Complementary feeding approach and maternal responsiveness in 8- and 12-month-old Italian infants: A longitudinal study.

In Western countries, infants are usually introduced to solids through spoon-fed puréed foods (parent-led weaning, PLW). However, an alternative approach known as "baby-led weaning" (BLW), in which infants usually participate in family meals and eat independently, is becoming increasingly popular. We investigated the relationship between the type of complementary feeding approach and maternal responsiveness to infant feeding cues in a longitudinal sample of 178 infants observed at 8 and 12 months. Mothers reported the complementary feeding method used and, from video-recorded meals, we coded the proportion of time infants self-fed and rated maternal responsiveness by means of the Responsiveness to Child Feeding Cues Scale (Hodges et al., 2013). Responsiveness to infant receptiveness and fullness cues were significantly correlated at 8 months, but not at 12 months, when unresponsiveness decreased for receptiveness but remained stable for fullness cues. Thus, as infants got older, mothers were increasingly tuned in to their receptiveness cues. However, we did not observe the same pattern for fullness cues, perhaps because mothers were concerned that their infants did not eat enough. Moreover, at both time points, mothers were more responsive to infants' receptiveness than fullness cues, possibly due to an evolutionary drive to protect infants from starvation. Finally, responsiveness to fullness, but not responsiveness to receptiveness, was positively related to the proportion of infant self-feeding, but there were no significant differences in responsiveness depending on the self-reported complementary feeding approach. Thus, a weaning style that emphasizes independent feeding, regardless of whether this is labeled as BLW, may promote more infant-centered maternal responses at the end of the meal, with potential implications for promoting infant self-regulation not only at mealtimes, but also in other domains.

An infant-led approach to complementary feeding is positively associated with language development.

The timing and strategy with which parents first introduce their infants to solid foods may be an important predictor of subsequent developmental outcomes. Recent years have seen a decline in the prevalence of traditional parent-led feeding of soft, puréed food and a rise in the prevalence of infant-led complementary feeding. Although there has been some research espousing the benefits of infant-led complementary feeding for improving food fussiness and self-regulation, there has been little exploration of this approach that may impact on other developmental outcomes in children. The current study explores whether aspects of the infant-led approach, specifically the child eating unaided and consuming finger foods and eating with the family, are related to child language outcomes. One hundred thirty one parents of children aged 8-24 months completed questionnaires about their approach to complementary feeding, their current feeding practices, their child's experiences with family foods and child language comprehension/production. The findings suggest that an approach to complementary feeding which promotes infant autonomy in feeding (i.e., eating finger foods rather than puréed foods) and consuming more family foods is related to more advanced child language production and comprehension. Specifically, the prevalence of eating family foods mediated the relationship between eating unaided at the onset of the complementary feeding period and later language outcomes. This study is the first to find a significant relationship between different approaches to introducing solid foods and child language outcomes and these findings highlight the potential for different complementary feeding approaches to influence behaviour beyond mealtimes.

Baby-led weaning in Italy and potential implications for infant development.

Baby-led weaning is an approach to complementary feeding that emphasizes an infant's ability to self-feed rather than being spoon fed, and to eat minimally-processed foods rather than puréed foods. This study aimed to investigate the variability in infant feeding practices and the possible association with developmental milestones in an Italian population. A sample of 1245 mothers of 6-12 month-old infants completed an online survey about complementary feeding and their infant's attainment of developmental milestones. Infants' eating of family food was positively related to self-feeding and to a lower consumption of puréed foods. As in previous studies in the UK and New Zealand, a baby-led weaning style was positively associated with breastfeeding, exposure to complementary foods around six months of age, earlier exposure to both finger and family foods, and higher interest in family food and shared family meals. Infants who were introduced to solid foods using a baby-led weaning approach were more likely to have met important developmental milestones; when controlling for covariates, percentage of family feeding was positively associated with sitting unsupported at an earlier age and a low spoon-feeding style was associated with crawling at an earlier age. These data suggest that baby-led weaning should be defined more comprehensively. Moreover, its potential influence on developmental domains beyond diet and eating behavior warrants future targeted exploration.

