Investigating the relationship between parental weight stigma and feeding practices

An exploration of the longitudinal relation between parental feeding practices and child anthropometric adiposity measures from the West Midlands Active Lifestyle and Healthy Eating in Schoolchildren (WAVES) Study

Background: Parental 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. Methods: A systematic search of five databases was conducted from inception to February 2022. Data synthesis was performed using a semi-quantitative and quantitative approach. Results: A 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). Conclusions: The 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.

Parental feeding practices and associations with child weight status. Swedish validation of the Child Feeding Questionnaire finds parents of 4-year-olds less restrictive

Abstract: Parental feeding practices are linked to child disordered eating. Less research has examined these associations in young adult children, particularly college-aged, and studies examining relationships between parent feeding practices and mental health concerns are also limited. Examining these relationships in college students is important because higher education represents a period of marked development and maintenance of maladaptive eating behaviors and mental health concerns. A cross-sectional study with the inclusion of 64 parent-child (i.e., young adult) dyads examined relationships between retrospective parental feeding practices and current disordered eating and mental health concerns in their young adult children. Higher retrospective parental structured feeding practices were associated with lower young adult current disordered eating and mental health concerns. Collegiate health-promotion programs may consider college students' early food environments, particularly structured food environments, as factors that may be associated with adaptive eating behaviors and better mental health outcomes.

Fussy eating, characterised by persistent refusal of familiar and/or novel food, is a risk factor for poor dietary variety, particularly fruits and vegetables which are protective against diet-related chronic diseases. Parents may attempt to modify children's diets by using feeding practices that are not responsive to a child's appetite, such as pressuring, restricting and using food as a reward. Little is known about the nature of children's fussy eating within the social, emotional and economic context of the family. This PhD thesis, presented as five papers (four published, one accepted), demonstrated the complexity of family feeding dynamics and fussy eating in children aged 5-years old and younger, in the family context of socioecocomic disadvantage. Evidence generated from this thesis suggests bi-directional behavioural associations between parental non-responsive feeding practices and child fussy eating, which may be mediated by parental concern for the child's fussy eating.

BackgroundLittle is known about the pathways linking parent feeding practices with appetitive traits and BMIz throughout infancy. This study examined bidirectional associations between parental feeding practices, infant appetitive traits, and infant BMIz.MethodsParents (n = 380) of infants aged less than 6 months at baseline reported their feeding practices (using the Feeding Practices and Structure Questionnaire (FPSQ) for infants and toddlers), infant appetitive traits (using the Baby Eating Behaviour Questionnaire) and infant BMIz (parent-reported) at three timepoints (< 6 months, ~ 9 months, ~ 12 months) up to 12 months of age. Cross-lagged models examined bidirectional associations between parent feeding practices, infant appetitive traits and infant BMIz.ResultsThere was strong continuity across the three timepoints for maternal feeding practices, infant appetitive traits, and infant BMIz. Infant food avoidance was prospectively associated with higher parental persuasive feeding. Infant BMIz was prospectively associated with higher parent-led feeding. Parent use of food to calm was prospectively associated with lower infant BMIz, and infant BMIz was prospectively associated with higher infant food approach. Feeding on demand was prospectively associated with lower infant food approach.ConclusionThis study highlights the complex associations between parental feeding practices, infant appetitive traits and infant BMIz. The study demonstrated that both child and parent effects are important, suggesting a need for tailored programs beginning in infancy to promote and support infant appetitive traits and parent feeding practices that support healthy development.

