Maternal feeding style and child weight status among Hispanic families with low-income levels: A longitudinal study of the direction of effects

Authors: HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC); POWER, THOMAS - Washington State University; O'CONNOR, TERESIA - Children'S Nutrition Research Center (CNRC); FISHER, JENNIFER - Temple University; MICHELI, NILDA - Children'S Nutrition Research Center (CNRC); PAPAIOANNOU, MARIA - Children'S Nutrition Research Center (CNRC)

Submitted to: International Journal of Behavioral Nutrition and Physical Activity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/3/2021
Publication Date: 2/15/2021
Citation: Hughes, S.O., Power, T.G., O'Connor, T.M., Fisher, J.O., Micheli, N., Papaioannou, M.A. 2021. Maternal feeding style and child weight status among Hispanic families with low-income levels: A longitudinal study of the direction of effects. International Journal of Behavioral Nutrition and Physical Activity. 18:30. https://doi.org/10.1186/s12966-021-01094-y.
DOI: https://doi.org/10.1186/s12966-021-01094-y

Interpretive Summary: Research has established the influence of the environment including parental feeding practices and styles, on children's weight status. However, much of the work to date has emphasized parent-driven influences without taking into account the child's part in these dyadic interactions. Developmental theories have recently shifted to an understanding that interactive processes as well as bidirectional effects may play a role in parenting and its influence on child outcomes. A handful of studies have examined the bi-directional nature of feeding practices and child weight in cross-sectional studies with assessments conducted at the same time point. Based on findings from these studies, there is some evidence to support a complex bidirectional relationship between highly controlling feeding practices and child weight. However, to date no study has examined bidirectional effects for feeding styles. That is, it is still unclear whether parents exhibit feeding styles in response to their children's weight status or if parent feeding styles lead to increases in children's weight status over time. We aimed to address this gap by examining the bidirectional association of parent-reported feeding styles and measured child weight status in 128 Hispanic parents with low incomes and their preschool children at 2 time points (when children were 4-5 years old and again later when they were 7-9 years old). Parents reported on their feeding styles, feeding practices, and their children's eating behaviors. Additionally, children's weight status was obtained using measured heights and weights. Results showed that parent-reported indulgent and authoritative feeding styles at the first time point positively predicted child weight status longitudinally at follow-up. Additionally, child weight status at the first time point positively predicted indulgent feeding and negatively predicted authoritarian feeding longitudinally. Overall, results of this study showed that there is a bidirectional relationship between an indulgent feeding style and child weight. It may be important to help parents change their styles of feeding when children are young, especially those that adopt an indulgent feeding style. Family-focused childhood obesity prevention programs may benefit from targeting changes in the way parents feed their young children.

Technical Abstract: The home environment is a central and modifiable influence on the development of childhood obesity. Evidence supports the central role of parents in shaping problematic child eating behaviors and excess weight. Most studies of feeding emphasize parent-driven influences without taking into account the child's role in eating interactions. Few studies have addressed the bi-directional nature of feeding dynamics in studies of young children. The goals of this study were: 1) to examine if parental feeding styles during preschool (4–5 years) predict child weight status at 7-9 years, and 2) to examine the direction of effects between parental feeding styles and child weight status over time. Participants were part of a larger longitudinal study of Hispanic Head Start families living in the West South Central United States. Data from mother/child dyads were collected at three time points: Time 1 (ages 4-5), Time 2 (ages 5.5-6.5), and at Time 3 (ages 7-9). Only data from the Times 1 and 3 were used in the current analyses. A total of 128 mothers and their children had data on all variables needed for the analyses. Assessments included parent-reported feeding styles, feeding practices, acculturation, child eating behaviors, and child height and weight. Hierarchical regression was used to examine the first aim; a cross-lagged panel analysis examined the second aim. An indulgent parental feeding style at ages 4-5 was associated with increased child BMI z-score at ages 7-9. Indulgent feeding significantly contributed to child BMI z-score beyond demographics, baseline child BMI z-score, parental acculturation, and child eating behaviors. Regarding the direction of effects in parental feeding interactions, the cross-lagged analyses showed that both indulgent feeding style and authoritative feeding style at Time 1 positively predicted child BMI z-scores at Time 3. Child effects were significant as well. Child BMI z-score at Time 1 positively predicted indulgent feeding and negatively predicted authoritarian feeding at Time 3. Indulgent feeding should be addressed in future family-focused childhood obesity initiatives focused on young children and their parents.