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

Nonresponsive Parenting Feeding Styles and Practices and Risk of Overweight and Obesity among Chinese Children Living Outside Mainland China: An Integrative Review of the Literature

Chinese immigrants are a fast-growing population group in many parts of the world. Childhood obesity is increasingly a public health problem among Chinese living outside mainland China. Evidence suggests that parenting feeding styles and practices critically influence children's eating behaviors and risk of being overweight or obese. Therefore, the objectives of this review were to identify and synthesize the evidence from studies examining the associations between parenting feeding styles, feeding practices, and risk of overweight and obesity among children of Chinese parents outside mainland China. A systematic search of four electronic databases (CINAHL, Medline, PsycINFO, and PubMed) was conducted to identify peer-reviewed studies published in English between January 2000 and March 2022. Fifteen studies met the inclusion criteria and were included in the review. Findings of some of the reviewed studies showed that parenting feeding styles and practices varied according to children's age, gender, weight, and parents' acculturation levels. The two most identified parenting feeding styles were indulgent and authoritarian. Parents classified as having indulgent and/or authoritarian feeding styles reported using several feeding practices with unintended detrimental effects, such as pressuring children to eat and restricting or controlling child food intake (type and amount). Some of these feeding practices were associated with an increased risk of child overweight. The findings of this review provide important information that can inform the design interventions to address modifiable nonresponisve parental feeding practices such as pressuring, restricting, and controlling that meet the specific needs of Chinese parents and children outside mainland China.

Associations of parental feeding practices with children's eating behaviors and food preferences: a Chinese cross-sectional study

BACKGROUND

Childhood inadequate eating behaviors contribute to the epidemic of obesity. Previous research suggests that parental feeding practices are partially associated with development of eating behaviors among children, but the results are inconsistent. The present study was to investigate whether parental feeding practices were associated with eating behaviors and food preferences among Chinese children.

METHODS

A cross-sectional study was conducted to collect data from 242 children (ages 7-12) in six-primary schools in Shanghai, China. A series of questionnaires including parental feeding practices and children's eating behaviors have been validated, and were completed by one of parent who has responded for child's daily diet and living. In addition, researchers instructed children to complete the questionnaire of food preference. After adjustment for children's age, sex and BMI status, as well as parental education and family income, the linear regression analysis was used to evaluate relationships of parental feeding practices with children's eating behaviors and food preferences.

RESULTS

Parents with boys had higher level of control overeating practice than those with girls. Mothers who responded to child's daily diet and living and completed feeding practices questionnaire used a greater level of emotional feeding practices than fathers. Boys had higher levels of food responsiveness, emotional overeating, enjoyment of food and desire to drink than girls. Boys had different preferences for meat, processed meat products, fast foods, dairy foods, eggs, and snacks and starchy staples & beans from girls. In addition, scores of instrumental feeding practice and preference for meat significantly differed among children with different weight status. Furthermore, parental emotional feeding practice was positively associated with children's emotional undereating (β 0.54, 95% CI 0.16 to 0.92). There were also positive associations of parental encouragement to eat with children's preference for the processed meat (β 0.43, 95% CI 0.08 to 0.77). Moreover, instrumental feeding practice was negatively associated with children's fish liking (β -0.47, 95% CI -0.94 to -0.01).

CONCLUSION

The current findings support associations of emotional feeding practice with some children's emotional undereating, as well as parental encouragement to eat and instrumental feeding practice related to preference for processed meat and fish, respectively. Further studies should continue to ascertain these associations using longitudinal designs, and to evaluate efficacy of parental feeding practices impacting developments of healthy eating behaviors and preferences for healthy foods among children by interventional studies.

Relationship of parental feeding practices and diet with children's diet among South Asians in Canada

BACKGROUND

South Asian children's diets are considered unhealthy, yet the relationship with food parenting among South Asians is understudied.

METHODS

In a cross-sectional study, questionnaires were administered to dyads of Canadian South Asian elementary and high school children and a parent. Relationships between parental factors (perceived responsibility, restriction, pressure to eat, monitoring, home food environment, nutrition knowledge and intake of fruits and vegetables (FV), sugary beverages (SB) and sweets and fast foods (SWFF) and children's intake of FV, SB and SWFF were assessed by linear regression adjusted for sociodemographics. Subgroup differences by children's age and acculturation were explored by interaction analysis.

RESULTS

291 children (age 9.8 ± 3.2 years) had mean daily intake frequencies of 3.1 ± 2.0 FV, 1.0 ± 0.9 SB and 2.1 ± 1.5 SWFF. Positive associations were found between parent and child intake of FV (standardized beta (ß) = 0.230, [95%CI 0.115, 0.345], p < 0.001), SB (β = 0.136 [0.019, 0.252], p = 0.02), and SWFF (β = 0.167 [0.052, 0.282], p = 0.005). Parental monitoring was associated with lower children's SWFF intake (ß = -0.131 [-0.248, -0.015], p = 0.03). Among those expressing less Western culture, parental SWFF intake was associated with child's SB intake (β = 0.255 [0.085, 0.425], p = 0.004). Among those expressing less traditional culture, positive home food environment was associated with lower child SWFF intake (β = -0.208 [-0.374, -0.042], p = 0.015).

CONCLUSION

South Asian children's diets have stronger relationships with their parents' diets than with food parenting practices or nutrition knowledge, though parental monitoring was associated with lower unhealthy food intake. However, with greater acculturation, the home food environment was more important for unhealthy food intake.