To examine the relationship between parent feeding practices (restriction, monitoring, pressure to eat), general parenting behaviors (acceptance, psychological control, firm control), and aberrant child eating behaviors (emotional eating and excessive snacking) among overweight and normal weight children. Overweight and normal weight children between 8 and 12 years old and their mothers (n = 79, parent-child dyads) participated in this study. Mothers completed surveys on parent feeding practices (Child Feeding Questionnaire) and child eating behaviors (Family Eating and Activity Habits Questionnaire). Children reported on their mothers' general parenting behaviors (Child Report of Parent Behavior Inventory). Parent and child height and weight were measured and demographic characteristics assessed. Logistic regression models, stratified by child weight status and adjusting for parent BMI, were used to determine which parenting dimensions and feeding practices were associated with child emotional eating and snacking behavior. Overweight children displayed significantly more emotional eating and excessive snacking behavior than normal weight children. Mothers of overweight children used more restrictive feeding practices and psychological control. Restrictive feeding practices were associated with emotional eating in the overweight group (OR = 1.26, 95 % CI, 1.02, 1.56) and excessive snacking behavior in the normal weight group (OR = 1.13, 95 % CI, 1.01, 1.26). When examining general parenting, firm control was associated with decreased odds of excessive snacking in the overweight group (OR = 0.51, 95 % CI, 0.28, 0.93). Restrictive feeding practices were associated with aberrant child eating behaviors in both normal weight and overweight children. Firm general parenting however, was associated with decreased snacking behavior among overweight children. Longitudinal studies following children from infancy are needed to better understand the direction of these relationships.

Fathers' feeding practices and children's weight status in Mexican American families

BackgroundAn avid eating behavior profile is characterized by a greater interest in food and a tendency to overeat in response to negative emotions. Parents use specific strategies to manage feeding interactions with children with avid eating behavior. While momentary and contextual factors, such as parental mood, have been found to influence parental feeding practices, there is a lack of research examining parents’ daily experiences of feeding children with avid eating behavior. Examining this is important because parental feeding practices are key levers in tailored interventions to support children’s healthy eating behavior.ObjectiveWe aim to describe the ecological momentary assessment methods and procedures used in the APPETItE (Appetite in Preschoolers: Producing Evidence for Tailoring Interventions Effectively) project, which aims to examine how variation in parental mood, feeding goals, and the context of eating occasions affect the parental feeding practices used to manage feeding interactions with children with an avid eating behavior profile.MethodsParticipants are primary caregivers from the APPETItE cohort who have a preschool-age child (aged 3-5 years) with an avid eating behavior profile. Caregivers complete a 10-day ecological momentary assessment period using signal- and event-contingent surveys to examine (1) mood and stress, (2) parental feeding goals, and (3) contextual factors as predictors of parental feeding practices.ResultsRecruitment and data collection began in October 2023 and is expected to be completed by spring 2024. The data have a 3-level structure: repeated measurements (level 1) nested within days (level 2) nested within an individual (level 3). Thus, lag-dependent models will be conducted to test the main hypotheses.ConclusionsThe findings from this study will provide an understanding of caregivers’ daily experiences of feeding preschool children with avid eating behavior, who are at greater risk for the development of obesity. Understanding the predictors of feeding practices at the moment they occur, and across various contexts, will inform the development of tailored resources to support caregivers in managing children’s avid eating behavior.International Registered Report Identifier (IRRID)DERR1-10.2196/55193

BackgroundPositive parental feeding practices and a higher frequency of family meals are related to healthier child dietary habits. Parents play an essential role when it comes to the development of their child’s eating habits. However, parents are increasingly distracted by their mobile phone during mealtimes. The aim of this study was to describe the feeding practices and daily shared family meals among parents who use and do not use a mobile phone during mealtimes, and further to explore the associations between the use of a mobile phone during mealtimes and feeding practices and daily shared family meals, respectively.MethodsCross-sectional data from the Food4toddler study were used to explore the association between mobile use during meals and parental feeding practices including family meals. In 2017/2018 parents of toddlers were recruited through social media to participate in the study. In total 298 out of 404 who volunteered to participate, filled in a baseline questionnaire, including questions from the comprehensive feeding practices questionnaire (CFPQ), questions of frequency of family meals and use of mobile phone during meals.ResultsHerein, 4 out of 10 parents reported various levels of phone use (meal distraction) during mealtimes. Parental phone use was associated with lower use of positive parental feeding practices like modelling (B = − 1.05 (95% CI -1.69; − 0.41)) and family food environment (B = − 0.77 (95% CI -1.51; − 0.03)), and more use of negative parental feeding practices like emotional regulation (B = 0.73 (95% CI 0.32; 1.14)) and the use of pressure to eat (B = 1.22 (95% CI 0.41; 2.03)). Furthermore, parental phone use was associated with a lower frequency of daily family breakfast (OR = 0.50 (95% CI 0.31; 0.82)) and dinner (OR = 0.57 (95% CI 0.35; 0.93)).ConclusionsMobile phone use is common among parents during mealtimes, and findings indicate that parental phone use is associated with less healthy feeding practices and shared family meals. These findings highlight the importance of making parents aware of potential impacts of meal distractions.Trial registrationISRCTN92980420. Registered 13 September 2017. Retrospectively registered.