A functional description of adult picky eating using latent profile analysis.

OBJECTIVE: Research has indicated that adult picky eating (PE) is associated with elevated psychosocial impairment and limited dietary variety and fruit and vegetable intake; however, research operationalizing PE behaviors is limited. Previous research identified a PE profile in children, marked by high food avoidance (satiety responsiveness, fussiness, and slow eating) and low food approach (food enjoyment and responsiveness) appetitive traits. The present study aimed to replicate a similar latent eating behavior profile in an adult sample. METHODS: A sample of 1339 US adults recruited through Amazon's MTurk completed an online survey that included a modified self-report version of the Child Eating Behavior Questionnaire (CEBQ-A). Latent profile analysis was employed to identify eating profiles using the CEBQ-A subscales, ANCOVAs were employed to examine profile differences on various self-report measures, and eating profiles were compared across BMI classifications. RESULTS: Analyses converged on a four-profile solution, and a picky eater profile that closely resembled the past child profile emerged. Participants in the picky eater profile (18.1%) scored higher on measures of adult PE and social eating anxiety compared to all other profiles, scored higher on eating-related impairment and depression than moderate eating profiles, and were more likely to be of normal weight. DISCUSSION: A distinct adult PE profile was observed, indicating childhood PE and appetitive behaviors may carry over into adulthood. Research identifying meaningful groups of picky eaters will help to shed light on the conditions under which picky eating is a risk factor for significant psychosocial impairment or distress, or weight-related problems.

Socioeconomic Position and Picky Eating Behavior Predict Disparate Weight Trajectories in Infancy.

Infant weight gain has long-term implications for the establishment of overall health. We examined whether socioeconomic position (SEP), the use of pressure as a feeding practice, and picky eating relate to changes infant in weight-for-length (WFL). A modified developmental design was used to examine whether current levels of child picky eating, parental use of pressure, and SEP were associated with changes in WFL during infancy. Health providers distributed survey packets during routine well-child visits made in the homes of families with young children in New Zealand (n = 193). Primary caregivers of young children provided their child's current level of picky eating, their use of pressure, and their SEP. They also reported their child's professionally-measured WFL from birth, 8, 15, and 21 months of age. A multi-level modeling analysis yielded an interaction between SEP and picky eating in predicting infant weight change over time. Children who had a low SEP and were not picky eaters were on the highest WFL trajectory and children who had a low SEP and were picky eaters were lowest on the WFL trajectory. A main effect revealed that higher levels of parental pressure predicted lower WFL in infants at each age, but did not interact with SEP or picky eating. Findings from this study indicate that the combination of eating behavior and SEP are associated with differential infant growth patterns. These results suggest that eating behavior and SEP should be included in the development of interventions designed to achieve healthy weight during childhood.

Picky eating and fruit and vegetable consumption in college students.

Picky eating (PE) may be an important individual-level factor related to fruit and vegetable (F&V) consumption in adulthood. Past studies showing negative relationships between Adult PE and F&V servings and variety have been limited by measurement issues. The purpose of the present study was replicate these relationships in college students using a well-validated F&V screener and comprehensive measure of adult PE. 1219 college students completed an online survey which included measures of adult PE, F&V daily servings, F&V variety, and other eating behaviors. Partial correlations were calculated, controlling for demographic factors and traditional disordered eating behavior, between the variables of interest. Factor analysis was also utilized to confirm the factor structure of the Adult Picky Eating Questionnaire (APEQ) in a college sample. Partial correlations revealed significant negative relationships between PE and measures of F&V servings and variety. Factor analysis confirmed the utility of the APEQ in a college sample. College students who reported higher levels of PE behaviors and attitudes were more likely to eat less fruits and vegetables, and reported lower F&V variety. Given that F&V servings and variety are related to adequate nutrient intake, and greater F&V consumption is a protective factor against chronic disease risk, the rigid inflexible eating patterns associated with adult PE should be further explored in future research aimed at increasing F&V consumption.

A multidimensional approach to understanding the potential risk factors and covariates of adult picky eating.

