Abstract
This study investigated parental influences on preschool children’s healthy and unhealthy snacking in relation to child obesity in a large cross-sectional multinational sample. Parents and 3–5 year-old child dyads (n = 5185) in a kindergarten-based study provided extensive sociodemographic, dietary practice and food intake data. Parental feeding practices that were derived from questionnaires were examined for associations with child healthy and unhealthy snacking in adjusted multilevel models, including child estimated energy expenditure, parental education, and nutritional knowledge. Parental healthy and unhealthy snacking was respectively associated with their children’s snacking (both p < 0.0001). Making healthy snacks available to their children was specifically associated with greater child healthy snack intake (p < 0.0001). Conversely, practices that were related to unhealthy snacking, i.e., being permissive about unhealthy snacking and acceding to child demands for unhealthy snacks, were associated with greater consumption of unhealthy snacks by children, but also less intake of healthy snacks (all p < 0.0001). Parents having more education and greater nutritional knowledge of snack food recommendations had children who ate more healthy snacks (all p < 0.0001) and fewer unhealthy snacks (p = 0.002, p < 0.0001, respectively). In the adjusted models, child obesity was not related to healthy or unhealthy snack intake in these young children. The findings support interventions that address parental practices and distinguish between healthy and unhealthy snacking to influence young children’s dietary patterns.
Highlights
Trends in childhood obesity are a concern in many countries, with evidence for increasing prevalence of obesity, even in preschool children [1]
As in the above studies, the present study focused on examining the dimensional structure of responses on items that were related to parental feeding practices, as being behaviourally and psychometrically more meaningful than examining associations with individual questionnaire items
We applied multilevel modelling to determine the independent influences of these parents’ feeding practices, their own snacking, and the parents’ nutritional knowledge in relation to snacks, on both healthy and unhealthy snacking by their children
Summary
Trends in childhood obesity are a concern in many countries, with evidence for increasing prevalence of obesity, even in preschool children [1]. Numerous interventions have been attempted, addressing eating, drinking, and activity energy-balance related behaviours, primarily in school-aged children, but with mixed success [2,3,4]. Snacking is an important energy-balance related dietary behaviour in children: young children have proportionately the highest nutritional and energetic requirements of any stage of the lifespan [7]; frequent eating, including snacking between meals, is typical, reinforced, and avoids acute nutritional deficits that might otherwise limit physical and psychological development [8,9]. There is concern that children’s choice of snacks are often high in sugar and fat [11,12]. It is important to distinguish between snacking on foods with a healthy nutrient profile (e.g., fruit and vegetables, unsweetened dairy) from those with unhealthy profiles (e.g., those high in fat, sugar, and/or salt, but low in essential nutrients), and to understand their determinants [8]
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