Children's eating behavior, feeding practices of parents and weight problems in early childhood: Results from the population-based Generation R Study

International Journal of Behavioral Nutrition and Physical Activity (Impact Factor: 4.11). 10/2012; 9(1):130. DOI: 10.1186/1479-5868-9-130
Source: PubMed


Weight problems that arise in the first years of life tend to persist. Behavioral research in this period can provide information on the modifiable etiology of unhealthy weight. The present study aimed to replicate findings from previous small-scale studies by examining whether different aspects of preschooler’s eating behavior and parental feeding practices are associated with body mass index (BMI) and weight status -including underweight, overweight and obesity- in a population sample of preschool children.

Cross-sectional data on the Child Eating Behaviour Questionnaire, Child Feeding Questionnaire and objectively measured BMI was available for 4987 four-year-olds participating in a population-based cohort in the Netherlands.

Thirteen percent of the preschoolers had underweight, 8% overweight, and 2% obesity. Higher levels of children’s Food Responsiveness, Enjoyment of Food and parental Restriction were associated with a higher mean BMI independent of measured confounders. Emotional Undereating, Satiety Responsiveness and Fussiness of children as well as parents’ Pressure to Eat were negatively related with children’s BMI. Similar trends were found with BMI categorized into underweight, normal weight, overweight and obesity. Part of the association between children’s eating behaviors and BMI was accounted for by parental feeding practices (changes in effect estimates: 20-43%), while children’s eating behaviors in turn explained part of the relation between parental feeding and child BMI (changes in effect estimates: 33-47%).

This study provides important information by showing how young children’s eating behaviors and parental feeding patterns differ between children with normal weight, underweight and overweight. The high prevalence of under- and overweight among preschoolers suggest prevention interventions targeting unhealthy weights should start early in life. Although longitudinal studies are necessary to ascertain causal directions, efforts to prevent or treat unhealthy child weight might benefit from a focus on changing the behaviors of both children and their parents.

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    • "A range of explanations has been offered to analyse the causes of children's poor dietary habits. Among which the lack of knowledge as well as being affected by many aspects including parents, peers, and advertisements have been marked as the main causes [2]. Peers and parents have the most important social influence on children's eating habits, although, many researchers respectively study the parents' and the peers' influences on the children's eating habits and attitude [3]. "

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    • "Whereas mothers seem to be most involved in buying food and preparing it, the influence of the other parent and the rest of family members (siblings, grandparents) should not be discounted. Additionally , as the relationship between parent and child is bi-directional, to fully understand parenting practices we need to take into account children's characteristics such as their eating behavior (Jansen et al., 2012), temperament (Bergmeier, Skouteris, Horwood, Hooley, & Richardson, 2014a, 2014b; Faith & Hittner, 2010) and appetitive traits (Llewellyn, van Jaarsveld, Johnson, Carnell, & Wardle, 2010). The fact that 94% of the children in this sample spend most of their daytime in kindergarten, thus, outside of the parent's direct influence on feeding, shows that the child care environment is of paramount importance . "
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    ABSTRACT: The Child Feeding Questionnaire (CFQ) assesses parental feeding attitudes, beliefs and practices concerned with child feeding and obesity proneness. The questionnaire has been developed in the U.S., and validation studies in other countries are limited. The aim of this study was to examine the psychometric properties of the CFQ in Sweden and the associations between parenting practices and children's weight status. Based on records from the Swedish population register, all mothers of 4-year-olds (n=3007) from the third largest city in Sweden, Malmo, were contacted by mail. Those who returned the CFQ together with a background questionnaire (n = 876) received the CFQ again to enable test-retest evaluation; 564 mothers completed the CFQtwice. We used confirmatory factor analysis to test whether the original 7-factor model was supported. Good fit (CFI = 0.94, TLI = 0.95, RMSEA = 0.04, SRMR = 0.05) was obtained after minor modifications such as dropping 2 items on restriction and adding 3 error covariances. The internal reliability and the 2-week test-retest reliability were good. The scores on restriction were the lowest ever reported. When the influence of parenting practices on child BMI (dependent variable) was examined in a structural equation model (SEM), child BMI had a positive association with restriction and a negative association with pressure to eat. Restriction was positively influenced by concern about child weight. The second SEM treated parenting practices as dependent variables. Parental foreign origin and child BMI had direct effects on restriction, while pressure to eat was also influenced by parental education. While the results of the study support the usefulness of the CFQin Sweden, carefully designed cross-cultural comparisons are needed to explain why the levels of restrictive feeding in Swedish families are the lowest reported. (C) 2014 The Authors. Published by Elsevier Ltd.
    Appetite 06/2014; 81. DOI:10.1016/j.appet.2014.06.027 · 2.69 Impact Factor
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    • "Previous studies using the CEBQ have mainly assessed fussy/picky eating with a continuous score on the “food fussiness” subscale consisting of 6 items (e.g. “Refuses to eat new food at first”) [1,15]. Finally, some studies have combined items from different questionnaires to assess picky eating on a continuous scale and defined a “picky eater” group based on the specific behaviors being sometimes or always present [16,17]. "
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    ABSTRACT: Definitions and assessment methods of fussy/picky eating are heterogeneous and remain unclear.We aimed to identify an eating behavior profile reflecting fussy/picky eating in children and to describe characteristics of fussy eaters. Eating behavior was assessed with the Child Eating Behavior Questionnaire (CEBQ) in 4914 4-year olds in a population-based birth cohort study. Latent Profile Analysis (LPA) was used to identify eating behavior profiles based on CEBQ subscales. We found a "fussy" eating behavior profile (5.6% of children) characterized by high food fussiness, slowness in eating, and satiety responsiveness in combination with low enjoyment of food and food responsiveness. Fussy eaters were more often from families with low household income than non-fussy eaters (42% vs. 31.8% respectively; Chi2(1) = 9.97, p < .01). When they were 14 months old, fussy eaters had a lower intake of vegetables (t [3008] = 2.42, p < .05) and fish (t [169.77] = 2.40, p < .05) but higher intake of savory snacks (t [153.69] = -2.03, p < .05) and sweets (t [3008] = -2.30, p < .05) compared to non-fussy eaters. Also, fussy eaters were more likely to be underweight at 4 years of age (19.3%) than non-fussy eaters (12.3%; Chi2(1) = 7.71, p < .01). A distinct fussy eating behavior profile was identified by LPA, which was related to family and child characteristics, food intake, and BMI. This behavior profile might be used in future research and the development of interventions.
    International Journal of Behavioral Nutrition and Physical Activity 02/2014; 11(1):14. DOI:10.1186/1479-5868-11-14 · 4.11 Impact Factor
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