Elsevier

The Journal of Pediatrics

Volume 221, June 2020, Pages 93-98.e20
The Journal of Pediatrics

Original Article
A Bidirectional Analysis of Feeding Practices and Eating Behaviors in Parent/Child Dyads from Low-Income and Minority Households

https://doi.org/10.1016/j.jpeds.2020.02.001Get rights and content

Objective

To prospectively examine the bidirectional relationship between parental feeding practices (eg, instrumental feeding, encouragement to eat) and child eating behaviors (eg, food responsiveness, emotional eating) in low-income, ethnically diverse preschool children over a 3-year period.

Study design

Parent/child (age 2-4 years at baseline) pairs (n = 222 non-Hispanics; n = 312 Hispanics) participated in NET-Works (Now Everybody Together for Amazing and Healthful Kids), a randomized controlled trial carried out in community and in-home settings in urban areas of Minnesota. Data were collected at baseline and 12, 24, and 36 months. The present study is a secondary data analysis using cross-lagged models to identify bidirectional associations between parental feeding practices and child eating behaviors.

Results

Three models showed significant cross-lagged effects (P < .05): model 1, parental instrumental feeding influencing later child food responsiveness; model 2, parental emotional feeding influencing later child food responsiveness; and model 3, parental emotional feeding influencing later child eating satiety. Model 1 showed significant bidirectional temporal paths, whereas models 2 and 3 showed significant unidirectional temporal paths from parental feeding practices to child eating behaviors.

Conclusions

Parental instrumental and emotional feeding practices prospectively influence child food responsiveness and satiety. This study demonstrates causal temporality between parental feeding practices and child eating behaviors. Heath care providers may want to use findings regarding parent feeding practices as part of their anticipatory guidance during well-child visits with parents of preschoolers.

Section snippets

Patients

In 2012-2014, the NET-Works (Now Everybody Together for Amazing and Healthful Kids) study (ClinicalTrials.gov: identifier NCT01606891) recruited and randomized 534 preschoolers who were age 2-4 years, above the 50th percentile for age and sex-adjusted height and weight as measured by Centers for Disease Control and Prevention standardized growth charts,22 and from a low-income household (<$65 000 annual household income) in the Minneapolis and St Paul, Minnesota area (Table I).23 Families who

Cross-Lagged Model Fit

No cross-lagged path model showed evidence for perfect fit to the data (model χ2 values, 189.1-283.2; P < .001 for all). The modest performance of the cross-lagged path models on measures of close model fit (comparative fit index, 0.86-0.91; root mean square error of approximation, 0.10-0.12) indicated that the variance in these behaviors may be explained by factors not included in the models (Table II; available at www.jpeds.com). However, because the primary purpose of the cross-lagged models

Discussion

There are bidirectional temporal associations between parental feeding practices and child eating behaviors, although many relationships were inconsistent or nonsignificant. These study findings are consistent with theory and extend previous research findings in the field of parental feeding practices and child eating behaviors. FST supports study findings showing a bidirectional relationship between parental instrumental feeding practices and child food responsiveness. Specifically, a parent

Data Statement

Data sharing statement available at www.jpeds.com.

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    Funding and conflict of interest information is available at www.jpeds.com (Appendix).

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