factors in the associations between children's early and later growth

BACKGROUND

Given inconsistent results in the literature, our objective was to examine the role of early parental feeding practices in children's growth.

METHODS

Analyses were based on 1245 children from the EDEN mother-child cohort. Parental feeding practices were assessed at the 2-year follow-up by using the Comprehensive Feeding Practices Questionnaire. International Obesity Task Force BMI z-scores were derived from weight and height assessed at 2, 4, 6, and 8 years. Associations between parental feeding practices and child BMI z-scores at 4, 6 and 8 years were assessed by multivariable linear regressions, notably adjusted for 2-year BMI z-score. Analyses were stratified by child sex when relevant. Moreover, interaction and mediation analyses were respectively performed to assess whether parental feeding practices could moderate or mediate the associations between early and later growth.

RESULTS

For a given BMI z-score at 2 years, parental restriction for weight at 2 years was positively associated with child BMI z-scores from 4 to 8 years (at 8 years: β [95% CI] = 0.09 [0.01; 0.16]). Among boys only, high use of food as a reward was positively associated with later BMI z-scores (at 8 years: β [95% CI] = 0.15 [0.03; 0.27]). Parental feeding practices were not moderating factors in the associations between early and later growth. Parental restriction for weight was a mediating factor in the associations between 2-year BMI z-score and BMI z-scores up to 8 years (mediation: 2.69% [0.27%; 5.11%] of the total effect at 8 years).

CONCLUSIONS

Restriction for weight reasons, often used by parents in response to the child's high appetite in infancy, appears to lie on the pathway between early and later BMI, but not restriction for health, suggesting that parental way of restricting the child's food intake matters.

Momentary predictors of a broad range of food parenting practices within a population-based sample of parents of preschool-aged children

Introduction

The current study sought to understand the influence of momentary factors within the home and family environment, including parent stress, parent and child mood and child behaviors, on parents' use of a broad range of food parenting practices later that same day.

Methods

Ecological Momentary Assessment (EMA) was used to evaluate parents' use of coercive, indulgent, structured and autonomy support food parenting practices, as well as numerous potentially salient momentary predictors, including parental stress, parent and child mood, and child behavior. Data were collected from 109 parents of preschool aged children multiple times per day over the course of a ten-day data collection period, allowing for temporal sequencing of momentary predictors and use of food parenting practices.

Results

With some notable exceptions, study findings align with study hypotheses in that parent stress, parent and child low mood, and child negative behaviors early in the day were found to be associated with the use of less supportive food parenting practices later that same day. For example, greater parent negative mood earlier in the day was associated with a decrease in use of feeding practices from within the structure domain later on that same day (-2.5%, p < 0.01), whereas greater parent positive mood earlier in the day was associated with an increase in use of structure later on that same day (+3.7%, p < 0.01). Greater parent stress earlier in the day was associated with an increase in the use of coercive control (+3.2%, p < 0.01) and indulgent (+3.0%, p < 0.01) practices later that same day; surprisingly, a similar increase in stress earlier in the day was also found to be associated with an increase in the use of autonomy support (5.6%, p < 0.01) feeding practices later on that same day.

Discussion

Developing an understanding of the types of momentary factors that influence a parent's use of particular food parenting practices across multiple contexts is a crucial next step toward developing effective interventions aimed at teaching parents to use food parenting practices that are supportive of healthful child dietary intake and eating behaviors in a way that is responsive to shifting factors.

Challenges and Barriers to Providing Primary Care to Children of South Asian Origin: Pediatricians' Perspectives

South Asian (SA) Americans have a high risk of metabolic and cardiovascular disease. Prevention efforts should start in childhood and should be culturally appropriate. We sought to understand the challenges and barriers that pediatricians face in providing care for SA children to inform professional education on culturally effective care. Qualitative interviews were conducted with a diverse sample (N = 17) of pediatricians. Challenges reported included feeding problems, inadequate physical activity, and mental health concerns. Communication barriers included parents' anxiety around feeding, influence of grandparents, stigma around mental health, and cultural communication gaps. Effective strategies included clear communication, a gradual approach, ensuring buy-in from grandparents, greater attention to family history, and improved cultural knowledge in pediatrician. Addressing feeding problems was the most mentioned challenge, which is especially concerning given the high chronic disease risk in SAs. Education on culturally appropriate strategies can equip pediatricians to effectively counsel SA families to address these risks.

