"You will eat all of that!": a retrospective analysis of forced consumption episodes

Retrospective reports of coercive control food parenting practices during childhood are related to eating behaviors in adulthood: A latent profile analysis

Food parenting practices are parents' actions that influence their child's eating habits and food intake. Coercive control food parenting practices are behaviors that seek to satisfy parental desires concerning their child's eating. These practices (including emotional regulation, pressure to eat, food as a reward, restriction for health, and restriction for weight) can have detrimental effects on children's eating behaviors and diet quality. Using a person-centered approach, the present study examined whether experiencing controlling food-related parenting practices as a child relates to eating behaviors, food liking, and food intake in adulthood. Participants were 441 French-Canadian adults (50.2 % female; mean age = 42.7 years). A latent profile analysis (LPA) empirically identified three subgroups of individuals based on patterns of controlling food-related practices used by their parents during childhood. The "high control" subgroup (n = 47) reported more emotional eating, cognitive restraint, and disinhibition than the "moderate control with restriction for health" subgroup (n = 200), which reported higher levels of these behaviors than the "low control" subgroup (n = 194). The "high control" subgroup also reported less intuitive eating and a higher intake frequency of both savory and sweet foods than participants of the two other profiles, which did not differ from each other on these outcomes. Interestingly, liking for savory and sweet foods did not significantly differ among the three groups. Overall, results indicate that exposure to less controlling food parenting practices during childhood is associated with more positive eating behaviors and healthier food intake in adulthood.

Family matters: Exploring the intergenerational transmission of the unhealthy = tasty intuition

Children often consume not enough vegetables, and the overall quality of their diet is concerning. This research investigates the intergenerational transmission of the Unhealthy = Tasty Intuition (UTI) from parents to children and its role in shaping children's vegetable consumption. In two studies involving both children and their parents, we test whether parental UTI beliefs predict their children's UTI beliefs. Our findings demonstrate a positive relationship between parental and child UTI beliefs, which, in turn, are negatively associated with children's vegetable consumption. In the second study, we explore which parental feeding practices can help explain the socialization of the UTI. Our research contributes to the understanding of how children's food beliefs and consumption are socialized. Recognizing the impact of the UTI on children's dietary consumption provides valuable insights for developing interventions and policies aimed at promoting healthier eating habits among children. By addressing the intergenerational transmission of the UTI, we can take significant steps toward mitigating childhood obesity and its associated health risks.

'You just eyeball it': Parent and nursery staff perceptions and influences on child portion size: A reflexive thematic analysis

Background: Childhood obesity is one of the most serious public health epidemics of the 21st century. Observational studies report that increases in portion size (PS) have occurred in parallel with levels of obesity. Increased PSs of high-energy-dense foods can promote overeating, and without compensatory behaviours, can contribute to childhood obesity. Caregivers make decisions about PSs for children in the home and nursery environment, thus are gatekeepers to child food intake. Understanding caregiver PS decisions can aid in the best practice of PS provision to young children. The aim of this study was to explore parent and nursery staff influences on child PS selection and their suggestions for useful tools/strategies in PS decisions. Methods: A qualitative design was employed using focus group discussions (FGDs) with parents and nursery staff of children aged 3-5 years. FGDs were employed given their ability to generate rich data, as well as permit the exploration of collective perceptions, attitudes, behaviours and experiences. Data were analysed using an inductive, semantic approach to reflexive thematic analysis. Results: Four FGDs were conducted: two with parents (n = 13), two with nursery staff (n = 17). Four overarching themes were derived: (i) awareness of PS guidelines; (ii) control over PS; (iii) social influences on children's eating behaviours; (iv) child-specific, social and external factors influencing parent and nursery staff PS decisions. Additionally, participants discussed tools/strategies they believe would be useful in PS decisions. Conclusion: Data from the themes suggest that caregiver control, social, child-specific and external factors are more influential than PS guidelines in both parent and nursery staff PS decisions for young children aged 3-5 years. These findings can inform future childhood obesity prevention initiatives focussed on improving parent and nursery staff provision/use of age-appropriate PSs.

Development of food literacy in children and adolescents: implications for the design of strategies to promote healthier and more sustainable diets

Food literacy has emerged as a key individual trait to promote the transformation of food systems toward healthy and sustainable diets. Childhood and adolescence are key periods for establishing the foundations of eating habits. Different food literacy competencies are acquired as children develop different cognitive abilities, skills, and experiences, contributing to the development of critical tools that allow them to navigate a complex food system. Thus, the design and implementation of programs to support the development of food literacy from early childhood can contribute to healthier and more sustainable eating habits. In this context, the aim of the present narrative review is to provide an in-depth description of how different food literacy competencies are developed in childhood and adolescence, integrating the extensive body of evidence on cognitive, social, and food-related development. Implications for the development of multisectoral strategies to target the multidimensional nature of food literacy and promote the development of the 3 types of competencies (relational, functional, and critical) are discussed.

Retrospective Reports of Parental Feeding Practices and Current Eating Styles in Polish Adults

The role of childhood food experiences (CFEs) in determining future eating behaviors remains unclear. The aim of the study was to examine the link between CFEs and selected eating styles (ESs), i.e., intuitive (IE), restrained (ResEat) and external (ExtEat) eating, among 708 Polish adults aged 18-65 (477 women and 231 men). CFEs were measured with the Adults' Memories of Feeding in Childhood questionnaire. Polish versions of the Intuitive Eating Scale-2 and Dutch Eating Behavior Questionnaire were used to assess ESs. Mann-Whitney U test was used to compare ESs scores between those with lower and higher CFEs. In the total sample, "Restrictions" and "Pressure and Food Reward" parental feeding practices favored lower IE, while "Healthy Eating Guidance" and "Monitoring" practices predisposed higher levels of IE in adulthood. "Restrictions" were found to correlate with greater chances of ResEat, whereas "Healthy Eating Guidance" was linked with lower probability of ResEat. "Pressure and Food Reward" and "Monitoring" were associated with higher score for ExtEat. "Restrictions", "Child Control", "Monitoring" and "Healthy Eating Guidance" practices were differently linked to ESs in women and men. The findings suggest that education programs for parents should focus on the long-term consequences of feeding practices.

Childhood Food Experiences and Selected Eating Styles as Determinants of Diet Quality in Adulthood-A Cross-Sectional Study

Available studies suggest that childhood food experiences (CFE) may be linked with eating behaviors in adulthood, as well as eating style (ES); thus, both CFE and ES can determine dietary intake. Little is known about the role of both of these factors in explaining the diet quality (DQ) of adults. The aim was to investigate to what extent selected ESs, i.e., intuitive (IE), restrained (ResEat), and external (ExtEat) eating, and CFE related to parental feeding practices (PFPs) will predict the DQ of women and men. Data from 708 Polish adults (477 women and 231 men) aged 18-65 were collected via the Internet from October 2022 to January 2023. Mann-Whitney's U Test was used to compare ES and CFE levels among women and men, while DQ determinants were tested with the multiple linear regression (MLR). In the total study sample, "Healthy Eating Guidance" (CFE), "Child Control" (CFE), "Body-Food Choice Congruence" (IE), and ResEat favored higher DQ scores, while "Unconditional Permission to Eat" (IE), "Eating for Physical Rather Than Emotional Reasons" (IE), and ExtEat predisposed to lower DQ scores. After the MLR was conducted separately in women and men, differences were noted in the role of "Healthy Eating Guidance" (CFE), "Pressure and Food Reward" (CFE), "Unconditional Permission to Eat" (IE), "Eating for Physical Rather Than Emotional Reasons" (IE), ExtEat, and ResEat in predicting DQ indices. Our findings suggest that childhood food experiences and selected eating styles may differently determine the DQ of women and men. Future studies conducted within representative samples are needed to confirm these results.

