Interactive effects of impulsivity and dietary restraint over snack intake in children.

Impulsivity and dietary restraint have been found to interact to affect dietary intake in adults. Few studies have explored this effect in children. The current study therefore aimed to investigate the interactive effects of behavioural impulsivity and dietary restraint on intake. Fifty 7-11-year-olds participated in this laboratory-based study. Impulsivity was assessed through behavioural tasks measuring a number of impulsivity facets. Children self-reported dietary restraint. Children visited the lab and had access to a range of snack foods; intake was recorded. Hunger at arrival was assessed. A series of 2 x 2 between-subjects ANCOVAs indicated that motor impulsivity and dietary restraint interacted to affect intake. Reward sensitivity, delay of gratification and inhibitory control did not interact with dietary restraint. Post-hoc analyses indicated that children high in motor impulsivity and restraint ate significantly more snacks than restrained children low in motor impulsivity. Furthermore, children low in motor impulsivity but high in dietary restraint were better at inhibiting their intake than children low in impulsivity and dietary restraint. The results indicate that high levels of impulsivity or dietary restraint in isolation do not affect children's dietary intake but that their combination may lead to overeating in food rich environments.

Children overcoming picky eating (COPE) - A cluster randomised controlled trial.

OBJECTIVES: Food neophobia limits dietary variety in children and adults. Interventions to alleviate the impact of neophobia on children's dietary variety have had varying success. The potential effectiveness of mindfulness, a process of bringing awareness to the present moment, has received little attention. This trial aimed to explore the effectiveness of two mindfulness exercises on novel food acceptance for children. METHODS: A cluster-randomised controlled trial with three trial arms compared the impact of two mindfulness exercises (mindful breathing and mindful raisin-eating) and a non-mindful control task on anticipated liking and intake of a novel fruit. Seventy-one children aged 10-12 years engaged in one of the three tasks at school over five days and were offered a novel fruit at the end of the intervention. Children self-reported mindfulness, food neophobia and anxiety at baseline and follow-up. RESULTS: Two mixed-effects models showed that, controlling for school effects and covariates (including mindfulness, food neophobia and anxiety), children in the mindful raisin-eating arm reported greater anticipated liking of a novel fruit and children in both mindfulness arms consumed greater amounts of a novel fruit than children in the control arm. Mixed-design ANOVAs indicated that mindfulness, food neophobia and anxiety did not change over time in each trial arm. CONCLUSIONS: The results provide promising evidence for the potential effectiveness of mindfulness interventions in encouraging children to try new foods. The mechanisms underlying effectiveness remain unclear and further research, exploring long-term effects and the possibility to generalise these findings to other food groups such as vegetables, is needed.

Infant temperament, maternal feeding behaviours and the timing of solid food introduction.

Despite guidance from the World Health Organization and the U.K. Department of Health, many mothers introduce solid food before their infant is 6 months old. The current study aimed to investigate relationships between maternal feeding behaviours (preintroduction and postintroduction to solids), infant temperament, and the timing of introduction to solid food. Eighty-one women were recruited on low-risk maternity units and were contacted at 1 week, 3, and 6 months postpartum. Mothers of infants (45 males, 36 females, mean birth weight 3.52 kg [SD 0.39]) completed the behaviours component of the Infant Feeding Style Questionnaire via telephone interview at 3 months. At 6 months, they were observed feeding their infant solid food at home and reported infant temperament using the Infant Behaviour Questionnaire-Revised (short form). Partial correlations (covariates: birth weight, maternal age, breastfeeding duration, and postnatal depression) revealed negative associations between age of introduction to solid food and temperament (smiling and laughter) and laissez-faire milk feeding behaviours; and positive associations between age of introduction to solid food and restrictive milk feeding behaviours and verbal involvement during an observed mealtime. Hierarchical multiple regression analysis revealed that an infant's birth weight and the degree to which their mothers perceive them to smile and laugh are key predictors of when they will be introduced to solid food, over and above other variables of interest (e.g., maternal milk feeding behaviours, breastfeeding duration, and postnatal depression).

