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Child Overweight and Parenting Concern in First Grade: Links to Parental Feeding Behaviors and Parenting Style
Hubbs-Tait, L., Topham, G. L., Harrist, A. W., Kennedy, T. S., Ledoux, T., Longoria, A., & Page, M. C.
ABSTRACT
METHOD
RATIONALE
PROCEDURE
MEASURES
RESULTS
HR07-04405545
FUNDING
Child height and weight to compute body mass index (BMI) were measured in Fall 2005 or 2006 during baseline data collection for a randomized child overweight intervention.
Parents completed questionnaires in Spring 2006 or 2007 and returned them to school or through the mail.
467 parents provided informed consent for children and agreed to complete questionnaires themselves.
457 children completed anthropometric measurement.241,216
Exclusion criterion of BMI < 5th percentile excluded 13 children (11 boys, 2 girls).
Final sample = 444 parents (93.5% mothers) and children:Age: M = 6.95 (.39)Gender: 230 boys, 214 girls
This sample comprises cohorts 1 and 2 (wave 1) of the Families and Schools for Health project. Cohort 1-wave1 data on parenting styles and feeding practices appeared in Journal of the American Dietetic Association, July 2008.
Feeding Practices • Subscales and sample items from Child Feeding
Questionnaire (CFQ, Birch, Fisher et al., 2001) :• Responsibility: How often are you responsible for
deciding what your child’s portion sizes are?• Restriction: I offer my child her/his favorite foods in
exchange for good behavior• Pressure to eat: My child should always eat all of the
food on her/his plate.• Perception of child weight: Your child now is (1)
noticeably underweight, (2) underweight, (3) normal, (4) overweight, (5) noticeably overweight.
• Overweight concern: How concerned are you about your child becoming overweight? Responses from 1- unconcerned to 4 – very concerned.
• Subscales and sample items from Parent Food Socialization Questionnaire (PFSQ, Cullen, Baranowski et al., 2000):
• Encourage: How much do you encourage your child to eat vegetables at supper?
• Model: I eat vegetables at lunch when I am with my child…
Parenting Styles• Authoritarian, authoritative, and permissive parenting
were assessed by the Parenting Styles and Dimensions Questionnaire (PSDQ; Robinson et al., 2001).
Internal consistencies of all measures were published in Hubbs-Tait et al. (2008) and ranged from .69 to .91.
Child Height and Weight Heights and weights were used to calculate individual BMI, BMI percentile rankings and BMI z-scores using the Epi-Info Software program (release 4.3.0, 2006, CDC Atlanta GA).
Recent reports vary in the degree of overlap among the following : parental feeding practices and attitudes, parenting styles, parental perception of child weight, parental concern about child overweight, and actual child weight. In nutrition science research, parental perceptions of child weight have been found to underestimate actual child weight. In contrast, parental concern about child weight and children’s actual weight are highly congruent. In developmental science research, parenting styles have been linked to child obesity or overweight in some studies but not others.
In the current report we test differences in parental feeding practices, attitudes, and styles among groups of parents differing in congruence between perceptions of their child’s weight and actual child weight. We also evaluate whether parents of obese children with more realistic perceptions differ in parenting practices, attitudes, or styles. Finally, we evaluate overlap between parental concern about overweight and parenting styles and feeding practices. Divergence in parental perceptions and child weight reality may help explain the lack of success of obesity interventions.
DATA ANALYSES
12% Underweight
88%Normal Weight
Parent Perception of Weight of255 Children > 5th and < 75th
n = 224
DIFFERENCES BETWEEN PARENT PERCEPTION OF CHILDREN’S WEIGHT AND CHILD ACTUAL WEIGHT
1.7% Under weight
38.3%
Nor-mal
weight
51.7% overweight
8.3% noticeably overweight
Parental perception of weight of 60 children > 95th %tile
95.5% Normal weight
4.5% Overweight
Parental perception of weight of 66 children > 85th and < 95th
100%Normal Weight
Parent Perception of Weight of 63 Children > 75th and < 85th
Children’s BMI percentiles were as follows:• > 5th percentile and < 75th percentile =
255• > 75th percentile and < 85th percentile =
63• > 85th percentile and < 95th percentile =
66 • > 95th percentile = 60Parents underestimated actual weight status of children. Numbers of parents perceiving their children as having normal weight are indicated on the pie charts in textboxes and ranged from 23/60 for parents of obese children to 224/ 255 for parents of normal weight children.