Parental feeding and childhood genetic risk for obesity: exploring hypothetical interventions with causal inference methods

BACKGROUND

Parental-feeding behaviors are common intervention targets for childhood obesity, but often only deliver small changes. Childhood BMI is partly driven by genetic effects, and the extent to which parental-feeding interventions can mediate child genetic liability is not known. Here we aim to examine how potential interventions on parental-feeding behaviors can mitigate some of the association between child genetic liability and BMI in early adolescence, using causal inference methods.

METHODS

Data from the Avon Longitudinal Study of Parents and Children were used to estimate an interventional disparity measure for a child polygenic score for BMI (PGS-BMI) on BMI at 12 years. The approach compares counterfactual outcomes for different hypothetical interventions on parental-feeding styles applied when children are 10-11 years (n = 4248). Results are presented as adjusted total association (Adj-Ta) between genetic liability (PGS-BMI) and BMI at 12 years, versus the interventional disparity measure-direct effect (IDM-DE), which represents the association that would remain, had we intervened on parental-feeding under different scenarios.

RESULTS

For children in the top quintile of genetic liability, an intervention shifting parental feeding to the levels of children with lowest genetic risk, resulted in a difference of 0.81 kg/m² in BMI at 12 years (Adj-Ta = 3.27, 95% CI: 3.04, 3.49; versus IDM-DE = 2.46, 95% CI: 2.24, 2.67).

CONCLUSIONS

Findings suggest that parental-feeding interventions have the potential to buffer some of the genetic liability for childhood obesity. Further, we highlight a novel way to analyze potential interventions for health conditions only using secondary data analyses, by combining methodology from statistical genetics and social epidemiology.

General Parenting and Hispanic Mothers' Feeding Practices and Styles

Previous research has shown that general parenting styles, general parenting dimensions, maternal feeding styles, and maternal feeding practices all show specific relationships with the weight status of young children. This study examined the relationships between general parenting and maternal feeding styles/practices in a sample of 187 Hispanic mothers with low incomes. As part of a larger study, mothers of preschool children were recruited through Head Start programs and completed validated questionnaires assessing their general parenting, feeding styles, and feeding practices. Results identified numerous associations between general parenting dimensions and specific feeding practices: i.e., maternal nurturance was positively associated with healthy eating guidance and feeding responsiveness; inconsistency was positively associated with restriction for weight and promotion of overconsumption; follow through on discipline was positively associated with monitoring, healthy eating guidance, and feeding responsiveness; and family organization was positively associated with monitoring and healthy eating guidance. General parenting styles were associated with feeding practices as well, with authoritative mothers showing the highest levels of healthy eating guidance and authoritarian mothers showing the lowest levels of monitoring. There were no significant associations between mothers' general parenting styles and mothers' feeding styles. Implications of these findings for the prevention of childhood obesity are considered.

Maternal parenting styles and ecological momentary assessment of maternal feeding practices and child food intake across middle childhood to early adolescence

BACKGROUND

Maternal parenting styles are salient trait-based factors associated with pediatric obesity risk. The purpose of this study was to examine the longitudinal associations of maternal parenting styles and ecological momentary assessment (EMA) measures of maternal feeding practices and child food intake across middle childhood to early adolescence.

METHODS

Mother-child dyads (n = 186; M baseline child age = 10.03 ± 0.89) enrolled in a six-wave bi-annual longitudinal study. At baseline, mothers completed a self-report measure of parenting styles. At each of the six waves, mothers and children completed EMA prompts of parenting practices and food intake, respectively, for eight days.

RESULTS

Children of mothers who reported a more permissive style consumed more pastries/sweets. Children of mothers who reported a more authoritative style decreased likelihood of pastry/sweets consumption with age, and children of mothers who reported a less authoritative style increased likelihood of pastry/sweets consumption with age. The likelihood of fruit/vegetable consumption decreased with age among children of mothers who reported a more authoritarian style, and the likelihood increased among children of mothers with a less authoritarian style. Mothers who either reported a more authoritarian style or a less authoritative style were more likely to report using food as a reward.

DISCUSSION

Results highlight the importance of maternal parenting styles in relation to child food intake and instrumental feeding.

The Association of Acculturation and Complementary Infant and Young Child Feeding Practices Among New Chinese Immigrant Mothers in England: A Mixed Methods Study

Acculturation has an influence on mothers' beliefs and the perceived behaviours of different ethnicities. Few studies have been conducted on complementary infant and young child feeding practices (CIYCFP) in minorities in England, particularly in Chinese immigrants. This mixed study aims to explore the association of acculturation and IYCF among new Chinese immigrant mothers using purposive snowball sampling from an informal Chinese community. The participants' responses to the Infant Feeding Style Questionnaire (IFSQ) and Mutual Intercultural Relations in Plural Societies (MIRIPS), questionnaire (n = 32) were collected. A sub-set of 15 also participated in semi-structured interviews. Pearson's correlation coefficient analysis and thematic analysis were performed to analyse the survey and semi-structured interview data, and triangulation was employed to integrate quantitative and qualitative findings. This study indicated that Chinese mothers who scored high in integration were more likely to respond to satiety and attention; those inclined to be marginalised were more likely to indulge their children. Those who were more culturally separated were more likely to restrict the food quality offered to their children. This study also indicated that Chinese immigrants balanced western and Chinese feeding practices to combat feeding and culture conflict. This study presents preliminary findings of the association between acculturation and CIYCFP, which can improve culturally appropriate CIYCFP in minorities. Further studies are needed to explore intervention programs to tailor CIYCFP with consideration for acculturation in the minority.