Changes in parental feeding practices and preschoolers' food intake following a randomized controlled childhood obesity trial

Maria Somaraki; Karin Eli; Kimmo Sorjonen; Anna Ek; Pernilla Sandvik; Paulina Nowicka

doi:10.1016/j.appet.2020.104746

Changes in parental feeding practices and preschoolers' food intake following a randomized controlled childhood obesity trial

Appetite. 2020 Nov 1:154:104746. doi: 10.1016/j.appet.2020.104746. Epub 2020 May 21.

Authors

Maria Somaraki¹, Karin Eli², Kimmo Sorjonen³, Anna Ek⁴, Pernilla Sandvik⁵, Paulina Nowicka⁶

Affiliations

¹ Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden. Electronic address: maria.somaraki@ikv.uu.se.
² Unit for Biocultural Variation and Obesity, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK; Social Science and Systems in Health, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK. Electronic address: karin.eli@anthro.ox.ac.uk.
³ Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden. Electronic address: kimmo.sorjonen@ki.se.
⁴ Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden. Electronic address: anna.ek@ki.se.
⁵ Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden. Electronic address: pernilla.sandvik@ikv.uu.se.
⁶ Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden; Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden. Electronic address: paulina.nowicka@ikv.uu.se.

PMID: 32446880
DOI: 10.1016/j.appet.2020.104746

Abstract

Childhood obesity treatment involving parents is most effective during the preschool age. However, the mechanisms of change are not known. The present study reports on secondary outcomes (changes in parental feeding practices and child food intake) of early obesity treatment. The More and Less study is a randomized controlled trial conducted in Stockholm County, Sweden. Children with obesity (n = 174, mean BMI SDS 3.0, mean age 5 years, 56% girls) and their parents (60% with foreign background, 40% with a university degree) were randomized to: 1) standard treatment focusing on lifestyle recommendations (ST), 2) a parent support program with boosters (PGB), and 3) a parent support program without boosters (PGNB). The Child Feeding Questionnaire (CFQ) was used to measure parental feeding practices. Child food intake was assessed with a Food Frequency Questionnaire (FFQ). We calculated the monthly changes in CFQ practices and FFQ items based on four measurements. We did not find any significant between-group differences in parental feeding practices and child food intake over time. However, general linear models showed that changes in certain feeding practices predicted changes in child food intake. When ST was compared to the parent support groups, some associations moved in opposite directions. For example, increasing maternal restriction predicted increased consumption of cookies/buns in PGNB (b = 2.3, p < 0.05) and decreased consumption of cookies/buns in ST (b = -2.1, p < 0.05). This is among the few studies to examine the effect of parental feeding practices on child food intake and weight status after obesity treatment among preschoolers. We found no evidence that changes in feeding practices or changes in child food intake mediated child weight loss. Future studies should consider other intermediary processes related to general parenting practices and parent-child interactions.

Keywords: Child eating; Child feeding questionnaire; Family-based treatment; Parental feeding practices; Randomized controlled trial.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
Eating
Feeding Behavior
Female
Humans
Male
Parenting
Parents
Pediatric Obesity*
Surveys and Questionnaires
Sweden