Caregiver Feeding Practices as Predictors for Child Dietary Intake in Low-Income, Appalachian Communities

Abstract

The Appalachian region of the U.S. is disproportionately impacted by poverty, obesity, and nutrition-related chronic diseases. Evidence suggests that caregiver feeding practices may promote healthful eating behaviors among children; however, this has not been examined in low-income, rural, Appalachian populations. This study examines caregiver feeding practices as predictors for child diet in low-income Appalachian families, using a cross-sectional analysis of 178 caregivers of young children (ages 2–10 years old), that were recruited from low-income, rural communities in East Tennessee, from November 2017 to June 2018. Caregivers self-reported measures of demographics, feeding practices, and child dietary intake. Multiple linear regression analyses were run, and found that higher use of caregiver modeling positively predicted child vegetable consumption (Beta = 1.02; p = 0.04). Higher caregiver intake of fruits and vegetables positively predicted child fruit consumption (Beta = 0.29; p = 0.02) and vegetable consumption (Beta = 1.56; p < 0.001), respectively. Higher home availability of healthier foods positively predicted child fruit consumption (Beta = 0.06; p = 0.002) and vegetable consumption (Beta = 0.09; p = 0.05). Higher home availability of less healthy foods positively predicted child consumption of high-sugar/high-fat snack foods (Beta = 0.59; p = 0.003). The findings of this study indicate that caregiver modeling, healthy caregiver dietary intake, and healthful home food availability are associated with healthier child dietary intake among young children in low-income, rural, Appalachian areas. Promoting these practices among caregivers may be an important strategy to enhancing dietary intake of children in this hard-to-reach, underserved population.

Contributing Factors to Dietary Quality and Food Security in Low-Income Households with Children in the United States: A Scoping Review

“…Four studies showed an association between parent modeling and increased fruit and vegetable intake among children while modeling of energy-dense food was associated with increased sugar sweetened beverage intake 42,43,44,45,46 . One study reported healthy eating modeling was associated with reduced child consumption of high-sugar/high-fat snacks 45 . In 5 studies, parental modeling acted as a support for encouraging healthy eating behaviors among children 47,48,49,50,51 .…”

“…Parental behaviors investigated included parental modeling, feeding practices, parental attitudes and support, and parenting styles. Parental modeling, in 11 of the studies 41,42,43,44,45,46,47,48,49,50,51 , refers to a parent’s effort to demonstrate healthy food choices and healthy eating behaviors with the objective that the child will exhibit similar behaviors. Parental modeling was associated with shaping child’s eating behaviors 41 .…”

“…One study reported an association between food security status and the availability of vegetables in the home 70 , while two studies reported an association between availability of fruit and vegetables in the home and increased child consumption of fruit and vegetables 93,94 . Similarly, two studies also suggested that the healthfulness of foods available may be associated with child's dietary quality, with increased fruit and vegetable intake 45,71 . Consistently, results indicate a relationship between the availability of healthy foods in the home and improved dietary quality and food security.…”

“…Parental modeling was associated with shaping child's eating behaviors 41 . Four studies showed an association between parent modeling and increased fruit and vegetable intake among children while modeling of energy-dense food was associated with increased sugar sweetened beverage intake 42,43,44,45,46 . One study reported healthy eating modeling was associated with reduced child consumption of high-sugar/high-fat snacks 45 .…”

“…Food preparation behaviors like incorporating meal planning, kitchen/cooking supplies, cooking skills, and food availability were addressed in 12 studies 13,5,59,60,70,71,72,73,74,93,94 . Availability of healthy foods was associated with dietary quality and food security in five of the studies 45,70,71,93,94 . One study reported an association between food security status and the availability of vegetables in the home 70 , while two studies reported an association between availability of fruit and vegetables in the home and increased child consumption of fruit and vegetables 93,94 .…”