Portion Sizes For Children Research Articles

‘It's not something I really think about’: Parents' perspectives and practices about how much food to offer in early childhood

AbstractChildren are born with an innate capacity to self‐regulate their energy intake, but cues from the food environment can undermine children's self‐regulation, promoting overconsumption, and challenging energy balance. The size of the portion offered by parents and caregivers has been shown to be correlated with how much food children consume, which is known as the portion size effect. Furthermore, some parental feeding practices may interfere with children's ability to self‐regulate. The present research explored parents' perspectives and practices about how much food they offer to their children in Uruguay. Forty‐two in‐depth interviews with parents of children between 6 months and 5 years old were conducted. Results showed that parental decisions about portion sizes for their children were mostly unconscious and intuitive. Parents were unconcerned about portion sizes, mainly due to the belief that children are able to self‐regulate. Although parents identified themselves as mainly responsible for deciding how much food to serve their children, the majority reported to be responsive when their child refuses to eat or finish their meal, or when they request to eat more. Coercive feeding practices were only mentioned by a minority of parents.Practical ApplicationsResults from the present work stress the need to raise awareness of children's vulnerability to portion size effects, since portion size selection seems to be a highly arbitrary process. Further research is needed to identify the best approaches to disseminate information among parents and caregivers to promote appropriate portion sizes for children, as well as responsive feeding practices.

P76 CUPS: A Teaching Unit Integrating Nutrition and Mathematics to Improve Primary School Children's Portion Size Estimation

<h3>Background</h3> Nutrition education programs at schools have improved children's dietary knowledge and behavior. However, crowded curricula mean teachers find it challenging to implement nutrition education as a stand-alone subject. Therefore, addressing this barrier by integrating nutrition with core subjects across the curriculum may be helpful. <h3>Objective</h3> The current study aimed to investigate the impact of a teaching unit on portion size estimation skills when nutrition is integrated within mathematics involving volume and capacity. <h3>Study Design, Setting, Participants</h3> A pilot randomised, controlled trial in 4 primary schools (n = 72 children in Year 3 and/or 4) was conducted. The intervention group (n = 46) received six 40-minute lessons about portion size, food groups, volume, and capacity utilising experiential learning with mathematics cubes and food replicas. The wait-list control group (n = 26) continued their usual lessons on volume and capacity. Outcome measures were taken pre-intervention, immediately post-intervention and 4 weeks after intervention completion. <h3>Measurable Outcome/Analysis</h3> Relative estimation errors (%) for portion size estimation of several food replicas were calculated to compare students' answers to the actual volumes expressed as cubes. Linear mixed models were used to determine the impact of treatment group, time, and the group-by-time as fixed effects. <h3>Results</h3> Preliminary results showed a decrease in relative estimation error for the intervention group (M=11.35, SE = 9.90), whereas the control group increased slightly (M = 2.48, SE = 13.39). This difference was not found statistically significant. <h3>Conclusions</h3> This trial uses a novel approach to teach students about serving sizes and estimation skills while incorporating learning outcomes from the NSW k-6 Mathematics Syllabus. The findings indicate that this integrated curriculum improved portion size estimation skills. However, significance of this result was not established in this small sample. Future cross-curricular nutrition education interventions and strategies targeting these skills should be conducted with a larger study population to further explore its potential impact.

The Food Parenting Inventory: Factor structure, reliability, and validity in a low-income, Latina sample

Currently, a number of questionnaires exist assessing a wide range of food parenting practices with young children. In 2016, a concept map covering three food parenting domains—coercive control, parental structure, and autonomy support—was published along with a critical review of the literature. Mapping existing food parenting questionnaires onto these concepts showed that the major focus had been on coercive control. Important aspects of the parenting process around feeding have been inadvertently omitted—parental responsiveness to children's fullness cues, parental strategies to encourage children to try new foods, and parental practices related to children's portion sizes. To address this, we developed the Food Parenting Inventory (FPI) targeting encouragement of new foods, mealtime structure, and external control. This new questionnaire draws from a variety of sources including the Child Feeding Questionnaire and the Family Rituals Questionnaire. The FPI addresses most of the food parenting practices outlined in the concept map with the exception of food availability/accessibility, food preparation, and praise. Psychometrics were assessed with a sample of 248 low-income, Latina mothers who completed questionnaires on food parenting practices, parental feeding styles, and child eating behaviors. Findings suggest good initial evidence for the reliability and validity of the FPI among Latina families with preschoolers. This questionnaire advances the field of food parenting by targeting neglected constructs that play an important role in the development of child eating behaviors.

