The effects of parental influences on children's food intake,physical activity,and relative weight

The current investigation assessed the relationship between observed child mealtime behavior, physical activity, selected parent behaviors, and child relative weight. Subjects were 30 (15 male, 15 female) preschool children varying in age from 22 to 46 months (mean = 30.5 months). Each subject and parents were observed during the dinnertime meal with an observational instrument designed to measure children's mealtime behaviors and parental influences on child eating. Further, children's activity levels were assessed for one hour and parental influences on child activity were observed. Results indicated that parental encouragements to eat correlated both with the percent of time the child ate and with child relative weight. Similarly, parental encouragements to be active correlated to extreme levels of child motor activity and negatively to relative weight. Implications of the current study are discussed and the present findings are compared and contrasted with previous research.     

Practice-Based Evidence of Effectiveness in an Integrated Nutrition and Parenting Education Intervention for Low-Income Parents

Research identifying associations between parental behaviors and children's food and activity choices and weight suggests that the integration of parenting and nutrition education holds promise for promoting healthful eating and activity in families. However, translational research leading to sustainable interventions lags behind. Development and testing of interventions within actual program contexts is needed to facilitate translation to full-scale implementation. Therefore, the goal of this pilot study was to develop and test an integrated nutrition and parenting education intervention for low-income families within the Expanded Food and Nutrition Education Program in New York State. During a 21-month period, low-income parents of 3- to 11-year-olds were recruited through usual programmatic channels by nutrition program staff to participate in a series of eight workshops delivered to small groups. A validated self-administered questionnaire was used to assess behavior change outcomes among 210 parents who completed the program. Mean scores improved significantly for most behaviors, including adult fruit and vegetable intake; adult and child low-fat dairy and soda intake; and child fast-food intake, activity, and screen time (P<0.001). Many parents reported eating together with children at program entry, leaving little room to improve, but about 20% reported at least a 1-point improvement (on a 5-point scale). The most frequent change was reducing how often children ate fast food and was reported by >50% of parents. Design and testing through practice-based research can facilitate development of interventions that are both feasible and likely to improve eating and activity behaviors among low-income families.     

Which adaptive maternal eating behaviors predict child feeding practices? An examination with mothers of 2- to 5-year-old children

Researchers have started to explore the detrimental impact of maladaptive maternal eating behaviors on child feeding practices. However, identifying which adaptive maternal eating behaviors contribute to lower use of negative and higher use of positive child feeding practices remains unexamined. The present study explored this link with 180 mothers of 2- to 5-year-old children. Hierarchical regression analyses (controlling for recruitment venue and maternal demographic characteristics, i.e., age, education, ethnicity, and body mass index) examined mothers' intuitive eating and eating competence as predictors of four feeding practices (restriction, monitoring, pressure to eat, and dividing feeding responsibilities with their child). Mothers who gave themselves unconditional permission to eat were less likely to restrict their child's food intake. Mothers who ate for physical (rather than emotional) reasons and had eating-related contextual skills (e.g., mindfulness when eating, planning regular and nutritious eating opportunities for themselves) were more likely to monitor their child's food intake. Mothers who had eating-related contextual skills were more likely to divide feeding responsibilities with their child. No maternal eating behavior predicted pressure to eat. Interventions to help mothers develop their eating-related contextual skills and eat intuitively, in particular, may translate into a more positive feeding environment for their young children.     

Is parenting style related to children's healthy eating and physical activity in Latino families?

Parenting styles influence a child's risk for obesity. The goals of this study are to evaluate the influence of (i) parenting style on children's health behaviors (physical activity and dietary intake), (ii) children's sociodemographic characteristics on parenting style and on children's health behaviors and (iii) parents' sociodemographic characteristics on their use of controlling styles to promote a healthy home environment. Survey and anthropometric data were collected from a community sample of Latino parents (n = 812) and their children in kindergarten through second grade. Parental use of positive reinforcement and monitoring was associated with children's healthy eating and exercise. Also, parents' use of appropriate disciplining styles was associated with healthier eating, while parental use of control styles was associated with unhealthy eating. The daughters of parents who used controlling styles ate more unhealthy foods than did the sons. Older, employed and more acculturated parents used less controlling styles than their counterparts. Parenting interventions targeting children's dietary intake and physical activity should encourage parents to use more positive reinforcement and monitor their children's health behaviors as these parenting styles are associated with healthier behaviors. Moreover, intervention researchers may want to encourage Latino parents to use less controlling styles with girls as this parenting style increased girls' risk for unhealthy eating.     

