A web-based and mobile randomised controlled trial providing complementary feeding guidelines to first-time parents in France to promote responsive parental feeding practices, healthy children's eating behaviour and optimal body mass index: the NutrienT trial study protocol.

BACKGROUND: Childhood obesity is a crucial public health issue. Early childhood is a critical time to foster the establishment of healthy eating behaviours and growth, which are partly shaped by parental feeding practices. To inform French parents of the recently updated national complementary feeding guidelines for 0-3 years (in terms of nutrition and responsive feeding as a mean to encourage infant appetite control skills and promote healthy growth), an official printed brochure was developed and nationally disseminated in 2021 by the French public health agency, Santé publique France. This randomised controlled trial aims to investigate whether the provision of guidelines through digital (smartphone application) and printed (brochure) tools (vs. the printed brochure alone, usual service) results in healthier parental feeding practices, infant eating behaviours and weight status. METHODS: This double-blinded monocentric 2-arm trial is currently conducted among first-time parents living in the area of Dijon (France) and recruited in a maternity ward. From child age 3 to 36 months (mo), an app provides a range of 106 age-adapted messages, including dietary recommendations, educational advice, recipes, and tips (intervention group only). Additionally, parents of both groups are provided with 48 messages related to child general development and the printed brochure at child age 2.7 mo. The primary outcome is the body mass index (BMI) z-score at child age 36 mo. Secondary outcome measures include a combination of online parents' reports and behavioural assessments (experimental meals) of parental feeding practices and infant eating behaviours from inclusion to 36 months of age. Analyses of covariance on these outcomes will assess the effect of the intervention, adjusted for relevant confounders. Complementary mediation and moderation analyses will be conducted. Sample size was determined to be n = 118 in each arm of the trial, plus 20% to compensate for potential attrition. DISCUSSION: This is the first public eHealth randomised control trial in France to assess the effect of a web-based and mobile intervention targeted to first-time parents to improve child feeding practices and child growth. TRIAL REGISTRATION: This trial was registered at clinicaltrials.gov as NCT05285761 (March 18, 2022).

Examining parents' experiences and challenges of feeding preschool children with avid eating behaviour.

Avid eating behaviours, including greater responsiveness to food cues and emotional over-eating, have been linked to child overweight and obesity. Parental feeding practices are modifiable components of a child's food environment and may be key levers for behaviour change in tailored interventions to support parents of children with avid eating behaviour. However, there is a lack of research examining parents' experiences in this context. This study aimed to explore parents' experiences of feeding children with avid eating behaviour and to understand any challenges experienced in this context. Semi-structured interviews with parents (N = 15) of a preschool child (3-5 years) identified as having an avid eating behaviour profile explored how children's avid eating manifests, the parental feeding practices used to manage avid eating, and the perceived effectiveness of these strategies. Data were analysed using reflexive thematic analysis. Four core themes were generated. Theme one, 'Have they got worms? Children's insatiable hunger', captures parents' interpretation of the complex ways in which avid eating behaviour manifests. Theme two, 'Parenthood as a duty', illustrates how parents' perceived responsibilities shape their feeding practices. Theme three, 'Lifelong habits', captures parents' use of responsive feeding practices to support children's healthy relationship with food. Theme four, 'Picking battles', captures the structure- and coercive-based feeding strategies commonly used to manage children's avid eating. This novel study provides an in-depth understanding of the complex ways that children's avid eating behaviour manifests, and the strategic and creative parental feeding practices used to manage these behaviours. Such findings are valuable for informing the development of future support resources for parents/caregivers to help their children with avid eating behaviours to develop a healthy relationship with food.

Reciprocal associations between parental feeding practices and child eating behaviours from toddlerhood to early childhood: bivariate latent change analysis in the Gemini cohort.