The Relationships between Parenting Practices and Child Health-Related Behaviors in Children with Intellectual Disability: The Moderating Role of Child Body Weight Status

This study aimed to examine the associations between parenting practices and child health-related behaviors, and the moderating role of child body weight status in children with intellectual disability (ID). A cross-sectional study was conducted among a sample of children with ID in Hong Kong; 440 participants were included in this study. All the variables investigated were collected from questionnaires, except body weight status, which was objectively measured. Logistic regression analysis was used to examine the associations between parenting practices and children's unhealthy behaviors. Interaction items were added to investigate the moderation effect of child body weight status, adjusting for significant background characteristics. Results showed that the parenting practices of "restricting access to unhealthy food and sedentary behaviors (RA)" (OR range: 0.63-0.64) and "using food or sedentary behaviors as rewards (UR)" (OR range: 1.28-1.60) were significantly associated with some eating behaviors, but not with sedentary behaviors. Body weight status significantly moderated these associations. Only RA showed favorable effects on some eating behaviors in children with overweight and obesity (OR range: 0.17-0.28), whereas the effects of UR differed by body weight status. Future research should focus on developing educational interventions which encourage parents to use practices that are tailored towards children's individual characteristics.

How time in the US and race/ethnicity shape food parenting practices and child diet quality

Childhood obesity prevalence is high among children from immigrant/refugee households who live in high-income countries. Poor child dietary intake is a critical risk factor for elevated obesity prevalence and food parenting practices have been found to be associated with child dietary intake and eating behaviors. The main aim of this study was to examine the associations between migrants'/refugees' food parenting practices, the length of residence time in the US, race/ethnicity, and child diet quality. The current study included 577 families from three racial/ethnic groups that include mostly foreign-born parents (Latino, Hmong, and Somali/Ethiopian), and a comparison group of 239 non-Hispanic White families. Results showed that for Latino and Hmong parents, some food parenting practices varied by how long they had lived in the US. For example, more recently moved parents engaged in more non-directive (e.g., avoid buying sweets) practices compared with US-born parents. In contrast, Somali/Ethiopian parents engaged in different food parenting practices than White parents, regardless of time in the US. Results also showed that diet quality among Hmong children was lower if their parents were US-born compared to foreign-born. Future researchers may want to consider studying why some food parenting practices change when parents move to the US and explore whether there is a combination of food parenting practices that are most useful in promoting a healthful child's diet and weight among immigrant and refugee families.

A descriptive assessment of a broad range of food-related parenting practices in a diverse cohort of parents of preschoolers using the novel Real-Time Parent Feeding Practices Survey

Background

Much of the research to-date on food parenting has evaluated typical use of various parent feeding practices via questionnaire. The Real-Time Parent Feeding Practices Measurement survey was developed for use within an Ecological Momentary Assessment (EMA) protocol to capture momentary use of parent feeding practices in real-time.

Methods

This manuscript describes the development of the EMA-based Real-Time Parent Feeding Practices survey and highlights initial descriptive data on the real-time use of 22 individual parent feeding practices (e.g., pressure-to-eat, guided choices, etc.) as reported via EMA by parents of preschool-aged children (n = 116) over a 10-day data collection time period. A total of 3382 eating occasions were reported, with an average of 29.2 reported eating occasions per participant.

Results

Results revealed that most participants used a variety of food-related parenting practices day-to-day that span four higher-order domains: structure, autonomy support, coercive control and indulgence. Supportive feeding practices, defined as those from the structure and autonomy support domains, were reported most frequently, with one or more structure behavior (e.g., specific mealtime rules/routines) was used at 88.9% of reported eating occasions and one or more autonomy support behavior (e.g., involvement of the child in meal preparation) was used at 87.3% of eating occasions. While unsupportive feeding practices, defined as practices from within the coercive control (e.g., pressure-to-eat) and indulgent (e.g., anticipatory catering) feeding domains, were reported less frequently, one or more behaviors from each of these domains were still reported at over 25% of all eating occasions.

