Associations Between Parenting Stress, Feeding Practices, and Child Eating Behaviors During the COVID-19 Pandemic

Objectives The pandemic provides an opportunity to explore how parenting stress during times of crisis may predict parent-child interactions, especially during mealtimes. The objective of the present study was to explore whether parents’ perceived increases in and overall levels of parenting stress during the pandemic were associated with feeding practices and perceptions of child eating behaviors. Methods Parents (n = 284) of children 4–6 years completed a cross-sectional online survey between March and April 2020. Perceived changes in parenting stress during the onset of the pandemic, levels of parenting stress during the pandemic, child feeding practices, and children's eating behaviors were assessed. We used ordinal linear regression to examine whether changes in and levels of parenting stress predicted use of controlling or responsive feeding practices and perceptions of child eating behaviors. Results The majority (63.7%, n = 181) of parents indicated their family was moderately or extremely emotionally affected by the pandemic and 56.7% (n = 161) indicated pandemic-related precautions had been moderately or extremely challenging. Perceived increases in parenting stress during the onset of the pandemic were associated with more frequent use of food as a reward (OR = 1.15, 95% CI = 1.04–1.26) and for emotional regulation (OR = 1.13, 95% CI = 1.04–1.23), as well as greater child food responsiveness (OR = 0.91, 95% CI = 0.84–0.99) and slow eating (OR = 0.92, 95% CI = 0.84–1.00). Higher overall levels of parenting stress were associated with more frequent use of food as a reward (OR = 1.05, 95% CI = 1.02–1.08) and for emotional regulation (OR = 1.05, 95% CI = 1.03–1.08) but also with use of pressuring feeding practices (OR = 1.03, 95% CI = 1.01–1.06) and encouraging a balanced diet (OR = 1.03, 95% CI = 1.01–1.06). Higher overall levels of parenting stress were associated with greater child food fussiness (OR = 1.05, 95% CI = 1.02–1.08), enjoyment of food (OR = 1.05, 95% CI = 1.02–1.07), and satiety responsiveness (OR = 0.95, 95% CI = 0.93–0.98). Conclusions During the pandemic, parenting stress predicted parents’ use of food for emotional and behavioral regulation and various domains of children's eating behaviors. Results highlight the need for targeted efforts to support families during times of crisis. Funding Sources None.

Maternal feeding style and child weight status among Hispanic families with low-income levels: a longitudinal study of the direction of effects

Background The home environment is a central and modifiable influence on the development of childhood obesity. Evidence supports the central role of parents in shaping problematic child eating behaviors and excess weight. Most studies of feeding emphasize parent-driven influences without taking into account the child’s role in eating interactions. Few studies have addressed the bi-directional nature of feeding dynamics in studies of young children. Methods The goals of this study were: 1) to examine if parental feeding styles during preschool (4–5 years) predict child weight status at 7–9 years, and 2) to examine the direction of effects between parental feeding styles and child weight status over time. Participants were part of a larger longitudinal study of Hispanic Head Start families living in the West South Central United States. Data from mother/child dyads were collected at three time points: Time 1 (ages 4–5), Time 2 (ages 5 ½-6 ½), and at Time 3 (ages 7–9). Only data from the Times 1 and 3 were used in the current analyses. A total of 128 mothers and their children had data on all variables needed for the analyses. Assessments included parent-reported feeding styles, feeding practices, acculturation, child eating behaviors, and child height and weight. Hierarchical regression was used to examine the first aim; a cross-lagged panel analysis examined the second aim. Results An indulgent parental feeding style at ages 4–5 was associated with increased child BMI z-score at ages 7–9. Indulgent feeding significantly contributed to child BMI z-score beyond demographics, baseline child BMI z-score, parental acculturation, and child eating behaviors. Regarding the direction of effects in parental feeding interactions, the cross-lagged analyses showed that both indulgent feeding style and authoritative feeding style at Time 1 positively predicted child BMI z-scores at Time 3. Child effects were significant as well. Child BMI z-score at Time 1 positively predicted indulgent feeding and negatively predicted authoritarian feeding at Time 3. Conclusions Indulgent feeding should be addressed in future family-focused childhood obesity initiatives focused on young children and their parents.

Effect of Family-Based REDUCE Intervention Program on Children Eating Behavior and Dietary Intake: Randomized Controlled Field Trial

The objective of this study was to evaluate the effect of a family-based intervention program (REDUCE) on children’s eating behaviors and dietary intake. A two-arm randomized controlled field trial was conducted among parents and children of 7 to 10 years old who were either overweight or obese. The intervention was conducted via face-to-face sessions and social media. The child eating behaviors were assessed using the child eating behaviors questionnaire (CEBQ), while their dietary consumption of vegetables and unhealthy snacks was assessed using a parental report of three days unweighted food. The generalized linear mixed modelling adjusted for covariates was used to estimate the intervention effects with alpha of 0.05. A total of 122 parents (91% response rate) completed this study. At the six-month post-training, there were statistically significant mean differences in the enjoyment of food (F(6481) = 4.653, p < 0.001), fruit and vegetable intake (F(6480) = 4.165, p < 0.001) and unhealthy snack intake (F(6480) = 5.062, p < 0.001) between the intervention and wait-list groups; however, it was not clinically meaningful. This study added to the body of knowledge of family-based intervention that utilized social media and assessed the effect in children’s eating behavior using the CEBQ and children’s dietary intake.