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Tauriello S, Moding K, Aronoff N, Kubiniec E, Anzman-Frasca S. Examining links between child temperament and feeding, eating, and weight outcomes: An updated systematic review of the literature. Eat Behav 2023; 49:101739. [PMID: 37209569 DOI: 10.1016/j.eatbeh.2023.101739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Weight outcomes have been associated with child temperament, defined as individual differences in reactivity and self-regulation. The current systematic review aims to provide an updated summary of the evidence linking temperamental negative reactivity, surgency, and regulation superfactors to early childhood feeding, eating, and weight outcomes. METHODS PubMed, PsycINFO and Embase databases, as well as scientific meeting programs, were searched using keywords and subject headings. Publication dates were limited to 2012-2019 as prior reviews were published in 2012 and 2014. Identified studies were eligible if they included children ages 0-5 years, a measure of child temperament, and a measure of parent/caregiver feeding, child eating, or child weight. 7113 studies were identified and 121 met inclusion criteria. RESULTS Feeding, eating, and weight outcomes were largely unrelated to overarching negative reactivity, surgency, and effortful control superfactors. Examination of individual temperament dimensions suggested difficult temperament was frequently linked to non-responsive feeding practices, whereas elevated emotionality and decreased self-regulation were linked to maladaptive eating behaviors, and lower inhibitory control to adiposity. Analyses with infants reported greater percentages of significant associations compared to children, and cross-sectional studies generally reported fewer significant associations than other study designs. CONCLUSIONS Difficult temperament, greater emotionality and lower self-regulation and inhibitory control were the aspects of temperament most consistently related to poorer early childhood feeding, eating, and weight outcomes. Associations tended to be stronger in infancy, and when examined within a non-cross-sectional study design. Findings can inform the development of tailored efforts to promote healthy eating and growth throughout childhood.
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Affiliation(s)
- Sara Tauriello
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America
| | - Kameron Moding
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, United States of America
| | - Nell Aronoff
- University Libraries, University at Buffalo, Buffalo, NY, United States of America
| | - Elizabeth Kubiniec
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America
| | - Stephanie Anzman-Frasca
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America; Center for Ingestive Behavior Research, University at Buffalo, Buffalo, NY, United States of America.
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Hamzallari O, Rosinski L, Petrenko A, Bridgett DJ. Mothers' Emotion Regulation and Negative Affect in Infants: The Role of Self-Efficacy and Knowledge of Parenting Practices. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010085. [PMID: 36670636 PMCID: PMC9857287 DOI: 10.3390/children10010085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/26/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
Early in development, children rely heavily on caregivers for assistance with the regulation of negative emotion. As such, it is important to understand parent characteristics that influence caregiver ability to attenuate infant negative affect and mediating factors by which this process may unfold. This study examined the relationship between parental emotional regulation strategies (ERs) and infants' negative affect and tested the mediating effects of parenting self-efficacy and knowledge of this association. Results indicated that higher maternal reappraisal was related to higher maternal self-efficacy whereas higher maternal suppression was related to lower knowledge of parenting practices. Maternal suppression was negatively related to infant frustration; maternal self-efficacy was positively related to infant falling reactivity and negatively related to sadness. There was a significant indirect effect between maternal reappraisal and infant falling reactivity through maternal self-efficacy. The mediation result suggests that mothers with higher use of reappraisal show higher self-efficacy and have infants with higher falling reactivity. Maternal knowledge about parenting practices was related to lower infant fear. Maternal knowledge of parenting practices did not mediate any associations between maternal emotion regulation strategies and infant negative affect. These findings contribute to the understanding early protective parenting mechanisms for supporting the external regulation of negative affect in infants and also in designing and implementing preventive parenting programs focused on the emotional needs of parents and children.
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Affiliation(s)
- Oriola Hamzallari
- Department of Psychology, Aleksandër Moisiu University, Rruga Miqësia, Spitallë, 2000 Durrës, Albania
- Correspondence: or (O.H.); (D.J.B.)
| | - Leanna Rosinski
- Department of Psychology, Northern Illinois University, DeKalb, IL 60115, USA
| | - Anton Petrenko
- Department of Psychology, Northern Illinois University, DeKalb, IL 60115, USA
| | - David J. Bridgett
- Department of Psychology, Northern Illinois University, DeKalb, IL 60115, USA
- Correspondence: or (O.H.); (D.J.B.)
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Seetharaman M, Benjamin A, McGrath JM, Vance AJ. Parenting self-efficacy instruments for parents of infants and toddlers: A review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100082. [PMID: 38745618 PMCID: PMC11080435 DOI: 10.1016/j.ijnsa.2022.100082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 11/21/2022] Open
Abstract
Background Parenting Self-Efficacy, a concept first described in Bandura's Social Cognitive Theory, is a parent's belief in their ability to successfully parent their child. The concept of parenting self-efficacy is used by researchers to increase our understanding of parenting abilities and influences on child health and developmental outcomes. Numerous instruments exist for measuring parental self-efficacy; but little is known about the specific topics included in the measures and consistency across instruments. Therefore, this scoping review sought to compare parenting self-efficacy instruments for parents of infants and toddlers, focusing on comparison of parenting topics, scale format, and administration with the goal of providing guidance and recommendations for measurement selection. Methods Our sample included 25 instruments and items from every instrument was evaluated and coded using NVIVO Qualitative Software. We reviewed the instruments' target population, subscales, number of items, response options, scoring range and instructions, theoretical background, and parenting topics across each instrument. Results This review found three common factors across all instruments: parent, social and family, and child factors. Parent personal factors were addressed most frequently to evaluate self-efficacy and included topics such as, perception of parenting abilities, emotional reactions, and perceived successes. From our synthesis, we also offer recommendations for instrument selection and provide a conceptual model of parenting self-efficacy. Conclusions The findings from this scoping review highlight the presence of key factors (parent, social & family, and child) necessary for the evaluation of parenting self-efficacy in parents of infants and toddlers. Given our results, a meta-analysis is needed to compare parenting self-efficacy scores across studies to better understand the associations between self-efficacy and parent and child outcomes.