OBJECTIVE: Adult picky eating (PE) has received increased attention in the eating behavior literature due to its important association with adult avoidant-restrictive food intake disorder (ARFID). The current study tested a model of potential risk factors of adult PE behavior, including perceived early parental feeding practices. An exploratory model was also utilized to understand associations with different aspects of adult PE behaviors. METHODS: A sample of 1339 US adults recruited through Amazon's MTurk completed an online survey that included the recently developed Adult Picky Eating Questionnaire (APEQ), retrospective reports of parental feeding practices, and other measures of eating behavior and demographic variables. A structural equation modeling procedure tested a series of regression models that included BMI and disordered eating behaviors as covariates. RESULTS: SEM modeling indicated that retrospective reports of greater parental pressure to eat, higher disgust sensitivity, lower PE age of onset, and experiencing an aversive food event were associated with general adult PE behavior. Results also indicated parental encouragement of healthy eating may be a protective factor, and that men endorsed higher levels of adult PE. Exploratory analyses indicated that cross-sectional predictors and covariates were differentially related to specific aspects of PE as measured by the APEQ subscales. CONCLUSIONS: Early experiences, including parental approaches to feeding, appear to be potential risk factors of PE behavior in adults. A nuanced understanding of adult PE is important for the prevention and treatment of severe PE behaviors, related psychosocial impairment, and ARFID.

Everyone else is doing it (I think): The power of perception in fat talk.

Fat talk (FT) involves critiquing one's own appearance in social conversations. Although peers are known to prompt FT behavior, there has been little exploration of the influence of mothers and research has not distinguished between self-reported FT and perceptions of FT. This study addresses this research gap by investigating the relationships between participants' FT and corresponding FT of both self-reported and perceived FT of their mothers and friends. A sample of 120 undergraduate women, along with their mothers and friends, reported their FT behavior. Hierarchical multiple regression analyses showed that friend-reported (but not mother-reported) FT and the daughters' perceived FT of both friends and mothers were significant predictors of daughter FT. However, daughters' perceptions of their friends' and mothers' FT predicted a significantly larger portion of variance than self-reported FT of friends and mothers. These results are important to consider when examining potential influences on the development of FT behavior.

Measuring adult picky eating: The development of a multidimensional self-report instrument.

A brief multidimensional measure of adult picky eating (PE) behavior was developed using a large U.S. adult sample. In addition, the study explored associations between specific aspects of adult PE behavior and psychosocial impairment in effort to support the inclusion of adults in the Diagnostic and Statistical Manual for Mental Disorders-Fifth Edition (DSM-5) avoidant-restrictive food intake disorder (ARFID). The study included 3 phases of qualitative and quantitative data collection. Participants were 1,663 U.S. adults who completed online surveys. Exploratory and confirmatory factor analyses were used to develop PE subscales. Associations among the PE subscales and measures of psychosocial impairment were examined. Exploratory and confirmatory factor analysis supported a 16-item 4-factor model of adult PE that included subscales of meal presentation, food variety, meal disengagement, and taste aversion. The measure also demonstrated convergence with previous measures of PE. The meal disengagement and meal presentation subscales demonstrated significant associations with social eating anxiety, anxiety sensitivity, eating related quality of life (QOL), and psychological flexibility. Meal disengagement alone was significantly associated with depressive symptoms. The Adult Picky Eating Questionnaire (APEQ) demonstrated sound psychometric properties and may be used to further investigate adult PE behavior. The relationships between adult PE and psychological impairment, particularly social anxiety, support the inclusion of ARFID in the DSM-5. (PsycINFO Database Record

Recollections of pressure to eat during childhood, but not picky eating, predict young adult eating behavior.

