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Updated: May 17, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Children's eating behavior, feeding practices of parents and weight problems in early childhood: results from the
Pauline W Jansen1, Sabine J Roza, Vincent Wv Jaddoe
1The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands. p.w.jansen@erasmusmc.nl
Insights
Early childhood eating behaviors and parental feeding practices significantly influence children's body mass index (BMI). Interventions targeting both child eating habits and parental feeding are crucial for preventing unhealthy weight in preschoolers.
Area of Science:
- Pediatric Nutrition
- Child Psychology
- Public Health
Background:
- Early childhood weight problems often persist into later life.
- Understanding modifiable factors in early childhood is key to addressing unhealthy weight.
- Preschoolers' eating behaviors and parental feeding practices are potential targets for intervention.
Purpose of the Study:
- To examine the association between preschoolers' eating behaviors and parental feeding practices with body mass index (BMI) and weight status.
- To replicate previous findings in a large population sample of four-year-olds.
- To investigate the interplay between child eating behaviors and parental feeding in relation to child weight.
Main Methods:
- Cross-sectional study of 4987 four-year-olds from a Dutch population-based cohort.
- Utilized the Child Eating Behaviour Questionnaire and Child Feeding Questionnaire.
- Objective measurement of Body Mass Index (BMI) for all participants.
Main Results:
- 13% of preschoolers were underweight, 8% overweight, and 2% obese.
- Food responsiveness, enjoyment of food, and parental restriction were linked to higher BMI.
- Emotional undereating, satiety responsiveness, fussiness, and pressure to eat were linked to lower BMI.
- Parental feeding practices partially mediated the link between child eating behaviors and BMI (20-43%), and vice versa (33-47%).
Conclusions:
- Significant differences in eating behaviors and feeding patterns exist across weight status groups in preschoolers.
- The high prevalence of unhealthy weight underscores the need for early intervention.
- Interventions should consider modifying both child eating behaviors and parental feeding strategies to address unhealthy weight in young children.
Background:
Weight problems that arise in the first years of life tend to persist. Behavioral research in this period can provide information on the modifiable etiology of unhealthy weight. The present study aimed to replicate findings from previous small-scale studies by examining whether different aspects of preschooler's eating behavior and parental feeding practices are associated with body mass index (BMI) and weight status -including underweight, overweight and obesity- in a population sample of preschool children.
Methods:
Cross-sectional data on the Child Eating Behaviour Questionnaire, Child Feeding Questionnaire and objectively measured BMI was available for 4987 four-year-olds participating in a population-based cohort in the Netherlands.
Results:
Thirteen percent of the preschoolers had underweight, 8% overweight, and 2% obesity. Higher levels of children's Food Responsiveness, Enjoyment of Food and parental Restriction were associated with a higher mean BMI independent of measured confounders. Emotional Undereating, Satiety Responsiveness and Fussiness of children as well as parents' Pressure to Eat were negatively related with children's BMI. Similar trends were found with BMI categorized into underweight, normal weight, overweight and obesity. Part of the association between children's eating behaviors and BMI was accounted for by parental feeding practices (changes in effect estimates: 20-43%), while children's eating behaviors in turn explained part of the relation between parental feeding and child BMI (changes in effect estimates: 33-47%).
Conclusions:
This study provides important information by showing how young children's eating behaviors and parental feeding patterns differ between children with normal weight, underweight and overweight. The high prevalence of under- and overweight among preschoolers suggest prevention interventions targeting unhealthy weights should start early in life. Although longitudinal studies are necessary to ascertain causal directions, efforts to prevent or treat unhealthy child weight might benefit from a focus on changing the behaviors of both children and their parents.
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