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What children bring to the table: The association of temperament and child fussy eating with maternal and paternal mealtime structure
Abstract
Fussy eating is a nuanced, mealtime-specific behaviour associated with difficult temperament but has been rarely examined within the context of mealtime structure. The aim of this study was to a) examine associations between child temperament, and mothers' and fathers' structure-related feeding practices and b) explore whether these associations were mediated by child fussy eating. Cohabiting mother-father pairs (N = 205) of children aged between 2- to 5-years residing in a socioeconomically disadvantaged Australian city completed self-reported, validated measures of child temperament, food fussiness and structure-related feeding practices (structured meal timing, structured meal setting and family meal setting). Child temperament was associated with maternal and paternal structure-related feeding practices, such that more difficult temperament was associated with less mealtime structure. Mothers' perception of child food fussiness mediated the relationship between difficult temperament and increased provision of alternative meals to the child from the rest of the family. Additionally, mothers' and fathers' perception of child food fussiness mediated the relationship between difficult child temperament and lower frequency of sitting at a table together for family meals. Therefore, perceptions of child food fussiness may explain why mothers and fathers use less structure at mealtimes with children who have more difficult temperaments. These results suggests that similar intervention approaches can be used for both mothers and fathers from socioeconomically disadvantaged families to target fussy eating and structure the mealtime environment. Promoting mealtime structure to facilitate parents’ appropriate responses to food refusal or difficult behaviour at mealtimes is indicated.
... parent decides on timing of meals) and Family Meal Setting (i.e. child eats same meals as rest of family) assessed with the Feeding Practices and Structure Questionnaire (FPSQ) [20,21], have been previously associated with child eating behaviors including lower food fussiness and higher self-regulation in eating [22][23][24][25][26]. However, less is known about relationships with the food approach behaviors food responsiveness and emotional overeating, those eating behaviors characterized by a greater interest in food. ...
... Structure-related food and snack-parenting practices did not differ by parent sex. In a previous study using the Feeding Practices and Structure Questionnaire, Searle and colleagues [25] found that in mother-father pairs of preschoolers, there was no difference in Structured Meal Setting or Family Meal Setting. Structured Meal Timing was significantly higher in mothers compared to fathers [25] although this difference might not be clinically significant. ...
... In a previous study using the Feeding Practices and Structure Questionnaire, Searle and colleagues [25] found that in mother-father pairs of preschoolers, there was no difference in Structured Meal Setting or Family Meal Setting. Structured Meal Timing was significantly higher in mothers compared to fathers [25] although this difference might not be clinically significant. In both the current study and Searle's, the difference in Structured Meal Timing was 0.1 on a 5-point scale. ...
Background
: During the COVID-19 pandemic, many mothers and fathers have spent more time at home with their children, warranting consideration of parenting practices around food during the pandemic as influences on obesogenic eating behaviors among children. Structure-related feeding practices, particularly around snacking, may be particularly challenging yet influential in the pandemic setting. Parent sex and levels of feeding-related co-operation among parents (co-feeding) are understudied potential influences on parent-child feeding relationships.
Methods
: We investigated relationships between structure-related parent feeding and child food approach behaviors during the COVID-19 pandemic, while considering potential moderating influences of parent sex and co-feeding levels. An online survey was completed by 318 parents (206 mothers and 112 fathers) of 2-12-year-olds who were living in states with statewide or regional lockdowns in May/June 2020 within the United States. Mothers and fathers were drawn from different families, with each survey corresponding to a unique parent-child dyad. Parental stress/mental health, co-feeding (Feeding Coparenting Scale), structure-related food and snack parenting (Feeding Practices and Structure Questionnaire and Parenting around SNAcking Questionnaire), and child eating behaviors (Child Eating Behaviour Questionnaire) were assessed. Relationships of parents’ structure-related food and snack parenting practices with their child's emotional overeating and food responsiveness behaviors were examined using structural equation modelling. Further, we investigated whether these relations were moderated by parent sex or level of co-feeding.
Results
: Parent sex differences were seen in parental stress, mental health, and co-feeding, but not in structure-related food and snack parenting or child food approach eating behaviors. Structure-related food parenting was negatively associated with emotional overeating. However, structure-related snack parenting was positively associated with emotional overeating and food responsiveness. While regression paths varied between mothers vs. fathers, as well as by co-feeding levels, neither parent sex nor co-feeding levels significantly moderated relationships between parent feeding and child eating variables.
Conclusions
: Future studies of food and snack parenting and co-operation in relation to feeding among mothers and fathers within a familial unit may be critical to identify intervention strategies that draw on all family resources to better navigate future disruptive events such as the COVID-19 pandemic.
... Ages and demographics of target population of included children also greatly varied between studies, with no consistency between age brackets considered or size of the age bracket. Most commonly the age bracket of toddlers (12 to 36 months old) or preschool aged children (aged three to five) was included either as the primary focus [20,25,30,34,[36][37][38][39]41,44,52,57,59,60,72,73,[76][77][78][79][80][81] or as part of a larger age inclusion [21,23,24,28,35,40,42,43,47,49,51,63,64,68,69,71,74,75,[82][83][84][85][86][87] or a focus on primary school aged (five to eleven years) [27,31,32,48,[53][54][55][56]61,70,88]. Another common focus was that of children from a socioeconomically disadvantaged area [20,33,53,58,62,82]. ...
... Most commonly the age bracket of toddlers (12 to 36 months old) or preschool aged children (aged three to five) was included either as the primary focus [20,25,30,34,[36][37][38][39]41,44,52,57,59,60,72,73,[76][77][78][79][80][81] or as part of a larger age inclusion [21,23,24,28,35,40,42,43,47,49,51,63,64,68,69,71,74,75,[82][83][84][85][86][87] or a focus on primary school aged (five to eleven years) [27,31,32,48,[53][54][55][56]61,70,88]. Another common focus was that of children from a socioeconomically disadvantaged area [20,33,53,58,62,82]. ...
... Behaviours of the child who was identified as a picky eater included slower to eat or longer feeding time than children who are typically developing [15,29,52,79,86], avoiding mealtimes [52,79,92] or sitting at the table [20,52], and rigid behaviours regarding food [52,79] such as inspecting foods [14,52]. Common responses of the picky eater to food included verbally [52] or physically gesturing refusal [14,37,75,79] or general disinterest in food [92]. ...
The health benefits and importance of family mealtimes have been extensively documented. Picky eating can impact this complex activity and has numerous extrinsic (or external) and in-trinsic (or internal) features. Occupational therapists work with children and their families by looking at both intrinsic and extrinsic influences and are therefore well-placed to work within this context. This scoping review comprises a comprehensive search of key health industry databases using pre-determined search terms. A robust screening process took place using the authors pre-agreed inclusion and exclusion criteria. There were 80 studies that met the inclusion criteria, which were then mapped using content analysis. The most common assessments used to identify picky eating relied on parental reports and recall. Often additional assessments were included in studies to identify both the intrinsic and extrinsic features and presentation. The most common reported intrinsic features of the child who is a picky eater included increased sensitivity partic-ularly to taste and smell and the child’s personality. Extrinsic features which appear to increase the likelihood of picky eating are authoritarian parenting, rewards for eating, and pressuring the child to eat. Most commonly reported extrinsic features that decrease the likelihood of picky eating are family meals, responsive parents, and involving the child in the preparation of food. In conclusion, there is a lack of published papers addressing the role of occupational therapists in the assessment and identification of picky eating in children. There appears to be a complex in-terplay between intrinsic and extrinsic features which impact caregiver responses and therefore on the picky eater.
... Anxiety and concern about the children being considered challenging to eat can model unresponsive practices [61]. Similarly, in this study, the tradition of offering many food options to the child was positively associated with FD. ...
... Similarly, in this study, the tradition of offering many food options to the child was positively associated with FD. According to the literature, the preparation of favorite dishes and avoiding conflicts at meals are strategies that, in addition to affecting the structure of meals [61], can reinforce the cycle of refusal and lead children to more restricted diets and lower consumption of fruits and vegetables [25,32,62]. Given these findings, it is recommended that the options be guided within a limit of the preparations offered [63]. ...
Background
Parental complaints about feeding difficulties (FD) during childhood are frequent in pediatrics. Behavioral factors about children’s feeding and parental aspects are fundamental in solving these problems, but research in this area lacks information considering the joint presence of fathers and mothers. Thus, this study aimed to investigate the features of children, parents and mealtime practices related to FD reported by fathers and mothers and to identify parenting styles, mealtime actions, practices and factors associated with FD in children.
Methods
323 parents (226 mothers and 97 fathers) of children aged 1 to 7 years were recruited in the emergency waiting room at Sabará Hospital Infantil, in São Paulo, Brazil, and self-completed electronic questionnaires on parenting style (Caregiver’s Feeding Styles Questionnaire), parents’ mealtime actions (Parent Mealtime Action Scale), socioeconomic information, personal and children’s health data and routine meal practices.
Results
The prevalence of FD in children was 26.6%. Indulgent parenting style was the most frequent (44.2%), followed by authoritarian (25.1%), authoritative (23.8%), and uninvolved (6.9%) styles. Most parents (75.8%) reported presence during meals, and 83.6% used distractions. Regression analyses after adjustments showed, as factors associated with FD, female children (OR: 2.06; 95%CI: 1.19–3.58), parents’ FD history (OR: 3.16; 95%CI: 1.77–5.64), and greater frequency of parents’ behavior of offering many food options (OR: 2.69; 95%CI: 1.18–6.14). Parents with indulgent styles had decreased chances of reporting FD in their children (OR: 0.13; 95%CI: 0.06–0.27). Furthermore, the practice of children sharing the family menu (OR: 0.43; 95%CI: 0.18–0.99) and higher frequency of parents’ behavior of setting snack limits (OR: 0.44; 95%CI: 0.23–0.85) were inversely associated with FD.
Conclusions
This study reinforces the multifactorial aspects involved in the feeding difficulties context. It points out the importance of expanding knowledge of the individual role of fathers and mothers to compose a scenario that can guide future studies and interventions.
Trial registration
CAAE #99221318.1.0000.5567 with registration number 2,961,598.
... Furthermore, the feeding practices that parents use may vary as a function of children's temperament. For example, mothers who perceived greater infant surgency or negative affect were less likely to use RF and more likely to use food to calm their infants even when they were not physically hungry (Schneider-Worthington et al., 2022), and parents of children with lower levels of negative affect were more likely to use RF (Searle et al., 2020). ...
