Parental feeding practices and concerns related to child underweight, picky eating, and using food to calm differ according to ethnicity/race, acculturation, and income

Understanding the relationships between acculturation, food insecurity, and food parenting practices among socioeconomically/racially diverse parents

Research suggests that acculturation and food insecurity are factors that are separately associated with the use of specific food parenting practices among United States (US) families. Certain food parenting practices, such as coercive control and unstructured food parenting practices, are related to negative health consequences in children, such as disordered eating behaviors. The current study aimed to explore associations between acculturation strategies and food parenting practices in a sample of 577 Latinx, Hmong, Somali/Ethiopian, and Multiracial families. A secondary objective was to understand whether food security status significantly modified the relationships between acculturation strategies and food parenting practices. Results showed that acculturation strategies were significantly related to food parenting practices, and patterns in these relationships differed across race and ethnicity. Further, food security status significantly modified the relationship between acculturation strategies and food parenting practices for Latinx, Hmong, and Somali/Ethiopian families, but not for Multiracial families. These results point to the complex relationships among acculturation strategies, food security status, and food parenting practices in immigrant populations in the US. Longitudinal studies exploring the temporal relationships between acculturation strategies, food security status, and food parenting practices would help tease apart how food parenting practices may evolve upon migrating to the US.

Differences in maternal and paternal pressure to eat and perception of household responsibilities

Controlling feeding practices, such as pressure to eat, are associated with a child's disinhibited eating and extremes in bodyweight. We aimed to explore which factors are associated with parent dyads' pressuring feeding practices, including how mothers and fathers perceive the sharing of household tasks such as mealtime and child feeding responsibilities. In this cross-sectional study, parent dyads (mother and father) of healthy preschool-aged children completed an identical questionnaire consisting of measures of picky eating (food fussiness subscale of Child Eating Behavior Questionnaire), parental concern for undereating, and pressure to eat (Child Feeding Questionnaire). We used separate multivariable linear regression models for mothers and fathers to assess correlates associated with pressure to eat subscale score, including slowness of eating and enjoyment of food, child BMI z-score and race/ethnicity, and household income. Separate unadjusted linear regression models for mothers and fathers were used to report the association of pressure to eat with household responsibilities. Parents (N = 88) had similar mean picky eating, concern for undereating, and pressure to eat scores; more fathers had high pressure to eat scores (36% vs 27%). Higher pressure to eat was significantly associated with lower income, non-Hispanic Black or Black race/ethnicity, slow eating, and lower enjoyment of food. Pressure was not associated with household responsibilities. While there were similar maternal and paternal perceptions of child eating behaviors, more fathers reported pressuring their child to eat. Identifying differences in parental feeding practices may assist in intervention development to improve feeding practices.

Correlates of feeding difficulties among children of Chinese transgender parents

Background

Ensuring proper early feeding for young children is crucial, as encountering feeding difficulties (FD) during this stage can give rise to a cascade of health problems, the repercussions of which may endure into late childhood and adolescence. Children raised by transgender parents may be at risk of encountering FD, however, there is no research conducted on Chinese transgender families.

Methods

We designed a cross-sectional survey in which the rate of FD and its influencing factors were investigated among transgender parents in China. A total of 446 Chinese transgender parents (average age 30.39 years) were included in the analysis. Logistic regression models were applied to investigate the influencing factors of FD among children of transgender parents. We also established structural equation modeling (SEM) to explore the possible pathways among these factors and FD.

Results

The rate of FD in children of Chinese transgender parents is 55.4%, with 34.5% having severe FD. Coming out after having a child (AOR = 2.26, 95%CI = 1.33 ∼ 3.91), family violence (AOR = 1.06, 95%CI = 1.04 ∼ 1.09), partner violence (AOR = 1.11, 95%CI = 1.08 ∼ 1.15), no feeding education (accepting feeding education: AOR = 0.43, 95%CI = 0.25 ∼ 0.74), being discriminated during seeking of childbearing health care (AOR = 1.99, 95%CI = 1.3 ∼ 3.05), and poor relationship with partner (fair: AOR = 0.09, 95%CI = 0.03 ∼ 0.22; good: AOR = 0.06, 95%CI = 0.02 ∼ 0.15) are significantly associated with higher FD. Furthermore, through the pathway analysis, the indirect effects of education level (β=-0.151), feeding education (β = 0.145), and relationship with partner (β=-0.196) on FD are observed.

Conclusions

Children of Chinese transgender parents showed a high FD rate. It is crucial to help build a better family and social environment for transgender families to reduce the FD and improve children's and adolescents' health.

Validation of the Comprehensive Feeding Practices Questionnaire (CFPQ) with Portuguese Caregivers of 2-to-8-Year-Olds

Recent findings have demonstrated an increase in the prevalence of childhood obesity and overweight in Portugal, urging the need to study modifiable risk factors such as parental feeding practices. The Comprehensive Feeding Practices Questionnaire (CFPQ) is an important self-report measure assessing a broad range of responsive and non-responsive feeding practices. However, the CFPQ has not yet been validated in Portugal. Therefore, the present study aimed to test the validity of this measure with Portuguese parents of 2-to-8-year-old children. A sample of 409 parents completed a Portuguese-adapted version of the CFPQ and the already validated Child Feeding Questionnaire (CFQ). Confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and psychometric analysis were conducted. CFA demonstrated the original 12-factor structure did not fit the sample. EFA identified an eight-factor structure comprising 29 items: Monitoring, Modeling, Environment, Involvement, Emotion Regulation, Restriction for Weight Control, Restriction for Health, and Pressure. Findings suggest that parental feeding practices are sensitive to parents' background cultures and children's developmental period.

Evaluating the influence of low birth weight on food parenting practices in preschool children

Food parenting practices, especially Autonomy Support practices and Structure practices, have not been comprehensively studied among parents of children born with low birth weight in Asia. The aim of this study was to investigate food parenting practices among parents of preschoolers who were born with low (<2500 g) and normal birth weight (≥2500 g) in Singapore. We recruited 197 parents of pre-school children (aged 3-5 years) who completed a socio-demographic questionnaire and the HomeSTEAD questionnaire, which examined food parenting practices. Among parents, 98 (49.8%) and 99 (50.2%) had children who were normal (NBW) and low birth weight (LBW) respectively. Parents of children with LBW had lower scores in one Autonomy Support practice (Encouragement) and three Structure practices (Meal setting, Planning and preparation of healthy meals, Rules and limits around unhealthy foods), after controlling for ethnicity and parental education. Parents of children with LBW also scored higher in one Autonomy Support practice (Guided choices: when food is given). There were no significant differences in Coercive Control practices between parents of both groups. Healthcare professionals could use this information to assess parental needs when facilitating parents' positive food parenting practices, especially among children with low birth weight.

Describing and Predicting Feeding Problems During the First 2 Years Within an Urban Pediatric Primary Care Center

We conducted a prospective cohort study with children aged 6 to 18 months to identify predictors of feeding problems in an urban sample. Parent-reported child feeding problems (Montreal Children's Hospital Feeding Scale) and picky eating, parental anxiety (Generalized Anxiety Disorder 7), and family meal structure (Meals in Our Household) were assessed via a Web-based survey at 3 time points. Data analysis included descriptive statistics, correlations, and mixed-effects regression modeling. Eighty parents completed the survey. Child picky eating (r =.51) and resistance to try new foods (r = .30), parental anxiety (r = .34), rushed mealtimes (r = .28), and child age (r = .32) were significantly associated with child feeding problems. Feeding Scale scores were, on average, 6 points higher among picky eaters than those who were not over time (p < .001). Parent reports of picky eating early in life may warrant additional clinical investigation and referral to feeding specialists.