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Affiliation(s)
| | | | | | - Ashlee J. Vance
- Henry Ford Health, Center for Health Policy and Health Services Research
- Michigan State University, College of Nursing
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Harris HA, Moore AM, Ruggiero CF, Bailey-Davis L, Savage JS. Infant Food Responsiveness in the Context of Temperament and Mothers' Use of Food to Soothe. Front Nutr 2022; 8:781861. [PMID: 35087856 PMCID: PMC8786708 DOI: 10.3389/fnut.2021.781861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/17/2021] [Indexed: 12/15/2022] Open
Abstract
Parents' use of food to soothe an infants' non-hunger related distress may impair an infants' development of appetite self-regulation. Parents tend to use food to soothe if their infant has more ‘difficult' temperamental tendencies. However, the role of infant appetite in this association is unclear. This study investigates the moderating effect of infant food responsiveness on cross-sectional and prospective associations between infant temperament and mothers' use of food to soothe. Mothers (n = 200) from low-income households reported their infants' temperament (i.e., surgency, negative affect and regulation) and food responsiveness at age 4 months, and their use of food to soothe at age 4 and 6 months. Temperament × food responsiveness interactions on mothers' use of food to soothe were examined using general linear models, adjusting for covariates. Cross-sectional associations showed that mothers used more food to soothe at 4 months for infants who were lower in negative affect and higher in food responsiveness (negative affect × food responsiveness interaction: p = 0.03). Prospective associations showed that mothers used more food to soothe at 6 months for infants who were lower in regulation and higher in food responsiveness (infant regulation × food responsiveness interaction: p = 0.009). Other interactions were not significant. Infant food responsiveness was consistently associated with mothers' use of food to soothe, independent of some temperamental dimensions. The findings highlight the salience of infant food responsiveness, both independent of and in association with temperament, on mothers' use of food to soothe.
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Affiliation(s)
- Holly A Harris
- Generation R Study Group, Erasmus MC, University Medical Center, Department of Child and Adolescent Psychiatry/Psychology, Rotterdam, Netherlands
| | - Amy M Moore
- Department of Human Health and Development, Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, United States
| | - Cara F Ruggiero
- Department of Human Health and Development, Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, United States
| | - Lisa Bailey-Davis
- Population Health Sciences, Obesity Institute Geisinger, Danville, PA, United States
| | - Jennifer S Savage
- Department of Human Health and Development, Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, United States
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Ruggiero CF, Hohman EE, Birch LL, Paul IM, Savage JS. INSIGHT responsive parenting intervention effects on child appetite and maternal feeding practices through age 3 years. Appetite 2021; 159:105060. [PMID: 33276013 PMCID: PMC7812701 DOI: 10.1016/j.appet.2020.105060] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 10/21/2020] [Accepted: 11/24/2020] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
- Cara F Ruggiero
- Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA; Nutritional Sciences, 110 C Chandlee Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.
| | - Emily E Hohman
- Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.
| | - Leann L Birch
- Foods and Nutrition, 280 Dawson Hall, 305 Sanford Dr., University of Georgia Athens, GA, 30602, USA.
| | - Ian M Paul
- Pediatrics and Public Health Sciences, 500 University Drive, Penn State College of Medicine Hershey, PA, 17033, USA.
| | - Jennifer S Savage
- Center for Childhood Obesity Research, 129 Noll Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA; Nutritional Sciences, 110 C Chandlee Laboratory, The Pennsylvania State University, University Park, PA, 16802, USA.
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Trabulsi JC, Smethers AD, Eosso JR, Papas MA, Stallings VA, Mennella JA. Impact of early rapid weight gain on odds for overweight at one year differs between breastfed and formula-fed infants. Pediatr Obes 2020; 15:e12688. [PMID: 32705816 PMCID: PMC7773222 DOI: 10.1111/ijpo.12688] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Early rapid weight gain (RWG) increases, whereas longer durations of breastfeeding decreases, odds for later obesity. OBJECTIVES To determine the independent and interactive effects of early weight gain and diet on infant weight status trajectories and odds for overweight at 1 year. METHODS We conducted secondary analysis on data from two longitudinal trials with repeated anthropometric measures. One trial consisted of predominantly or exclusively breastfed (BF, n = 97) infants, whereas the other consisted of exclusively formula-fed (FF, n = 113) infants. Weight-for-length z-score (WLZ) change from 0.5 to 4.5 months was used to categorize early weight gain as slow (<-0.67; SWG), normal (-0.67 to 0.67; NWG) or rapid (>0.67; RWG). Linear-mixed effects models were fit to examine the independent effects and interaction of early diet (BF, FF) and weight gain (SWG, NWG, RWG) groups on WLZ trajectories; logistic regression was used to assess odds for overweight at 1 year. RESULTS While similar percentages (41%) of BF and FF infants experienced RWG, we found a significant diet × early weight gain group interaction (P < .001) on weight status. At 1 year, the WLZ of FF infants with RWG (1.57 ± 0.99) was twice that of BF infants with RWG (0.83 ± 0.92). Using BF infants with NWG as the reference group, FF infants with RWG had increased odds [OR: 25.3 (95% CI: 3.21, 199.7)] for overweight at 1 year, whereas BF infants with RWG did not. CONCLUSIONS Early diet interacts with early weight gain and influences weight status trajectories and overweight risk at 1 year.
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Affiliation(s)
- Jillian C. Trabulsi
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | | | - Jessica R. Eosso
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware
| | - Mia A. Papas
- The Value Institute, Christiana Care Health System, Newark, Delaware
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van Eeden AE, Hoek HW, van Hoeken D, Deen M, Oldehinkel AJ. Temperament in preadolescence is associated with weight and eating pathology in young adulthood. Int J Eat Disord 2020; 53:466-475. [PMID: 32073176 PMCID: PMC7318707 DOI: 10.1002/eat.23241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/14/2020] [Accepted: 01/26/2020] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Few longitudinal studies have investigated the role of temperament traits on weight and eating problems thus far. We investigated whether temperament in preadolescence influences body weight and the development of eating pathology in adolescence and young adulthood. METHOD This study used data from TRAILS (Tracking Adolescents' Individual Lives Survey), a Dutch community cohort study (N = 2,230) from preadolescence into adulthood. At age 11, the temperament dimensions negative affectivity and effortful control were measured with the Early Adolescent Temperament Questionnaire-Revised. Body mass index (BMI) was measured at all assessment waves. At age 19, the prevalence of eating disorders was investigated by two-stage screening including interviews by eating disorder experts. At age 22 and 26, the Eating Disorder Diagnostic Scale was used to assess the level of eating pathology. RESULTS Higher negative affectivity in preadolescence was associated with higher BMI and eating pathology in young adulthood. Lower effortful control in preadolescence was found to be a risk factor for the development of obesity in young adulthood. No association was found between effortful control in preadolescence and eating pathology in later life. DISCUSSION Both negative affectivity and effortful control play a role in the development of weight or eating problems during adolescence.