Conclusions

Results of the current study take a next step towards deepening our understanding of the use of a broad range of food-related parenting practices in real-time. Findings revealed that the vast majority of practices used by parents fall within the structure and autonomy support domains. However, most parents did not exclusively use supportive or unsupportive practices, rather they used a combination of food-related parenting practices across all domains. Future research should continue to explore a broad range of food-related parenting practices and seek to understand how parent approaches to feeding are associated with long-term child outcomes, including dietary intake, food preferences, and eating patterns.

Stressed out and fed up: The effect of stress on maternal feeding behaviors and the moderating role of executive function

Stress is associated with a range of unhealthy eating habits, yet few studies have examined how stress may influence the intergenerational transmission of eating habits from parents to their children. Specifically, there is a lack of data regarding the role of stress on feeding practices. Moreover, most work investigating the associations between parental stress and their feeding behaviors has been correlational, limiting our understanding of causality. In the current study, we used an experimental design, induced high and low stress in mothers using a standard laboratory stressor, and observed mother-child interactions during a snack break. We also examined the potential role of maternal executive functioning (EF) for buffering the effects of stress on maternal feeding behaviors. Levels of maternal stress were manipulated with the Trier Social Stress Task (TSST) in a community sample (N = 80 dyads, Child M_age = 41.89 months, female = 43). We measured maternal EF with a series of computerized tasks. Maternal feeding behaviors were coded for controlling behaviors, which included pressuring and restricting behaviors. Results indicate a main effect of stress on controlling feeding behaviors, such that mothers in the high-stress condition exhibited higher levels of controlling behaviors. The effect of stress on controlling feeding behaviors was ameliorated among mothers with higher levels of EF after controlling for child age and income. Results provide causal evidence for the role of stress on feeding behaviors and suggest EF as a factor to be considered in the treatment and prevention of diet-related illnesses.

Associations between parental perception of- and concern about-child weight and use of specific food-related parenting practices

Little is known about the association between parental perception of their child's weight as well as parent's current and future concerns regarding their child's weight and a broad range of food-related parenting practices. This study used the first wave of cross-sectional data from the longitudinal Family Matters study to examine the relationships between parental perception of child weight status, parent concern for child's current and future weight and parent use of different types of food-related practices. Parent/child dyads (n = 150) were recruited from primary care clinics. Multiple regression models were fit to examine cross-sectional relationships between parental perception and concern for their child's weight and food-related parenting practices (food restriction, pressure-to-eat, food control, food monitoring, nutrition education, and parent modeling). Parents who perceived their child to be underweight had lower scores for food restriction than parents who perceived their child to be overweight. Parents who reported concern about their child's current weight reported higher scores for food restriction and monitoring than parents who were not currently concerned. Parents who reported concern about their child's future weight status reported higher scores for pressure-to-eat and monitoring than parents who were not at all concerned about their child's future weight status. The relationship between parental perception of child's current weight status and parent use of food restriction, pressure-to-eat, and overall food control was modified by child sex. Overall, results suggest that parent's perceptions of and concerns about their child's current and future weight status were correlated with their feeding approaches. Health care providers may want to consider providing anticipatory guidance for parents that have concerns about their child's weight by teaching them about positive, evidence-based ways they can engage in healthy food-related parenting practices.

A Media Literacy-Based Nutrition Program Fosters Parent-Child Food Marketing Discussions, Improves Home Food Environment, and Youth Consumption of Fruits and Vegetables

Background: Media use is a known contributor to childhood obesity, but encouraging reductions in screen use only partially eliminates media influence. We tested a family-centered, media literacy-oriented intervention to empower parents and children 9-14 years to skillfully use media to reduce marketing influences, enhance nutrition knowledge, improve the selection of foods in the home environment, and improve fruit and vegetable consumption. Methods: A community-based, 6-U program included separate parent and youth (ages 9-14 years) sessions, each of which was followed by a session together in which skills from the individual sessions were reinforced. A pretest to posttest field test with control groups (N = 189, parent-child dyads) tested the intervention's efficacy. Results: Standardized mean differences from the multiple analysis of covariance tests showed that the intervention group demonstrated improvements on parents' use of nutrition labels (0.29), the ratio of healthy to unhealthy food in the home environment (0.25), youth's fruit (0.30) and vegetable (0.25) consumption, parent and youth media literacy skills, and family communication dynamics about food. The largest effects found were for negative parental mediation (0.48) and parents' report of child-initiated discussion (0.47). Consistent but weaker results were revealed for Latinx families. Conclusions: This family-centered approach helped family members practice using media together to make better nutrition decisions without depending on the ability of parents to limit media use. It successfully addressed the often-negative impact of the media on behaviors that increase obesity risk while also cultivating the potential for media to provide useful information that can lead to behaviors that decrease obesity risk.

