Physical Status and Parent-Child Feeding Behaviours in Children and Adolescents with Down Syndrome in The United Arab Emirates
Abstract
:1. Introduction
2. Methods
2.1. Design and Participants
2.2. Data Collection
2.2.1. Survey: Socio-Demographic
2.2.2. Anthropometric Measurements
2.2.3. Survey: Feeding Problems
2.2.4. Survey: Parent-Child Feeding Relationship
2.2.5. Parental Feeding Behaviours
2.3. Statistical Analysis
3. Results
3.1. Socio-Demographic Considerations and Health Conditions
3.2. Physical Status
3.3. Feeding Problems (STEP-CHILD)
3.4. Parent-Child Feeding Relationship (CFQ)
3.5. Correlations of Physical Status, Feeding Problems and Parent-Child Feeding Relationship
3.6. Weight Outcome
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- De Graaf, G.; Buckley, F.; Skotko, B.G. Estimation of the number of people with Down syndrome in the United States. Genet. Med. 2017, 19, 439–447. [Google Scholar] [CrossRef] [PubMed]
- Aburawi, E.H.; Nagelkerke, N.; Deeb, A.; Abdulla, S.; Abdulrazzaq, Y.M. National Growth Charts for United Arab Emirates Children with Down Syndrome from Birth to 15 Years of Age. J. Epidemiol. 2015, 25, 20–29. [Google Scholar] [CrossRef] [PubMed]
- Down Syndrome Facts National Down Syndrome Society. Available online: https://www.ndss.org/about-down-syndrome/down-syndrome-facts/ (accessed on 24 May 2018).
- Bull, M.J.; Committee on Genetics. Health Supervision for Children with Down Syndrome. Pediatrics 2011, 128, 393–406. [Google Scholar] [CrossRef] [PubMed]
- Myrelid, A.; Gustafsson, J.; Ollars, B.; Annerén, G. Growth charts for Down’s syndrome from birth to 18 years of age. Arch. Dis. Child. 2002, 87, 97–103. [Google Scholar] [CrossRef] [PubMed]
- Theodoro, L. Overweight and Obesity in Down Syndrome: A Study of Factors Related to Weight Gain in Adolescents. Master’s Thesis, Universidade Presbiteriana Mackenzi, Sao Paulo, Brazil, 2007. [Google Scholar]
- Jobling, M.A.; Cuskelly, M.M.; Rutherford, J. Physical activity, food intake and television habits of young adults with Down syndrome and their siblings. ACHPER Healthy Lifestyles J. 2006, 53, 24–30. [Google Scholar]
- Shaw, R.J.; Garcia, M.; Thorn, M.; Farley, C.A.; Flanagan, G. Treatment of Feeding Disorders in Children with Down Syndrome. Clin. Child Psychol. Psychiatry 2003, 8, 105–117. [Google Scholar] [CrossRef]
- Seiverling, L.; Hendy, H.M.; Williams, K. The Screening Tool of Feeding Problems applied to children (STEP-CHILD): Psychometric characteristics and associations with child and parent variables. Res. Dev. Disabil. 2011, 32, 1122–1129. [Google Scholar] [CrossRef] [PubMed]
- Field, D.; Garland, M.; Williams, K. Correlates of specific childhood feeding problems. J. Paediatr. Child Health 2003, 39, 299–304. [Google Scholar] [CrossRef] [PubMed]
- Van Gameren-Oosterom, H.B.; van Dommelen, P.; Schonbeck, Y.; Oudesluys-Murphy, A.M.; van Wouwe, J.P.; Buitendijk, S.E. Prevalence of Overweight in Dutch Children with Down Syndrome. Pediatrics 2012, 130, e1520. [Google Scholar] [CrossRef] [PubMed]
- Abdallah, A.M.; Raffa, S.; Alaidaroos, T.; Obaid, R.; Abuznada, J. Nutritional Status of some Children and Adolescents with Down syndrome in Jeddah. Life Sci. J. 2013, 10, 1310–1318. [Google Scholar]
- Diamandopoulos, K.; Green, J. Down syndrome: An integrative review. J. Neonatal Nurs. 2018, 24, 235–241. [Google Scholar] [CrossRef]
- Lee, R.D.; Nieman, D.C. Nutritional Assessment; McGraw-Hill: New York, NY, USA, 2013; 500p. [Google Scholar]
- Loveday, S.J.; Thompson, J.M.; Mitchell, E.A. Bioelectrical impedance for measuring percentage body fat in young persons with Down syndrome: Validation with dual-energy absorptiometry. Acta Paediatr. 2012, 101, e491–e495. [Google Scholar] [CrossRef] [PubMed]
- Growth Charts-Clinical Growth Charts. Available online: https://www.cdc.gov/growthcharts/clinical_charts.htm (accessed on 24 June 2018).