Picky eating is a childhood behavior that vexes many parents and is a symptom in the newer diagnosis of Avoidant/Restrictive Food Intake Disorder (ARFID) in adults. Pressure to eat, a parental controlling feeding practice aimed at encouraging a child to eat more, is associated with picky eating and a number of other childhood eating concerns. Low intuitive eating, an insensitivity to internal hunger and satiety cues, is also associated with a number of problem eating behaviors in adulthood. Whether picky eating and pressure to eat are predictive of young adult eating behavior is relatively unstudied. Current adult intuitive eating and disordered eating behaviors were self-reported by 170 college students, along with childhood picky eating and pressure through retrospective self- and parent reports. Hierarchical regression analyses revealed that childhood parental pressure to eat, but not picky eating, predicted intuitive eating and disordered eating symptoms in college students. These findings suggest that parental pressure in childhood is associated with problematic eating patterns in young adulthood. Additional research is needed to understand the extent to which parental pressure is a reaction to or perhaps compounds the development of problematic eating behavior.

Parental child feeding practices: how do perceptions of mother, father, sibling, and self vary?

Mothers are important contributors to the development of eating behavior in children, but less is known about the influence of fathers. The purpose of this study was to investigate family perceptions of parental child feeding practices. Seventy two-parent American families including a mother, father, and two biologically related children participated in the study. Participants completed parent and child versions of the Child Feeding Questionnaire that assessed perceptions of parental control in child feeding. Most family member reports were positively correlated, indicating agreement about the use of the examined parental feeding practices; however, some salient differences between the reported behaviors of mothers and fathers were uncovered. Mothers reported using higher levels of monitoring and responsibility than fathers. In addition, fathers and children reported higher levels of paternal pressure related to feeding compared with mothers. Mothers and fathers used more pressure and felt more responsible for feeding younger children compared with older children. One interaction revealed that older male siblings reported the highest level of pressure from fathers. Reported differences in parents' use of child feeding practices suggest that mothers and fathers may have distinct interactions with their children regarding food. Paternal feeding practices are likely to have unique implications for understanding the development of children's eating behavior.

The role of child temperament in parental child feeding practices and attitudes using a sibling design.

Although previous research indicates that parental child feeding practices are one component of a bidirectional relationship between children and parents, little is known about how child temperament operates in this relationship. The purpose of this study was to investigate relationships between child temperament and parental feeding practices and attitudes using a sibling design. By collecting data regarding pairs of siblings, we were able to investigate sibling differences and differential parental treatment. We examined mothers' and fathers' perceptions of their two children's temperaments as well as reports of the feeding practices and attitudes they use with each child. Fifty-five mothers and fathers completed questionnaires including the Carey Temperament Scales and the Child Feeding Questionnaire (CFQ). Results from correlation analyses showed that 6 of the 9 father reports of temperament between two siblings were positively related, whereas 1 of the 9 mother reports were positively related. Mothers' and fathers' perceptions of temperament were positively correlated for a single child. Some patterns were found between parental reports of sibling temperament and child feeding practices and attitudes, suggesting that temperament plays a role in how parents feed their children.

Parental use of differential restrictive feeding practices with siblings.

OBJECTIVE: To investigate associations between sibling weight status, concerns about sibling weight, and parents' differential use of restrictive feeding practices. METHODS: Participants included 70 mother-father pairs with two biological children between 6 and 12 years old. Each parent completed three Child Feeding Questionnaire (CFQ) subscales (perception of child weight, concern about child weight, and restriction) for each participant sibling. Researchers measured heights and weights and converted child data into Body Mass Index percentiles (BMI%). Multiple regression analysis examined predictors of restrictive feeding practices used by both parents. The nature of differential treatment was examined by calculating Pearson's correlations among sibling differences (older minus younger sibling) in maternal and paternal CFQ reports and sibling BMI%. RESULTS: Concern for child weight, but not actual child BMI% or parental perception of child weight, predicted restrictive feeding practices for both parents. Child gender was not related to child weight status, perception of child weight, concern for child weight, or restriction. Parents were more likely to use differential restrictive feeding practices when they had differential concern for the weight status of their children. However, this differential treatment was not related to differences in actual sibling BMI% or parental perception of child weight. CONCLUSIONS: Parental concern for child weight, rather than actual child weight status, predicts restriction by both mothers and fathers. Across families, parents generally tend to use similar feeding practices with each of their children. Within families, parents may have different interactions with each sibling regarding food when differentially concerned about sibling weight status.

Predicting ideal body mass index: what does clothing size have to do with it?