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Affiliation(s)
- Annelies E. van Eeden
- Parnassia Psychiatric InstituteThe HagueThe Netherlands,University of Groningen, University Medical Center Groningen, Department of PsychiatryGroningenThe Netherlands
| | - Hans W. Hoek
- Parnassia Psychiatric InstituteThe HagueThe Netherlands,University of Groningen, University Medical Center Groningen, Department of PsychiatryGroningenThe Netherlands,Columbia UniversityMailman School of Public Health, Department of Epidemiology, New YorkNew York
| | | | - Mathijs Deen
- Parnassia Psychiatric InstituteThe HagueThe Netherlands
| | - Albertine J. Oldehinkel
- University of Groningen, University Medical Center Groningen, Department of PsychiatryGroningenThe Netherlands
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Walsh AD, Hesketh KD, Hnatiuk JA, Campbell KJ. Paternal self-efficacy for promoting children's obesity protective diets and associations with children's dietary intakes. Int J Behav Nutr Phys Act 2019; 16:53. [PMID: 31253143 PMCID: PMC6599370 DOI: 10.1186/s12966-019-0814-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 06/18/2019] [Indexed: 11/10/2022] Open
Abstract
Objective Fathers’ parenting behaviours contribute to the development of children’s dietary behaviours and subsequent weight outcomes, yet the majority of research focusses on maternal influences. Understanding fathers’ perceptions of their effectiveness to influence children’s dietary behaviours will allow the development of whole-of-family interventions promoting obesity protective behaviours. This unique study is the first to investigate 1) tracking of paternal self-efficacy for promoting obesity protective dietary intakes in young children; 2) demographic characteristics of fathers and their self-efficacy category; and 3) associations between paternal self-efficacy and young children’s dietary intakes. Methods Paternal self-efficacy for promoting children’s obesity protective dietary intakes was assessed longitudinally from fathers (n = 195) in the Extended Infant Feeding Activity and Nutrition Trial Program at child age 4 and 36 months. Multinomial logistic regression examined self-efficacy tracking categories (persistently high; persistently low; increasing; decreasing) by paternal age, education and BMI. Linear regression examined associations between paternal self-efficacy tracking categories and child dietary intakes at 36 months. Results Paternal self-efficacy for promoting children’s obesity protective dietary intakes reduced over time. Fathers with trade/certificate or university qualifications had lower odds of having persistently low/decreasing self-efficacy (97 and 87% lower respectively) compared to high-school educated fathers. Positive associations (β (95% CI)) were observed between paternal self-efficacy category and children’s dietary intakes at 36 months: increasing self-efficacy and fruit (β89.8 (6.8; 172.7)), and vegetables (β39.2 (12.2; 66.2)); persistently high self-efficacy and water (β69.1 (2.9; 135.1)); decreasing self-efficacy and non-core drinks ((β30.1 (10.1; 50.1)). Persistently high self-efficacy was negatively associated with non-core drinks (β-20.2 (− 34.8; − 5.5)), with negative associations observed between decreasing self-efficacy and children’s intakes of fruit (β − 49.9 (− 87.5; − 12.3)), vegetables (β-19.9 (− 31.7; − 8.2)) and water (β-92.4 (− 172.6; − 12.3)). Conclusions Higher and/or sustained paternal self-efficacy is associated with fathers’ education and is important in promoting children’s obesity protective dietary intakes. Associations between paternal self-efficacy and children’s dietary intakes are present at a young age. This investigation was unique in its focus on paternal self-efficacy for promoting children’s obesity protective dietary intakes and associations with children’s dietary intakes. Future family interventions should consider how to maintain and/or improve paternal self-efficacy to promote obesity protective intakes from early childhood.
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Affiliation(s)
- Adam D Walsh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Jill A Hnatiuk
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
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Bahorski JS, Childs GD, Loan LA, Azuero A, Morrison SA, Chandler-Laney PC, Hodges EA, Rice MH. Self-efficacy, infant feeding practices, and infant weight gain: An integrative review. J Child Health Care 2019; 23:286-310. [PMID: 30071746 PMCID: PMC8513131 DOI: 10.1177/1367493518788466] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
It has been suggested that self-efficacy specific to parenting or feeding may influence the decisions parents make regarding infant feeding; however, a review of this topic has not been conducted. The purpose of this integrative review is to synthesize the literature regarding the potential role of self-efficacy in infant feeding practices or infant weight gain. A total of 40 articles were used to guide this review, which were classified into three categories examining an association with self-efficacy (1) breastfeeding; (2) infant feeding practices such as parental feeding style and dietary quality; and (3) infant weight gain. Evidence regarding breastfeeding self-efficacy (BFSE) and breastfeeding is extensive; mothers with a higher sense of BFSE more often initiate breastfeeding and breastfeed for longer durations. The evidence regarding self-efficacy and the association with infant feeding practices other than breastfeeding is sparse. However, several studies report that mothers who have a higher sense of self-efficacy are more likely to follow infant feeding practices which align with recommendations. The authors have speculated an association between self-efficacy and infant weight gain; yet, to date, no study has found a significant association. More research is needed on the topic, particularly in diverse populations and with fathers and mothers.
