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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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Şarahman-Kahraman C, Memiç-İnan C, Yabanci-Ayhan N, Ozcelik AÖ. Investigation of the psychometric properties of the Comprehensive Feeding Practices Questionnaire in Turkish parents. Public Health Nutr 2024; 27:e148. [PMID: 38812438 DOI: 10.1017/s1368980024001125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
OBJECTIVE The Comprehensive Feeding Practices Questionnaire (CFPQ) measures parental attitudes towards feeding practices that directly influence children's eating habits. This study aims to determine the reliability and validity of the Turkish adaptation of the CFPQ developed by Musher-Eizenman et al. DESIGN Validity and reliability analyses were conducted for the Turkish version of the CFPQ (T-CFPQ). In addition to reliability analyses and partial correlations between scale dimensions, correlations between scale dimensions according to mothers' BMI and children's BMI z-scores were also examined. SETTING Parents with children aged 18 months to 8 years living in the community. PARTICIPANTS The study sample consisted of 274 parents with children aged 18 months to 8 years who agreed to participate in the online survey. RESULTS In this study, forty-seven items and twelve-factor structure describing feeding practices were supported by the confirmatory factor analysis. Although most of the dimensions of the T-CFPQ showed significant correlations with each other, the highest correlation was found between the encourage balance/variety and the dimension of modelling and teaching nutrition (r = 0·53; 0·50) (P < 0·05). There was a negative correlation between the child's BMI z-score and the pressure to eat dimension (r = -0·173; P < 0·01) and a positive correlation between the restriction for weight dimension (r = 0·339; P < 0·01). Maternal BMI was negatively associated with the involvement dimension (r = -0·121; P < 0·05) and positively associated with the restriction for weight dimension (r = 0·154; P < 0·01). CONCLUSIONS The findings revealed that the T-CFPQ is a valid and reliable measurement tool that can be applied to obtain the necessary information for evaluating nutritional interactions between parent and child.
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Affiliation(s)
- Ceren Şarahman-Kahraman
- Department of Nutrition and Dietetics, University of Alanya Alaaddin Keykubat, Alanya/Antalya, Turkey
| | - Cansu Memiç-İnan
- Department of Nutrition and Dietetics, Niğde Ömer Halisdemir University, Niğde, Turkey
| | | | - Ayse Özfer Ozcelik
- Department of Nutrition and Dietetics, University of Ankara, Ankara, Turkey
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Del Valle C, Miranda H, Orellana L, Grunet KG, Adasme-Berrios C, Schnettler B. Children's perception of food parenting practices: adaptation and validation of the comprehensive feeding practices questionnaire in Chilean adolescents. Front Public Health 2024; 12:1343623. [PMID: 38544728 PMCID: PMC10972623 DOI: 10.3389/fpubh.2024.1343623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/29/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Assessment of the Comprehensive Feeding Practices Questionnaire in adolescents (CFPQ-Teen) is still limited, with no evaluation of the measurement invariance. The participants comprised 473 Chilean adolescents of both sexes from dual-income nuclear families. The aims of this study were: (1) to adapt to Spanish and validate a model of five-factor version the CFPQ-Teen; (2) to examine the psychometric properties, (3) to evaluate the measurement invariance according to the adolescents' gender; and (4) to compare the scores of each factor between female and male adolescents. Methods The instrument was translated, back-translated, and adapted from the CFPQ-Teen, confirming the equivalence, conceptual, and face validity in a pilot sample of 40 adolescents. An exploratory factor analysis was performed on the five-factor model of the CFPQ-Teen: Monitoring, Adolescent Control, Restriction for weight control, Parental Modeling, and Environment. The Environment factor was eliminated as a result. Results The confirmatory factor analysis presented good reliability, convergent, discriminant, and concurrent validity values. In addition, medium to high goodness-of-fit levels were obtained by eliminating an item from the Adolescent Control factor. These results confirm a final 20-item model representing four factors. The multigroup invariance analysis of the measurement model verified configural, metric, scalar, and partial strict invariance. No significant differences were found between females and males in the scores on the four factors. Discussion These results enable comparisons by sex on the perceptions of Food Parenting Practices from the analyzed factors, primarily within the context of the Chilean sample.