Artificial intelligence as an analytic approximation to evaluate associations between parental feeding behaviours and excess weight in Colombian preschoolers

Parental practices can affect children's weight and BMI and may even be related to a high prevalence of obesity. Therefore, the aim of this study was to evaluate the relationship between parents' practices related to feeding their children and excess weight in preschoolers in Bucaramanga, Colombia, using artificial intelligence. A cross-sectional study was carried out between September and December 2017. The sample included preschoolers who attended child development institutions belonging to the Colombian Institute for Family Wellbeing in Bucaramanga and the metropolitan area (n 384). The outcome variable was excess weight and the main independent variable was parental feeding practices. Confounding variables analysed included sociodemographic characteristics, food consumption, and children's physical activity. All equipment for the anthropometric measurements was calibrated. Logistic regression was used to predict the effect of parental practices on the excess weight of the children, and the AUC was used to measure performance. The parental practices with the greatest association with excess weight in the children involved using food to control their behaviour and restricting the amount of food they offered (use of food to control emotions (OR 1·77; 95 % CI 1·45, 1·83; P = 0·034) and encouraging children to eat less (OR 1·22; 95 % CI 1·14, 1·89; P = 0·045)). Childrearing practices related to feeding were found to be an important predictor of excess weight in children. The results of this study represent implications for public health considering this as a baseline for the design of nutrition education interventions focused on parents of preschoolers.

Gender and racial/ethnic differences in food selectivity in children with intellectual disabilities

BACKGROUND

We examined differences in food selectivity by gender and parent race/ethnicity in children with intellectual disabilities.

METHOD

A convenience sample of 56 children with intellectual disabilities was analysed. A modified Youth/Adolescent Food Frequency Questionnaire and a 3-day food record were used to measure child food refusal rate and food repertoire, respectively.

RESULTS

Boys were about twice as likely to refuse total foods (rate ratio = 2.34, 95%CI = 1.34-4.09) and fruits (rate ratio = 2.03, 95%CI = 1.04-3.95) and 54% more likely to refuse vegetables (rate ratio = 1.54, 95%CI = 0.93-2.54). Children with Hispanic parents were twice as likely to refuse vegetables compared to children with non-Hispanic White parents (rate ratio = 2.00, 95%CI = 1.03-3.90). In analyses stratified by the presence or absence of co-occurring probable autism spectrum disorder, boys had greater food selectivity than girls.

CONCLUSIONS

This study expands our understanding of food selectivity in children with intellectual disabilities.

Identifying and predicting food parenting practice profiles among Canadian parents

Background

Food parenting practices (FPP) can affect children’s eating behaviours, yet little is known about how various FPP co-occur. The primary aim was to identify profiles of FPPs use among Canadian parents. Secondary aims included examining sociodemographic correlates of FPP profiles and evaluating whether children’s eating behaviours differed across FPP profiles.

Methods

Parents (n = 799) of 5–12-year-old children completed a validated FPP Item Bank and the Children’s Eating Behaviour Questionnaire. Latent Class Analysis (LCA) was used to identify distinct FPP profiles. Regression analyses were used to explore associations between FPP profiles, sociodemographic variables (race, sex and education) and children’s eating behaviours (emotional overeating, food responsiveness, food fussiness and satiety responsiveness).

Results

LCA revealed 6 FPP profiles: healthy eating environment, high engagement, reactive, high structure, controlling and low engagement. Relative to their non-White counterparts, White parents were more likely to belong in the healthy eating environment, high structure and low engagement profiles. Relative to fathers, mothers were more likely to fall in the healthy eating environment compared to low engagement profile. Parents with some post-secondary education were more likely to belong in the healthy eating environment, high structure and reactive profiles compared to the controlling profile. Emotional overeating and food responsiveness scores were lowest for healthy eating environment, high structure, low engagement profiles. Parents in the healthy eating environment profile also reported lower food fussiness scores compared to parents in the high engagement, high structure, reactive and controlling profiles.

Conclusions

Findings suggest that a continuum of 6 FPP profiles may be present among Canadian parents, representing parents who use either all (high engagement), some (healthy eating environment, reactive, high structure, controlling) or little (low engagement) of the FPP examined. Future longitudinal research should evaluate how various FPP profiles influence the development of children’s eating behaviors, dietary intakes and weight status.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01119-6.

Low-Income Caregivers' Attitudes and Behaviors on Children's Diets: Emergent Themes on Cultural Influences and Perceived Value of Nutrition Information from Healthcare Providers

INTRODUCTION

Limited access to affordable, healthy food and identifying as African-American or Hispanic-American are associated with greater risk of childhood obesity, especially for low-income individuals.

PURPOSE

To report on (1) the emergent theme of the influence of culture on primary caregivers' behaviors and motivations when preparing meals for their families; and (2) primary caregivers' perceptions of the nutritional information they receive from health care providers.

METHODS

Twelve focus groups with low-income, adult primary caregivers of children ages 3 to 6 years were conducted in Texas and the DC-Maryland-Virginia region and were segmented by race/ethnicity and access to grocery stores.

RESULTS

Culture emerged as an important theme in influencing which foods participants cook at home. In some cases, that influence spilled over into the child's diet. In other instances, the food that participants reported making for their children varied from the food they make for themselves. Participants reported having high trust in health care providers, but acknowledged that health care providers' nutritional advice might not always be applicable.

DISCUSSION AND CONCLUSIONS

Our findings highlight the importance of considering the role culture might play in influencing and informing caregivers' decisions regarding children's diets, and also better understanding caregivers' perceptions of health care providers as a source of nutrition information for their children.

Parental feeding practices across child's weight status: Evidence of the Italian validation of the Child Feeding Questionnaire

OBJECTIVE

The main aim of this study was to assess the psychometric proprieties of the Child Feeding Questionnaire (CFQ) in Italian mothers.

DESIGN

Mothers completed the Italian version of the CFQ, and children's anthropometric data were collected. Construct validity of the CFQ was assessed by comparing three different models: (a) a seven correlated factors model in which all items were analysed; (b) a seven correlated factors model with composite items based on the Restriction factor and (c) an eight correlated factors model with a separate Reward factor. Measurement invariance using BMI categories and gender was evaluated. Furthermore, discriminant validity with group comparison was performed between BMI categories and gender.

SETTING

Italy.

PARTICIPANTS

A total of 1253 6-year-old Italian children (53·9 % male) attending elementary school (1st grade) and their mothers (mean age = 38·22 years; sd = 4·89) participated in this study.

RESULTS

The eight-factor model with a separate reward factor provided the best fit for the data. The strict invariance of the CFQ across child BMI categories and gender was confirmed. The CFQ internal consistency was acceptable for most subscales. However, two subscales showed no adequate values. As expected, the CFQ scales showed significant differences between BMI categories, while no gender-related differences were found.

CONCLUSIONS

The study indicated the Italian version of the CFQ to be factorially valid for assessing parental feeding practices of 6-year-old children across BMI categories. Future research should address low internal consistency in some of the CFQ subscales.

