Abstract
Children's eating behavior, food intake, and weight status are highly influenced by parents, who shape their food environment via parental feeding practices. The aim of this study was to investigate associations between sociodemographic, anthropometric, and behavioral/attitudinal characteristics of parents and their 5- to 9-year-old children and a range of positive ("healthy eating guidance," "monitoring") and potentially negative ("restriction for weight control," "restriction for health," "emotion regulation/food as reward," and "pressure") parental feeding practices. Parents completed a questionnaire assessing parental and child characteristics. Parental feeding practices were measured using a Brazilian adaptation of the Comprehensive Feeding Practices Questionnaire. To test associations between parent and child characteristics and parental feeding practices, we ran bivariate logistic regression models with parent and child characteristics as independent variables and high (above median) scores on individual parental feeding practices as outcome variables. We then conducted multivariate logistic regression models containing all parent and child characteristics, controlling for child age and maternal education. Lower parental perceived responsibility for child feeding, higher child use of screen devices, and higher child ultra-processed food intake were associated with lower scores on "healthy eating guidance" and "monitoring." Higher parental perceived responsibility for child feeding and concern about child overweight were associated with higher scores on "restriction for weight control" and "restriction for health." Parental perceptions of low weight and concern about child underweight, and higher perceived responsibility for child feeding, were associated with higher scores on "pressure." Greater intake of ultra-processed foods and lower maternal age were associated with higher scores on "emotion regulation/food as reward." Parental concerns and perceptions relating to child weight were predictive of potentially negative feeding practices. Higher scores on potentially negative feeding practices, and lower scores on positive parent feeding practices, were associated with poorer child diet and higher use of screen devices. Parental engagement in the feeding interaction predicted greater adoption of both potentially negative and positive feeding practices. These results support the need for policies and programs to educate parents about child feeding and help motivated parents to promote healthy lifestyles in their children.
Highlights
Children’s eating behavior is highly influenced by parents, who are the main source of their child’s food experiences, their first nutritional educators, and act as providers, enforcers, and role models for the child (1–3)
The Comprehensive Feeding Practices Questionnaire (CFPQ) aims to assess feeding practices of parents of 2- to 8-year olds, and is unique in its inclusion of a wider range of feeding practices compared to previous questionnaires, including positive feeding strategies, and two varieties of restriction—one motivated by health and one by weight control (11)
These analyses showed that lower scores in “healthy eating guidance” were influenced by six parent–child characteristics that were eligible (p < 0.20) to enter the final model: four related to parent characteristics (e.g., Table 1 | Characteristics of the sample of school-aged children enrolled in private schools of Campinas and São Paulo, 2014 (n = 659)
Summary
Children’s eating behavior is highly influenced by parents, who are the main source of their child’s food experiences, their first nutritional educators, and act as providers, enforcers, and role models for the child (1–3). The CFPQ was developed in the United States (US) in 2007 and has since been validated in France (12), Norway (13), Iran (14), New Zealand (15), Malaysia (16), and, most recently, Brazil (17, 18) This Portuguese version, validated in a sample of Brazilians from 5- to 9-year olds, resulted in a slightly modified, shorter version of the questionnaire, with 42 items distributed into six factors: “healthy eating guidance”—15 items (assesses how parents guide their child’s eating through encouragement, modeling, and teaching about nutrition, as well as parental involvement in feeding and the creation of healthy food environments), “monitoring”—six items (assesses how much parents keep track of unhealthy food their child eats), “restriction for weight control”—seven items (assesses the degree to which parents restrict their child’s food intake with the goal of controlling their child’s weight), “restriction for health”—five items (assesses how much parents restrict their child’s food intake with the goal of influencing their child’s health), “emotion regulation/ food as reward”—five items (assesses parents’ use of food to regulate child’s emotions and/or to reward desirable behaviors), and “pressure”—four items (assesses the degree to which parents apply pressure to make their child eat more and/or a specific food) (17). The aim of this study was to investigate associations between sociodemographic, anthropometric, and behavioral/attitudinal characteristics of parents and their 5- to 9-year-old children and a range of positive (“healthy eating guidance,” “monitoring”) and potentially negative (“restriction for weight control,” “restriction for health,” “emotion regulation/food as reward,” and “pressure”) parental feeding practices
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