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Affiliation(s)
- Carola Del Valle
- Doctorado en Ciencias Agroalimentarias y Medioambiente, Facultad de Ciencias Agropecuarias y Medioambiente, Universidad de La Frontera, Temuco, Chile
| | - Horacio Miranda
- Facultad de Ciencias Agropecuarias y Medioambiente, Universidad de La Frontera, Temuco, Chile
| | - Ligia Orellana
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
- Departamento de Psicología, Facultad de Educación, Ciencias Sociales y Humanidades, Universidad de La Frontera, Temuco, Chile
| | - Klaus G. Grunet
- MAPP Centre, Aarhus University, Aarhus, Denmark
- University of Vaasa, Vaasa, Finland
| | | | - Berta Schnettler
- Facultad de Ciencias Agropecuarias y Medioambiente, Universidad de La Frontera, Temuco, Chile
- Centro de Excelencia en Psicología Económica y del Consumo, Universidad de La Frontera, Temuco, Chile
- Scientific and Technological Bioresource Nucleus (BIOREN-UFRO), Universidad de La Frontera, Temuco, Chile
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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Santos AF, Fernandes M, Fernandes C, Barros L, Veríssimo M. Validation of the Comprehensive Feeding Practices Questionnaire (CFPQ) with Portuguese Caregivers of 2-to-8-Year-Olds. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1924. [PMID: 38136126 PMCID: PMC10742423 DOI: 10.3390/children10121924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 11/29/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023]
Abstract
Recent findings have demonstrated an increase in the prevalence of childhood obesity and overweight in Portugal, urging the need to study modifiable risk factors such as parental feeding practices. The Comprehensive Feeding Practices Questionnaire (CFPQ) is an important self-report measure assessing a broad range of responsive and non-responsive feeding practices. However, the CFPQ has not yet been validated in Portugal. Therefore, the present study aimed to test the validity of this measure with Portuguese parents of 2-to-8-year-old children. A sample of 409 parents completed a Portuguese-adapted version of the CFPQ and the already validated Child Feeding Questionnaire (CFQ). Confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and psychometric analysis were conducted. CFA demonstrated the original 12-factor structure did not fit the sample. EFA identified an eight-factor structure comprising 29 items: Monitoring, Modeling, Environment, Involvement, Emotion Regulation, Restriction for Weight Control, Restriction for Health, and Pressure. Findings suggest that parental feeding practices are sensitive to parents' background cultures and children's developmental period.
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Affiliation(s)
- Ana F. Santos
- William James Center for Research, ISPA-Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.F.); (C.F.)
| | - Marília Fernandes
- William James Center for Research, ISPA-Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.F.); (C.F.)
| | - Carla Fernandes
- William James Center for Research, ISPA-Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.F.); (C.F.)
| | - Luísa Barros
- Centro de Investigação em Ciência Psicológica, Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal;
| | - Manuela Veríssimo
- William James Center for Research, ISPA-Instituto Universitário, 1149-041 Lisboa, Portugal; (A.F.S.); (M.F.); (C.F.)
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Morris Z, Norman Å, Elinder LS, Patterson E, Warnqvist A, Raposo S, Sidney Annerstedt K. Validation of the Comprehensive Feeding Practices Questionnaire among parents of 5- to 7-year-old children in Sweden. Front Psychol 2023; 14:1205427. [PMID: 38098534 PMCID: PMC10719845 DOI: 10.3389/fpsyg.2023.1205427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Parents' behaviours towards food and mealtimes, also known as parental feeding practices, are important in the development of children's eating habits. The Comprehensive Feeding Practices Questionnaire (CFPQ) was designed to measure parental feeding practices. The aim of this study was to evaluate the validity of the CFPQ in Sweden and to assess how it performs across different groups of people. Methods Data were from the baseline of a trial promoting children's healthy dietary and physical activity behaviours, the Healthy School Start Plus intervention, conducted in 17 schools in the Stockholm region in Sweden. The CFPQ was completed by 263 parents (59% mothers) of 173 children, aged 5 to 7 years. Exploratory factor analysis and the omega reliability test were performed to identify the underlying factors in the data. Invariance testing was used to investigate the equivalence of these factors across parental sex, parental education and children's weight status. Results Five factors were identified: monitoring of children's food intake, pressure to eat, restriction of food, use of food for emotional regulation, and healthy eating guidance. All five factors were invariant across parental sex and education, though some questions were excluded to achieve invariance. The monitoring, pressure to eat and emotional regulation factors were invariant across children's weight status. Discussion These results suggest that the CFPQ is valid for use in Sweden, amongst parents of children aged 5 to 7 years. The measurement invariance allows for comparisons of all five underlying factors across mothers and fathers and parental education levels, though across children's weight status for only three factors. Due to the importance of parental feeding practices throughout childhood, this questionnaire should also be validated in other age groups in Sweden.
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Affiliation(s)
- Zoë Morris
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Åsa Norman
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Liselotte Schäfer Elinder
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Centre for Epidemiology and Community Medicine (CES), Stockholm, Sweden
| | - Emma Patterson
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Swedish Food Agency, Uppsala, Sweden
| | - Anna Warnqvist
- Institute for Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Sara Raposo
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Centre for Epidemiology and Community Medicine (CES), Stockholm, Sweden
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Parental Feeding, Child Eating and Physical Activity: Differences in Children Living with and without Asthma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073452. [PMID: 33810395 PMCID: PMC8036624 DOI: 10.3390/ijerph18073452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to establish the differences in parental attitudes toward feeding and activity, as well as child eating and activity levels, between families of children living with and without asthma. Parents of children and young people aged between 10 and 16 years living both with asthma (n = 310) and without asthma (n = 311) completed measures for parental feeding, parental attitudes toward child exercise, child eating, child activity level and asthma control. Children living with asthma had a significantly higher BMIz (BMI standardised for weight and age) score, were significantly more likely to emotionally overeat and desired to drink more than their peers without asthma. Parents of children with asthma reported greater use of food to regulate emotions, restriction of food for weight control, monitoring of child activity, pressure to exercise and control over child activity. When asthma symptoms were controlled, parental restriction of food for weight management predicted greater child BMIz scores, and higher child activity predicted lower child BMIz scores. These relationships were not found to be significant for children with inadequately controlled asthma. Differences in parental attitudes toward feeding and exercise, and child eating and exercise behaviors, between families may help to explain the increased obesity risk for children with asthma.
