Parental predictors of fruit and vegetable consumption in treatment‐seeking overweight children

Background: Information on the role of family dietary behaviours is needed to enable the design of effective interventions for treatment of childhood obesity. The present study aimed to analyse differences in consumption and predictors of fruit, berries and vegetables (FBV) between normal‐weight and overweight treatment‐seeking children and their parents. Methods: Fifty‐four treatment‐seeking overweight and 65 normal‐weight 8‐year‐old children and their parents participated in the present study. Children’s and parent’s consumption of FBV were assessed by a food frequency questionnaire. Availability of vegetables at home meals, child’s preference for FBV and parent’s control over portion size were determined. Weight and height were measured and the standardised body mass index of each child was calculated. Multiple linear regression analysis was performed to investigate the predictors of children’s FBV consumption. Results: Normal‐weight children and parents ate FBV more frequently than overweight children. In the multiple linear regression analysis, mother’s (β = 0.476, P ≤ 0.001) and father’s consumption of FBV (β = 0.347, P = 0.001) and child’s preference for eating vegetables (β = 0.259, P = 0.002) were positively associated with the child’s consumption of FBV. In overweight children, parent’s consumption of FBV was the only predictor of the offspring’s consumption of FBV (P = 0.002). Conclusions: Predictors related to FBV consumption appear to be the similar in normal‐weight and treatment‐seeking overweight children. The findings obtained in the present study highlight the importance of parental modelling in determining the consumption of FBV in their children.     

Parent and child reports of fruit and vegetable intakes and related family environmental factors show low levels of agreement

OBJECTIVE: The purpose of the present study was to determine the level of agreement between child and parent reports of 9- to 10-year-old children's consumption of fruit and vegetables and potential family-environmental determinants. METHODS: Schoolchildren and their parents completed parallel questionnaires at baseline and at follow-up (1 year later) about usual fruit and vegetable consumption of the child, potential determinants and general demographics. Matched child-parent couples were included in the analyses (baseline = 380; follow-up = 307). To assess the level of agreement between child and parent reports at both points in time, dependent-sample t-test, correlation coefficients, weighted Cohen's kappa coefficients and Bland-Altman plots including limits of agreement were used. RESULTS: Both at baseline and at follow-up, the mean intake of fruit and vegetable reported by the children were significantly higher than reported by their parents, but differences were smaller at follow-up. Correlation coefficients between child and parent reports (0.28-0.43) and weighted Cohen's kappa coefficients (0.25-0.28) were weak to moderate. Limits of agreement were wide. CONCLUSION: The agreement between parent and child reports is weak to moderate and may depend on the age of the child. Fourth graders may overestimate their own intake of fruit and vegetables.     

Children's nutritional intake as part of the Eat Well Do Well scheme in Kingston‐upon‐Hull – a pilot study

In April 2004 Hull City Council introduced free healthy school meals for all primary and special schools in an attempt to reduce health inequalities. This pilot study aimed to compare nutritional intake between those children consuming a free healthy school meal and those consuming a packed lunch brought from home. The study compared two schools from different socio‐economic areas and considered the impact of lunch on total daily food and nutrient intakes in these children. Fieldwork was undertaken over five consecutive days in each school. Seven hundred and thirty‐five lunches were weighed and photographed before and after consumption to assess actual food intake vs. wastage. One hundred and forty‐seven children aged 8‐to‐11‐years participated from two primary schools. Five‐day food diaries were completed by a small number of participants (n = 20) receiving school meals (n = 10) and packed lunches (n = 10) from the two schools selected. While the lunches provided at the two schools met the majority of the nutritional guidelines for school meals, children ate only a small amount, often leaving the potatoes and vegetables behind; therefore, their intakes were below recommended levels. Children from both schools who opted for packed lunch consumed significantly more energy, fat, sugar and sodium but with this more micronutrients than children who had a free healthy school meal. Statistical differences (P < 0.01) were found between the two schools, with children from the less affluent school consuming less food from the school meal and therefore obtaining a lower nutrient intake from lunch than children from the more affluent school. Findings from a small number of food diaries suggest that the differences in intakes between those having a school meal and those having a packed lunch were compensated for by other food consumed during the day, such that daily nutrient intakes were not significantly different. This study suggests that many children may not be consuming sufficient amounts of the food provided in schools. Therefore, it cannot be assumed that the provision of school meals that conform to the School Food Trust guidelines will be of nutritional benefit to all children concerned. Bearing this in mind, more needs to be done to provide menus that are both healthy and enjoyable for children, so that they will want to consume the foods provided. Parents also need more advice regarding how they can provide their children with a healthy packed lunch, possibly via the introduction of a government‐led packed lunch policy, particularly in schools from areas of lower socio‐economic status. Although there was only a small sample of food diaries in this study, the findings suggest that socio‐economic demographics may exert more of an influence on the total daily nutrient intake of children than the type of lunch consumed.     