... Developmental contextualism suggests that the goodness of fit between individual traits (e.g., temperament) and the contexts (e.g., feeding environment) of individuals' lives determines whether the contexts promote the development of individuals (Zhang and Chen, 2009;Richardson, 2011). For example, the results from a cross-sectional study suggested that children with lower levels of negative affect were less likely to exhibit food fussiness when parents used RF, such as structured meal settings (Searle et al., 2020). It is possible that the fit between RF and children with special temperamental traits (e.g., lower surgency, lower negative affect, or higher effortful control) may be good and thus these children are more likely to exhibit good appetitive traits, which may indicate that RF may simply be more achievable or more successful in improving children's appetitive traits in children who possess particular temperament traits. ...
Introduction:
Between the ages of 6 and 12 months is a crucial stage for children to develop appetitive self-regulation. Evidence suggests that a combination of parental responsive feeding and infant temperament (surgency, effortful control, negative affect) shapes infant appetitive traits (food approach, food avoidance). There is a need for research to explore these relationships, in order to provide guidance for the design of an effective intervention to improve appetitive traits. The objective of the current study was to explore the moderating role of infant temperament in the relationship between parental responsive feeding and infant appetitive traits.
Methods:
A total of 616 questionnaires, measuring parental responsive feeding, infant appetitive traits, and infant temperament, were collected from parents with infants aged 6-12 months.
Results:
Results revealed that responsive feeding was associated with both food approach and food avoidance. Furthermore, only lower levels of surgency significantly moderated the relationship between responsive feeding and food approach, while responsive feeding was associated with food avoidance irrespective of infant temperament.
Discussion:
These findings suggest that a strategy embedding responsive feeding interventions should be adopted to reduce infant food avoidance and low-surgent infant food approach, and interventions that are tailored toward food approach for infants with effortful control, negative affect, or higher levels of surgency should be further sought.
... Family dinners have been associated with a lowered risk for eating unhealthy foods [49,50], lower rates of obesity [51], better academic performance [52], and fewer behavioral problems in children [53], among other benefits. However, the health benefits of family meals may be mediated by more unified families, better communication during mealtimes [54], parenting styles [25,47], or children's temperament [55]. Thus, creating a constructive or positive atmosphere at home may be challenging for families of children with ND [29]. ...
... Negative communication around food and mealtimes may create adverse connotations and experiences, so much so that children may even refuse to come to the dinner table [21,27]. Negative experiences may even lead to family members eating separate meals, in separate rooms, at different times during the day [21,34,55,63]. Importantly though, parents can be valuable role models and may positively impact children's eating and mealtime behaviors, especially when combined with family-based interventions [1,16,34]. ...
Fussy-eating children often display problematic behaviors around mealtimes, such as irritation, opposition, or may even throw tantrums. This may lead to reduced food variety and poor nutritional profiles, which may increase parents’ worries about their children’s diet, particularly when the children also have neurodevelopmental disorders (ND) such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactive Disorder (ADHD). To investigate the effect of Taste Education on problematic mealtime behaviors, 81 children aged 8–12 years, with ND (n = 33) and without (n = 48), and their parents, participated in a 7-week Taste Education intervention. Children were matched on age, sex, and ND, and allocated at random into Immediate-intervention and Delayed-intervention groups. Parents completed the Meals in Our Household Questionnaire (MiOH). To examine changes in MiOH-scores, repeated-measures analysis-of-variance with time-points were used, with condition as factors (Immediate intervention and Delayed intervention). Baseline measures were adjusted for, and a robust linear mixed-model was fitted. Results showed superior outcomes for Intervention compared to waiting on all measures of MiOH, with stable effects through six-month follow-up. Differences were non-significant between children with and without ND. The Taste Education program suggests a promising, simple, and non-intrusive way to reduce children’s problematic mealtime behaviors in the long term.
... Temperament refers to basic predispositions around reactivity and self-regulation that, like appetite, are believed to reflect an interplay of genetic, biological, and environmental factors [48][49][50]. While there has been considerable recent interest in understanding the role of temperament in children's self-regulation of appetite [49,[51][52][53][54][55][56], the extent to which eating behaviors are directly shaped by temperament is unclear [57]. Consistent with current theoretical perspectives, we hypothesized that empirically derived eating behavior profiles would broadly reflect dispositions towards food approach and food avoidance and would be aligned with weight outcomes [4] and differentiated by temperamental characteristics [57]. ...
... Int J Behav Nutr Phys Act (2022) 19:91 children with high food approach profiles had low inhibitory control compared to the other profiles. These findings are generally consistent with a number of recent studies that have evaluated associations of temperament with individual food avoidance and approach behaviors among children [49,[51][52][53][54][55][56]. For instance, in a longitudinal study of 997 Norwegian children followed from ages 4 to 10 years, higher negative affectivity (of which anger/ frustration is a component) was associated with higher food approach and food avoidance behaviors, whereas greater surgency (of which impulsivity is a component) was associated with higher food approach behaviors, but lower food avoidance behaviors [54]. ...
Background
Individual differences in eating behaviors among young children are well-established, but the extent to which behaviors aggregate within individuals to form distinct eating behavior profiles remains unknown. Our objectives were to identify eating behavior profiles among preschool-aged children and evaluate associations with temperament and weight.
Methods
A secondary, cross-sectional analysis of baseline data from 2 cohort studies was conducted involving 1004 children aged 3–4 years and their parents with low-income backgrounds. Children’s eating behaviors and temperament were assessed by parental report. Body mass index z -scores and weight status were calculated using measured heights and weights. Latent profile analysis (LPA) was used to generate profiles and bivariate analyses were used to evaluate associations with temperament and weight status.
Results
LPA revealed the presence of 3 eating behavior profiles among children. Children with High Food Approach profiles (21.2%) had lower temperamental inhibitory control and the highest percent of children with obesity relative to the other profiles. Children with High Food Avoidant profiles (35.6%) had lower temperamental impulsivity and lower BMI z -scores relative to the other profiles, whereas children with Moderate Eating profiles (intermediary levels of all behaviors; 43.2%) had higher temperamental inhibitory control and lower anger/frustration, than other profiles.
Conclusions
Young children’s eating behaviors appear to aggregate within individuals to form empirically distinct profiles reflecting food approach, food avoidance, and moderate approaches to eating that are differentiated by aspects of temperament and weight. Future work should seek to understand the extent to which health promotion and obesity prevention approaches should be tailored to take into account children’s fundamental dispositions towards eating.
... Both quantitative and qualitative literature have documented the feeding practices adopted by parents in response to food fussiness. Examples include food pressuring [1,14,17,19,20], the preparation of alternative meals [1,14,17,21], the use of food or non-food rewards [14,17,19,22] and the accommodation of children's food preferences during meal preparation [1,17,23]. A qualitative study conducted by Wolstenholme et al. [17], suggested that these practices vary across families and are likely to change over time in response to their perceived effectiveness. ...
... The cooking of alternative meals [1,21], use of food rewards [22,24,64], and pressuring [18,22,24] have been explored within the existing literature as common behavioural responses to fussy eating for fathers. Commentary on these behaviours within this review highlighted that there is not a 'one size fits all' approach to fussy eating behaviour. ...
The paternal experience of family mealtimes is an emerging field within qualitative literature. Previous quantitative studies suggest that differences exist between fathers’ and mothers’ mealtime behaviours, particularly in response to fussy eating. However, qualitative research has not yet focused exclusively on fathers’ fussy eating experiences. This metasynthesis aimed to provide insights into the general paternal experience, inclusive of their fussy eating responses. Thematic synthesis methodology was adopted to achieve this process and consisted of a systematic search resulting in the inclusion of 16 studies (18 papers). The direct quotations presented within each study were subjected to three stages of analysis to produce three analytical themes, supported by eight descriptive themes. The analytical themes presented were: (1) environmental influences on fathers’ mealtime experiences; (2) attitudes and emotions of fathers during mealtimes; and (3) observable behaviours of fathers during mealtimes. These themes highlighted the complexity of the mealtime experience from a paternal perspective. Multidirectional relationships were identified between each mealtime component (i.e., the environment, attitudes, emotions and behaviours) as evidenced by the paternal commentary presented. The findings also provided insights into fathers’ fussy eating experiences, recognising that fathers should be considered as individuals in the presence of mealtime intervention.
... One strategy to help facilitate the introduction of novel foods to children is to serve all family members the same meal [52]. Whether aimed at ensuring children eat, mitigating conflict at the meal, or minimizing food waste, parents often provide an alternative meal consisting of preferred foods to children who engage in fussy eating behaviors [51,53]. ...
... Whether aimed at ensuring children eat, mitigating conflict at the meal, or minimizing food waste, parents often provide an alternative meal consisting of preferred foods to children who engage in fussy eating behaviors [51,53]. This practice reduces the likelihood that children will try novel foods and may reinforce picky eating [52]. While feeding children who exhibit fussy eating can be challenging for all parents, how parents respond to fussy eating behaviors likely differs based on food security status. ...
The process of feeding is complex and highly dependent on parent, child, social, and environmental factors. Given the rising rates of food insecurity and concomitant poor nutrition and health, the purpose of this article was to outline the important and complex ways in which the context of food insecurity can impact parent feeding practices. Key factors discussed here include the impact of food insecurity on: expectations for motherhood, structural constraints, stress and depression, parents’ perceptions of health and child weight, and intergenerational transmission of parent feeding practices. Future research needs are also identified and discussed.
... For proxy-reports (e.g., by parents or teachers), respondents will also have varying levels of awareness about the behaviour they are asked to report on; parents can only report on their experiences with the child, and what their child tells them, and this can introduce bias (Podsakoff et al., 2003). Furthermore, for parent-reports of children's eating behaviours, each parent may see children in different contexts from other informants, teachers, childcare staff, or grandparents and this can affect their responses (Searle et al., 2020). Another consideration is that parents will have the knowledge of and experience with their own child's eating behaviours, however they may not be aware of the ranges or typical behaviours of other children in the same age group to compare with their child's behaviours. ...