Grow well/Crecer bien: a protocol for research on infant feeding practices in low-income families

BACKGROUND

The prevalence of obesity among children remains high. Given obesity's significant lifelong consequences, there is great interest in preventing obesity early in life. There is a need to better understand the relation of common infant feeding styles and practices to obesity in infants using longitudinal study designs. There is also an urgent need to understand the role of caregivers other than mothers in feeding. A better understanding of variation in feeding styles and practices can inform the identification of risk groups and the tailoring of interventions to them.

METHODS

In partnership with Early Head Start programs across four counties in southern California, mothers and infants will be enrolled in a two-year longitudinal study collecting survey and anthropometric data. A subsample of mothers and their selected other caregivers will participate in qualitative research involving feeding diaries and dyadic interviews. The results will be used to develop and test an enhanced nutrition education program.

DISCUSSION

We outline a study methodology to examine feeding styles and practices and their association with early childhood obesity risk and enhance an existing intervention to promote healthy infant feeding and growth among children in low-income families.

Using a social marketing approach to develop Healthy Me, Healthy We: a nutrition and physical activity intervention in early care and education

Although social marketing principles have been successfully employed in school-based interventions to prevent obesity, use in early care and education (ECE) settings has been limited. This paper describes the use of the social marketing approach to develop an ECE-based intervention that encourages an ECE provider-parent partnership to improve the quality of preschool children's diets and their level of physical activity. A six-step social marketing approach for public health interventions guided the development of this ECE-based intervention. These steps were as follows: (i) initial planning, (ii) formative research, (iii) strategy development, (iv) program development, (v) implementation, and (vi) monitoring and evaluation. During this process, we reviewed current literature, conducted focus groups with ECE providers and parents, developed a detailed conceptual model and content map, created and tested the campaign concept, and developed final campaign materials along with strategies for its implementation. The final intervention resulting from this process was an 8-month campaign known as Healthy Me, Healthy We. The campaign is delivered by the child care center and includes branded materials for use in the classroom and at home. The final campaign is being evaluated in a cluster-randomized trial. Healthy Me, Healthy We offers an innovative approach to promoting healthy eating and physical activity during early childhood, a key developmental period, that leverages partnership between ECE providers and parents to affect behavior change.

Young adult nutrition and weight correlates of picky eating during childhood

OBJECTIVE

To identify whether picky eating during childhood is associated with dietary intake, weight status and disordered eating behaviour during young adulthood.

DESIGN

A population-based study using data from young adults who responded online or by mail to the third wave of the Project EAT (Eating and Activity in Teens and Young Adults) study in 2008-2009. Participants retrospectively reported the extent to which they were a picky eater in childhood, sociodemographic characteristics, disordered eating behaviours, usual dietary intake, and weight and height.

SETTING

Participants were initially recruited in the Minneapolis/St. Paul metropolitan area of Minnesota, USA, in 1998-1999.

PARTICIPANTS

The analytic sample included 2275 young adults (55 % female, 48 % non-Hispanic White, mean age 25·3 (sd 1·6) years).

RESULTS

Young adults who reported picky eating in childhood were found to currently have lower intakes of fruit, vegetables and whole grains, and more frequent intakes of snack foods, sugar-sweetened beverages and foods from fast-food restaurants. No associations were observed between picky eating in childhood and young adults' weight status, use of weight-control strategies or report of binge eating.

CONCLUSIONS

While young adults who report picky eating during childhood are not at higher risk for disordered eating, those who were picky eaters tend to have less healthy dietary intake. Food preferences and dietary habits established by picky eaters during childhood may persist into adulthood.

Maternal Depressive Symptoms and Perceived Picky Eating in a Low-Income, Primarily Hispanic Sample

OBJECTIVE

Feeding concerns are common in the first 2 years of life and typically reflect maternal perceptions occurring within the larger context of the parent-child relationship. We aimed to determine whether (1) maternal depressive systems predicted perceived picky eating, mediated by maternal negative perceptions; (2) receipt of the Video Interaction Project (VIP) parenting intervention impacted perceived picky eating through this pathway; and (3) perceived picky eating was associated with child growth or subsequent dietary patterns.

METHODS

We performed a partial longitudinal analysis of 187 low-income, predominantly Hispanic mother-child dyads enrolled in a randomized controlled trial of the VIP. Mother-infant dyads were enrolled postpartum in an urban public hospital. Participants randomized to the VIP met with an interventionist on days of well-child visits; sessions were designed to facilitate interactions in play and shared reading through provision of learning materials and review of videotaped parent-child interaction; the curriculum did not contain feeding-specific elements. We used structural equation modeling to determine direct, indirect, and total effects of maternal depressive symptoms, maternal negative perceptions, and the VIP on perceived picky eating. We then tested associations between perceived picky eating and (1) child growth, using multivariable linear regression and multilevel modeling; and (2) subsequent child dietary consumption, using multivariable multinomial logistic regression.

RESULTS

Maternal depressive symptoms had significant total effects on negative maternal perceptions (β = 0.32, p < 0.001) and perceived picky eating (β = 0.21, p < 0.01) after controlling for potential confounders. This effect was partially mediated by maternal negative perceptions (indirect effect: β = 0.06, p = 0.04). When used in the model as the predictor, the VIP had a significant total effect on perceived picky eating (β = -0.16, p = 0.02), which was partially mediated by maternal depressive symptoms and negative perceptions (indirect effect: β = -0.05, p = 0.02). Perceived picky eating was not associated with child diet at age 2 years or adiposity from 6 months to 3 years.

CONCLUSION

Maternal concerns about picky eating may reflect deeper depressive symptoms and negative perceptions of her child's behavior. Interventions designed to facilitate positive parenting in general may lessen feeding-specific concerns, such as picky eating. Although reassurance about growth and nutritional outcomes for children perceived as picky eaters is appropriate, clinicians should also consider probing for underlying symptoms of depression that could lead to eating concerns.

Appetitive Traits and Weight in Children: Evidence for Parents' Controlling Feeding Practices as Mediating Mechanisms

Children's food approach and food avoidance are appetitive traits with genetic or biological bases. Nonetheless, parents play a critical role in children's dietary intake through parenting and feeding practices. The present study tested parents' controlling feeding practices (i.e., restriction and pressure to eat) as mediating mechanisms between child appetitive traits and child BMI in an economically and ethnically diverse sample. Participants were 139 children aged 4 to 6 years (51.8% males, M = 4.77 years, SD = 0.84) and their parents. Results showed that restriction and pressure to eat mediated the relation between child food approach or food avoidance and child BMI. Mediation effects did not differ across poverty status or racial/ethnic groups. Also, the type of controlling feeding that parents exert related to children's weight status in diametrically different or opposite ways. Thus, food-related parenting appears to be a promising point of entry for childhood obesity prevention programs. Findings are consistent with a biopsychosocial model of the development of eating and weight in childhood which takes into account both parent and child behavior and characteristics and links child biology and behavior with psychosocial processes and environment.