Food-related aversion in a female sample of people with anorexia nervosa: Cognitive-behavioural correlates, somatic and subjective anxiety, and early experiences

OBJECTIVE

Food-related anxiety and avoidance are key features of anorexia nervosa, and among the most arduous maintaining processes to address in treatment. This study gathered information on the behavioural and cognitive correlates of food-related anxiety, including their associations with early experiences of aversive learning related to food, and more general anxiety.

METHODS

One-hundred and forty-four patients with anorexia nervosa were recruited from clinical services in Italy. They completed online questionnaires to assess food-related anxiety, eating disorder psychopathology, eating disorder safety behaviours and threat cognitions, early experience of aversive learning related to food, and somatic anxiety.

RESULTS

Experiences of food-related aversive learning were recalled by the majority of the sample (87.86%), with negative psychological consequences following eating being the most often reported (75%). Safety behaviours and threat cognitions related to the consequences of eating were also reported (14.29%-87.86%, and 36.43-90% respectively, depending on the behaviour/cognition). Eating disorder psychopathology was predicted by both somatic anxiety and negative psychological consequences following eating, whereas self-reported food anxiety was only predicted by somatic anxiety.

CONCLUSION

Findings validate an anxiety-based model of anorexia nervosa which establishes the role of safety behaviours, threat cognitions, early aversive learning experiences, and anxiety in the psychopathology of the illness. Exposure-based interventions have the potential to target these factors, and inhibit food-related fear.

Changes in Eating Behaviors Following Taste Education Intervention: Focusing on Children with and without Neurodevelopmental Disorders and Their Families: A Randomized Controlled Trial

Fussy-eating children often display problematic behaviors around mealtimes, such as irritation, opposition, or may even throw tantrums. This may lead to reduced food variety and poor nutritional profiles, which may increase parents' worries about their children's diet, particularly when the children also have neurodevelopmental disorders (ND) such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactive Disorder (ADHD). To investigate the effect of Taste Education on problematic mealtime behaviors, 81 children aged 8-12 years, with ND (n = 33) and without (n = 48), and their parents, participated in a 7-week Taste Education intervention. Children were matched on age, sex, and ND, and allocated at random into Immediate-intervention and Delayed-intervention groups. Parents completed the Meals in Our Household Questionnaire (MiOH). To examine changes in MiOH-scores, repeated-measures analysis-of-variance with time-points were used, with condition as factors (Immediate intervention and Delayed intervention). Baseline measures were adjusted for, and a robust linear mixed-model was fitted. Results showed superior outcomes for Intervention compared to waiting on all measures of MiOH, with stable effects through six-month follow-up. Differences were non-significant between children with and without ND. The Taste Education program suggests a promising, simple, and non-intrusive way to reduce children's problematic mealtime behaviors in the long term.

Infant appetite and weight gain in early infancy: Moderating effects of controlling feeding styles

Excessive infant weight gain is a strong predictor of later obesity. While controlling feeding has been linked to negative weight outcomes, research has not considered associations between infant appetite and maternal feeding simultaneously in relation to infant weight. This longitudinal study examined infant food responsiveness and slowness in eating as predictors of infant weight outcomes and tested controlling feeding styles (restrictive and pressuring) as moderators. Data came from a diverse sample of mothers and their infants participating in an ongoing longitudinal study. Mothers (n = 159) reported infant appetite and feeding styles at 2 postnatal timepoints (2-month visits and 6-month visits). The infant weight outcomes included change in weight-for-age z-scores (WAZ-change) and rapid weight gain (RIWG; WAZ-change ≥ 0.67 SD) from birth to the second postnatal visit. Data were analyzed using hierarchical multiple and logistic regressions, controlling for birthweight, gestational age, maternal race/ethnicity, feeding mode, and residing with an intimate partner. Over 25% of infants exhibited RIWG. Greater infant food responsiveness predicted both greater infant weight gain and RIWG status. Infant food responsiveness and slowness in eating interacted with controlling feeding styles in a unique way. Infants with higher food responsiveness whose mothers were less restrictive had greater weight gain (b = 0.61, p < 0.001) and increased probability of RIWG (b = 2.71, p < 0.01) than infants with more restrictive mothers. Higher slowness in eating was associated with a lower RIWG probability among infants of mothers with lower pressuring feeding (b = -1.86, p < 0.05). For infants with a large appetite, some level of restrictive feeding may be beneficial for preventing excessive weight gain while pressuring may exacerbate the positive association between faster eating and RIWG.

Diet Quality and Changes in Food Intake during the University Studies in Polish Female Young Adults: Linkages with Food Experiences from Childhood and Perceived Nutrition Concerns

The transition from adolescence to young adulthood may be associated with unfavorable changes in food intake due to some substantial transformations in social life and environment. Factors that affect food choices and diet quality during early adulthood are still not well-recognized. This paper aims to explore the relationship between females’ childhood food experiences related to parents’ monitoring practices and healthy eating guidance, perceived nutrition concerns, changes in food intake during university studies, and diet quality. A cross-sectional study with the use of CAWI (Computer-Assisted Web Interview) was carried out on 657 female students aged 19–30 years. Beliefs and Eating Habits Questionnaire (KomPAN) was used to assess the frequency of eating various kinds of food and then to calculate the diet-quality index (DQI). Adults’ Memories of Feeding in Childhood (AMoFiC) questionnaire was used to assess food experiences from childhood, and Health Concern Scale (HCS) was used to assess nutrition concerns. Associations between changes in food intake, diet quality, and selected factors describing the study sample were verified using logistic regression analysis. The DQI of the majority of students indicated a low intensity of nonhealthy and pro-healthy dietary characteristics. The intensity was higher among nutrition and health students, those with low nutrition concerns, and those with childhood experiences of monitoring. The chances of a negative change in food intake were increased by a higher score for childhood food experiences associated with parents’ monitoring practices. The chances of a negative DQI were increased by bigger concerns about nutrition and by technical and agricultural majors; however, they were reduced by positive changes in food intake. Both childhood food experiences and perceived nutrition concerns should be factored into strategies aimed at improving youth diet and educating parents about effective parental feeding practices.

Relationships between retrospective parental feeding practices and Chinese university students' current appetitive traits, weight status, and satisfaction with food-related life

Accumulating evidence suggests that parental feeding practices during childhood are related to adults' eating behaviors and weight status, but research exploring these relationships is largely conducted in Western contexts. However, China, a country that holds the largest world population, has distinct patterns of eating habits and food culture from Western countries. Therefore, the present study aimed to examine relationships between retrospective parental feeding practices (e.g., concern, monitoring, pressure to eat, and restriction) and current body mass index (BMI) and satisfaction with food-related life in a sample of 476 Chinese university students (195 men; Mage = 19.78 years, SD = 1.23). We also examined whether appetitive traits mediated these associations. Retrospective parental feeding practices were significantly related with participants' current BMI (concern: r = 0.26, p < .001; pressure to eat: r = -0.15, p < .001) and satisfaction with food-related life (concern: r = 0.15, p < .001; monitoring: r = 0.12, p = .009; pressure to eat: r = 0.13, p = .006; restriction: r = 0.16, p < .001). Relationships were partially mediated by young adults' current appetitive traits (e.g., enjoyment of food, emotional overeating, satiety responsiveness, slowness in eating). These findings suggest that retrospective parental feeding practices are important correlates of young adults' current weight status and satisfaction with food-related life, and that appetitive traits partially explain these relationships in the Chinese context.

