A Bidirectional Analysis of Feeding Practices and Eating Behaviors in Parent/Child Dyads from Low-Income and Minority Households.
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ABSTRACT: Objective
To prospectively examine the bidirectional relationship between parental feeding practices (eg, instrumental feeding, encouragement to eat) and child eating behaviors (eg, food responsiveness, emotional eating) in low-income, ethnically diverse preschool children over a 3-year period.Study design
Parent/child (age 2-4 years at baseline) pairs (n = 222 non-Hispanics; n = 312 Hispanics) participated in NET-Works (Now Everybody Together for Amazing and Healthful Kids), a randomized controlled trial carried out in community and in-home settings in urban areas of Minnesota. Data were collected at baseline and 12, 24, and 36 months. The present study is a secondary data analysis using cross-lagged models to identify bidirectional associations between parental feeding practices and child eating behaviors.Results
Three models showed significant cross-lagged effects (P < .05): model 1, parental instrumental feeding influencing later child food responsiveness; model 2, parental emotional feeding influencing later child food responsiveness; and model 3, parental emotional feeding influencing later child eating satiety. Model 1 showed significant bidirectional temporal paths, whereas models 2 and 3 showed significant unidirectional temporal paths from parental feeding practices to child eating behaviors.Conclusions
Parental instrumental and emotional feeding practices prospectively influence child food responsiveness and satiety. This study demonstrates causal temporality between parental feeding practices and child eating behaviors. Heath care providers may want to use findings regarding parent feeding practices as part of their anticipatory guidance during well-child visits with parents of preschoolers.
SUBMITTER: Berge JM
PROVIDER: S-EPMC7252585 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundChild eating behaviors (CEBs) and parental feeding practices (PFPs) play critical roles in childhood obesity. However, the bidirectional relationships between CEBs and PFPs remain equivocal. This longitudinal study aimed to explore their bidirectional relationships.MethodsA convenience sample of 870 parents with preschoolers was recruited in this longitudinal study (Shanghai, China). Three non-responsive feeding practices (NFPs), three responsive feeding practices (RFPs), five CEBs, and covariates were collected using validated questionnaires at baseline and the 6-month follow-up. Cross-lagged analyses using structural equation modeling (SEM) were performed to examine their bidirectional relationships.ResultsEight hundred and fifty-three parents completed questionnaires, with a response rate of 98%. The mean age of their children at baseline was 4.39 years (standard deviation = 0.72 years). Eighteen out of sixty longitudinal cross-lagged paths were statistically significant. Parental encouragement of healthy eating and content-restricted feeding were found to be bidirectionally associated with child food fussiness. Four parent-driven associations and one child-driven association were identified between RFPs and CEBs. For example, monitoring was negatively associated with children's unhealthy eating habits (β = -0.066, standard error (SE) = 0.025, p < 0.01). Eight child-driven associations and one parent-driven association were observed between NFPs and CEBs. For example, higher child satiety responsiveness predicted a higher pressure to eat (β = 0.057, SE = 0.029, p < 0.01) and the use of food as a reward (β = 0.083, SE = 0.031, p < 0.01).ConclusionsThere were bidirectional, parent-driven, and child-driven associations. Parents should be encouraged to adopt RFPs to shape CEBs. Increasing parents' understanding of CEBs and providing them with reasonable coping strategies would help optimize PFPs.
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Project description:Food insecurity is becoming increasingly prevalent, especially for children from diverse households. Food insecurity presents a potentially different context in which parents engage in food-related parenting practices and children engage in eating behaviors. Parents may also experience higher levels of stress and depressed mood in the context of food insecurity. This study aims to examine associations between momentary parental stress and depressed mood, food-related parenting practices, and child eating behaviors within food secure and insecure households. Children ages 5–7 and their families (n = 150) from six racial/ethnic groups (n = 25 each African American, Hispanic, Hmong, Native American, Somali, White) were recruited for this mixed-methods study through primary care clinics in Minneapolis/St. Paul, MN in 2015–2016. High levels of parental stress and depressed mood experienced earlier in the day within food insecure households was associated with using restrictive feeding practices and serving more pre-prepared foods at the evening meal the same night. Parents from food secure households who experienced high levels of stress earlier in the day were more likely to engage in pressure-to-eat feeding practices, serve more fast food, and to have children who engaged in picky eating behaviors at the evening meal the same night. Health care clinicians may want to consider, or continue to, screen parents for food insecurity, stress, and depressed mood during well child visits and discuss the influence these factors may have on every day food-related parenting practices. Additionally, future research should consider using real-time interventions to reduce parental stress to promote healthy food-related parenting practices within food insecure and secure households.
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Project description:BackgroundParental non-responsive feeding practices and child eating behaviors both play significant roles in childhood obesity. However, their longitudinal relationships are less clear. This systematic review aimed to examine their bidirectional associations.MethodsA systematic search of five databases was conducted from inception to February 2022. Data synthesis was performed using a semi-quantitative and quantitative approach.ResultsA total of 14 studies with 15348 respondents were included. A total of 94 longitudinal effects from 14 studies of parental non-responsive feeding practices on child eating behaviors were investigated, and 19 statistically significant effects were discovered. Seventy-seven longitudinal effects from nine studies of child eating behaviors on parental feeding practices were examined, with fifteen being statistically significant. The pooled results of meta-analysis showed five statistically significant associations: parental restrictive feeding positively predicted child enjoyment of food (β = 0.044; 95% CI: 0.004, 0.085); use of food as a reward positively predicted child emotional eating (β = 0.09; 95% CI: 0.04, 0.15); child food responsiveness positively predicted restrictive feeding (β = 0.04; 95% CI: 0.02, 0.06); use food as a reward (β = 0.06; 95% CI: 0.03, 0.10). In addition, the pooled effects showed that child satiety responsiveness negatively predicted restrictive feeding (β = -0.05; 95% CI: -0.08, -0.01).ConclusionsThe bidirectional relationships between parental non-responsive feeding practices and child eating behaviors are inconsistent and a few showed statistical significance. Theory-driven longitudinal studies using validated instruments and controlling for potential confounders are needed to unveil their relationships and provide evidence for obesity prevention interventions.
