Parental Feeding Style and the Inter‐generational Transmission of Obesity Risk

Objective: This study was designed to determine whether a community sample of obese mothers with young children used different feeding styles compared with a matched sample of normal‐weight mothers. Four aspects of feeding style were assessed: emotional feeding, instrumental feeding (using food as a reward), prompting/encouragement to eat, and control over eating. Research Methods and Procedures: Participants were from 214 families with same‐sex twins; 100 families in which both parents were overweight or obese and 114 in which both parents were normal weight or lean. Results: We found that obese mothers were no more likely than normal‐weight mothers to offer food to deal with emotional distress, use food as a form of reward, or encourage the child to eat more than was wanted. The obese and normal‐weight mothers did differ on “control”; obese mothers reported significantly less control over their children's intake, and this was seen for both first‐born and second‐born twins. Twin analyses showed that these differences were not in response to children's genetic propensities, because monozygotic correlations were no greater than dizygotic correlations for maternal feeding style. Discussion: These results suggest that the stereotype of the obese mother, who uses food in nonnutritive ways so that her child also becomes obese, is more likely to be myth than fact. However, the results raise the possibility that lack of control of food intake might contribute to the emergence of differences in weight.     

Maternal Feeding Practices Become More Controlling After and Not Before Excessive Rates of Weight Gain

It is unclear whether controlling maternal feeding practices (CMFPs) lead to or are a response to increases in a child's BMI. Our goal was to determine the direction of this relationship. Data were obtained from National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development. Child BMI z‐score (zBMI) was calculated from measured weight and height. CMFP was defined by, “Do you let your child eat what he/she feels like eating?”. Change in child zBMI was calculated between 4–7 years and 7–9 years, and dichotomized into “increasing” vs. “no change or decreasing”. Change in CMFP was calculated over the same time periods, and dichotomized into “more controlling” vs. “no change or less controlling.” Multiple logistic regression, stratified by gender and controlling for race, maternal education, maternal weight status, and baseline child weight status, was used for analysis. A total of 789 children were included. From 4 to 9 years, mean zBMI increased (P = 0.02) and mothers became more controlling (P < 0.001). Increasing CMFP between 4 and 7 years was associated with decreased odds of increasing zBMI between 7 and 9 years in boys (odds ratio = 0.52, 95% confidence interval = 0.27–1.00). There was no relationship in girls. Increasing zBMI between 4 and 7 years was associated with increasing CMFPs between 7 and 9 years in girls (odds ratio = 1.72, 95% confidence interval = 1.08–2.74), but not boys. Early increases in CMFP were not associated with later increases in zBMI for boys or girls. However, early increases in zBMI among girls were associated with later increases in CMFP. Clarifying the relationship between maternal feeding practices and child weight will inform future recommendations.     

Controlled study of critical parent and family factors in the obesigenic environment

Objective: Critical gaps remain in our understanding of the obesigenic family environment. This study examines parent and family characteristics among obese youth presenting for treatment in a clinic setting. Research Methods and Procedures: Families of 78 obese youth (BMI z‐score = 2.4; age, 8 to 16 years; 59% girls; 49% African‐American) were compared with 71 non‐overweight (BMI z‐score = ?0.02) demographically matched comparisons. Parents completed measures assessing family demographics, psychological distress (Symptom Checklist 90‐Revised), and family functioning both broadly (Family Environment Scale: Conflicted, Support, Control) and at mealtimes (About Your Child's Eating‐Revised: Mealtime Challenges, Positive Mealtime Interaction). Height and weight were obtained from all participants. Results: Compared with mothers and fathers of non‐overweight youth, parents of obese youth had significantly higher BMIs (p < 0.001). Mothers of obese youth reported significantly greater psychological distress (p < 0.01), higher family conflict (p < 0.05), and more mealtime challenges (p < 0.01). Less positive family mealtime interactions were reported by both mothers (p < 0.01) and fathers (p < 0.05) of obese youth. These group differences did not vary by child sex or race. Logistic regression analyses indicated that maternal distress and mealtime challenges discriminated between obese and non‐overweight youth after controlling for maternal BMI. Family conflict was explained, in part, by maternal distress. Discussion: Obese youth who present for treatment in a clinic setting are characterized by psychosocial factors at the parent and family level that differ from non‐overweight youth. These data are critical because they identify factors that may be serving as barriers to a family's or youth's ability to implement healthy lifestyle behaviors but that are potentially modifiable.     

