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Associations between infant and maternal characteristics measured at child age 5 months and maternal feeding styles and practices up to child age two years.
Helle, C, Hillesund, ER, Øverby, NC
PloS one. 2022;(1):e0261222
Abstract
Facilitating positive feeding practices from infancy may be an important strategy to prevent childhood overweight and obesity. Since the feeding situation early in life constitutes a bidirectional relationship, it is important to understand the impact of both maternal and infant characteristics on maternal feeding practices to intervene in a customized and tailored way. Few studies have concurrently examined associations between maternal and infant characteristics in relation to early maternal feeding practices. The aim of the present study was to explore potential associations between infant and maternal characteristics measured at child age five months, and maternal feeding styles and practices during the child's first two years. Cross-sectional data from a Norwegian randomized controlled trial in which participants responded to questionnaires at child age 5 months (n = 474), 12 months (n = 293) and 24 months (n = 185) were used to explore potential associations. All maternal and child predictor variables were collected at child age five months. Maternal feeding styles and practices were mapped using subscales from the Infant Feeding Questionnaire at child age 5 and 12 months and the Child Feeding Questionnaire and the Parental Feeding Style Questionnaire at child age 24 months. The subscale-scores were split into roughly equal tertiles, and the upper or lower tertile for the outcome of interest were used to create binary outcome variables. Multivariable binary logistic regression models were conducted for each outcome. We found that maternal education and mental health symptoms as well as infant weight, temperament and feeding mode were associated with maternal feeding styles and practices over time. Our findings indicate that risk factors which may have long-term implications for child weight and health outcomes can be identified early. Larger, population-based studies with a longitudinal design are needed to further explore these pathways.
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Improving Toddlers' Healthy Eating Habits and Self-regulation: A Randomized Controlled Trial.
Nix, RL, Francis, LA, Feinberg, ME, Gill, S, Jones, DE, Hostetler, ML, Stifter, CA
Pediatrics. 2021;(1)
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OBJECTIVES In this study, we tested whether Recipe 4 Success, a preventive intervention featuring structured food preparation lessons, was successful in improving the following 4 protective factors related to overweight and obesity among families living in poverty: toddlers' healthy eating habits, toddlers' self-regulation, parents' responsive feeding practices, and parents' sensitive scaffolding. METHODS This randomized controlled trial was open to families enrolled in Early Head Start home visits and included 73 parents and their toddlers aged 18 to 36 months. Multimethod assessments were conducted at baseline and posttreatment. RESULTS Compared with toddlers in usual practice Early Head Start, toddlers in Recipe 4 Success consumed healthier meals and snacks (d = 0.57; P < .03; 95% confidence interval [CI]: 0.08-1.06) and displayed better self-regulation (d = 0.95; P < .001; 95% CI: 0.43-1.45). Compared with parents in usual practice Early Head Start, parents in Recipe 4 Success engaged in more responsive feeding practices (d = 0.87; P < .002; 95% CI: 0.34-1.40) and were better able to sensitively scaffold their toddlers' learning and development (d = 0.58; P < .04; 95% CI: 0.07-1.09). CONCLUSIONS This randomized controlled trial revealed medium to large intervention effects on 4 important protective factors that are related to overweight and obesity but are often compromised by living in poverty.
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The Moderating Effects of the Families Improving Together (FIT) for Weight Loss Intervention and Parenting Factors on Family Mealtime in Overweight and Obese African American Adolescents.
Wilson, DK, Sweeney, AM, Quattlebaum, M, Loncar, H, Kipp, C, Brown, A
Nutrients. 2021;(6)
Abstract
Few studies have integrated positive parenting and motivational strategies to address dietary outcomes such as frequency of family mealtime. The Families Improving Together (FIT) for Weight Loss trial was a randomized group cohort trial (n = 241 dyads) testing the efficacy of integrating a motivational plus family weight loss (M + FWL) intervention for healthy eating and weight loss in overweight and obese African American adolescents. The current study tested the interaction of parenting styles (responsiveness, demandingness) and parental feeding practices (restriction, concern about child's weight, pressure to eat) and the FIT intervention on frequency of family mealtime over 16 weeks. Multilevel modeling demonstrated significant interactions between the group-based treatment and responsiveness (p = 0.018) and demandingness (p = 0.010) on family mealtime. For the group-based M + FWL intervention, increased responsiveness and reduced demandingness were associated with increased frequency of family mealtime from baseline to 16 weeks. There was also a negative association between parental restriction and frequency of family mealtime, but a positive association between parental concerns about their adolescent's weight and frequency of mealtime. These findings are the first to demonstrate that an authoritative or nurturing parenting style moderated intervention effects for improving the frequency of family mealtime in overweight and obese African American adolescents.
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Fathers' food parenting: A scoping review of the literature from 1990 to 2019.