BACKGROUND: Parental feeding practices (PFPs) are a key component of a child's food environment. Parent-child feeding relationships are hypothesised to be bidirectional; however, to date, few large prospective studies have examined this, instead focussing on unidirectional relationships. As such, the direction of relationships between PFPs and children's eating behaviours remains unclear. METHODS: Data were from Gemini, a population-based sample of children born in England and Wales in 2007. Children's eating behaviours and PFPs were measured at 15/16 months and 5 years using validated psychometric measures (n = 1,858 children). Bivariate Latent Change Score Modelling was used to examine the nature of relationships between PFPs and children's eating behaviours at 15/16 months and 5 years. Models were adjusted to account for clustering of twins within families and for sex of the child, socioeconomic status, gestational age and age of the child at measurement time points. RESULTS: A reciprocal relationship was observed between instrumental feeding and emotional overeating, with greater instrumental feeding predicting greater increases in emotional overeating (ß = .09; 0.03-0.15; p = .004) and vice versa (ß = .09; 0.03-0.15; p = .005). Reciprocity was also observed between encouragement to eat nutritious foods and children's enjoyment of food, with greater encouragement predicting greater increases in enjoyment of food (ß = .08; 0.02-0.13; p = .006) and vice versa (ß = .07; 0.02-0.11; p = .003). Parent-child associations and child-parent associations were also observed. CONCLUSION: These findings are consistent with the hypothesis that certain feeding practices are used as a 'natural' response to a child expressing a greater interest in and enthusiasm for food, but at the same time, such practices impact the development of eating behaviours by nurturing and encouraging the expression of higher emotional overeating and greater enjoyment of food in preschool years. The findings provide important insights into the PFPs and eating behaviour traits that could be targeted as part of a tailored feeding intervention to support parents of children during the preschool formative years.

Parental food neophobia, feeding practices, and preschooler's food neophobia: A cross-sectional study in China.

This study explores the relationship between parental food neophobia, feeding practices, and preschoolers' food neophobia in China. METHODS: A cross-sectional study was conducted among 1616 pairs of preschoolers and their parents. Electronic questionnaires were conducted to collect information about social and demographic characteristics, scores of food neophobia among both children and their parents, parents' feeding patterns and children's dietary quality. RESULTS: Children's average food neophobia score was 23.73 ± 4.45. There was a positive correlation between parental food neophobia score (ß: 0.154; 95%CI: 0.113, 0.195), pressure to eat (ß: 0.694; 95%CI: 0.423, 0.964), postpartum breastfeeding initiation (ß: 0.010; 95%CI: 0.002, 0.018), and children's score of food neophobia. However, parental modeling (ß: -0.470; 95%CI: -0.732, -0.207) and the frequency of children eating with their families at home (ß: -0.407; 95%CI: -0.707, -0.108) were negatively associated with children's food neophobia scores. The consumption frequencies of vegetables (P < 0.001), fruits (P < 0.001), domestic animals and poultry (P < 0.01), aquatic products (P < 0.05), beans and their products (P < 0.01), eggs (P < 0.05) and nuts (P < 0.05) and children's dietary diversity score (P < 0.001) are negatively associated with children' food neophobia score. While the consumption frequencies of fast food (P < 0.001), sweets (P < 0.01) and puffed/fried food (P < 0.001) were positively associated with children's food neophobia. CONCLUSION: Chinese preschoolers' food neophobia needs more attention because children with high food neophobia tend to have lower dietary quality. Children whose parents have high-level food neophobia should be the focus of early prevention. Earlier postpartum breastfeeding, more use of parental modelling, less pressure to eat and higher frequency of children eating with families are helpful to reduce the incidence of children's food neophobia.

Prospective associations between parental feeding practices used in toddlerhood and preschool children's appetite vary according to appetite avidity in toddlerhood.

Parental feeding practices are a key modifiable component of children's food environments. Evidence suggests that certain feeding practices may differentially influence children's eating behaviour or weight, depending on the child's temperament (e.g. emotionality). Building on this work, we tested the hypothesis that feeding practices during toddlerhood influence children's developing eating behaviours differently, depending on their appetite avidity (which is characterised by a larger appetite and greater interest in food). Data were from Gemini, a population-based cohort of British twin children born in 2007. Parental feeding practices were assessed at 15/16-months, and child appetite at 15/16-months and 5-years, using validated psychometric measures (n = 1858 children). Complex samples general linear models examined prospective associations between PFPs at 15/16-months and child appetitive traits at 5-years, adjusting for clustering of twins within families and for the corresponding child appetitive trait at 15/16-months, difference in age between timepoints, child sex, gestational age, and socioeconomic status. Moderation analyses revealed that pressuring a child to eat led to greater increases in emotional overeating from 15/16-months to 5-years, only for children with high (1 SD above the mean: B = 0.13; SE± = 0.03,p < 0.001) or moderate emotional overeating (mean: B = 0.07 ± 0.03,p < 0.001) in toddlerhood. Greater covert restriction predicted greater reductions in emotional overeating and food responsiveness from 15/16-months to 5-years, only for children with high emotional overeating (1 SD above the mean: B = -0.06 ± 0.03,p = 0.03) and low food responsiveness (1 SD below the mean: B = -0.06 ± 0.03,p = 0.04) in toddlerhood. These findings are consistent with the hypothesis that children with a more avid appetite in toddlerhood are differentially affected by parental feeding practices; caregivers of toddlers may therefore benefit from feeding advice that is tailored to their child's unique appetite.