Eating behaviours affect food intakes and are involved in the aetiology of obesity. There has been impetus to translate findings about children's eating behaviour into intervention and policy programs. However, measurement limitations have hindered our capacity to understand and influence children's eating behaviours. In the present paper we provide an overview of some of the key methodological and measurement issues facing the field of children's eating behaviours and highlight implications for research and health promotion. Drawing on insight from parallel issues that occur in the measurement of early social and emotional development, we examine two overlapping themes in children's (aged 0-∼12 years) eating behaviours (Somaraki et al., 2021) measurement issues related to validity and reliability, and (Steinsbekk & Wichstrøm, 2015) associated methodological challenges, such as contextual influences and the importance of designing studies that use multiple informants and multiple methods. We then suggest insights and strategies aimed at advancing approaches to measurement of children's eating behaviours. To progress our understanding of children's eating behaviours, we conclude that a range of psychometrically sound, fit-for-purpose measurement instruments and procedures are needed for use in multi-trait, multi-method, multi-informant studies in a range of populations and contexts.
... Future research is needed to explicitly document such processes, but if observed, information about these processes may have implications for parent educational programs. Notably, these findings are consistent with studies that included only one child per family and showed that child negative affect was linked to greater use of food to soothe [21] and less mealtime structure [61] in early childhood. Ours, however, is the first analysis to use a sibling design to examine whether the effects of one child's negative affect spill over to affect the feeding practices used with another. ...
Background
Firstborn children have higher rates of obesity compared to secondborns, perhaps due, in part, to differential feeding practices. Despite the centrality of siblings in family life and potential for influence, almost nothing is known about the role of siblings in parent feeding practices in early childhood.
Methods
Participants ( n = 117) were mothers of consecutively born siblings. Firstborns participated in an RCT that compared a responsive parenting intervention designed for primary prevention of obesity against a safety control. Secondborns participated in an observational cohort. Multilevel models tested whether and how firstborn characteristics (temperament, appetite, rapid weight gain) at 16 weeks and 1 year were associated maternal feeding practices of secondborns in infancy at 16 weeks, 28 weeks, and 1 year (food to soothe) and at ages 1, 2, and 3 years (structure-and control-based feeding practices). A purposive subsample ( n = 30) of mothers also participated in semi-structured interviews to further illuminate potential sibling influences on maternal feeding practices during infancy and toddlerhood.
Results
Firstborn characteristics did not predict secondborn feeding in infancy (all ps > 0.05). Firstborn negative affect, however, predicted mothers’ less consistent mealtime routines ( b (SE) = − 0.27 (0.09); p = 0.005) and more pressure ( b (SE) = 0.38 (0.12); p = 0.001). Firstborn appetite predicted mothers’ less frequent use of food to soothe ( b (SE) = − 0.16 (0.07); p = 0.02) when secondborns were toddlers. Firstborn surgency, regulation, and rapid weight gain, however, did not predict secondborn feeding practices during toddlerhood (all ps > 0.05). Interviews with mothers revealed three ways that maternal experiences with firstborns informed feeding practices of secondborns: 1) Use of feeding practices with secondborn that worked for the firstborn; 2) Confidence came from firstborn feeding experiences making secondborn feeding less anxiety-provoking; and 3) Additional experiences with firstborn and other factors that contributed to secondborn feeding practices.
Conclusions
Some firstborn characteristics and maternal experiences with firstborns as well as maternal psychosocial factors may have implications for mothers’ feeding practices with secondborns. Together, these mixed methods findings may inform future research and family-based interventions focused on maternal feeding of siblings in early childhood.
... Results suggest that sitting at the table, about the same time every day and eating the same food together with the rest of the family shaped a favorable environment that was associated with appropriate feeding behaviors in the present study. Existing literature verifies that children who lack a structured and consistent meal routine are more likely to exhibit feeding problems [9,57,68,69]. In addition, as children learn to eat through observation and role-modeling by family members, this finding highlights the importance of systematically exposing the child to positive eating patterns and integrating into the feeding environment of the rest of the family [70]. ...
Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.
... However, negative affectivity has not consistently been linked to changes in vegetable consumption, and further temperament traits such as surgency (high activity level, extraversion, enjoyment of high intensity activities) and effortful control (high attention capacity, inhibitory control, ability to self-regulate) may be better linked to vegetable consumption and specific vegetable feeding practices used by parents [85]. For parental practices in particular, parents who perceive their child as fussy or with a difficult temperament may offer less structured mealtimes [125]. Thus, temperament may moderate the impact of parent feeding and learning paradigms, as well as invoking different feeding practices by the caregiver. ...
Children eat too few vegetables and this is attributed to disliked flavours and texture as well as low energy density. Vegetables confer selective health benefits over other foods and so children are encouraged to eat them. Parents and caregivers face a challenge in incorporating vegetables into their child's habitual diet. However, liking and intake may be increased through different forms of learning. Children learn about vegetables across development from exposure to some vegetable flavours in utero, through breastmilk, complementary feeding and transitioning to family diets. Infants aged between 5-7m are most amenable to accepting vegetables. However, a range of biological, social, environmental and individual factors may act independently and in tandem to reduce the appeal of eating vegetables. By applying aspects of learning theory, including social learning, liking and intake of vegetables can be increased. We propose taking an integrated and individualised approach to child feeding in order to achieve optimal learning in the early years. Simple techniques such as repeated exposure, modelling, social praise and creating social norms for eating vegetables can contribute to positive feeding experiences which in turn, contributes to increased acceptance of vegetables. However, there is a mismatch between experimental studies and the ways that children eat vegetables in real world settings. Therefore, current knowledge of the best strategies to increase vegetable liking and intake gained from experimental studies must be adapted and integrated for application to home and care settings, while responding to individual differences.
Family mealtimes are associated with benefits for children, including healthy eating, fewer behavior problems, and healthy psychological well-being. However, the interactions during family mealtimes, and the parent and child characteristics, which may affect both the family mealtime environment and the associated benefits in children are not fully understood. The goal of this study was to examine the role of child and parent characteristics on the family mealtime environment. We tested several mediation models to explain how child temperament (negative affectivity), parent stress, and the dimensions of parent feeding style (responsiveness and demandingness) interact and influence each other to impact the structure and quality of the mealtime environment. Parents (68 mothers; 82 fathers) of children between 2 and 6 years completed an online survey. Measures included the Children's Behavior Questionnaire, Perceived Stress Scale, Caregiver's Feeding Styles Questionnaire, and The Meals in Our Household Questionnaire. Child negative affectivity was associated with poorer mealtime quality and structure. These associations were mediated through parent responsiveness, but not demandingness. The role of demandingness in family mealtimes may depend on parent responsiveness. When examined together in a serial mediation model, child negative affectivity increased parent stress, which reduced responsiveness, and led to poorer mealtime quality and structure. These results emphasize the complex relationships between child temperament, parent stress, and the dimensions of parenting styles that occur within the mealtime context. This line of research is essential for understanding family mealtime dynamics and informing future studies aimed at creating positive interactions between parents and children during mealtimes.
Fussy eaters may have an increased risk of becoming overweight or obese as adolescents, with fussy eating and weight status also correlating with neurodevelopmental disorders (NDs) such as autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). Further, maternal and children’s weight status relationships are well-established. In this study, we analyzed the body composition of parent–child dyads using bioelectrical impedance analysis (BIA). Fifty-one children aged 8–12 years, with an ND (n = 18) and without (n = 33), and their parents, participated in a 7-week food-based Taste Education intervention with 6-month follow-up. The paired t-test was used to compare differences in body composition based on children’s ND status. In logistic regression analysis, odds of children being in the overweight/obese or overfat/obese categories increased by a factor of 9.1 and 10.6, respectively, when having NDs, adjusting for parents’ BMI (body mass index) or fat percentage (FAT%). Children with NDs and their parents had significantly higher mean BMI-SDS (BMI standard deviation score) and FAT% at pre-intervention than children without NDs and their parents. Mean BMI-SDS and FAT% lowered significantly between time points for children with NDs and their parents but not for children without NDs or their parents. The findings underline the need for additional exploration into the relationships between children’s and parents’ body composition based on children’s ND status.
Parental feeding practices and styles influence child diet quality and growth. The extent to which these factors have been assessed in the context of disadvantage, particularly household food insecurity (HFI), is unknown. This is important, as interventions designed to increase responsive practices and styles may not consider the unique needs of families with HFI. To address this gap, a scoping review of studies published from 1990 to July 2021 in three electronic databases was conducted. A priori inclusion criteria were, population: families with children aged 0–5 years experiencing food insecurity and/or disadvantage; concept: parental feeding practices/behaviours/style; and context: high income countries. The search identified 12,950 unique papers, 504 full-text articles were screened and 131 met the inclusion criteria. Almost all the studies (91%) were conducted in the United States with recruitment via existing programs for families on low incomes. Only 27 papers assessed feeding practices or styles in the context of HFI. Of the eleven interventions identified, two assessed the proportion of participants who were food insecure. More research is required in families outside of the United States, with an emphasis on comprehensive and valid measures of HFI and feeding practices. Intervention design should be sensitive to factors associated with poverty, including food insecurity.
Despite the lack of a “gold-standard” definition and identification of influential factors for identifying feeding difficulties in children, many international studies have been published in recent years on the subject. Thus, the aim was to examine studies on children with feeding difficulties and their associated factors that impact on their difficulties. Feeding difficulties were identified as limit the variety of food intake, and/or avoiding food due to sensory stimulus, i.e., food appearance, aroma, and flavor. A literature search in three databases was performed up to April 2021. English language articles were included if they investigated preschool and school age children using an observational or experimental design evaluating feeding difficulties and their factors. Findings indicate that almost 60% of the studies evaluated picky/fussy eaters, followed by 20% evaluating food neophobia. Parental influence, mainly mothers, were seemed to be the most reported influence. Studies have shown a lower consumption of fruit and vegetables and higher intake of discretionary foods among picky and food neophobic children. Most of the studies showed that children were on normal weight to overweight status. Few studies identified socio-demographics (i.e., age, sex, race/ethnicity, and birth age), emotional distress and other lifestyle behaviors (screen-time use during meals). Studies were mixed in terms of positive effects on breastfeeding and introduction to foods. Improved feeding difficulties in this population group are dependent from these factors, whereas they should be used to inform policies, strategies, and use in clinical practices.
Objective:
To examine the role of parent concern in explaining nonresponsive feeding practices in response to child fussy eating in socioeconomically disadvantaged families.
Design:
Mediation analysis of cross-sectional survey data.
Setting:
Socioeconomically disadvantaged urban community in Queensland, Australia.
Participants:
Cohabiting mother-father pairs (n = 208) with children aged 2-5 years.
