Parental Feeding Attitudes and Styles and Child Body Mass Index: Prospective Analysis of a Gene-Environment Interaction

Abstract

ABSTRACT.Background. Parental feeding styles were linked to child weight in cross-sectional studies, which were unable to test the direction of effect. Prospective studies can best establish causal relationships among such variables.Objective. We tested the 2-year stability of parental feeding attitudes and styles and investigated whether these variables predict child body mass index (BMI) z scores 2 years later. We evaluated whether these associations were dependent on children's predisposition to obesity.Methods. Participants were 57 families enrolled in an Infant Growth Study of children born at high risk or low risk for obesity, on the basis of maternal prepregnancy overweight or leanness. Children were evaluated for weight and height at 3, 5, and 7 years of age. Measures of parental feeding attitudes and styles were ascertained with the Child Feeding Questionnaire at 5 and 7 years of age. Correlation and multiple regression analyses tested whether parental feeding styles at age 5 predicted increased child BMI z scores 2 years later.Results. Parental feeding attitudes and styles were stable for child ages of 5 to 7 years. With respect to feeding attitudes, perceived responsibility at age 5 predicted reduced child BMI z scores at age 7 among lowrisk families, whereas child weight concern and perceived child weight predicted increased child BMI z scores among high-risk families. With respect to feeding styles, monitoring predicted reduced child BMI z scores at age 7 among low-risk children. In contrast, restriction predicted higher BMI z scores and pressure to eat predicted reduced BMI z scores among high-risk children. These associations remained significant after controlling for child weight status at age 3.Conclusions. The relationship between parental feeding styles and child BMI z scores depends on child obesity predisposition, suggesting a gene-environment interaction. Among children predisposed to obesity, elevated child weight appears to elicit restrictive feeding practices, which in turn may produce additional weight gain. Parenting guidelines for overweight prevention may benefit from consideration of child characteristics such as vulnerability to obesity and current weight status. C hildhood overweight is an increasingly prevalent disorder that is associated with multiple health complications in childhood and later adulthood. 1 The rapid increase in obesity in America provides strong evidence that, whatever the genetic liability, environmental influences play a key role in its development. There is active interest in identifying specific environmental influences on childhood obesity. 2 If these environmental factors are driving the current epidemic, then modifying these factors might reduce the epidemic.A prominent environmental influence on children's eating may be parental control of child eating. 3 Johnson and Birch 4 reported that parental control of child eating was associated with poorer eating regulation in a child development laboratory setting, which, in turn, was associated with increased ...

Cultural differences in parental feeding practices and children’s eating behaviours and their relationships with child BMI: a comparison of Black Afro-Caribbean, White British and White German samples

“…Restriction was associated with child weight in BAC families only. In line with previous research, 3,5 BAC parents used more restriction with heavier children. Controlling feeding may have been a parental response to their children's weight or may have led to the development of children's weight problems.…”

“…While moderate guidance and control of the child's food environment is necessary to facilitate healthy weight and eating, excessive control may be detrimental to healthy weight and eating outcomes. Restriction has also been associated with the development of obesigenic child eating behaviours [3][4][5] and pressure is associated with subsequent lower consumption and preference for pressured foods. 6 Monitoring, described as parents' awareness of their child's intake of foods high in salt, sugar and fat, seems to be effective in regulating children's intake.…”

Parental influences on children’s eating behaviour and characteristics of successful parent-focussed interventions

“…Covert restriction, however, appears not to be related with such effects (Ogden, Reynolds, & Smith, 2006). The extent to which parents overtly restrict food may be related to the perceived weight status of the child, with parents using more restriction with infants who have a higher BMI (at 6-12 months; Brown & Lee, 2011) or those perceived to be at risk of becoming obese (Faith et al, 2004). However, while greater restriction of food during infancy predicts lower child weight at age 2 (Farrow & Blissett, 2008), by 5 years of age the use of earlier maternal restriction predicts greater child weight scores (Farrow, 2011;but see also Campbell et al, 2010).…”

Dietary energy density increases during early childhood irrespective of familial predisposition to obesity: results from a prospective cohort study

“…Further details of parental characteristics and study design were reported previously. [20][21][22][23][24] The present analyses were based on a sub-sample of this cohort for whom food records were available for the years of interest. Weighed 3-day food records Each year, at 72 weeks of each child's birthday, the primary caretaker of each child completed 3-day weighed food records (2 weekdays, 1 weekend day).…”