This study examined demographic and anthropometric variables as predictors of ideal body mass index (BMI) from cross-sectional, archival, self-reported data from the Psychology of Size Survey of 4014 U.S. residents collected in 2007. As hypothesized, ideal BMI can be predicted by a within gender hierarchical multiple regression analysis with the predictor variables of age, number of clothing sizes from ideal size, and current BMI; these variables account for 54.1% of variance in women's ideal BMI and 65.5% of variance in men's ideal BMI. Findings also demonstrated a logarithmic relationship between current BMI and ideal BMI, with increasing variance in ideal BMI for individuals with high current BMIs. These findings evidence the strong role of current body characteristics in the formation of ideals. Understanding how individuals conceptualize body ideals can inform researchers and practitioners alike, as this evidence has important implications related to both medical and psychological health.

Retrospective reports of child feeding practices, current eating behaviors, and BMI in college students.

Research concerning child feeding practices has focused on children and adolescents, and little is known about how feeding practices used in childhood relate to eating behaviors and weight status in early adulthood. We assessed college students' and their parents' retrospective reports of child feeding practices used when the students were in middle childhood. We also assessed the college students' current reports of their eating behaviors using the Dutch Eating Behavior Questionnaire (DEBQ) and the Intuitive Eating Scale (IES), and measured their current BMI. Results showed that college students' and their parents' reports about previous parental use of child feeding practices were not correlated. Parent reports of their own use of child feeding practices were more related to students' eating behaviors and BMI than were students' recollections about feeding practices used by their parents. An analysis of gender effects showed that there were positive correlations between parental child feeding practices, BMI, and emotional eating for female students. These relationships did not exist for male students. The results suggest that child feeding practices recollected by parents are linked to the development of emotional eating and weight status of women in early adulthood.

'Finish your soup': counterproductive effects of pressuring children to eat on intake and affect.

The authors examined whether pressuring preschoolers to eat would affect food intake and preferences, using a repeated-measures experimental design. In the experimental condition, children were pressured to eat by a request to finish their food. We collected intake data, heights and weights, child-feeding practices data, and children's comments about the food. Children consumed significantly more food when they were not pressured to eat and they made overwhelmingly fewer negative comments. Children who were pressured to eat at home had lower body mass index percentile scores and were less affected by the pressure in the lab setting than children who were not pressured at home. These data provide experimental evidence supporting previous correlational research indicating that pressure can have negative effects on children's affective responses to and intake of healthy foods.

Specific social influences on the acceptance of novel foods in 2-5-year-old children.

Social influences have been shown to be very important to overcome food neophobia in young children. However, there is no experimental evidence about whether social influences on food acceptance are specific, that is if models eating the same food as the child are more effective in promoting food acceptance than models eating a different food. We assessed children's behavior towards novel foods when an adult model (a) was not eating (Presence condition), (b) was eating a food of a Different color (Different color condition), and (c) was eating a food of the Same color (Same color condition). We tested 27 children (ages 2- to 5-years-old) recruited from The Pennsylvania State University day-care facilities. Results show that children accepted and ate their novel food more in the Same color condition than in the Different color and in the Presence conditions. Therefore, in young children food acceptance is promoted by specific social influences. These data indicate that children are more likely to eat new food if others are eating the same type of food than when others are merely present or eating another kind of food.

Parental pressure, dietary patterns, and weight status among girls who are "picky eaters".