De-Implementation of Detrimental Feeding Practices in Childcare: Mixed Methods Evaluation of Community Partner Selected Strategies

This pilot evaluated strategies to decrease detrimental feeding practices in early care and education, which are hypothesized to compete with evidence-based feeding and obesity prevention practices. This study made two key comparisons: (1) a between-site comparison of sites receiving (a) no implementation or de-implementation strategies (i.e., Basic Support; B), (b) implementation strategies only (i.e., Enhanced Support; E), and (c) implementation and de-implementation strategies (i.e., De-implementation + Enhanced Support; D + E) and (2) a within-site pre-post comparison among sites with D + E. At nutrition lessons, the D + E group had more Positive Comments (Hedege’s g = 0.60) and higher Role Model fidelity (Hedege’s g = 1.34) compared to the E group. At meals, assistant teachers in the D + E group had higher Positive Comments than in the B group (g = 0.72). For within-group comparisons, the D + E group decreased Negative Comments (t(19) = 2.842, p = 0.01), increased Positive Comments (t(20) = 2.314, p = 0.031), and improved use of the program mascot at nutrition lessons (t(21) = 3.899, p = 0.001). At meals, lead teachers’ Negative Comments decreased (t(22) = 2.73, p = 0.01). Qualitative data identified strengths and opportunities for iteration. Despite a COVID interruption, mid-point comparisons and qualitative feedback suggest promise of the de-implementation strategy package.

Content and Validity of Claims Made about Food Parenting Practices in United Kingdom Online News Articles

The objective of this study was to qualitatively summarise the content of online news articles pertaining to food parenting practices and determine whether this content is substantiated by the scientific literature. News article data were identified and collected from United Kingdom online news published during 2010–2017 period using the News on the Web corpus. A coding framework was used to categorise the content of news articles to identify information related to food parenting practices. Then, claims made about food parenting practices were extracted from relevant news articles. Each claim was evaluated to determine the extent to which any claims were supported by the available scientific research evidence. The study identified ten claims across thirty-two relevant online news articles. Claims made across the news articles reported on the following food parenting practices: food restrictions, food-based threats and bribes, pressure to eat, use of food to control negative emotions, food availability, food preparation, and meal and snack routines. Eight out of the ten claims identified did not refer to scientific research evidence. News articles frequently lacked detail and information to explain to readers why and how the use of certain food parenting practices could have a lasting impact on children’s health outcomes. Considering the influence that news media has on parents, the reporting of food parenting practices in news articles should aim to provide a balanced view of the published scientific evidence and recognise the difficulties and barriers that prevent the use of helpful and healthy food parenting practices. The study results in this paper could be used to aid and structure of the dissemination of food parenting practice research findings in the media, inform public health education to influence perceptions of unhelpful food parenting practices, and promote parental use of responsive food parenting practices.

Food and Trauma: Anthropologies of Memory and Postmemory

Much has been written about the multifaceted significance of food and eating from an anthropological perspective; the same can be said about the role of food in collective identity construction and nation building. In contrast, the nexus of food, memory, psychological trauma, and disordered eating has been less explored. The aim of this interdisciplinary article is to synthesize available knowledge on this topic by engaging with research literature in fields such as food history, anthropology, sociology, and psychiatry as well as autobiographical works, cookbooks, etc. One main section of the article focuses on the role of food and cooking in exile and refuge. Another section deals with the role of food in the aftermath of historical trauma, whereas a final section discusses various works on disordered eating in the wake of traumatic experiences. In sum, the dual nature of food and cooking-at once concrete and abstract, material and symbolic-offers an arena in which ambivalent memories of trauma can take on tangible form. The concept of postmemory may be useful in understanding how food and cooking can function both as a vehicle and as a remedy for intergenerational trauma.

Odds of fussy eating are greater among children with obesity and anxiety

BACKGROUND

Fussy eating has been associated with autism spectrum disorder (ASD), attention-deficit/hyperactive disorder (ADHD), anxiety, and depression. Despite these disorders being prevalent in obesity treatment, no studies have been published on the association of fussy eating in children with obesity and these disorders. Understanding fussy eating in children with obesity and comorbid disorders is important as acceptance of healthy foods tends to be low, especially in children with sensory sensitivities.

OBJECTIVES

Investigate the prevalence of fussy eating in a cross-sectional sample of children with obesity and ASD, ADHD, anxiety, and depression; and whether they were more likely to be fussy eaters, comparing those with and without these disorders.

METHODS

One hundred and four children referred to family-based obesity treatment in Iceland 2011-2016, mean age 12.0 (SD = 3.0), mean body mass index standard deviation score 3.5 (SD = 0.9). Binary logistic regression was used to estimate the relationship between fussy eating and disorders, adjusting for medication use.

RESULTS

A large minority (41.6%) were fussy eaters and 48.9% had at least one comorbid disorder. Over a third of children rejected bitter and sour tastes, and 1.9% and 7.9% rejected sweet and salty tastes, respectively. Compared with those without disorders, the odds of being a fussy eater were increased by a factor of 4.11 when having anxiety (95% confidence intervals) (1.02-16.58, p = 00.046), adjusting for medication use. The odds of being a fussy eater were not increased for other disorders; ASD, ADHD, or depression.

CONCLUSIONS

In children attending obesity treatment, fussy eating was common. Clinical care models in pediatric obesity treatment should address fussy eating, especially in children with anxiety.

Development of Food Competence in Early Childhood Education

The increase in childhood obesity requires the incorporation of nutritional competence into school programs through appropriate activities, starting in the early years. In addition, it is important to promote scientific and cognitive skills during childhood education. The main objective of this study was the implementation of an instructional sequence focused on the learning of skills such as observation, measurement, or interpretation of data related to plants, their germination, and their growth, as well as its relation with the development of food competence. To do so, a set of differentiated activities, organized into several stages, was designed, starting from simple and concrete situations and progressively increasing in complexity and abstraction. The aims were to express ideas about known fruits, vegetables, and legumes in order to expand them by learning new information through student-centered activities, in which children were able to practice and talk about science. The activities were carried out in a class of 24 students aged 4–5 years and data were compared with a control group. The results revealed that the children were motivated in all the activities, which provided an excellent opportunity to initially develop an interest in science and to start to develop food competence in the early years.

Hungry is not safe: A mixed methods study to explore food insecurity in early care and education

The early care and education (ECE) environment has the potential to affect both children and their families. Food insecurity in ECE and its management may be an important influence. Objectives of this mixed methods study were to (1) elicit prominent themes relating to teacher experiences with food insecurity (in the classroom) through qualitative interviews; (2) translate interview themes into survey items and analyze survey data to explore generalizability of the qualitative findings; and (3) provide preliminary data on properties of a new tool to study the influence of food insecurity in the ECE setting. An exploratory sequential mixed methods design (QUAL → quant) was used. Twenty-eight interviews about teacher experiences with food insecurity were followed by 781 surveys to assess generalizability of interview findings. Qualitative themes highlighted that ECE teachers are concerned about children's food insecurity in their classroom; ECE teachers have developed their own set of strategies to manage their concern; and teachers often struggle with what to do. Quantitative results demonstrated many teachers had the same concerns and used the strategies described in the interviews. Further, in exploratory analyses, ECE teachers with Food Insecurity scored significantly higher on all scales (e.g., Food Insecurity Concerns, Struggle with Addressing Food Security) in both adjusted and unadjusted analyses. ECE teachers with Food Acquisition Stress had higher scores on Strategies to Address Food Insecurity with Families in adjusted analyses.

