Maternal feeding practices in relation to dietary intakes and BMI in 5 year-olds in a multi-ethnic Asian population

Abstract

BackgroundIn Asia, little is known about how maternal feeding practices are associated with dietary intakes and body mass index (BMI) in preschoolers.ObjectiveTo assess the relationships between maternal feeding practices with dietary intakes and BMI in preschoolers in Asia using cross-sectional analysis in the GUSTO (Growing Up in Singapore Towards healthy Outcomes) cohort.Participant settingsMothers (n = 511) who completed the Comprehensive Feeding Practices Questionnaire (CFPQ) and a semi-quantitative Food Frequency Questionnaire (FFQ) when children were 5 years old.Statistical analysisAssociations between 12 maternal feeding practices (mean scores divided into tertiles) and children’s dietary intakes of seven food groups and BMI z-scores were examined using the general linear regression model. Weight and height of the child were measured, and dietary intakes derived from the FFQ.ResultsCompared to those in the low tertile, mothers in the high tertile of modelling healthy food intakes had children with higher intakes of vegetables[+20.0g/day (95%CI:11.6,29.5)] and wholegrains[+ 20.9g/day (9.67,31.1)] but lower intakes of sweet snacks[-10.1g/day (-16.3,-4.94)] and fast-foods[-5.84g/day (-10.2,-1.48)]. Conversely, children of mothers in the high tertile for allowing child control (lack of parental control) had lower intake of vegetables[-15.2g/day (-26.6,-5.21)] and wholegrains[-13.6g/day (-22.9,-5.27)], but higher intakes of sweet snacks[+13.7g/day (7.7, 19.8)] and fast-foods[+6.63g/day (3.55,9.72)]. In relation to BMI at 5 years, food restrictions for weight was associated with higher BMI z-scores [0.86SD (0.61,1.21)], while use of pressure was associated with lower BMI z-scores[-0.49SD(-0.78,-0.21)].Conclusions and implicationsModelling healthy food intakes by mothers was the key feeding practice associated with higher intakes of healthy foods and lower intakes of discretionary foods. The converse was true for allowing child control. Only food restrictions for weight and use of pressure were associated with BMI z-scores.

Obesity and Obesogenic Behaviors in Asian American Children with Immigrant and US-Born Mothers

“…This finding differs from a study showing that Asian American preschool-age children with immigrant mothers are less likely to be obese than those with US-born mothers [7]. The contrast may be due to mothers being particularly influential on the diet [15] and physical activity [18] of younger children. The older children included in our study might be more influenced by external factors that attenuate any protective effects of having immigrant mothers.…”

“…As immigrants settle in the US, they may adopt Western obesogenic behaviors through acculturation, a complex process through which individuals from one culture adopt the practices of another [5,11]. Given the role of maternal influence on dietary [12][13][14][15] and sedentary behaviors [16][17][18], mothers may pass obesogenic habits onto their children and increase their obesity risk. Exploring how acculturation might influence obesity and obesogenic behaviors may identify opportunities for intervention.…”

Longitudinal Analysis Between Maternal Feeding Practices and Body Mass Index (BMI): A Study in Asian Singaporean Preschoolers

“…All the final covariates contributed to more than a 5% effect estimate change in the adjusted models compared to the unadjusted models. Furthermore, all covariates except for age at CFPQ assessment were previously reported to be associated with both maternal feeding practices and child BMI outcomes from our GUSTO cohort findings (22, 45, 46). Statistical significance in the linear regression models was identified by a P -value of <0.002, determined by applying the Bonferroni corrections accounting for the maximum 24 outcome variables examined in this study, and to minimize type I errors due to multiple comparisons.…”

“…Pushing the child to eat more at 3 years of age (5 items, e.g., “Made child eat all the food on the plate”) had the highest correlation values to subscales encouraging balance and variety ( r = 0.13), and pressure to eat ( r = 0.20) at 5 years of age, and was chosen as a baseline feeding practice. Based on an observation from our cohort study, encouraging balance and variety was associated with increased intake of vegetables in this cohort, which shows that it's quite likely these same parents were also the same ones who were pushing their children to eat more (22). Similarly, concern about child overeating or overweight at 3 years of age (7 items, e.g., “Had to stop child from eating too much”) was chosen as a baseline feeding practice for restriction for weight control at age 5 years because of its highest correlation value ( r = 0.33) (Supplementary Table 1).…”

Fairness-Based Tasks for Assessing Children’s Perceptions of Food Quantities and Associations with Portion Selection

“…A number of factors have been reported to impact children’s diet and energy intake, such as parental feeding practices [ 3 , 4 , 5 , 6 ], children’s food approach or food avoidance appetitive traits [ 7 , 8 ], children’s oral processing behaviors [ 9 , 10 ], and the sensory characteristics of the food that can influence the perception of quantities. Among the sensory cues that drive the eating experience, visual attributes seem to play a significant role on the amount of food selected and eaten [ 11 ].…”