Time to re-think picky eating?: a relational approach to understanding picky eating

Background: Estimates of picky eating are quite high among young children, with 14-50% of parents identifying their preschoolers as picky eaters. Dietary intake and preferences during the preschool years are characterized by slowing growth rates and children developing a sense of autonomy over their feeding and food selection. We argue that the current conceptualization of picky eating defines acts of resistance or expressions of preference (acts of autonomy) by a child as deviant behaviour. This conceptualization has guided research that uses a unidirectional, parent to child approach to understanding parent-child feeding interactions. Objectives: By reviewing the current feeding literature and drawing parallels from the rich body of child socialization literature, we argue that there is a need to both re-examine the concept and parent/clinician perspectives on picky eating. Thus, the objective of this paper is two-fold: 1) We argue for a reconceptualization of picky eating whereby child agency is considered in terms of eating preferences rather than categorized as compliant or non-compliant behaviour, and 2) We advocate the use of bi-directional relational models of causality and appropriate methodology to understanding the parent-child feeding relationship. Discussion: Researchers are often interested in understanding how members in the parent-child dyad affect one another. Although many tend to focus on the parent to child direction of these associations, findings from child socialization research suggest that influence is bidirectional and non-linear such that parents influence the actions and cognitions of children and children influence the actions and cognitions of parents. Bi-directional models of causality are needed to correctly understand parent-child feeding interactions. Conclusions: A reconceptualization of picky eating may elucidate the influence that parental feeding practices and child eating habits have on each other. This may allow health professionals to more effectively support parents in developing healthy eating habits among children, reducing both stress around mealtimes and concerns of picky eating

The family mealtime observation study (FaMOS): Exploring the role of family functioning in the association between mothers' and fathers' food parenting practices and children's nutrition risk

This cross-sectional study explores associations between mothers' and fathers' food parenting practices and children's nutrition risk, while examining whether family functioning modifies or confounds the association. Home observations assessed parents' food parenting practices during dinnertime (n = 73 families with preschoolers). Children's nutrition risk was calculated using NutriSTEP®. Linear regression models examined associations between food parenting practices and NutriSTEP® scores. An interaction term (family functioning × food parenting practice) explored effect modification; models were adjusted for family functioning to explore confounding. Among mothers, more frequent physical food restriction was associated with higher nutrition risk in their children (β = 0.40 NutriSTEP® points, 95% Confidence Interval (CI) = 2.30, 7.58) and among both mothers and fathers, positive comments about the target child's food were associated with lower nutrition risk (mothers: β = -0.31 NutriSTEP® points, 95% CI = -0.54, -0.08; fathers: β = -0.27 NutriSTEP® points, 95% CI = -0.75, -0.01) in models adjusted for parent education and child Body Mass Index (BMI) z-score. Family functioning did not modify these associations and they remained significant after adjustment for family functioning. Helping parents to use positive encouragement rather than restriction may help to reduce their children's nutrition risk

Dishing on dinner: a life course approach to understanding the family meal context among families with preschoolers

Objective: Family meals promote healthful dietary intake and well-being among children. Despite these benefits, family meal participation typically declines as children age. This study utilises life course theory to explore parents’ perceptions of family meals in order to understand how parents’ past experiences with family meals (in childhood and earlier in adulthood) influence their current beliefs and practices regarding mealtimes with their own children.Design: Semi-structured qualitative interviews. Setting:In-person interviews were conducted in participants’ homes. Participants: Twenty families (twenty-one mothers and fifteen fathers) with a child aged between 18 months and 5 years. Results: Thematic analysis revealed that families seemed to primarily approach mealtimes from one of three overarching orientations: meals for (1) Togetherness, (2) Nutrition Messaging or (3) Necessity. These orientations were informed by parents’ own mealtime experiences and significant life transitions (e.g. parenthood). The current family meal context, including the messages parents shared with their children during mealtimes and the challenges experienced with mealtimes, characterised the orientations and families’ approaches to mealtimes.Conclusions: Parents’ own early life experiences and significant life transitions influence why families eat meals together and have important implications for the intergenerational transmission of mealtime practices. Results may help to inform the content and timing of intervention strategies to support the continuation of frequent family meals beyond the preschool years.</div

Exploring the role of family functioning in the association between family dinner frequency and dietary intake among adolescents and young adults

Importance: Eating meals, particularly dinner, with family members has been associated with improved dietary intake among youth. However, existing studies have not examined how family functioning may moderate or confound this association. Objective: To examine whether level of family functioning is associated cross-sectionally with family dinner frequency and dietary intake among a national sample of adolescents and young adults. Methods: Linear regression models were used to examine the extent to which family dinner frequency was associated with self-reported intake of fruit and vegetables, sugar-sweetened beverages (SSB), fast food and take-out food. To explore effect modification by family functioning, an interaction term for family functioning and family dinner frequency was included for each dietary outcome. To explore confounding, models adjusted for family functioning were run. All models were stratified by sex and included participant age, educational attainment of mother’s spouse/partner and family structure as covariates. Analyses for this manuscript were conducted between 2017 and 2018. Results: Participants were 1 559 female and 1 169 males participating in the U.S. Growing Up Today Study 2 (GUTS2) who were 14-24 years old and living with their parents in 2011. The majority of participants identified as White (92.6%). More frequent family dinners were associated with higher quality dietary intake regardless of level of family functioning; interactions between family functioning and family dinner frequency were non-significant. Associations between family meal frequency and dietary intake outcomes did not change substantively when adjusting for family functioning. In adjusted models, more frequent family dinners were associated with higher intakes of fruits (females: = 0.09 servings/day, CI= 0.04, 0.15; males: = 0.07 servings/day, CI= 0.01, 0.12) and vegetables (females: = 0.21 servings/day, CI= 0.12, 0.30; males: = 0.19 servings/day, CI= 0.09, 0.30), and lower intakes of fast food (females: = -0.04 times/week, CI= -0.07, 0.00; males: = -0.10 times/week, C= -0.15,-0.04) and take-out foods (females: = -0.04 times/week, CI= -0.07,-0.01; males: = -0.06 times/week, CI= -0.10,-0.02). More frequent family dinners were associated with lower intakes of SSBs for males only (= -0.07 servings/day, CI= -0.13, -0.02). Conclusions: More frequent family dinners are associated with healthful dietary intakes among youth, regardless of level of family functioning. Family dinners may be an appropriate intervention target for improving dietary intake among youth