Plating up appropriate portion sizes for children: a systematic review of parental food and beverage portioning practices.

Consumption of larger portion sizes is associated with higher energy intake and weight status in children. As parents play a pivotal role in child feeding, we synthesized literature on 'parental portioning practices' using a mixed methods systematic design to inform future strategies addressing portion sizes served to children. Electronic databases PubMed, EMBASE, SCOPUS, PsycINFO and CINAHL Plus were searched. Two reviewers independently screened 385 abstracts and assessed 71 full-text articles against eligibility criteria: studies assessing portioning of foods or beverages by parent(s) with ≥1 child aged 2-12years. Narrative synthesis of 14 quantitative studies found that portion sizes parents serve vary substantially and are influenced by amounts parents serve themselves, perceived child hunger and parent and child body size. Thematic synthesis of 14 qualitative studies found that parents serve the portion sizes they learn to be appropriate for their child to be fed. Portioning is influenced by parents' desires for a healthy child with a balanced diet. Future guidance on appropriate portion sizes for children would ideally present recommended portion sizes for first serving, incremental with age. Future research is however needed to assess the adoption and efficacy of providing such guidance to families.

Reduction of Portion Size and Eating Rate Is Associated with BMI-SDS Reduction in Overweight and Obese Children and Adolescents: Results on Eating and Nutrition Behaviour from the Observational KgAS Study

Objective: Treatment of paediatric obesity focuses on changes of nutrition and eating behaviour and physical activity. The evaluation of the patient education programme by KgAS was utilised to analyse the association of changes of portion size, eating rate and dietary habits with BMI-SDS reductions. Methods: Patients (n = 297) were examined at the beginning and at the end of treatment and after 1-year follow-up at different out-patient centres. Their parents completed questionnaires including estimation of children's portion size, eating rate and frequency of food intake. Associations of 1- and 2-year changes in BMI-SDS and behaviour were calculated for patients with complete data in BMI-SDS, portion size, eating rate, frequency of green, yellow and red food intake (n = 131) by multiple linear regression models. Results: Significant changes were found in the desired direction for BMI-SDS, portion size, eating rate and the intake of unfavourable red food items both after 1 and 2 years as well as for the consumption of favourable green food items after 1 year. Significant positive associations with BMI-SDS reduction after 1 and 2 years were detected for portion size (Cohen's f² 0.13 and 0.09) and eating rate (Cohen's f² 0.20 and 0.10), respectively. Conclusion: Reduced portion sizes and eating rates are associated with BMI-SDS reduction after 1 and 2 years. These findings suggest to focus on appropriate portion sizes and reduced eating rates in patient education programmes.

Portion sizes for children are predicted by parental characteristics and the amounts parents serve themselves

Children's energy intakes are influenced by the portions they are served. Factors influencing the amounts adults offer children are not well described. We assessed whether the amounts that were served to and consumed by children at meals were related to amounts that parents served themselves. In this repeated-measures, cross-sectional observational study, 145 parents and their preschoolers (82 Hispanic, 57 African American, 6 unidentified) were recruited from Head Start settings in Houston, TX. The amounts served to and consumed by children and parents during 3 at-home evening meals were measured and analyzed. We assessed children's and parents' heights and weights, and body mass indexes (BMIs) were calculated. Associations between portions served for parents and children and between amounts served to and consumed by children were evaluated. Multiple linear regression was used to determine whether maternal characteristics (race-ethnicity, sociodemographic factors, and caregivers' BMIs) predicted the amounts caregivers served to children. The amounts that parents served themselves were significantly associated with the amounts that they served to their children (r = 0.51, P < 0.0001). Multiple regression analysis showed that African American parents (compared with Hispanics) served more food to themselves and to their children (P < 0.01, R² = 6.9%) and that employed (compared with unemployed) parents served more food to their children (P = 0.025, R² = 3.3%). The amounts served to children were strongly associated with the amounts children consumed (r = 0.88, P < 0.0001). When parents served more to themselves, they also served more to their children (P < 0.001). These findings underscore the strong relation between portions offered by caregivers and the amounts children consume at a meal and suggest that factors unrelated to the child (such as the amount a parent serves himself or herself) are important predictors of children's consumption. Efforts aimed at improving parents' recognition of developmentally appropriate portions for young children could be useful for future obesity-prevention efforts.

