The association of parental feeding and child eating behavior with young children BMI in preschool settings in Hong Kong

Objective The aims of this study are to explore the interplay between parental feeding style, child eating behavior, parenting stress, and young children's weight outcomes in preschool settings in relation to the intervention and prevention of childhood obesity. Design, Setting and Participants Quantitative and qualitative methods were used. A survey of 336 Chinese parents and primary caregivers of preschool children aged 2 to 6 years was nested in 3 detailed case studies in 2011. Outcome Measures and Analysis The Parental Feeding Behavior Questionnaire and Child Eating Behavior Questionnaires, Parenting Stress Index, and BMI of young children were measured. Quantitative data were analyzed by descriptive statistics. Analysis of variance, χ2 test, and Fisher exact test were used to compare and investigate associations between variables. Qualitative data were analyzed by a multilevel framework and incorporated data from the quantitative study into an overall model. Results Significant differences were found in food responsiveness (F3,332 = 4.25, P < .01), enjoyment of food (F3,332 = 6.00, P < .01), desire to drink (F3,332 = 4.36, P < .01) with obese children; satiety responsiveness (F3,332 = 9.84, P < .01), slowness in eating (F3,332 = 24.19, P < .01), and emotional undereating (F3,332 = 4.71, P < .01) with underweight children; and parents' encouragement to eat (F3,332 = 4.10, P < .01) with underweight children. Parent-child dysfunctional interaction positively correlated with instrumental feeding (radj = 0.37) and emotional feeding (radj = 0.29). Child age, schooling, and housing were associated with child BMI (P < .01). Conclusions and Implications These findings confirmed that children's eating and feeding relates to abnormal weight, which also links to parenting stress, family socioeconomic status, and childcare practices. Funding S.A.S. Dragon Holdings Ltd. R2090. Copyright © 2012 Society for Nutrition Education and Behavior.