Food-related Parenting Practices Research Articles

Examining within- and across-day relationships between transient and chronic stress and parent food-related parenting practices in a racially/ethnically diverse and immigrant population

BackgroundAlthough prior research suggests that stress may play a role in parent’s use of food-related parenting practices, it is unclear whether certain types of stress (e.g., transient, chronic) result in different food-related parenting practices. Identifying whether and how transient (i.e., momentary; parent/child conflict) and chronic (i.e., long-term; unemployment >6 months) sources of stress are related to parent food-related parenting practices is important with regard to childhood obesity. This is particularly important within racially/ethnically diverse parents who may be more likely to experience both types of stress and who have higher levels of obesity and related health problems. The current study examined the association between transient and chronic stressors and food-related parenting practices in a racially/ethnically diverse and immigrant sample.MethodsThe current study is a cross-sectional, mixed-methods study using ecological momentary assessment (EMA). Parents (mean age = 35; 95% mothers) of children ages 5–7 years old (n = 61) from six racial/ethnic groups (African American, American Indian, Hispanic, Hmong, Somali, White) participated in this ten-day in-home observation with families.ResultsTransient stressors, specifically interpersonal conflicts, had significant within-day effects on engaging in more unhealthful food-related parenting practices the same evening with across-day effects weakening by day three. In contrast, financial transient stressors had stronger across-day effects. Chronic stressors, including stressful life events were not consistently associated with more unhealthful food-related parenting practices.ConclusionsTransient sources of stress were significantly associated with food-related parenting practices in racially/ethnically diverse and immigrant households. Chronic stressors were not consistently associated with food-related parenting practices. Future research and interventions may want to assess for transient sources of stress in parents and target these momentary factors in order to promote healthful food-related parenting practices.

Momentary Parental Stress and Food-Related Parenting Practices.

Research suggests that stress and depressed mood are associated with food-related parenting practices (ie, parent feeding practices, types of food served at meals). However, current measures of parental stress, depressed mood, and food-related parenting practices are typically survey-based and assessed as static/unchanging characteristics, failing to account for fluctuations across time and context. Identifying momentary factors that influence parent food-related parenting practices will facilitate the development of effective interventions aimed at promoting healthy food-related parenting practices. In this study, we used ecological momentary assessment to examine the association between momentary factors (eg, stress, depressed mood) occurring early in the day and food-related parenting practices at the evening meal. Children aged 5 to 7 years and their families (N = 150) from 6 racial and/or ethnic groups (n = 25 each African American, Hispanic/Latino, Hmong, American Indian, Somali, and white families) were recruited for this mixed-methods study through primary care clinics. Higher stress and depressed mood earlier in the day predicted pressure-to-eat feeding practices and fewer homemade foods served at meals the same night. Effect modification was found for certain racial and/or ethnic groups with regard to engaging in pressure-to-eat feeding practices (ie, America Indian, Somali) or serving fewer homemade meals (ie, African American, Hispanic/Latino) in the face of high stress or depressed mood. Clinicians may want to consider discussing with parents the influence stress and depressed mood can have on everyday food-related parenting practices. Additionally, future researchers should consider using real-time interventions to reduce parental stress and depressed mood to promote healthy parent food-related parenting practices.

Parenting styles, feeding styles and food-related parenting practices in relation to toddlers' eating styles: A cluster-analytic approach.