- Zemel, B.S.; Pipan, M.; Stallings, V.A.; Hall, W.; Schadt, K.; Freedman, D.S.; Thorpe, P. Growth Charts for Children with Down Syndrome in the United States. Pediatrics 2015, 136, e1204. [Google Scholar] [CrossRef] [PubMed]
- Rezaei, M.; Rashedi, V.; Gharib, M.; Lotfi, G. Prevalence of Feeding Problems in Children with Intellectual Disability. Iran. Rehabil. J. 2011, 9, 56–59. [Google Scholar]
- Birch, L.; Fisher, J.; Grimm-Thomas, K.; Markey, C.; Sawyer, R.; Johnson, S. Confirmatory factor analysis of the Child Feeding Questionnaire: A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite 2001, 36, 201–210. [Google Scholar] [CrossRef]
- Polfuss, M.; Simpson, P.; Neff Greenley, R.; Zhang, L.; Sawin, K.J. Parental Feeding Behaviors and Weight-Related Concerns in Children with Special Needs. West. J. Nurs. Res. 2017, 39, 1070–1093. [Google Scholar] [CrossRef]
- Duncanson, K.; Burrows, T.L.; Collins, C.E. Child Feeding and Parenting Style Outcomes and Composite Score Measurement in the “Feeding Healthy Food to Kids Randomised Controlled Trial”. Children 2016, 3, 28. [Google Scholar] [CrossRef]
- Verma, R.S.; Huq, A. Sex ratio of children with trisomy 21 or Down syndrome. Cytobios 1987, 51, 145–148. [Google Scholar]
- Kovaleva, N.V. Sex ratio in Down syndrome. Tsitol. Genet. 2002, 36, 54–69. [Google Scholar]
- Ram, G.; Chinen, J. Infections and immunodeficiency in Down syndrome. Clin. Exp. Immunol. 2011, 164, 9–16. [Google Scholar] [CrossRef]
- Muñoz-López, F. Pediatrics, Down’s syndrome and allergic disease. Rev. Med. Int. Sindr. Down 2011, 15, 8–13. [Google Scholar] [CrossRef]
- Andersson, E.M.; Axelsson, S.; Austeng, M.E.; Øverland, B.; Valen, I.E.; Jensen, T.A.; Akre, H. Bilateral hypodontia is more common than unilateral hypodontia in children with Down syndrome: A prospective population-based study. Eur. J. Orthod. 2014, 36, 414–418. [Google Scholar] [CrossRef] [PubMed]
- Hickey, F.; Hickey, E.; Summar, K.L. Medical update for children with Down syndrome for the pediatrician and family practitioner. Adv. Pediatr. 2012, 59, 137–157. [Google Scholar] [CrossRef] [PubMed]
- Bertapelli, F.; Agiovlasitis, S.; Machado, M.R.; do Val Roso, R.; Guerra-Junior, G. Growth charts for Brazilian children with Down syndrome: Birth to 20 years of age. J. Epidemiol. 2017, 2, 265–273. [Google Scholar] [CrossRef] [PubMed]
- Grammatikopoulou, M.G.; Manai, A.; Tsigga, M.; Tsiligiroglou-Fachantidou, A.; Galli-Tsinopoulou, A.; Zakas, A. Nutrient intake and anthropometry in children and adolescents with Down syndrome—A preliminary study. Dev. Neurorehabil. 2008, 11, 260–267. [Google Scholar] [CrossRef]
- Basil, J.S.; Santoro, S.L.; Martin, L.J.; Healy, K.W.; Chini, B.A.; Saal, H.M. Retrospective Study of Obesity in Children with Down Syndrome. J. Pediatr. 2016, 173, 143–148. [Google Scholar] [CrossRef] [Green Version]
- Rodrigues, B.S.; Pellanda, L.C.; Gottschall, C.B.A. Nutritional Assessment of Children and Teenagers with Down Syndrome and Congenital Cardiopathy. Rev. Chil. Nutr. 2012, 39, 151–158. [Google Scholar] [CrossRef]