Additive Interactions of Maternal Prepregnancy BMI and Breast‐feeding on Childhood Overweight

Objective: To examine the interactions of maternal prepregnancy BMI and breast‐feeding on the risk of overweight among children 2 to 14 years of age. Research Methods and Procedures: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI ≥95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI ≥30 kg/m². The duration of breast‐feeding was measured as the weeks of age from birth when breast‐feeding ended. Results: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m²; p < 0.001 for linear trend). Breast‐feeding for ≥4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast‐feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast‐fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). Discussion: The combination of maternal prepregnancy obesity and lack of breast‐feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast‐feeding in developing childhood obesity intervention programs.     

Ability to taste 6-n-propylthiouracil and BMI in low-income preschool-aged children

Background: Sensitivity to the bitter compound 6‐n‐propylthiouracil (PROP) is genetically mediated. Sensitivity to PROP has been associated with weight status in both adults and children. Objective: To determine whether there is an association between PROP sensitivity and BMI in low‐income children of diverse race/ethnicity, among whom there is a high prevalence of obesity. Methods and Procedures: Eighty‐one preschool‐aged children attending Head Start tasted a solution of 560 μmol/l PROP and reported whether it tasted “like water” or “like something else”. Mothers reported child's race, age, maternal education, maternal weight and height, child's reluctance to sample new foods via the Food Neophobia Scale (FNS), and child's dietary intake using a food frequency questionnaire. Child weight and height were measured. BMI was calculated and for children, expressed in z‐scores. Regression analyses were used to evaluate the relationship between child's PROP taster status and BMI z‐score, testing covariates child's age, gender, race, maternal education and BMI, and child's FNS score. Children's dietary intake was compared by PROP taster status. Results: PROP tasters, compared with nontasters, had significantly higher BMI z‐scores (0.99 (s.d. 1.24) vs. 0.03 (1.12), P = 0.004) and had a significantly higher prevalence of overweight (31.8% vs. 5.6%, P = 0.025), but demonstrated no differences in reported dietary intake. The most parsimonious model predicting the child's BMI z‐score included only maternal BMI and the child's PROP taster status (R ² = 22.3%). Discussion: A genetically mediated ability to taste bitter may contribute to obesity risk in low‐income, preschool‐aged children.     

The Relationship of Childhood Adiposity to Parent Body Mass Index and Eating Behavior

Objective: To better understand risk factors for the development of obesity in early childhood, we examined the association between children's adiposity and their parents' eating behavior and body mass index (BMI). Research Methods and Procedures: Parents of 85 white children 36 months of age (49 boys and 36 girls) completed the Three‐Factor Eating Questionnaire measuring three dimensions of parent eating behavior: disinhibited eating, cognitive restraint of eating, and susceptibility to hunger. Parent BMI (kg/m²) was calculated using self‐reported height and weight. The children's percentage body fat was assessed by dual energy X‐ray absorptiometry analysis. Results: Twenty‐six percent of parents were obese (BMI ≥ 30 kg/m²). Both maternal and paternal BMI were associated with higher scores for disinhibition (r = 0.69 and r = 0.68, p < 0.001), and maternal BMI was also associated with higher scores for hunger (r = 0.51, p < 0.001). There were no significant relationships between children's percentage body fat and parent eating scores, and the correlation between children's percentage body fat and parent BMI was significant only between mothers and daughters (r = 0.35, p = 0.04). Obese parents were no more likely to have a child who was fatter (upper quintile of percentage body fat for gender). Discussion: Among 36 month‐old white children, parent eating behavior was related to parent BMI, but not to children's adiposity. There was only a weak relationship between parent BMI and child adiposity. Despite the aggregation of adiposity within families due to shared genes and environments, children may not express differences in susceptibility to obesity by 3 years of age.     