Association of food parenting practice patterns with obesogenic dietary intake in Hispanic/Latino youth: Results from the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth)

Some food parenting practices (FPPs) are associated with obesogenic dietary intake in non-Hispanic youth, but studies in Hispanics/Latinos are limited. We examined how FPPs relate to obesogenic dietary intake using cross-sectional data from 1214 Hispanic/Latino 8-16-year-olds and their parents/caregivers in the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth). Diet was assessed with 2 24-h dietary recalls. Obesogenic items were snack foods, sweets, and high-sugar beverages. Three FPPs (Rules and Limits, Monitoring, and Pressure to Eat) derived from the Parenting strategies for Eating and Activity Scale (PEAS) were assessed. K-means cluster analysis identified 5 groups of parents with similar FPP scores. Survey-weighted multiple logistic regression examined associations of cluster membership with diet. Parents in the controlling (high scores for all FPPs) vs. indulgent (low scores for all FPPs) cluster had a 1.75 (95% CI: 1.02, 3.03) times higher odds of having children with high obesogenic dietary intake. Among parents of 12-16-year-olds, membership in the pressuring (high Pressure to Eat, low Rules and Limits and Monitoring scores) vs. indulgent cluster was associated with a 2.96 (95% CI: 1.51, 5.80) times greater odds of high obesogenic dietary intake. All other associations were null. Future longitudinal examinations of FPPs are needed to determine temporal associations with obesogenic dietary intake in Hispanic/Latino youth.

Exploratory factor analysis of The Comprehensive Feeding Practices Questionnaire (CFPQ) in a low-income hispanic sample of preschool aged children

The Comprehensive Feeding Practices Questionnaire (CFPQ) is an important measure to assess parent feeding practices as it encompasses a broad range of feeding behaviors, not just behaviors negatively associated with child weight outcomes. However, parent feeding practices have been shown to differ across ethnicities and the CFPQ has not been tested among low-income, Hispanic-American parents with preschool-aged children, a group at elevated risk for developing obesity. A confirmatory factor analysis was performed with the present Hispanic-American sample of Head Start mothers with preschoolers to confirm the original 12-factor, 49-item structure of the CFPQ. Because the original factor structure was not confirmed in the present Hispanic-American sample, an exploratory factor analysis was conducted to examine the psychometric properties of the CFPQ in this sample (n = 187). Among this sample, a five-factor model with 34 items was found to more appropriately assess parent feeding practices than the original 12-factor, 49-item CFPQ. This study provides preliminary validation of the CFPQ for use among low income, Hispanic-American families. Although future research is needed to replicate findings among a larger sample, this study takes an important first step toward more accurately assessing parent feeding practices among this high-risk population to inform tailored interventions that aim to reduce economic and ethnic disparities in child obesity.

Latino-American Mothers’ Perspectives on Feeding Their Young Children: A Qualitative Study

OBJECTIVE. We explored the cultural beliefs that influence Latino-American mothers’ feeding practices with their young children and the sources they referenced in making food choices for their children.

METHOD. We conducted semistructured interviews with 12 Latino-American mothers focusing on their experiences of feeding their young children. Data analysis, based in grounded theory, consisted of interview transcription, content analysis, coding, and theme development.

RESULTS. We identified four themes summarizing the mothers’ feeding practices: (1) “Grandma knows best,” (2) “I want my child(ren) to be healthy,” (3) “always soup and always rice,” and (4) “mealtime is family time.”

CONCLUSION. Occupational therapy practitioners need to obtain accurate information from families about feeding practices and to understand and interpret those practices in broader cultural contexts to design and implement targeted feeding intervention strategies that avoid stereotyping or misinterpreted information. To promote family-centered, meaningful interventions, practitioners must understand the cultural influences on feeding practices and be sensitive to mothers’ needs.

Social and economic influences on infant and child feeding practices in a Marshallese community

OBJECTIVE

The present study aimed to examine the key influences on infant and child feeding practices among a Marshallese community at each social ecological level. It is the first study to examine the key influences on infant and child feeding practices with Marshallese immigrant women in the USA and helps fill a gap in the previous literature that has included other immigrant women.

DESIGN

Community-based participatory research design with twenty-seven participants taking part in four qualitative focus groups.

SETTING

The study took place within the Marshallese community in Arkansas, USA.ParticipantsParticipants included Marshallese women with children aged 1-3 years and/or caregivers. Caregivers were defined as someone other than the parent who cares for children. Caregivers were often older women in the Marshallese community.

RESULTS

There were five primary themes within multiple levels of the Social Ecological Model. At the intrapersonal level, mothers' and caregivers' autonomy emerged. At the interpersonal level, child-led and familial influences emerged. At the organizational level, health-care provider influences emerged; and at the policy level, the Special Supplemental Nutrition Program for Women, Infants, and Children emerged as the most salient influence.

CONCLUSIONS

Marshallese immigrant women's infant and child feeding practices are influenced at intrapersonal, interpersonal, organizational and policy levels. Understanding these multidimensional influences is necessary to inform the creation of culturally tailored interventions to reduce health disparities within the Marshallese community.

The Sociocultural Factors Underlying Latina Mothers' Infant Feeding Practices

In this study, we examined the sociocultural factors underlying infant feeding practices. We conducted four focus groups with 19 Latina mothers of children 0 to 2 years of age enrolled in Early Head Start programs in the United States over a 1-year period. We found these mothers considered both science- and family-based feeding recommendations. However, advice from family was often inconsistent with science- and nutrition-based recommended feeding practices. In the interest of showing respect and preserving harmonious relationships, some mothers accepted family advice instead of recommended practices while others employed strategies to follow recommended practices without offending. Nutrition educators need to consider the intersection of macro, organizational, and community factors with micro-level processes in shaping the implementation of recommended feeding practices within family systems. Nutrition interventions for Latino families should capitalize on Latina mothers’ strategies for navigating multiple information sources while preserving cultural values and family relationships.

Parental Feeding Beliefs and Practices and Household Food Insecurity in Infancy

OBJECTIVE

Food insecurity is associated with childhood obesity possibly mediated through caregiver feeding practices and beliefs. We examined if caregiver feeding practices differed by household food security status in a diverse sample of infants. We hypothesized that feeding practices differ based on food security status.

PATIENTS AND METHODS

Included in the baseline cross-sectional analysis of data from a randomized controlled trial to prevent obesity were 842 caregivers of 2-month-old infants presenting for well-child care at 4 academic institutions. Food insecurity exposure was based on an affirmative answer to 1 of 2 items in a 2-item validated questionnaire. Chi-square tests examined the association between parent feeding practices and food security status. Logistic regression adjusted for covariates. Differences in caregiver feeding practices by food security status and race/ethnicity were explored with an interaction term (food security status x race/ethnicity).

RESULTS

Forty-three percent of families screened as food insecure. In adjusted logistic regression, parents from food-insecure households were more likely to endorse that "the best way to make an infant stop crying is to feed him or her" (adjusted odds ratio [aOR], 1.72; 95% confidence interval [CI], 1.28-2.29) and "when my baby cries, I immediately feed him or her" (aOR, 1.40; 95% CI, 1.06-1.83). Food-insecure caregivers less frequently endorsed paying attention to their baby when he or she is full or hungry (OR, 0.57; 95% CI, 0.34-0.96). Racial/ethnic differences in beliefs and behaviors were observed by food security status.

CONCLUSIONS

During early infancy, feeding practices differed among caregivers by household food security status. Further research is needed to examine whether these practices are associated with increased risk of obesity and obesity-related morbidity.

