Sheryl presentation 5 26 11 version 5 sh2

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!