The aim of this study was to test the hypothesis that youths with obesity, when removed from structured school activities and confined to their homes during the coronavirus disease 2019 pandemic, will display unfavorable trends in lifestyle behaviors. Methods: The sample included 41 children and adolescents with obesity participating in a longitudinal observational study located in Verona, Italy. Lifestyle information including diet, activity, and sleep behaviors was collected at baseline and 3 weeks into the national lockdown during which home confinement was mandatory. Changes in outcomes over the two study time points were evaluated for significance using paired t tests. Results: There were no changes in reported vegetable intake; fruit intake increased (P = 0.055) during the lockdown. By contrast, potato chip, red meat, and sugary drink intakes increased significantly during the lockdown (P value range, 0.005 to < 0.001). Time spent in sports activities decreased by 2.30 (SD 4.60) h/wk (P = 0.003), and sleep time increased by 0.65 (SD 1.29) h/d (P = 0.003). Screen time increased by 4.85 (SD 2.40) h/d (P < 0.001). Conclusions: Recognizing these adverse collateral effects of the coronavirus disease 2019 pandemic lockdown is critical in avoiding depreciation of weight control efforts among youths afflicted with excess adiposity. Depending on duration, these untoward lockdown effects may have a lasting impact on a child's or adolescent's adult adiposity level.

Although research shows that "food parenting practices" can impact children's diet and eating habits, current understanding of the impact of specific practices has been limited by inconsistencies in terminology and definitions. This article represents a critical appraisal of food parenting practices, including clear terminology and definitions, by a working group of content experts. The result of this effort was the development of a content map for future research that presents 3 overarching, higher-order food parenting constructs--coercive control, structure, and autonomy support--as well as specific practice subconstructs. Coercive control includes restriction, pressure to eat, threats and bribes, and using food to control negative emotions. Structure includes rules and limits, limited/guided choices, monitoring, meal- and snacktime routines, modeling, food availability and accessibility, food preparation, and unstructured practices. Autonomy support includes nutrition education, child involvement, encouragement, praise, reasoning, and negotiation. Literature on each construct is reviewed, and directions for future research are offered. Clear terminology and definitions should facilitate cross-study comparisons and minimize conflicting findings resulting from previous discrepancies in construct operationalization.

FAITH, MYLES S., KELLEY S. SCANLON, LEANN L.BIRCH, LORI A. FRANCIS, AND BETTYLOU SHERRY. Parent-child feeding strategies and their relationships to child eating and weight status. Obes Res. 2004;12:1711-1722. Parental feeding styles may promote overeating or overweight in children. A comprehensive literature review was undertaken to summarize the associations between parental feeding styles and child eating and weight status. Twentytwo studies were identified. We systematically coded study attributes and outcomes and tested for patterns of association. Nineteen studies (86%) reported at least one significant association between parental feeding style and child outcome, although study methodology and results varied considerably. Studies measuring parental feeding restriction, as opposed to general feeding control or another feeding domain, were more likely to report positive associations with child eating and weight status. Certain associations differed by gender and by outcome measurement (e.g., rate of eating as opposed to total energy intake). Parental feeding restriction, but no other feeding domain, was associated with increased child eating and weight status. Longitudinal studies are needed to test underlying causal pathways, including bidirectional causal models, and to substantiate findings in the presence of other obesity risk factors.

No abstract

Background: Weight control programs for obese children monitor change in body mass index (BMI) adjusted for age. However, change can be measured in several ways: raw (kg/m 2 ) units, percentage, z-scores or centiles. The suitability of the different measures is not known. Aim: To identify the optimal BMI measure for change, whose short-term variability is most consistent for children across the spectrum of adiposity. Setting: An Italian kindergarten. Subjects: A total of 135 (66 female) children aged 29-68 months at baseline, with BMI measured three times over a 9-month period. Methods: Each child's short-term variability in adiposity was summarized by the standard deviation (s.d.) of BMI and BMI % adjusted for age, and BMI z-score and BMI centile. The s.d.'s were then compared in obese and nonobese children, and also correlated with each child's baseline BMI z-score. Results: The within-child s.d.s of BMI z-score and BMI centile were significantly smaller in obese than nonobese children, while the s.d.s of BMI and BMI % were similar in the two groups. Also, the within-child s.d.s of z-score and centile, and to a lesser extent BMI %, were significantly inversely correlated with baseline z-score, whereas the s.d. of BMI was not. The changes in adiposity over time, as assessed by the four measures, were very highly correlated with each other, particularly for BMI with BMI %. Discussion: Even though BMI z-score is optimal for assessing adiposity on a single occasion, it is not necessarily the best scale for measuring change in adiposity, as the within-child variability over time depends on the child's level of adiposity. Better alternatives are BMI itself or BMI %. Our results underscore the importance of using a relatively stable method to assess adiposity change when following children at risk of obesity.