Nutritional problems in childhood and adolescence: a narrative review of identified disparities

To inform programmes and policies that promote health equity, it is essential to monitor the distribution of nutritional problems among young individuals. Common nutritional problems include overall low diet quality, the underconsumption and overconsumption of certain dietary components, unhealthy meal and snack patterns, problematic feeding practices and disordered eating. The objective of the present narrative review was to summarise recent evidence of disparities among US children (2-19 years) according to age, sex, socio-economic status, ethnicity/race and rural-urban location. Searches in PubMed® and MEDLINE® were completed to identify peer-reviewed research studies published between January 2009 and January 2019. Findings from the ninety-nine reviewed studies indicate adolescent females, young individuals from lower socio-economic households and individuals who identify as non-Hispanic Black race are particularly vulnerable populations for whom targeted strategies should be developed to address evidence of increased risk with regards to multiple aspects of nutritional wellbeing. Limitations of the existing evidence relate to the accuracy of self-reported dietary data; the need for consistent definitions of disordered eating; the focus on individual dietary components v. patterns; the complexities of categorising socio-economic status, ethnicity/race, and rural and urban areas; and the cross-sectional, observational nature of most research designs. There is an urgent need for research to address these limitations and fill a large gap in evidence on rural-urban differences in nutritional problems. It will further be important for future studies to build greater understanding of how nutritional problems cluster among population groups.

Impacto de práticas parentais de peso e dieta na imagem corporal de adolescentes do sexo feminino

RESUMO Objetivo Avaliar as práticas parentais de peso e alimentação e sua relação com a insatisfação da imagem corporal em adolescentes. Métodos As análises referem-se aos dados de base de um ensaio clínico randomizado previamente realizado com 270 adolescentes do sexo feminino de escolas públicas de São Paulo que participaram do Programa New Moves Brasil durante os anos de 2014 e 2015. Dados antropométricos, nível econômico, insatisfação com a imagem corporal, autoestima e práticas parentais sobre a ótica das adolescentes quanto à alimentação e corpo foram coletados. Um modelo de regressão logística múltipla foi conduzido para avaliar a influência das variáveis sobre a insatisfação com a imagem corporal das adolescentes. Resultados Adolescentes que estavam acima do peso tinham média/baixa autoestima, sofriam provocações relativas ao peso e faziam menos refeições em família tiveram associação com a insatisfação com a imagem corporal. Na análise de regressão, somente o comentário sobre o peso da filha foi considerado como um fator de risco, e esse deixa de existir quando há o convívio de ambos os pais com as filhas. Em relação à influência do pai, no modelo de convivência familiar, ele pode ser tanto um modelo positivo, na influência de escolhas saudáveis, quanto negativo, ao fazer provocações sobre peso e o incentivar fazer dietas. Conclusões Práticas parentais relacionadas ao peso e alimentação são consideradas de risco para o desenvolvimento de uma insatisfação com a imagem corporal e consequente predisposição a problemas relacionados ao peso.

Food Parenting Practices That Influence Early Adolescents' Food Choices During Independent Eating Occasions

OBJECTIVE

To identify practices that parents use to influence early adolescents' food choices during independent eating occasions (iEOs) from parent and child perspectives.

DESIGN

In-depth interviews.

PARTICIPANTS

Low-income parents (n = 49) and early adolescent children (aged 10-13 years; n = 44) from 10 US states and the District of Columbia.

PHENOMENON OF INTEREST

Parent and child perspectives on parenting practices that influence food choices during iEOs.

ANALYSIS

Audio-recorded interviews transcribed verbatim, NVivo coding, and directed content analysis.

RESULTS

Parents reported setting rules and expectations and managing availability or accessibility as the most common practices used to influence iEOs. Other practices included teaching, pressuring to eat, monitoring, and modeling. Children reported that their parents had rules about what they could or could not eat during iEOs and that they used specific strategies (eg, call or text) to monitor their iEOs.

