The relationship between parental feeding practices and children's health-related quality of life

Healthy eating is essential throughout childhood and adolescence, and has been associated with better health-related quality of life (HRQoL). Healthy eating results from complex interactions, including the transmission of eating habits within families. Although parental feeding practices may influence children's HRQoL through several plausible behavioral pathways, empirical evidence examining this association remains limited. Therefore, the objective of this study was to investigate the association between parental feeding practices-monitoring, pressure-to-eat, and restriction-and children's HRQoL.

This cross-sectional study included 1,535 children (819 boys and 716 girls) aged 3 to 11 years recruited from 19 schools in Catalonia between 2022 and 2024. Parental feeding practices and children's HRQoL were assessed by the same parent using the Child Feeding Questionnaire and the KIDSCREEN-10 parent-proxy instrument, respectively.

Restrictive and pressure-to-eat feeding practices were associated with lower HRQoL in children (p < 0.001 and p = 0.03, respectively), whereas monitoring showed a significant non-linear association with HRQoL (p < 0.001), with higher HRQoL observed only at the highest levels of monitoring, after adjustment for children's age, gender, body mass index, adherence to the Mediterranean diet, physical activity level and parental education level.

Based on reports of both parental feeding practices and children's HRQoL provided by the same parent, our findings were broadly consistent with our hypothesis; however, future longitudinal studies incorporating multiple informants are needed to clarify the directionality of these associations and minimize potential reporting bias.