Identifying an avid eating profile in childhood: Associations with temperament, feeding practices and food insecurity.

This study aimed to identify distinct eating behaviour profiles in young children and examine how other key predictors of children's eating behaviour, including child temperament, the experience of food insecurity, or parental feeding practices, may vary by identified profiles. An online survey was conducted with 995 parents/carers living in England and Wales (N = 995, Mage = 35.4 years, 80% female, 88% White). Participants reported on their child's eating behaviour using the Child Eating Behaviour Questionnaire and completed measures of child temperament, household food security and parental feeding practices. Latent Profile Analysis (LPA) was carried out to identify distinct eating profiles amongst the children (36-72 months, Mage = 48.8 months, 52% female). Four eating profiles emerged from the sample of children: (a) avid eating, (b) avoidant eating, (c) happy eating, and (d) typical eating. Avid eating (21.9% of children) was characterised by higher levels of food responsiveness, enjoyment of food, and emotional over-eating in combination with lower satiety responsiveness, slowness in eating and food fussiness. Children with an avid eating profile were reported to be more surgent and experienced greater food insecurity than all other eating profiles. Parents of children belonging to the avid eating profile showed significantly greater use of food for emotional regulation, varied and balanced food provision, restriction of food for health, and restriction of food for weight feeding practices than the three other eating profiles.

Associations Among Parents' Eating Behaviors, Feeding Practices, and Children's Eating Behaviors.

Parental feeding practices influence children's eating behaviors, yet it is not well-understood whether parents' own eating behaviors are associated with their feeding practices. The purpose of this study was to examine associations among parents' eating behaviors, parental feeding practices, and children's eating behaviors. A cross-sectional study was conducted with 76 parents of children from an elementary school in Tampa, FL. Parents completed three questionnaires with topics related to parent eating behaviors, parental feeding practices, and children's eating behaviors. Multiple regression analysis was performed, controlling for demographic covariates. Parents who reported to eat more fruits per day (ß = 0.15), eat more than one kind of fruit each day (ß = 0.33), eat more than one kind of vegetable each day (ß = 0.29), eat 2 or more vegetables at the main meal (ß = 0.36), plan meals (ß = 0.19), and keep vegetables ready for the child to eat (ß = 0.25) indicated that they use more positive reinforcement feeding practices (all p ≤ 0.001). There were significantly positive associations between positive reinforcement and children's eating fruits or vegetables like apples, bananas or carrots as snacks (ß = 1.03) and eating more than one kind of vegetable a day (ß = 1.03; all p < 0.001). No other variables had any significant associations. Findings of this study indicate that there are potential associations among parent's own eating behaviors, feeding practices, and children's eating behaviors. Further research is needed to determine the mechanism of these relationships. Targeting these parental factors may be an effective way to maximize the impact of nutrition interventions on children's dietary behavior changes.

Too healthy for their own good: orthorexia nervosa and compulsive exercise in the community.

BACKGROUND: The similarities and differences between orthorexia nervosa symptoms (ONs) and the symptoms and correlates of eating disorders listed in the DSM-5 need to be elucidated. ONs were examined in a volunteer community sample in conjunction with compulsive exercise, disordered eating, as well as emotional and behavioral correlates of eating disorders. METHODS: Participants were 561 adult volunteers (93 men, 17.09%) aged 19-72 (M = 32.7 ± 11), recruited via social media networks. Participants self-reported on the following measures online: Düsseldorf Orthorexia Scale, Compulsive Exercise Test, Retrospective Child Feeding Questionnaire, Experiences in Close Relationships, Difficulties in Emotional Regulation Scale, Toronto Alexithymia Scale, and Eating Disorder Examination Questionnaire 13. Data were downloaded and analyzed in SPSS26 and Amos26. RESULTS: A theoretical model of the connections between the study variables was tested via SEM and confirmed. The profiles of participants with high, average and low levels of ONs were compared. Participants with the highest levels also scored highest for compulsive exercise, insecure attachment, alexithymia, emotion regulation difficulties, weight and shape concerns, body dissatisfaction, restriction, bingeing, purging and parental feeding practices of concern about child's weight and restricting and monitoring the child's intake of calorie-rich foods. DISCUSSION: High levels of ONs are related to disordered eating attitudes and behaviors, as well as to emotional and behavioral correlates of eating disorders. It is unclear to what extent these ONs are distinguishable from symptoms of other eating disorders listed in the DSM-5. Longitudinal studies may help to elucidate distinct trajectories and risk factors for ON. LEVEL OF EVIDENCE: Level III, case-control analytic study.

