Background: Evidence of the association between parental childfeeding practices and the child's body mass index (BMI) is controversial, and bidirectional effects have been poorly studied. Objective: We aimed to examine bidirectional associations between parental child-feeding practices and BMI at 4 and 7 y of age. Design: This study included 3708 singleton children from the Generation XXI birth cohort with data on parental child-feeding practices and BMI at 4 and 7 y old. Feeding practices were assessed through a self-administered questionnaire by combining the Child Feeding Questionnaire and the Overt/Covert Control scale and then adapting it to Portuguese preschool children. Weight and height were measured according to standardized procedures, and age-and sex-specific BMI z scores were computed based on the WHO Growth References. Linear regression models were used to estimate the bidirectional associations between each practice and BMI z score. Crosslagged analyses were performed to compare the directions of those associations (the mean score of each practice and BMI z score at both ages were standardized to enable effect size comparisons). Results: After adjustments, pressure to eat and overt control at 4 y of age were associated with a lower BMI z score 3 y later (b: 20.05; 95% CI: 20.08, 20.03 and b: 20.05; 95% CI: 20.09, 20.01, respectively). Regarding the opposite direction of association, a higher BMI z score at 4 y of age was significantly associated with higher levels of restriction and covert control at 7 y of age (b: 0.06; 95% CI: 0.03, 0.08 and b: 0.06; 95% CI: 0.04, 0.08, respectively) and with lower levels of pressure to eat (b: 20.17; 95% CI: 20.20, 20.15). The only bidirectional practice, pressure to eat, was more strongly influenced by the BMI z score than the reverse (b standardized : 20.17 compared with b standardized : 20.04; likelihood ratio test: P , 0.001). Conclusions: We found that parents both respond to and influence the child's weight; thus, this child-parent interaction should be considered in future research.Am J Clin Nutr 2016;103:861-7.

The Home Self-Administered Tool for Environmental Assessment of Activity and Diet (HomeSTEAD) survey evaluates a broad spectrum of food parenting practices related to parental use of control, autonomy support, and structure. This study aims to test the psychometric properties of the Portuguese version of the HomeSTEAD family food practices survey in parents of 3–12 year old children. Data were collected from 184 parents/caregivers. We performed an exploratory factor analysis (EFA), calculated the internal consistency coefficients of each subscale, and tested for associations with children’s food intake and weight. Based on the EFA, 61 items were included in the Portuguese version of the HomeSTEAD family food practices survey, and were distributed among four Coercive Control Practices (16 items); five Autonomy Support Practices (17 items); and nine Structure Practices (28 items). All scales demonstrated an acceptable level of internal consistency. A higher body mass index (BMI) SD score in children was associated with higher levels of restriction and weight talk by parents and distractions during meals. Higher levels of distractions during meals were also associated with higher sweets intake in children. Additionally, higher levels of parental modeling and the establishment of rules and limits were associated with lower intake of sugar-sweetened beverages. These associations provide preliminary evidence of the HomeSTEAD family food practices survey’s construct validity and attest to its potential to assess parental strategies and provide useful information to improve children’s eating.

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Objective: To determine the impact of an educational program for primary schools that explored the biodiversity of tomato, by promoting science and sensory education with three distinct varieties of it, in the acceptance of vegetables. Design: A randomized controlled study in which children were exposed to the educational program (intervention group) or remained in the class, as usual (control group). The educational program consisted of three sessions where children explained the observed differences between the three varieties of tomato and individual perceptions of their flavors based on sensory-based food education and by planning and implementing experiments to explain those differences. We tested the effects on both children’s willingness to try and their liking for tomato, and for lettuce and cabbage to study the carry-over effect, compared with the control group (Mann-Whitney U test; p < 0.05). Setting: The study took place in public primary schools in Porto, Portugal. Participants: Children in the third grade (8-13-year-old children) (n 136) that were randomly assigned to intervention or control group. Results: Children in the intervention group reported significant increases in their willingness to try and liking for tomato compared to the control group (p < 0.05), but not for lettuce and cabbage (p > 0.05). Conclusions: These results highlight the potential for fostering children’s acceptance of a vegetable by exploring biodiversity through science education. Further work may clarify the effects of exploring biodiversity on the consumption of vegetables and establish whether the results are stable over time and replicable across contexts and populations.