Psychosocial Factors and Health Perceptions in Parents and Children Who Are Overweight or Obese

This study examined the relationships among weight status (BMI), health perceptions, and psychosocial characteristics in children, parents, and parent–child dyads. A convenient sample of 114 parent–child dyads participated. All children were overweight or obese. Parents and children completed questionnaires by self‐report or interview. Questionnaires included the Parenting Stress Index–Short Form (PSI), the Parents' Stage of Change (SOC) Questionnaire, and the Pediatric Quality of Life Inventory (PedsQL). Child's mean age was 10.34 years (s.d. = 1.87), mean BMI was 28.13 kg/m² (s.d. = 5.46), and mean BMI z‐score was 2.17 (s.d. = 0.38). Parent mean age was 37.28 years (s.d. = 12.66) and mean BMI was 34.07 kg/m² (s.d. = 8.18). Most parents (68.5%) reported that they and their children (70.7%) were African American and many (44.3%) reported that they and their children were Hispanic. Significant correlations included: child health perceptions and child BMI (r = 0.309, P < 0.001) and parent perception of weight and parent BMI (r = 0.691, P < 0.001). For parent–child dyads, one correlation approached significance (child health perceptions and parent stage of change (r = ?0.269, P < 0.01). Findings suggest that characteristics of parent–child dyads may be important considerations in the management of childhood obesity.     

Identification of an Obese Eating Style in 4‐year‐old Children Born at High and Low Risk for Obesity

This study tested whether children's eating behavior and parental feeding prompts during a laboratory test meal differ among children born at high risk (HR) or low risk (LR) for obesity and are associated with excess child weight gain. At 4 years of age, 32 HR children (mean maternal prepregnancy BMI = 30.4 kg/m²) and 29 LR children (maternal BMI = 19.6 kg/m²) consumed a test meal in which their eating behavior was assessed, including rate of caloric consumption, mouthfuls/min, and requests for food. Parental prompts for the child to eat also were measured at year 4, and child body composition was measured at ages 4 and 6 years. T‐tests, and logistic and multiple regression analyses tested study aims. Results indicated that HR and LR children did not differ in eating rate or parental feeding prompts. Greater maternal BMI, child mouthfuls of food/min, and total caloric intake/min during the test meal predicted an increased risk of being overweight or obese at age 6, whereas greater active mealtime was associated with a reduced risk of being overweight or obese. Regression analyses indicated that only mouthfuls of food/min predicted changes in BMI from 4 to 6 years, and mouthfuls of food/min and gender predicted 2‐year changes in sum of skinfolds and total body fat. Thus, a rapid eating style, characterized by increased mouthfuls of food/min, may be a behavioral marker for the development of childhood obesity.     

Parental obesity moderates the relationship between childhood appetitive traits and weight

Objective:

In this study, the independent and combined associations between childhood appetitive traits and parental obesity on weight gain from 0 to 24 months and body mass index (BMI) z‐score at 24 months in a diverse community‐based sample of dual parent families (n = 213) were examined.

Design and Methods:

Participants were mothers who had recently completed a randomized trial of weight loss for overweight/obese postpartum women. As measures of childhood appetitive traits, mothers completed subscales of the Children's Eating Behavior Questionnaire, including Desire to Drink (DD), Enjoyment of Food (EF), and Satiety Responsiveness (SR), and a 24‐h dietary recall for their child. Heights and weights were measured for all children and mothers and self‐reported for mothers' partners. The relationship between children's appetitive traits and parental obesity on toddler weight gain and BMI z‐score were evaluated using multivariate linear regression models, controlling for a number of potential confounders.

Results:

Having two obese parents was related to greater weight gain from birth to 24 months independent of childhood appetitive traits, and although significant associations were found between appetitive traits (DD and SR) and child BMI z‐score at 24 months, these associations were observed only among children who had two obese parents. When both parents were obese, increasing DD and decreasing SR were associated with a higher BMI z‐score.

Conclusions:

The results highlight the importance of considering familial risk factors when examining the relationship between childhood appetitive traits on childhood obesity.     