Observations of feeding practices of US parents of young children with Down syndrome.

Parental behaviours influence food acceptance in young children, but few studies have measured these behaviours using observational methods, especially among children with Down syndrome (CWDS). The overall goal of this study was to understand parent feeding practices used during snack time with young CWDS (N = 111, aged 11-58 months). A coding scheme was developed to focus on feeding practices used by parents of CWDS from a structured home-use test involving tasting variously textured snack products. Behavioural coding was used to categorise parental feeding practices and quantify their frequencies (N = 212 video feeding sessions). A feeding prompt was coded as successful if the child ate the target food product or completed the prompt within 20 s of the prompt being given without a refusal behaviour. CWDS more frequently consumed the test foods and completed tasks in response to Autonomy-Supportive Prompts to Eat (49.3%), than to Coercive-Controlling Prompts to Eat (24.2%). By exploring the parent-CWDS relationship during feeding, we can identify potentially desirable parent practices to encourage successful feeding for CWDS. Future research should build upon the knowledge gained from this study to confirm longitudinal associations of parent practices with child behaviours during feeding.

Counseling parents about child feeding: a qualitative evaluation of French doctors and health/childcare professionals' experiences and perception of a brochure containing new recommendations.

BACKGROUND: Parents are crucial in establishing their children's eating habits, and doctors and health/childcare professionals (HCCPs) can provide meaningful and trusted guidance on feeding, especially in the 0-3-year-old period. With the upcoming release of the official brochure containing the new child feeding recommendations in France, this study aims to: (1) assess professionals' practices and perceptions regarding their communication with parents on child feeding and (2) evaluate their perception of the draft of the new brochure. METHODS: A 15-page draft brochure (without pictures) containing updated child feeding recommendations for children 0-3 years old was developed by Santé publique France (the French public health agency). Online semi-structured interviews were conducted with professionals (n = 21), including 13 pediatricians and general practitioners (doctors) and eight healthcare or childcare professionals (HCCPs) two weeks after they were provided with this draft brochure to read. The interview guide was developed and piloted with other professionals (n = 3) prior to these interviews. Interview data were transcribed verbatim and analyzed thematically using an inductive approach. RESULTS: While doctors and HCCPs mostly communicate orally with parents, both acknowledged that the brochure might be a helpful supplement, especially for HCCPs to legitimize their advice to parents. For doctors, giving the brochure to parents may help provide systematic advice and save time during consultations. Professionals serving parents of lower socioeconomic status would prefer a supplement with less text and more illustrations. In general, the messages were perceived to be easily understandable but providing detachable cards to distribute according to the child's age would facilitate information dissemination and might be more useful to parents. Professionals reported that lack of training, the circulation of contradictory information, and language barriers were common challenges. CONCLUSION: French professionals welcomed the new official brochure as a means to spread updated child feeding recommendations. However, this brochure could be modified and specific tools developed to better adapt to professionals' needs of communication with parents and to facilitate the relay of information. Providing updated and consistent information to parents should be considered a priority for public health stakeholders toward increased adherence to new recommendations.

Relationship of parental feeding practices and diet with children's diet among South Asians in Canada.

