Unpacking the relationships between positive feeding practices and children’s eating behaviours: The moderating role of child temperament

Evidence suggests that children’s eating behaviours are influenced by the feeding practices which parents employ. Furthermore, parents may alter the feeding practices they use according to their child’s temperament. However, there is a paucity of literature on how children’s temperament moderates the relationship between parents’ use of feeding practices and children’s eating behaviours. One hundred and eleven mothers of 2 to 4-year-old children completed questionnaire measures of their feeding practices along with their child’s eating behaviours and temperament. Two-tailed Spearman’s correlations revealed that mothers’ use of a range of positive (health promoting) feeding practices was associated with greater enjoyment of food and lower food fussiness among children. Moderation analyses found that relationships between mothers involving their children in food choice and preparation and children’s eating behaviours were moderated by children’s temperament. Involvement in food choice and preparation was no longer associated with higher enjoyment of food and lower fussiness for children who were either highly emotional or low in sociability. These findings suggest that while many previously identified positive feeding practices may be associated with more healthy eating for all children, some may be less helpful or less achievable with children who have particular temperamental traits. Future research should seek to develop interventions to promote healthy eating which are tailored towards children’s individual characteristics. <br

Supplemental Material - Influence of parental anxiety and beliefs about medicines on feeding and exercise in children living with asthma

Supplemental Material for Influence of parental anxiety and beliefs about medicines on feeding and exercise in children living with asthma by Rebecca Clarke, Gemma Heath, Prasad Nagakumar and Claire Farrow in Journal of Child Health Care.</p

Supplemental Material - Influence of parental anxiety and beliefs about medicines on feeding and exercise in children living with asthma

Supplemental Material for Influence of parental anxiety and beliefs about medicines on feeding and exercise in children living with asthma by Rebecca Clarke, Gemma Heath, Prasad Nagakumar and Claire Farrow in Journal of Child Health Care.</p

Preschool-aged children’s food approach tendencies interact with food parenting practices and maternal emotional eating to predict children’s emotional eating in a cross-sectional analysis

Background Children’s tendency to eat while they are emotional, irrespective of satiety, is termed emotional eating (EE). EE develops early in childhood and has been associated with maternal modelling of EE and food parenting practices. In addition, individual differences in a child’s appetitive traits (ie, food approach behaviors) are related to the development of EE. Objective The objective of this study was to examine whether or not the previously identified mediating relationship between maternal EE and child EE via maternal use of food as a reward, food for emotion regulation, or restriction of food for health reasons varies as a function of child food approach. Design A cross-sectional online questionnaire study was conducted. Participants/setting One hundred eighty-five mothers of children aged between 3 and 5 years were recruited between January 2020 and March 2020 from advertisements placed on social media in the United Kingdom. Main outcome measure Questionnaires assessed child EE, child food approach tendencies, maternal EE, and food parenting practices. Statistical analyses performed Using PROCESS version 3.4, model 14, moderated mediations were employed to assess whether or not child food approach tendencies moderated the mediating effect of controlling food parenting practices between maternal EE and child EE. Results This study found the relationship between maternal reports of maternal EE and child EE was mediated by maternal use of food as a reward, but only for children with high food approach tendencies (B = .05, 95% CI 0.010 to 0.101; R2 = 48%). This study also found the relationship between maternal EE and child EE was mediated by maternal use of restriction for health reasons, but only when children showed medium (B = .02, 95% CI 0.004 to 0.072) to high (B = .06, 95% CI 0.016 to 0.110; R2 = 51%) food approach tendencies. Conclusions The potential for the intergenerational transmission of EE via the use of food as a reward and food restriction may be exacerbated when a child has higher food approach behaviors.</p

Supplemental Material - Influence of parental anxiety and beliefs about medicines on feeding and exercise in children living with asthma