Maternal corticotropin-releasing hormone levels during pregnancy and offspring adiposity

Objective: Animal models suggest that fetal exposure to glucocorticoids can program adiposity, especially central adiposity, later in life. We examined associations of maternal corticotropin‐releasing hormone (CRH) levels in the late 2nd trimester of pregnancy, a marker of fetal glucocorticoid exposure, with child adiposity at age 3 years. Research Methods and Procedures: We analyzed data from 199 participants in Project Viva, a prospective cohort study of pregnant women and their children, At age 3 years, the main outcomes were age‐sex‐specific BMI z score and the sum of subscapular (SS) and triceps (TR) skinfold thicknesses to represent overall adiposity, and ratio of SS to TR (SS:TR) to represent central adiposity. Results: Mean (standard deviation) maternal 2nd trimester log CRH was 4.94 (0.56) pg/mL. At age 3, mean (standard deviation) for BMI z score was 0.52 (1.02); for SS + TR, 16.51 (3.94) mm; and for SS:TR, 0.67 (0.17). Log CRH was mildly inversely correlated with birth weight (r = ?0.08), chiefly because of its association with length of gestation (r = ?0.21) rather than fetal growth (r = ?0.004). After adjustment for sociodemographic factors, maternal smoking, BMI, and gestational weight gain, fetal growth, length of gestation, breastfeeding duration, and (for SS:TR only) child's 3‐year BMI, each increment of 1 unit of log CRH was associated with a reduction in BMI z score [?0.43; 95% confidence interval (CI), ?0.73, ?0.14; p = 0.004] and possible reduction in SS + TR (?1.10; 95% CI, ?2.33, 0.14; p = 0.08). In contrast, log CRH was associated with higher SS:TR (0.07; 95% CI, 0.02, 0.13; p = 0.007). Discussion: Fetal exposure to glucocorticoids, although associated with an overall decrease in body size, may cause an increase in central adiposity.     

Maternal and paternal controlling feeding practices: reliability and relationships with BMI

Objective: This study aimed to examine the interrelationships between mothers' and fathers' reports on the child‐feeding questionnaire (CFQ), the BMI of parents and their children, and observations of parents' controlling feeding practices at mealtimes. Methods and Procedures: Twenty‐three mothers and twenty‐three fathers of children aged between 18 and 67 months reported on their child‐feeding practices, on their child's height and weight, and were observed during a normal family mealtime at home. Results: No associations were found between mothers' reported and observed feeding practices. Fathers' reported pressure to eat and restriction were associated with more controlling observed mealtime feeding practices. Mothers and fathers did not significantly differ in their reported or observed child‐feeding practices. Children's BMI was not related to maternal or paternal reported or observed feeding practices. More mealtime pressure was observed in parents with a higher BMI. Discussion: Fathers' self‐reports of their mealtime practices are reliable. Mothers' feeding practices may differ when fathers are present and further work should examine mothers at mealtimes with and without fathers. Although children's BMI was not related to parents' use of reported or observed control, parents with a higher BMI were more controlling, highlighting the importance of considering parents' own weight in future studies.     

Getting Worse: The Stigmatization of Obese Children

Objective: The prevalence of childhood obesity more than doubled in the period from 1961 to 2001. We replicated a 1961 study of stigma in childhood obesity to see what effect this increased prevalence has had on this stigma. Research Methods and Procedures: Participants included 458 5th‐ and 6th‐grade children attending upper‐middle and lower‐middle income U.S. public schools. Children ranked six drawings of same‐sex children with obesity, various disabilities, or no disability (“healthy”), in order of how well they liked each child. Results: Children in both the present and the 1961 study liked the drawing of the obese child least. The obese child was liked significantly less in the present study than in 1961 [Kruskal‐Wallis H (1) = 130.53, p < 0.001]. Girls liked the obese child less than boys did [H (1) = 5.23, p < 0.02]. Children ranked the healthy child highest and significantly higher than in 1961 [H (1) = 245.40, p < 0.001]. The difference in liking between the healthy and obese child was currently 40.8% greater than in 1961. Discussion: Stigmatization of obesity by children appears to have increased over the last 40 years.     