Oregon Parents’ Perceptions of the Supportiveness of the School Environment for Their Children's Health Behaviors

ObjectiveTo describe Oregon parents’ perceptions of their children's school regarding health behaviors; examine how perceptions vary by parent, child, and community characteristics; and identify recommendations for improving school environments.MethodsOregon parents with an elementary school–aged child completed an electronic survey.ResultsOver 90% of parents (n = 814) described their child's school as supportive of healthy eating and physical activity. Parents who ate ≥5 fruits/vegetables per day more often perceived their children's school as unsupportive of healthy eating (P < 0.001) and physical activity (P < 0.05) relative to others. Parents of children eligible for free/reduced-price lunch more often perceived the school as unsupportive of physical activity (P < 0.05) relative to others. Parental recommendations included improving school meals and providing short physical activity breaks.Conclusions and ImplicationsParents’ suggested school improvements can inform school wellness committees’ and administrators’ quality-improvement efforts and, in turn, better support children's healthy behaviors.     

Nutritional Knowledge,Parenting Styles and Feeding Practices of a South African Sample of Parents

ABSTRACT

Parenting can be considered as being an all-encompassing network of development for children. Children learn about eating not only through their own experiences but also by watching others. Mothers and children show similar patterns of food acceptance and food preferences. Children’s intake of fruit and vegetables was positively related to parents’ intake of fruit and vegetables. The current study used self-reported data from parents/primary caregivers' children aged 3–18 covering sociodemographic characteristics, feeding style dimensions (‘control overeating’, ‘emotional feeding’, ‘encouragement to eat’ and ‘instrumental feeding’) and parenting style dimensions (‘involvement’ and ‘strictness’). The results suggest, that in general, parents were inclined to encourage balance and variety in the food intake of their children, modeling healthy eating behavior, as well as monitoring the food intake of children while restricting unhealthy foods. Further research is needed into whether parents’ diets affect children’s food choices feeding.     

Indulgent Feeding Style Moderates the Association of Food Responsiveness to Body Mass Index Z-scores of Preschoolers

ObjectiveTo investigate the moderating role of caregiver feeding styles in the association between preschool children's food-approaching eating behaviors and body mass index (BMI) z-scores.MethodsThis cross-sectional study examined 81 caregiver-preschooler dyads from low-income neighborhoods in Santiago, Chile. Moderated multiple linear regression analyses were used to determine the moderating effect of the indulgent feeding style in the relation between eating behaviors and BMI z-scores of preschool children.ResultsThe indulgent caregiver feeding style moderated the association between food responsiveness and BMI z-scores of preschoolers. In an indulgent feeding style, food responsiveness was associated with higher child BMI z-scores (β = 0.50; P < 0.001). There was no interaction between enjoyment of food and feeding styles in relation to children's BMI z-scores (β = 0.17; P = 0.58).Conclusions and ImplicationsAn indulgent feeding style can be a risk factor for unhealthy weight outcomes in food responsive preschoolers, but not in those who enjoy food. Educating indulgent parents in the feeding context, and prioritizing children with food-approaching behaviors who are sensitive to external food cues may be effective for approaching childhood obesity.     

学龄前儿童饮食行为与生存质量相关性研究

目的 探索学龄前儿童饮食行为与生存质量间的相关性,为改善学龄前儿童生存质量提供科学依据.方法 2016年4至6月间,采用第四军医大学儿童健康相关行为研究团队自主研制的学龄前儿童饮食行为量表及PedsQLTM4.0生存质量量表中文版,对319例3～6岁儿童进行调查.采用多元线性回归分析儿童饮食行为与生存质量间的相关性.结果 不同性别儿童挑食行为得分差异有统计学意义(=3.087,P ＜0.05);是否独生子女、母亲教育程度间食物响应维度得分差异均有统计学意义(t独生子女=3.817、F母亲教育程度=3.732,均P＜0.05);不同性别、母亲教育程度、家庭人均月收入及家庭人口数间不良进食习惯得分差异均有统计学意义(t不同性别=2.943、F母亲教育程度 =4.091、F家庭月收入=4.160、F家庭人口数=4.987,均P＜0.05).不同年龄、是否独生子女、母亲不同教育程度、不同家庭经济收入及家庭人口数间儿童生存质量得分差异均有统计学意义(t不同年龄=3.736、t独生子女=4.985、F母亲教育程度=3.890、F家庭经济收入=3.787、F家庭人口数=5.982,均P＜0.05).在控制了家庭人口学特征后,儿童生存质量总分与儿童饮食行为中挑食、食物响应、不良进食习惯、过饱响应及情绪性进食呈负相关关系,不同饮食行为对生存质量各维度影响不同.结论 学龄前儿童饮食行为与其生存质量存在一定关系,不良饮食行为会降低儿童生存质量.     