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Affiliation(s)
- Jessica S Bahorski
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gwendolyn D Childs
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lori A Loan
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shannon A Morrison
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Paula C Chandler-Laney
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric A Hodges
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marti H Rice
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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Faith MS, Hittner JB, Hurston SR, Yin J, Greenspan LC, Quesenberry CP, Gunderson EP. Association of Infant Temperament With Subsequent Obesity in Young Children of Mothers With Gestational Diabetes Mellitus. JAMA Pediatr 2019; 173:424-433. [PMID: 30855657 PMCID: PMC6503510 DOI: 10.1001/jamapediatrics.2018.5199] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
IMPORTANCE Infant temperament is associated with excess weight gain or childhood obesity risk in samples of healthy individuals, although the evidence has been inconsistent. To our knowledge, no prior research has examined this topic among children exposed to gestational diabetes mellitus (GDM) in utero. OBJECTIVE To prospectively evaluate infant temperament in association with overweight and obesity status at ages 2 to 5 years among children born to mothers who experienced GDM. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study took place at Kaiser Permanente Northern California medical centers. We studied singleton infants delivered at 35 weeks' gestational age or later to mothers who had been diagnosed with GDM. Data were collected from 2009 to 2016, and data analysis occurred from June 2017 to October 2018. EXPOSURES The primary exposures in the child's first year were soothability, distress to limitations, and activity aspects of temperament, as assessed by a validated questionnaire. Modifiable covariates in the child's first year included breastfeeding intensity and duration monthly ratio scores, along with the timing of the introduction of sugary beverages and complementary foods. MAIN OUTCOMES AND MEASURES The primary outcome was child overweight and obesity status, assessed at ages 2 to 5 years. Multinomial logistic regression models estimated adjusted odds ratios and 95% CIs for infants whose temperaments were measured at 6 to 9 weeks of age and categorized as elevated (≥75th percentile) or not elevated in the 3 domains. We controlled for nonmodifiable and modifiable covariates across models. RESULTS A total of 382 mother-infant pairs participted, including 130 infants (34.0%) who were non-Hispanic white, 126 infants (33.0%) who were Hispanic, 96 infants (25.1%) who were Asian, 26 infants (6.8%) who were non-Hispanic black, and 4 infants (1.1%) who were of other races/ethnicities. In descriptive analyses, elevated infant soothability and activity temperaments were associated with the early introduction of 100% fruit juice and/or sugar-sweetened beverages (at ages <6 months) and shorter breastfeeding duration (from 0 to <3 months), while elevated distress to limitations was associated with early introduction of complementary foods (at ages <4 months). Elevated soothability consistently was associated with a higher odds of later childhood obesity, with adjusted odds ratios across models ranging from 2.22 (95% CI, 1.04-4.73) to 2.54 (95% CI, 1.28-5.03). Greater breastfeeding intensity and duration (12-month combined) score was associated with lower odds of obesity, independent of infant temperament and other covariates. CONCLUSIONS AND RELEVANCE Among this high-risk population of infants, elevated soothability was associated with early childhood obesity risk, perhaps in part because caregivers use sugary drinks to assuage infants. Soothability temperament may be a novel screening target for early obesity prevention interventions involving responsive feeding and emotion regulation.
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Affiliation(s)
- Myles S. Faith
- Department of Counseling, School, and Educational Psychology, Graduate School of Education, University at Buffalo–State University of New York, Buffalo
| | - James B. Hittner
- Department of Psychology, College of Charleston, Charleston, South Carolina
| | - Shanta R. Hurston
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
| | - Jie Yin
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
| | | | - Charles P. Quesenberry
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
| | - Erica P. Gunderson
- Division of Research, Cardiovascular and Metabolic Conditions Section, Kaiser Permanente Northern California, Oakland
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Paul IM, Savage JS, Anzman-Frasca S, Marini ME, Beiler JS, Hess LB, Loken E, Birch LL. Effect of a Responsive Parenting Educational Intervention on Childhood Weight Outcomes at 3 Years of Age: The INSIGHT Randomized Clinical Trial. JAMA 2018; 320:461-468. [PMID: 30088009 PMCID: PMC6142990 DOI: 10.1001/jama.2018.9432] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Rapid growth and elevated weight status in early childhood increase risk for later obesity, but interventions that improve growth trajectories are lacking. OBJECTIVE To examine effects of a responsive parenting intervention designed to promote developmentally appropriate, prompt, and contingent responses to a child's needs on weight outcomes at 3 years. DESIGN, SETTING, AND PARTICIPANTS A single-center randomized clinical trial comparing a responsive parenting intervention designed to prevent childhood obesity vs a home safety intervention (control) among 279 primiparous mother-child dyads (responsive parenting group, 140; control group, 139) who enrolled and completed the first home visit from January 2012 through March 2014 with follow-up to age 3 years (completed by April 2017). INTERVENTIONS Research nurses conducted 4 home visits during infancy and annual research center visits. The responsive parenting curriculum focused on feeding, sleep, interactive play, and emotion regulation. The control curriculum focused on safety. MAIN OUTCOMES AND MEASURES The primary outcome was body mass index (BMI) z score at 3 years (z score of 0 represents the population mean; 1 and -1 represent 1 SD above and below the mean, respectively). BMI percentile at 3 years was designated previously as the primary outcome. Secondary outcomes included the prevalence of overweight (BMI ≥85th percentile and <95th percentile) and obesity (BMI ≥95th percentile) at 3 years. RESULTS Among 291 mother-child dyads randomized, 279 received the first home visit and were included in the primary analysis. 232 mother-child dyads (83.2%) completed the 3-year trial. Mean age of the mothers was 28.7 years; 86% were white and 86% were privately insured. At age 3 years, children in the responsive parenting group had a lower mean BMI z score (-0.13 in the responsive parenting group vs 0.15 in the control group; absolute difference, -0.28 [95% CI, -0.53 to -0.01]; P = .04). Mean BMI percentiles did not differ significantly (47th in the responsive parenting group vs 54th in the control group; reduction in mean BMI percentiles of 6.9 percentile points [95% CI, -14.5 to 0.6]; P = .07). Of 116 children in the responsive parenting group, 13 (11.2%) were overweight vs 23 (19.8%) of 116 children in the control group (absolute difference, -8.6% [95% CI, -17.9% to 0.0%]; odds ratio [OR], 0.51 [95% CI, 0.25 to 1.06]; P = .07); 3 children (2.6%) in the responsive parenting group were obese vs 9 children (7.8%) in the control group (absolute difference, -5.2% [95% CI, -10.8% to 0.0%]; OR, 0.32 [95% CI, 0.08 to 1.20]; P = .09). CONCLUSIONS AND RELEVANCE Among primiparous mother-child dyads, a responsive parenting intervention initiated in early infancy compared with a control intervention resulted in a modest reduction in BMI z scores at age 3 years, but no significant difference in BMI percentile. Further research is needed to determine the long-term effect of the intervention and assess its efficacy in other settings. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01167270.