Home Food Environment Factors Associated With Hispanic Preschoolers' Intake of Fruits and Vegetables

The purpose of this study was to evaluate the relationship of home fruit and vegetable (F&V) availability and maternal feeding practices with Hispanic preschoolers' F&V intake (N = 238). "Availability' of total fruit" (P < .0001) and "modeling" (P < .020) increased the odds of consuming 1 or more cups of fruit. "Pressure" (P < .009) and the child being female (P < .028) increased the odds of consuming 1 or more cups of vegetables, while having a greater number of children in the home (P < .037) reduced the odds of consuming 1 or more cups of vegetables. To increase preschoolers' intake of F&V, interventions should target specific environmental factors in the home and maternal monitoring practices.

The Association Between Acculturation and Parental Feeding Practices in Families With Overweight and Obese Hispanic/Latino Children

This study examines the association between acculturation and parental feeding practices in low-income Latinos. Overweight/obese children (N = 117), aged 5 to 14 years, and their parents were recruited from a rural health clinic. Findings show that more acculturated parents have greater control over their child's eating behavior (P = .04). Parents who perceive their child as having a weight problem also have more control over their child's eating behavior (P = .02). Control measured from regulation of how much and when the child should eat to offering sweets and screen time for good behavior. Results underscore the need for interventions to consider parental acculturation and perceptions of child weight.

Infant temperament and parent use of food to soothe predict change in weight-for-length across infancy: early risk factors for childhood obesity

OBJECTIVES

Greater weight gain in infancy is a risk factor for childhood obesity. The present study examined the interaction between infant temperament and parent use of food to soothe infant distress (FTS) as predictors of weight gain across the first 2 years of life.

SUBJECTS/METHODS

A total of 160 mother-infant dyads were recruited into a longitudinal study. Infant temperament was assessed by parents through a questionnaire (surgency, negativity) and by observer ratings (surgency, irritability) during a laboratory visit when infants were 6 months old. Parents also completed a 3-day infant cry diary when their children were 6 months of age to assess when they used food in response to infant cry/fuss bouts. Infant weight/length was measured in the lab at 6 and 18 months. Multiple regressions were run to test the moderating effect of FTS on weight gain.

RESULTS

Significant interactions were revealed for both measures of surgency and parent FTS in predicting weight gain. Surgent infants whose parents had a greater tendency to use FTS had greater weight-for-length gain in 1 year than if their parents tended to use less FTS. The interaction between observer ratings of irritability and parent FTS was also significant but in an unexpected direction.

CONCLUSIONS

The findings point to the role of temperament, specifically surgency, in weight gain during infancy, but only if their parents used FTS. Surgency may have evoked this feeding practice that increased their health risk.

Parental correlates of food parenting practices: socioeconomic status, weight, and dieting status

Little research has considered how parents' socioeconomic indicators, body mass index (BMI), and dieting status relate to their food parenting. The current study used self-report data from parents of young children to examine group differences on three types of food parenting practices (Structure, Coercive Control, and Autonomy Promotion). Few group differences were found for socioeconomic indicators. However, parent dieting status moderated effects of parent BMI on structure and autonomy promotion. Obese, non-dieting parents reported lower scores on both variables. More research is needed to better understand how parents' dieting status moderates the effects of parent's weight.

Latino Fathers' Perspectives and Parenting Practices Regarding Eating, Physical Activity, and Screen Time Behaviors of Early Adolescent Children: Focus Group Findings

BACKGROUND

Involvement of Latino fathers in food and activity parenting practices has implications for child obesity prevention yet remains largely unknown.

OBJECTIVE

To explore Latino fathers' perspectives and parenting experiences regarding early adolescents' eating, physical activity, and screen-time behaviors using the focus group method.

DESIGN

Twenty-six fathers (primarily Mexican-American men) of 10- to 14-year-old children participated in one of four focus groups between March and October 2016. Focus groups were conducted in Spanish by male moderators.

PARTICIPANTS/SETTINGS

A convenience sample was recruited from three community centers and one charter school in Minneapolis/St Paul, MN.

ANALYSIS

Audiotaped focus groups were transcribed verbatim in Spanish and translated to English; transcripts were coded and analyzed for themes based on the grounded theory approach.

RESULTS

Three themes emerged including 1) paternal beliefs and concerns about early adolescents' diet, physical activity, and screen time; 2) paternal food and activity parenting practices; and 3) factors that may influence paternal involvement in promoting healthy lifestyle behaviors. Father-reported food and activity parenting practices included setting expectations and limits, role modeling, managing availability and accessibility, teaching and reasoning, monitoring, motivating, and doing things together. Factors influencing paternal involvement were identified at intrapersonal, interpersonal, and social-environmental levels, which included paternal dietary and activity behaviors, self-efficacy, time and financial constraints, parental congruency, child resistance, perceived gender role, and environmental challenges.

CONCLUSIONS

Fathers identified eight major food and activity parenting practices they use to promote a healthy lifestyle for their adolescent children and factors that influence their involvement. Health care professionals can use this information to provide culturally appropriate and specific interventions for Latino American fathers of young adolescents.

Significant differences in maternal child-feeding style between ethnic groups in the UK: the role of deprivation and parenting styles

BACKGROUND

Nonresponsive maternal child-feeding interactions, such as restricting, pressurising and emotional feeding, can affect the ability of a child to self-regulate intake and increase the risk of becoming overweight. However, despite findings that South Asian and Black children living in the UK are more likely to be overweight, UK research has not considered how maternal child-feeding style might differ between ethnic groups. The present study aimed to explore variations in maternal child-feeding style between ethnic groups in the UK, taking into account associated factors such as deprivation and parenting style.

METHODS

Six hundred and fifty-nine UK mothers with a child who was aged 5-11 years old completed a questionnaire. Items included ethnicity and demographic data, as well as copies of the Child Feeding Questionnaire, Parental Feeding Styles Questionnaire and Parenting Styles and Dimensions Questionnaire.

RESULTS

Significant differences in perceived responsibility (P = 0.002), restriction (P = 0.026), pressure to eat (P = 0.045), instrumental feeding (P = 0.000) and emotional feeding (P = 0.000) were found between the groups. Mothers from South Asian backgrounds reported higher levels of pressure to eat, emotional feeding and indulgent feeding styles, whereas mothers from Chinese backgrounds reported greater perceived responsibility and restriction. Mothers from Black and White British backgrounds were not significantly higher with respect to any behaviour. Maternal child-feeding style was also associated with deprivation and parenting style, although these did not fully explain the data.

CONCLUSIONS

Understanding cultural factors behind maternal child-feeding style, particularly around pressurising and indulgent feeding behaviours, may play an important part in reducing levels of children who are overweight and obese in the UK.

Parental experiences and perceptions of infant complementary feeding: a qualitative evidence synthesis

BACKGROUND

Interventions to prevent childhood obesity increasingly focus on infant feeding, but demonstrate inconsistent effects. A comprehensive qualitative evidence synthesis is essential to better understand feeding behaviours and inform intervention development. The aim of this study is to synthesize evidence on perceptions and experiences of infant feeding and complementary feeding recommendations.

METHODS

Databases CINAHL, EMBASE, MEDLINE, PsycINFO, Academic Search Complete, SocIndex and Maternity and Infant Care were searched from inception to May 2017. Eligible studies examined parents' experiences of complementary feeding of children (<2 years). Data were synthesized using thematic synthesis.

