Most childhood obesity prevention efforts have focused on school-age children and adolescents and have had limited success. We argue that the first years of life, including the prenatal period, the postnatal suckling period and the transition to the modified adult diet, may provide opportunities for preventive interventions. These early periods are characterized by high plasticity and rapid transitions, and parents have a high degree of control over children's environments and experiences. Observational and experimental evidence reveal persistent effects of early environments on eating behavior and obesity risk, suggesting that interventions should be tested during these early periods. The central task parents have in early development points to their potential as key targets and agents of change in early preventive interventions. In this paper, we review evidence of early environmental effects on children's eating and obesity risk, highlighting ways that parental feeding practices and parents' own behaviors impact these outcomes and calling for further experimental research to elucidate whether these factors are indeed promising targets for childhood obesity preventive interventions.

Recent theoretical approaches to food intake hypothesize that eating represents a balance between reward-driven motivation to eat versus inhibitory executive function processes, however this hypothesis remains to be tested. The objective of the current study was to test the hypothesis that the motivation to eat, operationalized by the relative reinforcing value (RRV) of food, and inhibitory processes, assessed by delay discounting (DD), interact to influence energy intake in an ad libitum eating task. Female subjects (n = 24) completed a DD of money procedure, RRV task, and an ad libitum eating task in counterbalanced sessions. RRV of food predicted total energy intake, however the effect of the RRV of food on energy intake was moderated by DD. Women higher in DD and RRV of food consumed greater total energy, whereas women higher in RRV of food but lower in DD consumed less total energy. Our findings support the hypothesis that reinforcing value and executive function mediated processes interactively influence food consumption.

Intake of energy-dense snack foods is high among US children. Although the use of restrictive feeding practices has been shown to be counterproductive, there is very limited evidence for effective alternatives to restriction that help children moderate their intake of these foods and that facilitate the development of self-regulation in childhood. The developmental literature on parenting and child outcomes may provide insights into alternatives to restrictive feeding practices. This review paper uses a model of parental control from the child development and parenting literatures to (i) operationally define restrictive feeding practices; (ii) summarize current evidence for antecedents and effects of parental restriction use on children's eating behaviours and weight status, and (iii) highlight alternative feeding practices that may facilitate the development of children's self-regulation and moderate children's intake of palatable snack foods. We also discuss recent empirical evidence highlighting the role of child temperament and food motivation related behaviours as factors that prompt parents to use restrictive feeding practices and, yet, may increase children's dysregulated intake of forbidden foods.

Effects of maternal control on girls' EAH and BMI may differ by the type of practice used (eg, limit-setting or restrictive practices). Girls with low inhibitory control were more susceptible to the negative effects of low and high control.

Parents’ use of restrictive feeding practices is counterproductive, increasing children’s intake of restricted foods and risk for excessive weight gain. The aims of this research were to replicate Fisher and Birch’s (1999b) original findings that short-term restriction increases preschool children’s (3–5 y) selection, intake, and behavioral response to restricted foods, and to identify characteristics of children who were more susceptible to the negative effects of restriction. The experiment used a within-subjects design; 37 children completed the food reinforcement task and heights/weights were measured. Parents reported on their use of restrictive feeding practices and their child’s inhibitory control and approach. Overall, the findings replicated those of Fisher and Birch (1999b) and revealed that the effects of restriction differed by children’s regulatory and appetitive tendencies. Greater increases in intake in response to restriction were observed among children lower in inhibitory control, higher in approach, who found the restricted food highly reinforcing, and who had previous experience with parental use of restriction. Results confirm that parents’ use of restriction does not moderate children’s consumption of these foods, particularly among children with lower regulatory or higher appetitive tendencies.

Studies have indicated that family meals may be a protective factor for childhood obesity; however, limited evidence is available in children with different racial, socioeconomic, and individual characteristics. The purpose of this study was to examine family meal frequency (FMF) as a protective factor for obesity in a US-based sample of non-Hispanic White, non-Hispanic Black, and Hispanic children aged 6 to 11, and to identify individual, familial, and socioeconomic factors that moderate this association. Data were from the 2003 National Survey of Children’s Health (n=16,770). Multinomial logistic regression analyses were used to test the association between FMF and weight status, and the moderating effects of household structure, education, poverty level, and sex, by racial group. Non-Hispanic White children who consumed family meals everyday were less likely to be obese than those eating family meals 0 or few days a week. A moderating effect for gender was observed in non-Hispanic Black children such that FMF was marginally protective in boys but not girls. Higher FMF was a marginal risk factor for obesity in Hispanic boys from low-education households, but not in girls from similar households. In conclusion, family meals appear to be protective of obesity in non-Hispanic White children, and non-Hispanic Black boys; whereas, they may put Hispanic boys living in low education households at risk. Greater emphasis is needed in future research on understanding why this association differs among different race/ethnic groups, and the influence of the quality in addition to the quantity of family meals on child obesity.

Background: Economic theory and limited empirical data suggest that costs per unit of HIV prevention program output (unit costs) will initially decrease as small programs expand. Unit costs may then reach a nadir and start to increase if expansion continues beyond the economically optimal size. Information on the relationship between scale and unit costs is critical to project the cost of global HIV prevention efforts and to allocate prevention resources efficiently.

Background-The acculturation hypothesis proposes an overall disadvantage in health outcomes for Hispanic immigrants with more time spent living in the U.S., but little is known about how generational status and language may influence Hispanic children's relative weight and activity patterns.