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da Silva AB, Piccoli ÂB, Pellanda LC. Knowledge and food practices questionnaire: construction and validation. J Pediatr (Rio J) 2021; 97:177-183. [PMID: 32084439 PMCID: PMC9432235 DOI: 10.1016/j.jped.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To develop and validate an instrument about nutritional knowledge and feeding practices to be used in children aged 7-11 years, based on the latest Brazilian Food Guide. METHODS Review on the subject; instrument creation; content validity with two groups of judges: first, nutritionists and, after adjustments, a multidisciplinary group (content validity index [CVI]); FACE validity; reproducibility analysis (intraclass correlation coefficient [ICC], level of agreement, and kappa [k]); internal consistency analysis (Cronbach's alpha[α]) and construct validity (Kaiser-Meyer-Olkin and exploratory factorial analysis). The sample was calculated, considering at least ten subjects for each question of the questionnaire. RESULTS There was a final sample of 453 children (53.6% girls), with a mean age of 9.45 years (SD = 1.44). The content validity showed a CVI ≥ 0.80 for relevance in 62.3% of the items for nutritionists' group and 100% of the items for the multidisciplinary group, clarity (49.4%, 91.8%), and pertinence (58.8%, 98.4%), respectively. The test-retest showed a level of agreement of 84.3% and k = 0.740 for the Knowledge dimension and ICC = 0.754 for the Food Practices dimension. The internal consistency showed α = 0.589 for the Knowledge dimension and α = 0.618 for the Food Practices dimension. For the construct validity, Kaiser-Meyer-Olkin was 0.724 and exploratory factorial analysis showed a variance of 47.01 with varimax rotation and defined five factors for the Practices Dimension. CONCLUSION The Food Knowledge and Practices Questionnaire (Questionário de Conhecimento e Práticas Alimentares [QCPA]) instrument showed validity and reliability to assess nutritional knowledge and food practices in children aged 7-11 years.
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Affiliation(s)
| | - Ângela B Piccoli
- Fundação Universitária de Cardiologia, Instituto de Cardiologia, Porto Alegre, RS, Brazil
| | - Lucia C Pellanda
- Fundação Universitária de Cardiologia, Instituto de Cardiologia, Porto Alegre, RS, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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Ayine P, Selvaraju V, Venkatapoorna CMK, Geetha T. Parental Feeding Practices in Relation to Maternal Education and Childhood Obesity. Nutrients 2020; 12:nu12041033. [PMID: 32283764 PMCID: PMC7231200 DOI: 10.3390/nu12041033] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/31/2020] [Accepted: 04/07/2020] [Indexed: 11/24/2022] Open
Abstract
Parental beliefs, attitudes, and feeding practices play a vital role in childhood obesity. This study aimed to assess parental perceptions, concerns about weight, feeding practices using the Child Feeding Questionnaire (CFQ), and its association with body mass index (BMI) and maternal education in elementary school children. Participants aged 6–10 years (n = 169) were recruited and anthropometric measurements were obtained. Pearson’s correlation and hierarchical linear regression analysis were used to examine the association between BMI z-score and the seven factors of the CFQ. The BMI z-score was significantly associated with parental perceived child weight and concern about child weight. The BMI z-score had a significant negative association with parents pressuring children to eat. Parents of obese children reported significantly higher (p < 0.001) levels of perceived child weight (β = 0.312) and concern (β = 0.320) about their child’s weight compared to the normal weight and overweight groups. Parents of overweight children showed considerably less (β = −0.224; p < 0.005) pressuring towards their children to eat as compared to parents of normal weight children. Additionally, we found that the parental feeding practice (pressure to eat) was only dependent upon maternal education. The path analysis indicates that maternal education has a mediating effect on BMI z-score and pressure to eat is related to BMI z-score through maternal education. The findings demonstrate the association between the parents’ perceptions, concerns, and pressure to eat with BMI z-score of elementary school-aged children. Only the parental feeding practice pressure to eat was dependent upon the maternal education.
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Affiliation(s)
- Priscilla Ayine
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (P.A.); (V.S.); (C.M.K.V.)
| | - Vaithinathan Selvaraju
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (P.A.); (V.S.); (C.M.K.V.)
| | - Chandra M. K. Venkatapoorna
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (P.A.); (V.S.); (C.M.K.V.)
| | - Thangiah Geetha
- Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL 36849, USA; (P.A.); (V.S.); (C.M.K.V.)
