Assistant Professor Wake Forest School of Medicine Wake Forest School of Medicine Winston-Salem, North Carolina, United States
Background: Parents commonly report that their 3-5-year-old children are picky eaters (eat a small variety of foods) or do not eat enough, concordant with the age-normal physiologic dip in body mass index (BMI). These concerns often lead parents to pressure their children to eat. Children who are pressured to eat can have decreased self-regulation of eating and higher levels of overeating in response to emotion, which may place them at greater risk for obesity. However, most of these relationships have been examined in separate cohorts.
Objective: We aimed to assess if parental concern for picky eating and undereating are associated with pressure to eat and increased child BMI z-score (BMIz).
Design/Methods: We recruited 300 parents of healthy 3-5-year-old children to complete a questionnaire assessing picky eating (food fussiness subscale of Child Eating Behavior Questionnaire), parental concern for undereating, pressure to eat (Child Feeding Questionnaire), and relevant covariates. Dyads’ heights and weights were measured and BMIz calculated using CDC growth charts. Structural equation modeling (SEM) was performed using Mplus to assess the relationships between parental concerns, pressure to eat, and child BMIz (Figure 1, Path Diagram). Covariates that were significant in bivariate analysis with p<0.1 were included in the final model. Measurement models were tested and refined, and the structural model was tested. Model fit was determined using multiple goodness-of-fit indices.
Results: Dyads were racially and socioeconomically diverse (Table 1). Mean picky eating scores were 2.79 (SD 0.80) and 13.3% of parents were concerned that their child didn’t eat enough. Mean pressure to eat score was 2.71 (SD 0.92) with 32% of parents exerting high pressure to eat (score >3). Picky eating was significantly associated with undereating. Pressure to eat was associated with undereating, picky eating, and lower child BMIz (Figure 1). The model demonstrated excellent goodness-of-fit with RMSEA=0.04, CFI=0.98, and TLI=0.97. Conclusion(s): In a single cohort of diverse 3-5 year old children, parent concerns about feeding were associated with increased pressure to eat, and pressure to eat was associated with decreased BMIz. We will follow this cohort over time to assess the effect of parent concerns and feeding practices on BMIz. Identifying the relationship of parental concerns and feeding practices is important to develop effective interventions to improve feeding practices and establish healthy weight trajectories in young children.
Authors/Institutions: Callie L. Brown, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States; Edward Ip, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States; Joseph Skelton, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States; Caroline Lucas, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States; Mara Vitolins, Wake Forest University School of Medicine, Winston Salem, North Carolina, United States