Main outcome measure(s):
Two validated measures of nonresponsive feeding: persuasive feeding and reward for eating.
Analysis:
Mediation analysis tested concern as a mediator of the relationship between child food fussiness (independent variable) and parent nonresponsive feeding practices (dependent variables), adjusted for significant covariates and modeled separately for mothers and fathers.
Results:
Maternal concern fully mediated the relationship between child food fussiness and persuasive feeding (indirect effect: B [SE] = 0.10 [0.05]; 95% confidence interval [CI], 0.01-0.20). Concern also fully mediated the relationship between child food fussiness and reward for eating for mothers (indirect effect: B [SE] = 0.17 [0.07]; CI, 0.04-0.31) and fathers (indirect effect: B [SE] = 0.14 [0.05]; CI, 0.04-0.24) CONCLUSIONS AND IMPLICATIONS: Concern for fussy eating behaviors may explain mothers' and fathers' nonresponsive feeding practices. In addition to providing education and behavioral support, health professionals working with socioeconomically disadvantaged families can incorporate strategies that aim to alleviate parents' concerns about fussy eating.
Objective:
Child fussy eating has been associated with a range of maternal feeding practices; however, whether effects are parent-driven, child-driven, or bidirectional (i.e., both) remains unclear. This study tested for bidirectional relationships between nonresponsive and structure-related maternal feeding practices and child fussy eating at age 2, 3.7, and 5 years using a cross-lagged model approach.
Methods:
First-time Australian mothers (N = 207) reported four nonresponsive and four structure-related feeding practices and child food fussiness (FF) using validated questionnaires at child age 2, 3.7, and 5 years. Bivariate cross-lagged analyses were conducted for each of the eight feeding practices separately.
Results:
Both child- and parent-driven associations were observed. Higher FF at 3.7 years predicted higher nonresponsive feeding practices and less structure-related practices at 5 years. Higher structure-related practices at 2 and 3.7 years predicted lower FF at 3.7 and 5 years, respectively. Use of food as a reward for behavior at 3.7 years predicted higher FF at 5 years.
Conclusions:
Both parent- and child-driven associations explain the relationship between fussy eating and feeding practices. Given that early fussy eating is associated with more nonresponsive feeding, providing parents with anticipatory guidance to manage fussy eating behavior in infants and toddlers may help to avoid the use of these practices. Furthermore, the use of structure-related feeding practices and avoiding the use of food rewards may help to prevent the development of fussy eating.
Objective:
Few studies on child feeding have focused on family dynamics or disadvantaged families, yet feeding occurs in the complex social, economic, and relational context of the family. We examined how the level (high vs low) and concordance (concordant vs discordant) of nonresponsive feeding practices of mothers and fathers are associated with child fussy eating, in a socioeconomically disadvantaged Australian sample.
Methods:
Mother-father pairs (N = 208) of children aged 2 to 5 years old independently completed validated questionnaires reporting their "persuasive feeding," "reward for eating," "reward for behavior," and child's "food fussiness." The fussiness scores did not differ between mother-father pairs and were averaged to derive a single dependent variable. K-means cluster analyses were used to assign mother-father pairs to clusters for each feeding practice, based on mean scores. Three ANCOVAs, corresponding to each feeding practice, tested differences in child fussiness across clusters while controlling for covariates.
Results:
Four clusters were identified for each feeding practice-concordant: (1) high (MHi/FHi) for both parents and (2) low (MLo/FLo) for both parents; and discordant: (3) high for mother but low for father (MHi/FLo); and (4) low for mother but high for father (MLo/FHi). For "persuasive feeding," MLo/FLo reported lower levels of fussiness compared with MHi/FLo, MHi/FHi, and MLo/FHi (p values < 0.05). For "reward for eating," MLo/FLo reported lower levels of fussiness than did MHi/FHi (p < 0.05). Child fussiness did not differ across "reward for behavior" clusters.
Conclusion:
In socioeconomically disadvantaged families, when parents are concordant in avoiding nonresponsive feeding practices, less child "food fussiness" is reported. Findings suggest that feeding interventions should consider inclusion of both parents in 2-parent households.
Objective
To characterise parent presentations of fussy eating and mealtime interactions at a point of crisis, through analyses of real-time recordings of calls to a parenting helpline.
Design
Qualitative analysis included an inductive thematic approach to examine clinical parent presentations of fussy eating and derive underlying themes relating to mealtime interactions.
Setting
Calls made to the Child Health Line regarding feeding concerns were recorded and transcribed verbatim.
Subjects
From a corpus of 723 calls made during a 4-week period in 2009, twelve were from parents of children aged 6–48 months.
Results
Parents of infants (≤12 months, n 6) presented feeding concerns as learning challenges in the process of transitioning from a milk-based to a solid-based diet, while parents of toddlers (13–48 months, n 6) presented emotional accounts of feeding as an intractable problem. Parents presented their child’s eating behaviour as a battle (conflict), in which their children’s agency over limited intake and variety of foods (child control) was constructed as ‘bad’ or ‘wrong’. Escalating parent anxiety (parent concern) had evoked parent non-responsive feeding practices or provision of foods the child preferred.
Conclusions
Real-time descriptions of young children’s fussy eating at a time of crisis that initiated parents’ call for help have captured the highly charged emotional underpinnings of mealtime interactions associated with fussy eating. Importantly, they show the child’s emerging assertion of food autonomy can escalate parents’ emotional distress that, in the short term, initiates non-responsive feeding practices. The current study identifies the importance of educational and emotional support for parents across the period of introducing solids.
Background
This study examined bidirectional relationships between maternal feeding practices and child food responsiveness and satiety responsiveness from 2 to 5 years. Methods
Mothers (N = 207) reported their own feeding practices and child eating behaviours using validated questionnaires at child ages 2, 3.7, and 5 years. Cross-lagged analyses were conducted to test for bidirectional effects, adjusting for child BMI z-score (based on measured weight and height) at 14 months. ResultsEating behaviours and feeding practices showed strong continuity across the three time points. Maternal feeding practices (higher reward for behaviour [β = 0.12, p = 0.025] and lower covert restriction [β = −0.14, p = 0.008]) were prospectively associated with higher food responsiveness. Conversely, increased child satiety responsiveness was primarily prospectively associated with mothers’ feeding practices (increased structured meal timing [β = 0.11, p = 0.038], overt [β = 0.14, p = 0.010] and covert restriction [β = 0.11, p = 0.022]). The only exception was family meal setting, which was prospectively negatively associated with satiety responsiveness (β = −0.11, p = 0.035). Conclusion
While maternal feeding practices and child satiety and food responsiveness show strong continuity between child age 2 and 5 years, maternal feeding practices appear to be associated with child food responsiveness over time. Conversely, child satiety responsiveness, but not food responsiveness, may also be associated with maternal feeding practices over time. These results are consistent with interventions that provide feeding advice to parents on how to respond appropriately to individual child eating behaviour phenotype. Trial registrationACTRN12608000056392. Registered 29 January 2008.
Objective: Determine whether feeding practices across mothers and fathers are interpreted and measured with equivalent accuracy (measurement invariance) using the Feeding Practices and Structure Questionnaire-28 (FPSQ-28)
Design: Cross-sectional hard-copy and online survey design
Setting: Socioeconomically disadvantaged community in Queensland, Australia
Participants: Mothers (n=279) and fathers (n=225) of 2- to 5-year old children
Variables Measured: Parental feeding practices were measured using the 7 multi-item factors from the FPSQ-28.
Analysis: Confirmatory factor analysis (CFA) was applied to evaluate the factor structure of the FPSQ-28 among mothers and fathers from a socioeconomically disadvantaged community. Measurement invariance between mothers and fathers was examined using hierarchical multi-group CFAs.
Results: The 7-factor FPSQ-28 model showed good fit and was invariant across parent gender.
Conclusions and Implications: The FPSQ-28 subscales appear to be interpreted equivalently, and thus to measure the same constructs, irrespective of the gender of the parents. The questionnaire can be used to measure or compare mothers’ and fathers’ self-reported feeding practices and examine influence on child health outcomes. In the current sample of mothers and fathers recruited from a socioeconomically disadvantaged community, mothers used more ‘covert restriction’ than fathers.
Background
Estimates of picky eating are quite high among young children, with 14-50% of parents identifying their preschoolers as picky eaters. Dietary intake and preferences during the preschool years are characterized by slowing growth rates and children developing a sense of autonomy over their feeding and food selection. We argue that the current conceptualization of picky eating defines acts of resistance or expressions of preference (acts of autonomy) by a child as deviant behaviour. This conceptualization has guided research that uses a unidirectional, parent to child approach to understanding parent-child feeding interactions.
Objectives
By reviewing the current feeding literature and drawing parallels from the rich body of child socialization literature, we argue that there is a need to both re-examine the concept and parent/clinician perspectives on picky eating. Thus, the objective of this paper is two-fold: 1) We argue for a reconceptualization of picky eating whereby child agency is considered in terms of eating preferences rather than categorized as compliant or non-compliant behaviour, and 2) We advocate the use of bi-directional relational models of causality and appropriate methodology to understanding the parent-child feeding relationship.
Discussion
Researchers are often interested in understanding how members in the parent-child dyad affect one another. Although many tend to focus on the parent to child direction of these associations, findings from child socialization research suggest that influence is bidirectional and non-linear such that parents influence the actions and cognitions of children and children influence the actions and cognitions of parents. Bi-directional models of causality are needed to correctly understand parent-child feeding interactions.
Conclusions
A reconceptualization of picky eating may elucidate the influence that parental feeding practices and child eating habits have on each other. This may allow health professionals to more effectively support parents in developing healthy eating habits among children, reducing both stress around mealtimes and concerns of picky eating.
Background:
Fussy eating is common in young children, often raising concerns among parents. The use of pressuring feeding practices may provoke or worsen child fussiness, but these practices could equally be a parent's response to child fussy eating.
Objective:
In longitudinal analyses, we assessed directionality in the relation between fussy eating and parent's pressure to eat across childhood.
Methods:
Study participants were 4845 mother-child dyads from the population-based Generation R cohort in the Netherlands. The Child Behavior Checklist was used to assess fussy eating (2 items) at child ages 1½, 3 and 6years. Parents' pressure to eat was assessed with the Child Feeding Questionnaire (4 items) when children were 4years old. All scale scores were standardized.