CONCLUSIONS AND IMPLICATIONS

Additional studies are needed to confirm findings from this exploratory study. Future cross-sectional and longitudinal studies could determine whether and to what extent food parenting practices identified in the current study are associated with healthy dietary intake during iEOs, as well as potential racial and ethnic differences.

Family weight teasing, ethnicity and acculturation: Associations with well-being among Latinx, Hmong, and Somali Adolescents

OBJECTIVE

This study examines the prevalence of weight-based teasing by family members and associations with unhealthy weight control behaviors, body satisfaction, self-esteem, and depressive symptoms among adolescents from three immigrant communities (Latinx, Hmong, and Somali).

METHODS

Data come from EAT 2010, a population-based study of weight and related behaviors (N = 1577, mean age = 14.5 years). Adjusted models tested associations between weight-based teasing and well-being, controlling for BMI and ethnic group; effect modification by ethnic group and acculturation were also explored.

RESULTS

Family weight-based teasing was common (12.1%-42.9% reporting this experience across gender and ethnic groups) and was associated with all four measures of well-being in the expected direction. Associations were statistically equivalent in all ethnic groups and were not modified by acculturation.

CONCLUSION

Youth from immigrant communities experience family weight-based teasing and associated threats to well-being. Additional research is needed to further understand the cultural context of weight-based teasing and develop relevant prevention messages.

A qualitative exploration into momentary impacts on food parenting practices among parents of pre-school aged children

Food parenting practices have been identified as a potentially significant correlate of weight status and weight-related behaviors in children. The extent to which food parenting practices fluctuate across time and context is not well known. In particular, situational factors are thought to shape the types of food parenting practices used in the moment, but the nature of those factors remain unclear. In this paper data from interviews with parents (n = 40) of preschoolers was used to: 1) describe parents' day-to-day lived experiences of food parenting within the broad theoretical domains of coercive control, structure and autonomy support; 2) identify salient momentary factors that influence use of these food parenting practices; and 3) understand how these momentary factors impact the use of different types of food parenting practices. The feeding practices described by parents align well with the three overarching themes described within the literature: coercive control, autonomy support, and structure. Parents described using a combination of practices from within each of these domains; they also indicated that their feeding practices were easily influenced by momentary factors that impacted their food parenting within and across eating occasions. For the most part, parents described momentary factors (e.g. schedule changes, parental stress, child behavior) that shifted them away from structure and autonomy support feeding practices, towards indulgent and coercive feeding practices. Researchers should be aware of the likely interplay between different types of feeding practices as well as the potential that momentary factors may shift parents from one type of practice towards another. The use of novel data collection methods, such as ecological momentary assessment, that allow for exploration of food parenting practices as dynamic, rather than static, behaviors should be explored.

A Qualitative Exploration Into the Parent-Child Feeding Relationship: How Parents of Preschoolers Divide the Responsibilities of Feeding With Their Children

OBJECTIVE

To explore the extent to which parents divide responsibilities of feeding (what, when, where, how much, and whether) with their children and the factors that influence parents' approach to feeding.

DESIGN

Individual interviews.

PARTICIPANTS

Parents (n = 40) of preschoolers.

PHENOMENON OF INTEREST

Division of feeding responsibilities; motivation for feeding approach; challenges to feeding.

ANALYSIS

Audio-recorded interviews were transcribed verbatim and coded using deductive and inductive content analysis.

RESULTS

Parent's approaches to feeding varied widely. A few parents followed the Division of Responsibility approach closely. Instead, many parents gave their child more than the recommended amount of influence over what foods were served and offered children less than the recommended amount of autonomy over the whether and how much of eating. Meals and snacks were approached differently; parents exhibited less control over the timing of snacks as well as the types and amounts of foods eaten during snacks, compared with the control exhibited during meals.

CONCLUSIONS AND IMPLICATIONS

These data support future research to understand the impact of this framework on child health outcomes when it is adhered to on all eating occasions, including snacks. Collaboration by researchers and clinicians to explore alternative frameworks that encourage parents to provide the structure and autonomy support may enhance positive outcomes in children.

Relationship of physical activity with body image, self esteem sedentary lifestyle, body mass index and eating attitude in adolescents: A cross-sectional observational study

AIM

To Study Relationship of physical activity (PA) with body image, self-esteem, body mass index (BMI), sedentary lifestyle and eating attitude in adolescents.