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Affiliation(s)
- Ian M. Paul
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Jennifer S. Savage
- Center for Childhood Obesity Research, Pennsylvania State University, University Park
- Department of Nutritional Sciences, Pennsylvania State University, University Park
| | | | - Michele E. Marini
- Center for Childhood Obesity Research, Pennsylvania State University, University Park
| | - Jessica S. Beiler
- Department of Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
| | | | - Eric Loken
- Department of Education Psychology, University of Connecticut, Storrs
| | - Leann L. Birch
- Department of Foods and Nutrition, University of Georgia, Athens
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Vance AJ, Brandon DH. Delineating Among Parenting Confidence, Parenting Self-Efficacy, and Competence. ANS Adv Nurs Sci 2018; 40:E18-E37. [PMID: 28825934 PMCID: PMC5664183 DOI: 10.1097/ans.0000000000000179] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This article examined the concepts of parenting self-efficacy, parenting confidence, and competence. Using Morse's method of concept delineation, a literature review of each concept was conducted to uncover commonalities, distinctions, and measurement overlaps between concepts and provide conceptual boundaries. Findings revealed that parenting confidence and parenting self-efficacy describe a parents' internal attribution or beliefs about their ability to engage in parenting behaviors. Both terms have similar antecedents, attributes, and consequences, whereas competence is a concept that should be used as an objective measure by someone other than the parent to assess parenting quality.
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Affiliation(s)
- Ashlee J Vance
- Division of Women and Children (Dr Brandon), Duke University School of Nursing (Ms Vance), Durham, North Carolina
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13
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Low-Income Women's Feeding Practices and Perceptions of Dietary Guidance: A Qualitative Study. Matern Child Health J 2018; 20:2510-2517. [PMID: 27465059 DOI: 10.1007/s10995-016-2076-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objectives Describe themes characterizing feeding behaviors of low-income women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and identify the attitudes, beliefs, and sources of information that inform these practices. Methods Formative research was conducted including focus groups and semi-structured individual phone interviews with a total of 68 low-income women participating in WIC. Qualitative data were recorded, transcribed, imported into NVivo 8.0, and analyzed for common themes. Results Mothers reported feeding behaviors inconsistent with guidance from WIC and the American Academy of Pediatrics. Three main themes were identified. First, mothers reported receiving conflicting messaging/advice from medical professionals, WIC nutritionists, and family members, which was confusing. Mothers also reported dissatisfaction with the "one size fits most" approach. Lastly, mothers reported relying on their "instincts" and that "all babies are different" when deciding and rationalizing what feeding guidance to follow. Conclusions Future interventions targeting this high-risk population should consider developing personalized (individualized) messaging, tailored to the needs of each mother-child dyad. Focused efforts are needed to build partnerships between WIC providers and other health care providers to provide more consistent messages about responsive feeding to prevent early obesity.
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Sutin AR, Kerr JA, Terracciano A. Temperament and body weight from ages 4 to 15 years. Int J Obes (Lond) 2017; 41:1056-1061. [PMID: 28280272 PMCID: PMC5496782 DOI: 10.1038/ijo.2017.62] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 01/11/2017] [Accepted: 02/10/2017] [Indexed: 12/20/2022]
Abstract
Background/Objectives In adulthood, conscientiousness and neuroticism are correlates of body weight and weight gain. The present research examines whether the childhood antecedents of these traits, persistence and negative reactivity, respectively, are associated with weight gain across childhood. We likewise examine sociability as a predictor of childhood weight gain and whether these three traits are associated with weight concerns and weight management strategies in adolescence. Subjects/Methods Participants (N=4,153) were drawn from the Longitudinal Study of Australian Children, an ongoing, population-based study of child and family health and well-being. At the baseline assessment, caregivers reported on their child's temperament. At every assessment from ages 4-5 to 14-15, study children were weighed and measured by trained staff; there were up to six biennial assessments of body mass index (BMI) and waist circumference. At age 14-15, study children (n=2,975) also self-reported on their weight concerns and weight management strategies. Results Study children rated lower in persistence or higher in negative reactivity in early childhood gained more weight between the ages of 4 and 15. Sociability was associated with weight gain among girls but not among boys. Lower persistence and higher negative reactivity at age 4-5 were also associated with greater weight concerns, restrained eating, and use of unhealthy weight management strategies at ages 14-15. Conclusions Childhood traits related to conscientiousness and neuroticism are associated with objective weight gain across childhood and with concerns and strategies to manage weight in adolescence. These results are consistent with a lifespan perspective that indicates that trait psychological functioning contributes to health-related markers from childhood through old age.
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Affiliation(s)
- A R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahasse, FL, USA
| | - J A Kerr
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia.,Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - A Terracciano
- Department of Geriatrics, Florida State University College of Medicine, Tallahasse, FL, USA
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15
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Godefroy V, Trinchera L, Darcel N, Rigal N. Behavioural measures of child's eating temperament and their link with BMI. Appetite 2017; 110:6-14. [PMID: 27940311 DOI: 10.1016/j.appet.2016.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/22/2016] [Accepted: 12/05/2016] [Indexed: 11/30/2022]
Abstract
Rothbart's model of temperament, defined as individual differences in reactivity and self-regulation, has a strong heuristic value with applications in a wide variety of children's outcomes. Our objective was to test Rothbart's model applied to children's food behaviours and BMI outcome through behavioural measures. Our hypotheses, according to Rothbart's model, were as follows: (i) self-regulation in eating modulates appetite reactivity; (ii) appetite reactivity increases the risk of excess BMI, whereas self-regulation in eating limits this risk. One hundred and four children aged between 7 and 12 years completed four behavioural tasks to assess scores for two components of appetite reactivity (i.e. appetite arousal and appetite persistence) and two components of self-regulation in eating (i.e. self-regulation in eating without hunger and self-regulation in eating speed). Their heights and weights were measured in order to calculate their BMI-for-age. T-tests and regression analysis were used to verify our hypotheses. None of the scores of self-regulation in eating was directly associated with BMI but we observed a significant impact of self-regulation in eating without hunger on appetite arousal (p-value = 0.04), together with a modest but significant association between appetite persistence and BMI (p-value = 0.02). We can thus conclude that our behavioural measures could be used for the determination of the child's eating temperament. Further studies are needed to investigate how to use these measures to improve the treatment of overweight in children.