BACKGROUND: South Asian children's diets are considered unhealthy, yet the relationship with food parenting among South Asians is understudied. METHODS: In a cross-sectional study, questionnaires were administered to dyads of Canadian South Asian elementary and high school children and a parent. Relationships between parental factors (perceived responsibility, restriction, pressure to eat, monitoring, home food environment, nutrition knowledge and intake of fruits and vegetables (FV), sugary beverages (SB) and sweets and fast foods (SWFF) and children's intake of FV, SB and SWFF were assessed by linear regression adjusted for sociodemographics. Subgroup differences by children's age and acculturation were explored by interaction analysis. RESULTS: 291 children (age 9.8 ± 3.2 years) had mean daily intake frequencies of 3.1 ± 2.0 FV, 1.0 ± 0.9 SB and 2.1 ± 1.5 SWFF. Positive associations were found between parent and child intake of FV (standardized beta (ß) = 0.230, [95%CI 0.115, 0.345], p < 0.001), SB (ß = 0.136 [0.019, 0.252], p = 0.02), and SWFF (ß = 0.167 [0.052, 0.282], p = 0.005). Parental monitoring was associated with lower children's SWFF intake (ß = -0.131 [-0.248, -0.015], p = 0.03). Among those expressing less Western culture, parental SWFF intake was associated with child's SB intake (ß = 0.255 [0.085, 0.425], p = 0.004). Among those expressing less traditional culture, positive home food environment was associated with lower child SWFF intake (ß = -0.208 [-0.374, -0.042], p = 0.015). CONCLUSION: South Asian children's diets have stronger relationships with their parents' diets than with food parenting practices or nutrition knowledge, though parental monitoring was associated with lower unhealthy food intake. However, with greater acculturation, the home food environment was more important for unhealthy food intake.

Relationships between retrospective parental feeding practices and Chinese university students' current appetitive traits, weight status, and satisfaction with food-related life.

Accumulating evidence suggests that parental feeding practices during childhood are related to adults' eating behaviors and weight status, but research exploring these relationships is largely conducted in Western contexts. However, China, a country that holds the largest world population, has distinct patterns of eating habits and food culture from Western countries. Therefore, the present study aimed to examine relationships between retrospective parental feeding practices (e.g., concern, monitoring, pressure to eat, and restriction) and current body mass index (BMI) and satisfaction with food-related life in a sample of 476 Chinese university students (195 men; Mage = 19.78 years, SD = 1.23). We also examined whether appetitive traits mediated these associations. Retrospective parental feeding practices were significantly related with participants' current BMI (concern: r = 0.26, p < .001; pressure to eat: r = -0.15, p < .001) and satisfaction with food-related life (concern: r = 0.15, p < .001; monitoring: r = 0.12, p = .009; pressure to eat: r = 0.13, p = .006; restriction: r = 0.16, p < .001). Relationships were partially mediated by young adults' current appetitive traits (e.g., enjoyment of food, emotional overeating, satiety responsiveness, slowness in eating). These findings suggest that retrospective parental feeding practices are important correlates of young adults' current weight status and satisfaction with food-related life, and that appetitive traits partially explain these relationships in the Chinese context.

Social networking sites: a new source of child feeding information for parents in Thailand.

Social networking sites (SNSs) provide opportunities for health and nutrition communication. Data are lacking on whether these SNSs influence Thai parent's food provisioning to young children. In the current study, we examined the prevalence and characteristics of Thai parents who reported participating in child food and nutrition-SNSs and investigated the association between participation in these sites and parents' perceptions and feeding practices. A sample of 379 Thai parents completed a survey about the use of child food and nutrition-SNSs, and feeding practices and child eating behavior. Around 70% of participants, especially female millennials with their first child, have participated in SNSs that provide information about children's diets. High engagement was more common among younger and less educated participants, as well as rural dwellers and those with abnormal body mass index. Among these SNSs' participants, those with higher engagement had higher levels of trust in the nutritional information shared on SNSs. Further analyses showed that parents who have joined these sites had positive associations with not only providing children with more fresh fruits and vegetable but also more processed meats. Further investigations are needed to explore the information these SNSs provided and what influences they have on parents' perceptions around feeding children.

Parental health literacy and nutrition literacy affect child feeding practices: A cross-sectional study.

BACKGROUND: Health literacy (HL) and nutrition literacy (NL) are important issues to consider, in the provision of health care to children and the establishment of healthy eating behaviors. AIM: The study investigates the possible role of HL and NL levels of Greek parents, in parental Feeding Practices (PFP). METHODS: This is a cross-sectional study which was conducted in the urban area of the Attica region, Greece. The sample consisted of 402 parents (68.4% mothers). Parents completed the Greek version of Comprehensive Parental Feeding Questionnaire, the European Health Literacy Questionnaire 47 and the Greek version of the Nutrition Literacy Scale. Sociodemographic and anthropometric characteristics were also assessed. The non-parametric tests Mann-Whitney and Kruskal Wallis, the chi-square test and linear regression models were applied. RESULTS: The median for HL and NL were 33.69 and 24.00, respectively. Mothers applied the "child control" practice more frequently than fathers (p = 0.015). Linear regression analysis revealed that HL was associated positively with "healthy eating guidance" and "monitoring" (p = 0.009 and p < 0.0001, respectively) and negatively with "emotion regulation/food as reward" and "child control" (p = 0.037 and p = 0.015, respectively). NL was associated positively only with "healthy eating guidance" (p = 0.009), positively but marginally with "monitoring" (p = 0.051) and negatively with "emotion regulation/food as reward" (p = 0.020). CONCLUSIONS: Higher parental levels of HL and NL are significantly positively associated with better parental feeding practices in Greece.