Association of school nutrition policy and parental control with childhood overweight

BACKGROUND: Schools and parents may play important roles in preventing childhood obesity by affecting children's behaviors related to energy balance. This study examined how school nutrition policy and parental control over children's eating and physical activity habits are associated with the children's overweight/obesity (hereafter overweight) status. METHODS: Data were analyzed from a total of 246 pairs of children and parents who were recruited in the 2008‐2009 academic year from 10 randomly selected public secondary schools in Indiana (school response rate = 66.7%; participant response rate = 73.5%). Logistic regression analyses were performed to examine odds ratios of different levels of school nutrition policies and parental control with and without adjusting for sociodemographic characteristics. RESULTS: Children who attended schools where soda pop (OR = 3.79, p < .01) and non‐low‐fat salty snacks (OR = 2.46, p = .05) could be purchased were more likely to be obese than those at schools where such items were not sold. Children whose parents rarely or never ensured that their child was avoiding eating too many sweets (OR = 2.33, p = .08), avoiding spending too much time watching TV (OR = 2.24, p = .06), or engaging in physical activity (OR = 2.35, p = .09) were more likely to be obese than children whose parents did so always or most of the time. CONCLUSIONS: School nutrition policy and parental control over children's eating and physical activity habits are associated with the children's overweight status.     

Parents of Children With Eating Disorders: Developing Theory-Based Health Communication Messages to Promote Caregiver Well-Being

Parents of children with eating disorders experience extreme emotional burden because of the intensity and duration of the recovery process. While parental involvement in a child's eating disorder treatment improves outcomes, parents often neglect their own well-being, which can impede their child's recovery. This study extends the research on caregivers and on health theory in practice by conducting formative research to develop a theory-based communication intervention encouraging parents to engage in adaptive coping and self-care behaviors. The Transactional Model of Stress and Coping and the Transtheoretical Model guided qualitative assessments of the determinants of parents' coping behaviors. Three focus groups with 19 parents of children with eating disorders and 19 semi-structured interviews with experts specializing in eating disorders were conducted. Findings indicate that parents and experts see parents' need for permission to take time for themselves as the main barrier to self-care. The main motivator for parents to engage in coping behaviors is awareness of a connection between self-care and their child's health outcomes. Participant evaluation of six potential messages for main themes and effectiveness revealed that theory-based elements, such as certain processes of change within the Transtheoretical Model, were important to changing health behavior.     

Comparison of visual estimates of children's portion sizes under both shared-plate and individual-plate conditions

OBJECTIVE: This paper compares the accuracy of visual estimations of children's food intake in settings where several children eat together off 1 plate vs individual-plate eating scenarios. DESIGN: Eight trained observers were tested in their ability to estimate food portions consumed by children enacting common eating scenarios. Foods were categorized by food group and according to their presentation by individual-plate and shared-plate. Observed food weight estimates were compared to actual weights. SUBJECTS/SETTING: The 8 observers visually estimated 69 food portions of children eating alone and 26 portions where children were eating from a shared plate. This study was carried out in Sarlahi District, a rural, central lowland region of Nepal. STATISTICAL ANALYSES: Pearson's correlation coefficients were calculated to examine associations between estimated and actual weights. A fixed effects model was constructed to compare observers. RESULTS: Analyses revealed that observer estimates of food weights under field conditions were well correlated with actual weights for individual-plate (r = 0.89) and for shared-plate (r = 0.84) scenarios. Observers estimated food weights when children ate together on a shared plate less accurately than they did in settings where children ate alone. With the exception of 1 observer, observers did not differ significantly in their ability to estimate food weights. Accuracy of estimations was influenced by food weight with greater error associated with food quantities of less than 70 g. CONCLUSIONS: Visual estimation is a relatively accurate, valid method of assessing child food intake under rural field conditions, and the only method to obtain accurate information on dietary intake in regions where shared-plate eating is frequent.     