The Montreal Children's Hospital Feeding Scale: Relationships with parental report of child eating behaviours and observed feeding interactions.

Feeding problems are common, with implications for nutrition, growth and family stress, placing burden on primary care services. The Montreal Children's Hospital Feeding Scale (MCHFS) is a quick and reliable measure of feeding problems for clinical settings, but there is little examination of its relationship to commonly used research measures of parental feeding practice, child eating behaviour and observations of parent-infant interaction at mealtimes. We examined the relationships between the MCHFS, demographics and early feeding history, weight across the first year, parental report of feeding practices and child eating behaviours, and observations of maternal-infant feeding interaction at 1 year. The MCHFS, Comprehensive Feeding Practices Questionnaire (CFPQ) and Child Eating Behaviour Questionnaire (CEBQ) were completed by 69 mothers when their infants were 1-year-old (37 male, 32 female). Infant weight was measured at 1 week, 1 month, 6 months and 1 year. Mothers were observed feeding their infants at 1 year. The MCHFS was reliable (Cronbach's alpha = .90) and showed significant overlap with other measures of feeding and eating. Potential feeding problems were identified in 10 of the children (14%) reflecting similar rates in other community samples. Higher MCHFS scores were associated with lower birthweight and weight across the first year, greater satiety responsiveness, fussiness and slowness in eating, lower enjoyment of food and food responsiveness, and less observed infant food acceptance. Parents of infants with more feeding problems reported less encouragement of balance and variety in their children's diets. CONCLUSION: MCHFS showed good criterion validity with other parental report measures of eating and observations of mealtime interactions. MCHFS may be a useful tool for researching feeding problems in community samples.

Breastfeeding duration and its relation to weight gain, eating behaviours and positive maternal feeding practices in infancy.

Research examining the relationship between breastfeeding and infant weight has generated conflicting results. Few studies account for significant covariates and many suffer methodological problems such as retrospective self-report. The current study aimed to investigate relationships between breastfeeding duration, infant weight and eating and positive maternal mealtime behaviours, whilst overcoming many of the limitations of previous research. Eighty-one women on low-risk maternity units gave informed consent and were visited at home at 1-week, 1-, 6- and 12-months postpartum. Infants included 45 males and 36 females (mean birth-weight 3.52 kg [SD 0.39]). Mothers and infants were weighed and measured and feeding information was recorded at each visit. Infant weight was converted to a standard deviation score (SDS), accounting for age and sex. Mothers reported infant eating behaviours at 12-months using the Children's Eating Behaviour Questionnaire and were observed feeding their infants solid food at home at 6- and 12-months. Partial correlations (covariates: maternal age, education, BMI, smoking during pregnancy, household income, infant birth weight SDS and age introduced to solid foods) revealed negative associations between breastfeeding duration and 1- to 6- and 1- to 12-month weight gain, and 6- and 12-month weight. Breastfeeding duration was also associated with a slower rate of infant eating and greater observed maternal vocalisations, appropriateness and sensitivity. Results support a dose-response relationship between breastfeeding and infant weight and suggest that breastfeeding may encourage the development of obesity-protective eating behaviours through learning to attend to internal hunger and satiety signals. Future research should investigate whether relationships between slowness in eating and weight extend to satiety responsiveness after infancy.

Parental modelling and prompting effects on acceptance of a novel fruit in 2-4-year-old children are dependent on children's food responsiveness.