Obesity Prevention in Preschool Native‐American Children: A Pilot Study Using Home Visiting

Objective : To determine whether maternal participation in an obesity prevention plus parenting support (OPPS) intervention would reduce the prevalence of obesity in high‐risk Native‐American children when compared with a parenting support (PS)‐only intervention. Research Methods and Procedures : Forty‐three mother/child pairs were recruited to participate. Mothers were 26.5 ± 5 years old with a mean BMI of 29.9 ± 3 kg/m². Children (23 males) were 22 ± 8 months old with mean weight‐for‐height z (WHZ) scores of 0.73 ± 1.4. Mothers were randomly assigned to a 16‐week OPPS intervention or PS alone. The intervention was delivered one‐on‐one in homes by an indigenous peer educator. Baseline and week 16 assessments included weight and height (WHZ score and weight‐for‐height percentile for children), dietary intake (3‐day food records), physical activity (measured by accelerometers), parental feeding style (Child Feeding Questionnaire), and maternal outcome expectations, self‐efficacy, and intention to change diet and exercise behaviors. Results : Changes in WHZ scores showed a trend toward significance, with WHZ scores decreasing in the PS condition and increasing among the OPPS group (?0.27 ± 1.1 vs. 0.31 ± 1.1, p = 0.06). Children in the OPPS condition also significantly decreased energy intake (?316 ± 835 kcal/d vs. 197 ± 608 kcal/d, p < 0.05). Scores on the restriction subscale of the Child Feeding Questionnaire decreased significantly in the OPPS condition (?0.22± 0.42 vs. 0.08± 0.63, p < 0.05), indicating that mothers in the OPPS group were engaging in less restrictive child feeding practices over time. Discussion : A home‐visiting program focused on changing lifestyle behaviors and improving parenting skills showed promise for obesity prevention in high‐risk Native‐American children.     

Influence of parents' eating behaviors and child feeding practices on children's weight status

Objective : To investigate the effects of mothers’ and fathers’ eating behaviors, child feeding practices, and BMI on percentage body fat and BMI in their children. Research Methods and Procedures : Four hundred fifty‐eight parents (239 mothers, 219 fathers) were asked to complete two questionnaires: the Three‐Factor Eating Questionnaire and the Child Feeding Questionnaire, which measure dimensions of parent eating behavior and child feeding practices, respectively. Parent BMI was calculated from self‐reported height and weight; children's measures included BMI and percentage fat assessed by DXA. Regression analyses were used to analyze relationships between parents’ BMI and questionnaire scores and children's weight status. Results : One hundred forty‐three mothers and 68 fathers returned questionnaires, representing parents of 148 children 3 to 5 years old (78 boys). Children's weight was related to mothers’ BMI, but not fathers’. Girls had a greater BMI if either parent reported being overweight as a child, and both girls and boys were likely to be overweight if their mothers believed they had risky eating habits (fussiness, eating too much, etc.). Girls with fathers who were more controlling had a higher percentage fat; these fathers were also more concerned about their daughters’ future health. Discussion : Mothers exert a strong influence over their children's weight and seem to be more concerned about their children's eating behaviors; however, fathers play a role in imposing child feeding practices. Gender bias may be present in child feeding, as suggested by dissimilar effects of parent practices on the weight status of girls vs. boys. Fathers should be included in future studies analyzing parent feeding practices and children's weight outcome.     

Psychosocial predictors of 4‐year BMI change in overweight and obese children in primary care

Objective:

This study aimed to determine whether (( 1 ) ) initial and/or (( 2 ) ) changes in psychosocial functioning predict body mass index (BMI) z‐score change over 4 years in overweight/mildly obese 5‐ to 9‐year old children presenting to primary care.

Design and Methods:

Eligible participants (n = 258) were overweight/mildly obese children (IOTF criteria) recruited into the LEAP2 trial (ISRCTN52511065) from 3,958 children visiting general practitioners in Melbourne, Australia from May 2005 to July 2006. Predictors were change scores calculated from repeated measures of parent‐ and child‐reported child health‐related quality of life (PedsQL) and self‐esteem; child‐reported desire to be thinner; and parent‐reported child weight concern. Outcome was measured BMI z‐score change from baseline to 4 years.

