Child Obesity and Parental Concern: Mismatch, Feeding Behaviors, and Child Obesity and Parental Concern: Mismatch, Feeding Behaviors, and Parenting StylesParenting Styles

Nicole Lee Moore, Laura Hubbs-Tait, Robert E. Larzelere, Eric Ray Baker, Tay S. Kennedy, & Nicole Lee Moore, Laura Hubbs-Tait, Robert E. Larzelere, Eric Ray Baker, Tay S. Kennedy, & Glade L.TophamGlade L.Topham

Departments of Human Development and Family Science and Nutritional ScienceDepartments of Human Development and Family Science and Nutritional ScienceOklahoma State UniversityOklahoma State University

RationaleRationaleAlthough the increase in child obesity appears to have stabilized from 1999-2000 to 2005-2006, the percentage of 2- to 5-year-old-children with BMI > 85th percentile was recently reported to be 24.4% (Ogden et al, 2008). One explanation for the high rate of child obesity is that parental concern about child obesity and overweight lags behind actual child weight. Implicit in this explanation is that parents do not take steps quickly enough to halt increases in child weight. There is need to examine relationships among parental concern about child overweight, general parenting style, specific feeding practices, and actual child weight.

ABSTRACTStudy objective was to evaluate relations among parental concern about child overweight, parenting styles, specific feeding practices, and actual child weight. Participants were 128 (70 boys and 58 girls) children in rural Head Start and their parents. Measures included Parental Behavior Questionnaire – Head Start (PBQ-HS), Demographic Information Questionnaire, Child Feeding Questionnaire (CFQ), Parent Food Socialization Questionnaire, and child anthropometric measurements. Parental concern about child overweight did lag behind child actual weight in that 36.4% of parents of obese children were not concerned about their children’s weight, and 65.2% of parents of overweight children were not concerned. Restrictive parenting style, external food focus, rationale, and perceived responsibility predicted parental concern about child weight after the link between child body mass index (BMI) and concern was controlled. Odds of child obesity were associated with permissive parenting style, Exp(b) = 2.84 (95% CI of 1.06, 7.60), P = .038, and discouraging feeding practices, Exp(b) = 3.77 (95% CI of 1.35, 10.55), P = .011. Above and beyond these two parenting variables, parental concern about child overweight was associated with an increase in the child’s odds of being obese, Exp(b) = 2.02 (95% CI of 1.41, 2.90), P = .0002. Regression analyses revealed greater parental control of junk foods in the fall was linked to decreases in BMI-z from fall to spring (β = -.215), R2 = .046, P = .046. We conclude that accelerating child weight in Oklahoma is linked to parenting processes, lag between parental concern and actual child weight, inappropriate feeding behaviors, and restrictive and permissive parenting styles.

Research hypothesesResearch hypotheses•Hypothesis 1: Mismatch between parental concern about child overweight and actual child weight, with parental concern lagging behind child obesity and overweight.

•Hypothesis 2 : Parental feeding behaviors that could increase child unhealthy eating would be linked to parental concern about child overweight.

•Hypothesis 3: Restrictive general parenting style that could result in child emotion-based eating would be linked to parental concern about child overweight, but responsive and permissive style would not.

• Hypothesis 4: Permissive parenting style and inappropriate feeding behaviors would increase the odds of children’s being obese or overweight;

•Hypothesis 5: Restrictive parenting style and feeding behaviors would predict fall to spring gains in preschool child weight.

Method - ParentsDemographic Questionnaire •Child Feeding Questionnaire (CFQ) – Subscales: perceived responsibility, overweight concern, control of junk foods (Birch et al. 2001) •Parent Behavior Questionnaire – Head Start (PBQ-HS) – Subscales: Active-responsive, passive- permissive, active-restrictive (Coolahan et al., 2002) •Food Socialization Questionnaire - Subscales: discouraging, external food focus, parent rationale (Cullen et al. 2000)

Participants•128 children (70 boys)• Of 152 children, 150 had BMI > 5th percentile in both fall and spring. • 132 parents (88% return rate) answered questionnaires• 58.5% White; 20.3% Hispanic• maternal education: 20.8% high school dropout; 60.8% high school grad; 18.4% college grad.

Method – ChildrenResearchers evaluated child anthropometry – including height and weightHeights and weights were then 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).

Definitions: Obese = BMI > 95th percentileOverweight = BMI > 85th percentileNormal weight = BMI < 85th percentile