This study examined bidirectional relationships between maternal feeding practices and child food responsiveness and satiety responsiveness from 2 to 5 years.
Mothers (N = 207) reported their own ...feeding practices and child eating behaviours using validated questionnaires at child ages 2, 3.7, and 5 years. Cross-lagged analyses were conducted to test for bidirectional effects, adjusting for child BMI z-score (based on measured weight and height) at 14 months.
Eating behaviours and feeding practices showed strong continuity across the three time points. Maternal feeding practices (higher reward for behaviour β = 0.12, p = 0.025 and lower covert restriction β = -0.14, p = 0.008) were prospectively associated with higher food responsiveness. Conversely, increased child satiety responsiveness was primarily prospectively associated with mothers' feeding practices (increased structured meal timing β = 0.11, p = 0.038, overt β = 0.14, p = 0.010 and covert restriction β = 0.11, p = 0.022). The only exception was family meal setting, which was prospectively negatively associated with satiety responsiveness (β = -0.11, p = 0.035).
While maternal feeding practices and child satiety and food responsiveness show strong continuity between child age 2 and 5 years, maternal feeding practices appear to be associated with child food responsiveness over time. Conversely, child satiety responsiveness, but not food responsiveness, may also be associated with maternal feeding practices over time. These results are consistent with interventions that provide feeding advice to parents on how to respond appropriately to individual child eating behaviour phenotype.
ACTRN12608000056392 . Registered 29 January 2008.
Abstract Objective To identify associations between structure-related and non-responsive feeding practices and children's eating behaviors. Design Cross-sectional online survey design. Participants ...Parents (n = 413) of 1- to 10-year-old children. Main Outcome Measures Parental feeding practices and child eating behaviors were measured via the validated Feeding Practices and Structure and Children's Eating Behaviour questionnaires. Analysis Associations between parental feeding practices and children's eating behaviors were tested using hierarchical multivariable linear regression models, adjusted for covariates. Results Feeding practices accounted for 28% and 21% of the variance in food fussiness and enjoyment of food, respectively ( P < .001). For all other eating behaviors the amount of variance explained by feeding practices was < 10% ( P < .001). Key findings were that more structure and less non-responsive practices were associated with lower food fussiness and higher enjoyment of food. Conclusions and Implications Overall, the findings suggested that mealtime structure and responsive feeding are associated with more desirable eating behaviors. Contrary to predictions, there was no evidence to indicate that these practices are associated with better self-regulation of energy intake. Longitudinal research and intervention studies are needed to confirm the importance of these feeding practices for children's eating behaviors and weight outcomes.
Against a background of changing family structures and socioeconomic demands in contemporary families, fathers are more actively engaged in meal preparation and feeding of their children, yet in ...research studies targeting improvement in nutrition and feeding practices fathers are under-represented. Among possible explanations for this bias are acceptability of research projects and accessibility to male research participants. The aims of this study were to identify (i) fathers' preferences for participation in child nutrition research and interventions and (ii) the potential to recruit fathers through their workplaces with the possibility of delivering interventions through those workplaces.
This paper draws on two independent yet linked studies that explored fathers' roles in family feeding, and intervention studies aimed at supporting father's dietary knowledge and feeding practices. For Study 1 (conducted first) secondary data analysis was conducted on survey data (n = 463 fathers of preschool children) to determine preferences related to type of program, delivery mode, and location and timing. For Study 2 six focus groups and one individual interview were conducted with n = 28 fathers to determine acceptability of recruitment of fathers working in traditionally blue-collar occupations and service industries (as defined by the Australian Bureau of Statistics) and potential of intervention delivery through their workplaces.
Fathers were engaged in child feeding and indeed sought nutrition-related information. Fathers indicated a preference for family-focused and online delivery of interventions. Whilst potential to recruit through blue-collar workplaces was evident, participants were divided in their views about the acceptability of interventions conducted through the workplace. There was a sense of support for the logic of such interventions but the focus group participants in this study showed only modest enthusiasm for the idea.
With limited support for the workplace as an intervention setting, further systematic exploration of technology-based intervention design and engagement is warranted. Based on findings, interventions should target a) content that is focused on the family and how to make changes at the family level, rather than the father individually; and b) online delivery, such as Apps or online video chat sessions, for convenience and to facilitate sharing of information with family members.
Appetitive traits are associated with body weight. Increased understanding of how appetitive traits evolve from early life could advance research on obesity risk and inform intervention development. ...We report on tracking and age-related differences in appetitive traits in childhood within the RESONANCE cohort. Parents of RESONANCE children aged 6.02 ± 2.99 years completed the Child Eating Behavior Questionnaire (CEBQ). Pearson correlations of appetitive traits and age were tested for all participants contributing at least one observation, using each participant's first observation (N = 335). Children's first and second observations of the CEBQ (n = 127) were used to test tracking (paired correlations) and age-related differences (paired
-tests) within individuals. CEBQ correlations with age suggested that satiety responsiveness, slowness in eating, emotional undereating, and desire to drink decreased with age (r = -0.111 to r = -0.269, all
< 0.05), while emotional overeating increased with age (r = 0.207,
< 0.001). Food fussiness demonstrated a quadratic relationship with age. Paired
-tests further supported an increase in emotional overeating with age (M: 1.55 vs. 1.69,
= 0.005). All CEBQ subscales demonstrated moderate to high tracking (r = 0.533 to r = 0.760,
< 0.001). Our initial findings within the RESONANCE cohort suggest that food avoidant traits are negatively related with age, while emotional overeating increases with age, and that appetitive traits track through childhood.