- Boshell Metabolic Diseases and Diabetes Program, Auburn University, Auburn, AL 36849, USA
- Correspondence: ; Tel.: +1-334-844-7418
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Minaie M, Mirzaei K, Heshmat R, Movahedi A, Dorosty Motlagh A, Parsaeian M, Raghebi SS, Djazayery A. Revising the Comprehensive Feeding Practices Questionnaire Used in Planning Preventive Overweight, Obesity, and Underweight Programs for 2-5-year-old Children. Int J Prev Med 2020; 10:159. [PMID: 32133077 PMCID: PMC6826674 DOI: 10.4103/ijpvm.ijpvm_34_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 01/24/2018] [Indexed: 12/02/2022] Open
Abstract
Background: Overweight, obesity, and underweight are common child health problems in Iran. Child-feeding practices are one of the major factors affecting children's weight through eating behavior and dietary intake. The Comprehensive Feeding Practices Questionnaire (CFPQ), a 49-item measure comprising 12 subscales, assesses parental child-feeding practices. It is used to determine factors that may affect the development of overweight, obesity, and underweight and therefore, helps us plan appropriate preventive action. The aim of this study was to revise and adapt CFPQ to be used for 2–5-year-old children. Methods: This study including, 300 mothers selected by simple systematic random sampling, was conducted in the rural and urban areas of Birjand city, Iran. Health workers interviewed the mothers and completed questionnaire according to the standard protocol. Exploratory factor analysis (EFA), tests for internal consistency, and test–retest reliability were conducted. Results: EFA resulted in a final questionnaire with 39 items distributed over seven factors, including Healthy Eating Guidance, Modeling, Parent Pressure, Monitoring, Emotion Regulation, Child Control, and Restriction. The internal consistency reliability for the proposal scales was acceptable for five out of the seven factors and all of the seven factors demonstrated excellent test–retest reliability. Conclusions: The revised CFPQ is a valid tool for determining the various aspects of parental feeding practices aiming to prevent overweight, obesity, and underweight among 2–5-year-old children.
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Affiliation(s)
- Mina Minaie
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Disease Research Centre, Endocrinology and Population Sciences Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ariyo Movahedi
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Ahmadreza Dorosty Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Parsaeian
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Soori Soghra Raghebi
- Department of Clinical Nutrition, Deputy of Curative Affaires, Birjand University of Medical Sciences, Birjand, Iran
| | - Abolghasem Djazayery
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Arlinghaus KR, Hernandez DC, Eagleton SG, Chen TA, Power TG, Hughes SO. Exploratory factor analysis of The Comprehensive Feeding Practices Questionnaire (CFPQ) in a low-income hispanic sample of preschool aged children. Appetite 2019; 140:82-90. [PMID: 31054276 DOI: 10.1016/j.appet.2019.04.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 04/08/2019] [Accepted: 04/30/2019] [Indexed: 01/20/2023]
Abstract
The Comprehensive Feeding Practices Questionnaire (CFPQ) is an important measure to assess parent feeding practices as it encompasses a broad range of feeding behaviors, not just behaviors negatively associated with child weight outcomes. However, parent feeding practices have been shown to differ across ethnicities and the CFPQ has not been tested among low-income, Hispanic-American parents with preschool-aged children, a group at elevated risk for developing obesity. A confirmatory factor analysis was performed with the present Hispanic-American sample of Head Start mothers with preschoolers to confirm the original 12-factor, 49-item structure of the CFPQ. Because the original factor structure was not confirmed in the present Hispanic-American sample, an exploratory factor analysis was conducted to examine the psychometric properties of the CFPQ in this sample (n = 187). Among this sample, a five-factor model with 34 items was found to more appropriately assess parent feeding practices than the original 12-factor, 49-item CFPQ. This study provides preliminary validation of the CFPQ for use among low income, Hispanic-American families. Although future research is needed to replicate findings among a larger sample, this study takes an important first step toward more accurately assessing parent feeding practices among this high-risk population to inform tailored interventions that aim to reduce economic and ethnic disparities in child obesity.
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Affiliation(s)
- Katherine R Arlinghaus
- University of Houston, Department of Health & Human Performance, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX, 77240, USA.
| | - Daphne C Hernandez
- University of Houston, Department of Health & Human Performance, 3875 Holman Street, Garrison Gymnasium, Room 104, Houston, TX, 77240, USA; HEALTH Research Institute, University of Houston, Health 2, 3839 Calhoun Road, Houston, TX, 77204, USA.
| | - Sally G Eagleton
- Center for Childhood Obesity Research, Penn State College of Health and Human Development, University Park, PA, USA; Department of Nutritional Sciences, Penn State College of Health and Human Development, University Park, PA, USA.
| | - Tzu-An Chen
- HEALTH Research Institute, University of Houston, Health 2, 3839 Calhoun Road, Houston, TX, 77204, USA.
| | - Thomas G Power
- Department of Human Development, Washington State University, Pullman, WA, USA.
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, 1100 Bates Ave, Houston, TX, 77030, USA.
