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A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Modifications in parent feeding practices and child diet during family-based behavioral treatment improve child zBMI
Jodi Cahill Holland1, Rachel P Kolko, Richard I Stein
1Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.
Insights
Family-based treatment (FBT) reduced parental restriction, leading to lower child energy intake and improved weight status. This approach helps manage child obesity by modifying feeding practices.
Area of Science:
- Pediatric Obesity Research
- Behavioral Medicine
- Nutritional Science
Background:
- Childhood obesity is a significant public health concern requiring effective interventions.
- Parental feeding practices play a crucial role in shaping children's dietary habits and weight outcomes.
- Family-based behavioral weight loss treatment (FBT) is a common approach for managing pediatric overweight and obesity.
Purpose of the Study:
- To investigate the relationship between changes in parental feeding practices, child diet, and child weight status post-treatment.
- To identify potential dietary mediators linking parental feeding practice modifications to changes in child weight.
Main Methods:
- A cohort of 170 overweight or obese children (aged 7-11) participated in a 16-session FBT program.
- Data collected included anthropometrics (standardized BMI z-score), parental feeding questionnaires, and 24-hour dietary recalls at baseline and post-treatment.
- Statistical analyses, including linear regression and mediation analysis, were used to examine associations and mediating roles of dietary changes.
Main Results:
- FBT led to a significant decrease in restrictive parental feeding practices.
- Reductions in parental restriction, child's energy intake, and fat intake, alongside increased protein intake, were associated with decreased child BMI z-scores.
- Childhood energy intake changes mediated the association between reduced parental restriction and improved child weight status.
Conclusions:
- FBT effectively reduces parental restriction, which in turn lowers child energy intake and improves relative weight.
- Interventions that guide parents to decrease children's energy intake without excessive restriction may enhance weight management outcomes.
- Targeting parental feeding behaviors within FBT is a viable strategy for pediatric obesity treatment.
Objective:
To examine associations between modifications in parent feeding practices, child diet, and child weight status after treatment and to evaluate dietary mediators.
Methods:
Children classified as overweight or obese and 7-11 years old (N = 170) completed a 16-session family-based behavioral weight loss treatment (FBT) program. Anthropometrics (standardized body mass index (zBMI)), Child Feeding Questionnaire, and 24-hr dietary recalls were collected at baseline and post-FBT. Linear regression predicted child zBMI change. Single and multiple mediation tested child dietary modifications as mediators between change in parent feeding practices and child zBMI.
Results:
Restrictive parent feeding practices significantly decreased during FBT. Reductions in parent restriction, child weight concern, child's total energy intake, and percent energy from fat, and increases in parent perceived responsibility, and child percent energy from protein, predicted reductions in child zBMI. Change in child total energy intake mediated the relation between parent restriction and child zBMI change after accounting for covariates and additional dietary mediators.
Conclusions:
FBT is associated with a decrease in parental restriction, which is associated with reductions in child relative weight, which was mediated by a decrease in child energy intake. Teaching parents to reduce children's energy intake without being overly restrictive may improve child weight.
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