'Do play with your food!'

'Do play with your food!

'Why don't you try it again?' A comparison of parent led, home based interventions aimed at increasing children's consumption of a disliked vegetable

Previous research suggests that the use of modelling and non-food rewards may be effective at increasing tasting, and consequential liking and acceptance, of a previously disliked food. Although successful school-based interventions have been developed, there is a lack of research into home-based interventions using these methods. This study aimed to develop and investigate the efficacy of a parent led home-based intervention for increasing children's acceptance of a disliked vegetable. A total of 115 children aged 2-4 years were allocated to one of four intervention groups or to a no-treatment control. The four intervention conditions were: repeated exposure; modelling and repeated exposure; rewards and repeated exposure; or modelling, rewards and repeated exposure. Children in all of the intervention conditions were exposed by a parent to daily offerings of a disliked vegetable for 14 days. Liking and consumption of the vegetable were measured pre and post-intervention. Significant increases in post-intervention consumption were seen in the modelling, rewards and repeated exposure condition and the rewards and repeated exposure condition, compared to the control group. Significant post-intervention differences in liking were also found between the experimental groups. Liking was highest (>60%) in the modelling, rewards and repeated exposure group and the rewards and repeated exposure group, intermediate (>26%) in the modelling and repeated exposure and repeated exposure groups, and lowest in the control group (10%). Parent led interventions based around modelling and offering incentives may present cost efficient ways to increase children's vegetable consumption

Observing maternal restriction of food with 3–5-year-old children: Relationships with temperament and later BMI

Overt parental restriction of food has previously been associated with child weight; however, most research has relied on self-reported feeding behaviour, or observations which give little opportunity to observe restriction of food. Using a novel lab-based observational technique to increase the opportunity to observe maternal feeding restriction, we explored the relationships between maternal restriction, child responses to restriction and child temperament with child body mass index (BMI) Z-scores over time. Sixty-two mother child dyads were recruited to the study when their children were aged 3–5 years and were followed up 2 years later (N = 39 dyads). Families were observed during a feeding interaction in the laboratory where cookies were offered with the main meal to increase the opportunity for maternal restriction of food. Feeding observations were coded and child temperament and BMI were measured. Controlling for current child BMI Z-scores, greater maternal verbal and physical restriction of food at 3–5 years was related to higher child BMI Z-scores at 5–7 years. More emotional children were less likely to experience restriction and less likely to accept attempts to restrict their food intake. Further research should consider children’s reactions to parental feeding behaviours in greater depth and explore how feeding practices interact with child temperament in the prediction of changes in child weight

Milk feeding, solid feeding and obesity risk: a review of the relationships between early life feeding practices and later adiposity

Childhood obesity is a major health issue with associated ill-health consequences during childhood and into later adolescence and adulthood. Given that eating behaviours are formed during early childhood, it is important to evaluate the relationships between early life feeding practices and later child adiposity. This review describes and evaluates recent literature exploring associations between child weight and the mode of milk feeding, the age of introducing solid foods and caregivers’ solid feeding practices. There are many inconsistencies in the literature linking early life feeding to later obesity risk and discrepancies may be related to inconsistent definitions, or a lack of control for confounding variables. This review summarises the literature in this area and identifies the need for large scale longitudinal studies to effectively explore how early life feeding experiences may interact with each other and with nutritional provision during later childhood to predict obesity risk

An ‘app’ropriate resource? Using mobile apps to provide feeding advice and support to parents

Feeding problems in children are extremely common and can affect long-term physical health, in addition to being acutely stressful for both the parent and child. Despite this, advice on child feeding is still poorly communicated to parents and many struggle to find professional support and advice when they experience problems feeding their child. The purpose of this research was to develop a resource to address this; one which allows for wide and cost-effective dissemination of expert advice and avoids traditional barriers to healthcare access. To this end, we developed a free-to-download mobile app for smartphones (and website version for non-app users). Following a review of the literature on infant feeding problems, the resource was developed to offer: (1) education on the most prevalent feeding difficulties; (2) interactive, tangible tools and tips to implement suggested strategies; and (3) assessment tools to monitor problem severity and parent/child subjective wellbeing. Mothers (N = 18) discussed their feeding experiences and appraised the mobile app and website prototypes. Feedback confirmed that feeding problems were common, guidance was inadequate, and that this resource was viewed as extremely helpful, novel, and contained a depth of information beyond anything previously seen. Importantly, mothers welcomed the possibility of using a mobile app to access feeding-related guidance. Overall, this resource represents a novel way to deliver education and guidance in an easy-to-use, highly accessible way that fits with modern parents’ lifestyles. Further evaluation activities are planned to test the efficacy of the resource as an intervention tool

Development and preliminary evaluation of the Child Feeding Guide website and app: a tool to support caregivers with promoting healthy eating in children.