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Freitas FR, Moraes DEB, Warkentin S, Mais LA, Ivers JF, Taddei JAAC. Maternal restrictive feeding practices for child weight control and associated characteristics. J Pediatr (Rio J) 2019; 95:201-208. [PMID: 29438685 DOI: 10.1016/j.jped.2017.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 12/08/2017] [Accepted: 12/12/2017] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To identify associations between maternal restrictive feeding practices for child weight control and sociodemographic, behavioral, dietetic, and anthropometric characteristics. METHODS Cross-sectional study with mothers of children aged 2-8 years. Maternal feeding practices were measured by the Comprehensive Feeding Practices Questionnaire, in private schools in Brazil. Bivariate and multivariate associations were performed, using nonparametric analyses to estimate odds ratios and significance levels. RESULTS Maternal restrictive feeding practices for weight control were independently associated with the mother's perception of her child being a little overweight/overweight/obese (OR=4.61, p=0.001), greater concern about the child's overweight (OR=2.61, p<0.001), child's overweight/obesity/severe obesity (OR= 2.18, p<0.001), and the child's greater intake of ultra-processed foods (OR=1.40, p=0.026). CONCLUSION In this study, the risk variables identified for the use of the maternal restrictive feeding practices to control the child's weight can be used to provide education and guidance interventions in health and education networks directed to groups with similar characteristics to those of the studied population.
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Affiliation(s)
- Fabrícia R Freitas
- Universidade Federal de São Paulo (Unifesp), Departamento de Pediatria, São Paulo, SP, Brazil.
| | - Denise E B Moraes
- Universidade Federal de São Paulo (Unifesp), Departamento de Pediatria, São Paulo, SP, Brazil
| | - Sarah Warkentin
- Universidade Federal de São Paulo (Unifesp), Departamento de Pediatria, São Paulo, SP, Brazil
| | - Laís A Mais
- Universidade Federal de São Paulo (Unifesp), Departamento de Pediatria, São Paulo, SP, Brazil
| | - Júlia F Ivers
- Universidade Federal de São Paulo (Unifesp), Departamento de Pediatria, São Paulo, SP, Brazil
| | - José Augusto A C Taddei
- Universidade Federal de São Paulo (Unifesp), Departamento de Pediatria, Disciplina de Nutrologia, São Paulo, SP, Brazil
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Freitas FR, Moraes DE, Warkentin S, Mais LA, Ivers JF, Taddei JAA. Maternal restrictive feeding practices for child weight control and associated characteristics. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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de Souza Rezende P, Bellotto de Moraes DE, Mais LA, Warkentin S, Augusto de Aguiar Carrazedo Taddei J. Maternal pressure to eat: Associations with maternal and child characteristics among 2-to 8-year-olds in Brazil. Appetite 2019; 133:40-46. [DOI: 10.1016/j.appet.2018.10.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 09/12/2018] [Accepted: 10/09/2018] [Indexed: 11/25/2022]
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Longitudinal factor analysis of the Comprehensive Feeding Practices Questionnaire among parents of preschool-aged children. Appetite 2018; 129:94-102. [DOI: 10.1016/j.appet.2018.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 06/17/2018] [Accepted: 07/04/2018] [Indexed: 02/07/2023]
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Warkentin S, Mais LA, Latorre MDRDDO, Carnell S, Taddei JADAC. Parents Matter: Associations of Parental BMI and Feeding Behaviors With Child BMI in Brazilian Preschool and School-Aged Children. Front Nutr 2018; 5:69. [PMID: 30148134 PMCID: PMC6096004 DOI: 10.3389/fnut.2018.00069] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 07/19/2018] [Indexed: 12/19/2022] Open
Abstract
Background: Brazil is undergoing nutritional transition and rates of obesity in preschool and school-aged children are increasing. Excess weight in the first years of life could predict excess weight in adulthood, making it essential to study risk factors in this population. Objective: Our goal was to investigate associations of parent feeding behaviors, as well as more distal familial influences including family SES and maternal and paternal weight, with BMI z-score in preschool and school-aged children in a Brazilian sample. Methods: Cross-sectional study. Data were collected in 14 Brazilian private schools. Parents of children aged 2–8 years (n = 1,071) completed a questionnaire assessing parent feeding behaviors, as well as sociodemographic and anthropometric information. Hierarchical linear regression models were fitted to investigate relationships between parent and child characteristics and child BMI z-score in preschool (2–5 years, n = 397) and school-aged (6–8 years, n = 618) children. Results: Final models indicated that higher maternal BMI and “restriction for weight control” were associated with higher child BMI z-score in both age groups (excessive weight, i.e., BMI ≥ +1 z-score, in preschoolers and school-aged children: 24.4 and 35.9%, respectively). In preschoolers only, “healthy eating guidance” and “pressure” were associated with lower child BMI z-score. For school-aged children, male sex, higher father BMI, and “restriction for health” were associated with higher child BMI z-score. Conclusions: Parent feeding behaviors and parent weight, as well as child sex, are associated with child BMI z-score, with evidence for differential relationships in preschool and school-aged children. Optimal obesity prevention and treatment strategies may differ by child age.