- Fernhall, B.; Figueroa, A.; Collier, S.; Goulopoulou, S.; Giannopoulou, I.; Baynard, T. Resting metabolic rate is not reduced in obese adults with Down syndrome. Ment. Retard. 2005, 43, 391–400. [Google Scholar] [CrossRef]
- González-Agüero, A.; Matute-Llorente, Á.; Gómez-Cabello, A.; Vicente-Rodríguez, G.; Casajús, J.A. Percentage of body fat in adolescents with Down syndrome: Estimation from skinfolds. Disabil. Health J. 2017, 10, 100–104. [Google Scholar] [CrossRef]
- Manikam, R.; Perman, J.A. Pediatric feeding disorders. J. Clin. Gastroenterol. 2000, 30, 34–46. [Google Scholar] [CrossRef]
- Rodgers, R.F.; Paxton, S.J.; Massey, R.; Campbell, K.J.; Wertheim, E.H.; Skouteris, H.; Gibbons, K. Maternal feeding practices predict weight gain and obesogenic eating behaviors in young children: A prospective study. Int. J. Behav. Nutr. Phys. Act. 2013, 10, 24. [Google Scholar] [CrossRef] [PubMed]
- Wehrly, S.E.; Bonilla, C.; Perez, M.; Liew, J. Controlling parental feeding practices and child body composition in ethnically and economically diverse preschool children. Appetite 2014, 73, 163–171. [Google Scholar] [CrossRef] [PubMed]
- O’Neill, K.L.; Shults, J.; Stallings, V.A.; Stettler, N. Child-feeding practices in children with down syndrome and their siblings. J. Pediatr. 2005, 146, 234–238. [Google Scholar] [CrossRef] [PubMed]
- Schmidt, R.; Richter, R.; Brauhardt, A.; Hiemisch, A.; Kiess, W.; Hilbert, A. Parental feeding practices in families with children aged 2–13 years: Psychometric properties and child age-specific norms of the German version of the Child Feeding Questionnaire (CFQ). Appetite 2017, 109, 154–164. [Google Scholar] [CrossRef] [PubMed]
- Berkowitz, R.I.; Moore, R.H.; Faith, M.S.; Stallings, V.A.; Kral, T.V.E.; Stunkard, A.J. Identification of an obese eating style in 4-year-old children born at high and low risk for obesity. Obesity 2010, 18, 505–512. [Google Scholar] [CrossRef]
Category | Age Group | Male (n = 55) % (n) | Female (n = 28) % (n) |
---|---|---|---|
Toddlers & pre-school age | 2–4.99 years | 12.7 (7) | 25.0 (7) |
Middle childhood | 5–8.99 years | 29.1 (16) | 39.3 (11) |
Preadolescence | 9–11.99 years | 21.8 (12) | 10.7 (3) |
Adolescence | 12–19.99 years | 36.4 (20) | 25.0 (7) |
Chart Reference | Height for Age (n = 80) | BMI for Age (n = 78) | |||||
---|---|---|---|---|---|---|---|
Short | Normal | Tall | Underweight | Normal | Overweight | Obese | |
CDC % (n) | 61.2 (49) | 37.5 (30) | 1.3 (1) | 5.1 (4) | 37.2 (29) | 32.1 (25) | 25.6 (20) |
DS % (n) | 6.2 (5) | 87.5 (70) | 6.3 (5) | 7.7 (6) | 71.7 (56) | 10.3 (8) | 10.3 (8) |
Age Groups (Years) | 5.00–8.99 Median (IQR) | 9.00–11.99 Median (IQR) | 12.00–19.99 Median (IQR) | ||||||
---|---|---|---|---|---|---|---|---|---|
M (n = 11) | F (n = 9) | p Value | M (n = 9) | F (n = 2) | p Value | M (n = 16) | F (n = 6) | p Value | |
Fat mass (kg) | 3.7 (2.6) | 4.9 (5.6) | 0.22 | 8.3 (8.0) | 7.7 (-) | 1.00 | 9.5 (9.3) | 16.2 (6.1) | 0.03 |