Associations of parenting factors and weight related outcomes in African American adolescents with overweight and obesity.

This study evaluated the associations between parenting factors and adolescent weight related outcomes in African American adolescents with overweight and obesity. Baseline heights and weights were collected from 241 African American adolescents (11-16 years) with overweight and obesity. Self-reported adolescent perceptions of caregiver's parenting style (responsiveness, demandingness), parental feeding practices (monitoring, responsibility, weight related concerns, pressure-to-eat, and restriction), and their own dietary self-efficacy for healthy eating were assessed. Results demonstrated that greater parental responsiveness was significantly associated with lower adolescent body mass index (BMI) and higher adolescent dietary self-efficacy. In contrast, parental concern about adolescent weight was significantly associated with greater adolescent BMI, while greater parental responsibility for foods was associated with lower adolescent BMI. Although parental pressure-to-eat was significantly associated with higher dietary self-efficacy, greater parental restriction was associated with lower dietary self-efficacy. The results of this study highlight the importance of parental responsiveness and responsibility in understanding obesity related outcomes in African American adolescents with overweight and obesity.

Emotion Regulation Difficulties Strengthen Relationships Between Perceived Parental Feeding Practices and Emotional Eating: Findings from a Cross-Sectional Study.

BACKGROUND: People with emotional eating (EE) may experience weight gain and obesity, eating disorder psychopathology, and emotion dysregulation. Limited research has examined experiences in childhood that may be associated with EE in adulthood. Perceived parental feeding practices and emotion regulation difficulties were examined as correlates of negative and positive EE in adulthood. METHODS: A cross-sectional study using an online community sample of adults (N = 258) examined self-reported negative (Emotional Eating Scale-Revised; EE-anger/anxiety, EE-boredom, and EE-depression) and positive (Emotion Appetite Questionnaire; EE-positive) EE, perceived parental feeding practices (Child Feeding Questionnaire), and emotion regulation difficulties (Difficulties in Emotion Regulation Scale). RESULTS: Moderation analyses calculated in PROCESS macro examined emotion regulation difficulties as a moderator of relationships between perceived parental feeding practices and EE. Across all models tested, age, BMI, and gender were entered as covariates. Higher perceptions of parental control (monitoring and restriction) of unhealthy eating behaviors and pressure to eat were more strongly associated with EE-anger/anxiety and EE-positive when emotion regulation difficulties were high. Higher perceptions of parental restriction of unhealthy eating behaviors and pressure to eat were more strongly associated with higher EE-boredom when emotion regulation difficulties were high. No significant interactions between perceived parental feeding practices and emotion regulation difficulties emerged in relation to EE-depression. CONCLUSIONS: Perceived controlling parental feeding practices and emotion regulation difficulties may explain meaningful variance in negative and positive EE in adulthood.

Fostering infant food texture acceptance: A pilot intervention promoting food texture introduction between 8 and 15 months.

Healthy infant feeding practices form the basis of healthy eating behaviour later in life. The effect of providing parents with recommendations on textured food introduction between 8 and 15 months on children's experience with and acceptance of textured foods was studied. Sixty parent/child dyads were randomly assigned to a control group (CG) receiving current French recommendations and an intervention group (IG) receiving a brochure with supplementary advice, tips and monthly counselling on food texture introduction. After the intervention, parents completed self-report measures about the introduction of 188 food items, including purees, soft/small pieces, hard/large pieces and double textures. Children's acceptance of eight textured foods was assessed in a laboratory setting. Parents in the IG introduced more soft/small food pieces (P = 0.004) but not more complex textures (P = 0.15). There was no group difference in children acceptance for any of the textured foods offered in the laboratory. Independent of their study group, children's exposure to texture was associated with birth order, self-feeding with fingers, low gagging frequency and seldom use of commercial baby foods. Higher acceptance was associated with higher exposure to food pieces but not to pureed foods (either smooth or rough) and with children's eating behavioural traits (high food enjoyment, high food responsiveness and low food fussiness). This pilot intervention demonstrated that providing information can be effective in promoting the introduction of small and soft food pieces, but the most effective way to influence the introduction of more challenging textures (hard pieces and double texture) is uncertain. Further research should focus on the identification of barriers to complex texture introduction and on how building on this knowledge for a population-based public health intervention.

