Restriction and Pressure to Eat Are Associated Cross-Sectionally, But Not Longitudinally, With BMI z-Score in a Longitudinal Cohort Study of Adolescents.

Abstract

Background: Parents can influence child weight through their use of food parenting practices, although data are limited in adolescents. The purpose of this study was to examine the cross-sectional and longitudinal relationships between BMI z-Score (zBMI) and restriction and pressure to eat in adolescents. Methods: Adolescents (12-14 years of age at baseline; N = 236) had their height/weight measured at baseline and 24 months and their parent completed the Child Feeding Questionnaire. Linear regressions examined relationships between food parenting practices and zBMI. Results: Cross-sectionally, restriction was positively associated with zBMI at both baseline (β = 0.28, p < 0.001) and 24 months (β = 0.141, p = 0.039). In contrast, pressure to eat was negatively associated with zBMI at both baseline (β = -0.30, p < 0.001) and 24 months (β = -0.31, p < 0.001). Neither restriction (β = -0.028, p = 0.446) nor pressure to eat (β = -0.027, p = 0.493) at baseline predicted 2-year changes in zBMI. zBMI at baseline did not predict 2-year changes in either restriction (β = -0.003, p = 0.965) or pressure to eat (β = -0.056, p = 0.611). Conclusion: Findings highlight that adolescents perceive moderate levels of restriction and pressure to eat, with levels differing by weight status. These findings suggest that the bidirectional relationships between child weight status and food parenting practices are likely established before adolescence, but persist throughout adolescence. Further longitudinal studies should examine the impact of restriction and pressure to eat early in childhood on weight trajectories into adolescence and adulthood. Clinicaltrials.gov: NCT04027608.