Results:
Linear regression analyses indicated that preschoolers' fussy eating prospectively predicted higher levels of parents' pressure to eat at child age 4years, independently of confounders (adjusted B=0.24, 95% CI: 0.21, 0.27). Pressure to eat at 4years also predicted more fussiness in children at age 6years, independently of confounders and of fussy eating at baseline (adjusted B=0.14, 95% CI: 0.11, 0.17). Path analyses indicated that the relation from fussy eating at 3years to parenting one year later was stronger than from pressure at 4years to fussy eating two years later (p<0.001).
Conclusions:
Our findings suggest bi-directional associations with parental pressuring feeding strategies being developed in response to children's food avoidant behaviors, but also seemingly having a counterproductive effect on fussiness. Thus, the use of pressure to eat should be reconsidered, while providing parents alternative techniques to deal with their child's fussy eating.
Background
Parental feeding practices are thought to play a causal role in shaping a child’s fussiness; however, a child-responsive model suggests that feeding practices may develop in response to a child’s emerging appetitive characteristics. We used a novel twin study design to test the hypothesis that mothers vary their feeding practices for twin children who differ in their ‘food fussiness’, in support of a child-responsive model.
Methods
Participants were mothers and their 16 month old twin children (n = 2026) from Gemini, a British twin birth cohort of children born in 2007. Standardized psychometric measures of maternal ‘pressure to eat’, ‘restriction’ and ‘instrumental feeding’, as well as child ‘food fussiness’, were completed by mothers. Within-family analyses examined if twin-pair differences in ‘food fussiness’ were associated with differences in feeding practices using linear regression models. In a subset of twins (n = 247 pairs) who were the most discordant (highest quartile) on ‘food fussiness’ (difference score ≥ .50), Paired Samples T-test were used to explore the magnitude of differences in feeding practices between twins. Between-family analyses used Complex Samples General Linear Models to examine associations between feeding practices and ‘food fussiness’.
Results
Within-pair differences in ‘food fussiness’ were associated with differential ‘pressure to eat’ and ‘instrumental feeding’ (ps < .001), but not with ‘restriction’. In the subset of twins most discordant on ‘food fussiness’, mothers used more pressure (p < .001) and food rewards (p < .05) with the fussier twin. Between-family analyses indicated that ‘pressure to eat’ and ‘instrumental feeding’ were positively associated with ‘food fussiness’, while ‘restriction’ was negatively associated with ‘food fussiness’ (ps < .001).
Conclusions
Mothers appear to subtly adjust their feeding practices according to their perceptions of their toddler’s emerging fussy eating behavior. Specifically, the fussier toddler is pressured more than their less fussy co-twin, and is more likely to be offered food rewards. Guiding parents on how to respond to fussy eating may be an important aspect of promoting feeding practices that encourage food acceptance.
Electronic supplementary material
The online version of this article (doi:10.1186/s12966-016-0408-4) contains supplementary material, which is available to authorized users.
Objective
. The aim was to investigate the influence of feeding styles and food parenting practices on low-income children’s weight status over time.
Method
. Participants were 129 Latina parents and their Head Start children participating in a longitudinal study. Children were assessed at baseline (4 to 5 years old) and again eighteen months later. At each time point, parents completed questionnaires and height and weight measures were taken on the child.
Results
. The indulgent feeding style (parent-report at baseline) was associated with increased child BMI
z
-score eighteen months later compared to other feeding styles. Authoritative, authoritarian, and uninvolved feeding styles were not significantly associated with increased child BMI
z
-score. Child BMI
z
-score at Time 1 (strongest) and maternal acculturation were positive predictors of child BMI
z
-score at Time 2. Maternal use of restriction positively predicted and maternal monitoring negatively predicted Time 2 BMI
z
-score, but only when accounting for feeding styles.
Conclusion
. This is the first study to investigate the impact of feeding styles on child weight status over time. Results suggest that indulgent feeding predicts later increases in children’s weight status. The interplay between feeding styles and food parenting practices in influencing child weight status needs to be further explored.
Prospective studies and intervention evaluations that examine change over time assume that measurement tools measure the same construct at each occasion. In the area of parent-child feeding practices, longitudinal measurement properties of the questionnaires used are rarely verified. To ascertain that measured change in feeding practices reflects true change rather than change in the assessment, structure, or conceptualisation of the constructs over time, this study examined longitudinal measurement invariance of the Feeding Practices and Structure Questionnaire (FPSQ) subscales (9 constructs; 40 items) across 3 time points. Mothers participating in the NOURISH trial reported their feeding practices when children were aged 2, 3.7, and 5 years (N = 404). Confirmatory Factor Analysis (CFA) within a structural equation modelling framework was used. Comparisons of initial cross-sectional models followed by longitudinal modelling of subscales, resulted in the removal of 12 items, including two redundant or poorly performing subscales. The resulting 28-item FPSQ-28 comprised 7 multi-item subscales: Reward for Behaviour, Reward for Eating, Persuasive Feeding, Overt Restriction, Covert Restriction, Structured Meal Setting and Structured Meal Timing. All subscales showed good fit over 3 time points and each displayed at least partial scalar (thresholds equal) longitudinal measurement invariance. We recommend the use of a separate single item indicator to assess the family meal setting. This is the first study to examine longitudinal measurement invariance in a feeding practices questionnaire. Invariance was established, indicating that the subscales of the shortened FPSQ-28 can be used with mothers to validly assess change in 7 feeding constructs in samples of children aged 2-5 years of age.
Background
Identifying the determinants of child’s liking for different foods may help to prevent future choices of unhealthy food.Objective
To study early-life food-related characteristics associated with child’s liking for different foods at 5y with a longitudinal study.Design1142 5y- old children completed a liking test for “fruit and vegetables”, “meat, fish and eggs”, desserts and cheese. Data related to maternal food intake before pregnancy, infant feeding during the first year of life, maternal feeding practices at 2y, child’s food intake at 3y, and child’s food neophobia from 1 to 4y were collected prospectively from the mother. The associations between these factors and child‘s liking for each category of foods were analyzed using structural equation modelling.ResultsHigh food neophobia at 4 y was related to lower child’s liking for all food groups. Maternal feeding practices at 2y were associated with liking for dessert: negatively for the practices allowing child to control his/her own food intake, positively for restriction of child’s food intake for weight reasons. Moreover, child’s food intake at 3y was positively associated with child’s liking for “fruit and vegetables” as well as for cheese. Finally, adherence to the infant feeding pattern “long breastfeeding, later introduction of main meal components and use of home-made products” was positively associated with child’s liking for meat/fish/eggs.Conclusions
For all food groups, food neophobia was a common determinant of child’s liking for food at 5y, whereas other factors were associated with food liking for specific food groups.
Food intake patterns begin to be shaped at the earliest points in life. Early exposures and experiences are critical for the acceptance of some foods, particularly healthful foods such as vegetables, which often have a bitter component in their flavor profiles. In addition to repeated exposure to these foods, the quality and emotional tone of parent-child interactions are important in facilitating children's acceptance of vegetables. During early childhood, parents are challenged by children's developmental characteristics related to eating, such as the emergence of child neophobia, and by individual characteristics of the child that are more biologically based, including genetic predispositions to bitter taste and sensory sensitivities. Experimental studies consistently show that repeated exposure to novel and rejected familiar foods is the most powerful method to improve acceptance. However, the manner and persistence with which these exposures are performed are critical. Research investigating influences on children's vegetable acceptance and ingestion has focused on associations among availability, parent intakes, child neophobia, and the parental feeding response to children's reluctance to try and consume vegetables. Because young children's dietary intakes are low and below dietary recommendations, investigations have focused more on factors that impede children's vegetable acceptance, such as controlling feeding practices, than on positive influences. Research that addresses the multifaceted nature of these interactions among different levels of social-ecological environment, individual traits, parental feeding styles and practices, and socioeconomic influences and that uses longitudinal designs and complex statistical approaches is called for to ascertain more effective methods to improve children's vegetable acceptance.
Picky eating (also known as fussy, faddy or choosy eating) is usually classified as part of a spectrum of feeding difficulties. It is characterised by an unwillingness to eat familiar foods or to try new foods, as well as strong food preferences. The consequences may include poor dietary variety during early childhood. This, in turn, can lead to concern about the nutrient composition of the diet and thus possible adverse health-related outcomes. There is no single widely accepted definition of picky eating, and therefore there is little consensus on an appropriate assessment measure and a wide range of estimates of prevalence. In this review we first examine common definitions of picky eating used in research studies, and identify the methods that have been used to assess picky eating. These methods include the use of subscales in validated questionnaires, such as the Child Eating Behaviour Questionnaire and the Child Feeding Questionnaire as well as study-specific question(s). Second, we review data on the prevalence of picky eating in published studies. For comparison we present prevalence data from the UK Avon Longitudinal Study of Parents and Children (ALSPAC) in children at four time points (24, 38, 54 and 65 months of age) using a study-specific question. Finally, published data on the effects of picky eating on dietary intakes (both variety and nutrient composition) are reviewed, and the need for more health-related data and longitudinal data is discussed.
Copyright © 2015. Published by Elsevier Ltd.
Background
Early feeding practices lay the foundation for children’s eating habits and weight gain. Questionnaires are available to assess parental feeding but overlapping and inconsistent items, subscales and terminology limit conceptual clarity and between study comparisons. Our aim was to consolidate a range of existing items into a parsimonious and conceptually robust questionnaire for assessing feeding practices with very young children (<3 years).
Methods
Data were from 462 mothers and children (age 21–27 months) from the NOURISH trial. Items from five questionnaires and two study-specific items were submitted to a priori item selection, allocation and verification, before theoretically-derived factors were tested using Confirmatory Factor Analysis. Construct validity of the new factors was examined by correlating these with child eating behaviours and weight.
Results
Following expert review 10 factors were specified. Of these, 9 factors (40 items) showed acceptable model fit and internal reliability (Cronbach’s α: 0.61-0.89). Four factors reflected non-responsive feeding practices: ‘Distrust in Appetite’, ‘Reward for Behaviour’, ‘Reward for Eating’, and ‘Persuasive Feeding’. Five factors reflected structure of the meal environment and limits: ‘Structured Meal Setting’, ‘Structured Meal Timing’, ‘Family Meal Setting’, ‘Overt Restriction’ and ‘Covert Restriction’. Feeding practices generally showed the expected pattern of associations with child eating behaviours but none with weight.
