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Berge JM, Hazzard VM, Trofholz A, Hochgraf A, Zak-Hunter L, Miller L. Reported Intergenerational Transmission of Parent Weight Talk and Links with Child Health and Wellbeing. J Pediatr 2024; 270:114012. [PMID: 38494088 PMCID: PMC11176000 DOI: 10.1016/j.jpeds.2024.114012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To examine if intergenerational transmission of parent weight talk occurs, the contextual factors prompting weight talk, and whether parent weight talk is associated with child weight, dietary intake, psychosocial outcomes, and food parenting practices. STUDY DESIGN Children aged 5-9 years and their families (n = 1307) from 6 racial and ethnic groups (African-American, Hispanic, Hmong, Native American, Somali/Ethiopian, White) were recruited for a longitudinal cohort study through primary care clinics in Minneapolis/St. Paul, Minnesota from 2016 through 2019. Parents filled out surveys at 2 time points, 18 months apart. Adjusted regression models examined associations of interest. RESULTS Intergenerational transmission of parent weight talk was observed. In addition, significant associations were found between parent engagement in weight talk and higher weight status and poorer psychosocial outcomes in children 18 months later. Parent engagement in weight talk was also associated with more restrictive food parenting practices 18 months later. CONCLUSIONS Parents' exposure to weight talk as children increased the likelihood of engaging in weight talk with their own children and had harmful associations over time with parent restrictive feeding practices, child weight, and psychosocial wellbeing in children. Health care providers may want to consider both modeling positive health-focused conversations and educating parents about the potential harmful and long-lasting consequences of engaging in weight talk with their children.
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Affiliation(s)
- Jerica M Berge
- Department of Family Medicine and Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Vivienne M Hazzard
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN
| | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Anna Hochgraf
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota Twin Cities, Minneapolis, MN
| | - Lisa Zak-Hunter
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
| | - Laura Miller
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN
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Harris HA, Kininmonth AR, Nas Z, Derks IPM, Quigley F, Jansen PW, Llewellyn C. Prospective associations between early childhood parental feeding practices and eating disorder symptoms and disordered eating behaviors in adolescence. Int J Eat Disord 2024; 57:716-726. [PMID: 38387486 DOI: 10.1002/eat.24159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Nonresponsive parental feeding practices are associated with poorer appetite self-regulation in children. It is unknown whether this relationship extends beyond childhood to be prospectively associated with the onset of eating disorder (ED) symptoms in adolescence. This exploratory study therefore investigated prospective associations between early childhood parental feeding practices and adolescent ED symptoms and disordered eating behaviors. METHODS Data were from two population-based cohorts with harmonized measures: Generation R (Netherlands; n = 4900) and Gemini (UK; n = 2094). Parents self-reported their pressure to eat, restriction and instrumental feeding (i.e., using food as a reward) at child age 4-5 years. Adolescents self-reported their compensatory behaviors (e.g., fasting, purging), binge-eating symptoms, restrained eating, uncontrolled eating, and emotional eating at 12-14 years. Associations between feeding practices and ED symptoms were examined separately in each cohort using generalized linear models. RESULTS In Gemini, pressure to eat in early childhood was associated with adolescents engaging in compensatory behaviors. In Generation R, parental restriction was associated with adolescents engaging in compensatory behaviors, restrained eating, uncontrolled eating, and emotional eating. Instrumental feeding was associated with uncontrolled eating and emotional eating in Generation R. DISCUSSION Nonresponsive parental feeding practices were associated with a greater frequency of specific ED symptoms and disordered eating in adolescence, although effect sizes were small and findings were inconsistent between cohorts. Potentially, the cultural and developmental context in which child-parent feeding interactions occur is important for ED symptoms. Further replication studies are required to better understand parents' role in the development and maintenance of ED-related symptoms. PUBLIC SIGNIFICANCE Prospective research examining how early childhood parental feeding practices might contribute to adolescent ED symptoms is limited. In two population-based cohorts, nonresponsive feeding practices (restriction, instrumental feeding, pressure to eat) predicted increased frequency of some ED symptoms and disordered eating behaviors in adolescence, although associations were small and further replication is required. Findings support the promotion of responsive feeding practices, which may benefit young children's developing relationship with food.
