Child adiposity and maternal feeding practices: a longitudinal analysis

Abstract

Parental control has been hypothesized to cause weight gain in children by weakening self-regulatory processes. However, most studies that link control with weight have been cross-sectional, and therefore causation is uncertain. It remains possible that parental control is a response to child overweight rather than a cause. We investigated the direction of the association between parental feeding practices and children's adiposity in a longitudinal study. Three subscales of the Child Feeding Questionnaire (CFQ) that measure "pressure," "restriction," and "monitoring" were completed by 213 mothers of 7-9-y-old children as part of the Physical Exercise and Appetite in CHildren Study (PEACHES) and repeated by 113 mothers 3 y later. Baseline and follow-up anthropometric measurements [body mass index (BMI); fat mass index (FMI), and waist circumference (WC)] were made by researchers when the children were aged 7-9 y and 10-11 y. Regression analyses showed no association between any of the CFQ scales at baseline and change in child adiposity. In contrast, higher child BMI at baseline predicted a smaller decrease in follow-up CFQ "monitoring" (P = 0.003) and a larger decrease in "pressure to eat" (P = 0.04) after baseline scores were controlled for. Similar results were observed for FMI and WC, although they did not reach significance for WC. There were no significant longitudinal associations between child adiposity and the CFQ "restriction" subscale. The results were more consistent with a "child-responsive" model whereby a mother's choice of feeding practice is influenced by her child's weight status rather than her feeding practices influencing the child's weight gain.