IntroductionToddlers’ eating behaviors are influenced by the way parents interact with their children. The objective of this study was to explore how five major constructs of general parenting behavior cluster in parents of toddlers. These parenting clusters were further explored to see how they differed in the use of feeding strategies (i.e. feeding styles and food parenting practices) and by reported child eating styles.MethodsAn online survey with 1005 mothers/caregivers (legal guardians) with at least one child between 12 and 36 months old was conducted in the United States in 2012, assessing general parenting behavior, feeding style, food parenting practices and the child eating styles.ResultsA three cluster solution of parenting style was found and clusters were labelled as overprotective/supervising, authoritarian, and authoritative. The clusters differed in terms of general parenting behaviors. Both overprotective and authoritative clusters showed high scores on structure, behavioral control, and nurturance. The overprotective cluster scored high on overprotection. The ‘authoritarian’ cluster showed lowest levels of nurturance, structure and behavioral control. Overprotective and authoritative parents showed very similar patterns in the use of food parenting practices, e.g. monitoring food intake, modeling, and promoting healthy food intake and availability at home. Overprotective parents also reported higher use of pressure to eat and involvement. Authoritarian parents reported high use of giving the child control over their food behaviors, emotion regulation, using food as a reward, and controlling food intake for weight control. Children’s eating styles did not largely vary by parenting cluster.ConclusionThis study showed that a relatively new parenting style of overprotection is relevant for children’s eating behaviors. Overprotective parents reported food parenting practices that are known to be beneficial for children’s food intake, such as modelling healthy food intake, as well as more unfavorable practices such as pressure. Longitudinal data on parenting practices and their relation to healthy eating in children is needed to inform communication and interventions for parents, reinforcing key feeding strategies which have positive effects on child eating behaviors and addressing parenting styles that have unintended negative effects.

Practices and preferences: Exploring the relationships between food-related parenting practices and child food preferences for high fat and/or sugar foods, fruits, and vegetables

The purpose of this study was to determine the relationship between food-related parenting practices and child fruit, vegetable, and high fat/sugar food preferences. Parents (n = 148) of children (3–7 years old) completed the Comprehensive Feeding Practices Questionnaire (CFPQ), the Preschool Adapted Food Liking Scale (PALS), and answered demographic questions. Separate linear regressions were conducted to test relationships between the different food categories on PALS (fruits, vegetables, and high fat/sugar foods) and each food-related parenting practice using race, ethnicity, and income level, and child age and gender as covariates. It was found that when a parent allows a child to control eating, it was negatively associated with a child's preference for fruit (β = −0.15, p = 0.032) and parent encouragement of child involvement in meal preparation was positively related to child preference for vegetables (β = 0.14, p = 0.048). Children preferred high fat and sugar foods more if parents used food to regulate child emotions (β = 0.24, p = 0.007), used food as a reward (β = 0.32, p < 0.001), pressured the child to eat more food (β = 0.16, p = 0.045), and restricted unhealthy food (β = 0.20, p = 0.024). Conversely, children preferred high fat and sugar foods less if parents made healthy food available in the home (β = −0.13, p = 0.05), modeled healthy eating in front of the child (β = −0.21, p = 0.021), and if parents explained why healthy foods should be consumed (β = −0.24, p = 0.011). Although it cannot be determined if the parent is influencing the child or vice versa, this study provides some evidence that coercive feeding practices are detrimental to a child's food preferences.

Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes

This study examines associations between an expanded conceptualization of food-related parenting practices, specifically, directive and non-directive control, and child weight (BMI z-score) and dietary outcomes [Healthy Eating Index (HEI) 2010, daily servings fruits/vegetables] within a sample of parent-child dyads (8–12 years old; n = 160). Baseline data from the Healthy Home Offerings via the Mealtime Environment (HOME Plus) randomized controlled trial was used to test associations between directive and non-directive control and child dietary outcomes and weight using multiple regression analyses adjusted for parental education. Overall variance explained by directive and non-directive control constructs was also calculated. Markers of directive control included pressure-to-eat and food restriction, assessed using subscales from the Child Feeding Questionnaire; markers of non-directive control were assessed with a parental role modeling scale and a home food availability inventory in which an obesogenic home food environment score was assigned based on the types and number of unhealthful foods available within the child's home food environment. Directive controlFood restriction and pressure-to-eat were positively and negatively associated with BMI z-scores, respectively, but not with dietary outcomes. Non-directive controlAn obesogenic home food environment was inversely associated with both dietary outcomes; parental role modeling of healthful eating was positively associated with both dietary outcomes. Neither non-directive behavioral construct was significantly associated with BMI z-scores. Total varianceGreater total variance in BMI-z was explained by directive control; greater total variance in dietary outcomes was explained by non-directive control.Including a construct of food-related parenting practices with separate markers for directive and non-directive control should be considered for future research. These concepts address different forms of parental control and, in the present study, yielded unique associations with child dietary and weight outcomes.

