Sheryl O. Hughes

Revisiting a neglected construct: parenting styles in a child-feeding context

The extent to which general parenting represents feeding styles in ethnically diverse populations is not well documented. Existing measures of child feeding have focused almost exclusively on specific behaviors of European-American parents. A valid and reliable instrument was developed to identify feeding styles in parents of low-income minority preschoolers. Two hundred thirty-one parents (130 Hispanic; 101 African-American) completed questionnaires on feeding practices and parenting styles. Based on self-reported feeding behavior, parents were assigned to four feeding styles (authoritarian, n=84; authoritative, n=34; indulgent, n=80; and uninvolved, n=33). Convergent validity was evaluated by relating feeding styles to independent measures of general parenting and authoritarian feeding practices. Authoritarian feeding styles were associated with higher levels of general parental control and authoritarian feeding practices. Alternatively, authoritative feeding styles were associated with higher levels of general parental responsiveness. Among the two permissive feeding styles, Hispanic parents were more likely to be indulgent, whereas African-American parents were more likely to be uninvolved. Further, differences were found among the feeding styles on an independent measure of childs body mass index.

Indulgent Feeding Style and Children’s Weight Status in Preschool

Purpose: The primary aim of this study was to examine whether parent affect and child temperament characteristics differ across feeding styles in low-income families, given suggestive evidence. The secondary aim was to examine whether feeding styles were still related to children’s body mass index independent of parent affect, child temperament, and known correlates. Methods: Participants in this study were 718 parents of childrens attending Head Start programs across two sites (Texas and Alabama). Parents were categorized into feeding styles of authoritative (n = 118), authoritarian (n = 219), indulgent (n = 240) and uninvolved (n = 141) using a parent-report questionnaire characterizing feeding in a general parenting paradigm. Parents completed questionnaires and measured height and weight was obtained from parents and children. Results: Differences were found across feeding styles on parent affect and child temperament characteristics. Indulgent parents reported lower Negative Affect for themselves and lower Negative Affectivity for their children. The indulgent feeding style was significantly associated with higher child body mass index after controlling for parent affect, child temperament, and correlates (ethnicity, child age, parent body mass index). Conclusions: The results of this study not only show a robust association between the indulgent feeding style and weight status of low-income preschool childrens, but also suggest how congruence between parent emotional affect and child temperament characteristics may contribute to excess consumption among children of indulgent parents.

A Systematic Review of Responsive Feeding and Child Obesity in High-Income Countries

Child overweight/obesity continues to be a serious public health problem in high-income countries. The current review had 3 goals: 1) to summarize the associations between responsive feeding and child weight status in high-income countries; 2) to describe existing responsive feeding measures; and 3) to generate suggestions for future research. Articles were obtained from PubMed and PsycInfo using specified search criteria. The majority (24/31) of articles reported significant associations between nonresponsive feeding and child weight-for-height Z-score, BMI Z-score, overweight/obesity, or adiposity. Most studies identified were conducted exclusively in the United States (n = 22), were cross-sectional (n = 25), and used self-report feeding questionnaires (n = 28). A recent trend exists toward conducting research among younger children (i.e. infants and toddlers) and low-income and/or minority populations. Although current evidence suggests that nonresponsive feeding is associated with child BMI or overweight/obesity, more research is needed to understand causality, the reliability and validity between and within existing feeding measures, and to test the efficacy of responsive feeding interventions in the prevention and treatment of child overweight/obesity in high-income countries.

Measuring feeding in low-income African–American and Hispanic parents

Current feeding measures have been developed based on the premise that a childs obesity risk is increased when parents exert high levels of control over feeding. Although these measures provide useful ways to assess parental restrictiveness in feeding, they do not capture other important aspects of feeding that describe the behavior of parents not overly concerned about child obesity. Alternative measures are important to develop, especially for minority populations where concerns about child obesity are often not a significant determinant of parental feeding practices. The current study describes a culturally informed method used to develop a broader assessment of parental feeding strategies across two low-income ethnic groups. To be able to accurately measure cultural differences associated with feeding, qualitative and quantitative methods were used to assure conceptual, linguistic, and measurement equivalency across African-American and Hispanic parents. Based on responses from 231 parents, mean differences in feeding strategies were found with Hispanic parents reporting significantly more parent-centered/high control and child-centered feeding strategies compared to African-Americans. Furthermore, the relationship between childrens weight status and parental feeding strategies varied by the two ethnic groups and child gender. Implications of these results for understanding the role of parental socialization in the development of child obesity are discussed.