RESULTS

Twenty-five studies met inclusion criteria for review. Four key themes emerged. 'Guidelines and advice' highlights variety and inconsistencies between sources of complementary feeding information. 'Stage of weaning' describes infant feeding as a process involving different stages. 'Knowing and trying' outlines parents' engagement in feeding approaches based on instinct, prior experience or trial and error. 'Daily life' highlights problematic cost and time constraints for parents.

DISCUSSION

Parents predominantly understand and want to engage in healthy feeding processes. Consideration of infant feeding as a process that changes over time is necessary to support parents. Provision of clear, consistent information and guidance from trusted sources on when, what and how to feed is also essential.

Psychometric properties of the intuitive eating scale-2 (IES-2) in a culturally diverse Hispanic American sample

BACKGROUND

Intuitive eating is an adaptive eating tendency consistently associated with positive physical and mental health outcomes, including lower risk for obesity and eating disorders (EDs). Obesity rates are disproportionately high in Hispanic American populations, yet the properties of intuitive eating remain to be examined in such samples.

METHOD

The current study examined the psychometric properties of the Intuitive Eating Scale-2 (IES-2) in a Hispanic American sample of adult college students (N=482), and related IES-2 scores to levels of disordered eating, body mass index (BMI), fruit and vegetable consumption, and body shape satisfaction.

RESULTS

The final confirmatory factor analysis supported a three factor, 11 item measure with the subscales of Eating for Physical Rather Than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Body Food Choice Congruence. The Unconditional Permission to Eat subscale could not be replicated in the current sample. As predicted, scores on the revised measure differed by BMI category and body shape satisfaction, and correlated with disordered eating tendencies and fruit and vegetable consumption.

CONCLUSION

The current findings demonstrate that the modified IES-2 is better tailored to assess the cultural nuances influencing intuitive eating and can advance understanding how intuitive eating is understood and practiced in Hispanic Americans, compared to the original measure.

Effects of healthcare professional delivered early feeding interventions on feeding practices and dietary intake: A systematic review

BACKGROUND

Childhood obesity is a global public health challenge. Parental feeding practices, such as responsive feeding, are implicated in the etiology of childhood obesity.

PURPOSE

This systematic review aimed to examine of effects of healthcare professional-delivered early feeding interventions, on parental feeding practices, dietary intake, and weight outcomes for children up to 2 years. The role of responsive feeding interventions was also specifically examined.

METHODS

Databases searched included: CINAHL, the Cochrane Library, EMBASE, Medline, PubMed, PsycINFO, and Maternity and Infant Care.

INCLUSION CRITERIA

participants are parents of children ≤2 years; intervention includes focus on early child feeding to prevent overweight and obesity; intervention delivered by healthcare professionals.

RESULTS

Sixteen papers, representing 10 trials, met inclusion criteria for review. Six interventions included responsive feeding components. Interventions demonstrated inconsistent effects on feeding practices, dietary intake, and weight outcomes. Findings suggest some reductions in pressure to eat and infant consumption of non-core beverages. Responsive feeding based interventions demonstrate greater improvements in feeding approaches, and weight outcomes.

CONCLUSIONS

The findings of this review highlight the importance of incorporating responsive feeding in healthcare professional delivered early feeding interventions to prevent childhood obesity. Observed inconsistencies across trials may be explained by methodological limitations.

Psychometric properties of the Parental Feeding Behaviours Questionnaire for Indonesian parents of young children

PURPOSE

The objective of this study was to test the psychometric properties of the Parental Feeding Behaviours Questionnaire (PFBQ) to measure feeding behaviours of Indonesian parents of toddlers (young children).

METHODS

A total of 696 parents of toddlers were obtained by convenience sampling during September 2013 to April 2014. To validate the PFBQ, confirmatory factor analysis and the contrasted group technique were conducted. Reliability of this instrument was examined by construct reliability and test-retest reliability.

RESULTS

Results showed that the regression coefficients of all 56 indicators were statistically significant (P < 0.001). The contrasted group technique showed significantly different parental feeding behaviours between parents of well-nourished and malnourished toddlers (P = 0.047). The test-retest reliability of the PFBQ was acceptable (Pearson correlation = 0.644), and the construct reliability ranged from 0.88 to 0.96.

CONCLUSIONS

The PFBQ is a valid and reliable instrument; however, more studies are required to identify acceptable tools to measure more culturally diverse range of parental feeding behaviours.

Sociocultural and Environmental Influences on Brazilian Immigrant Mothers' Beliefs and Practices Related to Child Feeding and Weight Status

Background Length of residence in the United States (US), changes in dietary and physical activity behaviors, and economic and social barriers contribute to high childhood obesity rates among children from immigrant families in the US. Brazilians comprise a fast-growing immigrant population group in the US, yet little research has focused on health issues affecting Brazilian children in immigrant families. Understanding sociocultural and environmental influences on parents' beliefs and practices related to child feeding and weight status is essential to altering obesity trends in this group. Methods Qualitative study consisting of five focus groups with a convenience sample of 29 Brazilian immigrant mothers. Results Analyses revealed that the sociocultural and environment transitions faced by Brazilian immigrant mothers' influence their beliefs and practices related to child feeding and weight status. Additionally, acculturation emerged as a factor affecting mothers' feeding practices and their children's eating habits, with mothers preferring Brazilian food environments and that their children preferring American food environments. Mothers viewed themselves as being responsible for promoting and maintaining their children's healthy eating and feeding behaviors, but changes in their social and cultural environments due to immigration and the pressures and demands of raising a family in a new country make this difficult. Conclusions Health promotion interventions to improve healthful eating and feeding practices of Brazilian children in immigrant families must account for social and cultural changes and daily life demands due to immigration as well as potential variation in the levels of acculturation between mothers and their children.

Feeding styles, parenting styles and snacking behaviour in children attending primary schools in multiethnic neighbourhoods: a cross-sectional study

OBJECTIVE

The aim of the present study was to investigate whether feeding styles and parenting styles are associated with children's unhealthy snacking behaviour and whether the associations differ according to children's ethnic background.

METHOD

Cross-sectional data from the population-based 'Water Campaign' study were used. Parents (n=644) of primary school children (6-13 years) completed a questionnaire covering sociodemographic characteristics, feeding style dimensions ('control over eating', 'emotional feeding', 'encouragement to eat' and 'instrumental feeding'), parenting style dimensions ('involvement' and 'strictness') and children's unhealthy snacking behaviour. Logistic regression analyses were performed to determine whether feeding styles and parenting styles were associated with children's unhealthy snacking behaviour.

RESULT

Overall, children whose parents had a higher extent of 'control over eating' had a lower odds of eating unhealthy snacks more than once per day (OR, 0.57; 95% CI 0.42 to 0.76). Further stratified analysis showed that 'control over eating' was associated with less unhealthy snacking behaviour only in children with a Dutch (OR, 0.37; 95% CI 0.20 to 0.68) or a Moroccan/Turkish (OR, 0.44; 95% CI 0.25 to 0.77) ethnic background. 'Encouragement to eat' was associated with a lower odds of eating unhealthy snacks every day in children with a Dutch ethnic background only (OR, 0.48; 95% CI 0.25 to 0.90). 'Instrumental feeding' was associated with a higher odds of eating unhealthy snacks more than once a day in children with a Moroccan/Turkish ethnic background only (OR, 1.43; 95% CI 1.01 to 2.04).