Associations Between Food Restriction and Pressure-to-Eat Parenting Practices and Dietary Intake in Children: a Selective Review of the Recent Literature

The identification of modifiable determinants child dietary intake has become a public health priority. Food-related parenting practices, including pressure-to-eat and food restriction, have been identified as potentially significant determinants of dietary intake in children. This is a review of the literature to date that has explored the relationship between food restriction and pressure-to-eat and child dietary intake. In general, findings from laboratory-based studies and longitudinal studies suggest that children exposed to high levels of food restriction and pressure-to-eat are more likely to consume sugar-sweetened beverages, palatable snack foods, and calorie-dense food items than children exposed to lower levels. Results from the body of cross-sectional studies examining this relationship are decidedly less conclusive, yielding inconsistent and sometimes contradictory results. Overall, the concept of food-related parenting practices as a potentially modifiable factor with the potential to positively impact child dietary intake patterns continues to be worth pursuing through additional future research.

A cultural understanding of Chinese immigrant mothers' feeding practices. A qualitative study

Differences in parental feeding practices revealed across and within different ethnic/cultural groups indicate that cultural examinations of feeding practices in understudied non-European-American populations require urgent attention. China ranks as the second largest source country for children in foreign-born U.S. households. Contrary to the stereotype of slender Asians, Chinese-American young children are at high risk for obesity but have not received sufficient attention from researchers and practitioners dealing with parental feeding practices and childhood obesity. The present study aimed to understand food-related parenting practices among Chinese immigrants in the U.S. using qualitative focus groups. Twenty-two mothers with preschool aged children participated in a discussion regarding parent–child food-related interactions and feeding practices. A thematic approach was adopted to analyze the focus group data following five stages of framework analysis. Thirteen key themes of feeding practices were identified, including 9 that are in existing feeding measures (pre-exiting practices) and 4 practices that have not been documented or emphasized in previous feeding measures (culturally-emphasized practices), including regulating healthy routines and food energy, spoon-feeding, using social comparison to pressure the child to eat, and making an effort to prepare/cook specific foods. Through the use of an emic approach and meaning-centered evidence, the complexities of parent–child interactions and unique nuances of parental feeding in this understudied population were revealed. Our findings can guide future development of culturally-appropriate measurement and inform intervention programs to promote the healthy development of Chinese-American children.

Food-related parenting practices and child and adolescent weight and weight-related behaviors.

The prevalence of overweight and obesity in children has reached a concerning plateau in the past three decades, with overweight or obesity impacting approximately one-third of youth. Unhealthy weight-related behaviors, including dieting, unhealthy weight control practices and binge eating, are also a great public health concern for young people given both their high prevalence and harmful consequences. Food-related parenting practices, including food restriction and pressure-to-eat, have been associated with higher weight status, as well as the use of unhealthy weight-related behaviors, in children and adolescents. Physicians and other health care providers who work with families should discourage parents from using food restriction and pressure-to-eat parenting practices with their child or adolescent. Alternatively, parents should be empowered to promote healthy eating by focusing on making nutritious food items readily available within their home and modeling healthy food choices for their child or adolescent.

Are food restriction and pressure‐to‐eat parenting practices associated with adolescent disordered eating behaviors?