We examined whether genetic risk for higher BMI, parental feeding practices (restriction, pressure to eat, and monitoring), and their interactions were associated with overweight trajectories during adolescence. Data came from 5568 participants aged 10-18 in the Twins' Early Development Study who had at least one measurement of weight. Parental feeding practices were reported at age 10 using the Child Feeding Questionnaire. A polygenic score for BMI was used as a proxy for genetic risk. We identified overweight trajectories using latent class growth analysis, and associations with genetic risk, feeding practices, and their interactions were tested using multinomial logistic regression with trajectory as the outcome. Three trajectories were identified: non-overweight, persistent overweight, and adolescent-onset overweight. Higher genetic risk and greater parental restriction and monitoring were associated with persistent overweight, whereas pressure to eat was associated with non-overweight. Associations remained after adjustment for general parenting and additional risk factors. We found no evidence for gene-environment interaction. Genetic risk and parental feeding practices were independently associated with adolescent weight development. While this suggests feeding practices may be relevant targets for prevention, the findings likely represent complex bidirectional parent-child dynamics.

Validity of the toddler feeding questionnaire for measuring parent authoritative and indulgent feeding practices which are associated with stress and health literacy among Latino parents of preschool children

Relationship of Chinese American Parental Perceptions, Feeding Practices, Styles and Level of Acculturation to Their Child's BMI

Background and Objective: This study compared children's eating behaviors, body mass index, and parents' feeding practices between typically developing (TD) children and children with attention-deficit/hyperactivity disorder (ADHD). Materials &amp; Methods: In this descriptive study, 95 children with ADHD and 95 TD children aged 6 to 11 years were studied. The Conner's parents rating scale, the comprehensive feeding practice questionnaire, and the child eating behavior questionnaire were completed for both groups. In addition, both groups' weight and body mass index were measured and calculated. Clinical interviews and the Kiddie Schedule were held for both groups. The obtained data were analyzed by the independent t test and the Chi-square test in SPSS software, version 19.0, at a significance level of less than 0.05. Results: The two groups showed no significant differences in demographic characteristics and feeding practices. The parents in the two groups were similar in all study variables except for emotional control and monitoring over feeding practice. The correlation between body mass index and child eating behavior scores showed significant relationships with food disorder (r=-0.281, P=0.006), enjoyment of food (r=0.295, P=0.004), and food responsiveness/emotional binge (r=0.288, P=0.005).According to the stepwise regression, the predictors of body mass index were weight restraints and food disorder in the ADHD group and health restraints in the control group. Conclusion: This study found no significant differences between TD children and ADHD children regarding weight, body mass index, eating behavior, or parental feeding practice. Further research is needed to evaluate related variables, such as physical activity and birth weight.

To combat childhood obesity, researchers have focused on parental feeding practices that promote child health. The current study investigated how parenting style relates to twelve parental feeding practices. Data on parenting style and parental feeding practices were obtained for a correlational study from users of Amazon's Mechanical Turk, an online survey system. USA. Mothers of children aged 7-11 years (n 193). Parenting style related differentially to eleven out of the twelve measured practices. Authoritative mothers displayed more feeding practices that promote child health and fewer practices that impede child health. Authoritarian and permissive mothers displayed more unhealthy practices than authoritative mothers, but differed from each other on the practices they employed. Parenting style may relate to more aspects of feeding than previously realized. The inclusion of numerous healthy feeding practices along with unhealthy practices in the current study provides suggestions for the application of healthy feeding behaviours. Instruction on feeding behaviours and parenting style should be a focus of future educational programmes.