Few children consume the recommended portions of fruit or vegetables. This study examined the effects of parental physical prompting and parental modelling in children's acceptance of a novel fruit (NF) and examined the role of children's food-approach and food-avoidance traits on NF engagement and consumption. A total of 120 caregiver-child dyads (fifty-four girls, sixty-six boys) participated in this study. Dyads were allocated to one of the following three conditions: physical prompting but no modelling, physical prompting and modelling or a modelling only control condition. Dyads ate a standardised meal containing a portion of a fruit new to the child. Parents completed measures of children's food approach and avoidance. Willingness to try the NF was observed, and the amount of the NF consumed was measured. Physical prompting but no modelling resulted in greater physical refusal of the NF. There were main effects of enjoyment of food and food fussiness on acceptance. Food responsiveness interacted with condition such that children who were more food responsive had greater NF acceptance in the prompting and modelling conditions in comparison with the modelling only condition. In contrast, children with low food responsiveness had greater acceptance in the modelling control condition than in the prompting but no modelling condition. Physical prompting in the absence of modelling is likely to be detrimental to NF acceptance. Parental use of physical prompting strategies, in combination with modelling of NF intake, may facilitate acceptance of NF, but only in food-responsive children. Modelling consumption best promotes acceptance in children with low food responsiveness.

Examining evidence for behavioural mimicry of parental eating by adolescent females. An observational study.

Behavioural mimicry is a potential mechanism explaining why adolescents appear to be influenced by their parents' eating behaviour. In the current study we examined whether there is evidence that adolescent females mimic their parents when eating. Videos of thirty-eight parent and female adolescent dyads eating a lunchtime meal together were examined. We tested whether a parent placing a food item into their mouth was associated with an increased likelihood that their adolescent child would place any food item (non-specific mimicry) or the same item (specific mimicry) in their mouth at three different time frames, namely, during the same second or within the next fifteen seconds (+15), five seconds (+5) or two second (+2) period. Parents and adolescents' overall food intake was positively correlated, whereby a parent eating a larger amount of food was associated with the adolescent eating a larger meal. Across all of the three time frames adolescents were more likely to place a food item in their mouth if their parent had recently placed that same food item in their mouth (specific food item mimicry); however, there was no evidence of non-specific mimicry. This observational study suggests that when eating in a social context there is evidence that adolescent females may mimic their parental eating behaviour, selecting and eating more of a food item if their parent has just started to eat that food.

Effects of sucrose detection threshold and weight status on intake of fruit and vegetables in children.

Past research on the relationship between taste sensitivity and fruit and vegetable (FV) intake in children has focused on sensitivity to bitter taste. The effects of sensitivity to sweet taste on intake of FV have never been investigated. Furthermore, the effects of children's weight on intake of FV are inconclusive. This study measured the effects of Sucrose Detection Threshold (SDT) and weight status on intake of FV in children. The participants of this study were 99 children between 5-9 years old. Parents reported their own and their children's 24 hour intake of FV and completed a measure of children's sensory sensitivity. Children completed the triangle test with suprathreshold concentrations of sucrose ranging between 0.2% and 1.6%, in 0.2% increments. Two MANCOVAs showed that, controlling for parental intake and children's sensory sensitivity, there was a main effect of SDT on intake of fruit (p < 0.05), which was exclusive to non-astringent fruit (p < 0.05), and cruciferous vegetables (p < 0.01). Weight status had no effect on intake of FV. Mechanisms behind the effects of SDT are discussed in the context of past research on bitter taste sensitivity.

Measuring hunger and satiety in primary school children. Validation of a new picture rating scale.