There is a substantial body of research on children's eating behaviours (e.g., food responsiveness and fussiness) and related constructs (e.g., eating in the absence of hunger, appetite ...self-regulation). This research provides a foundation for understanding children's dietary intakes and healthy eating behaviours, as well as efforts at intervention, whether in relation to food avoidance, overeating and/or trajectories to excess weight gain. The success of these efforts and their associated outcomes is dependent on the theoretical foundation and conceptual clarity of the behaviours and constructs. This, in turn contributes to the coherence and precision of the definitions and measurement of these behaviours and constructs. Limited clarity in these areas ultimately creates uncertainty around the interpretation of findings from research studies and intervention programs. At present there does not appear to be an overarching theoretical framework of children's eating behaviours and associated constructs, or for separate domains of children's eating behaviours/constructs. The main purpose of the present review was to examine the possible theoretical foundations of some of the main current questionnaire and behavioural measures of children's eating behaviours and related constructs.
We reviewed the literature on the most prominent measures of children's eating behaviours for use with children aged ~ 0-12 years. We focused on the explanations and justifications for the original design of the measures and whether these included theoretical perspectives, as well as current theoretical interpretations (and difficulties) of the behaviours and constructs.
We found that the most commonly used measures had their foundations in relatively applied or practical concerns rather than theoretical perspectives.
We concluded, consistent with Lumeng & Fisher (1), that although existing measures have served the field well, to advance the field as a science, and better contribute to knowledge development, increased attention should be directed to the conceptual and theoretical foundations of children's eating behaviours and related constructs. Suggestions for future directions are outlined.
(1) Background: The coronavirus (COVID-19) pandemic has caused disruptions to what people eat, but the pandemic's impact on diet varies between individuals. The goal of our study was to test whether ...pandemic-related stress was associated with food intake, and whether relationships between stress and intake were modified by appetitive and cognitive traits. (2) Methods: We cross-sectionally surveyed 428 adults to examine current intake frequency of various food types (sweets/desserts, savory snacks, fast food, fruits, and vegetables), changes to food intake during the pandemic, emotional overeating (EOE), cognitive flexibility (CF), and COVID-19-related stress. Models tested associations of stress, EOE, and CF with food intake frequency and changes to intake. (3) Results: Models demonstrated that the positive relationship between stress and intake of sweets/desserts was stronger with higher EOE, while the positive relationship between stress and intake of chips/savory snacks was weaker with higher CF. Higher EOE was associated with greater risk of increased intake of palatable foods. (4) Conclusions: Findings suggest that emotional overeating may escalate stress-associated intake of high-sugar foods, and cognitive flexibility may attenuate stress-associated intake of high-fat foods. Differences in appetitive and cognitive traits may explain changes to and variability in food intake during COVID-19, and efforts to decrease emotional overeating and encourage cognitive flexibility could help lessen the effect of COVID-19-related stress on energy dense food intake.
Concerns about fussy eating are common amongst parents of young children. However, studies of the long-term impact of fussy eating show mixed results with regard to adequacy of dietary intake and ...child growth. This may be in part because there is no accepted definition of fussy eating and studies measure the construct in different ways, commonly relying on parent perception. This longitudinal analysis explores maternal and child characteristics associated with maternal perception of her toddler as a fussy eater in early toddlerhood and subsequent use of feeding practices at 2 years.
Mothers completed a self-administered questionnaire at child age 14 months, describing perception of their child as fussy/not fussy and child behaviour. Intake was assessed using a single 24-h recall and weight was measured by research staff. At child age 2 years mothers completed the validated 28-item Feeding Practices and Structure Questionnaire (FPSQ-28). Weight-for-age z-score (WAZ) was derived from WHO standards. Gram daily intake of fruit, vegetables and meat/alternative and a dietary diversity score were determined. Maternal/child characteristics independently associated (p ≤ 0.05) with perception of child as a fussy eater were determined using logistic regression. Variables were combined in a structural equation model assessing the longitudinal relationship between child/maternal characteristics, perception of child as a fussy eater and eight FPSQ factors.
Mothers' (n = 330) perception of her child as a fussy eater at age 14 months, was associated with higher frequency of food refusal and lower WAZ (R
= 0.41) but not dietary intake. Maternal perception as fussy (age 14 months) was associated with four FPSQ factors at 2 years (n = 279) - Reward for Eating, Reward for Behaviour, Persuasive Feeding and Overt Restriction, x
/df = 1.42, TLI = 0.95, CFI = 0.95, RMSEA = 0.04(0.03-0.05), PCLOSE = 0.99.