Conclusion
The Feeding Practices and Structure Questionnaire (FPSQ) provides a new reliable and valid measure of parental feeding practices, specifically maternal responsiveness to children’s hunger/satiety signals facilitated by routine and structure in feeding. Further validation in more diverse samples is required.
This article uses diary data from the most recent Australian Bureau of Statistics Time Use Survey (N > 4,000) to compare by gender total child care time calculated in the measurements of (1) main activity, (2) main or secondary activity, and (3) total time spent in the company of children. It also offers an innovative gender comparison of relative time spent in (1) the activities that constitute child care, (2) child care as double activity, and (3) time with children in sole charge. These measures give a fuller picture of total time commitment to children and how men and women spend that time than has been available in previous time use analyses. The results indicate that compared to fathering, mothering involves not only more overall time commitment but more multitasking, more physical labor, a more rigid timetable, more time alone with children, and more overall responsibility for managing care. These gender differences in the quantity and nature of care apply even when women work full-time.
Regular consumption of fruits, vegetables, whole grains, and other plant foods has been negatively correlated with the risk of the development of chronic diseases. There is a huge gap between the average consumption of fruits and vegetables in Americans and the amount recommended by the 2010 Dietary Guidelines for Americans. The key is to encourage consumers to increase the total amount to 9 to 13 servings of fruits and vegetables in all forms available. Fresh, processed fruits and vegetables including frozen and canned, cooked, 100% fruit juices and 100% vegetable juices, as well as dry fruits are all considered as servings of fruits and vegetables per day. A wide variety of fruits, vegetables, whole grains, and other plant foods provide a range of nutrients and different bioactive compounds including phytochemicals, vitamins, minerals, and fibers. Potatoes serve as one of the low-fat foods with unique nutrients and phytochemical profiles, particularly rich in vitamin C, vitamin B-6, potassium, manganese, and dietary fibers. Potatoes provide 25% of vegetable phenolics in the American diet, the largest contributors among the 27 vegetables commonly consumed in the United States, including flavonoids (quercetin and kaempferol), phenolic acids (chlorogenic acid and caffeic acid), and carotenoids (lutein and zeaxanthin). More and more evidence suggests that the health benefits of fruits, vegetables, whole grains, and other plant foods are attributed to the synergy or interactions of bioactive compounds and other nutrients in whole foods. Therefore, consumers should obtain their nutrients, antioxidants, bioactive compounds, and phytochemicals from a balanced diet with a wide variety of fruits, vegetables, whole grains, and other plant foods for optimal nutrition, health, and well-being, not from dietary supplements.
Vegetables and fruit provide a significant part of human nutrition, as they are important sources of nutrients, dietary fibre, and phytochemicals. However, it is uncertain whether the risk of certain chronic diseases can be reduced by increased consumption of vegetables or fruit by the general public, and what strength of evidence has to be allocated to such an association.
Therefore, a comprehensive analysis of the studies available in the literature and the respective study results has been performed and evaluated regarding obesity, type 2 diabetes mellitus, hypertension, coronary heart disease (CHD), stroke, cancer, chronic inflammatory bowel disease (IBD), rheumatoid arthritis (RA), chronic obstructive pulmonary disease (COPD), asthma, osteoporosis, eye diseases, and dementia. For judgement, the strength of evidence for a risk association, the level of evidence, and the number of studies were considered, the quality of the studies and their estimated relevance based on study design and size.
For hypertension, CHD, and stroke, there is convincing evidence that increasing the consumption of vegetables and fruit reduces the risk of disease. There is probable evidence that the risk of cancer in general is inversely associated with the consumption of vegetables and fruit. In addition, there is possible evidence that an increased consumption of vegetables and fruit may prevent body weight gain. As overweight is the most important risk factor for type 2 diabetes mellitus, an increased consumption of vegetables and fruit therefore might indirectly reduces the incidence of type 2 diabetes mellitus. Independent of overweight, there is probable evidence that there is no influence of increased consumption on the risk of type 2 diabetes mellitus. There is possible evidence that increasing the consumption of vegetables and fruit lowers the risk of certain eye diseases, dementia and the risk of osteoporosis. Likewise, current data on asthma, COPD, and RA indicate that an increase in vegetable and fruit consumption may contribute to the prevention of these diseases. For IBD, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association with the consumption of vegetables and fruit.
This critical review on the associations between the intake of vegetables and fruit and the risk of several chronic diseases shows that a high daily intake of these foods promotes health. Therefore, from a scientific point of view, national campaigns to increase vegetable and fruit consumption are justified. The promotion of vegetable and fruit consumption by nutrition and health policies is a preferable strategy to decrease the burden of several chronic diseases in Western societies.
Evidence suggests that children's eating behaviours are influenced by the feeding practices which parents employ. Furthermore, parents may alter the feeding practices they use according to their child's temperament. However, there is a paucity of literature on how children's temperament moderates the relationship between parents' use of feeding practices and children's eating behaviours. One hundred and eleven mothers of 2 to 4-year-old children completed questionnaire measures of their feeding practices along with their child's eating behaviours and temperament. Two-tailed Spearman's correlations revealed that mothers' use of a range of positive (health promoting) feeding practices was associated with greater enjoyment of food and lower food fussiness among children. Moderation analyses found that relationships between mothers involving their children in food choice and preparation and children's eating behaviours were moderated by children's temperament. Involvement in food choice and preparation was no longer associated with higher enjoyment of food and lower fussiness for children who were either highly emotional or low in sociability. These findings suggest that while many previously identified positive feeding practices may be associated with more healthy eating for all children, some may be less helpful or less achievable with children who have particular temperamental traits. Future research should seek to develop interventions to promote healthy eating which are tailored towards children's individual characteristics.
Temperament, defined as individual differences in reactivity and regulation, has important implications for the development of childhood obesity. Indeed, numerous studies have demonstrated associations between temperament and children's eating behavior, parent feeding practices, and children's weight outcomes. Together, these findings have significantly improved our understanding of the developmental pathways to obesity-related outcomes. However, to better our understanding of the role of temperament in children's health, greater attention to how temperament is conceptualized and measured is needed. The purpose of this paper is to review the concept and principles of temperament, describe challenges in the measurement of temperament, and provide considerations for future research aimed at understanding the relationship between temperament, food intake, and childhood obesity. Moving forward, a fuller appreciation of the complexity of the temperament concept and thoughtful selection of temperament measures may help improve predictions and identify targets for interventions aimed at decreasing the risk for obesity in childhood.
Objective:
To examine the associations among negative/reactive temperament, feeding styles, and selective eating in a sample of preschoolers because preschool eating behaviors likely have lasting implications for children's health.
Methods:
A community sample of preschoolers aged 3-5 years (M = 4.49 years, 49.5% female, 75.7% European American) in the Midwest of the United States was recruited to participate in the study (N = 297). Parents completed measures of temperament and feeding styles at two time points 6 months apart.
Results:
A series of regressions indicated that children who had temperaments high in negative affectivity were significantly more likely to experience instrumental and emotional feeding styles. They were also significantly more likely to be selective eaters. These associations were present when examined both concurrently and after 6 months.
Conclusions:
This study provides a novel investigation of child temperament and eating behaviors, allowing for a better understanding of how negative affectivity is associated with instrumental feeding, emotional feeding, and selective eating. These results inform interventions to improve child health.
The last few years have seen a steady increase in research addressing the potential influence of fathers on their children’s development. There has also been a clearer acknowledgement of the need to study families as a complex system, rather than just focussing on individual aspects of functioning in one or other parent. Increased father involvement and more engaged styles of father-infant interactions are associated with more positive outcomes for children. Studies of paternal depression and other psychopathology have begun to elucidate some of the key mechanisms by which fathers can influence their children’s development. These lessons are now being incorporated into thinking about engaging both mothers and fathers in effective interventions to optimise their children’s health and development.
Context:
Despite their important influence on child health, it is assumed that fathers are less likely than mothers to participate in pediatric obesity treatment and prevention research.
Objective:
This review investigated the involvement of fathers in obesity treatment and prevention programs targeting children and adolescents (0-18 years).
Data sources:
A systematic review of English, peer-reviewed articles across 7 databases. Retrieved records included at least 1 search term from 2 groups: "participants" (eg, child*, parent*) and "outcomes": (eg, obes*, diet*).
Study selection:
Randomized controlled trials (RCTs) assessing behavioral interventions to prevent or treat obesity in pediatric samples were eligible. Parents must have "actively participated" in the study.
Data extraction:
Two authors independently extracted data using a predefined template.
Results:
The search retrieved 213 eligible RCTs. Of the RCTs that limited participation to 1 parent only (n = 80), fathers represented only 6% of parents. In RCTs in which participation was open to both parents (n = 133), 92% did not report objective data on father involvement. No study characteristics moderated the level of father involvement, with fathers underrepresented across all study types. Only 4 studies (2%) suggested that a lack of fathers was a possible limitation. Two studies (1%) reported explicit attempts to increase father involvement.
Limitations:
The review was limited to RCTs published in English peer-reviewed journals over a 10-year period.
Conclusions:
Existing pediatric obesity treatment or prevention programs with parent involvement have not engaged fathers. Innovative strategies are needed to make participation more accessible and engaging for fathers.
Children are frequently described as being picky eaters. However, this term has been inconsistently defined in prior research. There is limited qualitative research data investigating how parent's define picky eating, how they respond to it, or how they see picky eating impacting their child's dietary intake or the family meal. For this study, parents (n = 88) of siblings (ages 2–18 years old) were interviewed in their homes. The semi-structured interviews focused on parent feeding practices and child eating behaviors. A qualitative content analysis approach was used to analyze the data; themes regarding picky eating emerged. Results of this study show that the majority of parents (94% female; mean age 35 years) were from minority and low income homes. The following themes regarding picky eating were identified: 1) children were frequently described as being picky eaters; 2) parents defined picky eating in a variety of ways (i.e., not liking a few foods; limited intake; resisting texture or appearance of foods; resistance to new foods); 3) picky eating impacts the family meal (i.e., promotes meal-related parent stress; impacts meal preparation); and 4) parents respond to picky eating in a variety of ways (i.e., require child tries food; allow child to make separate meal; allow child not to eat; parent makes a separate meal; allows child to choose only food he/she likes; requires child to eat anyway). This study demonstrates that many parents experience child picky eating and report that it impacts family meals. It provides information on the specific ways pickiness impacts the family meal and how parents respond to pickiness. This study also provides guidance for future studies wishing to define picky eating or evaluate the prevalence of child pickiness.
