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      Time to re-think picky eating?: a relational approach to understanding picky eating

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          Abstract

          Background

          Estimates of picky eating are quite high among young children, with 14-50% of parents identifying their preschoolers as picky eaters. Dietary intake and preferences during the preschool years are characterized by slowing growth rates and children developing a sense of autonomy over their feeding and food selection. We argue that the current conceptualization of picky eating defines acts of resistance or expressions of preference (acts of autonomy) by a child as deviant behaviour. This conceptualization has guided research that uses a unidirectional, parent to child approach to understanding parent-child feeding interactions.

          Objectives

          By reviewing the current feeding literature and drawing parallels from the rich body of child socialization literature, we argue that there is a need to both re-examine the concept and parent/clinician perspectives on picky eating. Thus, the objective of this paper is two-fold: 1) We argue for a reconceptualization of picky eating whereby child agency is considered in terms of eating preferences rather than categorized as compliant or non-compliant behaviour, and 2) We advocate the use of bi-directional relational models of causality and appropriate methodology to understanding the parent-child feeding relationship.

          Discussion

          Researchers are often interested in understanding how members in the parent-child dyad affect one another. Although many tend to focus on the parent to child direction of these associations, findings from child socialization research suggest that influence is bidirectional and non-linear such that parents influence the actions and cognitions of children and children influence the actions and cognitions of parents. Bi-directional models of causality are needed to correctly understand parent-child feeding interactions.

          Conclusions

          A reconceptualization of picky eating may elucidate the influence that parental feeding practices and child eating habits have on each other. This may allow health professionals to more effectively support parents in developing healthy eating habits among children, reducing both stress around mealtimes and concerns of picky eating.

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          Most cited references23

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          Parent-child feeding strategies and their relationships to child eating and weight status.

          Parental feeding styles may promote overeating or overweight in children. A comprehensive literature review was undertaken to summarize the associations between parental feeding styles and child eating and weight status. Twenty-two studies were identified. We systematically coded study attributes and outcomes and tested for patterns of association. Nineteen studies (86%) reported at least one significant association between parental feeding style and child outcome, although study methodology and results varied considerably. Studies measuring parental feeding restriction, as opposed to general feeding control or another feeding domain, were more likely to report positive associations with child eating and weight status. Certain associations differed by gender and by outcome measurement (e.g., rate of eating as opposed to total energy intake). Parental feeding restriction, but no other feeding domain, was associated with increased child eating and weight status. Longitudinal studies are needed to test underlying causal pathways, including bidirectional causal models, and to substantiate findings in the presence of other obesity risk factors.
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            Learning to overeat: maternal use of restrictive feeding practices promotes girls' eating in the absence of hunger.

            Experimental findings causally link restrictive child-feeding practices to overeating in children. However, longitudinal data are needed to determine the extent to which restrictive feeding practices promote overeating. Our objectives were to determine whether restrictive feeding practices foster girls' eating in the absence of hunger (EAH) and whether girls' weight status moderates the effects of restrictive feeding practices. Longitudinal data were used to create a study design featuring 2 maternal restriction factors (low and high), 2 weight-status factors (nonoverweight and overweight), and 3 time factors (ages 5, 7, and 9 y). Mean EAH increased significantly (P < 0.0001) from 5 to 9 y of age. Higher levels of restriction at 5 y of age predicted higher EAH at 7 y of age (P < 0.001) and at 9 y of age (P < 0.01). Girls who were already overweight at 5 y of age and who received higher levels of restriction had the highest EAH scores at 9 y of age (P < 0.05) and the greatest increases in EAH from 5 to 9 y of age (P < 0.01). The developmental increase in EAH from 5 to 9 y of age may be especially problematic in obesigenic environments. These longitudinal data provide evidence that maternal restriction can promote overeating. Girls who are already overweight at 5 y of age may be genetically predisposed to be especially responsive to environmental cues. These findings are not expected to be generalized to boys or to other racial and ethnic groups.
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              Maternal feeding practices predict weight gain and obesogenic eating behaviors in young children: a prospective study

              Background Maternal feeding practices have been proposed to play an important role in early child weight gain and obesogenic eating behaviors. However, to date longitudinal investigations in young children exploring these relationships have been lacking. The aim of the present study was to explore prospective relationships between maternal feeding practices, child weight gain and obesogenic eating behaviors in 2-year-old children. The competing hypothesis that child eating behaviors predict changes in maternal feeding practices was also examined. Methods A sample of 323 mother (mean age = 35 years, ± 0.37) and child dyads (mean age = 2.03 years, ± 0.37 at recruitment) were participants. Mothers completed a questionnaire assessing parental feeding practices and child eating behaviors at baseline and again one year later. Child BMI (predominantly objectively measured) was obtained at both time points. Results Increases in child BMI z-scores over the follow-up period were predicted by maternal instrumental feeding practices. Furthermore, restriction, emotional feeding, encouragement to eat, weight-based restriction and fat restriction were associated prospectively with the development of obesogenic eating behaviors in children including emotional eating, tendency to overeat and food approach behaviors (such as enjoyment of food and good appetite). Maternal monitoring, however, predicted decreases in food approach eating behaviors. Partial support was also observed for child eating behaviors predicting maternal feeding practices. Conclusions Maternal feeding practices play an important role in the development of weight gain and obesogenic eating behaviors in young children and are potential targets for effective prevention interventions aiming to decrease child obesity.
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                Author and article information

                Contributors
                +647-988-4684 , kwalton@uoguelph.ca
                lkuczyns@uoguelph.ca
                e.haycraft@lboro.ac.uk
                abreen@uoguelph.ca
                jhaines@uoguelph.ca
                Journal
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central (London )
                1479-5868
                5 May 2017
                5 May 2017
                2017
                : 14
                : 62
                Affiliations
                [1 ]ISNI 0000 0004 1936 8198, GRID grid.34429.38, Department of Family Relations and Applied Nutrition, , University of Guelph, ; 50 Stone Rd. E, Guelph, ON N1G 2W1 Canada
                [2 ]ISNI 0000 0004 1936 8542, GRID grid.6571.5, School of Sport, Exercise and Health Sciences, , Loughborough University, ; Loughborough, UK
                Author information
                http://orcid.org/0000-0002-9794-2592
                Article
                520
                10.1186/s12966-017-0520-0
                5420103
                28476160
                629f20e2-211a-4034-baa8-ff07945ba0c5
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 December 2016
                : 26 April 2017
                Categories
                Debate
                Custom metadata
                © The Author(s) 2017

                Nutrition & Dietetics
                picky eating,fussy eating,bi-directional research methods,parent-child relationship,parental feeding practices

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