sheryl presentation 5 26 11 version 5 sh2
TRANSCRIPT
Sheryl O. Hughes, PhD
Baylor College of Medicine
Children’s Nutrition Research Center
Do Parents Influence Children’s
Self-Regulation During Feeding?
Environment
BiologyGlass, McAtee, Soc Sci Med, 2006
Percent of US children &
adolescents who are obese*
Centers for Disease Control and Prevention, http://www.cdc.gov
*BMI-for-age >95th%tile
t
CHILD
Sedentary behavior
Physical activity
Activity parenting
Parents’ activity
Computers/TVs in home
Parents’ weight
Parenting/Feeding styles &
practices
FAMILY
Food available
Caregiver’s diet and
behaviors
Recreational facilities
Corner stores & restaurants
Culture
COMMUNITY
SES
CHILD OBESITY
Neighborhood safety
Work demands
School &childcare
meals
Adapted from Davison, Birch, Obes Rev, 2001
Foodstores
Eating Behavior
Sportsprograms
SchoolPE
Dietary Intake
Ecological perspective on child obesity
Attachment
Academic Achievement
Emotional Competence
Peer Relationships
Benefits of Optimal Parenting
Parents socialize their children
through helping them to internalize
goals, values and beliefs in order to
become productive members of
society.
Presentation Overview
• Parenting styles and their relationship to child weight
status
• Feeding styles and their relationship to child eating
behaviors and child weight status
– moderating effect of FS on the relationship between
feeding practices and child eating behaviors
• Current ongoing research on observations during
mealtime in low-income families
Parenting Styles
& child weight
9
Styles of general parenting
Demands
On
Child
Responsiveness To Child
Authoritative
Uninvolved Indulgent
Authoritarian
Reflect the larger context within which
practices are expressed
Baumrind, Dev Psych Monographs, 1971; Maccoby & Martin, 1983
High
High
Lo
Lo
Socialization
Goals & Values
Parenting Style
Parenting Practices
Child Willingness
to be Socialized
Child Eating and
Weight Outcomes
Darling & Steinberg, Psych Bull, 1993
-Overall attitude
toward child
-Goal directed behaviors
Rhee, K. E. et al., Pediatrics, 2006
NICHD Early Child Care and Youth Development Study
*Adjusted for income/needs ratio and race
• Over 800 1st grade children studied at 10 sites across the US
n = 298n = 132n = 263 n = 179
R
% O
bese
In a sample of middle-class,
predominantly White parents, this
study showed that the authoritarian
style is highly related to child
obesity!
Feeding Styles,
eating behaviors,
& child weight
Feeding stylesD
em
an
din
gn
ess
Responsiveness
AuthoritativeAuthoritarian
IndulgentUninvolved
Reflect the larger context within which
feeding practices are expressed
Actively encourage eating using non-
directive and supportive behaviors
Make few demands to eat but those
demands are supportive
Make few demands on children
to eat and are unsupportive
Encourage eating using highly directive
behaviors and are unsupportive
Lo High
Lo
High
Hughes et al., Appetite, 2005; Hughes et al., JDBP, 2008
Feeding style influences on child
eating behaviors and weight
Parent-report and observational studies of:
• 231 Hispanic and Black low-income families with preschoolers
in TX1
• 718 ethnically-diverse low-income preschoolers in TX, AL2
• 177 Hispanic and Black low-income preschoolers in TX 3
• 99 Hispanic, Black and White low-income rural children in KY,
CA, MS, SC 4
Laboratory study
• 61 ethnically diverse 5-6 year-old children5
1Hughes et al., Appetite, 2005; 2 Hoerr et al, IJBNPA, 2009; Hughes et al., JDBP, 2008; 3Hughes et al., under review; 4 Hennessy et al.,
Appetite, 2010; 5Fisher et al., unpublished;
Parents with Authoritative Feeding Styles
Report 1:
– More monitoring of eating
– Make fruit and vegetables more availableObserved at meals to be 2:
– Less negative, disapproving
– Give more promptsHave children 3:
– Smaller self-selected portions
– Eat more dairy, vegetables
1Hughes et al., Appetite, 2005; Patrick et al., Appetite, 2005; 2Hughes et al., under review; 3 Fisher et al, unpublished; Patrick et al., Appetite, 2005
Parents with Authoritarian Feeding Styles
Report 1:
– More restriction, pressure to eat
– Make fewer fruit and vegetables availableObserved at meals to be 2:
– Spoon-feeding, hurrying
– Telling child to eat small amount
– Disapproving, intrusiveHave children 3:
– Larger self-selected portions
– Eat fewer vegetables
1Hughes et al., Appetite, 2005; Patrick et al., Appetite, 2005; 2Hughes , under review; 3 Fisher et al, unpublished; Patrick et al., Appetite, 2005;
Parents with Indulgent Feeding Styles
Report 1:
– Less restrictive feeding
Observed at meals to be 2:
– Less involved in the meal
– Less negative and intrusive
– Make fewer eating demands
Have children 3:
– Larger self-selected portions
– Eat more energy-dense meals and snacks
– At a greater risk for obesity1Hughes et al., Appetite, 2005; 2Hughes , under review; 3 Fisher et al., unpublished;
Hennessy et al., under review; Hoerr et al, IJBNPA, 2009; Hughes et al., JDBP, 2008
In samples of low-income minority
parents, our studies consistently
showed that the indulgent feeding
style is related to less optimal child
eating behaviors and obesity!
Socialization
Goals & Values
Parenting Style
Parenting Practices
Child Willingness
to be Socialized
Child Eating and
Weight Outcomes
Darling & Steinberg, Psych Bull, 1993
-Overall attitude to
child
-Goal directed behaviors
• 99 Hispanic, Black, and White low-income families (child age 6 to 11 years)
• Rural families were recruited in four states (KY, CA, MS, and SC)
• Multiple measures
– Child Feeding Questionnaire (CFQ; feeding practices)
– Caregiver’s Feeding Style Questionnaire (CFSQ; feeding styles)
– 24 hour recalls on the children
– Heights and weights measured
Hennessy, Hughes, Goldberg & Hyatt, in press
Moderating effect of feeding styles
Moderating effect of styles on relationship
between restrictive practices and LNED foods
Hennessy, Hughes, Goldberg & Hyatt, in press
Moderating effect of styles on relationship
between parent monitoring and LNED foods
Hennessy, Hughes, Goldberg & Hyatt, in press
Summary and Conclusions
• Evidence of association between indulgent
feeding style and higher child weight
- Based on parent self-report
- Most of these studies were based on low-
income minority samples
- Observations are needed to support the self-
reported feeding styles in minorities
Observations
at dinnertime
Goal: To better understand indulgent feeding through observation including the emotional climate of the meal and specific feeding practices used by these parents
Observations during the dinner meal
Hughes et al., under review
• 177 Hispanic and Black low-income families with preschoolers
• 3 evening meal observations on each family
• Measures
– Caregiver’s Feeding Styles Questionnaire (CFSQ; parent-report)
– Live global coding of the emotional climate
– Live behavioral coding (feeding practices)
Observational study of meal times
Hughes et al., under review
Differences in Emotional Climate Variables
across Feeding Styles
Emotional Climate
Variables
Overall F = 2.98 p < .001
Positive Affect F = 1.50 ns
Negative Affect F = 5.28 p < .01
Intrusiveness F = 3.64 p < .05
Detachment F = 5.58 p < .001
Hughes et al., under review
Hughes et al, under review
Emotional Climate and Feeding Styles
Emotional climate of the meal
• Authoritarian parents were observed to be HIGHER on
– Negative Affect / Intrusion
• Uninvolved parents were observed to be HIGHER on
– Negative Affect / Detachment
• Authoritative and Indulgent parents (high
responsivity) were observed to be LOWER on