Associations among parental feeding styles and children's food intake in families with limited incomes

BackgroundAlthough general parenting styles and restrictive parental feeding practices have been associated with childrens weight status, few studies have examined the association between feeding styles and proximal outcomes such as childrens food intake, especially in multi-ethnic families with limited incomes. The purpose of this study was to evaluate the association of parental feeding styles and young childrens evening food intake in a multiethnic sample of families in Head Start.MethodsParticipants were 715 Head Start children and their parents from Texas and Alabama representing three ethnic groups: African-American (43%), Hispanic (29%), and White (28%). The Caregivers Feeding Styles Questionnaire (Hughes) was used to characterize authoritative, authoritarian (referent), indulgent or uninvolved feeding styles. Food intake in several food groups was calculated from 3 days of dietary recalls for the child for evening food intakes from 3 PM until bedtime.ResultsCompared to children of authoritarian parents, intakes of fruits, juice and vegetables were lowest among children of indulgent or uninvolved parents (1.77 ± 0.09 vs 1.45 ± 0.09 and 1.42 ± 0.11 cups) as were intakes of dairy foods (0.84 ± 0.05 vs 0.67 ± 0.05 and 0.63+0.06 cups), respectively.ConclusionFindings suggest that permissive parent feeding styles like indulgent or uninvolved relate negatively to childrens intake of nutrient-rich foods fruit, 100% fruit juice, vegetables and dairy foods from 3 PM until bedtime.

Parent behavior and child weight status among a diverse group of underserved rural families.

The purpose of this study was threefold: to investigate the association between three parenting behaviors (parenting style, feeding style, and feeding practices), to evaluate whether these behaviors were associated with child weight, and to determine whether style (parenting and feeding) moderated the relationship between feeding practice and child weight. Ninety-nine parent-child dyads were recruited for a cross-sectional study where parents self-reported their parenting style, feeding style, and feeding practices along with demographic characteristics. Height and weight were measured for each dyad. The relationship between parenting style and feeding style showed modest agreement. Feeding style, but not parenting style, was associated with child BMI z-score while controlling for known covariates. An indulgent feeding style was associated with a higher child weight status. Multiple regression analysis demonstrated that feeding style moderated the association between restrictive feeding practices and child BMI z-score. No moderating relationship was found between feeding style and the practices of pressure to eat or monitoring and child weight. This research suggests that an indulgent feeding style may be predictive of higher child weight and that future studies should examine the possible moderating role of feeding style in the parent feeding practice-child weight relationship.

The Impact of Child Care Providers' Feeding on Children's Food Consumption

Background: In young children, the eating environment is an important social context within which eating behaviors develop. Among many low-income young children, the responsibility for feeding may have shifted from family members to child care providers because these children spend the majority of their day in child care settings. Methods: To examine the influence of feeding among low-income children in child care settings, feeding behaviors of child care providers in Head Start were observed and food consumption was assessed. Head Start, a comprehensive child development program that serves children from ages 3 to 5, was chosen because of the large percentage of minorities, the low-income status of the families, and the age of the children. Fifty child care providers (25 African-American; 25 Hispanic) randomly selected from Head Start centers in a large, urban southwestern city were observed on three mealtime occasions and self-reported feeding styles were assessed. Observed feeding behaviors were categorized into four feeding patterns based on their conceptual similarity to a general parenting typology (i.e., authoritarian, authoritative, indulgent, and uninvolved). Measures of food consumption were assessed on 549 children sitting with the child care providers during lunch at the Head Start centers. Results: Indulgent feeding behaviors were positively related to children’s consumption of vegetables, dairy, entrée, and starch; authoritative feeding behaviors were positively related to dairy consumption. Conclusion: This research highlights the important influence that child care providers have in the development of healthy and unhealthy eating behaviors in minority children. Implications for intervention training for child care providers to promote healthy eating among Head Start children are discussed.

Parent-child interactions and objectively measured child physical activity: a cross-sectional study.