Davison, KK, Haines, J, Garcia, EA, Douglas, S, McBride, B
Pediatric obesity. 2020;(10):e12654
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BACKGROUND While food parenting is a robust area of inquiry, studies have largely focused on mothers. Given the diversity of family structures today and increases in fathers' engagement in caregiving, fathers' food parenting warrants attention. OBJECTIVE We present a scoping review of research on fathers' food parenting (1990-2019). Eligible studies included peer-reviewed research published in English documenting fathers' food parenting and presenting results for fathers separate from mothers. RESULTS Seventy-seven eligible studies were identified. Most studies were based in the U.S (63.6%) and utilized a cross-sectional design (93.5%). Approximately half of studies used a validated measure of food parenting (54.5%) and slightly less than 30% utilized theory (28.6%). Many studies did not report information on fathers' residential status (37.7%) or their relationship to the target child (biological vs social) (63.6%). Content analysis of study findings showed that: fathers are involved in food parenting, but at lower levels than mothers; there are few consistent mother-father differences in food parenting practices; and fathers' controlling food parenting is linked with negative nutrition outcomes in children while responsive food parenting is linked with positive child outcomes. CONCLUSION To better inform family interventions to prevent childhood obesity, future food parenting research with fathers should recognize the diversity of family structures and utilize prospective, theory-based, designs.
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The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) responsive parenting intervention for firstborns impacts feeding of secondborns.
Ruggiero, CF, Hohman, EE, Birch, LL, Paul, IM, Savage, JS
The American journal of clinical nutrition. 2020;(1):21-27
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BACKGROUND The Intervention Nurses Start Infant Growing on Healthy Trajectories (INSIGHT) study's responsive parenting (RP) intervention, initiated in early infancy, prevented the use of nonresponsive, controlling feeding practices and promoted use of structure-based feeding among first-time parents compared with controls. OBJECTIVES We sought to examine the spillover effect of the RP intervention on maternal feeding practices with their secondborn (SB) infants enrolled in an observational-only study, SIBSIGHT, and to test the moderating effect of spacing of births. METHODS SB infants of mothers participating in the INSIGHT study were enrolled into the observation-only ancillary study, SIBSIGHT. SBs were healthy singleton infants ≥36 weeks of gestation. Infant feeding practices (i.e., food to soothe, structure vs. control-based practices) were assessed using validated questionnaires: Babies Need Soothing Questionnaire, Infant Feeding Styles Questionnaire, and the Structure and Control in Parent Feeding Questionnaire. RESULTS SBs (n = 117 [RP: 57, control: 60]; 43% male) were delivered 2.5 ± 0.8 y after firstborns (FBs). At age 1 y, the Structure and Control in Parent Feeding Questionnaire revealed that the mothers in the RP group used more consistent feeding routines (4.19 [0.43] compared with 3.77 [0.62], P = 0.0006, Cohen's D: 0.69) compared with control group mothers. From the Infant Feeding Styles Questionnaire, RP group mothers also used less nonresponsive, controlling feeding practices such as pressuring their SB infant to finish (1.81 [0.52] compared with 2.24 [0.68], P = 0.001, Cohen's D: 0.68) compared with controls. In contrast to our hypotheses, no differences were detected in bottle-feeding practices such as putting to bed with a bottle/sippy cup or adding cereal to the bottle, despite observing study group differences in FBs. Spacing of births did not moderate intervention effects. CONCLUSIONS RP guidance given to mothers of FBs may prevent the use of some nonresponsive, controlling feeding practices while establishing consistent feeding routines in subsequent siblings.
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Parent Stress as a Consideration in Childhood Obesity Prevention: Results from the Guelph Family Health Study, a Pilot Randomized Controlled Trial.
Hruska, V, Darlington, G, Haines, J, Ma, DWL
Nutrients. 2020;(6)
Abstract
Parents' stress is independently associated with increased child adiposity, but parents' stress may also interfere with childhood obesity prevention programs. The disruptions to the family dynamic caused by participating in a behaviour change intervention may exacerbate parent stress and undermine overall intervention efficacy. This study explored how family stress levels were impacted by participation in a home-based obesity prevention intervention. Data were collected from 77 families (56 fathers, 77 mothers) participating in the Guelph Family Health Study (GFHS), a pilot randomized control trial of a home-based obesity prevention intervention. Four measures of stress were investigated: general life stress, parenting distress, depressive symptoms, and household chaos. Multiple linear regression was used to compare the level of stress between the intervention and control groups at post-intervention and 1-year follow-up, adjusted for baseline stress. Analyses for mothers and fathers were stratified, except for household chaos which was measured at the family level. Results indicate no significant differences between intervention and control groups for any stress measure at any time point, indicating a neutral effect of the GFHS intervention on family stress. Future work should investigate the components of family-based intervention protocols that make participation minimally burdensome and consider embedding specific stress-reduction messaging to promote family health and wellbeing.
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Parenting styles and the dietary intake of pre-school children: a systematic review.