Taste education - A food-based intervention in a school setting, focusing on children with and without neurodevelopmental disorders and their families. A randomized controlled trial

Children with neurodevelopmental disorders (ND) such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactive Disorder (ADHD) have high levels of fussy eating. However, no school-based food interventions exist for children with ASD and ADHD. To investigate the effect of Taste Education, 81 children with ND (n = 33), and without (n = 48), aged 8-12 years, and their parents, participated in a 7-week food intervention. Children were matched on age, ND, and sex, and randomized into Immediate-intervention and Delayed-intervention groups. Parents completed the Children's Eating Behaviour Questionnaire (CEBQ), and a food-variety questionnaire. After adjusting for baseline measures, repeated-measures analysis-of-variance with time-points, and condition as factors (Immediate intervention and Delayed intervention) were used to examine changes in CEBQ-scores, with a robust linear mixed-model fitted. Changes in percentage of accepted foods were tested using a logistic-regression model adjusting for baseline acceptance. Results showed superior results for Intervention compared to waiting, on Food fussiness, but not Enjoyment of food, with stable effects through six-months follow-up. There were non-significant differences between children with and without ND. Results also showed increased odds of accepting vegetables by a factor of 1.6 (95% Confidence Interval [CI]: 1.33-1.93, p < .001); nuts and seeds by a factor of 1.4 (95% CI: 1.27-1.6, p < .001), but no significant association for fruit (OR 1.12, 95% CI: 0.92-1.34, p = .244). Trends were similar for children regardless of ND-status. The Taste Education program, shows promise, as a simple, non-invasive way to decrease fussy eating and increase food variety in the long-term.

Intergenerational Transmission of Child Feeding Practices

This study assessed the relationships between parents’ retrospective recollections of their mothers’ child feeding practices (CFP), current disordered eating (DE) and current CFP (how they now feed their children). 174 Israeli parents (136 mothers, 38 fathers; 40.1 ± 6.9 years of age) of children between the ages of 2 and 18, living at home, completed questionnaires online assessing demographics, retrospective recollections of the CFP that their mothers used when they were children, current CFP and current DE. Specific aspects of retrospectively recalled maternal CFP were significantly associated with the same aspects of current CFP. Current DE mediated the association between retrospectively recalled maternal CFP and current CFP and moderated the association between current concern about child’s weight and pressure for child to eat. Results highlight that the way adults pass on their feeding practices to their children is strongly influenced by their childhood recollections of their mothers’ concern about their weight, pressure for them to eat or restriction of their food intake. People often strive to behave differently from their parents, especially in the realm of food and eating. However, our findings suggest that parental CFP can become entrenched and can be passed on to our children.

Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases

Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.

INSIGHT responsive parenting intervention effects on child appetite and maternal feeding practices through age 3 years

Expert guidance encourages interventions promoting structure-based practices to establish predictable eating environments in order to foster children's self-regulatory skills. However, few studies have examined whether and how child characteristics may moderate effects of interventions on maternal feeding practices. This analysis aimed to examine the effect of the INSIGHT Responsive Parenting (RP) intervention delivered largely during infancy, on child appetitive traits at 2.5 years and maternal feeding practices at 3 years. Primiparous mother-newborn dyads were randomized to a RP intervention designed for obesity prevention or a safety control intervention. Mothers completed the Child Eating Behavior Questionnaire at 2.5 years and the Structure and Control in Parent Feeding Questionnaire at 3 years. T-tests assessed study group differences on child appetitive traits at 2.5 years and maternal feeding practices at age 3. ANCOVA models assessed the effect of study group on parent feeding practices and tested appetitive traits as a moderator. Two hundred thirty-two mother-child dyads completed the trial. Mothers were predominantly white, non-Hispanic, college educated, and married. RP group mothers used more consistent meal routines, and less pressure, food to soothe, and food as reward compared to controls. Child satiety responsiveness moderated the RP intervention effect on maternal use of limiting exposure to unhealthy foods such that the RP intervention was most effective for children at higher levels of satiety responsiveness. Food responsiveness moderated RP intervention effects on maternal use of pressure, such that at lower levels of food responsiveness, control group mothers used more pressure than RP mothers. The INSIGHT RP intervention demonstrated sustained effects on maternal feeding practices through age 3 years, with some intervention effects showing moderation by child appetitive traits.

Using association rules mining to characterize loss of control eating in childhood

Childhood loss of control (LOC)-eating, the perceived inability to stop or control eating, is associated with increased risk for binge-eating disorder and obesity. However, the correlates of LOC-eating in childhood remain unclear. A secondary analysis of 177, 7-12-year-old children from five laboratory feeding studies was performed to investigate potential family (e.g., frequency of meals together, feeding practices), parental (e.g., education, weight status), and child (e.g., weight status, appetite traits) correlates of LOC-eating. Association rules mining (ARM¹), a data-driven approach, was used to examine all characteristics that were common across studies to identify which were associated with LOC-eating. Results showed LOC-eating was characterized by a combination of child appetitive behaviors and parental feeding practices. In particular, LOC-eating was associated with low parental pressure to eat in combination with a high propensity to want to eat all the time and frequent refusal or dislike of novel foods. This pattern of both food approach (i.e., wanting to eat all the time) and avoidant behaviors (i.e., food fussiness) highlights the need for more research to characterize the complex patterns of appetitive traits associated with LOC-eating. In contrast, the absence of LOC-eating was associated with a low propensity to want to eat all the time, greater family income, and infrequent emotional overeating. Therefore, propensity to want to eat all the time, a single question from the Children's Eating Behavior Questionnaire, characterized both the presence and absence of LOC-eating, highlighting the need for more research to determine if this question captures clinically relevant individual differences. Future studies addressing these questions will advance our understanding of pediatric LOC-eating and may lead to interventions to reduce risk for more severe eating disorder symptomology.

Does Examining the Childhood Food Experiences Help to Better Understand Food Choices in Adulthood?

Impact of parental feeding practices on children’s eating behaviors is well-documented in the literature. Nevertheless, little is known about how many of these behaviors might persist into adulthood. There is a lack of a tool measuring childhood feeding experiences recollected by adults, while the Comprehensive Feeding Practices Questionnaire (CFPQ) is used to measure parental feeding practices applied towards children. The aim of the study was to adapt the CFPQ to measure adults’ recollections of their childhood (5–10 years old) feeding experiences, to examine its discriminant validity and then to assess if these practices are related to adults’ food choices. In 2020, the modified version of CFPQ (mCFPQ) and questions on current food consumption were administered in a group of 500 adults twice over a two-week interval. The analysis included 443 participants whose questionnaires were correctly completed in both stages of the study. The Q-sorting procedure was used to test for discriminant validity of the questionnaire, i.e., confirmatory and exploratory factor analysis (EFA), Cronbach’s alpha, correlations coefficients, and the analysis of the differences between groups according to the intake of certain food products. Test–retest reliability was examined by calculating interclass correlation coefficients (ICC) for each obtained factor. As a result of EFA, five subscales were identified: “Restrictions”, “Healthy Eating Guidance”, “Pressure and Food Reward”, “Monitoring”, and “Child Control”. Items from these subscales created a new tool—Adults’ Memories of Feeding in Childhood (AMoFiC). Test for internal consistency, factor correlations, and discriminant validity proved satisfactory psychometric parameters of AMoFiC. “Pressure and Food Reward” and “Child Control” were associated with higher intake of sweets and salty snacks, whereas “Healthy Eating Guidance”, “Monitoring”, and “Restrictions” were associated with higher consumption of fresh fruits and vegetables. Despite the fact that the AMoFiC questionnaire requires further research, the findings of the study might be of practical use in counseling addressed to the parents.