Do You See What I See? Parent and Child Reports of Parental Monitoring of Media

Research on parental monitoring of children's media use suggests parents can reduce the negative effects of media exposure on children, although this research is rarely conducted with elementary school children and leaves open questions about whether parents or children are better reporters. Participants were 1,323 children, their parents, and teachers. Parents and children reported on four aspects of monitoring for TV and video games: co‐using, limit setting on amount, limit setting on content, and active mediation. Parents gave much higher estimates than did children. Monitoring was moderated by child age, child sex, parent marital status, parent education, and parent income. Although parent‐ and child‐reported monitoring correlated rather poorly, both types were almost equally good predictors of children's screen time, media violence exposure, and teacher reports of school performance. When there were differences, the child reports tended to be slightly better predictors, demonstrating the validity of child reports of parental monitoring.     

The health of children in sole‐parent families in New Zealand: results of a population‐based cross‐sectional survey

Objective: To investigate whether children in sole‐parent families in New Zealand bear excess risks of poor mental and physical health relative to children in two parent families. Data sources and statistical methods: The data source was the 2006/07 New Zealand Health Survey, a nationally representative household survey that sampled 502 children (5‐14 years) of sole mothers and 1,281 children of partnered mothers. Results: Children of sole mothers were 1.26 (0.94 – 2.69) times as likely as children of partnered mothers to return a low PhS score. Adjusting for maternal health and family socio‐economic disadvantage eliminated this weak association (which in any case was of borderline statistical significance). Children of sole mothers were more than twice as likely as children of partnered mothers to return a low PsS score, adjusting for demographic variables only. Conclusions: There is only a weak negative association (if any) between sole‐parenting and child physical health, but a stronger association with child mental health – consistent with most of the New Zealand and international literature. The association with child mental health is largely (but possibly not completely) ‘explained’ by the poorer mental health of sole‐parents and the poorer socio‐economic circumstances of single‐parent families (on average). Implications: These findings support policies aiming to improve access of sole‐parents and their children to community mental health services, and (more especially) policies aiming to ameliorate the disadvantaged economic circumstances of single parent families.     

Do Parents Perceive That Organized Activities Interfere with Family Meals? Associations between Parent Perceptions and Aspects of the Household Eating Environment

BackgroundResearch has related child participation in organized activities to health and academic benefits; however, participation may interfere with family meals.ObjectiveExamine whether parents perceive child participation in organized activities to interfere with family meals and how perceptions are related to the household eating environment.DesignA cross-sectional analysis was completed using survey data collected in 2015-2016 as part of the Project EAT (Eating and Activity in Teens and Young Adults) cohort study.ParticipantsSurvey participants were originally recruited in Minneapolis–St Paul schools in 1998-1999. The analytic subsample of parents (one per household, n=389, 69% female, 31% nonwhite race, mean age=31) had one or more children involved in an organized activity. Approximately 33% of households included a child aged 2 to 5 and no older child; two thirds of households included school-aged children (6 to 18 years).Main outcome measuresParents reported family meal frequency, family meal scheduling difficulties, frequency of at-home meal preparation, and their own intake of fast food, fruit, and vegetables.Statistical analyses performedAnalyses compared household environment characteristics reported by parents who perceived low interference between organized activities and family meals to characteristics reported by parents who perceived moderate to high interference from at least one form of activity. Regression models included a dichotomous indicator of interference as the independent variable and were adjusted for parental and household characteristics.ResultsAmong parents with children at any age, moderate to high interference was associated with lower family meal frequency, greater difficulty scheduling family meals, and more fast-food intake (all P≤0.01). The perception of moderate to high interference was more common among parents who reported involvement in both sport and nonsport activities (P<0.001) and those with a school-aged child (P<0.001) vs those with only preschool-aged children.ConclusionsFollow-up research, including qualitative studies, is needed to identify the specific aspects of child participation in organized activities (eg, scheduled time of day) that may interfere with family meals.     