Measuring hunger and satiety in children is essential to many studies of childhood eating behaviour. Few validated measures currently exist that allow children to make accurate and reliable ratings of hunger/satiety. Three studies aimed to validate the use of a new categorical rating scale in the context of estimated and real eating episodes. Forty-seven 6- to 8-year-olds participated in Study 1, which used a between-participant design. Results indicated that the majority of children were able to make estimated hunger/satiety ratings for a story character using the scale. No significant differences in the ratings of hunger/satiety of children measured before and after lunch were observed and likely causes are discussed. To account for inter-individual differences in hunger/satiety perceptions Study 2 employed a within-participant design. Fifty-four 5- to 7-year-olds participated and made estimated hunger/satiety ratings for a story character and real hunger/satiety ratings before and after lunch. The results indicated that the majority of children were able to use the scale to make estimated and real hunger and satiety ratings. Children were found to be significantly hungrier before compared to after lunch. As it was not possible to establish the types and quantities of food children ate for lunch a third study was carried out in a controlled laboratory environment. Thirty-six 6- to 9-year-olds participated in Study 3 and made hunger/satiety ratings before and after ingesting an ad libitum snack of known composition and quantity. Results indicated that children felt hungrier before than after the snack and that pre-snack hunger/satiety, and changes in hunger/satiety, were associated with snack intake. Overall, the studies indicate that the scale has potential for use with primary school children. Implications of the findings are discussed.

Maternal mind-mindedness during infancy, general parenting sensitivity and observed child feeding behavior: a longitudinal study.

Maternal mind-mindedness, or the tendency to view the child as a mental agent, has been shown to predict sensitive and responsive parenting behavior. As yet the role of mind-mindedness has not been explored in the context of feeding interactions. This study evaluates the relations between maternal mind-mindedness at 6 months of infant age and subsequently observed maternal sensitivity and feeding behaviors with children at age 1 year. Maternal mind-mindedness was greater in mothers who had breast-fed compared to formula-fed. Controlling for breast-feeding, mind-mindedness at 6 months was correlated with observations of more sensitive and positive feeding behaviors at 1 year of age. Mind-mindedness was also associated with greater general maternal sensitivity in play and this general parenting sensitivity mediated the effect of mind-mindedness on more sensitive and positive feeding behaviors. Interventions to promote maternal tendency to consider their child's mental states may encourage more adaptive parental feeding behaviors.

Social influences on eating: implications for nutritional interventions.

We review recent research on the effect of social context on food intake and food choice and assess the implications for nutritional interventions. We focus on studies of modelling of eating behaviour and the impact of perceived eating norms on the amounts and types of food that individuals eat. We suggest that social context influences eating via multiple mechanisms, including identity signalling and self-presentation concerns. However, building on existing theoretical models, we propose that social factors may be particularly influential on nutrition because following the behaviour of others is adaptive and social norms inform individuals about behaviours that are likely to be optimal ('if everyone else is doing it, I probably should be'). Guided by understanding of the potential underlying mechanisms, we discuss how social norms might be used to promote healthier nutrition.

Changing memory of food enjoyment to increase food liking, choice and intake.

Novel ways to increase liking and intake of food are needed to encourage acceptance of healthier food. How enjoyable we remember food to have been is likely to be a significant predictor of food choice. Two studies examined whether remembered enjoyment of eating a food can be increased and whether this makes individuals more likely to eat that food in the future. In Study One, a simple manipulation of instructing participants to rehearse what they found enjoyable about a food immediately after eating it was used to increase remembered enjoyment (relative to controls). In a separate study; Study Two, the effect of increasing remembered enjoyment on food choice was tested by examining whether the manipulation to increase remembered enjoyment resulted in participants choosing to eat more of a food as part of a later buffet lunch. The experimental manipulation increased remembered enjoyment for the food (Study One). A change in remembered enjoyment was shown to have a significant effect on the amount of a food participants chose to eat the following day for lunch (Study Two). The present studies suggest that remembered enjoyment can be increased via a simple act of rehearsal, resulting in a later increase in the amount of food chosen and eaten. Interventions based on altering remembered enjoyment of healthy food choices warrant further investigation.

Relationships between parenting style, feeding style and feeding practices and fruit and vegetable consumption in early childhood.