Permissive parental feeding behavior is associated with an increase in intake of low-nutrient-dense foods among American children living in rural communities

Parents play an important role in shaping children's eating habits. Few studies have evaluated the influence of both parenting style and parenting practices on child outcomes such as dietary intake. During spring 2007, 99 parent-child dyads from four rural US areas participated in this cross-sectional study. Child food intake was reported during two interviewer-administered, parent-assisted 24-hour recalls. Diet quality was defined as the average number of low-nutrient-dense (LND) foods consumed. Validated questionnaires were used to assess parental feeding practices and feeding style. Pearson correlations identified relationships among child food intake, parental feeding style typologies, and covariates. Regression analyses were used to predict child diet quality. Sixty percent of children and 76% of parents were overweight or obese. A permissive feeding style, which is highly responsive to a child's requests and sets few demands on him or her, was the most common (n=37) parental feeding style. This feeding style was associated with child intake of LND foods (r=0.3; P<0.001) and moderated the relationship between parental feeding practices and child intake of LND foods. In the presence of a permissive feeding style, higher levels of monitoring were associated with child intake of LND foods (β=.69; P<0.05). Parental feeding style may alter the effectiveness of parental feeding practices on children's food intake. More research is needed to understand the parent-child feeding relationship in the context of parental feeding styles and practices.     

The economic benefits of reducing physical inactivity: an Australian example

Background

Time spent watching television affects multiple aspects of child and adolescent health. Although a diverse range of factors have been found to be associated with young people's television viewing, parents and the home environment are particularly influential. However, little is known about whether parents, particularly those who are concerned about their child's television viewing habits, translate their concern into action by providing supportive home environments (e.g. rules restricting screen-time behaviours, limited access to screen-based media). The aim of this study was to examine associations between parental concerns for child television viewing and child television viewing and the home sedentary environment.

Methods

Parents of children aged 5-6 years ('younger' children, n = 430) and 10-12 years ('older children', n = 640) reported usual duration of their child's television (TV) viewing, their concerns regarding the amount of time their child spends watching TV, and on aspects of the home environment. Regression analyses examined associations between parental concern and child TV viewing, and between parental concern and aspects of the home environment. Analyses were stratified by age group.

Results

Children of concerned parents watched more TV than those whose parents were not concerned (B = 9.63, 95% CI = 1.58-17.68, p = 0.02 and B = 15.82, 95% CI = 8.85-22.80, p < 0.01, for younger and older children respectively). Parental concern was positively associated with younger children eating dinner in front of the television, and with parental restriction of sedentary behaviours and offering sedentary activities (i.e. TV viewing or computer use) as a reward for good behaviour among older and young children. Furthermore, parents of older children who were concerned had fewer televisions in the home and a lower count of sedentary equipment in the home.

Conclusions

Children of concerned parents watched more TV than those whose parents who were not concerned. Parents appear to recognise excessive television viewing in their children and these parents appear to engage in conflicting parental approaches despite these concerns. Interventions targeting concerned parents may be an innovative way of reaching children most in need of strategies to reduce their television viewing and harnessing this parental concern may offer considerable opportunity to change the family and home environment.     

Dietary Adherence and Mealtime Behaviors in Young Children with Type 1 Diabetes on Intensive Insulin Therapy

Diet is an important component of diabetes treatment and integral to successful management. While intensive insulin therapy can allow patients to eat more freely, it is not known how the rapid uptake of intensive therapy in young children with type 1 diabetes has impacted their diet and if diet and healthful eating in young children correlates with mealtime behaviors and glycemic control. This study examined diet, mealtime behaviors, and glucose control in a sample of 39 young children on intensive therapy. This was a one-sample, cross-sectional study. Children had a mean age of 5.1±1.1 years. Children's 3-day diet diaries were assessed using a deviation scale (measure of adherence) and a healthy eating index. Mealtime behaviors were assessed using the Behavioral Pediatric Feeding Assessment Scale. Children's glucose control was measured using continuous glucose monitoring. Children's mean carbohydrate intake was 72%±24% of the recommended levels based on their age, sex, size, and activity level, and children exceeded national guidelines for percentage of calories from fat and saturated fat. A more healthful diet correlated with fewer child mealtime behavior problems, but better dietary adherence correlated with more parent mealtime behavior problems. Even in the context of intensive management, diet can be problematic for young children with type 1 diabetes. Parent-reported problems with mealtime behaviors seem to correlate with healthy eating and dietary adherence.     

Creating Potential for Common Ground and Communication Between Early Childhood Program Staff and Parents About Young Children’s Eating

ObjectivesTo explore child care staff and parent perspectives and communications about children’s eating in child care.DesignFocus groups (FGs) conducted with child care staff and parents.SettingFour Western states in the United States.ParticipantsThirty-nine child care staff in 7 FGs and 25 parents in 6 FGs.Phenomenon of InterestThoughts and concerns about children’s eating and opportunities to improve communication between staff and parents.AnalysisContent analysis (FG coding inter-rater reliability: staff = 0.74; parents = 0.81) and identification of meta-themes.ResultsThree meta-themes were identified: (1) recognition of positive influences of the child care setting in children’s development of healthy eating; (2) concerns about children’s eating in child care and at home; and (3) strategies to improve communications and transactions related to children’s eating.Conclusions and ImplicationsStaff reported that their roles included informing parents about food at mealtimes in child care (eg, menus, recipes) but also educating parents about child nutrition and feeding. Parents valued daily information about their child’s eating to adjust home mealtimes and to feel connected to their child. Barriers to effective communication included limited time and concerns regarding parent reactions and defensiveness. Staff requested training about child nutrition and feeding and about sensitive communications with parents.     