OBJECTIVE: To determine whether mothers' fruit and vegetable intake and mothers' use of pressure in the feeding domain when their daughters were 7 years old predicted picky eating and dietary intake when their daughters were 9 years old, and to examine diet and weight status in picky and nonpicky eaters. DESIGN/SUBJECTS: Participants were 173 9-year-old non-Hispanic white girls and their mothers. A longitudinal analysis was used to assess maternal influences on picky eating and diet. A cross-sectional analysis was used to examine diet and weight status between picky and nonpicky eaters. Measures included maternal feeding practices, daughters' pickiness, mothers' fruit and vegetable intake, daughters' food intake, and weight status. STATISTICAL ANALYSES: t tests examined differences between picky and nonpicky eaters. Structural equation modeling examined relationships among mothers' fruit and vegetable intake; child feeding practices; daughters' pickiness; and fruit, vegetable, micronutrient, and fiber intakes. RESULTS: Mothers consuming more fruits and vegetables were less likely to pressure their daughters to eat and had daughters who were less picky and consumed more fruits and vegetables. Picky eaters consumed fewer fruits and vegetables, but also fewer fats and sweets. All girls consumed low amounts of vitamin E, calcium, and magnesium, but more picky girls were at risk for not meeting recommendations for vitamins E and C and also consumed significantly less fiber. In addition, picky eaters were less likely to be overweight. CONCLUSIONS: Mothers influenced daughters' fruit and vegetable intake via their own patterns of fruit and vegetable intake and by influencing their daughters' tendencies to be picky eaters. Both picky and nonpicky eaters had aspects of their diets that did not meet recommendations. Taken together, these findings suggest that parents should focus less on "picky eating" behavior and more on modeling fruit and vegetable consumption for their children.

Taste perception and food choices in capuchin monkeys and human children.

Despite more than 40 million years of independent evolution, capuchin monkeys and human children share several features that make a comparison in the domain of feeding behaviour interesting. As with humans, capuchin monkeys have a long life span and an extended infancy period; moreover, they are omnivorous and food neophobic. In both species, taste provides an immediate and powerful feedback when selecting foods. In humans, acceptance and rejection responses are evident beginning in early infancy, before experiencing any consequences from the ingestion of sweet or bitter substances. Similarly, capuchins initially prefer novel foods with a high sugar content that is readily perceived through taste. However, after repeated encounters with these foods, capuchins change their preferences, responding to the feedback coming from the foods' energy content, in order to maximize the net gain of energy. Also in children, positive consequences of the ingestion of a food can be associated with the flavour of that food and can increase its consumption. Preschool children learn to prefer food with a high caloric content over food with a low caloric content and use different flavours as immediate cues to distinguish foods. Another factor influencing the consumption of a novel food is how often it is encountered. For capuchins, a food remains unfamiliar only for the first few encounters. Similarly, children's neophobic response decreases with repeated exposures to novel foods. Furthermore, in both species social influences may help to overcome food neophobia and to accelerate the acceptance of novel foods into the diet. In conclusion, we argue that capuchin monkeys provide a good model for investigating the factors affecting the acquisition of diet in human children.

Predictors and consequences of food neophobia and pickiness in young girls.

OBJECTIVE: Vegetable intake among children is well below recommended levels. We assessed whether food neophobia and pickiness contribute to low vegetable intake in school-aged girls and if there are distinct predictors for neophobia and pickiness. Children with food neophobia are reluctant to eat new foods whereas picky children resist eating many familiar foods. Design/subjects Participants were 192 7-year-old girls and their parents, recruited for a study of girls' nutrition and development. We examined relationships between food neophobia and pickiness and assessed whether these variables predicted girls' vegetable consumption and predictors of food neophobia and pickiness. ANALYSES: The data were analyzed using a two-step process. First, we used a two-way analysis of variance to assess whether girls who scored high or low on food neophobia and pickiness measures had different levels of vegetable consumption. We used multiple regression analysis to determine predictors of food neophobia and pickiness in the girls. RESULTS: Girls with both food neophobia and pickiness consumed fewer vegetables (1.1+/-0.1) than girls with neither neophobia nor pickiness (1.6+/-0.1). Neophobia and pickiness were modestly related in this sample, but had different predictors. Girls with food neophobia were more anxious and had mothers with food neophobia. Picky girls had mothers with less variety in their vegetable intake (r=-0.22) and mothers who perceived their family to have little time to eat healthful foods (r=0.36). In addition, picky eaters were breastfed for fewer than 6 months (r=-0.25). Pickiness was predicted primarily by environmental or experiential factors subject to changes; neophobia was predicted by more enduring and dispositional factors. APPLICATIONS: Because food neophobia and pickiness negatively influence vegetable intake, intervention strategies to increase vegetable intake should focus on predictors of neophobia and pickiness, especially those subject to change.