Percent Body Fat (%) | 18.2 (4.0) | 25.5 (14.3) | 0.03 | 23.1 (20.5) | 22.4 (-) | 0.81 | 16.3 (12.2 | 29.9 (2.8) | 0.006 |
Fat free mass (kg) | 18.0 (6.2) | 17.4 (6.80) | 0.85 | 27.7 (8.0) | 26.0 (-) | 0.63 | 44.6 (18.5) | 38.8 (10.9) | 0.46 |
Muscle mass (kg) | 16.9 (5.9) | 16.5 (6.45) | 0.85 | 26.2 (7.6) | 28.2 (-) | 0.63 | 42.3 (17.7) | 36.9 (7.3) | 0.34 |
Total body water (kg) | 13.2 (4.5) | 12.7 (5.0) | 0.85 | 20.3 (5.9) | 19.0 (-) | 0.55 | 32.6 (13.9) | 28.5 (4.4) | 0.30 |
Percent Total body water (%) | 60.0 (2.9) | 54.8 (10.8) | 0.03 | 56.3 (15.1) | 55.2 (-) | 0.63 | 61.8 (8.8) | 51.3 (3.9) | 0.005 |
Variable | Not at All % (n) | 1–10 Times/Month % (n) | >10 Times/Month % (n) |
---|---|---|---|
My child cannot independently feed | 40.2 (33) | 20.7 (17) | 39.0 (32) |
My child does not demonstrate ability to chew. | 52.4 (43) | 8.5 (7) | 39.0 (32) |
My child swallows without chewing sufficiently. | 29.3 (24) | 20.7 (17) | 50.0 (41) |
My child only eats a small amount of food presented. | 28.0 (23) | 30.5 (25) | 41.5 (34) |
My child will continue to eat as long as food is presented | 28.0 (23) | 14.6 (12) | 57.3 (47) |
My child eats large amounts in short time. | 35.4 (29) | 23.2 (19) | 41.5 (34) |
My child’s problem behaviours increase during meals. | 50.0 (41) | 25.6 (21) | 24.4 (20) |
My child pushes food away or attempts to leave area. | 50.0 (41) | 25.6 (21) | 24.4 (20) |
My child only eats foods at certain temperature. | 36.6 (30) | 24.4 (20) | 39.0 (32) |
My child will only eat select types of foods. | 17.1 (14) | 20.7 (17) | 62.2 (51) |
My child only eats certain textures. | 37.8 (31) | 26.8 (22) | 35.4 (29) |
My child regurgitates or re-swallows food. | 76.8 (63) | 13.4 (11) | 9.8 (8) |
My child vomits during or right after meals. | 82.9 (68) | 9.8 (8) | 7.3 (6) |
My child steals or attempts to steal food during meals. | 73.2 (60) | 11.0 (9) | 15.9 (13) |
My child steals or attempts to steal food outside mealtimes. | 67.1 (55) | 11.0 (9) | 22.0 (18) |
Subscale Category | Total Sample (n = 82) Median (IQR) | Males (n = 54) Median (IQR) | Females (n = 28) Median (IQR) | p Value |
---|---|---|---|---|
Chewing (3 items) | 3.0(4.0) | 4.0(4.0) | 2.5(4.0) | 0.60 |
Rapid Eating (3 items) | 4.0(3.0) | 3.5(2.0) | 4.0(2.75) | 0.78 |
Food Refusal (3 items) | 2.0(3.0) | 1.0(3.75) | 2.0(3.0) | 0.79 |
Food Selectivity (2 items) | 2.0(2.0) | 2.5(4.0) | 2.0(1.0) | 0.41 |
Vomiting (2 items) | 0.0(0.25) | 0.0(1.0) | 0.0(0.0) | 0.26 |
Stealing Food (2 items) | 0.0(2.0) | 0.0(1.75) | 0.0(2.0) | 0.44 |
Total | 13.0(7.0) | 12.5(10) | 13.5(7.5) | 0.72 |
Age Groups in Years | |||||
---|---|---|---|---|---|
Subscale Category | 2.00–4.99 n = 13 Median (IQR) | 5.00–8.99 n = 27 Median (IQR) | 9.00–11.99 n = 15 Median (IQR) | 12.00–19.99 n = 27 Median (IQR) | p Value |
Chewing (3 items) | 4.0(5.0) | 4.0(5.0) | 3.0(4.0) | 2.0(3.0) | 0.25 |
Rapid Eating (3 items) | 4.0(3.5) | 3.0(2.0) | 5.0(2.0) | 4.0(2.0) | 0.17 |
Food Refusal (3 items) | 4.0(2.5) | 2.0(2.0) | 3.0(4.0) | 2.0(2.0) | 0.07 |