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Affiliation(s)
- Valérie Godefroy
- Université Paris Ouest, Department of Psychology, F-92000 Nanterre, France.
| | - Laura Trinchera
- NEOMA Business School, Department of Information Systems, Supply Chain and Decisions, F-76100 Rouen, France
| | - Nicolas Darcel
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, 75005 Paris, France
| | - Natalie Rigal
- Université Paris Ouest, Department of Psychology, F-92000 Nanterre, France
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16
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Savage JS, Rollins BY, Kugler KC, Birch LL, Marini ME. Development of a theory-based questionnaire to assess structure and control in parent feeding (SCPF). Int J Behav Nutr Phys Act 2017; 14:9. [PMID: 28125997 PMCID: PMC5270355 DOI: 10.1186/s12966-017-0466-2] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 01/17/2017] [Indexed: 01/21/2023] Open
Abstract
Background Parents shape children’s eating environments and act as powerful socialization agents, impacting young children’s behavioral controls of food intake. Most feeding measures assess parents’ use of control to manage children’s intake of energy dense foods. The Structure and Control in Parent Feeding (SCPF) questionnaire was developed to assess more positive aspects of feeding practices with their young children —setting limits, providing routines—that promote self-regulation, as well as controlling feeding practices. Methods A mixed method approach was used to develop the SCPF. In 2013, cognitive interviews informed the modification, deletion and/or replacement of items. In 2014, the survey was distributed statewide to mothers of toddlers aged 12 to 36 months participating in the Women, Infants, and Children program. In 2016, exploratory factor analyses was conducted to test our theoretical parenting model and content validity and criterion validity were assessed (n = 334). Results Exploratory factor analysis (EFA) and second-order EFA revealed a 2-factor, 22-item Structure model and a 2-factor, 12-item Control model. Internal consistencies for all factors exceeded 0.70. As predicted, the Structure superfactor was positivity associated with responsiveness, whereas the Control superfactor was positively associated with demandingness on the Caregiver’s Feeding Styles Questionnaire. The Structure subscales were also positively associated with mealtime behaviors and Control subscales were positively associated with control-oriented feeding measures from the Control in Parent Feeding Practices questionnaire. Conclusion The SCPF questionnaire is a reliable tool that can be used to assess aspects of structure- and control-based feeding practices to better understand how parents feed their toddlers.
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Affiliation(s)
- Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, 16802, USA. .,Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, 16802, USA. .,Department of Nutritional Sciences, Center for Childhood Obesity Research, The Pennsylvania State University, 129 Noll Laboratory, University Park, PA, 16802, USA.
| | - Brandi Y Rollins
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Kari C Kugler
- The Methodology Center, The Pennsylvania State University, 204 E. Calder Way, Suite 400, University Park, PA, 16801, USA
| | - Leann L Birch
- Department of Foods and Nutrition, University of Georgia, 176 Dawson Hall, Athens, GA, 30602, USA
| | - Michele E Marini
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, PA, 16802, USA
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17
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Miller AL, Rosenblum KL, Retzloff LB, Lumeng JC. Observed self-regulation is associated with weight in low-income toddlers. Appetite 2016; 105:705-12. [PMID: 27397726 PMCID: PMC4980170 DOI: 10.1016/j.appet.2016.07.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 06/12/2016] [Accepted: 07/06/2016] [Indexed: 01/21/2023]
Abstract
Obesity emerges in early childhood and tracks across development. Self-regulation develops rapidly during the toddler years, yet few studies have examined toddlers' self-regulation in relation to concurrent child weight. Further, few studies compare child responses in food and non-food-related tasks. Our goal was to examine toddlers' observed behavioral and emotional self-regulation in food and non-food tasks in relation to their body mass index z-score (BMIz) and weight status (overweight/obese vs. not). Observational measures were used to assess self-regulation (SR) in four standardized tasks in 133 low-income children (M age = 33.1 months; SD = 0.6). Behavioral SR was measured by assessing how well the child could delay gratification for a snack (food-related task) and a gift (non-food-related task). Emotional SR was measured by assessing child intensity of negative affect in two tasks designed to elicit frustration: being shown, then denied a cookie (food-related) or a toy (non-food-related). Task order was counterbalanced. BMIz was measured. Bivariate correlations and regression analyses adjusting for child sex, child race/ethnicity, and maternal education were conducted to examine associations of SR with weight. Results were that better behavioral SR in the snack delay task associated with lower BMIz (β = -0.27, p < 0.05) and lower odds of overweight/obesity (OR = 0.66, 95% CI 0.45, 0.96), but behavioral SR in the gift task did not associate with BMIz or weight status. Better emotional SR in the non-food task associated with lower BMIz (β = -0.27, p < 0.05), and better emotional SR in food and non-food tasks associated with lower odds of overweight/obesity (OR = 0.65, 95% CI 0.45, 0.96 and OR = 0.56, 95% CI 0.37, 0.87, respectively). Results are discussed regarding how behavioral SR for food and overall emotional SR relate to weight during toddlerhood, and regarding early childhood obesity prevention implications.
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Affiliation(s)
- Alison L Miller
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, 1023NW, Ann Arbor, MI 48109-0406, USA; Department of Health Behavior and Health Education, University of Michigan School of Public Health, USA.
| | - Katherine L Rosenblum
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, 1023NW, Ann Arbor, MI 48109-0406, USA; Department of Psychiatry, University of Michigan Medical School, USA.
| | - Lauren B Retzloff
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, 1023NW, Ann Arbor, MI 48109-0406, USA.