Are food parenting practices gendered? Impact of mothers' and fathers' practices on their child's eating behaviors.

Past research has mainly focused on the links between child eating behaviors and maternal food practices. The impact of fathers and of concordant/discordant food parenting practices within families has received much less attention. To fill this gap, both parents of 105 French children aged 2.01-6.51 years (54 boys, Mage = 3.88 years, SD = 1.40) filled in a survey with items from validated questionnaires. Results showed that fathers and mothers perceived their child's eating behaviors in similar ways (Pearson correlations between 0.34 and 0.78; M = 0.60), despite mothers taking significantly more meals with their child than fathers. Fathers reported using significantly more pressure to eat and food as reward, but reported lower levels of "family meal setting" than mothers. Moderate to high correlations were observed between mothers' and fathers' feeding practices and styles. Regression analyses showed that both maternal and paternal practices and styles were predictors for child eating behaviors. One interaction effect was observed: in households where both parents used higher levels of pressure to eat, the child showed a significantly lower food enjoyment than expected if the effects were additive. Our findings underline the importance of studying the individual role of each parent in child feeding research and that both parents within families should avoid using coercive practices. This could finally stimulate new interventions and recommendations addressed to both parents.

Adherence to the Mediterranean diet and weight status in children: the role of parental feeding practices.

The study examines Parental Feeding Practices (PFP) in relation to adherence to the Mediterranean Diet (MD) and children's weight status. It's a cross-sectional study of 402 parents (68.4% mothers), with children aged 2-12 years. Parents completed the Comprehensive Parental Feeding Questionnaire and the Mediterranean Diet Quality Index for children and adolescents (KIDMED), evaluating children's adherence to the MD. Logistic regression showed that in children aged 2-<6 years, "emotion regulation/food as reward" and "pressure" decrease MD adherence (OR = 0.186, p < 0.0001 and OR = 0.496, p = 0.004), and "monitoring" decrease excess body weight (OR = 0.284, p = 0.009). In older children (6-12 years), "healthy eating guidance" and "monitoring" increase MD adherence (OR = 3.262, p = 0.001 and OR = 3.147, p < 0.0001), "child control" decreases MD adherence (OR = 0.587, p = 0.049), "pressure" decrease excess body weight (OR = 0.495, p < 0.0001) and "restriction" increase excess body weight (OR = 1.784, p = 0.015). "Healthy eating guidance" and "monitoring" seem to be the best PFP employed, in terms of children's MD adherence and weight status.

Grazing in children: associations with child's characteristics and parental feeding practices.

PURPOSE: Grazing is a problematic eating behavior linked with poor weight loss outcomes, disordered eating psychopathology, and psychological distress in the adult population. However, no study assessed this behavior in children. Childhood is an important time frame for the development and maintenance of healthy eating habits, which can be influenced by children's psychological state, eating habits, and parental practices. This study investigates the associations between grazing behavior in children and children's psychological variables (anxiety, depression and withdrawn symptoms, body image dissatisfaction), children eating habits, and parental feeding practices. METHODS: In this cross-sectional study, 330 primary school students (6-10 years old) and their parents completed measures assessing children's grazing, anxiety/depression and withdrawn symptoms, body image dissatisfaction, children eating habits and style, and parental feeding practices. RESULTS: The path analysis tested showed that more restrictive parental feeding practices, inappropriate children eating habits, children's anxiety/depression symptoms, and body image dissatisfaction were associated with increased grazing scores (CMIN = 12.679; DF = 11; p = 0.315; RMSEA = 0.025; CFI = 0.990; NFI = 0.935; TLI = 0.982; IFI = 0.991; SRMR = 0.045). CONCLUSION: Grazing tends to occur in a context of children's psychological distress, inappropriate children eating habits, and restrictive parental feeding practices. These variables should be addressed for the improvement of healthy eating habits and in weight-loss interventions for children. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.