Development and preliminary evaluation of the Child Feeding Guide website and app: a tool to support caregivers with promoting healthy eating in children

If at first you don’t succeed: assessing influences associated with mothers’ reoffering of vegetables to preschool age children

Repeatedly offering vegetables has been shown to be one of the most effective methods for increasing acceptance and subsequent intake in young children. In order to increase successful offerings of vegetables and resultant consumption amongst young children, it is necessary to consider the influences on maternal reoffering of vegetables. This study aimed to investigate the relationships between mothers' tendency to reoffer vegetables and a range of demographic factors and psychological variables. A cross-sectional design was used, where mothers completed questionnaires assessing how often they reoffer rejected vegetables, concerns for economic factors, and a range of possible child and maternal influences. Mothers of preschool children were recruited from toddler groups across Leicestershire, UK, as well as online. Spearman's correlations were run to look for associations between demographic and psychological factors with maternal reoffering of vegetables. Significantly associated factors were then entered into a stepwise regression to predict maternal reoffering of vegetables. Mothers were significantly less likely to reoffer rejected vegetables if they were concerned about time, money, and waste, were influenced by their child's mood, or were concerned about their child having tantrums. Moreover, mothers who consumed more vegetables themselves reoffered vegetables more frequently. Regression analyses revealed that mothers' concern about food waste and tantrums, as well as maternal vegetable consumption, all significantly predicted mothers' reoffering of vegetables. With these findings in mind, mothers should be educated and supported with how to tackle and minimise children's tantrums during feeding, as well as being made aware of effective methods for avoiding food waste. Moreover, given that mothers' own vegetable consumption is associated with lower reoffering of vegetables to their child, interventions which seek to increase familial vegetable consumption should be pursued

The cost of paediatric obesity

There has been a great deal of media attention given to the rising levels of obesity and overweight in children and adolescents, but what is the real cost of pediatric obesity? This article reviews information about the recent rise in pediatric obesity and discusses the cost of this condition from medical, financial and psychological perspectives

Investigating offering of vegetables by caregivers of preschool age children

Background: Research into the methods which caregivers use to encourage children to eat vegetables is limited, with minimal evidence about what the barriers are to offering these foods. Vegetable consumption in children is typically low and so gaining information on these factors is vital in order to develop further caregiver-centred interventions to increase children’s vegetable consumption. This study aimed to investigate the methods caregivers use to offer vegetables to preschool aged children, as well as the factors which influence whether and how caregivers present vegetables to their children. Method: Seventeen caregivers with a preschool aged child participated in focus groups to assess these questions. Results: Thematic analysis indicated that caregivers use a range of methods to offer their children vegetables, with these methods falling into three broad categories: behavioural/active methods, passive methods, and food manipulations. Influences on caregiver offering which emerged from the focus groups formed four categories: information, cost, parent factors, and child factors. Conclusions: Together with large scale quantitative data, this information can be used to shape future interventions aiming to increase children’s vegetable intake as well as to tailor advice given to caregivers striving to achieve a healthful diet for their children

Appetite regulation in early childhood: the impact of parenting behaviours and child temperament

The ability to appropriately regulate appetite appears to be intrinsic from birth. However as children develop and become socialised, problems with the control and regulation of appetite are commonplace, as evidenced by the high prevalence of overweight and obesity in later childhood and adulthood. This chapter explores different theories of appetite regulation and discusses the various eating behaviour traits which have been identified during early childhood. Although there are several aspects of parenting behaviour that may contribute to a child's appetite regulation, or lack of regulation, this chapter focuses on the impact of the feeding practices that parents employ, and the feeding environment that parents provide when parenting their children, in influencing children's eating behaviours, appetite and weight. This chapter also explores the literature on child temperament and its contribution to eating behaviour and appetite regulation. Although the literatures on parenting influence and child temperament have been poorly integrated in relation to early child eating, some speculative suggestions are made about how these two aspects of behaviour may interact together to influence the regulation and control of appetite in young children