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Affiliation(s)
- Holly A Harris
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Alice R Kininmonth
- School of Psychology, University of Leeds, Leeds, UK
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Zeynep Nas
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Ivonne P M Derks
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Fiona Quigley
- Institute for Nursing and Health Research, Ulster University, Belfast, Northern Ireland
| | - Pauline W Jansen
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
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Smith AD, Sanchez N, Harrison K, Bourne C, Clark ELM, Miller RL, Melby CL, Johnson SA, Lucas-Thompson RG, Shomaker LB. Observations of parent-adolescent interactions relate to food parenting practices and adolescent disordered eating in adolescents at risk for adult obesity. FAMILY PROCESS 2023; 62:1687-1708. [PMID: 36347267 PMCID: PMC11045300 DOI: 10.1111/famp.12829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 07/29/2022] [Accepted: 08/11/2022] [Indexed: 05/03/2023]
Abstract
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.
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Affiliation(s)
- Amy D. Smith
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Natalia Sanchez
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Kadyn Harrison
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Caitlin Bourne
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Emma L. M. Clark
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Reagan L. Miller
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Christopher L. Melby
- Colorado School of Public Health, Fort Collins, Colorado, USA
- Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado, USA
| | - Sarah A. Johnson
- Food Science and Human Nutrition, Colorado State University, Fort Collins, Colorado, USA
| | | | - Lauren B. Shomaker
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
- Colorado School of Public Health, Fort Collins, Colorado, USA
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Duck SA, Guarda AS, Schreyer CC. Parental dieting impacts inpatient treatment outcomes for adolescents with restrictive eating disorders. EUROPEAN EATING DISORDERS REVIEW 2023. [PMID: 36934407 DOI: 10.1002/erv.2977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/13/2023] [Accepted: 03/08/2023] [Indexed: 03/20/2023]
Abstract
OBJECTIVE Parental feeding practices and disordered eating are potential risk factors for the development of disordered eating in children and adolescents. This study measured the relationship between parental dieting behaviours and inpatient treatment outcomes for adolescents with restrictive eating disorders (EDs). METHOD Parents of adolescents with restrictive EDs (N = 45) admitted to a specialty integrated inpatient-partial hospital meal-based ED treatment programme completed questionnaires assessing parental eating and exercise behaviours. Adolescent clinical data, including percentage median body mass index (%mBMI) at admission and discharge and rate of weight gain, were abstracted from the electronic medical record. RESULTS Adolescents whose parents reported dieting had a slower rate of weight gain (3.47 lbs./week) compared to participants whose parents were not dieting (4.54 lbs./week; p = 0.017). Additionally, participants whose parents reported dieting had a lower %mBMI at programme discharge (M = 93.56) than participants whose parents did not report dieting (M = 95.99; p = 0.033). CONCLUSION Parental dieting behaviours may impact an adolescent's response to inpatient ED treatment. Findings suggest a need to assess parental dieting behaviour, and when appropriate, provide additional psychoeducation regarding the potential risks of weight or shape-focussed dialogue and the benefits of modelling adaptive meal behaviours.
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Affiliation(s)
- Sarah Ann Duck
- Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Angela S Guarda
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Colleen C Schreyer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Transtornos alimentares na infância. PSICO 2022. [DOI: 10.15448/1980-8623.2022.1.38780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Transtornos alimentares são um tema preocupante em qualquer fase de desenvolvimento humano. Essa revisão da literatura teve o objetivo de analisar as produções científicas quanto a transtornos alimentares em crianças, com a busca de artigos publicados entre 2014-2019 nas bases de dados Scielo, Pepsic, BVS (Lilacs) e Periódicos CAPES, utilizando os termos “childhood” AND “eating disorder”, “child” AND “eating disorder”, “children” AND “eating disorder”, “childhood” AND “eating difficulty”. 43 artigos foram selecionados após a aplicação dos critérios de exclusão e inclusão. Os resultados indicaram três tópicos principais discutidos nos estudos: a forma como os cuidadores influenciam na alimentação de crianças, fatores emocionais e psicológicos que influenciam nos transtornos alimentares, e o tratamento de crianças com transtornos alimentares. Concluiu-se que o tema ainda é pouco estudado e o cenário internacional é referência em publicações.