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Affiliation(s)
- Sarah Warkentin
- Discipline of Nutrology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Laís A Mais
- Discipline of Nutrology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | | | - Susan Carnell
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Warkentin S, Mais LA, Latorre MDRDDO, Carnell S, de Aguiar CarrazedoTaddei JA. Relationships between parent feeding behaviors and parent and child characteristics in Brazilian preschoolers: a cross-sectional study. BMC Public Health 2018; 18:704. [PMID: 29880038 PMCID: PMC5992628 DOI: 10.1186/s12889-018-5593-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 05/23/2018] [Indexed: 01/28/2023] Open
Abstract
Background Eating habits formed in early childhood are influenced by parental feeding behaviors, warranting investigation of predictors and correlates of parent feeding. We aimed to describe relationships between parental feeding practices and parent and child characteristics in a sample of Brazilian preschoolers. Methods Four hundred and two parents of preschoolers enrolled in private schools of São Paulo and Campinas, Brazil, completed a Brazilian version of the Comprehensive Feeding Practices Questionnaire, as well as questions about parental attitudes, child food intake, other obesity-associated behaviors, and socioeconomic and demographic characteristics. We ran bivariate logistic regression models examining associations between independent variables and each feeding practice. Next, we ran multiple logistic regression models predicting each parental feeding practice. Results Greater ‘Restriction for Weight Control’ and ‘Restriction for Health’ were associated with lower maternal education (OR = 2.42 (CI 95% 1.07–5.48) and 2.79 (CI 95% 1.25–6.22), respectively), and with higher concern about child overweight (OR = 2.46, CI 95% 1.64–3.69 for ‘Restriction for Weight Control’, only), while greater ‘Pressure’ was associated with greater concern about child underweight (OR = 2.30, CI 95% 1.53–3.47) and lower maternal BMI (OR = 0.94, CI 95% 0.88–1.00). Greater use of ‘Emotion Regulation/ Food as Reward’ was associated with lower maternal education (OR = 2.22, CI 95% 1.05–4.71). In analyses of positive feeding practices, lesser use of ‘Healthy Eating Guidance’ and ‘Monitoring’ was associated with greater intake of less healthy foods in children (OR = 1.53 (CI 95% 1.01–2.32) and OR = 1.94 (CI 95% 1.27–2.97), respectively), and greater use of screen devices (OR = 1.59 (CI 95% 1.04–2.44) and OR = 1.57 (CI 95% 1.03–2.39), respectively). Lesser use of ‘Healthy Eating Guidance’ was additionally associated with higher maternal BMI (OR = 1.09, CI 95% 1.03–1.16), and lesser use of ‘Monitoring’ with lesser perceived parent responsibility for child feeding (OR = 1.68, CI 95% 1.12–2.52). Conclusions Our results demonstrate diverse socioeconomic, anthropometric and behavioral correlates of parent feeding in a large Brazilian sample of parents of preschoolers.
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Affiliation(s)
- Sarah Warkentin
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP), Rua Loefgreen, 1647, São Paulo, SP, CEP: 04040-032, Brazil.
| | - Laís Amaral Mais
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP), Rua Loefgreen, 1647, São Paulo, SP, CEP: 04040-032, Brazil
| | | | - Susan Carnell
- Department of Psychiatry and Behavioral Sciences, Division of Child & Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - José Augusto de Aguiar CarrazedoTaddei
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP), Rua Loefgreen, 1647, São Paulo, SP, CEP: 04040-032, Brazil
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Warkentin S, Mais LA, Latorre MDRDO, Carnell S, Taddei JAAC. Factors associated with parental underestimation of child's weight status. J Pediatr (Rio J) 2018; 94:162-169. [PMID: 28826796 DOI: 10.1016/j.jped.2017.05.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 02/07/2017] [Accepted: 03/08/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine the prevalence of parental misperception of child weight status, and identify socioeconomic, anthropometric, behavioral and dietary factors associated with underestimation. METHOD Cross-sectional study. Data was collected in 14 Brazilian private schools. Parents of children aged 2-8 years (n=976) completed a self-reported questionnaire assessing their perception of their child's weight status, and sociodemographic, anthropometric, behavioral and dietary information. To measure the agreement between parental perception about child weight status and actual child weight status, the Kappa coefficient was estimated, and to investigate associations between parental underestimation and independent variables, chi-squared tests were performed, followed by multiple logistic regression, considering p≤0.05 for statistical significance. RESULTS Overall, 48.05% of the parents incorrectly classified their child's weight. Specifically, 45.08% underestimated their child's weight status, with just 3% of parents overestimating. Children with higher body mass index (OR=2.03; p<0.001) and boys (OR=1.70; p<0.001) were more likely to have their weight status underestimated by parents. CONCLUSION Since awareness of weight problems is essential for prevention and treatment, clinical practitioners should help parents at high risk of misperception to correctly evaluate their child's weight status.
