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Parental Feeding Styles, Sugary Drinks Intake, and Early Childhood Caries in Egyptian Children: A Mediation Analysis
Aya Taha1, Wafaa Essam1, Maha El Tantawi1
1Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Insights
Parental feeding styles impact early childhood caries (ECC). Instrumental feeding increased ECC risk, while encouragement-to-eat reduced it, with sugary drinks mediating other feeding styles.
Area of Science:
- Pediatric Dentistry
- Public Health Nutrition
- Child Psychology
Background:
- Early childhood caries (ECC) is a significant public health issue.
- Unhealthy eating patterns are strongly linked to ECC development in young children.
Purpose of the Study:
- To investigate the association between parental feeding styles (PFS) and ECC.
- To examine the mediating role of sugary drink consumption in the PFS-ECC relationship.
Main Methods:
- Cross-sectional study of 412 children aged 2-6 years in Egypt.
- Clinical assessment of ECC and plaque, with feeding styles evaluated using the PFS questionnaire.
- Statistical analysis using negative binomial regression and PROCESS macro for mediation analysis.
Main Results:
- A high prevalence of ECC (80.8%) and daily sugary drink consumption (84.2%) was observed.
- Instrumental feeding was associated with significantly higher odds of ECC (AOR=2.35), while encouragement-to-eat was linked to lower odds (AOR=0.62).
- Sugary drinks significantly mediated the relationship between control-over-feeding and emotional feeding styles with ECC.
Conclusions:
- Parental feeding styles, specifically instrumental feeding and encouragement-to-eat, are significantly associated with ECC.
- Sugary drink consumption acts as a mediator in the link between certain parental feeding styles (emotional feeding, control-over-feeding) and ECC.
- Identifying at-risk parental feeding styles is crucial for developing targeted preventive strategies and health education programs for ECC.
Background:
Early childhood caries (ECC) is associated with unhealthy eating.
Aim:
To assess the relationship of parental feeding styles (PFS) with ECC and the mediating effect of sugary drinks.
Design:
A cross-sectional study was conducted at a hospital in Egypt (2022-2023) including 2-6-year-old children. Clinical examination assessed ECC and plaque. Children's feeding habits were assessed by the PFS questionnaire. The World Health Organization Child Questionnaire assessed children's oral hygiene practices. A standardized questionnaire assessed the frequency and quantity of daily sugary drinks. Negative binomial regression assessed the relation between dmfs, PFS, and sugary drinks, controlling for confounders. PROCESS macro was used to assess mediation by sugary drinks.
Results:
The study included 412 children. Most children (80.8%) had ECC and consumed sugary drinks daily (84.2%). There were significantly higher odds of dmfs with instrumental feeding (AOR = 2.35, 95% CI: 1.82, 3.03) and lower odds with encouragement-to-eat (AOR = 0.62, 95% CI: 0.50, 0.77). Sugary drinks significantly mediated the relationship of control-over-feeding and emotional feeding with ECC.
Conclusion:
ECC was significantly associated with encouragement-to-eat and instrumental feeding. Sugary drinks significantly mediated the association with emotional feeding and control-over-feeding. Identifying PFS helps children at risk through preventive and health education programs.
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