Supplemental Material for Influence of parental anxiety and beliefs about medicines on feeding and exercise in children living with asthma by Rebecca Clarke, Gemma Heath, Prasad Nagakumar and Claire Farrow in Journal of Child Health Care</p

Predicting preschool children's emotional eating: The role of parents' emotional eating, feeding practices and child temperament

Emotional eating (EE; defined as overeating irrespective of satiety and in response to emotional states) develops within childhood, persists into adulthood, and is linked with obesity. The origins of EE remain unclear, but parental behaviours (e.g., controlling feeding practices and modelling) and child characteristics (e.g., temperament) are often implicated. To date, the interaction between these influences has not been well investigated. This study explores whether the relationship between parent and child EE is shaped by parental feeding practices, and if the magnitude of this relationship varies as a function of child temperament. Mothers (N = 244) of 3–5-year-olds completed questionnaires about their EE, feeding practices, their children's EE and temperament. Results showed that parental use of food to regulate children's emotions fully mediated the relationship between parent and child EE, and using food as a reward and restricting food for health reasons partially mediated this relationship. Analyses demonstrated that the mediated relationship between parent and child EE via use of food as a reward and restriction of food for health reasons varied as a function of child negative affect, where high child negative affect moderated these mediations. These findings suggest child EE may result from interrelationships between greater parent EE, use of food as a reward, restriction of food for health reasons and negative affective temperaments, but that greater use of food for emotion regulation may predict greater child EE irrespective of child temperament

Emotional eating following a laboratory mood induction: the interaction between parental feeding practices and child temperament

Children who emotionally eat (EE) tend to consume palatable foods that are high in sugar and fat. How EE develops remains unclear, but children's temperament and parental feeding practices may interact to shape child EE. To date, no research has explored these interaction effects on EE experimentally. Furthermore, most research has explored EE in response to generic ‘negative’ mood rather than specific negative emotions, such as boredom, which has never been explored in this context. This study aimed to explore interactions between induced mood condition (sadness, boredom, control), parent-reported non-responsive feeding practices and parent-reported child temperament (negative affect, surgency, effortful control) in predicting kilocalories consumed by children aged 4–5-years in a laboratory setting. Using three-way ANOVA, the interactions between mood state, parental feeding practice and child temperament were assessed. Results indicated that children who experienced boredom consumed significantly more total kilocalories than children in the control condition. Additionally, children with high negative affect who also had parents who reported high use of food for emotion regulation consumed significantly more kilocalories from sweet food when experiencing boredom compared to control condition, and children with high negative affect who also had parents who reported low use of food as a reward consumed significantly more kilocalories from sweet food when experiencing boredom compared to control condition. These findings suggest that feelings of boredom differentially predict children's snack food intake, and that child negative affect and non-responsive feeding practices play an important role in the expression of this relationship.</p

Role-model, reoffer, reward: A thematic analysis and TDF mapping of influences on families’ use of evidence-based vegetable feeding practices

Children's vegetable intake is low, despite benefits for immediate and long-term health. Repeatedly reoffering vegetables, role-modelling consumption, and offering non-food rewards effectively increase children's vegetable acceptance and intake. However, a number of barriers prevent families from reoffering previously-rejected vegetables. This study used the Theoretical Domains Framework (TDF) and the COM-B model of behaviour to explore barriers and enablers to reoffering, role-modelling and offering non-food rewards among parents of 2-4-year-old children. Twenty-five semi-structured interviews were conducted, from which eleven core inductive themes were generated: ‘Child factors’, ‘Eating beliefs’, ‘Effectiveness beliefs’, ‘Past experience’, ‘Current family behaviours’, ‘Harms’, ‘Knowledge’, ‘Need for change’, ‘Parent effort’, ‘Parent values’ and ‘Practical issues’. The codes underpinning these themes were inductively mapped to 11 of the 14 TDF domains, and five of the six COM-B components. Previously-reported influences on families' vegetable feeding practices were confirmed, including concerns about child rejection of foods/meals, cost of vegetables, and food waste. Novel findings included some parents' perceptions that these practices are pressurising, and that certain beliefs/knowledge about children's eating behaviour can provide a “protective mindset” that supports families' perseverance with reoffering over time. Future interventions should be tailored to better reflect the diversity of needs and previous experiences of feeding that families have, with some families likely to find that troubleshooting and further signposting is appropriate for their needs while others might benefit from more persuasive and educational approaches. The mapping of codes to the TDF and COM-B will facilitate the identification of appropriate intervention functions and behaviour change techniques when designing new interventions to support families with increasing their children's vegetable intake.</p