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, 300 North Ingalls Street, 1023NW, Ann Arbor, MI 48109-0406, USA; Department of Pediatrics, University of Michigan Medical School, USA; Department of Nutritional Sciences, University of Michigan School of Public Health, USA.
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18
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Barrett KJ, Thompson AL, Bentley ME. The influence of maternal psychosocial characteristics on infant feeding styles. Appetite 2016; 103:396-402. [PMID: 27174251 PMCID: PMC5461822 DOI: 10.1016/j.appet.2016.04.042] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 04/26/2016] [Accepted: 04/28/2016] [Indexed: 12/11/2022]
Abstract
Maternal feeding styles in infancy and early childhood are associated with children's later risk for overweight and obesity. Maternal psychosocial factors that influence feeding styles during the complementary feeding period, the time during which infants transition from a milk-based diet to one that includes solid foods and other non-milk products, have received less attention. The present study explores how maternal psychosocial factors-specifically self-esteem, parenting self-efficacy, parenting satisfaction, and depression symptoms-influence mothers' infant feeding styles at nine months of age, a time during which solid foods eating habits are being established. Participants included 160 low-income, African-American mother-infant pairs in central North Carolina who were enrolled in the Infant Care and Risk of Obesity Study. Regression models tested for associations between maternal psychosocial characteristics and pressuring and restrictive feeding styles. Models were first adjusted for maternal age, education, marital status and obesity status. To account for infant characteristics, models were then adjusted for infant weight-for-length, distress to limitations and activity level scores. Maternal self-esteem was negatively associated with pressuring to soothe. Maternal parenting self-efficacy was positively associated with restriction-diet quality. Maternal parenting satisfaction and depression symptoms were not associated with feeding styles in the final models. Focusing on strengthening maternal self-esteem and parenting self-efficacy may help to prevent the development of less desirable infant feeding styles.
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Affiliation(s)
- Katherine J Barrett
- Department of Anthropology, University of North Carolina at Chapel Hill, 301 Alumni Building, CB# 3115, Chapel Hill, NC, 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, 206 West Franklin St. Rm 208, Chapel Hill, NC, 27516-2569, USA.
| | - Amanda L Thompson
- Department of Anthropology, University of North Carolina at Chapel Hill, 301 Alumni Building, CB# 3115, Chapel Hill, NC, 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, 206 West Franklin St. Rm 208, Chapel Hill, NC, 27516-2569, USA.
| | - Margaret E Bentley
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 170 Rosenau Hall, CB# 7400, Chapel Hill, NC, 27599-7400, USA; Carolina Population Center, University of North Carolina at Chapel Hill, 206 West Franklin St. Rm 208, Chapel Hill, NC, 27516-2569, USA.
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Czajkowski SM. National Institutes of Health Update: Translating Basic Behavioral Science into New Pediatric Obesity Interventions. Pediatr Clin North Am 2016; 63:389-99. [PMID: 27261541 PMCID: PMC4894534 DOI: 10.1016/j.pcl.2016.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Pediatric obesity increases the risk of later-life obesity and chronic diseases. Basic research to better understand factors associated with excessive weight gain in early life and studies translating research findings into preventive and therapeutic strategies are essential to our ability to better prevent and treat childhood obesity. This overview describes several National Institutes of Health efforts designed to stimulate basic and translational research in childhood obesity prevention and treatment. These examples demonstrate the value of research in early phase translational pediatric obesity research and highlight some promising directions for this important area of research.
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Affiliation(s)
- Susan M Czajkowski
- Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Room 3E108, Rockville, MD 20892, USA.
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20
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Hittner JB, Johnson C, Tripicchio G, Faith MS. Infant emotional distress, maternal restriction at a home meal, and child BMI gain through age 6years in the Colorado Adoption Project. Eat Behav 2016; 21:135-41. [PMID: 26872074 DOI: 10.1016/j.eatbeh.2016.01.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/30/2015] [Accepted: 01/19/2016] [Indexed: 11/26/2022]
Abstract
Infant temperament and parental feeding practices may be risk factors for childhood obesity, however most studies have relied upon parent-report assessments. We tested whether infant emotional distress and maternal restrictive feeding at 12-months of age, assessed observationally at a home feeding interaction, predicted child BMI through age 6years. We conducted a prospective observational study of 86 children (34 girls and 52 boys, from 55 adoptive and 31 non-adoptive families) enrolled in the Colorado Adoption Project. Mother-infant feeding interactions were video-recorded during a home snack or meal at year 1, and child anthropometrics (length or height, and weight) were assessed at years 1 through 6. The main outcome measures were child weight-for-length at year 1 and body mass index (BMI: kg/m(2)) at years 2-6. Results of generalized linear models indicated that greater infant emotional distress at 12-months predicted greater increases in child weight status through age 6years, B=0.62 and odds ratio (OR)=1.87. In separate analyses, restrictive feeding interacted with child sex in predicting weight status trajectories (p=.012). Male infants whose mothers displayed any compared to no restriction at year 1 showed a downward BMI trajectory from 2 to 6years; for female infants, exposure to any compared to no restriction prompts predicted increasing BMI from 4 to 6years. In sum, early obesity prevention strategies should pay greater attention to infant temperament, especially distress and negative affect, and how parents respond to such cues. Additionally, 'responsive feeding' strategies that provide an alternative to restriction warrant greater research during infancy.
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Affiliation(s)
- James B Hittner
- Department of Psychology, College of Charleston, United States
| | - Cassandra Johnson
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, United States
| | - Gina Tripicchio
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, United States
| | - Myles S Faith
- Department of Counseling, School, and Educational Psychology (CSEP), Graduate School of Education, University of Buffalo - SUNY, United States.