METHODS

An observational cross-sectional study done at the Centre for Adolescent Health, Kalawati Saran Children Hospital, Lady Hardinge Medical College, New Delhi, India. Volunteering adolescents between the age group of 13 and 18 years were included and assessed using PA questionnaire for adolescents Score, Body Shape Questionnaire-34 Score, Rosenberg self esteem Score, adolescent sedentary activity questionnaire score, eating attitude test (EAT-26) and BMI Z-score. Relationship of these scales to various parameters was assessed using correlation and regression.

RESULTS

A total of 191 boys and girls were included in the study; 25% had underweight, 75% were normal (only 1 child had overweight and none had obesity). Three fourth (77%) of the children had low PA. The girls were relatively more inactive (83.9% girls vs. 72.1%boys). Most (90.05%) subjects did not have any concerns related to body image. Almost all the subjects had normal or high self esteem. Nearly one quarter of the subjects (23.56%) had disordered eating behaviours. Multiple regression found the PA is positively dependent on EAT 26 score and adolescent sedentary activity questionnaire (ASAQ) score (sedentary score) in girls, whereas in males ASAQ (sedentary score) score was only variable related to physical activity questionnaire for adolescents score (PAQ-A).

CONCLUSION

Normal weight and underweight adolescents had minimal PA and despite this, almost all had normal self-esteem and body image. PA was significantly related to eating and sedentary behaviours.

Parenting styles and body mass index: a systematic review of prospective studies among children

BACKGROUND

Parenting style may be an important determinant of an individual's future weight status. However, reviews that evaluate the relationship between parenting style and weight-related outcomes have not focused on prospective studies.

METHODS

We systematically searched PubMed, Embase and PsychInfo for studies published between 1995 and 2016 that evaluated the prospective relationship between parenting style experienced in childhood and subsequent weight outcomes.

RESULTS

We identified 11 prospective cohort studies. Among the eight studies that categorized parenting style into distinct groups (i.e. authoritative, authoritarian, permissive and neglectful), five provided evidence that authoritative parenting was associated with lower body mass index gains. Among the six highest quality studies, four suggested a protective role of authoritative parenting style against adverse weight-related outcomes. However, only one study controlled for a comprehensive set of confounders, and the small number of studies conducted within certain age groups precluded our ability to ascertain critical periods when parenting style is most strongly related to child weight.

CONCLUSIONS

The present literature supports the idea that authoritative parenting may be protective against later overweight and obesity, although findings are mixed. More prospective cohort studies of longer durations, with more sophisticated methods that examine age-varying relationships, and that control for a comprehensive set of confounders, are needed.

Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes

This study examines associations between an expanded conceptualization of food-related parenting practices, specifically, directive and non-directive control, and child weight (BMI z-score) and dietary outcomes [Healthy Eating Index (HEI) 2010, daily servings fruits/vegetables] within a sample of parent-child dyads (8-12 years old; n = 160). Baseline data from the Healthy Home Offerings via the Mealtime Environment (HOME Plus) randomized controlled trial was used to test associations between directive and non-directive control and child dietary outcomes and weight using multiple regression analyses adjusted for parental education. Overall variance explained by directive and non-directive control constructs was also calculated. Markers of directive control included pressure-to-eat and food restriction, assessed using subscales from the Child Feeding Questionnaire; markers of non-directive control were assessed with a parental role modeling scale and a home food availability inventory in which an obesogenic home food environment score was assigned based on the types and number of unhealthful foods available within the child's home food environment.

DIRECTIVE CONTROL

Food restriction and pressure-to-eat were positively and negatively associated with BMI z-scores, respectively, but not with dietary outcomes.

NON-DIRECTIVE CONTROL

An obesogenic home food environment was inversely associated with both dietary outcomes; parental role modeling of healthful eating was positively associated with both dietary outcomes. Neither non-directive behavioral construct was significantly associated with BMI z-scores.

TOTAL VARIANCE

Greater total variance in BMI-z was explained by directive control; greater total variance in dietary outcomes was explained by non-directive control. Including a construct of food-related parenting practices with separate markers for directive and non-directive control should be considered for future research. These concepts address different forms of parental control and, in the present study, yielded unique associations with child dietary and weight outcomes.