Examining parent mood, feeding context, and feeding goals as predictors of feeding practices used by parents of preschool children with avid eating behavior: protocol for an ecological momentary assessment study

Background: An avid eating behavior profile is characterized by a greater interest in food and a tendency to overeat in response to negative emotions. Parents use specific strategies to manage feeding interactions with children with avid eating behavior. While momentary and contextual factors, such as parental mood, have been found to influence parental feeding practices, there is a lack of research examining parents’ daily experiences of feeding children with avid eating behavior. Examining this is important because parental feeding practices are key levers in tailored interventions to support children’s healthy eating behavior.  Objective: We aim to describe the ecological momentary assessment methods and procedures used in the APPETItE (Appetite in Preschoolers: Producing Evidence for Tailoring Interventions Effectively) project, which aims to examine how variation in parental mood, feeding goals, and the context of eating occasions affect the parental feeding practices used to manage feeding interactions with children with an avid eating behavior profile.  Methods: Participants are primary caregivers from the APPETItE cohort who have a preschool-age child (aged 3-5 years) with an avid eating behavior profile. Caregivers complete a 10-day ecological momentary assessment period using signal- and event-contingent surveys to examine (1) mood and stress, (2) parental feeding goals, and (3) contextual factors as predictors of parental feeding practices.  Results: Recruitment and data collection began in October 2023 and is expected to be completed by spring 2024. The data have a 3-level structure: repeated measurements (level 1) nested within days (level 2) nested within an individual (level 3). Thus, lag-dependent models will be conducted to test the main hypotheses. Conclusions: The findings from this study will provide an understanding of caregivers’ daily experiences of feeding preschool children with avid eating behavior, who are at greater risk for the development of obesity. Understanding the predictors of feeding practices at the moment they occur, and across various contexts, will inform the development of tailored resources to support caregivers in managing children’s avid eating behavior. International Registered Report Identifier (IRRID): DERR1-10.2196/55193</p

Identifying an avid eating profile in childhood: associations with temperament, feeding practices and food insecurity

This study aimed to identify distinct eating behaviour profiles in young children and examine how other key predictors of children's eating behaviour, including child temperament, the experience of food insecurity, or parental feeding practices, may vary by identified profiles. An online survey was conducted with 995 parents/carers living in England and Wales (N = 995, Mage = 35.4 years, 80% female, 88% White). Participants reported on their child's eating behaviour using the Child Eating Behaviour Questionnaire and completed measures of child temperament, household food security and parental feeding practices. Latent Profile Analysis (LPA) was carried out to identify distinct eating profiles amongst the children (36–72 months, Mage = 48.8 months, 52% female). Four eating profiles emerged from the sample of children: (a) avid eating, (b) avoidant eating, (c) happy eating, and (d) typical eating. Avid eating (21.9% of children) was characterised by higher levels of food responsiveness, enjoyment of food, and emotional over-eating in combination with lower satiety responsiveness, slowness in eating and food fussiness. Children with an avid eating profile were reported to be more surgent and experienced greater food insecurity than all other eating profiles. Parents of children belonging to the avid eating profile showed significantly greater use of food for emotional regulation, varied and balanced food provision, restriction of food for health, and restriction of food for weight feeding practices than the three other eating profiles.</p