Patterns of maternal feeding and child eating associated with eating disorders in the Norwegian Mother and Child Cohort Study (MoBa)

The impact of eating disorders on maternal feeding practices and children's eating behaviors is not well understood. In the prospective Norwegian Mother and Child Cohort Study (MoBa), we compared self-reported feeding behavior in mothers with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and no eating disorders (No ED) as well as child eating behaviors and psychological symptoms. The sample comprised 13,006 women and their children from a prospective population-based study of 100,000 births throughout Norway. Eating disorder status was measured 6 months prior to pregnancy and during pregnancy. Maternal feeding, child eating, and psychological variables were reported by mothers when their child was 36 months old. Mothers with BN and BED were more likely to report restrictive feeding styles and child eating problems than mothers without eating disorders. Regarding the pressure to eat feeding style, no significant differences emerged across groups. Differences in self-reported feeding styles and children's eating behavior exist between mothers with and without eating disorders. Longitudinal follow-up will assist in determining the implications of feeding style on later growth trajectories and development.     

陕西省农村学龄前留守儿童饮食行为特征及影响因素

目的调查陕西省农村地区学龄前儿童不健康饮食行为特征,并分析影响因素,为培养学龄前留守儿童良好的进食习惯、提高营养状况和生存质量提供依据。方法利用"学龄前儿童饮食行为量表",选取陕西省3区县6所农村托幼机构512名学龄前儿童作为研究对象,并利用多因素logistics回归分析影响因素。结果学龄前留守儿童最常见的不健康饮食行为是主动进食能力、挑食、过饱响应以及外因性进食等。经多因素logistics回归分析可知,年龄(OR=0.69)、是否独生子女(OR=0.65)、家庭人均年收入(OR=0.64)、家庭人口数(OR=1.9)是影响儿童饮食行为的主要因素。结论农村学龄前留守儿童年龄越大、非独生子女、家庭人均年收入越高、家庭人口数越少儿童饮食行为表现越好。因此在学龄前留守儿童喂养的过程中,要将重点放在年龄较小的学龄前儿童和独生子女,家庭应该建立统一、科学的抚养观念,在提供良好抚养条件的同时,避免对儿童的溺爱,减少儿童挑食、过饱响应以及外因性进食,培养儿童自主进食能力。     

Do parental feeding practices moderate the relationships between impulsivity and eating in children?

This study examines the relationships between children's impulsivity, their eating behaviours, and their perceptions of their parent's feeding practices. 153 10-13 year old children completed questionnaires assessing their eating behaviours, their impulsiveness and their perception of their parent's feeding practices. Children's reports of dysfunctional eating behaviours were significantly correlated with their perceptions of their parents feeding practices and with their levels of impulsivity. Children's reports of parental monitoring of their food intake significantly moderated the influence of child impulsiveness upon emotional eating. Children's perceptions of parental monitoring of their food intake may potentially have a protective effect at preventing more impulsive children from eating in response to emotional feelings.     

Parent Readiness to Change Differs for Overweight Child Dietary and Physical Activity Behaviors

Parent involvement is important to help overweight children lose weight. However, parent readiness to make changes around child eating and physical activity (PA) behaviors can differ across domains. Using a cross-sectional design, our aim was to examine which factors were associated with parents being in the Action/Maintenance stage of change in each domain. From November 2008 to August 2009, parents of overweight/obese children (n=202) attending a tertiary care obesity clinic in Providence, RI, answered questions assessing their stage of change, beliefs about child health and weight, and provider behaviors. Separate multivariate logistic regression models were created to determine which factors were associated with parent readiness to make changes for child dietary and PA behaviors. Almost 62% of parents were in the Action stage of change for child dietary behaviors, but only 41% were in the Action stage of change for PA behaviors. Parents who believed their own weight was a health problem were less likely to be ready to make changes to their child's dietary behaviors. Physician discussion of strategies was related to readiness to make changes for child dietary behaviors, but not PA behaviors. In the PA domain, parents of younger children were more likely to be ready to make changes. Training health care providers to address PA readiness and be aware of factors influencing dietary and PA readiness may result in more effective conversations with parents and improve behavior change efforts for pediatric weight loss.