Child Weight Concern Research Articles

Child feeding practices and perceptions of childhood overweight and childhood obesity risk among mothers of preschool children

AbstractAim: The present study assessed the relationship between maternal attitudes, beliefs and child feeding practices. It was hypothesised that: (i) maternal control over feeding would increase when mothers perceived their children as over‐ or underweight and were concerned about the weight status of their children; and (ii) mothers would express more concern about their daughters' weight, and report higher levels of control over feeding as a result.Methods: Participants included 112 mothers and their children aged 2–6 years who were attending swim lessons at a Central Coast swim school. Mothers completed the Child Feeding Questionnaire to assess maternal attitudes, beliefs and control over child feeding. Child and maternal body mass indexes were measured. Correlational analyses, t‐tests and multiple regression analyses were performed.Results: Mothers reported a high overall level of control in child feeding, and a low level of concern for child weight. Child overweight and obesity were marginally lower than reported in previous studies. Mothers reported more concern for their daughters' weight, but did not report increased control over feeding based on child gender. Pressure to eat was negatively associated with maternal education, suggesting a link between socioeconomic status and child feeding practices. Mothers displayed higher levels of parental control over obese than normal‐weight children, suggesting that they accurately assessed the weight status at the obese level.Conclusion: Mothers may be able to detect obesity in their children, but not overweight. Mothers may also be unconcerned about their sons' weight, and this discrepancy should be investigated in clinical and educational settings. Nutrition education and child obesity prevention and treatment programs should take maternal attitudes, perceptions and child feeding practices into account when planning interventions.

Influence of PROP taster status and maternal variables on energy intake and body weight of pre-adolescents

Genetic taste blindness to the bitterness of 6- n-propylthiouracil (PROP) may be a marker for increased energy intake and body weight. This hypothesis has not been tested in pre-adolescent children. This study determined if non-taster children would report higher energy intakes and maintain higher body weights than taster children. Maternal variables which are known to influence food intake and body weight during childhood were also considered including maternal weight, maternal restraint and disinhibition and child feeding practices. Sixty-five children with a mean age of 9.0 ± 0.2 years participated. They completed a 3-day diet recall for the estimation of daily energy and macronutrient intakes. BMI (mothers) and BMI%-for-age (children) were calculated from measured heights and weights. Non-taster children reported higher daily energy intakes than super-taster children ( p ≤ 0.05), but no differences in macronutrient selection were observed. Also, children of disinhibited mothers reported higher daily energy intakes than children of mothers who were not disinhibited ( p ≤ 0.05). However, these variables did not predict children's body weight. Rather, regression modeling ( R 2 = 0.59; p ≤ 0.0001) revealed that restriction, concern for child weight and maternal BMI were positive predictors of children's BMI%-for-age and pressure to eat was a strong negative predictor ( p-value range = 0.02–0.004). PROP status was not a predictor of body weight in these children. These results suggest that in pre-adolescent children, current energy intakes were negatively related to children's PROP status and positively related to maternal disinhibition. However, BMI%-for-age, a measure of long-term energy balance, was related to child feeding practices and maternal BMI.

Confirmatory factor analysis of the child-feeding questionnaire among parents of adolescents

We investigated the validity of the child-feeding questionnaire (CFQ) among parents of adolescents. The original CFQ was developed to assess perceptions of obesity-proneness and child-feeding practices among parents of 2- to 11-year-old children. We modified the CFQ to make it applicable to parents of adolescents and added one item on monitoring sugared beverages. Confirmatory factor analysis was conducted using the latent variable approach. Factor scores were related to adolescent body mass index percentiles (BMI%) using structural equation modeling. The modified CFQ was completed by 260 parent/guardians (mean age 39.8 years; 92% female; 55% Black, 35% White, 10% Other). The original published measurement model was fit to our sample and yielded an acceptable fit (CFI=0.95, TLI=0.93, RMSEA=0.05). Adding the extra variables decreased the fit; however, minor modifications improved the fit without changing the factor structure (CFI=0.95, TLI=0.94, RMSEA=0.05). Cronbach's alphas for the subscales ranged from 0.60 to 0.88. The factors, parental perceptions of child weight, concern for child weight, monitoring and restriction were positively associated, and pressure to eat was inversely associated with adolescent BMI%. In conclusion, the psychometric properties of the modified CFQ tested among parents of a multi-ethnic adolescent sample were similar to those of the original CFQ.

Maternal restriction of children's eating and encouragements to eat as the ‘non-shared environment’: a pilot study using the child feeding questionnaire

This pilot study tested whether maternal feeding attitudes and styles towards children are part of the 'shared' or 'non-shared' home environment. A secondary aim was to test whether within-family differences in maternal feeding attitudes and styles relate to within-family differences in child weight status. Mothers of 3- to 7-year-old sibling pairs (N=15 pairs) completed the Child Feeding Questionnaire (CFQ), which assessed feeding attitudes (perceived responsibility, perceived child overweight and child weight concern) and feeding styles (monitoring, restriction and pressure to eat) towards children. Mothers rated each sibling separately. Child weight and height were measured and converted to body mass index (BMI) z-scores. Intraclass correlations tested the familial associations for each CFQ subscale. Pearson's correlations tested whether within-family differences in CFQ subscales were related to within-family differences in child BMI z-scores. Perceived responsibility (rho=0.77, P=0.0004), perceived child overweight (rho=0.99, P<0.0001) and monitoring (rho=0.57, P=0.01) showed significant familial correlations. Mothers reported significantly greater weight concern (r=0.85, P=0.02) and reduced pressure to eat (r=-0.80, P=0.03) towards heavier than thinner children within families. Whether or not maternal feeding practices are shared or non-shared components of the home environment depends on the specific feeding domain being measured. Restrictive feeding practices and encouragements to eat by mothers might be tested as non-shared environmental variables in genetics studies of childhood obesity.