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Affiliation(s)
- Sarah Warkentin
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Nutrologia, São Paulo, SP, Brazil.
| | - Laís A Mais
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Nutrologia, São Paulo, SP, Brazil
| | - Maria do Rosário D O Latorre
- Universidade de São Paulo (USP), Faculdade de Saúde Pública, Departamento de Epidemiologia, São Paulo, SP, Brazil
| | - Susan Carnell
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Baltimore, United States
| | - José Augusto A C Taddei
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Nutrologia, São Paulo, SP, Brazil
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Warkentin S, Mais LA, Latorre MDRD, Carnell S, Taddei JAA. Factors associated with parental underestimation of child's weight status. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Piccoli ÂB, Neiva-Silva L, Mosmann CP, Musher-Eizenman D, Pellanda LC. Adolescents' perception of parental feeding practices: Adaptation and validation of the Comprehensive Feeding Practices Questionnaire for Brazilian adolescents-The CFPQ-Teen. PLoS One 2017; 12:e0187041. [PMID: 29145485 PMCID: PMC5690605 DOI: 10.1371/journal.pone.0187041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/18/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Parental feeding practices may play a key role in dietary habits and nutritional status of adolescents, but research from adolescents' point of view on this topic is scarce. OBJECTIVE To adapt and validate an instrument of parental feeding practices as perceived by adolescents in a Brazilian setting. METHODS The Comprehensive Feeding Practices Questionnaire was translated into Portuguese and adapted to be answered by adolescents (ages 12 to 18). Content analysis and FACE validity to assess cultural equivalence was undertaken by experts in the adolescent nutritional and psychological fields. Pilot study was evaluated in 23 adolescents. The final version was administered to 41 students to assess instrument reproducibility (Intraclass Correlation Coefficient). Internal consistency (Cronbach's Alpha) and construct validity (Confirmatory Factor Analysis) were assessed in a third sample of 307 adolescents. RESULTS Experts and adolescents considered content validity as appropriate. In reproducibility analysis (Intraclass Correlation Coefficient), 10 of the 12 factors were above 0.7. The factors "teaching about nutrition" and "food as reward" obtained values of 0.60 and 0.68, respectively. The Cronbach's Alpha of the whole scale was 0.83 and alphas for subscales ranged from 0.52 to 0.85; the factors "teaching about nutrition" and "food as a reward" had the lowest values (0.52). After removing these two factors, the Confirmatory Factor Analysis indicated that the structural model was appropriate. The final scale was made up of 10 factors with 43 questions. CONCLUSIONS The Comprehensive Feeding Practices Questionnaire-Teen demonstrates validity and reliability, and is a suitable tool to evaluate the perceptions of adolescents regarding parental feeding practices.
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Affiliation(s)
- Ângela Bein Piccoli
- Post Graduation Program in Health Sciences: Cardiology, Instituto de Cardiologia / Fundação Universitária de Cardiologia. Porto Alegre, Brazil
| | - Lucas Neiva-Silva
- Psychology Graduate Program, Post Graduation Program in Public Health, Universidade Federal do Rio Grande. Rio Grande, Brazil
| | | | - Dara Musher-Eizenman
- Department of Psychology, Bowling Green State University, Bowling Green, United States of America
| | - Lucia C. Pellanda
- Post Graduation Program in Health Sciences: Cardiology, Instituto de Cardiologia / Fundação Universitária de Cardiologia. Porto Alegre, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre. Porto Alegre, Brazil
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Sociodemographic, anthropometric and behavioural risk factors for ultra-processed food consumption in a sample of 2–9-year-olds in Brazil. Public Health Nutr 2017; 21:77-86. [DOI: 10.1017/s1368980017002452] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
AbstractObjectiveThe present study aimed to identify food patterns among 2–9-year-olds and investigate sociodemographic, anthropometric and behavioural predictors of less healthy dietary patterns.DesignCross-sectional study. Parents of 2–9-year-olds completed an FFQ and factor analysis was applied to identify dietary patterns. Parents also completed questionnaires assessing sociodemographic, anthropometric and behavioural characteristics of parents and children, including parental feeding practices.SettingParticipants were recruited from private schools of Campinas and São Paulo, SP, Brazil, between April and June 2014.SubjectsParents of 2–9-year-olds (n 929).ResultsTwo dietary patterns emerged: ‘traditional food’ and ‘ultra-processed food’. Lower maternal education (OR=2·05, P=0·010) and higher maternal weight status (OR=1·43, P=0·044) were associated with a greater likelihood of the ultra-processed food pattern. Lower perceived parental responsibility for adequacy of food group intake (OR=2·41, P=0·020), and lower scores on the parental feeding practices of ‘Healthy Eating Guidance’ (OR=1·83, P<0·001) and ‘Monitoring’ (OR=2·52, P<0·001), were also associated with the presence of this pattern, as was higher child’s screen use during mealtimes (OR=1·61, P=0·004).ConclusionsThe present study is the first to evaluate associations between less healthy dietary patterns of Brazilian 2–9-year-olds and parental feeding practices. Our findings highlight sociodemographic, anthropometric and behavioural factors within families that could be used to target tailored policies to at-risk populations.