CONCLUSION

Our results suggest that 'control over eating' may be associated with less unhealthy snack consumption in children. The associations of feeding styles and parenting styles with children's unhealthy snacking behaviour differed between children with different ethnic backgrounds.

Parental Feeding Style and Pediatric Obesity in Latino Families

INTRODUCTION

Pediatric obesity has become an epidemic in the United States. Previous research has shown that parenting factors related to feeding style affect child weight and that Latino families are especially at risk for pediatric obesity. The goal of the current study was to evaluate the relationship between parental feeding style and child body mass index (BMI) in Latino families.

METHOD

Latino parents of children between the ages of 2 and 8 ( N = 124) completed a survey on parental feeding styles, acculturation, and demographics. The outcome variable was child BMI.

RESULTS

Among respondents, 89% were mothers, 72% were overweight or obese, and 40% reported an indulgent feeding style. Children had a mean age of 59 months ( SD = 23.8) and a mean BMI z score of 0.77 ( SD = 1.14). A demanding parental feeding style was associated with lower child BMI z score, r = -.179, p < .05, and higher acculturation level, r = .213, p < .05.

CONCLUSIONS

Findings from the current study can be used to inform health care practitioners of the need to use culturally sensitive interventions that consider parents' feeding behaviors. Future research is warranted in the area of ethnic variations of parenting and how these affect feeding and obesity in this highly vulnerable population.

Home Environmental Influences on Childhood Obesity in the Latino Population: A Decade Review of Literature

Latinos are the largest and fastest-growing ethnically diverse group in the United States. Latino children are also among the most overweight and obese ethnic groups of children in the United States. Research over the last decade has identified the home environment as a key influence on the diet and physical activity of children. To summarize cross-sectional and longitudinal research that has identified factors within the home environment of Latino families that are associated with childhood obesity and to provide recommendations for future research and intervention development with Latino families. A decade review from 2005 to 2015 was conducted. Studies identifying factors within the home environments of Latino families that were associated with childhood obesity were examined. Five main factors were identified across the literature as home environment factors that are associated with childhood obesity in Latino children. These factors included: parental influences (e.g., parent feeding practices, modeling), screen time, physical activity/sedentary behavior, socioeconomic status/food security and sleep duration. The current review identified several home environment factors that may contribute to the disparities in childhood obesity for Latino children. Results from this review such as, focusing on decreasing controlling parent feeding practices, and increasing parent modeling of healthy behaviors and child sleep duration, can be used in developing culturally-specific interventions for Latino children.

Associations between feeding practices and maternal and child weight among mothers who do and do not correctly identify their child's weight status

OBJECTIVE

This study aimed to explore factors associated with accuracy of maternal weight perception and determine if maternal feeding practices are associated with weight status.

METHODS

Overweight/obese mothers reported demographics and perception of their child's weight and completed a modified preschooler feeding questionnaire. Mother's and child's height and weight were measured. Logistic regression was used to explore associations between demographic factors and accuracy. Correlations between the preschooler feeding questionnaire scales and mom's body mass index (BMI) and child's BMI-percentile were explored for the total sample and accurate and underestimating moms.

RESULTS

Among mothers whose child was overweight or obese, only 20% of mothers correctly identified the child as overweight. Forty percent of moms were underestimaters. There was a positive correlation between concern the child was overweight/overeating and the child's BMI-percentile among underestimating moms; in the total sample (r = 0.32, p < .001) and accurate moms (r = 0.52, p < .001). In underestimaters only, there was a negative relationship between child BMI-percentile and pressure to eat (r = -0.30, p < .001) and concern about child underweight (r = -0.47, p < .001).

CONCLUSIONS

This study identified different associations between child weight and mother's feeding practices in mothers accurately and inaccurately perceiving her child's weight. Intervention studies should explore targeting education on feeding practices based on these perceptions.

Do Maternal Caregiver Perceptions of Childhood Obesity Risk Factors and Obesity Complications Predict Support for Prevention Initiatives Among African Americans?

Objectives African American maternal caregiver support for prevention of childhood obesity may be a factor in implementing, monitoring, and sustaining children's positive health behaviors. However, little is known about how perceptions of childhood obesity risk factors and health complications influence caregivers' support of childhood obesity prevention strategies. The objective of this study was to determine if childhood obesity risk factors and health complications were associated with maternal caregivers' support for prevention initiatives. Methods A convenience sample of maternal caregivers (N = 129, ages 22-65 years) completed the childhood obesity perceptions (COP) survey. A linear regression was conducted to determine whether perceptions about childhood obesity risk factors and subsequent health complications influenced caregivers' support for prevention strategies. Results Caregivers' perceptions of childhood obesity risk factors were moderate (M = 3.4; SD = 0.64), as were their perceptions of obesity-related health complications (M = 3.3; SD = 0.75); however, they perceived a high level of support for prevention strategies (M = 4.2; SD = 0.74). In the regression model, only health complications were significantly associated with caregiver support (β = 0.348; p < 0.004). Conclusions Childhood obesity prevention efforts should emphasize health complications by providing education and strategies that promote self-efficacy and outcome expectations among maternal caregivers.

Evaluating Latino WIC Mothers' Perceptions of Infant's Healthy Growth: A Formative Assessment

OBJECTIVES

This article reports on a formative assessment with Latino mothers in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) evaluating knowledge, attitudes and behaviors regarding healthy growth for infants and their understanding of infant growth monitoring. Further, we explored the acceptability and feasibility of mothers' monitoring their infants' growth. This assessment includes healthy growth perceptions from mothers, caregivers and from WIC staff.

METHODS

Utilizing a mixed method approach, this assessment included qualitative focus groups with WIC mothers that included a growth chart plotting exercise and a quantitative survey. In-depth interviews with clinic staff discussing protocols used in assessing children's growth were also conducted in one WIC clinic.

RESULTS

Focus group participants included 34 mothers and 19 caregivers with a mean age of 32 years; 90 % identified as Latino. Themes included concern for underweight status, and reports of limited conversations between mothers and healthcare providers regarding overweight status, and infant feeding practices/beliefs that may contribute to feeding behaviors associated with risk for excess weight gain during infancy. Growth charts were well received, mothers were able to plot with modest accuracy; but effectiveness of growth plotting might be limited without refinement for health literacy and the provision of culturally-sensitive education in relation to feeding behaviors to support healthy infant growth.

CONCLUSIONS

This represents a first effort in evaluating Latino mothers' perceptions of infants' healthy growth and use growth charts as a potential tool that can help prevent excess weight gain in early infancy.

