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Updated: Mar 6, 2026

Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Observed parent-child feeding dynamics in relation to child body mass index and adiposity
C M Johnson1,2, M S Henderson3, G Tripicchio1
1Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, USA.
Insights
Heavier children received more maternal discouragements and encouragements to eat. Nonverbal parenting cues in child eating regulation and obesity warrant further investigation.
Area of Science:
- Pediatric obesity research
- Behavioral science
- Parenting and child development
Background:
- Restrictive feeding practices are linked to childhood overweight, but previous studies relied on parent self-reports.
- Objective measurement of parent-child interactions during eating is crucial for understanding obesity development.
Purpose of the Study:
- To investigate the association between objective measures of child adiposity and observed parent-child behaviors during meals.
- To utilize a novel behavioral coding system (BCS) for precise assessment of eating-related interactions.
Main Methods:
- 109 children and their mothers participated in a twin study.
- Parent-child dyads were video-recorded during laboratory-based buffet lunches.
- Child adiposity (BMI z-score, body fat percentage) and maternal/child behaviors (BCS) were directly measured.
Main Results:
- Higher child BMI z-score correlated with increased maternal discouragements (total, nonverbal, temporary) and encouragements (total, nonverbal, reward).
- Child body fat percentage was associated with greater nonverbal discouragements and maternal health encouragements.
- Maternal encouragement to eat associations were not significant after accounting for twin dependence.
Conclusions:
- Children with higher adiposity experienced more maternal discouragements and encouragements to eat.
- The influence of nonverbal parenting cues on children's eating regulation and obesity risk requires further research.
Background:
Restrictive feeding is associated with child overweight; however, the majority of studies used parent-report questionnaires.
Objectives:
The relationship between child adiposity measures and directly observed parent and child behaviours were tested using a novel behavioural coding system (BCS).
Methods:
Data from 109 children, participants in a twin study and their mothers, were analyzed. Parent-child dyads were video-recorded twice in the laboratory, while children ate ad libitum from a buffet lunch. Mother and child behaviours were assessed using the BCS. Height, body weight and body fat were directly measured for each child. Associations between child adiposity measures and average BCS behaviour (i.e. pooled across visits) were tested using partial correlations adjusting for child age.
Results:
Regarding discouragement prompts, child body mass index (BMI) z-score was significantly associated with a greater rate of total discouragements (per minute, min-1 ), nonverbal discouragements (min-1 ) and temporary (delay) discouragements (min-1 ) (p < 0.05). Child percent body fat was associated with greater nonverbal discouragements (min-1 ). Regarding encouragement prompts, child BMI z-score was significantly associated with a greater rate of total encouragements (min-1 ), nonverbal encouragements (min-1 ) and reward encouragements (min-1 ). Child BMI z-score and percent body fat were both positively associated with greater maternal health encouragements (min-1 ). Associations with encouragement to eat prompts were no longer significant when accounting for the dependence among twins (being part of the same family).
Conclusions:
Heavier children received greater maternal discouragements to eat and, with qualifications, encouragements to eat. The role of nonverbal parenting cues warrants further research regarding child eating regulation and obesity.
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