De-implementation of detrimental feeding practices: a pilot protocol

BACKGROUND

Early childhood educators (ECEs) often use detrimental feeding practices and are slow to implement positive feeding practices. Nevertheless, few studies have aimed to understand and change ECEs' feeding practices. This gap needs to be addressed because implementation (i.e., adding new, evidence-based practices) and de-implementation (i.e., stopping low-value or harmful practices) are distinct processes that require unique strategies.

METHODS

We will develop a de-implementation strategy for detrimental feeding practices using evidence-based quality improvement (EBQI) sessions to engage stakeholders and draw on the Niven process model for de-implementation. Then, we will investigate the effects of the de-implementation strategy in a proof-of-principle study. The de-implementation strategy will be evaluated in 2 partnering childcare agencies using a pre-post, within-site design. For our primary outcome, we will interview educators throughout the school year to assess the feasibility and acceptability of the intervention and survey them with standard measures for assessing feasibility and acceptability. For secondary outcomes, we will investigate its effects on the use of detrimental and evidence-based feeding practices by teachers and impacts on child BMI and diet.

DISCUSSION

The current study will establish the feasibility and acceptability of our de-implementation approach and will provide preliminary data toward 3 predicted secondary outcomes: (1) decreased detrimental feeding practices by ECEs, (2) increased adoption of and fidelity to nutrition promotion practices, and (3) improved child dietary outcomes. These results are expected to contribute to the uptake and sustainability of mealtime interventions to improve the diets of young children. Results will also apply to the field of implementation science by informing processes for developing de-implementation approaches in a community setting.

Self-Determination Theory as a Theoretical Framework for a Responsive Approach to Child Feeding

Supporting positive childhood eating behaviors is a central and ongoing priority for health care providers, encompassing both health outcomes for typical eaters and best practice in relation to pediatric feeding challenges. Building on existing work, this perspective draws on literature from multiple fields to recommend the use of Self-Determination Theory as a framework for responsive feeding. Additionally, it contributes to the definition and conceptualization of responsive feeding. The 3 basic needs proposed by Self-Determination Theory (autonomy, relatedness and competence) have significant implications for both professional practice and the direction of future research.

Retrospective reports of childhood feeding in mother-daughter dyads

Significant research has linked parents' feeding practices to children's eating habits. However, much less is known about how childhood feeding relates to longer-term outcomes such as eating in adulthood. The current study uses retrospective reports from mother-daughter dyads (N = 217) to compare childhood feeding practices and to examine how recalled feeding is related to current eating (emotional eating, intuitive eating, unrestrained eating) and body mass index (BMI) in adult daughters. Mothers and daughters completed the Comprehensive Feeding Practices Questionnaire (CFPQ), subscales from the Three Factor Eating Questionnaire, and the Intuitive Eating Scale. Results of an exploratory factor analysis indicated that mothers and daughters largely had similar factor structures on retrospective reports, with factor loadings varying on four of twelve original CFPQ subscales: monitoring, restriction for health, child control, and modelling. Paired samples t-tests examined mean differences between mother and daughter reports on each subscale; there was no significant difference between mother and daughter reports on six of the 11 scales. Daughters reported significantly higher levels of pressure to eat; mothers reported significantly higher levels of healthy practices, child control, involvement, and unhealthy environment than their daughters recalled. Hierarchical regressions revealed that daughters' reports of specific childhood feeding practices accounted for significant change in unadjusted variance for uncontrolled eating (18.8%), emotional eating (13.1%), intuitive eating (14.7%), and BMI (16.1%). Similarly, regressions revealed that mothers' reports of childhood feeding practices accounted for significant change in unadjusted variance for emotional eating (11.5%) and BMI (11.2%), but not uncontrolled or intuitive eating. Collectively, results lend strong support to the use of retrospective reports on childhood feeding and provide evidence that recalled childhood feeding practices have lasting relations with adult eating behaviors.

Communication With Family Child Care Providers and Feeding Preschool-Aged Children: Parental Perspectives

OBJECTIVE

To describe parent communication about child nutrition-related topics with family child care providers (FCCPs).

DESIGN

Five focus groups conducted from December, 2016 to July, 2017.

PARTICIPANTS

Parents (n = 25) of 2- to 5-year-old children attending family child care homes in Rhode Island.

PHENOMENON OF INTEREST

How and what parents communicate about with FCCPs related to feeding young children.

ANALYSIS

Recordings were transcribed verbatim. Two independent coders employed content analysis to analyze transcripts. Reflections, emerging themes, and final themes were discussed.

RESULTS

Participants were recruited through FCCPs and were mostly Hispanic and female. Parents mainly communicated with FCCPs in person. Communication with FCCPs related to how and what children were fed did not occur frequently, and parents usually inquired about how much children ate.

CONCLUSIONS AND IMPLICATIONS

Parents did not engage in frequent child nutrition-related communication with their FCCP. However, parents trusted FCCPs to provide healthy and sufficient food to children. More research is needed to identify effective strategies that facilitate child nutrition communication between parents and FCCPs.

The Influence of Taste Liking on the Consumption of Nutrient Rich and Nutrient Poor Foods

Repeated consumption of high-energy nutrient poor foods can lead to undesirable health outcomes such as obesity. Taste plays an important role in food choice, and a better understanding of the links between the taste of foods, individual taste preferences, food choices, and intakes will aid in our understanding of why some people might select and consume unhealthy foods. The present review focuses on three main questions: (1) do nutrient poor and nutrient rich foods significantly differ in taste profile? (2) are humans predisposed toward developing a liking or preference for certain taste profiles? (3) how are individual variations in liking of the basic taste qualities related to long term food intake and adverse health outcomes such as obesity? Results indicated that nutrient poor foods were likely to be sweet, salty and fatty mouthfeel, while the taste profiles of nutrient rich foods were diverse. Although humans are born with a universal liking for sweet and aversion for bitter taste, large individual differences exist in liking of all the basic taste qualities. These individual differences partly explain differences in short term intakes of foods varying in taste profiles. However they fail to sufficiently explain long term food choices and negative health outcomes such as obesity. Future studies should focus on how the full sensory profile of food which includes taste, smell and texture interacts with individual characteristics (e.g., taste or health motivations, taste preferences) to affect consumption of nutrient rich and nutrient poor foods.