– Negative Affect / Intrusion
Feeding style differences on observed
feeding practices
Helps F = 1.00 ns
Spoon Feeds F = 3.67 p < .05
Physically Intervenes F = 3.33 p < .05
Verbal Prompts to Eat F = 2.68 p < .05
Eat Small Amount F = 4.06 p < .01
Eat All F = 0.89 ns
Hurries F = 2.79 p < .05
Reasons F = 2.23 p < .09
Comparison F = 0.54 ns
Praises/Approves F = 2.07 ns
Disapproves/Scolds F = 4.66 p < .01
Positive Comments Food F = 2.23 p < .09
Hughes et al, under review
Feeding style differences on observed
feeding practices
Authoritative Authoritarian Indulgent Uninvolved
Spoon Feeds
the child - + - -Physically
Intervenes+ -
Verbal
Prompts+ + - -
Eat Small
Amount - + - -Hurries the
child+ - -
Disapproves/
Scolds - + -
Practices during the meal
• FS w/high demand used some practices more
frequently than FS w/low demand
– Verbal prompts to eat
• Authoritarian FS (highly directive /low responsivity)
used specific practices more frequently than other FS
– Spoon feeding / Eat a small amount / Hurrying
• Authoritarian FS used punitive practices more
frequently than FS w/ high responsivity (authoritative
and indulgent)
– Disapproving/scolded
Indulgent Feeding Style was
observed to be:
• High on Detachment
• Low on Negative Affect &
Intrusiveness
• Made few demands on
their children to eat
Overall Conclusions
• Observations of both emotional climate during the
meal and specific feeding practices strongly
supported self-reported feeding styles
• Represents one of the first attempts to examine
emotional components of parents during the meal
through direct observation
• Attempts to define the infrastructure of parent/
child interactions during eating
• Level of Directiveness (risk low with moderate levels)
• Responses to internal cues (risk low if responsive and high if overrides)
• Responses to exploring food (risk low if positive)
– Distinguish between exploring and playing with food
• Emphasis on manners (risk low with moderate levels)
– Emphasis on sitting properly, being quiet, etc.
• Emphasis on developing eating skills and autonomy
• Emotional responsiveness (risk low if responsive)
– Global ratings of positive affect, negative affect, intrusion, and detachment
– Responsiveness to child behaviors (verbalizations , gestures)
Current coding of audio/video tapes
High Low
Verbal Threats Suggests
Punishments Asks questions
Begs Hints
Tells
Non-verbal Spoon feeds Moves food closer
Physically forces Arranges food
Physically punishes Serves
Level of Directiveness
Hughes, Goodell, Johnson, Power (in progress)
How much is
enough?
• Explicit – hunger & fullness
statements
• Implicit – stops eating, serves self
Responses to Internal Cues
Hughes, Goodell, Johnson, Power (in progress)
Was the parent feeding style in this
sample (assessed by observation)
related to child weight status?
Design for preliminary coding of the
dinner meal audio/videotapes
Child Weight Status
Male Female
Normal weight n = 26 (10) n = 22 (10)
Overweight/Obese n = 17 (10) n = 16 (10)
Child Weight Status
Male Female
Normal weight n = 16 (10) n = 20 (10)
Overweight/Obese n = 11 (10) n = 10 (10)
Black:
Hispanic:
Hughes, Goodell, Johnson, Power (in progress)
Coding of Mealtime Behaviors:
Feeding Styles (assessed by observation)
and Child Weight
Percent of
overweight/obese
children*
Hughes, Goodell, Johnson, Power (in progress)
* BMI-for-age >85th%tile
Balance between Responsiveness and
Demandingness
Responsiveness
Demandingness
-Encouragement and discouragement
Hughes et al Appetite 2005
-Sensitivity/warmth to child
• Research was supported by funds from USDA NRI grant 2006-55215-16695
• Research was supported by funds from NICHD grant R01 HD062567
• Research was supported by funds from USDA AFRI grant 2011-68001-30009
Acknowledgements
Future research!