Cross-cultural equivalence of feeding beliefs and practices: The psychometric properties of the child feeding questionnaire among Blacks and Hispanics

Background Psychometrically sound measures are considered a necessary condition for valid research. This study used structural equation modeling to examine the cross-cultural equivalence of a widely used measure of parental beliefs and practices regarding child feeding, the Child Feeding Questionnaire [Birch L.L., Fisher J.O., Grimm-Thomas K., Markey C.N., Sawyer R., Johnson S.L. Confirmatory factor analysis of the child feeding questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite 2001;36:201–10]. Methods Low-income parents of 101 Black and 130 Hispanic pre-school children (126 girls, 105 boys) completed a reduced version of the CFQ. Results Confirmatory factor analyses using LISREL 8.51 supported the hypothesized factor structure but revealed cross-cultural conceptual problems on the perceived child weight factor and problematic items on the restriction factor that were addressed in a modified model. Invariance analyses demonstrated invariance of factor structure, loadings, and covariances in the modified model across ethnic groups. MANCOVA, that controlled for parent BMI and marital status, revealed ethnic differences on the child feeding responsibility, child weight concern, and perceived weight of child factors that were moderated by parent education and child BMI. Conclusions Results supported the use of a modified version of the CFQ among Blacks and Hispanics and revealed no ethnic differences on factor scores, except on interactions with parent education and overweight status of child.

Parental feeding attitudes and styles and child body mass index: prospective analysis of a gene-environment interaction.

Parental feeding styles were linked to child weight in cross-sectional studies, which were unable to test the direction of effect. Prospective studies can best establish causal relationships among such variables. We tested the 2-year stability of parental feeding attitudes and styles and investigated whether these variables predict child body mass index (BMI) z scores 2 years later. We evaluated whether these associations were dependent on children's predisposition to obesity. Participants were 57 families enrolled in an Infant Growth Study of children born at high risk or low risk for obesity, on the basis of maternal prepregnancy overweight or leanness. Children were evaluated for weight and height at 3, 5, and 7 years of age. Measures of parental feeding attitudes and styles were ascertained with the Child Feeding Questionnaire at 5 and 7 years of age. Correlation and multiple regression analyses tested whether parental feeding styles at age 5 predicted increased child BMI z scores 2 years later. Parental feeding attitudes and styles were stable for child ages of 5 to 7 years. With respect to feeding attitudes, perceived responsibility at age 5 predicted reduced child BMI z scores at age 7 among low-risk families, whereas child weight concern and perceived child weight predicted increased child BMI z scores among high-risk families. With respect to feeding styles, monitoring predicted reduced child BMI z scores at age 7 among low-risk children. In contrast, restriction predicted higher BMI z scores and pressure to eat predicted reduced BMI z scores among high-risk children. These associations remained significant after controlling for child weight status at age 3. The relationship between parental feeding styles and child BMI z scores depends on child obesity predisposition, suggesting a gene-environment interaction. Among children predisposed to obesity, elevated child weight appears to elicit restrictive feeding practices, which in turn may produce additional weight gain. Parenting guidelines for overweight prevention may benefit from consideration of child characteristics such as vulnerability to obesity and current weight status.

Predictors of maternal child-feeding style: maternal and child characteristics

We investigated relationships among maternal and child characteristics, and two aspects of maternal child-feeding styles that may place daughters at risk for developing problems with energy balance. Participants included 104 overweight (BMI≥25) and 92 non-overweight (BMI<25) mothers and their 5-year-old, non-Hispanic, White daughters. Child-feeding styles included (a) restriction of daughters' intake of energy-dense snack food, and (b) pressure to eat more food. Predictors of child-feeding styles included measures of (1) maternal investment in weight and eating issues, including dietary restraint and weight concern, (2) child adiposity, (3) maternal perceptions of the child as underweight or overweight, and (4) maternal concern for child weight. Mothers reported using more restrictive feeding practices when they were invested in weight and eating issues, when they perceived daughters as overweight, when they were concerned about daughters' weight, and when daughters were heavier. Mothers reported using more pressure in child feeding when daughters were thinner, and when mothers perceived daughters as underweight. Further analyses examined whether relationships among child-feeding styles were different for overweight and non-overweight mothers. Overweight mothers' child-feeding styles appeared to be influenced by observable child weight characteristics, concerns for the child's weight status, and mothers' own history of overweight. Non-overweight mothers' child-feeding styles appeared to be influenced by distorted perceptions of and concerns for children, as well as distorted self-perceptions.