The Relationships between Caregivers’ Concern about Child Weight and Their Non-Responsive Feeding Practices: A Systematic Review and Meta-Analysis

Abstract

Background: It is unclear whether caregivers’ concern about child weight impacts their non-responsive feeding practices. This systematic review aimed to examine their relationships. Methods: A systematic search of PubMed, Embase, PsycINFO, Web of Science core collection, CINAHL and grey literature was conducted from inception to March 2022, following PRISMA guidelines. Data synthesis was performed using a semi-quantitative approach and a meta-analysis. Results: A total of 35 studies with 22,933 respondents were included in the review for semi-quantitative analyses. Thirty-four studies examined 52 associations between concern about child weight and restriction with 40 statistically significant associations being observed. A total of 34 relationships between concern about child weight and pressure to eat were investigated, with 12 being statistically significant. The pooled regression coefficients (β) demonstrated that caregivers’ concern about child overweight was positively associated with restriction (β = 0.22; 95%CI: 0.12, 0.31), negatively associated with use of food as a reward (β = −0.06; 95%CI: −0.11, −0.01), and not statistically associated with pressure to eat (β = −0.05; 95%CI: −0.13, 0.04). The pooled odds ratios (ORs) indicated that caregivers who were concerned about child overweight were found to use restrictive feeding more often (OR = 2.34; 95%CI: 1.69, 3.23), while less frequently adopting pressure to eat (OR = 0.76; 95%CI: 0.59, 0.98) compared with those without concerns. The results also showed that caregivers who were concerned about child underweight were more likely to force their children to eat (OR = 1.83; 95%CI: 1.44, 2.33) than those without concerns. Conclusion: Caregivers’ concern about child weight may be an important risk factor for non-responsive feeding practices. Thus, interventions are needed to focus on managing and relieving caregivers’ excessive concern about child weight, especially overweight, which may optimize feeding practices and subsequently contribute to child health.

The effectiveness of interventions on changing caregivers' feeding practices with preschool children: A systematic review and meta‐analysis

“…58 The subgroup analysis and meta-regression were used to evaluate effect heterogeneity. The exploratory subgroup analysis was based on some potential factors 7,53,59,60…”

“…Quantitative approaches were any method that used a numerical method to summarize across at least two studies and were further divided into semi-quantitative and quantitative approaches (metaanalysis). We used a semi-quantitative approach to summarize the findings of all the included articles (i.e., study characteristics, outcomes, and intervention features) narratively, as adopted by recent reviews [51][52][53][54] because not all included studies had necessary numerical results for meta-analysis. Information was retrieved by one reviewer (JW) and checked by a second reviewer (XW).…”

“…The subgroup analysis and meta‐regression were used to evaluate effect heterogeneity. The exploratory subgroup analysis was based on some potential factors 7,53,59,60 (i.e., country's level of development, sample size, caregivers' education, family income, study quality, mode of intervention delivery, number of BCT clusters and control condition). All analyses were performed in Stata 17.0 (StataCorp, College Station, TX, USA).…”

Empowering parents to optimize feeding practices with preschool children (EPO-Feeding): A study protocol for a feasibility randomized controlled trial

“…Feeding practices refer to specific behaviours or strategies caregivers adopt to manage what, when and how much their children eat and shape their children's eating behaviours [14][15][16][17]. There are two types of feeding practices: responsive and non-responsive feeding [14][15][16][17].…”

“…Feeding practices refer to specific behaviours or strategies caregivers adopt to manage what, when and how much their children eat and shape their children's eating behaviours [14][15][16][17]. There are two types of feeding practices: responsive and non-responsive feeding [14][15][16][17]. Responsive feeding practices (e.g., monitoring, encouragement of healthy eating, and modelling) show reciprocal relationships between children and their caregivers [18,19], which refer to food parenting practices that respond to their children's developmental and physiological needs, and encourage children to eat autonomously and independently.…”