Food neophobia and pickiness among children and associations with socioenvironmental and cognitive factors

Food neophobia and picky eating are common behaviors exhibited among children that may impact their nutritional health. Due to the limited data available regarding food neophobia and pickiness in Saudi Arabia, this study aimed to estimate the prevalence of picky eating and food neophobia among Saudi children and to examine the association of socioenvironmental and cognitive factors with food neophobia and pickiness. The study included 216 healthy children with no known allergy, aged 3-7 years old, recruited from six schools in Jeddah, Saudi Arabia. A questionnaire was utilized to collect sociodemographic information from parents. Food neophobia and pickiness were evaluated using 2 separate scales. Socioenvironmental factors that may contribute to the development of food neophobia and pickiness were evaluated, such as breastfeeding duration and weaning practices, parental strategies, peer modeling, and social facilitation. Sensory sensitivity and disgust were also evaluated to assess the association with cognitive factors. Linear regression analysis with 95% confidence intervals was used to test the associations with the selected socioenvironmental and cognitive factors. The majority of children showed moderate to severe food neophobia and pickiness (98.6% and 89.8%, respectively). The socioenvironmental factors of peer modeling and selected parental strategies were found to have a significant association with food neophobia and pickiness. Assessed cognitive factors were found to be associated with food neophobia and pickiness. Future studies investigating causes of food neophobia and food pickiness among children are warranted.

Anorexia Nervosa and a Lost Emotional Self: A Psychological Formulation of the Development, Maintenance, and Treatment of Anorexia Nervosa

In this paper, we argue that Anorexia Nervosa (AN) can be explained as arising from a 'lost sense of emotional self.' We begin by briefly reviewing evidence accumulated to date supporting the consensus that a complex range of genetic, biological, psychological, and socio-environmental risk and maintenance factors contribute to the development and maintenance of AN. We consider how current interventions seek to tackle these factors in psychotherapy and potential limitations. We then propose our theory that many risk and maintenance factors may be unified by an underpinning explanation of emotional processing difficulties leading to a lost sense of 'emotional self.' Further, we discuss how, once established, AN becomes 'self-perpetuating' and the 'lost sense of emotional self' relentlessly deepens. We outline these arguments in detail, drawing on empirical and neuroscientific data, before discussing the implications of this model for understanding AN and informing clinical intervention. We argue that experiential models of therapy (e.g., emotion-focused therapy; schema therapy) be employed to achieve emergence and integration of an 'emotional self' which can be flexibly and adaptively used to direct an individual's needs and relationships. Furthermore, we assert that this should be a primary goal of therapy for adults with established AN.

Evidence for gene-environment correlation in child feeding: Links between common genetic variation for BMI in children and parental feeding practices

The parental feeding practices (PFPs) of excessive restriction of food intake (‘restriction’) and pressure to increase food consumption (‘pressure’) have been argued to causally influence child weight in opposite directions (high restriction causing overweight; high pressure causing underweight). However child weight could also ‘elicit’ PFPs. A novel approach is to investigate gene-environment correlation between child genetic influences on BMI and PFPs. Genome-wide polygenic scores (GPS) combining BMI-associated variants were created for 10,346 children (including 3,320 DZ twin pairs) from the Twins Early Development Study using results from an independent genome-wide association study meta-analysis. Parental ‘restriction’ and ‘pressure’ were assessed using the Child Feeding Questionnaire. Child BMI standard deviation scores (BMI-SDS) were calculated from children’s height and weight at age 10. Linear regression and fixed family effect models were used to test between- (n = 4,445 individuals) and within-family (n = 2,164 DZ pairs) associations between the GPS and PFPs. In addition, we performed multivariate twin analyses (n = 4,375 twin pairs) to estimate the heritabilities of PFPs and the genetic correlations between BMI-SDS and PFPs. The GPS was correlated with BMI-SDS (β = 0.20, p = 2.41x10^-38). Consistent with the gene-environment correlation hypothesis, child BMI GPS was positively associated with ‘restriction’ (β = 0.05, p = 4.19x10^-4), and negatively associated with ‘pressure’ (β = -0.08, p = 2.70x10^-7). These results remained consistent after controlling for parental BMI, and after controlling for overall family contributions (within-family analyses). Heritabilities for ‘restriction’ (43% [40–47%]) and ‘pressure’ (54% [50–59%]) were moderate-to-high. Twin-based genetic correlations were moderate and positive between BMI-SDS and ‘restriction’ (r_A = 0.28 [0.23–0.32]), and substantial and negative between BMI-SDS and ‘pressure’ (r_A = -0.48 [-0.52 - -0.44]. Results suggest that the degree to which parents limit or encourage children’s food intake is partly influenced by children’s genetic predispositions to higher or lower BMI. These findings point to an evocative gene-environment correlation in which heritable characteristics in the child elicit parental feeding behaviour.

It is widely believed that parents influence their child’s BMI via certain feeding practices. For example, rigid restriction has been argued to cause overweight, and pressuring to eat to cause underweight. However, recent longitudinal research has not supported this model. An alternative hypothesis is that child BMI, which has a strong genetic basis, evokes parental feeding practices (‘gene-environment correlation’). To test this, we applied two genetic methods in a large sample of 10-year-old children from the Twins Early Development Study: a polygenic score analysis (DNA-based score of common genetic variants associated with BMI in genome-wide meta-analyses), and a twin analysis (comparing resemblance between identical and non-identical twin pairs). Polygenic scores correlated positively with parental restriction of food intake (‘restriction’; β = 0.05, p = 4.19x10^-4), and negatively with parental pressure to increase food intake (‘pressure’; β = -0.08, p = 2.70x10^-7). Associations were unchanged after controlling for all genetic and environmental effects shared within families. Results from twin analyses were consistent. ‘Restriction’ (43%) and ‘pressure’ (54%) were substantially heritable, and a positive genetic correlation between child BMI and ‘restriction’ (r_A = 0.28), and negative genetic correlation between child BMI and ‘pressure’ (r_A = -0.48) emerged. These findings challenge the prevailing view that parental behaviours are the sole cause of child BMI by supporting an alternate hypothesis that child BMI also causes parental feeding behaviour.

Study of the reasons for the consumption of each type of vegetable within a population of school-aged children

BACKGROUND

Several studies have evaluated the existence of factors that influence the consumption of vegetables in children, such as family environment, daily exposure to one or several vegetables, parents' consumption and consumption pattern and the way in which vegetables are prepared in the household, among others. The objective of this study was to investigate the reasons for consumption associated with each vegetable in school-aged children through a survey designed to be answered by the parents.

METHODS

A preliminary study with 162 parents was carried out on the consumption of vegetables in children aged 6 to 12 years. Based on the information obtained, a survey was designed with 14 phrases to investigate the reasons for the low consumption of each type of vegetable among school-aged children, which was answered online by 419 parents.

RESULTS

The results obtained allowed us to categorise the vegetables into 6 groups. Group A consisted of tomatoes, corn, pumpkin and carrots as the vegetables that children like to eat most. Group B contains the vegetables that are consumed mostly camouflaged in other preparations, such as onions and red peppers. Group C contains only cauliflower, which was negatively associated with senses, such as colour, smell and taste. This vegetable was never offered to children by a high percentage of parents. Group D consists of green vegetables: zucchini, spinach, chard and peas. Vegetables of this group are added to other foods and the child usually ingests them camouflaged or obliged. Group E consists of beetroot, lettuce and broccoli. Beetroot and lettuce were the vegetables parents reported were most often rejected by their children. This rejection, they stated, was due to sensory aspects, such as colour, texture and taste.

CONCLUSIONS

The reasons for consumption among school-aged children depend on each type of vegetable and cannot be generalized. The sensory characteristics of the vegetable (mainly colour and flavour) and the habits of consumption in the family environment play a major role in children's acceptance or rejection of vegetables.