“We're the Heroes!”: Fathers' Perspectives on Their Role In Protecting Their Preteenage Children from Sexual Risk

CONTEXT: Parents can be an important influence on their children's sexual behavior. However, relatively little research has focused on fathers’ roles in protecting children from sexual risk or on their discussions with children about sex. METHODS: Sixteen focus groups comprising 131 parents of children aged 10–12 were conducted in three U.S. cities in 2007. Separate groups were held for mothers and fathers, and for white, black, English‐speaking Hispanic and Spanish‐speaking Hispanic participants. Content analysis was used to identify core themes and patterns related to fathers’ communications with their children about sex. RESULTS: Fathers were highly invested in ensuring that their children are safe and successful in life. Although some had not talked to their children about sex, others had discussed it frequently and openly, and nearly all agreed that fathers’ perspectives are important for children to hear. Fathers reported being better suited to discussing some topics (e.g., male puberty, how young men think) than others (menstruation). Fathers also described other strategies that they use to guide their children's development, such as emphasizing future goals and monitoring children's activities and friends. Many fathers, especially Hispanic participants, reported being more protective of daughters than of sons, and some had particular difficulty talking with their daughters about sex. CONCLUSIONS: Research and interventions concerning parent‐child communication about sex should not neglect the role of fathers. However, some fathers may need support to overcome barriers to effective communication, especially with their daughters.     

What parents find important in the support of a child with profound intellectual and multiple disabilities

Background The importance of a partnership between parents and professionals in the support of children with disabilities is widely acknowledged and is one of the key elements of ‘family‐centred care’. To what extent family‐centred principles are also applied to the support of persons with profound intellectual and multiple disabilities (PIMD) is not yet known. Aim The purpose of this exploratory study was to examine what parents with a child with PIMD find important in the support of their child. In addition, we examined which child or parent characteristics influence these parental opinions. Method In total, 100 parents completed an adapted version of the Measure of Processes of Care. Mean unweighted and weighted scale scores were computed. Non‐parametric tests were used to examine differences in ratings due to child (gender, age, type and number of additional disabilities, type of services used and duration of service use) and parent characteristics (gender, involvement with support and educational level). Results Parents rated situations related to ‘Respectful and Supportive Care’ and ‘Enabling and Partnership’ with averages of 7.07 and 6.87 respectively on a scale from 1 to 10. They were generally satisfied with the services provided, expressed in a mean score of 6.88 overall. The age of the child significantly affected the scores for ‘Providing Specific Information about the Child’. Parents of children in the ‘6–12 years’ age group gave significantly higher scores on this scale than did parents of children in the ‘≥17 years’ age group (U = 288, r = ?0.34). Conclusion This study shows that parents with children with PIMD find family‐centred principles in the professional support of their children important. Although the majority of parents are satisfied with the support provided for their children, a substantial minority of the parents indicated that they did not receive the support they find important.     

Parent versus child report of young children’s parasocial relationships in the United States

This study examines parent perceptions of their young children’s one-sided, emotionally tinged relationships with media characters, also known as parasocial relationships (PSR). Prior research has collected data on young children’s PSR by surveying parents, while other studies have relied directly on child interview. The current study is the first to compare children’s answers to those of their parents. Factor analyses revealed that parents and children both reported three components of children’s PSR: social realism, attachment and character personification (parents) or attachment and friendship (for their children), and humanlike needs. Both parent and child reports accounted for approximately 60% of the variance in children’s PSR. Nonetheless, only approximately one-third of parents and children reported on the same favorite character. The implications for research on children’s PSR using both parent and child reports are discussed.     