Food Selectivity (2 items) | 2.0(2.0) | 3.0(3.0) | 2.0(2.0) | 2.0(3.0) | 0.41 |
Vomiting (2 items) | 0(1.0) | 0(2.0) | 0(1.0) | 0(0) | 1.00 |
Stealing Food (2 items) | 0(1.25) | 0(2.0) | 0(2.0) | 0(2.0) | 0.43 |
Total | 3.0(4) | 2.5(3.25) | 2.5(3.5) | 2.0(2.5) | 0.46 |
Variable | Never % (n) | Rarely % (n) | Sometimes % (n) | Often % (n) | Always % (n) |
Restriction | |||||
I have to be sure that my child does not eat too many sweets. (candy, ice cream, cake, pastries) | 7.3(6) | 12.2(10) | 41.5(34) | 19.5(16) | 19.5 (16) |
I have to be sure that my child does not eat too many fatty foods. (cheese, butter, pizza, burger) | 14.6(12) | 14.6(12) | 30.5(25) | 22.0(18) | 18.3 (15) |
I have to be sure that my child does not eat too much of his/her favourite foods. | 13.4(11) | 12.2(10) | 30.5(25) | 23.2(19) | 20.7 (17) |
I intentionally keep some food out of my child’s reach. | 20.7(17) | 6.1 (5) | 20.7(17) | 29.3(24) | 23.2 (19) |
I offer sweets (candy, ice cream, cake, pastries) to my child as a reward for good behaviour. | 23.2(19) | 14.6(12) | 31.7(26) | 18.3(15) | 12.2 (10) |
I offer my child his/her favourite food in exchange for good behaviour. | 20.7(17) | 18.3(15) | 31.7(26) | 18.3(15) | 11.0 (9) |
If I did not guide or regulate my child’s eating, she/he would eat too many junk foods. (chips, pizza, burger, French fries, sweets). | 17.1(14) | 13.4(11) | 15.9(13) | 30.5(25) | 23.2 (19) |
If I did not guide or regulate my child’s eating, she/he would eat too many of her/his favourite foods. | 12.2(10) | 8.5 (7) | 23.2(19) | 28.0(23) | 28.0 (23) |
Pressure to eat | |||||
My child should always eat all of the food on his/her plate. | 12.2(10) | 11.0 (9) | 23.2(19) | 28.0(23) | 25.6 (21) |
I have to be especially careful to make sure my child eats enough | 7.3 (6) | 11.0 (9) | 13.4(11) | 30.5(25) | 37.8 (31) |
If my child says I’m not hungry, I try to get him/her to eat anyway. | 56.1 (46) | 15.9(13) | 17.1(14) | 6.1 (5) | 4.9 (4) |
If I did not guide my child’s eating, she/he would eat much less than she/he should. | 32.9(27) | 15.9(13) | 26.8(22) | 12.2(10) | 12.2 (10) |
Extremely unconcerned % (n) | Unconcerned % (n) | Slightly concerned % (n) | Moderately concerned % (n) | Extremely concerned % (n) | |
Concern about child weight | |||||
How concerned are you about your child eating too much when you are not around her/him? | 23.2(19) | 3.7 (3) | 24.4(20) | 17.1(14) | 31.7 (26) |
How concerned are you about your child having to diet to maintain a desirable weight? | 24.4(20) | 3.7 (3) | 23.2(19) | 22.0(18) | 26.8 (22) |
How concerned are you about your child becoming over weight? | 13.4(11) | 2.4 (2) | 17.1(14) | 18.3(15) | 48.8 (40) |
Variable | 2.00–4.99 Years | 5.00–8.99 Years | ||||||||
Never | Rarely | Sometimes | Often | Always | Never | Rarely | Sometimes | Often | Always | |
% (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | |
Restriction | ||||||||||
I have to be sure that my child does not eat too many sweets. (candy, ice cream, cake, pastries) | 15.4 (2) | 15.4 (2) | 23.1 (3) | 30.8 (4) | 15.4 (2) | 3.8 (1) | 15.4 (4) | 50.0 (13) | 11.5 (3) | 19.2 (5) |