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Mais LA, Warkentin S, Latorre MDRDDO, Carnell S, Taddei JAADC. Parental Feeding Practices among Brazilian School-Aged Children: Associations with Parent and Child Characteristics. Front Nutr 2017; 4:6. [PMID: 28377921 PMCID: PMC5359473 DOI: 10.3389/fnut.2017.00006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 03/07/2017] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Children's eating behavior, food intake, and weight status are highly influenced by parents, who shape their food environment via parental feeding practices. The aim of this study was to investigate associations between sociodemographic, anthropometric, and behavioral/attitudinal characteristics of parents and their 5- to 9-year-old children and a range of positive ("healthy eating guidance," "monitoring") and potentially negative ("restriction for weight control," "restriction for health," "emotion regulation/food as reward," and "pressure") parental feeding practices. METHODS Parents completed a questionnaire assessing parental and child characteristics. Parental feeding practices were measured using a Brazilian adaptation of the Comprehensive Feeding Practices Questionnaire. To test associations between parent and child characteristics and parental feeding practices, we ran bivariate logistic regression models with parent and child characteristics as independent variables and high (above median) scores on individual parental feeding practices as outcome variables. We then conducted multivariate logistic regression models containing all parent and child characteristics, controlling for child age and maternal education. RESULTS Lower parental perceived responsibility for child feeding, higher child use of screen devices, and higher child ultra-processed food intake were associated with lower scores on "healthy eating guidance" and "monitoring." Higher parental perceived responsibility for child feeding and concern about child overweight were associated with higher scores on "restriction for weight control" and "restriction for health." Parental perceptions of low weight and concern about child underweight, and higher perceived responsibility for child feeding, were associated with higher scores on "pressure." Greater intake of ultra-processed foods and lower maternal age were associated with higher scores on "emotion regulation/food as reward." CONCLUSION Parental concerns and perceptions relating to child weight were predictive of potentially negative feeding practices. Higher scores on potentially negative feeding practices, and lower scores on positive parent feeding practices, were associated with poorer child diet and higher use of screen devices. Parental engagement in the feeding interaction predicted greater adoption of both potentially negative and positive feeding practices. These results support the need for policies and programs to educate parents about child feeding and help motivated parents to promote healthy lifestyles in their children.
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Affiliation(s)
- Laís Amaral Mais
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Sarah Warkentin
- Department of Pediatrics, Discipline of Nutrology, Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | | | - Susan Carnell
- Johns Hopkins School of Medicine , Baltimore, MD , USA
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Al-Qerem WA, Ling J, AlBawab AQ. Validation of the comprehensive feeding practice questionnaire among school aged children in Jordan: a factor analysis study. Int J Behav Nutr Phys Act 2017; 14:23. [PMID: 28219402 PMCID: PMC5319026 DOI: 10.1186/s12966-017-0478-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 02/13/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obesity has become a significant worldwide contributor to morbidity with an alarming increase in the incidence of childhood obesity. Few studies have evaluated parental feeding practices and their impact on child obesity in the Middle East. The Comprehensive Feeding Practice questionnaire (CFPQ; Musher-Eizenman & Holub, 2007) has been validated in different age groups and in different countries, however no previous studies have validated the questionnaire in the Middle East. METHOD In this study, 970 children aged 6-12 completed the Arabic translated version of the CFPQ. The height and weight of the children were also measured. Confirmatory factor and exploratory factor analysis were used to evaluate different factor models. An ordinal logistic regression was conducted to evaluate the association between maternal feeding practices and child weight status. RESULTS Confirmatory analysis of the CFPQ determined that the original 12 factor structure of the questionnaire was not suitable for this sample. The analysis suggested that the most suitable structure was an 11 factors model (CMIN/DF = 2.18, GFI = 0.92, CFI = 0.93, TLI = 0.92 and RMSEA = 0.03) that included Modelling, Monitoring, Child control, Food as a reward, Emotional regulation, Involvement, Restriction for health, Restriction for weight control, Environment, Teach and encourage and Pressure. Of the children tested, 12.6% were obese and 25.1% were overweight. The ordinal regression showed Restriction to health and weight, Emotional regulation and maternal BMI were negatively associated with healthy weight status, while Modelling, Monitoring, Child Control, Environment, Involvement, and Teach and encourage were positively associated with healthy weight status. CONCLUSION The Arabic translated version of the CFPQ was validated among the study sample, and the best fit for the model was found to utilize 11 factors. This study indicated that child weight status was associated with maternal feeding practices.
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Affiliation(s)
- Walid A. Al-Qerem
- Al-Zaytoonah University of Jordan, P.O. Box 130, Amman, 11733 Jordan
| | - Jonathan Ling
- Department of Pharmacy, Health and Wellbeing, Faculty of Applied Sciences, University of Sunderland, Chester Rd, Sunderland, SR1 3SD UK
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