Expanding the understanding of how parenting influences the dietary intake and weight status of children: A cross‐sectional study

Aim: The present study explored whether existing tools measuring parenting could be combined to assess an expanded parenting definition, specifically to include co‐participation in food‐related activities and teaching children about nutrition. The relationships between parenting, child dietary intake and weight outcomes were explored. Methods: The sample included 93 children aged 4–13 years and their parent/caregiver. Child outcomes were dietary intake and body mass index z‐score. Parent measures included demographics, nutrition knowledge and parenting practices. Exploratory factor analysis was used to identify underlying dimensions of parenting. Hierarchical linear regression was used to investigate the independent effects of parenting on child outcomes (body mass index z‐score, fruit and vegetable, fibre, saturated and total fat) after adjustment for covariates. Results: Five factors were extracted, accounting for 44% of the total variance (α= 0.77–0.87). The regression model for kilojoules explained 31% of the variance (P= 0.001), with a significant independent contribution from construct ‘guide and reward’ (β=?0.249, P= 0.027). For child body mass index z‐score, the model explained 25% of variance, and parenting constructs ‘guide and reward’ (β= 0.274, P= 0.015) and ‘concern about intake’ (β=?0.273, P= 0.008) made significant contributions. Conclusions: The present study adds to our understanding of parenting influences on children's dietary intake and weight status. Results support the inclusion of parenting strategies in obesity prevention interventions. Future research should explore the range of ways parenting influences children's diet and risk of obesity, preferably longitudinally.     

5-Year Follow-Up of a Telephone Intervention to Increase Fruit and Vegetable Consumption in Preschoolers: The ‘Healthy Habits’ Cluster Randomised Trial

Little is known about the long-term impact of telephone-based interventions to improve child diet. This trial aimed to assess the long-term effectiveness (after 5 years) of a telephone-based parent intervention in increasing children’s fruit and vegetable consumption. Parents of 3–5 year olds were recruited from 30 Australian preschools to participate in a cluster randomised controlled trial. Intervention parents received four, weekly, 30-min support calls aimed at modifying the home food environment. Control parents received printed materials. Consumption was assessed using the Fruit and Vegetable subscale of the Children’s Dietary Questionnaire (F&V-CDQ) (children) and daily servings of fruit and vegetables (children and parents) via parent telephone interview. Of the 394 parents who completed baseline, 57% (99 intervention, 127 control) completed follow-up. After 5-years, higher intervention F&V-CDQ scores, bordering on significance, were found in complete-case (+1.1, p = 0.06) and sensitivity analyses (+1.1, p = 0.06). There was no difference in parent or child consumption of daily fruit servings. Complete-case analysis indicated significantly higher consumption of child vegetable servings (+0.5 servings; p = 0.02), which was not significant in sensitivity analysis (+0.5 servings; p = 0.10). This telephone-based parent intervention targeting the family food environment may yield promising improvements in child fruit and vegetable consumption over a 5-year period.     

Family Home Food Environment and Nutrition-Related Parent and Child Personal and Behavioral Outcomes of the Healthy Home Offerings via the Mealtime Environment (HOME) Plus Program: A Randomized Controlled Trial

Background

Research has demonstrated a significant positive association between frequent family meals and children’s dietary intake; however, the promotion of healthful family meals has not been rigorously tested for key food environment and nutrition-related behavioral outcomes in a randomized trial.

The Association Between Overparenting,Parent‐Child Communication,and Entitlement and Adaptive Traits in Adult Children

What is colloquially referred to as “helicopter parenting” is a form of overparenting in which parents apply overly involved and developmentally inappropriate tactics to their children who are otherwise able to assume adult responsibilities and autonomy. Overparenting is hypothesized to be associated with dysfunctional family processes and negative child outcomes. Predictions were tested on 538 parent‐young adult child dyads from locations throughout most of the United States. Parents completed a newly developed measure of overparenting as well as family enmenshment, parenting styles, and parent‐child communication scales. Young adult children completed measures of parent‐child communication, family satisfaction, entitlement, and several adaptive traits. Results showed that overparenting is associated with lower quality parent‐child communication and has an indirect effect on lower family satisfaction. Overparenting was also a significant predictor of young adult child entitlement, although it was not related to any of the adaptive traits measured in young adult children.     