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21
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Skogheim TS, Vollrath ME. Associations of Child Temperament with Child Overweight and Breakfast Habits: A Population Study in Five-Year-Olds. Nutrients 2015; 7:10116-28. [PMID: 26633494 PMCID: PMC4690074 DOI: 10.3390/nu7125522] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 11/04/2015] [Accepted: 11/26/2015] [Indexed: 11/20/2022] Open
Abstract
This study examines the associations of child temperament with overweight/obesity and breakfast habits. Participants were 17,409 five-year-olds whose mothers partake in the Norwegian Mother and Child Cohort Study (MoBa), and completed a questionnaire at the child’s 5th birthday. Temperament was assessed as externalizing, internalizing and sociable temperament. Breakfast habits differentiated between “every day”, “4 to 6 times a week”, and “0 to 3 times a week”. The child’s weight status was determined by Body Mass Index-percentiles and categorized as normal weight versus overweight/obese. Children with externalizing temperament had higher odds of being overweight and higher odds of not eating breakfast daily. Children high in internalizing temperament had higher odds of not eating breakfast daily, but not of being overweight. Children with average scores of sociability were more prone to being overweight but had normal breakfast habits. All results were adjusted for key confounders. That five-year-olds high in externalizing temperament had a higher risk to be overweight adds important information to the literature. The association of externalizing temperament with child breakfast habits so early in life is intriguing, as parents mostly control eating patterns in children that young. Mechanisms mediating this association should be explored.
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Affiliation(s)
| | - Margarete Erika Vollrath
- Norwegian Institute of Public Health, Oslo 0403, Norway.
- Institute of Psychology, University of Oslo, Oslo 0373, Norway.
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22
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Han E, Jones-Smith J, Surkan PJ, Kharmats AY, Vedovato GM, Trude ACB, Anderson Steeves E, Gittelsohn J. Low-income African-American adults share weight status, food-related psychosocial factors and behaviours with their children. Obes Sci Pract 2015; 1:78-87. [PMID: 27774251 PMCID: PMC5064723 DOI: 10.1002/osp4.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/28/2015] [Accepted: 09/04/2015] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This study aims to examine the extent to which low-income African-American children's weight status, psychosocial characteristics and food-related behaviours are associated with that of their adult caregivers. METHODS Cross-sectional data from baseline evaluation of B'More Healthy Communities for Kids obesity prevention trial were used. Outcomes of interest were children's overweight and/or obesity status, food-related self-efficacy, knowledge, intentions and healthier/less healthy food acquisition scores. The primary exposures were adult caregiver's overweight and/or obesity status, their psychosocial factors and food acquisition scores. Multiple logistic regression analyses were used to assess associations. RESULTS Children had higher odds of overweight or obesity if they had an overweight/obese caregiver (odds ratio [OR] 4.04, 95% confidence interval [95%CI] 1.59-10.28) or an obese caregiver (OR 2.50, 95%CI 1.39-4.51). Having a caregiver in the highest quartile of self-efficacy, food intentions and healthy food acquisition patterns was associated with higher odds of their child also having a higher score on these factors (self-efficacy: OR 3.77 [95%CI 1.76-8.04]; food intentions: OR 1.13 [95%CI 1.01-1.27]; and healthy food acquisition: OR 2.19 [95%CI 1.05-4.54]). CONCLUSIONS Child and adult caregiver weight status and psychosocial characteristics were positively associated in this low-income, urban population. These findings may help inform obesity treatment or prevention programmes and interventions aimed at parents and families.
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Affiliation(s)
- E Han
- Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - J Jones-Smith
- Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - P J Surkan
- Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - A Y Kharmats
- Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - G M Vedovato
- Health and Society Institute Federal University of São Paulo Santos SP Brazil
| | - A C B Trude
- Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - E Anderson Steeves
- Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
| | - J Gittelsohn
- Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD USA
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Seburg EM, Olson-Bullis BA, Bredeson DM, Hayes MG, Sherwood NE. A Review of Primary Care-Based Childhood Obesity Prevention and Treatment Interventions. Curr Obes Rep 2015; 4. [PMID: 26213643 PMCID: PMC4512668 DOI: 10.1007/s13679-015-0160-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Effective obesity prevention and treatment interventions targeting children and their families are needed to help curb the obesity epidemic. Pediatric primary care is a promising setting for these interventions, and a growing number of studies are set in this context. This review aims to identify randomized controlled trials of pediatric primary care-based obesity interventions. A literature search of 3 databases retrieved 2947 publications, of which 2899 publications were excluded after abstract (n=2722) and full-text review (n=177). Forty-eight publications, representing 31 studies, were included in the review. Eight studies demonstrated a significant intervention effect on child weight outcomes (e.g., BMI z-score, weight-for-length percentile). Effective interventions were mainly treatment interventions, and tended to focus on multiple behaviors, contain weight management components, and include monitoring of weight-related behaviors (e.g., dietary intake, physical activity, or sedentary behaviors). Overall, results demonstrate modest support for the efficacy of obesity treatment interventions set in primary care.
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Affiliation(s)
- Elisabeth M. Seburg
- HealthPartners Institute for Education and Research, 8170 33rd Ave. S., Mailstop 23301A, Minneapolis, MN 55440, USA
| | - Barbara A. Olson-Bullis
- HealthPartners Institute for Education and Research, 8170 33rd Ave. S., Mailstop 23301A, Minneapolis, MN 55440, USA
| | - Dani M. Bredeson
- HealthPartners Institute for Education and Research, 8170 33rd Ave. S., Mailstop 23301A, Minneapolis, MN 55440, USA
| | - Marcia G. Hayes
- HealthPartners Institute for Education and Research, 8170 33rd Ave. S., Mailstop 23301A, Minneapolis, MN 55440, USA
| | - Nancy E. Sherwood
- HealthPartners Institute for Education and Research, 8170 33rd Ave. S., Mailstop 23301A, Minneapolis, MN 55440, USA
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Body image concerns during pregnancy are associated with a shorter breast feeding duration. Midwifery 2015; 31:80-9. [DOI: 10.1016/j.midw.2014.06.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 06/10/2014] [Accepted: 06/16/2014] [Indexed: 12/14/2022]
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25
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Cosentino-Rocha L, Klein VC, Linhares MBM. Effects of preterm birth and gender on temperament and behavior in children. Infant Behav Dev 2014; 37:446-56. [DOI: 10.1016/j.infbeh.2014.04.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 01/09/2014] [Accepted: 04/08/2014] [Indexed: 11/29/2022]
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