How time in the US and race/ethnicity shape food parenting practices and child diet quality

Exploring Disparities in Dietary Quality Among Young Children Across Diverse Racial, Ethnic, and Immigrant Households

Background: Although racial, ethnic minorities, and immigrants are more likely to have poor diet-related health outcomes, few studies have compared children's dietary quality across diverse households, which is the formative step to designing targeted interventions. The current study evaluates and compares the dietary quality of young children from diverse racial, ethnic, and immigrant households in Nebraska. Methods: Cross-sectional survey data were collected from adults living in Nebraska with at least one 2-6-year-old child residing in their household via an online survey regarding their federal assistance program participation and dietary quality of child(ren) residing in their household, measured using the short Healthy Eating Index (sHEI). Results: With nearly two-third participating in a federal assistance program, the sample includes respondents from diverse households (n = 1,277) including first-generation immigrant (n = 61), non-immigrant Hispanic (n = 538), non-immigrant non-Hispanic White (n = 509), non-immigrant non-Hispanic Black or African American (n = 120), and non-Hispanic American Indian or Native Hawaiian (n = 49). Based on analysis of covariance controlling for demographic variables, children from immigrant households had lower mean sHEI score 43.9 as compared to non-immigrant Hispanic 46.4, non-immigrant non-Hispanic White 47.1, non-immigrant non-Hispanic Black or African American 50.2, and non-Hispanic American Indian or Native Hawaiian 48.9. Racial/ethnic/immigrant household group differences were also observed for some sHEI component scores. Conclusions: Children from immigrant and non-immigrant Hispanic households had significantly lower sHEI scores on some subcomponents compared with other groups. Findings emphasize the need for additional research and culturally responsive multilevel nutrition interventions.

Identifying sources of variation in added sugar intake for Alaska Native children using a hair biomarker

Sugars from sugar-sweetened beverages (SSBs) are an important risk factor for tooth decay. The study goal was to determine if there was variation in added sugar intake across communities and between and within households. In this cross-sectional study, intakes of total sugar, added sugar, and sugar-sweetened beverages (SSBs) were estimated for 282 Alaska Native children ages 0-10 years from 131 households in three Yukon-Kuskokwim (YK) Delta communities using biomarker equations based on hair carbon and nitrogen isotope ratios previously developed for the Yup'ik population. ANOVA was used to assess associations between each predictor (community and household) and outcome (estimated total sugars, added sugars, and SSB intake). Between- and within-household variation was estimated using a linear mixed-effects model with a random intercept for households with three or more children. There was no significant difference in mean estimated total sugar (p = 0.29), added sugar (p = 0.24), or SSB intake (p = 0.40) across communities. Significant variations were observed between and within households, with within-household variation amounting to 59% of the between-household variation. Added sugar intake in Alaska Native children from the three study communities is higher than the recommended maximum, and the variation is greater within households than between households.

Impact of parent child interaction therapy on child eating behaviors

BACKGROUND

Picky eating commonly co-occurs with disruptive behaviors in young children. While feeding interventions exist, it remains unknown whether unmodified behavioral parent training (BPT) improves maladaptive child eating. As coercive feeding practices may exacerbate picky eating, BPT could ameliorate associated behaviors by increasing authoritative parenting.

METHODS

Caregiver-child dyads (N = 194, ages 2-8) received 18 weeks of Parent-Child Interaction Therapy (PCIT). Caregivers completed the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) at pre-, mid-, and post-treatment. The BPFAS overall picky eating frequency and number of problems was examined, as well as the subscale of mealtime misbehaviors, and overall caregiver feeding practices.

RESULTS

From pre-to post-treatment, reductions occurred in frequency/problems scales across overall BPFAS child behaviors. Mealtime misbehaviors significantly declined at all checkpoints - early skill acquisition may drive this early change, whereas changes in frequency/problem scales occurred after mid-treatment, suggesting later skill acquisition may be driving these changes. On the coercive caregiver feeding subscale, multivariate regression identified a significant race by time interaction (p = .02) - multiracial caregivers improved while others showed no difference.

CONCLUSION

Standard PCIT, not adapted for feeding concerns, decreased maladaptive child eating behaviors across all caregivers and coercive feeding practices in multiracial caregivers. Authoritative parenting principles may generalize to eating contexts for certain cultural groups. PCIT shows promise as an early upstream intervention potentially changing trajectories without needed feeding content modifications. Assessment of long-term maintenance is warranted. Coupling with nutrition education could optimize impact.

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.

Parents' emotion dysregulation and children's emotional overeating: The role of emotion regulation feeding

Parents' use of food to regulate children's emotions (i.e., emotion regulation feeding) has been associated with children's emotional overeating. However, less is known about how parents' emotion regulation feeding acts as a moderator between parents' emotion dysregulation and children's emotional overeating. A total of 216 parents (Mage = 35.84 years, SD = 6.11) of 3- to 5-year-old children were recruited to complete an online survey. Analyses revealed that emotion regulation feeding moderated the association between parents' emotion dysregulation and children's emotional overeating, such that parents with high emotion dysregulation and high emotion regulation feeding had children who engaged in more emotional overeating compared to parents with low emotion regulation feeding. This finding suggests that less adaptive feeding aggravates the association between parents' emotion dysregulation and children's emotional overeating.

Associations between parenting strategies and BMI percentile among Latino children and youth with intellectual and developmental disabilities

Introduction

Maintaining healthy weight is a challenge for all children, and particularly for children with IDD compared to nondisabled children and for Latino children compared to non-Latino White children. Parenting practices related to food intake and physical activity have been found to be important in maintaining children's weight. In this study, we describe the prevalence of overweight and obesity status among Latino children with IDD and their maternal caregivers and determine the relationship between food and physical activity parenting practices and childhood obesity among Latino children with IDD.

Methods

We interviewed 94 Latino parent/child dyads and collected information about parenting practices, home environment, and parent and child height and weight using standardized measures. Parent body mass index (BMI) and child BMI percentile were calculated from height and weight.

Results

The combined overweight/obesity status for children in our sample was high (60.3%) compared to national rates among nondisabled Latino children (56%) and non-Latino White children with autism (37%). Contrary to research on nondisabled children, we found that greater parental use of controlling dietary strategies was associated with lower BMI percentile in Latino children with IDD. These findings may be indicative of the fact that children with IDD tend to have unique dietary behaviors that warrant more disability and culturally sensitive strategies.

Discussion

Our findings suggest that overweight and obesity is especially prevalent for Latino children with IDD and that more research is needed on family factors that promote health in Latino families of children with IDD.