Results:

The 189 respondents (61% female; 73% retention) showed little mean change in BMI z‐score (?0.08) but wide variation (standard deviation 0.50, range ?1.32 to 1.20). Only one baseline measure (better parent‐reported PedsQL School Functioning) predicted improving BMI z‐score. However, parents and children consistently reported that changes in psychosocial functioning (i.e., PedsQL Social and Global Self‐esteem) were inversely related to BMI z‐score change scores. The strongest predictors of decreases in BMI z‐scores were changes in child‐reported body‐image variables, i.e., improvements in Physical Appearance Self‐esteem (β =0.40, 95% CI ?0.98 to ?0.15, P < 0.01) and declines in Desire to be Thinner (β = 0.33, 95% CI 0.04 to 0.23, P < 0.01).

Conclusions:

At presentation to primary care, it seems unlikely that targeting the psychosocial factors measured in this study would influence BMI z‐score change in overweight/mildly obese children. Subsequent change in psychosocial well‐being covaries with BMI z‐score change and may have important adolescent ramifications; the causal directions for these associations require further research.

     

The Effect of Breast‐Feeding with and without Formula Use on the Risk of Obesity at 4 Years of Age

Objective: To determine the minimal duration of breast‐feeding required to protect against later obesity, whether the concurrent use of formula lessened any protective effect of breast‐feeding, and what maternal or child characteristics might modify the association between breast‐feeding and child obesity. Research Methods and Procedures: This was a retrospective cohort study. Participants were 73, 458 white and black low‐income children followed from birth through 4 years of age. Obesity at age 4 years was defined as measured BMI ≥ 95th percentile. Feeding exposure was based on breast‐feeding duration and the age of formula initiation. Covariates were obtained from the children's birth certificates. Results: At age 4 years, the prevalence of obesity was 11.5%. Only 16% of children were breast‐fed 8 weeks or longer. Breast‐feeding was associated with a reduced risk of obesity only in white children whose mothers had not smoked in pregnancy. In this subgroup, the reduction in obesity risk (adjusted odds ratio, 95% confidence interval), compared with those never breast‐fed, occurred only for children who were breast‐fed at least 16 weeks without formula (0.71, 0.56 to 0.92) or at least 26 weeks with concurrent formula (0.70, 0.61 to 0.81). Among whites whose mothers smoked in pregnancy and among blacks, breast‐feeding was not associated with a reduced risk of obesity at age 4 years. Discussion: In a population of low‐income children, breast‐feeding was associated with a reduced risk of obesity at age 4 years only among whites whose mothers did not smoke in pregnancy and only when breast‐feeding continued for at least 16 weeks without formula or at least 26 weeks with formula.     

Maternal short stature does not predict their children's fatness indicators in a nutritional dual‐burden sample of urban Mexican Maya

The co‐existence of very short stature due to poor chronic environment in early life and obesity is becoming a public health concern in rapidly transitioning populations with high levels of poverty. Individuals who have very short stature seem to be at an increased risk of obesity in times of relative caloric abundance. Increasing evidence shows that an individual is influenced by exposures in previous generations. This study assesses whether maternal poor early life environment predicts her child's adiposity using cross sectional design on Maya schoolchildren aged 7–9 and their mothers (n = 57 pairs). We compared maternal chronic early life environment (stature) with her child's adiposity (body mass index [BMI] z‐score, waist circumference z‐score, and percentage body fat) using multiple linear regression, controlling for the child's own environmental exposures (household sanitation and maternal parity). The research was performed in the south of Merida, Yucatan, Mexico, a low socioeconomic urban area in an upper middle income country. The Maya mothers were very short, with a mean stature of 147 cm. The children had fairly high adiposity levels, with BMI and waist circumference z‐scores above the reference median. Maternal stature did not significantly predict any child adiposity indicator. There does not appear to be an intergenerational component of maternal early life chronic under‐nutrition on her child's obesity risk within this free living population living in poverty. These results suggest that the co‐existence of very short stature and obesity appears to be primarily due to exposures and experiences within a generation rather than across generations. Am J Phys Anthropol 153:627–634, 2014. © 2013 Wiley Periodicals, Inc.     