Lower relative child weight and food refusal prompted mothers to perceive their child as fussy. These behaviours in healthy weight children most likely reflect self-regulation of energy intake and neophobia. This perception was prospectively associated with use of non-responsive feeding practices, which may increase obesity risk. Future interventions could directly address perceptions of growth and fussiness, supporting parents to understand food refusal as developmentally appropriate behaviour in healthy young children.
ACTRN12608000056392 . Registered 29 January 2008.
The COVID-19 pandemic and public health measures to reduce its transmission have increased stress. Stress is associated with alterations in eating behavior which may be partly driven by effects on ...food-related motivation. To investigate effects of COVID-related stress on food motivation, we recruited adults (N = 429; 272 F, 157 M) to complete an online survey via Amazon MTurk in May 2020. Current COVID-related stress, retrospective pre-COVID stress, and motivation in relation to individualized preferred foods from five categories (sweet snacks, fruit, savory snacks, vegetables, and fast food) were assessed. Food motivation measures included willingness to wait, willingness to expend low effort finger taps, willingness to expend high effort jumping jacks, and willingness to pay for hypothetical delivery of the food item. Food motivation for each food type was assessed using a novel instrument designed for brief assessment of multiple aspects of food motivation across multiple food types. Participants were willing to pay the most for fast food followed by sweet snacks, and willing to wait longer for sweet snacks relative to other food types. While fast food and sweets also generated the most willingness to expend high and low effort, willingness to expend low effort for fruit was similar to that for fast food and sweets, and willingness to expend high effort for fruit was comparable to that for fast food. Participants were least willing to pay or expend low effort for vegetables. Higher COVID-related stress levels were associated with willingness to expend more effort and pay more for food items. These data collected during the pandemic demonstrate that highly processed and sweet foods have high motivating value across multiple measures of motivation, and COVID-related stress increases food motivation across food categories. Interventions to mitigate stress and target the link between stress and overeating may help to limit the effects of the COVID-19 pandemic on obesity.
Little is known about the pathways linking parent feeding practices with appetitive traits and BMIz throughout infancy. This study examined bidirectional associations between parental feeding ...practices, infant appetitive traits, and infant BMIz.
Parents (n = 380) of infants aged less than 6 months at baseline reported their feeding practices (using the Feeding Practices and Structure Questionnaire (FPSQ) for infants and toddlers), infant appetitive traits (using the Baby Eating Behaviour Questionnaire) and infant BMIz (parent-reported) at three timepoints (< 6 months, ~ 9 months, ~ 12 months) up to 12 months of age. Cross-lagged models examined bidirectional associations between parent feeding practices, infant appetitive traits and infant BMIz.
There was strong continuity across the three timepoints for maternal feeding practices, infant appetitive traits, and infant BMIz. Infant food avoidance was prospectively associated with higher parental persuasive feeding. Infant BMIz was prospectively associated with higher parent-led feeding. Parent use of food to calm was prospectively associated with lower infant BMIz, and infant BMIz was prospectively associated with higher infant food approach. Feeding on demand was prospectively associated with lower infant food approach.
This study highlights the complex associations between parental feeding practices, infant appetitive traits and infant BMIz. The study demonstrated that both child and parent effects are important, suggesting a need for tailored programs beginning in infancy to promote and support infant appetitive traits and parent feeding practices that support healthy development.
Purpose
To provide detailed long-term data after initial observation for patients after histological confirmation of low grade (WHO II) gliomas according to molecular stratification.
Methods
A series ...of 110 patients with watchful waiting strategy after initial surgery for LGG and re-surgery at tumor progression were analyzed. Progression-free survival, time to malignant transformation, post-recurrence survival, and overall survival were estimated with the Kaplan–Meier method. Prognostic factors were identified by the Log Rank test and Cox multivariate proportional hazards model.
Results
The cohort comprised 18 IDH wild type (IDH
wt
) and 53 IDH mutated (IDH
mut
) astrocytomas, and 39 IDH mutated and 1p 19q co-deleted (IDH
mut/codel
) patients. The median follow-up was 126 (95% CI 109–143) months. Surgery was gross total resection in 58, subtotal resection in 28, and biopsy in 24 patients. Progression-free survival rates at 5, 10 and 15 years was 38% 18% and 1%. The corresponding malignant transformation rates were 17%, 39% and 71%.
The initial extent of resection influenced progression-free survival, time to malignant transformation and overall survival. Molecular subtype IDH
mut/codel
was the strongest prognostic factor for overall survival and for time to malignant transformation.
Conclusion
The strongest determinant of the patients’ course after initial watchful waiting was the molecular tumor status. Extensive resection may increase time to progression and malignant transformation. Observation may be justified in selected patients.
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