Is frequency of family meals associated with fruit and vegetable intake among preschoolers? A logistic regression analysis

Background

The present study aimed to examine the associations between frequency of family meals and low fruit and vegetable intake in preschool children. Promoting healthy nutrition early in life is recommended for combating childhood obesity. Frequency of family meals is associated with fruit and vegetable intake in school‐age children and adolescents; the relationship in young children is less clear.

Methods

We completed a secondary analysis using data from the Early Childhood Longitudinal Study‐Birth Cohort. Participants included children, born in the year 2001, to mothers who were >15 years old (n = 8 950). Data were extracted from structured parent interviews during the year prior to kindergarten. We used hierarchical logistic regression to describe the relationships between frequency of family meals and low fruit and vegetable intake.

Results

Frequency of family meals was associated with low fruit and vegetable intake. The odds of low fruit and vegetable intake were greater for preschoolers who shared less than three evening family meals per week (odds ratio = 1.5, β = 0.376, P < 0.001) than preschoolers who shared the evening meal with family every night.

Conclusions

Fruit and vegetable intake is related to frequency of family meals in preschool‐age children. Educating parents about the potential benefits of frequent shared meals may lead to a higher fruit and vegetable consumption among preschoolers. Future studies should address other factors that likely contribute to eating patterns during the preschool years.

     

Comparison of Parent and Child Ratings of Fruit and Vegetable Liking to Assess Parent Accuracy as Proxy Reporters

This study examined the accuracy of parent-report child fruit/vegetable (FV) liking. Child/parent dyads (n = 24) were recruited from six Head Start preschools in North Carolina. Liking for 10 FVs was assessed using a validated pictorial tool for children; a similar scale was used for parents. Negative relationships were observed between parent/child for one fruit (grapes) and one vegetable (broccoli). Positive relationships were observed among oranges, grapes, and overall fruit rankings. Parents tended to rank children’s liking of fruits higher than their children, while children ranked liking vegetables higher. Findings suggest parents may not be accurate respondents for preschool children’s FV liking.     

The relationship between proxy reported health-related quality of life and parental distress: gender differences

Objective Although primary caregiver proxy reports of health‐related quality of life (HRQOL) are often used for healthcare decision making when child self‐reports are unable to be collected (because of a variety of reasons such as child illness, disability or age), we have little understanding of the correlates of parent‐proxy reports. The aim of this study was to examine the relationship between parental depression and parent‐proxy reported QOL for primary caregivers (mothers and fathers), using a multidimensional HRQOL instrument. It was hypothesized that maternal depression would be negatively correlated with maternal reported HRQOL, but that paternal depression would not be correlated with paternal reported HRQOL. Methods Data were from parents of children aged 4–5 years (n = 4983) involved in the Longitudinal Study of Australian Children. A questionnaire assessing parental depression (Kessler‐6) and proxy reported HRQOL (Pediatric Quality of Life Inventory) was completed by the primary caregiver. Results For maternal primary caregivers, maternal depression was negatively correlated with all domains of maternal proxy reports of HRQOL (r = ?0.24 to r = ?0.36). For paternal primary caregivers, there was no relationship between paternal depression and paternal proxy reports of HRQOL. Multiple regression analyses demonstrated that maternal depression was a significant predictor of total HRQOL, accounting for 12% of the variance. For paternal mental health, depression did not predict parent‐proxy reported total HRQOL. Conclusion These results highlight the importance of assessing maternal mental health when measuring proxy reported QOL. Further research is needed in this area to examine the relationship between parental depression and proxy reported HRQOL (including both mothers and fathers, where possible), as well as child self‐reported HRQOL.     