I have to be sure that my child does not eat too many fatty foods. (cheese, butter, pizza, burger) | 15.4 (2) | 15.4 (2) | 38.5 (5) | 23.1 (3) | 7.7 (1) | 8.0 (2) | 16.0 (4) | 32.0 (8) | 24.0 (6) | 20.0 (5) |
I have to be sure that my child does not eat too much of his/her favourite foods. | 0 (0) | 16.7 (2) | 25.0 (3) | 33.3 (4) | 25.0 (3) | 3.8 (1) | 15.4 (4) | 26.9 (7) | 26.9 (7) | 26.9 (7) |
I intentionally keep some food out of my child’s reach. | 7.7 (1) | 7.7 (1) | 30.8 (4) | 38.5 (5) | 15.4 (2) | 25.0 (6) | 4.2 (1) | 20.8 (5) | 25.0 (6) | 25.0 (6) |
I offer sweets (candy, ice cream, cake, pastries) to my child as a reward for good behaviour. | 30.8 (4) | 0 (0) | 53.8 (7) | 15.4 (2) | 0 (0) | 15.4 (4) | 15.4 (4) | 26.9 (7) | 34.6 (9) | 7.7 (2) |
I offer my child his/her favourite food in exchange for good behaviour. | 30.8 (4) | 15.4 (2) | 46.2 (6) | 0 (0) | 7.7 (1) | 23.1 (6) | 19.2 (5) | 23.1 (6) | 26.9 (7) | 7.7 (2) |
If I did not guide or regulate my child’s eating, she/he would eat too many junk foods. (chips, pizza, burger, French fries, sweets). | 8.3 (1) | 8.3 (1) | 16.7 (2) | 58.3 (7) | 8.3 (1) | 7.7 (2) | 19.2 (5) | 19.2 (5) | 23.1 (6) | 30.8 (8) |
If I did not guide or regulate my child’s eating, she/he would eat too many of her/his favourite foods. | 7.7 (1) | 7.7 (1) | 7.7 (1) | 46.2 (6) | 30.8 (4) | 4.0 (1) | 16.0 (4) | 32.0 (8) | 20.0 (5) | 28.0 (7) |
Pressure to eat | ||||||||||
My child should always eat all of the food on his/her plate. | 16.7 (2) | 8.3 (1) | 66.7 (8) | 8.3 (1) | 0 (0) | 15.4 (4) | 19.2 (5) | 19.2 (5) | 30.8 (8) | 15.4 (4) |
I have to be especially careful to make sure my child eats enough | 15.4 (2) | 0 (0) | 30.8 (4) | 38.5 (5) | 15.4 (2) | 0 (0) | 15.4 (4) | 11.5 (3) | 26.9 (7) | 46.2 (12) |
If my child says I’m not hungry, I try to get him/her to eat anyway. | 30.8 (4) | 23.1 (3) | 23.1 (3) | 7.7 (1) | 15.4 (2) | 57.7 (15) | 11.5 (3) | 19.2 (5) | 7.7 (2) | 3.8 (1) |
If I did not guide my child’s eating, she/he would eat much less than she/he should. | 15.4 (2) | 7.7 (1) | 38.5 (5) | 15.4 (2) | 23.1 (3) | 30.8 (8) | 7.7 (2) | 38.5 (10) | 11.5 (3) | 11.5 (3) |
Concern about child weight | Extremely unconcerned | Unconcerned | Slightly concerned | Moderately concerned | Extremely concerned | Extremely unconcerned | Unconcerned | Slightly concerned | Moderately concerned | Extremely concerned |
How concerned are you about your child eating too much when you are not around her/him? | 38.5 (5) | 0 (0) | 23.1 (3) | 23.1 (3) | 15.4 (2) | 29.6 (8) | 3.7 (1) | 29.6 (8) | 7.4 (2) | 29.6 (8) |
How concerned are you about your child having to diet to maintain a desirable weight? | 23.1 (3) | 0 (0) | 30.8 (4) | 38.5 (5) | 7.7 (1) | 25.9 (7) | 7.4 (2) | 22.2 (6) | 18.5 (5) | 25.9 (7) |
How concerned are you about your child becoming over weight? | 23.1 (3) | 0 (0) | 15.4 (2) | 38.5 (5) | 23.1 (3) | 18.5 (5) | 0 (0) | 33.3 (9) | 7.4 (2) | 40.7 (11) |