African-American and Hispanic children's beverage intake: Differences in associations with desire to drink, fathers' feeding practices, and weight concerns

Relationships of African-American and Hispanic fathers' feeding practices and weight concerns and preschoolers' desire to drink with children's beverage intake were examined, and associations between fathers' feeding practices and children's weight status were evaluated. Fathers' (Hispanic n = 61, African-American n = 49) difficulty in child feeding, use of food to calm, use of food as reward, and concern about the child being under and overweight as well as their child's desire to drink were assessed. Preschoolers' (ages 2 to 5) total sugar-sweetened beverage (SSB), fruit juice, and water intake were measured by a modified beverage intake questionnaire. Body Mass Index (BMI) and BMI percentile were calculated for fathers and children, respectively. Multiple regressions revealed that, in Hispanics, difficulty in feeding, concern about underweight, use of food to calm, and use of food as a reward were significantly associated with child intake of total SSB, whereas, in African-Americans, child desire to drink was associated with total SSB and fruit juice. Concern about the child being underweight was inversely associated with child BMI percentile in Hispanics. Significant differences in regression coefficients of child SSB intake to fathers' behaviors versus child desire to drink between the two racial-ethnic groups indicated that use of food to calm the child predicted increased intake of SSB by Hispanic but not by African-American children, while child desire to drink predicted increased intake of SSB by African-American but not by Hispanic children. Because of these significant differences, future research might profitably explore socio-cultural influences on associations of additional child feeding behaviors with fathers' attempts to control them. Furthermore, practitioners should consider developing and evaluating different child obesity interventions for these two racial-ethnic groups.

Barriers for Hispanic Caregivers With Obese Preschool Children

INTRODUCTION

Childhood obesity is a growing epidemic, and the rates are disproportionately higher in minorities. Clinical guidelines have contributed to decreased prevalence overall, but the rates in Hispanic preschoolers have increased.

METHOD

This review of the literature summarizes the perceptions and beliefs of caregivers of Hispanic preschool children regarding weight status and feeding behaviors, as well as the perceived cultural barriers to guideline adherence. A search of the CINAHL, PubMed, Joanna Briggs, and Global Health databases identified studies performed between January 1, 2008, and April 1, 2016. Search terms included Hispanics, guideline adherence, gap, barriers, obesity, overweight, and attitude to obesity.

RESULTS

Fifteen studies met the inclusion criteria, including some about Hispanic caregivers of preschool-aged children. Several cultural perceptions and beliefs were identified.

CONCLUSION

Further study is needed to develop more culturally relevant and sensitive guidelines and to design specific and effective interventions for this population.

Changing maternal perceptions of healthy feeding: a novel intervention

OBJECTIVE

This study sought to better understand factors influencing mothers' perceptions about healthy feeding. Additionally, a social consensus intervention was used to try to change mothers' likelihood to serve healthy foods.

METHODS

Mothers saw photographs of healthy and unhealthy snacks and meals and rated them on several factors that were hypothesized to predict the likelihood of serving the foods. Then, mothers were randomly assigned to the experimental or control condition. Those in the experimental condition received social consensus information about these foods, whereas the control condition did not. The change in perceptions in the control and experimental conditions was examined.

RESULTS

Mothers rated healthy meals and snacks less favourably than unhealthy meals and snacks on factors including cost, preparation time and difficulty, and child preference. Furthermore, mothers' perceptions of foods as liked by their child, easy to prepare and 'kid-friendly' predicted higher likelihood to serve those foods. Finally, mothers were more likely to describe the healthy snack as kid-friendly and indicated being more likely to serve it after receiving favourable social norm information about the food.

CONCLUSIONS

The use of social consensus interventions to change parents' perceptions of healthy snacks may be one means of increasing the quality of children's diets.

Maternal and infant correlates of maternal feeding beliefs and practices in a multi-ethnic Asian population: the GUSTO (Growing Up in Singapore Towards healthy Outcomes) study

OBJECTIVE

Little is known about the influences of maternal and infant correlates on maternal feeding beliefs and practices in the first 2 years of life, despite its important role in early obesogenic eating behaviours and weight gain.

DESIGN

Cross-sectional study using demographic data of mothers and infants obtained at 26-28 weeks of gestation, and postnatally from birth to 15 months, respectively. The Infant Feeding Questionnaire was administered at 15 months postpartum. The associations between maternal and infant characteristics with seven maternal feeding beliefs and practices subscales were evaluated using multivariate linear regression analysis.

SETTING

Data obtained from the Singapore GUSTO (Growing Up in Singapore Towards healthy Outcomes) mother-offspring birth cohort.

SUBJECTS

Mothers and infants (n 1237).

RESULTS

Among other maternal correlates such as age, education, BMI, income and milk feeding practices, ethnicity was a consistent factor associated with six subscales, including concern about infant overeating/undereating and weight status, concern and awareness about infants' hunger and satiety cues, social interaction during feeding and feeding an infant on schedule. Similarly, among infant correlates such as gender and birth order, infant body size gain (reflected by BMI Z-score change from 0 to 15 months) was significantly associated with all subscales except feeding an infant on schedule. Overall, maternal correlates had greater influence on all subscales compared with infant correlates except for the maternal concern about infant undereating or becoming underweight subscale.

CONCLUSIONS

The present study highlights that maternal feeding beliefs and practices can be influenced by both maternal correlates and infant correlates at 15 months of age.

Fundamental constructs in food parenting practices: a content map to guide future research

Although research shows that "food parenting practices" can impact children's diet and eating habits, current understanding of the impact of specific practices has been limited by inconsistencies in terminology and definitions. This article represents a critical appraisal of food parenting practices, including clear terminology and definitions, by a working group of content experts. The result of this effort was the development of a content map for future research that presents 3 overarching, higher-order food parenting constructs--coercive control, structure, and autonomy support--as well as specific practice subconstructs. Coercive control includes restriction, pressure to eat, threats and bribes, and using food to control negative emotions. Structure includes rules and limits, limited/guided choices, monitoring, meal- and snacktime routines, modeling, food availability and accessibility, food preparation, and unstructured practices. Autonomy support includes nutrition education, child involvement, encouragement, praise, reasoning, and negotiation. Literature on each construct is reviewed, and directions for future research are offered. Clear terminology and definitions should facilitate cross-study comparisons and minimize conflicting findings resulting from previous discrepancies in construct operationalization.

Overeating with and without loss of control: Associations with weight status, weight-related characteristics, and psychosocial health

OBJECTIVE

The relative importance of loss of control and overeating in the relationship between binge eating and eating-related and general psychopathology has been debated in the literature. This study assessed the prevalence and correlates of overeating with and without loss of control within a diverse, population-based sample of adolescents.

METHOD

A highly diverse (81.1% non-White) sample of adolescents (n = 2,793) from EAT-2010 (Eating and Activity in Teens) completed self-report questionnaires assessing eating-related psychopathology, substance use, nonsuicidal self-injury, depressive symptoms, and self-esteem.

RESULTS

Overeating without loss of control was reported by 6.9% of girls and 5.0% of boys, while 9.6% of girls and 6.3% of boys reported overeating with loss of control (binge eating). Overall, overeating (with or without loss of control) was positively associated with unhealthy or extreme weight control behaviors, dieting, nonsuicidal self-injury, lower body satisfaction, and self-esteem, and higher depressive symptoms relative to no overeating. Among girls, binge eating was associated with unhealthy or extreme weight control behaviors, lower self-esteem, and higher depressive symptoms relative to overeating without loss of control, while in boys, binge eating was associated with greater cigarette usage, lower body satisfaction, and greater depressive symptoms than overeating without loss of control (although cigarette usage was comparable in boys reporting binge eating and no overeating).

DISCUSSION

Any overeating, with or without loss of control, was associated with multiple adverse correlates among adolescents. Loss of control was uniquely associated with multiple health indicators, further highlighting its importance as a marker of severity of overeating.