Observed Gender Differences in African American Mother‐Child Relationships and Child Behavior

African American mother‐child dyads (N = 99) were observed interacting on a collaborative puzzle exercise. Raters blind to the purpose of the study rated the dyads on several mother and child behaviors. Mothers of daughters were rated as more empathetic, encouraging, warm, and accepting and less negative than mothers of sons. Male children were more challenging and less happy, relaxed, and engaged. Mediation analyses found that the differences in mother‐child relationships explained the gender differences in child behavior. These patterns were consistent across different child age groups and after controlling for family socioeconomic status. It was concluded that many of the gender disparities may be reduced with empirically informed and culturally sensitive parent training interventions that teach parents the necessity of being warm and loving as well as encouraging both male and female children to excel.     

Self-reporting versus parental reporting of acute respiratory symptoms of children and their relation to pulmonary function and air pollution.

BACKGROUND: Studies of acute effects of outdoor air pollution on acute respiratory symptoms in children generally rely on reports by parents. Little is known about the validity of parental reporting of symptoms of their children. We therefore compared symptoms reported by the parents with self-reported symptoms and measured pulmonary function of 741 7-11-year-old Dutch children. We also analysed the association of symptoms reported by the child or parent and outdoor air pollution. METHODS: The parents of the children completed a daily diary of symptoms of their children for about 3 months. The children reported presence of acute respiratory symptoms in the preceding week before a pulmonary function test was conducted (6-10 test days). RESULTS: Children reported between 80% and 220% more acute respiratory symptoms than their parents for them in the same period. The agreement between symptom reports by the parent and the child was low to moderate (Kappa between 0.22 for eye irritation and 0.43 for fever). Presence of cough reported by child or parent was associated with similar small decrements in forced vital capacity (FVC), forced expiratory volume in one second (FEV1.0) and especially peak expiratory flow (PEF) and maximal mid-expiratory flow (FEF25-75). The largest pulmonary function decrements were found when symptoms were reported by both parent and child. Symptoms reported by either child or parent were not associated with air pollution. CONCLUSIONS: Symptom reports of the children were more prevalent but did not agree well with parental reports. The similar association with pulmonary function suggested that self-reported symptoms were neither superior nor inferior to symptoms reported by the parents.     

Parents' perception of their child's weight status and intention to intervene: a Western Australian cross‐sectional population survey, 2009–12

Objective: To report on parents' perceptions of their child's weight status and how the child's body mass index (BMI) is associated with parent intentions to change or maintain the child's weight. Methods: Estimates were derived via data collected from 4,437 parents from 2009 to 2012 as part of the Western Australian Health and Wellbeing Surveillance System. To measure weight perceptions, parents were asked, “Is your child underweight, normal weight, overweight or very overweight?” BMI values were also derived via parent‐reported height and weight. Parent intentions were assessed by asking parents, “What are your intentions regarding your child's weight?” Results: Significantly fewer parents perceived their child as overweight (8.2%) or very overweight (0.2%) than was derived via parent‐reported height and weight (16.3% and 5.8%, respectively). More than half the parents with children above or below the healthy BMI range reported an intention to “do nothing” about their child's weight (between 54.5% and 70.0%). Conclusions: A large proportion of Western Australian parents misjudge their child's weight status and the majority express no intention to help their child achieve a healthy weight. Implications: The results reinforce the importance of population‐level, parent‐focussed interventions targeting perceptions of children's weight and appropriate action.     

The family meal panacea: exploring how different aspects of family meal occurrence,meal habits and meal enjoyment relate to young children’s diets

The general consensus in the research to date is that family meals are linked to healthier eating habits in children, compared to not eating with the family. Yet, few studies explore what it is about commensality which leads to better food choices among children. Using a representative Scottish sample of five‐year‐old children, this research explores the extent to which family meal occurrence, meal patterns regarding where, when and with whom children eat and perceived meal enjoyment predict the quality of children’s diets after controlling for indicators of maternal capital that influence both meal rituals and taste preferences. Eating the same food as parents is the aspect of family meals most strongly linked to better diets in children, highlighting the detrimental effect in the rise of ‘children’s food’. Although theoretical and empirical work pointed to the important health advantage in children eating together with parents, the results suggested that eating together was a far less important aspect of family meals. In evaluating the importance of the family meal, this article redirects attention away from issues of form and function towards issues of food choice. Policy implications and the importance for public health to recognise the way eating habits are defined by and reproduce social and cultural capital are discussed.