Socioeconomic Position and Picky Eating Behavior Predict Disparate Weight Trajectories in Infancy

Infant weight gain has long-term implications for the establishment of overall health. We examined whether socioeconomic position (SEP), the use of pressure as a feeding practice, and picky eating relate to changes infant in weight-for-length (WFL). A modified developmental design was used to examine whether current levels of child picky eating, parental use of pressure, and SEP were associated with changes in WFL during infancy. Health providers distributed survey packets during routine well-child visits made in the homes of families with young children in New Zealand (n = 193). Primary caregivers of young children provided their child's current level of picky eating, their use of pressure, and their SEP. They also reported their child's professionally-measured WFL from birth, 8, 15, and 21 months of age. A multi-level modeling analysis yielded an interaction between SEP and picky eating in predicting infant weight change over time. Children who had a low SEP and were not picky eaters were on the highest WFL trajectory and children who had a low SEP and were picky eaters were lowest on the WFL trajectory. A main effect revealed that higher levels of parental pressure predicted lower WFL in infants at each age, but did not interact with SEP or picky eating. Findings from this study indicate that the combination of eating behavior and SEP are associated with differential infant growth patterns. These results suggest that eating behavior and SEP should be included in the development of interventions designed to achieve healthy weight during childhood.

Predictors of obesity and overweight in preschoolers: The role of parenting styles and feeding practices

Childhood obesity/overweight (OB/OW) displayed a rapid increase and high prevalence in the last few decades in preschool-aged children, which raised health concerns across the world and motivated researchers to investigate the factors that underlie childhood obesity. The current study examined parenting styles and child-feeding practices as potential predictors for OB/OW in preschool children, controlling for child's temperament, which has been shown to be linked with OB/OW. The sample included 61 normal weight (NW) and 61 obese/overweight (OB/OW) Turkish pre-schoolers (M age = 62.2 months; SD = 7.64, range = 45-80 months). Parenting styles (authoritarian, authoritative), child-feeding practices (restriction, pressure to eat, monitoring), and child's temperament (negative affectivity) were measured with mothers' reports. Results showed that authoritarian parenting and maternal pressure to eat were the two parenting variables that significantly predicted child's weight status; the odds of being OB/OW was 4.71 times higher in children whose mothers used higher authoritarian parenting style, and was 0.44 times lower when mothers pressured their child to eat. These findings suggest that understanding the unique role of different aspects of parenting in the risk of early OB/OW status of children would be important in developing more effective interventions from early years in life.

Staff Food-Related Behaviors and Children's Tastes of Food Groups during Lunch at Child Care in Oklahoma

BACKGROUND

Young children should consume a variety of nutrient-dense foods to support growth, while limiting added fat and sugar. A majority of children between the ages of 3 and 5 years attend child care in the United States, which makes this environment and the child-care staff influential at meals.

OBJECTIVE

The aim was to determine the association between best-practice food-related behaviors and young children's tastes of fruit, vegetable, low-fat dairy, and high-fat/high-sugar foods at child care.

DESIGN

This was a cross-sectional study.

PARTICIPANTS

A community-based study with 201 children ages 3 to 5 years from 25 early care and education centers, including 11 tribally affiliated centers and two Head Start programs across Oklahoma. Data collection occurred from fall 2011 to spring 2014.

MAIN OUTCOME MEASURES

Classroom observations used the Environmental Policy Assessment Observation tool to measure the staff behaviors and environment. Staff behavior was compared at three different levels: the composite score of staff nutrition behavior, each constituent staff behavior, and staff behaviors grouped into broader feeding behaviors. Tasted food was measured through the Dietary Observation in Child Care method. The children's meals were categorized into the following food groups: fruit, vegetable, low-fat dairy, fried vegetable, fried meat, high-fat meat, and high-fat/high-sugar food.

STATISTICAL ANALYSIS PERFORMED

Descriptive statistics were calculated for relevant variables. Relationships between the constituent staff behaviors and food groups that children tasted were compared using multilevel mixed-model analysis.

RESULTS

The mean number of tasted fruit or vegetable items was higher and the mean number of tasted high-fat/high-sugar food items was lower when staff: 1) determined fullness before plate removal when less than half of food was eaten, 2) ate with the children, 3) and talked about healthy food.

CONCLUSIONS

The utilization of the three staff behaviors and their association with higher mean tastes of nutrient-dense items and lower mean tastes of high-fat/high-sugar food items among exposed children demonstrated support for the use of the best practices in early care and education centers.

Implementing a Health and Wellbeing Programme for Children in Early Childhood: A Preliminary Study

In New Zealand, there is a high prevalence of childhood poverty and food insecurity, which can impact a family’s ability to provide high quality, nutrient dense foods for their children. In an attempt to increase the quality of the food consumed by children attending a decile two (low socio-economic) kindergarten and to address food insecurity issues, an educational health and wellness initiative, in conjunction with a free lunch programme, was introduced. The impact of the lunches and the effectiveness of the programme were evaluated. Baseline and end-intervention 24-h modified dietary recall questionnaire data and a vegetable- and fruit-specific food frequency questionnaire (FFQ) were collected. A follow-up FFQ was administered six months after the end of the intervention. The nutrient composition of the foods recorded in the 24-h recall questionnaires were analysed using FoodWorks8™. Whilst no significant differences were observed with the intakes of individual nutrients, there was a significant decrease in the consumption of ultra-processed snack foods (p = 0.015). The results of the follow-up FFQ, including the comments collected from the parents, suggested that the intervention had a longer-term positive impact on not only the children involved in the study but also on their whānau (wider family members)

Salad bar selection patterns of elementary school children

From the perspective of child-focused nutrition research, the analysis of the school cafeteria culture and environment is critical. Most children eat at least one meal at school per school day, thus elementary schools are a good setting for influencing the early development of healthy eating habits. The salad bar in particular has gained attention as a means of increasing fruit and vegetable consumption. The purpose of the present study was to provide insight about the types of items children choose or do not choose from the salad bar. Our aims were to document elementary school children's food selection patterns by examining photographs of 2903 cafeteria trays. Our results show students in this study took very few items - and a substantial number did not take any at all. We examined three factors, gender, grade, and item placement, in relation to food selection. Gender was the most significant factor, with girls being more likely to choose both fruits and vegetables. Students in lower grades were more likely to select vegetables and to choose more of them. Finally, item placement did not affect choice. Our findings lead us to suggest the importance of integrating information about fruits and vegetables into the school curriculum and that schools strongly consider which items to offer because our results indicate children consistently do not choose certain items and probably do not conceive of them in the context of the adult concept of a salad. Finally, because a child's choice of food is not always a simple act we suggest ethnographic research on how children perceive and use salad bars would provide important insight into the value of retaining or expanding salad bars in elementary schools.

Table Talk: development of an observational tool to assess verbal feeding communications in early care and education settings

OBJECTIVE

Children's dietary intake impacts weight status and a range of short- and long-term health outcomes. Accurate measurement of factors that influence children's diet is critical to the development and evaluation of interventions designed to improve children's diets. The purpose of the current paper is to present the development of the Table Talk observational tool to measure early care and education teachers' (ECET) verbal feeding communications.

DESIGN

An observational tool to assess ECET verbal communication at mealtimes was deigned based on the extant literature. Trained observers conducted observations using the tool during lunch for both lead and assistant ECET. Descriptive statistics, test-retest for a subgroup, interclass correlations for each item, and comparisons between leads and assistants were conducted.

SETTING

Head Start centres, Southern USA.

SUBJECTS

Seventy-five Head Start educators.