Variable | 9.00–11.99 years | 12.00–19.99 years | ||||||||
Never | Rarely | Sometimes | Often | Always | Never | Rarely | Sometimes | Often | Always | |
% (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | % (n) | |
Restriction | ||||||||||
I have to be sure that my child does not eat too many sweets. (candy, ice cream, cake, pastries) | 6.7 (1) | 0 (0) | 20.0 (3) | 33.3 (5) | 40.0 (6) | 3.7 (1) | 14.8 (4) | 55.6 (15) | 14.8 (4) | 11.1 (3) |
I have to be sure that my child does not eat too many fatty foods. (cheese, butter, pizza, burger) | 6.7 (1) | 13.3 (2) | 20.0 (3) | 20.0 (3) | 40.0 (6) | 18.5 (5) | 14.8 (4) | 33.3 (9) | 22.2 (6) | 11.1 (3) |
I have to be sure that my child does not eat too much of his/her favourite foods. | 20.0 (3) | 6.7 (1) | 33.3 (5) | 20.0 (3) | 20.0 (3) | 18.5 (5) | 11.1 (3) | 37.0 (10) | 18.5 (5) | 14.8 (4) |
I intentionally keep some food out of my child’s reach. | 20.0 (3) | 0 (0) | 6.7 (1) | 40.0 (6) | 33.3 (5) | 14.8 (4) | 11.1 (3) | 25.9 (7) | 25.9 (7) | 22.2 (6) |
I offer sweets (candy, ice cream, cake, pastries) to my child as a reward for good behaviour. | 26.7 (4) | 26.7 (4) | 20.0 (3) | 13.3 (2) | 13.3 (2) | 22.2 (6) | 14.8 (4) | 33.3 (9) | 7.4 (2) | 22.2 (6) |
I offer my child his/her favourite food in exchange for good behaviour. | 20.0 (3) | 20.0 (3) | 33.3 (5) | 13.3 (2) | 13.3 (2) | 11.1 (3) | 18.5 (5) | 33.3 (9) | 22.2 (6) | 14.8 (4) |
If I did not guide or regulate my child’s eating, she/he would eat too many junk foods. (chips, pizza, burger, French fries, sweets). | 20.0 (3) | 6.7 (1) | 13.3 (2) | 33.3 (5) | 26.7 (4) | 22.2 (6) | 14.8 (4) | 14.8 (4) | 25.9 (7) | 22.2 (6) |
If I did not guide or regulate my child’s eating, she/he would eat too many of her/his favourite foods. | 20.0 (3) | 0 (0) | 20.0 (3) | 33.3 (5) | 26.7 (4) | 11.1 (3) | 7.4 (2) | 25.9 (7) | 25.9 (7) | 29.6 (8) |
Pressure to eat | ||||||||||
My child should always eat all of the food on his/her plate. | 6.7 (1) | 6.7 (1) | 20.0 (3) | 26.7 (4) | 40.0 (6) | 3.7 (1) | 7.4 (2) | 11.1 (3) | 37.0 (10) | 40.7 (11) |
I have to be especially careful to make sure my child eats enough | 0 (0) | 13.3 (2) | 20.0 (3) | 40.0 (6) | 26.7 (4) | 11.1(3) | 11.1 (3) | 3.7 (1) | 25.9 (7) | 48.1 (13) |
If my child says I’m not hungry, I try to get him/her to eat anyway. | 46.2 (6) | 7.7 (1) | 38.5 (5) | 7.7 (1) | 0 (0) | 66.7 (18) | 22.2 (6) | 3.7 (1) | 3.7 (1) | 3.7 (1) |
If I did not guide my child’s eating, she/he would eat much less than she/he should. | 21.4 (3) | 28.6 (4) | 14.3 (2) | 21.4 (3) | 14.3 (2) | 44.4 (12) | 22.2 (6) | 18.5 (5) | 7.4 (2) | 7.4 (2) |
Concern about child weight | Extremely unconcerned | Unconcerned | Slightly concerned | Moderately concerned | Extremely concerned | Extremely unconcerned | Unconcerned | Slightly concerned | Moderately concerned | Extremely concerned |
How concerned are you about your child eating too much when you are not around her/him? | 6.7 (1) | 13.3 (2) | 26.7 (4) | 13.3 (2) | 40.0 (6) | 18.5 (5) | 0 (0) | 18.5 (5) | 25.9 (7) | 37.0 (10) |
