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Changes in parental feeding practices and preschoolers' food intake following a randomized controlled childhood
Maria Somaraki1, Karin Eli2, Kimmo Sorjonen3
1Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
Insights
Parental feeding practices did not significantly change in preschool obesity treatment. However, specific feeding changes influenced child food intake, with some effects varying by treatment group.
Area of Science:
- Pediatrics
- Public Health
- Behavioral Science
Background:
- Childhood obesity is a significant public health concern, particularly in preschool-aged children.
- Parental involvement is key in early obesity treatment, but mechanisms of change remain unclear.
- Understanding how parental feeding practices influence child food intake is crucial for effective interventions.
Purpose of the Study:
- To investigate secondary outcomes of early childhood obesity treatment, focusing on changes in parental feeding practices and child food intake.
- To explore the relationship between parental feeding practices and child food intake within different treatment modalities.
- To determine if changes in feeding practices or food intake mediate weight loss in preschool children with obesity.
Main Methods:
- A randomized controlled trial (The More and Less study) involving 174 preschool children with obesity.
- Three treatment arms: standard treatment (ST), parent group with boosters (PGB), and parent group without boosters (PGNB).
- Parental feeding practices assessed using the Child Feeding Questionnaire (CFQ) and child food intake via a Food Frequency Questionnaire (FFQ) over four measurements.
Main Results:
- No significant between-group differences were observed in parental feeding practices or child food intake over time.
- Changes in specific parental feeding practices were associated with changes in child food intake.
- Maternal restriction showed opposing effects on cookie/bun consumption depending on the treatment group (increased in PGNB, decreased in ST).
Conclusions:
- This study found no evidence that changes in parental feeding practices or child food intake mediated weight loss in preschool obesity treatment.
- While specific feeding practices influenced intake, their impact varied across treatment groups.
- Future research should explore broader parenting practices and parent-child interactions as potential mediators of treatment outcomes.
Abstract:
Childhood obesity treatment involving parents is most effective during the preschool age. However, the mechanisms of change are not known. The present study reports on secondary outcomes (changes in parental feeding practices and child food intake) of early obesity treatment. The More and Less study is a randomized controlled trial conducted in Stockholm County, Sweden. Children with obesity (n = 174, mean BMI SDS 3.0, mean age 5 years, 56% girls) and their parents (60% with foreign background, 40% with a university degree) were randomized to: 1) standard treatment focusing on lifestyle recommendations (ST), 2) a parent support program with boosters (PGB), and 3) a parent support program without boosters (PGNB). The Child Feeding Questionnaire (CFQ) was used to measure parental feeding practices. Child food intake was assessed with a Food Frequency Questionnaire (FFQ). We calculated the monthly changes in CFQ practices and FFQ items based on four measurements. We did not find any significant between-group differences in parental feeding practices and child food intake over time. However, general linear models showed that changes in certain feeding practices predicted changes in child food intake. When ST was compared to the parent support groups, some associations moved in opposite directions. For example, increasing maternal restriction predicted increased consumption of cookies/buns in PGNB (b = 2.3, p < 0.05) and decreased consumption of cookies/buns in ST (b = -2.1, p < 0.05). This is among the few studies to examine the effect of parental feeding practices on child food intake and weight status after obesity treatment among preschoolers. We found no evidence that changes in feeding practices or changes in child food intake mediated child weight loss. Future studies should consider other intermediary processes related to general parenting practices and parent-child interactions.
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