To examine associations between parental pressure-to-eat and food restriction and adolescent disordered eating behaviors, within a sample of parent-adolescent pairs. Adolescents (N = 2,231) and their parents (N = 3,431) participated in two, coordinated, population-based studies designed to examine factors associated with weight and weight-related behaviors in adolescents. Overall, higher levels of pressure-to-eat or food restriction were significantly and positively associated with use of disordered eating behaviors among boys. For every one unit increase [Scale Range: 1 (low control) to 4 (high control)] in mothers' food restriction, boys were twice as likely to engage in extreme weight control behaviors (p ≤ .01). Examination of the association between food-related parenting practices and disordered eating behaviors among girls revealed fewer significant associations. However, analyses revealed that for every one unit increase in mothers' food restriction, girls were 1.33 times more likely to engage in extreme weight control behaviors (p = .04). Study findings provide evidence of an association between controlling food-related parenting practices and adolescent disordered eating behaviors, particularly in boys. Future longitudinal research is needed to establish directionality of observed associations.

Understanding parental health literacy and food related parenting practices

Health literacy, which relates to the acquisition, understanding and application of health information, has become an increasingly important public health issue, particularly where parents and children are concerned. Given that the home setting comprises a strong influence on children’s diets, this qualitative study explored the concept of health literacy using parents’ experiences with health information seeking and food related parenting practices. Semi-structured focus groups and in-depth interviews were conducted with parents, with children aged from birth to 12 years, in a low socio-economic region of South Australia. The results of this study indicated that there were a number of perceived barriers to accessing, understanding and utilising health information related to children’s nutrition. These findings contribute to a broader understanding of how parents obtain and process dietary information and the channels through which they appear to be accessible.

Food-Related Parenting Practices and Adolescent Weight Status: A Population-Based Study

To examine food-related parenting practices (pressure-to-eat and food restriction) among mothers and fathers of adolescents and associations with adolescent weight status within a large population-based sample of racially/ethnically and socioeconomically diverse parent-adolescent pairs. Adolescents (N = 2231; 14.4 years old [SD = 2.0]) and their parents (N = 3431) participated in 2 coordinated population-based studies designed to examine factors associated with weight status and weight-related behaviors in adolescents. Adolescents completed anthropometric measurements and surveys at school. Parents (or other caregivers) completed questionnaires via mail or phone. Findings suggest that the use of controlling food-related parenting practices, including pressure-to-eat and restriction, is common among parents of adolescents. Mean restriction levels were significantly higher among parents of overweight and obese adolescents compared with nonoverweight adolescents. However, levels of pressure-to-eat were significantly higher among nonoverweight adolescents. Results indicate that fathers are more likely than mothers to engage in pressure-to-eat behaviors and boys are more likely than girls to be on the receiving end of parental pressure-to-eat. Parental report of restriction did not differ significantly by parent or adolescent gender. No significant interactions by race/ethnicity or socioeconomic status were seen in the relationship between restriction or pressure-to-eat and adolescent weight status. Given that there is accumulating evidence for the detrimental effects of controlling feeding practices on children's ability to self-regulate energy intake, these findings suggest that parents should be educated and empowered through anticipatory guidance to encourage moderation rather than overconsumption and emphasize healthful food choices rather than restrictive eating patterns.

'Treats', 'sometimes foods', 'junk': a qualitative study exploring 'extra foods' with parents of young children.

The present study investigated parents' understanding and approaches to providing energy-dense and nutrient-poor 'extra foods' to pre-school children and explored variation between parents of low and high socio-economic status in relation to these issues. We conducted thirteen focus groups. Data were subject to framework analysis. Child-care centres in distinctly socially disadvantaged and socially advantaged areas. Eighty-eight parents of children aged 3-5 years. The three most common terms parents identified to describe foods that are not 'everyday foods' were 'treats', 'sometimes foods' and 'junk'. Parents' perceptions regarding what influences them in providing food to their children included seven sub-themes: (i) the influence of the child; (ii) food-related parenting practices; (iii) health considerations; (iv) food costs and convenience; (v) external factors perceived as influencing their child; (vi) factors related to child care; and (vii) social influences and occasions. Parents' decision-making processes regarding provision of 'extra foods' related to moderation and balance. Parents generally expressed the position that as long as a child is eating healthy foods, then treats are appropriate; and for many parents, this might apply frequently. All groups described the health of their child as an influence, but parents in low socio-economic groups were more likely to describe immediate concerns (dental health, behaviour) in relation to avoiding sugar-dense food or drink. The belief that provision of 'extra foods' can be frequent as long as children are eating a healthy balance of foods is factored into parents' decision making. Challenging this belief may be important for reducing the consumption of 'extra foods' by young children.