BackgroundParents influence their childrens behaviors directly through specific parenting practices and indirectly through their parenting style. Some practices such as logistical and emotional support have been shown to be positively associated with child physical activity (PA) levels, while for others (e.g. monitoring) the relationship is not clear. The objectives of this study were to determine the relationship between parents PA-related practices, general parenting style, and childrens PA level.MethodsDuring the spring of 2007 a diverse group of 99 parent-child dyads (29% White, 49% Black, 22% Hispanic; 89% mothers) living in low-income rural areas of the US participated in a cross-sectional study. Using validated questionnaires, parents self-reported their parenting style (authoritative, authoritarian, permissive, and uninvolved) and activity-related parenting practices. Height and weight were measured for each dyad and parents reported demographic information. Child PA was measured objectively through accelerometers and expressed as absolute counts and minutes engaged in intensity-specific activity.ResultsSeventy-six children had valid accelerometer data. Children engaged in 113.4 ± 37.0 min. of moderate-vigorous physical activity (MVPA) per day. Children of permissive parents accumulated more minutes of MVPA than those of uninvolved parents (127.5 vs. 97.1, p < 0.05), while parents who provided above average levels of support had children who participated in more minutes of MVPA (114.2 vs. 98.3, p = 0.03). While controlling for known covariates, an uninvolved parenting style was the only parenting behavior associated with child physical activity. Parenting style moderated the association between two parenting practices - reinforcement and monitoring - and child physical activity. Specifically, post-hoc analyses revealed that for the permissive parenting style group, higher levels of parental reinforcement or monitoring were associated with higher levels of child physical activity.ConclusionsThis work extends the current literature by demonstrating the potential moderating role of parenting style on the relationship between activity-related parenting practices and childrens objectively measured physical activity, while controlling for known covariates. Future studies in this area are warranted and, if confirmed, may help to identify the mechanism by which parents influence their childs physical activity behavior.

Feeding styles and child weight status among recent immigrant mother-child dyads

BackgroundResearch has shown that parental feeding styles may influence children’s food consumption, energy intake, and ultimately, weight status. We examine this relationship, among recent immigrants to the US. Given that immigrant parents and children are at greater risk for becoming overweight/obese with increased time in the US, identification of risk factors for weight gain is critical.MethodsBaseline data was collected on 383 mother-child dyads enrolled in Live Well, a community-based, participatory, randomized controlled lifestyle intervention to prevent weight gain in recent immigrant mothers. Socio-demographic information together with heights and weights were collected for both mother and child. Acculturation, behavioral data, and responses to the Caregiver’s Feeding Styles Questionnaire (CFSQ) were also obtained from the mother.ResultsThe children’s average age was 6.2 ± 2.7 years, 58% male. Mothers had been in the country for an average of 6.0 ± 3.3 years, and are Brazilian (36%), Haitian (34%) and Latino (30%). Seventy-two percent of the mothers were overweight/obese, while 43% of the children were overweight/obese. Fifteen percent of mothers reported their feeding style as being high demanding/high responsive; 32% as being high demanding/low responsive; 34% as being low demanding/high responsive and 18% as being low demanding/low responsive. In bivariate analyses, feeding styles significantly differed by child BMIz-score, ethnic group, and mother’s perceived stress. In multiple linear regression, a low demanding/high responsive feeding style was found to be positively associated (ß = 0.56) with a higher child weight as compared to high demanding/high responsive, controlling for known covariates (p = 0.01).ConclusionsMost mothers report having a low demanding/high responsive feeding style, which is associated with higher child weight status in this diverse immigrant population. This finding adds to the growing literature that suggests this type of feeding style may be a risk factor for childhood obesity. Further research is needed to help understand the larger socio-cultural context and its influence on feeding dynamics among immigrant families and families of lower incomes. How parents establish a certain feeding style in their home country compared to when they move to the US “obesogenic” environment, should also be explored.

Permissive Parental Feeding Behavior Is Associated with an Increase in Intake of Low-Nutrient-Dense Foods among American Children Living in Rural Communities

Parents play an important role in shaping childrens eating habits. Few studies have evaluated the influence of both parenting style and parenting practices on child outcomes such as dietary intake. During spring 2007, 99 parent-child dyads from four rural US areas participated in this cross-sectional study. Child food intake was reported during two interviewer-administered, parent-assisted 24-hour recalls. Diet quality was defined as the average number of low-nutrient-dense (LND) foods consumed. Validated questionnaires were used to assess parental feeding practices and feeding style. Pearson correlations identified relationships among child food intake, parental feeding style typologies, and covariates. Regression analyses were used to predict child diet quality. Sixty percent of children and 76% of parents were overweight or obese. A permissive feeding style, which is highly responsive to a childs requests and sets few demands on him or her, was the most common (n=37) parental feeding style. This feeding style was associated with child intake of LND foods (r=0.3; P<0.001) and moderated the relationship between parental feeding practices and child intake of LND foods. In the presence of a permissive feeding style, higher levels of monitoring were associated with child intake of LND foods (β=.69; P<0.05). Parental feeding style may alter the effectiveness of parental feeding practices on childrens food intake. More research is needed to understand the parent-child feeding relationship in the context of parental feeding styles and practices.