RESULTS

On average, 17·2 total verbal feeding communications (sd 8·9) were observed per ECET. For lead ECET, the most prevalent Supportive Comment was Exploring Foods whereas for assistants Making Positive Comments was the most prevalent. Overall, lead ECET enacted more Supportive Comments than assistant ECET (F(2,72)=4·8, P=0·03). The most common Unsupportive Comment was Pressuring to Eat, with a mean of 3·8 (sd 4·3) and a maximum of 25. There was no difference in Unsupportive Comments between lead and assistant ECET.

CONCLUSIONS

Table Talk may be a useful tool to assess verbal feeding communications of ECET, with potential applications such as informing ECET training and assessing intervention efforts.

A Qualitative Application of the Belsky Model to Explore Early Care and Education Teachers' Mealtime History, Beliefs, and Interactions

OBJECTIVE

Studies on factors associated with nutrition practices in early care and education settings often focus on sociodemographic and programmatic characteristics. This qualitative study adapted and applied Belsky's determinants of parenting model to inform a broader exploration of Early Care and Education Teachers (ECETs) practices.

DESIGN

Qualitative cross-sectional study with ECETs.

SETTING

The researchers interviewed ECETs in their communities across a Southern state.

PARTICIPANTS

Purposive sampling was employed to recruit ECETs (n = 28) from Head Start or state-funded centers serving low-income families.

PHENOMENON OF INTEREST

Developmental histories of ECETs regarding food and nutrition, beliefs about child nutrition, and teaching interactions related to food.

ANALYSIS

Qualitative interviews were coded using a deductive content analysis approach.

RESULTS

Three distinct interrelationships were observed across the themes. First, rules and routines regarding food and mealtime in the educators' childhood often aligned with educator beliefs and behaviors at meals in their classroom. Second, some ECETs described motivations to leave a healthy food legacy for children in their class. Finally, an experience of food insecurity appeared in narratives that also emphasized making sure children got enough through various strategies.

CONCLUSIONS AND IMPLICATIONS

The influence of ECET developmental histories and their related beliefs can be addressed through professional development and ongoing support. Future study should quantify model constructs in a larger sample and study their relationships over time.

Are There Sensitive Periods for Food Acceptance in Infancy?

PURPOSE OF REVIEW

A sensitive period in development is one in which it is easier for learning to take place; the behaviour can however still be learned at a later stage, but with more difficulty. This is in contrast to a critical period, a time at which a behaviour must be learned, and if this window of opportunity is missed, then the behaviour can never be acquired. Both might determine food acceptance in childhood.

RECENT FINDINGS

There is evidence to support the idea of a sensitive period for the introduction of tastes, a critical period for the introduction of textures and for the development of oral motor function, and a possible critical period for the introduction of new foods but only in children where there is an innate disposition to develop early and extreme disgust responses.

SUMMARY

There are both sensitive and critical periods in the acquisition of food preferences.

Bi-directional associations between child fussy eating and parents' pressure to eat: Who influences whom?

Background

Fussy eating is common in young children, often raising concerns among parents. The use of pressuring feeding practices may provoke or worsen child fussiness, but these practices could equally be a parent’s response to child fussy eating.

Objective

In longitudinal analyses, we assessed directionality in the relation between fussy eating and parent’s pressure to eat across childhood.

Methods

Study participants were 4845 mother-child dyads from the population-based Generation R cohort in the Netherlands. The Child Behavior Checklist was used to assess fussy eating (2 items) at child ages 1½, 3 and 6 years. Parents’ pressure to eat was assessed with the Child Feeding Questionnaire (4 items) when children were 4 years old. All scale scores were standardized.

Results

Linear regression analyses indicated that preschoolers’ fussy eating prospectively predicted higher levels of parents’ pressure to eat at child age 4 years, independently of confounders (adjusted B=0.24, 95% CI: 0.21, 0.27). Pressure to eat at 4 years also predicted more fussiness in children at age 6 years, independently of confounders and of fussy eating at baseline (adjusted B=0.14, 95% CI: 0.11, 0.17). Path analyses indicated that the relation from fussy eating at 3 years to parenting one year later was stronger than from pressure at 4 years to fussy eating two years later (p<0.001).

Conclusions

Our findings suggest bi-directional associations with parental pressuring feeding strategies being developed in response to children’s food avoidant behaviors, but also seemingly having a counterproductive effect on fussiness. Thus, the use of pressure to eat should be reconsidered, while providing parents alternative techniques to deal with their child’s fussy eating.

Development of a Comprehensive Assessment of Food Parenting Practices: The Home Self-Administered Tool for Environmental Assessment of Activity and Diet Family Food Practices Survey

BACKGROUND

Parents' food parenting practices influence children's dietary intake and risk for obesity and chronic disease. Understanding the influence and interactions between parents' practices and children's behavior is limited by a lack of development and psychometric testing and/or limited scope of current measures. The Home Self-Administered Tool for Environmental Assessment of Activity and Diet (HomeSTEAD) was created to address this gap.

OBJECTIVE

This article describes development and psychometric testing of the HomeSTEAD family food practices survey.

PARTICIPANTS/DESIGN

Between August 2010 and May 2011, a convenience sample of 129 parents of children aged 3 to 12 years were recruited from central North Carolina and completed the self-administered HomeSTEAD survey on three occasions during a 12- to 18-day window. Demographic characteristics and child diet were assessed at Time 1. Child height and weight were measured during the in-home observations (following Time 1 survey).

STATISTICAL ANALYSIS

Exploratory factor analysis with Time 1 data was used to identify potential scales. Scales with more than three items were examined for scale reduction. Following this, mean scores were calculated at each time point. Construct validity was assessed by examining Spearman rank correlations between mean scores (Time 1) and children's diet (fruits and vegetables, sugar-sweetened beverages, snacks, sweets) and body mass index (BMI) z scores. Repeated measures analysis of variance was used to examine differences in mean scores between time points, and single-measure intraclass correlations were calculated to examine test-retest reliability between time points.

RESULTS

Exploratory factor analysis identified 24 factors and retained 124 items; however, scale reduction narrowed items to 86. The final instrument captures five coercive control practices (16 items), seven autonomy support practices (24 items), and 12 structure practices (46 items). All scales demonstrated good internal reliability (α>.62), 18 factors demonstrated construct validity (significant association with child diet, P<0.05), and 22 demonstrated good reliability (intraclass correlation coefficient>0.61).

CONCLUSIONS

The HomeSTEAD family food practices survey provides a brief, yet comprehensive and psychometrically sound assessment of food parenting practices.

Role of food preoccupation and current dieting in the associations of parental feeding practices to emotional eating in young adults: A moderated mediation study

Parental feeding practices reflecting coercive control are related to children's later eating behaviors, but the mechanisms underlying these effects remain poorly understood. This study examined the relationships between recalled childhood experiences of parental pressure to eat and restriction and current food preoccupation, dieting, and emotional eating in a racially diverse sample of college students (N = 711). Results revealed that parental restriction, but not pressure to eat, was associated with more emotional eating (r = 0.18, p < 0.0001). Food preoccupation mediated the association between restriction and emotional eating (95% CI [3.6495-7.2231]); however, a moderated mediation model revealed that the strength of the indirect effect of restrictive feeding on emotional eating through food preoccupation was significantly different for dieters and non-dieters (index of moderated mediation = 1.79, Boot SE = 0.79; 95% bias-corrected bootstrap CI [-3.5490 to -0.4515]). These findings provide unique insight into the mechanisms linking parental feeding practices with emotional eating in young adulthood. Future studies attempting to clarify the processes through which child feeding practices impact later eating behaviors should consider the role of current dieting.