Despite substantial evidence suggesting that a diet high in fruit and vegetables (FV) is associated with reduced risk of cancer, only 21% of children in the UK consume the recommended 5 portions of fruit or vegetables a day. This review examines the role of parenting style, feeding style and feeding practices in FV consumption in early childhood. Whilst inconsistencies in concepts and terminology cloud this literature, overall the evidence suggests that the context of an authoritative parenting and feeding style is associated with better FV consumption in the childhood years. This context is typified by emotional warmth but high expectations for children's dietary adequacy and behaviour, accompanied by specific feeding practices such as modeling consumption of FV, making FV available within the home, covertly restricting unhealthy alternative snack foods, and encouraging children to try FV. Further longitudinal and intervention studies are required to determine the efficacy of modification of parenting style and feeding practice on children's FV intake.

Peak and end effects on remembered enjoyment of eating in low and high restrained eaters.

Memory is likely to be important in food choice because many food likes and dislikes are learnt. Evidence suggests that the final few moments of an experience ('end effect') and the most intense moments of an experience ('peak effect') have a disproportionately large influence on hedonic memories. In Study 1 we examined whether the end effect bias is applicable to remembered enjoyment of a food and whether this holds true for restrained and unrestrained eaters. One hundred and four participants ate the same yoghurt but half the participants experienced a pleasant end and half a bland end (control condition). Although both the 'pleasant ending' and control group had a similar online enjoyment of the yoghurt, unrestrained eaters who experienced a pleasant end remembered it to have been significantly more enjoyable than those in the control condition. No end effect was observed for restrained eaters. In Study 2 we examined predictors of remembered enjoyment of a multi-item meal. Forty-six participants consumed and rated 5 buffet style food items as part of a lunch time meal. For unrestrained eaters, remembered enjoyment of the meal was only predicted by 'peak' online enjoyment of the most liked item. Participant's enjoyment of the first, last and least liked items did not predict remembered enjoyment. For restrained eaters, remembered enjoyment was not predicted by any of the four predictor variables. These results suggest that for unrestrained eaters key moments in eating experiences have disproportionately large influence on remembered enjoyment of eating.

Relationships between temperament and eating behaviours in young children.

This study examined the associations between eating behaviours and temperament in a sample of young children. Mothers (N=241) of children aged 3-8 years completed measures of their children's eating behaviours and temperament and reported their child's height and weight. Children with more emotional temperaments were reported to display more food avoidant eating behaviours. Shyness, sociability and activity were not related to children's eating behaviours. Higher child BMI was related to more food approach eating behaviours but BMI was unrelated to child temperament. Future research should explore more specifically how emotional temperaments might influence child eating behaviour.

OCD in the perinatal period: is postpartum OCD (ppOCD) a distinct subtype? A review of the literature.

BACKGROUND: It has been suggested that the perinatal period is a period of increased risk for the development and/or exacerbation of OCD and that postpartum OCD (ppOCD) presents a distinct clinical picture. This raises the possibility that ppOCD might be a distinct subtype of OCD. This review examines this contention. METHOD: A search using Ovid (Medline, PsycINFO and Embase), EBSCO, Cochrane Library, Web of Science (ISI), Pubmed databases and Google Scholar was carried out using the key words: "obsessive compulsive disorder" (and derivatives), "perinatal", "pregnancy", "postnatal", "postpartum", "mothers" (and derivatives), "anxiety disorders" and "subtypes." These articles and their references were reviewed. RESULTS: The majority of studies reviewed were retrospective, which makes it impossible to infer causality. Two prospective studies found a higher incidence of OCD in the postpartum period. These were carried out in Turkey and Brazil and, as such, may be limited in their applicability to other cultural groups. CONCLUSION: The concept of ppOCD as a specific subtype has not been robustly demonstrated. The evidence that OCD is more prevalent in the postpartum period is mixed. The evidence that OCD in the postpartum period presents a distinctive clinical picture with specific symptomatology and course is more compelling. In view of the impact of culture and religion on the expression of OCD, collaborative, international, prospective studies that take into account the methodological and definitional issues raised in this review are necessary to provide clarification.

Eating disorder symptoms and parenting styles.