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Project description:Previous studies have examined the independent influence of mother's weight status or child's weight status on parents' use of specific feeding practices (ie, food restriction, pressure-to-eat). However, studies have not examined the mutual influence of parents' and adolescents' weight status on parents' feeding practices. This study examines the relationship between parent and adolescent weight status concordance and discordance and parent feeding practices.Data from 2 linked population-based studies, Eating and Activity in Teens (EAT) 2010 and Families and Eating and Activity in Teens (F-EAT), were used for cross-sectional analysis. Parents (n = 3252; 63% female; mean age 42.6 years) and adolescents (n = 2153; 54% female; mean age 14.4 years) were socioeconomically and racially/ethnically diverse. Anthropometric assessments and surveys were completed at school by adolescents, and surveys were completed at home by parents.Parents used the highest levels of pressure-to-eat feeding practices when parents and adolescents were both nonoverweight compared with all other combinations of concordant and discordant parent/adolescent weight status categories. Additionally, parents used the highest levels of food restriction when parents and adolescents were both overweight/obese compared with all other combinations of concordant and discordant parent/adolescent weight status categories. Sensitivity analyses with 2-parent households revealed similar patterns.Results suggest that parents use feeding practices in response to both their adolescents' and their own weight status. Results may inform health care providers and public health interventionists about which parent/adolescent dyads are at highest risk for experiencing food restriction or pressure-to-eat parent feeding practices in the home environment and whom to target in interventions.
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Project description:Background:Parent feeding styles have been linked to child weight status across multiple studies. However, to our knowledge, the link between feeding styles and children's dietary quality, a more proximal outcome, has not been investigated. Objective:The purpose of this study was to examine the relation between parent feeding styles and dietary quality of Head Start preschoolers' dinner meals. Design:The amount of food served and consumed by children was measured by using a standardized digital photography method during 3 in-home dinner observations of low-income minority families in Houston, Texas. Trained dietitians entered food served and consumed into the Nutrient Data System for Research 2009 for nutrient analysis. Overall dietary quality of the food served and consumed at dinner was evaluated by using the Healthy Eating Index 2010 (HEI-2010). Parent feeding style was assessed with the use of the Caregiver's Feeding Style Questionnaire (CFSQ). On the basis of a parent's level of demandingness and responsiveness to his or her child during feeding, the CFSQ categorizes parent feeding into 4 styles: authoritative (high demandingness and high responsiveness), authoritarian (high demandingness and low responsiveness), indulgent (low demandingness and high responsiveness), or uninvolved (low demandingness and low responsiveness). Results:For the overall sample, the mean ± SD HEI score for dinner served was 44.2 ± 8.4, and the mean ± SD HEI score for dinner consumed was 43.4 ± 7.0. In the fully adjusted model, ANCOVA indicated that the authoritative parent feeding style was associated with significantly higher child dietary quality compared with the authoritarian feeding style (mean ± SEE HEI consumed-authoritative 45.5 ± 0.9; authoritarian: 41.9 ± 0.7; P = 0.001). Conclusions:Parent feeding style contributes to the overall dietary quality of children, and among low-income minority preschoolers an authoritative feeding style was associated with the highest dietary quality of the 4 feeding styles. Interventions to promote feeding practices that contribute to authoritative feeding are needed to improve the dietary quality of preschool children at dinner. This trial was registered at https://clinicaltrials.gov as NCT02696278.
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Project description:BackgroundUnderstanding children's feeding practices and eating behaviors is important to determine etiology of childhood obesity. This study aimed to explore the relationship between early feeding practices, eating behavior and body composition among primary school children.MethodsThe data were collected from 403 primary school children. They were administered structured questionnaire, including sociodemographic characteristics, early feeding practices and Child's Eating Behavior Questionnaire. Anthropometric and blood pressure (BP) measurements were performed.ResultsChildren with obesity and overweight showed higher food approach subscales and lower food avoidance subscales compared to a healthy and underweight child. Children who were exclusively or predominantly breast fed during the first 6 months had the lowest scores for the food approach subscales, food responsiveness (FR) and emotional overeating (EOE) and had the highest scores for the food avoidance subscales, satiety responsiveness (SR) and emotional under eating (EUE). Children who were introduced solid food after 6 months showed lower scores for FR, enjoyment of food and EOE but scored highest for SR, slowness in eating (SE) and EUE. All anthropometric measurements were positively correlated with all food approach subscales and negatively with SE, SR and food fussiness. All food approach subscales were positively correlated with BP percentiles. All food avoidance subscales were negatively correlated with both BP percentiles, except for EUE, which was negatively correlated with diastolic BP percentile only. Age, SR, SE and FR were predictors for child body mass index.ConclusionEarly feeding practices and eating behavior are considered as prevention approaches for obesity.
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