Young Children’s Eating in the Absence of Hunger: Links With Child Inhibitory Control, Child BMI, and Maternal Controlling Feeding Practices

Kaat Philippe,Sylvie Issanchou,Sandrine Monnery-Patris,Claire Chabanet

doi:10.3389/fpsyg.2021.653408

Abstract

This study aimed to gain a better understanding of the associations between young children’s eating in the absence of hunger (EAH), inhibitory control, body mass index (BMI) and several maternal controlling feeding practices (food as reward, restriction for health, restriction for weight control). In addition, to more properly assess the relationship between children’s and maternal variables, the link between EAH and restriction was explored separately in two directionalities: “child to parent” or “parent to child.” To do this, mothers of 621 children aged 2.00–6.97years (51% boys, M=4.11years, SD=1.34) filled in a questionnaire with items from validated questionnaires. Structural equation modeling (SEM) was used to analyze the data. The results showed, whatever the directionality considered, a positive association between children’s eating in the absence of hunger and their BMI z-scores. Restriction for health and restriction for weight control were differently linked to EAH and to children’s BMI z-scores. Namely, low child inhibitory control, food as reward and restriction for health were identified as risk factors for EAH. Restriction for weight control was not linked to EAH, but was predicted by child BMI z-scores. Interventions aiming to improve children’s abilities to self-regulate food intake could consider training children’s general self-regulation, their self-regulation of intake, and/or promoting adaptive parental feeding practices.

Highlights

The prevalence of overweight and obesity in children and adolescents has increased in a large number of countries since the 1980s (GBD 2015 Obesity Collaborators, 2017)
According to maternal reports of child weight and height, 11% of children in our sample were underweight (z-body mass index (BMI) < −2), 71% had a normal weight (−2 ≤ z-BMI < 1), 10% were at risk for overweight (1 ≤ z-BMI < 2), 5% had overweight (2 ≤ z-BMI < 3), and 2% had obesity (z-BMI > 3; weight categories according to World Health Organization, 2006)
The results further indicated that environmental factors, parental feeding practices, were linked to child eating in the absence of hunger (EAH): both food as reward and restriction for health were significantly positively associated with EAH

Summary

Introduction

The prevalence of overweight and obesity in children and adolescents has increased in a large number of countries since the 1980s (GBD 2015 Obesity Collaborators, 2017). World Health Organization (2018) reported that on average almost one in eight children aged seven to eight has obesity in Europe This is a reason for concern given that childhood obesity has been associated with social, psychological, emotional and health effects both in the short and long terms Young children are believed to have an innate capacity to self-regulate their food intake, by following their internal signals of hunger and fullness (e.g., Birch and Deysher, 1986) As they grow older, environmental factors, such as inappropriate portion sizes, the availability of energy-dense foods and parental controlling food practices could divert children from their internal signals and could cause them to overeat, resulting in an increased risk of weight gain (Birch et al, 2003; Fisher and Kral, 2008; Kral et al, 2012; Frankel et al, 2014; Monnery-Patris et al, 2019). The results of these studies indicated a counterproductive effect of these practices as they were linked to or resulted in less adaptive child eating behaviors

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Discussion

Conclusion