Eat this, not that! Parental demographic correlates of food-related parenting practices

To understand how parents of adolescents attempt to regulate their children’s eating behaviors, the prevalence of specific food-related parenting practices (restriction, pressure-to-eat) by sociodemographic characteristics (parent gender, race/ethnicity, education level, employment status, and household income) were examined within a population-based sample of parents (n=3709) of adolescents. Linear regression models were fit to estimate the association between parent sociodemographic characteristics and parental report of food restriction and pressure-to-eat. Overall, findings suggest that use of controlling food-related parenting practices, such as pressuring children to eat and restricting children’s intake, is common among parents of adolescents, particularly among parents in racial/ethnic minority subgroups, parents with less than a high school education, and parents with a low household income. Results indicate that that social or cultural traditions, as well as parental access to economic resources, may contribute to a parent’s decision to utilize specific food-related parenting practices. Given that previous research has found that restriction and pressure-to-eat food-related parenting practices can negatively impact children’s current and future dietary intake, differences in use of these practices by sociodemographic characteristics may contribute, in part, to the disparities that exist in the prevalence of overweight and obesity among adolescents by their race/ethnicity and socioeconomic status.

Parenting Practices that can Prevent or Reduce Childhood Obesity

Overweight in children is more prevalent than ever before. What can parents do to try to promote health and prevent obesity in their own children? The present paper reviews research related to parenting and childhood obesity. The review describes what food-related parenting practices may be helpful: modeling healthy eating behaviors, making time for family meals, making sure healthy food is available and accessible, becoming aware of appropriate portion sizes, encouraging children to eat breakfast, and limiting soda and fast food intake. The paper also discusses food-related parenting practices that may not work to help prevent obesity: pressure to eat, food rewards, restriction, permissiveness, and modeling of unhealthy eating behaviors. Additional parenting practices such as supporting and engaging in physical activity, encouraging an adequate amount of sleep, and limiting television and other screen-media may also help children to maintain healthy weights. Suggestions are also given for professionals working with youth.

The relationship between children’s home food environment and dietary patterns in childhood and adolescence

To identify the correlates of the home food environment (parents' intake, availability and food-related parenting practices) at the age of 10 years with dietary patterns during childhood and in adolescence. Primary-school children of fifty-nine Flemish elementary schools completed a questionnaire at school in 2002. Four years later they completed a questionnaire by e-mail or mail at home. Their parents completed a questionnaire on food-related parenting practices at baseline. Longitudinal study. The analyses included 609 matched questionnaires. Multi-level regression analyses were used to identify baseline parenting practices (pressure, reward, negotiation, catering on demand, permissiveness, verbal praise, avoiding negative modelling, availability of healthy/unhealthy food items and mothers' fruit and vegetable (F&V) and excess scores) associated with children's dietary patterns (F&V and excess scores). Mother's F&V score was a significant positive independent predictor for children's F&V score at baseline and follow-up, whereas availability of unhealthy foods was significantly negatively associated with both scores. Negotiation was positively associated with children's follow-up score of F&V, while permissiveness was positively associated with children's follow-up excess score. Availability of unhealthy foods and mother's excess score were positively related to children's excess score at baseline and follow-up. Parental intake and restricting the availability of unhealthy foods not only appeared to have a consistent impact on children's and adolescents' diets, but also negotiating and less permissive food-related parenting practices may improve adolescents' diets.