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Quinn M, Herty L, Weeks HM, Kwan J, Haines J, Bauer KW. Low-income mothers' perspectives on the involvement of family members in child feeding. Appetite 2021; 168:105683. [PMID: 34496273 DOI: 10.1016/j.appet.2021.105683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/02/2022]
Abstract
Nearly all research on child feeding has focused on mothers. Very little is known about other family members' roles in feeding children nor how mothers engage with these family members regarding child feeding. The objective of this study was to examine mothers' perceptions of other family members' child feeding roles and practices within low-income families, including the challenges experienced and strategies employed by mothers when sharing responsibility for child feeding. Low-income mothers (n = 100) of pre-adolescent children participated in semi-structured interviews regarding child feeding including shared responsibility for child feeding. A content analysis was then conducted to identify main themes in mothers' responses, with three main themes arising from the interviews. First, many family members were actively involved in child feeding and food-related decision-making. The majority of mothers (85%) reported that another family member was involved in feeding their child including fathers and father figures, who were involved in feeding in 63% of families. Other family members, mainly grandparents, were involved in feeding in 35% of families. Mothers identified several concerns regarding their child's eating when with other family members, particularly when grandparents fed children. Finally, mothers employed several strategies to control their children's eating when children were cared for by other family members. Future interventions to promote healthy child feeding among low-income families may benefit from helping mothers negotiate child feeding with other family members, particularly grandparents, and supporting family members' engagement in child feeding.
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Affiliation(s)
- Martha Quinn
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Lauren Herty
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Janice Kwan
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Moderating Effects of Parental Feeding Practices and Emotional Eating on Dietary Intake among Overweight African American Adolescents. Nutrients 2021; 13:nu13061920. [PMID: 34204927 PMCID: PMC8229013 DOI: 10.3390/nu13061920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/25/2021] [Accepted: 05/31/2021] [Indexed: 12/22/2022] Open
Abstract
This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child’s weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; Mage = 12.83 ± 1.74; MBMI% = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for Weight Loss trial and an ancillary study. Dietary outcomes (fruit and vegetables (F&Vs), energy intake, sweetened beverage, total fat, and saturated fat) were assessed using random 24-h dietary recalls. Validated surveys were used to assess adolescent-reported EE and parental feeding practices. Results demonstrated a significant interaction between EE and parental monitoring (adjusted analyses; B = 0.524, SE = 0.176, p = 0.004), restriction (B = −0.331, SE = 0.162, p = 0.043), and concern (B = −0.602, SE = 0.171, p = 0.001) on F&V intake; under high monitoring, low restriction, and low concern, EE was positively associated with F&V intake. There were no significant effects for the other dietary outcomes. These findings indicate that parental feeding practices and EE may be important factors to consider for dietary interventions, specifically for F&V intake, among overweight African American adolescents.
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Two to Tango? The Dance of Maternal Authority and Feeding Practices with Child Eating Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041650. [PMID: 33572265 PMCID: PMC7915551 DOI: 10.3390/ijerph18041650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to elucidate the relationship between maternal feeding practices and children’s eating problems. Mothers of 292 children aged 5.9 ± 1.1, 50% boys, reported online on parental authority, overt and covert control of the child’s food choices, child feeding practices, and their child’s problematic eating behavior. Structural equation modelling yielded a model with excellent indices of fit (χ(2)(52) = 50.72, p = 0.56; normed fit index (NFI) = 0.94; root mean square error of approximation (RMSEA) = 0.001). The model showed that an authoritarian maternal authority style was associated with overt control, which was associated with maternal tendency to pressure children to eat and with maternal restriction of highly processed or calorie-rich snack foods. These, in turn, were positively associated with the child’s satiety response, food fussiness, and slow eating, and negatively with the child’s enjoyment of food. In contrast, a permissive maternal authority style was associated with covert control of the child’s eating, concern over the child being overweight, and the restriction of highly processed and calorie-rich snack foods, which were in turn positively associated with the child’s emotional overeating and the child’s food responsiveness. The model seems to tap into two distinct patterns of mother-child feeding and eating dynamics, apparently related to children with opposing appetitive tendencies.
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Abstract
Eating and feeding disturbances are prevalent yet understudied health conditions in youth. They are characterized by aberrant eating behaviors, cognitive and emotional dysfunctions, and dysregulated body weight. The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition defines several feeding and eating disorders with a common onset in youth; however, data on their clinical validity at young ages are lacking. Further non-normative eating behaviors exist, but their clinical relevance needs elucidation. This Special Issue compiles state-of-the-art reviews and empirical research on the presentation, development, course, and maintenance of diverse eating and feeding disturbances as a prerequisite for delineating evidence-based interventions for treatment and prevention.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, 04103 Leipzig, Germany
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