Developing a nutrition intervention in children's centres: exploring views of parents in rural/urban settings in the UK.

The present study explored parents’ requirements for healthy eating support prior to the development of a tailored intervention. A cross-sectional study of parents attending children’s centres. Children’s centres in Cornwall (rural south-west England) and Islington (urban London borough). A total of 261 parents (94.2% female) of pre-school children (aged 2–5 years) completed a questionnaire on factors influencing food choice, and preferences for and views on healthy eating support. Parents reported that health, taste, freshness and quality were the most important factors influencing their food choices for their pre-school children. The importance of individual factors varied according to level of educational attainment. Over a third (38 %) of parents said they wanted more advice on healthy eating for children. Less educated parents showed the greatest interest in learning more about several aspects: what a ‘healthy diet’ means, how to prepare and cook healthy food, how to understand food labels, budgeting for food, examples of healthy food and snacks for children, appropriate portion sizes for children and ways to encourage children to eat well. There was demand for healthy eating support among parents of pre-school children, especially those who are less educated, in one rural and one urban area of England

Mothers’ views on portion sizes for children

Childhood obesity has increased steadily over recent years and has coincided with a general trend towards larger portions of foods consumed both inside and outside the home. A causal link between portion size and weight gain has not been established, although there is evidence of an association between larger portions and greater energy intake. The present study aimed to investigate parent's attitudes, knowledge, practices, and concerns about appropriate portions for children. Four focus groups with a total of 14 volunteer mothers of 8-11-year-old children taking part in a larger school-based study. Mothers were asked their views about portion sizes for their children and were asked to demonstrate typical servings that they would offer their children, by weighing five common foods provided. Conversations were tape-recorded and transcribed for thematic analysis. Participants were unconcerned about portion sizes and would not welcome official guidance, particularly if it involved weighing foods. Mothers fed their children the amount that they believed they would eat and felt that this varied across children and across occasions. The weighing task revealed a wide variation in portion sizes served to children, with portions of the more energy-dense foods being smaller on average than those of less energy-dense foods. There was little understanding of age-appropriate serving sizes amongst mothers in this study. Education campaigns should be mindful of the need to make portion information clear and simple because parents may not be prepared to weigh the food that they serve to their children.

Comparison of Fast-Food and Non-Fast-Food Children's Menu Items

Objective Compare the macronutrient content of children's meals sold by fast-food restaurants (FFR) and non-fast-food restaurants (NFF). Design All restaurants within the designated city limits were surveyed. Non-fast-food children's meals were purchased, weighed, and analyzed using nutrition software. All fast-food children's meals were recorded, with nutrient content information obtained from their respective commercial Web sites. Setting Community in southeastern United States. Participants 33 restaurants, 10 FFR and 23 NFF. Main Outcome Measure(s) Total weight, total calories, fat, saturated fat, protein, carbohydrates, and fiber. Analysis Paired t tests, 1-way analysis of variance, and general linear model analyses. Results Overall mean percentage of calories from fat for children's meals at FFR was 37.5%, and 40.5% at NFF. Significant differences ( P < .01) existed between FFR and NFF, with FFR providing smaller servings, fewer calories, and less total fat, saturated fat, protein, carbohydrates, and fiber. When analyzing only with the highest calorie option side, controlling for portion size, no differences remained except saturated fat. Conclusions and Implications Fast-food restaurants offered smaller children's portion sizes and lower-fat options. These results have implications for restaurants, parents, children, and nutrition educators.

Children's estimates of food portion size: the effect of timing of dietary interview on the accuracy of children's portion size estimates

For food intakes to be converted into nutrient intakes a measure or estimate of the amount of food consumed is required. A number of methods have been developed to assist subjects in providing an estimate of portion size. Children's ability to use perception, conceptualisation and memory skills to estimate food portion size has not been investigated systematically. The aim of the present study was to test the effect of the timing of a dietary interview on the accuracy of estimates of food portion sizes made by children, using food photographs, food models and an interactive portion size assessment system, developed for use with children and based on portion sizes of foods consumed by children. Children (n 108) aged 4-14 years were supplied with known quantities of foods and asked to estimate the portion size of each food using each of the three portion size assessment tools. Interviews took place (a) with the food in view, (b) just after the child had eaten the food or (c) 24 h after the child had eaten the food. There were no significant differences in children's ability to estimate food portion size (either as served or as eaten) with timing of interview. That is, children were as accurate in their estimates of portion size 24 h after consuming the food as when the food was in view. Under these conditions many children were able to estimate food portion size utilising perception, conceptualisation and memory skills.