Associations between General Parenting Styles and Specific Food-Related Parenting Practices and Children's Food Consumption

Explore the impact of general parenting style and specific food-related parenting practices on children's dietary habits. Cross-sectional study of sixth graders and their parents. Data were gathered (in 2003) in 69 of 100 randomly selected elementary schools in Belgium. All sixth graders (N = 1957) were invited to participate; 82.4% of their parents gave consent and completed questionnaires, resulting in 1614 parent-child pairs. Children's consumption of breakfast, fruit, vegetables, soft drinks, and sweets was assessed by self-administered food frequency questionnaires. Parents completed questionnaires on sociodemographic characteristics, general parenting styles (authoritarian, authoritative, indulgent, or neglecting) and specific food-related parenting practices (pressure, reward, encouragement through negotiation, catering on children's demands, permissiveness, avoiding negative modeling, and praise). Logistic regression analyses were performed, with general parenting style and specific food-related parenting practices as predictors and dietary habits as dependent variables, controlling for sociodemographic characteristics and children's weight status. General parenting style did not show any significant impact on dietary habits. In contrast, the food-related parenting practice "encouragement through negotiation" showed a significant positive impact, whereas "pressure," "catering on demand," and "permissiveness" were practices with an unhealthy impact. Nutrition education programs that guide parents in firm but not coercive food parenting skills are likely to have a positive impact upon children's dietary habits.

Perceived parenting style and practices and the consumption of sugar-sweetened beverages by adolescents

The purpose of this study was to investigate whether perceived parenting practices and parenting style dimensions (strictness and involvement) are associated with adolescents' consumption of sugar-sweetened beverages. In this cross-sectional study, secondary school students (n = 383, mean age 13.5 years) completed a self-administered questionnaire on their consumption of sugar-sweetened beverages, attitude, social influences, self-efficacy, habit strength, food-related parenting practices and the general parenting style dimensions of 'strictness' and 'involvement'. Data were analyzed using multiple linear regression analyses. More restrictive parenting practices were associated with lower consumption of sugar-sweetened beverages (beta = -38.0 ml; 95% CI = -48.1, -28.0). This association was highly mediated ( approximately 55%) by attitude, self-efficacy and modeling from parents. Nevertheless, a significant direct effect remained (beta = -17.1 ml; 95% CI = -27.2, -6.90). Interactions between perceived parenting style and parenting practices showed that the association between parenting practices and sugar-sweetened beverage consumption was stronger among adolescents who perceived their parents as being moderately strict and highly involved. Parents influence their children's sugar-sweetened beverage consumption and should therefore be involved in interventions aimed at changing dietary behaviors. Interventions aimed at the promotion of healthy parenting practices will improve when they are tailored to the general parenting style of the participants.

Parenting style and adolescent fruit consumption

The importance of the social environment for dietary behaviour has been highlighted in the past decade. A type of environmental influence that has received increasing research attention in recent years is the influence that parents can have on their children's dietary behaviour through food-related parenting practices. Much of the work done so far, however, has reported inconsistent findings and poorly understood mechanisms of influence. The present study aimed to explore the possible environmental influence of general parenting style on adolescent food choice patterns. Data were collected at schools ( N=643; mean age 16.5 years), using self-administered questionnaires on parenting style, fruit intake behaviour and fruit-specific cognitions. Consistent and theoretically predictable differences were found between adolescents who described their parents as authoritative, authoritarian, indulgent or neglectful. Fruit consumption and fruit-specific cognitions were most favourable among adolescents who were being raised with an authoritative parenting style. Children of parents with indulgent parenting styles consumed more fruit than adolescents from authoritarian or neglectful homes. Consequences of these results for the interpretation of earlier studies on the influence of parenting practices are discussed, and a research model is proposed for future studies of parental influences on adolescent dietary behaviours.