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Title: Authoritative parent feeding style is associated with better child dietary quality at dinner among low-income minority families

Author
item ARLINGHAUS, KATHERINE - University Of Houston
item VOLLRATH, KIRSTIN - Children'S Nutrition Research Center (CNRC)
item HERNANDEZ, DAPHNE - University Of Houston
item MOMIN, SHABNAM - Children'S Nutrition Research Center (CNRC)
item O'CONNOR, TERESIA - Children'S Nutrition Research Center (CNRC)
item POWER, THOMAS - Washington State University
item HUGHES, SHERYL - Children'S Nutrition Research Center (CNRC)

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/30/2018
Publication Date: 10/1/2018
Citation: Arlinghaus, K.R., Vollrath, K., Hernandez, D.C., Momin, S., O'Connor, T., Power, T.G., Hughes, S.O. 2018. Authoritative parent feeding style is associated with better child dietary quality at dinner among low-income minority families. American Journal of Clinical Nutrition. 108:730-736. https://doi.org/10.1093/ajcn/nqy142.
DOI: https://doi.org/10.1093/ajcn/nqy142

Interpretive Summary: Research has shown that parental feeding styles are linked to child eating behaviors and weight status in low-income families. Styles of feeding (authoritarian, authoritative, indulgent, uninvolved) encompass the behavioral, social, and nutritional aspects of parental feeding from meal conceptualization to consumption thus providing a comprehensive picture of the child’s eating environment. To date, no study has examined the relationship between feeding styles and child dietary quality thus highlighting an important gap in the literature on parenting influences on the development of child eating behaviors. To fill this gap, we analyzed data from a study examining feeding among Head Start families (131 mother-child pairs) and compared the dietary quality of preschoolers’ dinner meals across parent feeding styles. Three dinner meals were observed at the families’ homes and parents were instructed to proceed as they normally would during dinner. After the meal was completed, the leftovers were weighed (plate waste). The Healthy Eating Index-2010 (HEI-2010) was used to measure dietary quality. The HEI provides an overall dietary quality score, evaluates adherence to the Dietary Guidelines for Americans, and includes information on diets typically consumed by ethnic and cultural groups. Results showed that for the overall sample, the dietary quality of what was served to children and what they consumed was highly related. However, differences were seen across the feeding styles. For example, significant differences were seen in the dietary quality of what was served to and what was consumed in children with authoritarian and indulgent feeders. Little difference was found in consumed and served scores with authoritative and uninvolved feeders. These differences may have to do with behaviors exhibited by parents during the meal. Also, children of authoritative feeders consumed a dinner meal with significantly higher HEI scores compared to children of authoritarian feeders. Providing meals with better dietary quality and using responsive feeding behaviors may be some of the ways in which authoritative feeders promote better health outcomes with preschoolers. More research is needed to better understand why authoritative feeders provide dinners with better dietary quality compared to the other styles. Results of this study may inform parental feeding interventions targeting dietary quality and healthier lifestyles of children.

Technical Abstract: Parent feeding styles have been linked to child weight status across multiple studies. However, to our knowledge, the link between feeding styles and children's dietary quality, a more proximal outcome, has not been investigated. The purpose of this study was to examine the relation between parent feeding styles and dietary quality of Head Start preschoolers' dinner meals. The amount of food served and consumed by children was measured by using a standardized digital photography method during 3 in-home dinner observations of low-income minority families in Houston, Texas. Trained dietitians entered food served and consumed into the Nutrient Data System for Research 2009 for nutrient analysis. Overall dietary quality of the food served and consumed at dinner was evaluated by using the Healthy Eating Index 2010 (HEI-2010). Parent feeding style was assessed with the use of the Caregiver's Feeding Style Questionnaire (CFSQ). On the basis of a parent's level of demandingness and responsiveness to his or her child during feeding, the CFSQ categorizes parent feeding into 4 styles: authoritative (high demandingness and high responsiveness), authoritarian (high demandingness and low responsiveness), indulgent (low demandingness and high responsiveness), or uninvolved (low demandingness and low responsiveness). For the overall sample, the mean ± SD HEI score for dinner served was 44.2 +/- 8.4, and the mean ± SD HEI score for dinner consumed was 43.4 +/- 7.0. In the fully adjusted model, ANCOVA indicated that the authoritative parent feeding style was associated with significantly higher child dietary quality compared with the authoritarian feeding style (mean +/- HEI consumed-authoritative 45.5 +/- 0.9; authoritarian: 41.9 +/- 0.7; P = 0.001). Parent feeding style contributes to the overall dietary quality of children, and among low-income minority preschoolers an authoritative feeding style was associated with the highest dietary quality of the 4 feeding styles. Interventions to promote feeding practices that contribute to authoritative feeding are needed to improve the dietary quality of preschool children at dinner. This trial was registered at https://clinicaltrials.gov as NCT02696278.