Despite contemporary acceptance that children are active agents in their own socialization, that causality between parents and children is bidirectional, and that context matters, basic concepts used in socialization research continue to reflect an underlying mechanistic ontology. In this chapter we propose that a dialectical relational systems conception of the transaction model provides direction for future advances in the study of dynamic parent-child socialization processes with an emphasis of intergenerational change, not only continuity. The chapter begins by exploring dialectics as a framework underlying an organismic-contextual meta-theory for understanding the transactional model of human development. The chapter then outlines social relational theory as a framework for translating four assumptions of a dialectical ontology including agency, holism, contradiction, and synthesis to reformulate major transactional processes in parent-child relations and socialization. The chapter ends by considering implications for application and methodology informed by dialectics.
Objective:
This cohort study describes the prevalence of picky eating and examines prognostic factors for picky eating trajectories during childhood.
Methods:
4,018 participants of a population-based cohort with measurements from pregnancy onwards were included. Picky eating was assessed by maternal report when children were 1.5, 3, and 6 years old. The associations of child and family characteristics with trajectories of picky eating were examined using logistic regression. Never picky eaters were used as the reference group.
Results:
Prevalence of picky eating was 26.5% at 1.5 years of age, 27.6% at the age of 3 and declined to 13.2% at 6 years. Four main picky eating trajectories were defined: (1) never picky eating at all three assessments (55% of children), (2) remitting (0-4 years, 32%), (3) late-onset (6 years only, 4%), and (4) persistent (all ages, 4%). This implies that almost two thirds of the early picky eaters remitted within 3 years. Male sex, lower birth weight, non-Western maternal ethnicity, and low parental income predicted persistent picky eating. More often late-onset picky eaters were children of parents with low income and non-Western ethnicity.
Discussion:
We found that nearly half (46%) of children were picky eaters at some point during early childhood. Remittance was very high. This suggests that picky eating is usually a transient behavior and part of normal development in preschool children. However, a substantial group of persistent picky eaters, often from a socially disadvantaged background, continues to have problems beyond the preschool age. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:570-579).
The article aims to study mother-child and father-child interactions with 24-month-old children during feeding, considering the possible influence of time spent by the parent with the child, the infantile temperament, and the parental psychological profile. The families were recruited from 12 preschools in Italy (N = 77 families). Through an observation of the feeding [Scala di Valutazione dell'Interazione Alimentare (SVIA - Feeding Scale; I. Chatoor et al., ; L. Lucarelli et al., )], self-reporting [Symptom Checklist-90-Revised (SCL-90-R; L.R. Derogatis, ), and report-form questionnaires [Italian Questionnaires on Temperament (QUIT; G. Axia, )], and information provided by the parents about the amount of time spent with their children, results showed that the overall quality of father-child interactions during feeding is lower than that of mother-child interactions. Fathers showed higher psychological symptoms than did mothers. No associations were found between the fathers' psychopathological risk and the quality of interactions with their children during feeding. Mothers' psychopathological risks predicted less contingent exchanges interactions with their children during feeding. Children's temperaments significantly influence mother-child interactions, but no association exists between maternal involvement and the quality of interactions with their children. Paternal involvement predicts a better quality of father-infant interactions when associated with a child's higher scores on Social Orientation. The quality of parents' interactions with their children during feeding are impacted by different issues originating from the parent's psychological profile, the degree of involvement, and from the child's temperament.
© 2014 Michigan Association for Infant Mental Health.
Despite their expanding role in child rearing, fathers are underrepresented in child feeding research. To address this knowledge gap and encourage father-focused research, this review compiles child feeding research that has included fathers and (i) documents characteristics of studies assessing fathers' feeding practices including study design, setting, recruitment strategies, participant characteristics, theoretical models utilized and measures of child feeding, (ii) outlines general patterns in fathers' feeding practices along with similarities and differences in mothers' and fathers' feeding practices, (iii) summarizes evidence on child and parent correlates of fathers' feeding practices and (iv) generates future research recommendations. A literature review of relevant articles published up to February 2014 was conducted. Studies were eligible for inclusion if they: (i) included fathers, or primary male caregivers, of children 2-18 years of age, (ii) measured fathers' child feeding practices or perceived role in child feeding through objective (e.g., meal observations) or subjective (i.e., fathers' self-report) methods, (iii) analyzed and presented data on fathers separately from mothers and (iv) were published in a peer reviewed journal in the English language. Twenty studies met eligibility criteria. Few studies included an operational definition of "father" and only two studies focused exclusively on fathers. Samples were generally small and focused on white, well-educated fathers, cohabiting with the child's mother. Most studies utilized self-report measures of child feeding practices that have not been validated specifically for use with fathers. Pressuring children to eat was a common feeding strategy adopted by fathers. Some differences were noted in mothers' and fathers' feeding practices; fathers were generally less likely to monitor children's food intake and to limit access to food compared with mothers. Child adiposity and a range of child and parent characteristics were associated with fathers' feeding practices. The literature on fathers' child feeding practices is scant. This review consolidates what is known to date and highlights focal areas for future research including the need to recruit diverse samples of fathers and utilize measures validated for use with fathers.
Research has previously identified relationships between child temperament and BMI during childhood. However, few studies have addressed the broader implications of child temperament on the development of obesogenic risk factors, such as maternal feeding, child eating and body mass index (BMI) of pre-schoolers. Hence, the current study evaluated cross-sectional and prospective associations between child temperament, maternal feeding, maternal parenting styles, mother-child interaction, preschoolers' eating behaviours and BMI. Child irritability, cooperation-manageability and easy-difficult temperaments, mother-child dysfunctional interaction, maternal pressure to eat and restriction were significantly cross-sectionally associated with child eating behaviours. Child enjoyment of food was significantly associated with child BMI. Child easy-difficult temperament and mother-child dysfunctional interaction predicted child eating behaviours longitudinally and baseline child BMI measures predicted child BMI longitudinally. Average maternal ratings of child temperament were relatively neutral, potentially explaining why most associations were not robust longitudinally. Future research should include a sample of greater socio-economic and BMI diversity as well as objective measures of child temperament, diet composition, maternal feeding practices, and mother-child interaction.
To determine the extent to which the presence and accessibility of healthful and less healthful foods in children's homes vary with level of food security.
A total of 41 parents or primary caregivers who had at least 1 child ages 2-13 and resided in a low-income area with limited food access completed a home food inventory and a validated measure assessing household food security.
Compared with food-secure participants, marginal or low/very low food-secure caregivers reported significantly more obesity-promoting foods in the home, more microwavable or quick-cook frozen foods, and greater access to less healthful foods in the kitchen (all Ps < .05).
Given the greater presence and accessibility of less healthful foods, targeting home food environment may improve diet quality and health status in children of low-income, food insecure households.
It is a research priority to identify modifiable risk factors to improve the effectiveness of childhood obesity prevention strategies. Research, however, has largely overlooked the role of child temperament and personality implicated in obesogenic risk factors such as maternal feeding and body mass index (BMI) of preschoolers. A systematic review of relevant literature was conducted to investigate the associations between child temperament, child personality, maternal feeding and BMI and/or weight gain in infants and preschoolers; 18 papers were included in the review. The findings revealed an association between the temperament traits of poor self-regulation, distress to limitations, low and high soothability, low negative affectivity and higher BMI in infants and preschool-aged children. Temperament traits difficult, distress to limitations, surgency/extraversion and emotionality were significantly associated with weight gain rates in infants. The results also suggested that child temperament was associated with maternal feeding behaviours that have been shown to influence childhood overweight and obesity, such as using restrictive feeding practices with children perceived as having poor self-regulation and feeding potentially obesogenic food and drinks to infants who are more externalizing. Interestingly, no studies to date have evaluated the association between child personality and BMI/weight gain in infants and preschoolers. There is a clear need for further research into the association of child temperament and obesogenic risk factors in preschool-aged children.
The role of fathers in shaping their child's eating behaviour and weight status through their involvement in child feeding has rarely been studied. This study aims to describe fathers' perceived responsibility for child feeding, and to identify predictors of how frequently fathers eat meals with their child.
Four hundred and thirty-six Australian fathers (M age = 37 years, SD = 6 years; 34% university educated) of a 2-5-year-old child (M age = 3.5 years, SD = 0.9 years; 53% boys) were recruited via contact with mothers enrolled in existing research projects or a university staff and student email list. Data were collected from fathers via a self-report questionnaire. Descriptive and hierarchical linear regression analyses were conducted.
The majority of fathers reported that the family often/mostly ate meals together (79%). Many fathers perceived that they were responsible at least half of the time for feeding their child in terms of organizing meals (42%); amount offered (50%) and deciding if their child eats the 'right kind of foods' (60%). Time spent in paid employment was inversely associated with how frequently fathers ate meals with their child (β = -0.23, P < 0.001); however, both higher perceived responsibility for child feeding (β = 0.16, P < 0.004) and a more involved and positive attitude toward their role as a father (β = 0.20, P < 0.001) were positively related to how often they ate meals with their child, adjusting for a range of paternal and child covariates, including time spent in paid employment.
Fathers from a broad range of educational backgrounds appear willing to participate in research studies on child feeding. Most fathers were engaged and involved in family meals and child feeding. This suggests that fathers, like mothers, should be viewed as potential agents for the implementation of positive feeding practices within the family.
Understanding communication processes is the goal of most communication researchers. Rarely are we satisfied merely ascertaining whether messages have an effect on some outcome of focus in a specific context. Instead, we seek to understand how such effects come to be. What kinds of causal sequences does exposure to a message initiate? What are the causal pathways through which a message exerts its effect? And what role does communication play in the transmission of the effects of other variables over time and space? Numerous communication models attempt to describe the mechanism through which messages or other communication-related variables transmit their effects or intervene between two other variables in a causal model. The communication literature is replete with tests of such models. Over the years, methods used to test such process models have grown in sophistication. An example includes the rise of structural equation modeling (SEM), which allows investigators to examine how well a process model that links some focal variable X to some outcome Y through one or more intervening pathways fits the observed data. Yet frequently, the analytical choices communication researchers make when testing intervening variables models are out of step with advances made in the statistical methods literature. My goal here is to update the field on some of these new advances. While at it, I challenge some conventional wisdom and nudge the field toward a more modern way of thinking about the analysis of intervening variable effects.