FAMILY ENVIRONMENTAL FACTORS INFLUENCING THE DEVELOPING BEHAVIORAL CONTROLS OF FOOD INTAKE AND CHILDHOOD OVERWEIGHT

Although a large body of research has assessed direct genetic links between parent and child weight status, relatively little research has assessed the extent to which parents (particularly parents who are overweight) select environments that promote overweight among their children. Parents provide food environments for their children's early experiences with food and eating. These family eating environments include parents' own eating behaviors and child-feeding practices. Results of the limited research on behavioral mediators of familial patterns of overweight indicate that parents' own eating behaviors and their parenting practices influence the development of children's eating behaviors, mediating familial patterns of overweight. In particular, parents who are overweight, who have problems controlling their own food intake, or who are concerned about their children's risk for overweight may adopt controlling child-feeding practices in an attempt to prevent overweight in their children. Unfortunately, research reveals that these parental control attempts may interact with genetic predispositions to promote the development of problematic eating styles and childhood overweight. Although the authors have argued that behavioral mediators of family resemblances in weight status, such as parents' disinhibited or binge eating and parenting practices are shaped largely by environmental factors, individual differences in these behaviors also have genetic bases. A primary public health goal should be the development of family-based prevention programs for childhood overweight. The findings reviewed here suggest that effective prevention programs must focus on providing anticipatory guidance on parenting to foster patterns of preference and food selection in children more consistent with healthy diets and promote children's ability to self-regulate intake. Guidance for parents should include information on how children develop patterns of food intake in the family context. Practical advice for parents includes how to foster children's preferences for healthy foods and how to promote acceptance of new foods by children. Parents need to understand the costs of coercive feeding practices and be given alternatives to restricting food and pressuring children to eat. Providing parents with easy-to-use information regarding appropriate portion sizes for children is also essential as are suggestions on the timing and frequency of meals and snacks. Especially during early and middle childhood, family environments are the key contents for the development of food preferences, patterns of food intake, eating styles, and the development of activity preferences and patterns that shape children's developing weight status. Designing effective prevention programs will, however, require more complete knowledge than currently available regarding behavioral intermediaries that foster overweight, including the family factors that shape activity patterns, meals taken away from home, the impact of stress on family members' eating styles, food intake, activity patterns, and weight gain. The research presented here provides an example of how ideas regarding the effects of environmental factors and behavioral mediators on childhood overweight can be investigated. Such research requires the development of reliable and valid measures of environmental variables and behaviors. Because childhood overweight is a multifactorial problem, additional research is needed to develop and test theoretic models describing how a wide range of environmental factors and behavioral intermediaries can work in concert with genetic predispositions to promote the development of childhood overweight. The crucial test of these theoretic models will be in preventive interventions.

Comparison of Visual Estimates of Children's Portion Sizes Under Both Shared-Plate and Individual-Plate Conditions

Objective This paper compares the accuracy of visual estimations of children's food intake in settings where several children eat together off 1 plate vs individual-plate eating scenarios. Design Eight trained observers were tested in their ability to estimate food portions consumed by children enacting common eating scenarios. Foods were categorized by food group and according to their presentation by individual-plate and shared-plate. Observed food weight estimates were compared to actual weights. Subjects/setting The 8 observers visually estimated 69 food portions of children eating alone and 26 portions where children were eating from a shared plate. This study was carried out in Sarlahi District, a rural, central lowland region of Nepal. Statistical analyses Pearson's correlation coefficients were calculated to examine associations between estimated and actual weights. A fixed effects model was constructed to compare observers. Results Analyses revealed that observer estimates of food weights under field conditions were well correlated with actual weights for individual-plate ( r=0.89) and for shared-plate ( r=0.84) scenarios. Observers estimated food weights when children ate together on a shared plate less accurately than they did in settings where children ate alone. With the exception of 1 observer, observers did not differ signifi-cantly in their ability to estimate food weights. Accuracy of estimations was influenced by food weight with greater error associated with food quantities of less than 70 g. Conclusions Visual estimation is a relatively accurate, valid method of assessing child food intake under rural field conditions, and the only method to obtain accurate informa-tion on dietary intake in regions where shared-plate eating is frequent. J Am Diet Assoc. 2001;101:47–52.