The relationship between parents' anti-fat attitudes and restrictive feeding

Objective: Anti‐fat prejudice is a common attitude in our society, and it has implications for those who hold and are targets of this prejudice. Little is known, however, about how parents’ anti‐fat attitudes impact the ways they feed their young children. We hypothesized that parents’ attitudes about weight would predict parents’ restrictive feeding practices above and beyond the effects of the child's actual weight and the parents’ concern about child overweight. Research Methods and Procedures: A total of 126 mothers and 102 fathers returned surveys about anti‐fat attitudes, feeding practices (restriction for weight and restriction for health), and concern about child overweight. Results: Parental concern about child overweight was related to higher restrictive feeding practices for both mothers and fathers. Parents’ anti‐fat attitudes also predicted restrictive feeding above and beyond the effects of parent and child BMI and parental concern about overweight. Discussion: These findings suggest that parents’ anti‐fat attitudes impact the way they feed their children.     

Maternal BMI and country of birth as indicators of childhood obesity in children of Mexican origin

Objective: The goal of this study was to evaluate the relationship between maternal and childhood BMI at baseline in a group of 5‐ to 18‐year‐old children and their mothers, all of whom were of Mexican origin, low socioeconomic status, and enrolled in a cohort study in Houston, TX. Research Methods and Procedures: Using data from 438 mother‐child dyads residing in the same household, we completed logistic regression analyses to determine maternal factors associated with the child being overweight or at‐risk‐for‐overweight, after adjusting for the child's gender, age, and level of physical activity and other maternal confounders. Results: Almost one‐half of the boys and girls (47% and 44%, respectively) were either overweight or at‐risk‐for‐overweight. Obese mothers were twice as likely to have an overweight and/or at‐risk‐for‐overweight child compared with normal‐weight mothers. Women born in the U.S. were twice as likely to have an overweight and/or at‐risk‐for‐overweight child compared with women born in Mexico. In addition, women with less than a high school education were twice as likely to have an overweight child compared with their more educated peers. Discussion: The high prevalence of overweight or at‐risk‐for‐overweight among Mexican‐origin children of low socioeconomic status suggests a continued need to develop and implement culturally sensitive preventive interventions for this minority population. Our data also suggest a need to tailor such interventions particularly for children of obese mothers and those born in the U.S.     

Interaction of PDGFRA promoter haplotypes and maternal environmental exposures in the risk of spina bifida

BACKGROUND: Neural tube defects are multifactorial malformations involving both environmental exposures, such as maternal nutrition, and genetic factors. Aberrant expression of the platelet‐derived growth factor alpha‐receptor (PDGFRA) gene has been implicated in neural‐tube‐defect etiology in both mice and humans. METHODS: We investigated possible interactions between the PDGFRA promoter haplotype of mother and child, as well as maternal glucose, myo‐inositol, and zinc levels, in relation to spina bifida offspring. Distributions were determined of the PDGFRA promoter haplotypes H1 and H2 in a Dutch cohort, consisting of 88 spina bifida children with 56 of their mothers, and 74 control children with 72 of their mothers, as well as maternal plasma glucose, myo‐inositol, and red blood cell zinc concentrations. RESULTS: A significantly higher frequency of H1 was observed in children with spina bifida than in controls (30.1 vs. 20.3%; OR = 1.69, 95% CI 1.02–2.83). High maternal body mass index (BMI) and glucose were significant risk factors for both H1 and H2 children, whereas low myo‐inositol and zinc were risk factors for H2 but not for H1 children. Stepwise multiple logistic regression analysis showed that high maternal glucose and low myo‐inositol are the main risk factors for H2 spina bifida children, whereas for H1 spina bifida children, maternal BMI was the main risk factor. Interestingly, H1 mothers (median 165.5 cm) showed a significantly lower body height than H2 mothers (median 169.1 cm; p = 0.003). CONCLUSIONS: These data suggest that the child's PDGFRA promoter haplotype is differentially sensitive for periconceptional exposure to glucose, myo‐inositol, and zinc in the risk of spina bifida. Birth Defects Research (Part A), 2009. © 2009 Wiley‐Liss, Inc.