This study aimed to examine associations between symptoms of eating disorders and parenting style, in a non-clinical sample. One hundred and five mothers completed self-report measures of eating disorder symptoms and parenting style. Higher levels of eating disorder symptoms were associated with more authoritarian and permissive parenting styles. Authoritative parenting was not significantly related to eating disorder symptoms. The findings demonstrate that eating disorder symptoms in non-clinical individuals are related to less adaptive parenting styles. These findings have potential implications for clinicians working with mothers with eating disorders.

The role of parents' romantic relationship warmth and hostility in child feeding practices and children's eating behaviours.

This research examined the associations between parents' reports of the quality of their romantic relationships with their partner/spouse, their feeding interactions with their children, and their children's eating behaviours. One hundred and fifty-six married/cohabiting mothers of young children completed self-report measures of their romantic relationship quality, child feeding practices and children's eating behaviours. Reports of a less warm, more hostile romantic relationship were associated with children's less adaptive eating behaviours. More hostile relationship quality was also related to greater restriction of their children's food intake. The quality of parents' romantic relationships is associated with parental feeding practices and children's eating behaviours. Further work should examine the emotional tone of mealtimes in order to discover whether this may be the mechanism of the relationship.

Fruit and vegetable consumption in children and their mothers. Moderating effects of child sensory sensitivity.

A cross-sectional study was carried out to ascertain the relative contribution of food neophobia and taste sensitivity to the amount of fruit and vegetables consumed in a typical day by 73, 2-5-year-old children attending nurseries in the South Birmingham area, UK. Sensory processing, parental control, child food neophobia and fruit and vegetable (FV) consumption of both mothers and children were measured. Parental and child FV consumption in the sample were positively associated (p<0.001). Moderated regression analyses showed that taste/smell sensitivity, but not food neophobia or tactile sensitivity, moderated the relationship between maternal and child FV consumption. In particular, children who were sensitive to taste/smell stimuli ate fewer fruit and vegetables, regardless of their mothers FV consumption. This finding implies that those children, who are sensitive to taste/smell stimuli, may be less likely to model maternal FV consumption. For these children, a more gradual route to encouraging acceptance, with attention to small sensory changes in foods, may be necessary to increase FV consumption.

Associations between Otitis media, taste sensitivity and adiposity: Two studies across childhood.

BACKGROUND: Otitis media (OM), or middle ear infections, are one of the most common diseases during early childhood. OM has been linked to changes in food preferences through potential effects on taste signalling, and thereby, to increased weight. OBJECTIVES: We investigated the associations between OM, taste sensitivity and adiposity across two studies in early childhood and conducted exploratory post-hoc analyses of sex differences. METHODS: Study I assessed 101 children between 2 and 3 years old (59.0% boys). Children were weighed and their height was measured to estimate BMI centiles. Waist measurements were taken to calculate Waist-to-Height Ratio (WHtR). Child's taste sensitivity was assessed using Short Sensory Profile questionnaire. Study II included 95 children between 5 and 9 years old (52.9% boys). Children were weighed and their height was measured to calculate their BMI. Children took part in a Sucrose Detection Threshold (SDT) assessment to establish their taste sensitivity. In both studies parents reported child's history of OM. RESULTS: In Study I OM was associated with higher WHtR (p=0.047), though this was observed among girls (p=0.011), but not boys (p=0.53). OM was not linked to BMI centiles or taste sensitivity (all p>0.05). In Study II children with OM history had higher BMI centiles (p=0.010), and this effect was stronger in boys (p=0.037) than girls (p=0.17). Multiple OM exposure increased the odds of overweight by 6.2 times (95%CI [1.46, 26.50]). Boys with multiple OM exposure had higher SDT (p=0.022) compared to boys not exposed to OM, akin to lower taste sensitivity. This was not observed in girls (p=0.67). CONCLUSIONS: OM history was associated with higher BMI among 5-9 year old children and this may be linked to taste impairments. This association was not observed in 2-3 year old children. Potential sex differences in these associations require further investigation.