ABSTRACT
BACKGROUND: Little is known about how mothers respond to their child eating palatable foods. OBJECTIVES: The objectives of the study are to examine maternal behaviours when children are presented with a large portion of energy-dense palatable food in an experimental setting and to examine differences by child weight status. METHODS: Mother-child dyads (N = 37) (mean child age 70.8 months) participated in a videotaped eating protocol with cupcakes. Anthropometrics were measured. Videos were analysed using discourse analysis and were reliably coded for the presence or absence of the most salient theme. Analysis of variance examined theme presence by child and mother weight status. RESULTS: Mothers disavowed responsibility for their child's eating. Mothers were observed to roll their eyes at the child, throw their hands up in exasperation and distance themselves both physically and emotionally when the child ate the cupcakes voraciously or with high enjoyment. Mothers of children with obesity (vs recommended weight) engaged in more counts of disavowal (p = 0.01). CONCLUSIONS: Mothers of children with obesity distanced themselves from their child, seeming to disavow responsibility for the child's eating of 'junk food'. Mothers may respond to their child's seemingly gluttonous eating by disavowing responsibility due to the stigma of being a parent of a child with obesity.
Subject(s)
Feeding Behavior/psychology , Maternal Behavior/psychology , Mother-Child Relations/psychology , Pediatric Obesity/psychology , Adult , Body Mass Index , Body Weight , Child , Child, Preschool , Cross-Sectional Studies , Female , Food , Humans , Male , Mothers/psychology , Surveys and QuestionnairesABSTRACT
BACKGROUND: Few tools exist to quantify body mass index visually. OBJECTIVE: To examine the inter-rater reliability and validity (sensitivity and specificity for overweight/obesity and obesity) of a three-dimensional visual rating system to quantify body mass index (BMI) in young children. METHODS: Children (n = 242, mean age 5.9 years, 50.0% male; 40.5% overweight/ obese) participated in a videotaped protocol and weight and height were measured. Research staff applied a novel three-dimensional computer-based figure rating system (shapecoder) to the child's videotaped image. Inter-rater reliability was calculated, as well as correlation with measured body mass index (BMI) and sensitivity, specificity, positive predictive value and negative predictive value for overweight/obesity and obesity. RESULTS: Inter-rater reliability was excellent (intraclass correlation coefficient = 0.98). The correlation of shapecoder-generated BMI with measured BMI was 0.89. For overweight/obesity, the sensitivity, specificity, positive predictive value and negative predictive value were 62%, 97%, 94% and 79% respectively. For obesity, these values were 65%, 99%, 97% and 92% respectively. CONCLUSION: shapecoder provides a method to quantify child BMI from video images with high inter-rater reliability, fair sensitivity and good specificity for overweight/obesity and obesity. The approach offers an improvement over existing two-dimensional rating scales for BMI.
Subject(s)
Anthropometry/methods , Body Mass Index , Pediatric Obesity/diagnosis , Software , Videotape Recording , Child, Preschool , Female , Humans , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
BACKGROUND: Mothers' goals are important for health behavior change, and engagement in child obesity interventions. It is unknown if maternal feeding goals are associated with observed home mealtime or feeding practices. The objective of this study was to examine the association of four common feeding goals (restrict junk food, promote fruit or vegetable intake, promote autonomy in eating and prevent obesity) with mothers' observed home mealtime and feeding practices. METHODS: Low-income mothers (N = 265) of children (mean child age 70.8 months) participated in a semi-structured interview about child feeding. A coding scheme was developed and reliably applied to identify mothers' feeding goals from transcripts. Mothers' observed home mealtime and feeding practices were reliably coded from home mealtimes and a laboratory eating protocol. Mothers completed a questionnaire and reported demographics. Participant weights and heights were obtained. Regression models were used to test the association of each feeding goal with observed maternal practices, controlling for covariates. RESULTS: The goal of restricting junk food was associated with the child always eating at a table (OR 2.87, 95% CI (1.39-5.96) p = 0.005), but not with the mother restricting junk food. The goal of promoting fruit or vegetable intake was associated with observationally promoting vegetables (OR 1.41, 95% CI (1.09-1.84), p = 0.01). The goals of promoting autonomy and preventing obesity were not associated with any observed maternal home mealtime or feeding practices. CONCLUSIONS: While mothers' goals to restrict junk food and promote fruit or vegetable intake were associated with observed home mealtime and feeding practices, promoting autonomy and preventing obesity were not. Increased understanding of why low-income mothers may not translate certain feeding goals into practices may inform childhood obesity interventions.