Analysis of variance comparing the parenting behaviors and styles of the four weight groups of parents who rated their children as normal revealed:• No differences in parenting style across the four groups.• Significant difference across groups in pressure to eat, with 23 parents of obese children having lowest mean for pressure to eat and
differing from the other means of the other three groups, t (1, 366) = 2.75, p = .006 (see Table 1).• Significant different across groups in parental concern about child overweight, with 23 parents of obese children showing greatest concern. The linear trend in concern for lowest to highest BMI groups was significant, F (1, 368) = 25.56, p = .0000007 (see Table 1).
Interpretation: Although parental perceptions are not congruent with child weight, differences in pressuring of children to eat and in concern about child overweight suggest that parents’ feeding behavior and emotions are more in line with actual child weight than are their perceptions.
n = 63 n = 63 n = 23
24 parents saw obese children as underweight (n = 1) or normal weight (n = 23). 36 saw obese children as overweight or noticeably overweight. We compared the 24 underestimators with the 36 more accurate parents in terms of parenting styles and feeding practices (see Table 2).
This project is supported by OCAST Grant HR07-044 to Amanda W. Harrist, Melanie Page, Glade Topham, Lenka Humenikova Shriver, and Laura Hubbs-Tait, College of Human Environmental Sciences, Oklahoma State University and USDA-CSREES Grant 05545 to Amanda W. Harrist, Tay S. Kennedy, Glade Topham, Laura Hubbs-Tait, and Melanie Page. For further information about the FiSH Project, contact [email protected]. For further information about this poster, contact [email protected].
OBESEOVERWEIGHT
Variable and group Mean SD
Pressure to eat
Normal 2.90 0.97
Borderline 2.70 0.93
Overweight 2.58 0.84
Obese 2.17 0.82
Overweight concern
Normal 1.51 0.87
Borderline 1.59 0.87
Overweight 2.14 0.98
Obese 2.35 0.88
SAMPLE
PERCEPTION DIFFERENCES AMONG PARENTS OF OBESE
CHILDREN
Data analyses included:• Chi square analyses – to construct pie charts• One-way analysis of variance – to evaluate differences
in parenting styles and feeding practices• Logistic regression – to evaluate which feeding
practices increased odds of obesity and overweight
Consistent with Krebs et al. (2007)> 85th %tile and < 95th = overweight> 95th percentile = obeseClassifications used here:> 5th %tile and < 75th = normal > 75th %tile and < 85th = borderline overweight
Table 1. Item means and standard deviations for weight groups
Table 2. Item means Variable and group Mean SD
Responsibility*
Underestimate 4.49 0.53
Accurate 4.18 0.60
Model fruit and veg*
Underestimate 2.84 0.51
Accurate 2.56 0.57
Concern***
Underestimate 2.42 0.93
Accurate 3.42 0.77
* p < .05, *** p < .001
Logistic regressions compared 60 parents of obese children with the other 384 parents. • For each increase of 1 in parental
Restriction, child odds of obesity increased by 2.72.• Restriction Exp(b) = 2.72 (95% CI of 1.65,
4.49), p = .000009Logistic regressions were conducted comparing the 66 parents of overweight children with parents of all children with BMI < 85th percentile.• For each increase of 1 in parental
Restriction, child odds of obesity increased by 2.03. • Restriction Exp(b) = 2.03 (95% CI of 1.28,
3.22), p = .003
When parents of obese children who view them as normal are compared to parents of children in other weight groups, the major differences are in
overweight concern and pressure to eat. Although parents of obese children say that they see their children as normal in weight, these two variables suggest
otherwise and offer potential channels for behavior change.
When parents of obese children who view them as normal are compared to parents of obese children who view them as overweight, the underestimating
parents also report themselves as feeling more responsible for feeding their child and for their child’s eating behaviors. They also report greater modeling of eating
fruits and vegetables and lower concern about their child’s overweight. This pattern suggests that these parents may be more defensive or resistant about interventions to change family eating behaviors and may help explain lack of
success in obesity and overweight interventions.
PERCEPTION DIFFERENCES AMONG PARENTS OF OBESE
CHILDREN
CORRELATIONS
Perception and Concern: r = .419Perception and Pressure: r = -.301Concern and Authoritarian: r = .109Concern and Restriction: r = .256Concern and Pressure: r = -.131
Participants were 444 children and parents participating in wave 1 of the Families and Schools for Health (FiSH) project. Parents completed questionnaires and children’s heights and weights were measured during baseline data collection for a randomized child overweight intervention. The current report examines parental feeding practice and style differences for parents with greater and less convergence in perception of child weight status and child actual status. Compared to parents of obese children who saw them as overweight, parents of obese children who perceived them as normal weight felt more responsible for child eating, reported more modeling of eating fruits and vegetables, and reported less concern about child overweight. Results are interpreted as suggesting that parents who underestimate child weight may be more resistant to overweight interventions for their children.
CONCLUSIONS
Wave 1 Child Weight Status Groups