Examined the structure of temperament as assessed by the Childhood Temperamaent Questionnaire (CTQ) on 1,366 children and compared the factor analytically derived structure both to the original 9 dimensions and to the structure found on the same sample when they were infants. The study also determined differences in temperament characteristics among children at the ages of 3–4 yrs, 5–6 yrs, and 7–8 yrs; differences between boys and girls; and differences by social class. Results confirm that the 9-dimensional model was not well represented in the CTQ. Differences in temperament structure were shown between boys and girls on only 1 factor. In terms of the expression of temperament, boys tended to have more negative ratings on several factors. Age and SES differences were also observed, although they were quantitatively small. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This paper critically reviews the literature on the links between temperament and social development in children and adolescents. Social development is broadly defined to include externalizing and internalizing behaviour problems, prosocial behaviour and social competence. It concludes that there are clear links between specific dimensions of temperament and particular aspects of social development. Examples include the association of negative reactivity with externalizing behaviour problems, inhibition with internalizing behaviour problems, and attention regulation with school functioning. Theoretical and methodological issues to be confronted in future research are identified, including the need to investigate further the interactions between temperament and social context. Analysis of patterns of change in temperament, in relation to physiological changes and to such factors as parenting and socio-cultural expectations of children, promise to refine our understanding of how temperament works in context. Some practical implications which can be drawn from the research are also discussed.
Individual differences in several aspects of eating style have been implicated in the development of weight problems in children and adults, but there are presently no reliable and valid scales that assess a range of dimensions of eating style. This paper describes the development and preliminary validation of a parent-rated instrument to assess eight dimensions of eating style in children; the Children's Eating Behaviour Questionnaire (CEBQ). Constructs for inclusion were derived both from the existing literature on eating behaviour in children and adults, and from interviews with parents. They included reponsiveness to food, enjoyment of food, satiety responsiveness, slowness in eating, fussiness, emotional overeating, emotional undereating, and desire for drinks. A large pool of items covering each of these constructs was developed. The number of items was then successively culled through analysis of responses from three samples of families of young children (N= 131; N= 187; N= 218), to produce a 35-item instrument with eight scales which were internally valid and had good test-retest reliability. Investigation of variations by gender and age revealed only minimal gender differences in any aspect of eating style. Satiety responsiveness and slowness in eating diminished from age 3 to 8. Enjoyment of food and food responsiveness increased over this age range. The CEBQ should provide a useful measure of eating style for research into the early precursors of obesity or eating disorders. This is especially important in relation to the growing evidence for the heritability of obesity, where good measurement of the associated behavioural phenotype will be crucial in investigating the contribution of inherited variations in eating behaviour to the process of weight gain.
In the developed world, child overweight and obesity rates are highest among the disadvantaged. This has resulted in calls for more research with low socio-economic families to better understand their experiences with disadvantage and how they might lead to poorer weight outcomes. The present study, conducted in Australia, adopted a qualitative approach to investigate the factors affecting low socio-economic parents' child-feeding practices. Methods used to collect data were introspections, interviews and focus groups. In total, 37 parents of overweight or obese children aged between 5 and 9 years took part in the 6-month study. Guilt emerged as an emotion that parents regularly experienced when allowing their children to consume too much food or foods high in fat, salt and/or sugar. Parents attributed their guilt-inducing child-feeding practices to both external and internal factors. Time scarcity and cost were factors that were primarily characterized by an external locus of control. The factors characterized by an internal locus of control were fear of their children experiencing hunger, the perceived need to secure their children's affection through the provision of treat foods, perceptions of their ability to balance their children's diets across eating situations and perceived laziness. Recommendations are provided for addressing guilt-inducing child-feeding practices.
The aim of the present study was to explore the parent feeding practice of using food to soothe infant/toddler distress and its relationship to child weight status. Seventy eight families with infants and toddlers (43 males) ranging in age from 3 to 34 months (M=14 mos, SD=9 mos) completed a survey which included questions on their use of food to soothe, questionnaires on parent feeding practices, parenting self-efficacy, child temperament and child's weight and length at the time of their last well-baby visit. Results revealed the use of food to soothe to be a valid construct. In addition, mothers who used food to soothe rated themselves lower in parenting self-efficacy and their children higher in temperamental negativity. Analyses examining weight status as the outcome variable revealed that mothers who reported the use of food to soothe had heavier children, however, this relationship was stronger for children rated as high in temperamental negativity.
Although previous research indicates that parental child feeding practices are one component of a bidirectional relationship between children and parents, little is known about how child temperament operates in this relationship. The purpose of this study was to investigate relationships between child temperament and parental feeding practices and attitudes using a sibling design. By collecting data regarding pairs of siblings, we were able to investigate sibling differences and differential parental treatment. We examined mothers' and fathers' perceptions of their two children's temperaments as well as reports of the feeding practices and attitudes they use with each child. Fifty-five mothers and fathers completed questionnaires including the Carey Temperament Scales and the Child Feeding Questionnaire (CFQ). Results from correlation analyses showed that 6 of the 9 father reports of temperament between two siblings were positively related, whereas 1 of the 9 mother reports were positively related. Mothers' and fathers' perceptions of temperament were positively correlated for a single child. Some patterns were found between parental reports of sibling temperament and child feeding practices and attitudes, suggesting that temperament plays a role in how parents feed their children.
Parental dietary intake, lifestyle behavior, and parenting style influence a child's weight status. Few studies have examined associations between parent-child dietary intake, or specific father-child associations. This cross-sectional study examined associations between father-child dietary intakes of fruit, vegetables, and selected energy-dense nutrient-poor foods. The study population consisted of overweight fathers with 50 father-child dyads included in the analysis; median (interquartile range) age of fathers was 39±8.0 years; body mass index was 32.7±5.3; and their primary school-aged children (n=50) (54% boys aged 8.5±3.0 years, body mass index z score 0.6±1.6) who had been targeted to participate in the Healthy Dads, Healthy Kids pilot trial in the Hunter region, New South Wales, Australia in 2008. Dietary intakes of fathers and children were assessed using validated food frequency questionnaires, with mothers reporting their child's food intake. Descriptive statistics were reported and Spearman's rank order correlations used to test the strength of associations between father-child intakes. Fathers' median (interquartile range) daily fruit and vegetable intakes were 0.9 (1.5) and 2.2 (1.3) servings/day, respectively, whereas children consumed 2.1 (2.4) fruit and 2.9 (2.1) vegetable servings/day. Moderately-strong positive correlations were found between father-child fruit intakes (r=0.40, P<0.01), cookies (r=0.54, P<0.001), and potato chips (r=0.33, P<0.05). There were no associations between intakes of vegetables, ice cream, chocolate, or french fries (P>0.05). Children's intakes of fruit and some energy-dense nutrient-poor foods but not vegetables were related to their father's intakes. The targeting of fathers should be tested in experimental studies as a potential strategy to improve child and family eating habits.
This study aimed to identify predictors of controlling feeding practices in both mothers and fathers of young children.
Cross-sectional, questionnaire design.
Nursery schools within the United Kingdom recruited participants.
Ninety-six mothers and fathers comprising 48 mother-father pairs of male and female children aged 2 to 5 years.
Parents' child feeding practices, eating psychopathology, general mental health symptomology, and their children's eating behaviors and temperament.
Preliminary correlations; stepwise regressions.
Maternal controlling feeding was predicted by children's eating behaviors (emotional over- and undereating), child temperament (sociability), and maternal general mental health symptoms. Paternal reports of children's eating behaviors (slow eating and emotional undereating) were the only significant predictors of fathers' controlling feeding practices.
Mothers' and fathers' feeding practices seem to be better linked to child characteristics than to the presence of eating psychopathology symptoms. Children's emotional eating predicted all 3 controlling feeding practices in mothers and warrants further study to elucidate the causal nature of this relationship.
This study examined the associations between eating behaviours and temperament in a sample of young children. Mothers (N=241) of children aged 3-8 years completed measures of their children's eating behaviours and temperament and reported their child's height and weight. Children with more emotional temperaments were reported to display more food avoidant eating behaviours. Shyness, sociability and activity were not related to children's eating behaviours. Higher child BMI was related to more food approach eating behaviours but BMI was unrelated to child temperament. Future research should explore more specifically how emotional temperaments might influence child eating behaviour.
Children throughout the world are confronted with growth problems ranging from underweight and stunting to overweight and obesity. The development of healthy eating behaviors depends on both healthy food and responsive parenting behaviors. With origins from anthropology, psychology, and nutrition, responsive parenting reflects reciprocity between child and caregiver, conceptualized as a 4-step mutually responsive process: 1) the caregiver creates a routine, structure, expectations, and emotional context that promote interaction; 2) the child responds and signals to the caregiver; 3) the caregiver responds promptly in a manner that is emotionally supportive, contingent, and developmentally appropriate; and 4) the child experiences predictable responses. This paper examines evidence for the practice and developmental benefits of responsive parenting with a view to providing a theoretical basis for responsive feeding. Recommendations are made that future efforts to promote healthy growth and to prevent underweight and overweight among young children incorporate and evaluate responsive feeding.
This study investigated whether infants' temperament at 18 months is associated with the feeding of foods and drinks that may increase the risk for later obesity.
This was a cross-sectional study of mothers and infants (N = 40 266) participating in the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. Data were collected by questionnaire. Predictor variables were: infants' temperament at 18 months (internalizing, externalizing, and surgency/extraversion), and mothers' negative affectivity. Outcome variables were feeding of sweet foods, sweet drinks, and night-time caloric drinks at 18 months (all dichotomized). Confounders were child's gender, weight-for-height at 1 year, breastfeeding, and mother's level of education.
After controlling for confounders, infant temperament dimensions at 18 months were significantly associated with mothers' feeding of potentially obesogenic foods and drinks independent of mothers' negative affectivity. Infants who were more internalizing were more likely to be given sweet foods (OR 1.47, CI 1.32-1.65), sweet drinks (OR 1.76, CI 1.56-1.98), and drinks at night (OR 2.91, CI 2.54-3.33); infants who were more externalizing were more likely to be given sweet food (OR 1.53, CI 1.40-1.67) and sweet drinks (OR 1.22, CI 1.11-1.34); and infants who were more surgent were more likely to be given drinks at night (OR 1.66, CI 1.42-1.92).
The association between infant temperament and maternal feeding patterns suggests early mechanisms for later obesity that should be investigated in future studies.