Burnett, AJ, Lamb, KE, McCann, J, Worsley, A, Lacy, KE
Psychology & health. 2020;(11):1326-1345
Abstract
Objective: The prevalence of childhood overweight and obesity has been increasing globally, with poor diet a key contributor. Parents play an influential role over the food intake of young children. This review explores whether parenting styles (authoritative, authoritarian, permissive and disengaged) or parenting dimensions (warmth and control) are associated with pre-school children's dietary intake.Design: Following the PRISMA guidelines, a systematic search of six electronic databases was conducted. Included articles were based on children aged 2-5 years and reported associations between parenting styles or dimensions and children's food intake. Two independent reviewers extracted the data and assessed the quality of the articles.Main outcome measures: Pre-school children's dietary intake.Results: Seven articles met the inclusion criteria. Six of the seven articles found evidence of at least one association between parenting styles or parenting dimensions and children's dietary intake. Several different measurement tools were used to identify parenting styles (n = 3) and dietary intake (n = 6), with reliability and validity reported in varying ways. The quality score of the articles ranged from 33% to 58%.Conclusion: Overall, an authoritative parenting style or higher levels of warmth appear to be associated with healthier dietary intakes among pre-school children.
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Influence of fathers on the feeding practices and behaviors of children: A systematic review.
Litchford, A, Savoie Roskos, MR, Wengreen, H
Appetite. 2020;:104558
Abstract
INTRODUCTION This systematic review will identify and summarize current research concerning the influence of fathers on the feeding behaviors of their children. Outcomes specific to child health, development of eating habits, relationships between paternal weight and child weight, and paternal dietary habits and child dietary habits were specifically targeted. METHODS A systematic review was conducted based on protocols outlined by PRISMA. A database search produced 851 relevant articles to be screened based on pre-determined inclusion criteria. Twenty-three studies met inclusion criteria for full review including two papers based on a single randomized control trial, 3 longitudinal studies, and 18 cross-sectional studies. RESULTS The most consistent findings across studies include the following. Father's BMI was positively correlated with child's BMI, father's dietary intake was predictive of child's dietary intake, food availability in the home influenced child intake, father's food parenting style predicted their children's eating behaviors and congruent parenting by mothers and fathers produced the best child food choices. CONCLUSIONS A growing body of research indicates that fathers play a key role in influencing child eating behaviors. Further research, including randomized control trials, will help strengthen current conclusions and better inform education and interventions designed for fathers.
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Responding positively to "children who like to eat": Parents' experiences of skills-based treatment for childhood obesity.
Ek, A, Nordin, K, Nyström, CD, Sandvik, P, Eli, K, Nowicka, P
Appetite. 2020;:104488
Abstract
This study aims to understand the challenges parents of preschoolers with obesity face. We assessed parents' experiences of a group treatment program focused on parenting skills; the treatment program was evaluated in a randomized controlled trial in Stockholm County. After completing the program's 10 weekly sessions, parents were invited to participate in a semi-structured interview. The interviews were audio recorded, transcribed and analyzed using thematic analysis. In total, 36 parents (67% mothers, mean age 39 years, 33% foreign background, 50% with university degree) were interviewed. Two main themes were developed: Emotional burden and Skills and strength from others. Emotional burden encompassed the parents' experiences of raising a child with obesity. Parents spoke about the difficulties of managing their child's appetite and of seeking help and treatment, as well as their feelings about the social stigma attached to obesity. Skills and strength from others encompassed the parents' experiences of participating in group treatment. Parents reported that they appreciated the practical behavior change techniques taught, especially those regarding food and how to make everyday life more predictable, and said the focus on parenting skills gave them the confidence to apply the techniques in everyday life. Parents also highlighted the strength of the group setting, saying it enabled them to discuss perceived challenges and learn from other parents. Our findings show that childhood obesity carries social and emotional implications for parents, and that an intervention that provides parents with skill-building and a discussion space can help in negotiating these implications. This suggests that childhood obesity intervention programs benefit from including a parent-based approach which offers training in parenting skills and support in managing socially and emotionally challenging situations.
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Parents' perceptions of parent-child interactions related to eating and body image: an experimental vignette study.
Lydecker, JA, Cunningham, PM, O'Brien, E, Grilo, CM
Eating disorders. 2020;(3):272-288
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Parents are key to children's health because they can influence children's eating behavior and body image and can make health-related decisions for children. Despite their influence, research on parents' opinions about parenting practices related to weight and eating is limited. Experimental vignettes examined parents' perceptions of parent-child interactions around body image, eating, and weight loss. We manipulated vignette-child weight (healthy-weight, overweight) and communication tone (positive, negative, neutral) to assess their influence on parents' perceptions. Parents (N = 233, 27.5% fathers, 72.5% mothers) were randomly assigned to read one of six vignettes. When the vignette-child had overweight, parents were more likely to recommend seeking help for body image and that the vignette-parent should choose the restaurant food order. Parents were less opposed to commenting on the vignette-child's weight when tone was positive. Parents were more likely to recommend weight-loss efforts that could be implemented by the family rather than those requiring professional assistance. This study is among the first to examine parents' opinions about parenting practices related to weight and eating using an experimental design. Findings might inform future research and continued work on prevention and treatment applications to help align parents' existing opinions about weight and eating with evidence-based health-promoting strategies.