How concerned are you about your child having to diet to maintain a desirable weight? | 20.0 (3) | 6.7 (1) | 26.7 (4) | 6.7 (1) | 40.0 (6) | 25.9 (7) | 0 (0) | 18.5 (5) | 25.9 (7) | 29.6 (8) |
How concerned are you about your child becoming over weight? | 6.7 (1) | 13.3 (2) | 0 (0) | 20.0 (3) | 60.0 (9) | 7.4 (2) | 0 (0) | 11.1 (3) | 18.5 (5) | 63.0 (17) |
Subscale Category | Total Sample (n = 82) Median (IQR) | Males (n = 54) Median (IQR) | Females (n = 28) Median (IQR) | p Value |
---|---|---|---|---|
Restriction (8 items) | 3.3 (1.0) | 3.3 (1.2) | 3.3 (1.0) | 0.90 |
Pressure to eat (4 items) | 3.0 (0.8) | 3.1 (1.4) | 3.0 (0.6) | 0.90 |
Concern about child weight (3 items) | 3.7 (2.3) | 4.0 (2.7) | 3.7 (2.0) | 0.86 |
Total | 3.2 (0.9) | 3.2 (1.2) | 3.2 (0.7) | 0.89 |
Variable | Sex | Age | Weight | Height | BMI | Total-CFQ | Restriction | Pressure | Concern | Total-STEP | Chewing | Rapid Eating | Food Refusal | Food Selectivity | Vomiting |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age | −0.19 | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
Weight | −0.15 | 0.89 ** | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
Height | −0.21 | 0.93 ** | 0.93 ** | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
BMI | 0.04 | 0.65 ** | 0.83 ** | 0.63 ** | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
Total-CFQ | 0.02 | 0.06 | 0.14 | 0.03 | 0.31 ** | -- | -- | -- | -- | -- | -- | -- | -- | -- | -- |
Restriction | 0.02 | 0.02 | 0.08 | 0.01 | 0.18 | 0.80 ** | -- | -- | -- | -- | -- | -- | -- | -- | -- |
Pressure | 0.01 | −0.00 | −0.05 | −0.10 | 0.08 | 0.58 ** | 0.22 | -- | -- | -- | -- | -- | -- | -- | -- |
Concern | 0.01 | 0.17 | 0.31 ** | 0.18 | 0.41 ** | 0.65 ** | 0.26 * | 0.20 | -- | -- | -- | -- | -- | -- | -- |
Total-STEP | −0.02 | −0.26 * | −0.30 ** | −0.30 ** | −0.18 | 0.19 | 0.20 | 0.13 | −0.04 | -- | -- | -- | -- | -- | -- |
Chewing | −0.03 | −0.33 ** | −0.42 ** | −0.37 ** | −0.29 ** | 0.02 | 0.02 | 0.25 * | −0.27 * | 0.60 ** | -- | -- | -- | -- | -- |
Rapid eating | 0.08 | 0.00 | 0.01 | −0.07 | 0.11 | 0.32 ** | 0.41 ** | 0.06 | 0.09 | 0.61 ** | 0.11 | -- | -- | -- | -- |
Food refusal | 0.01 | −0.17 | −0.21 | −0.20 | −0.17 | 0.22 | 0.19 | 0.10 | 0.04 | 0.76 ** | 0.30 ** | 0.44 ** | -- | -- | -- |
Food selectivity | −0.08 | −0.11 | −0.15 | −0.11 | −0.13 | 0.11 | −0.02 | 0.11 | 0.12 | 0.65 ** | 0.28 * | 0.23 * | 0.52 ** | -- | -- |
Vomiting | −0.11 | −0.17 | −0.16 | −0.18 | −0.13 | 0.00 | −0.01 | 0.14 | −0.08 | 0.48 ** | 0.22 | 0.33 ** | 0.22 | 0.25 * | -- |
Stealing | 0.10 | 0.05 | 0.15 | 0.05 | 0.21 | 0.17 | 0.21 | −0.11 | 0.20 | 0.34 ** | −0.03 | 0.37 ** | 0.07 | 0.02 | 0.14 |
* p < 0.05 | ** p < 0.001 |
Variable | B | OR | p Value | 95% CI for OR | |
---|---|---|---|---|---|
Lower | Upper | ||||
Concern about child weight | 0.34 | 1.40 | 0.02 | 1.06 | 1.86 |
Chewing problem | −0.08 | 0.92 | 0.62 | 0.66 | 1.27 |
Participant age | −0.03 | 0.96 | 0.58 | 0.84 | 1.09 |
Parent-child feeding questionnaire (CFQ) total score | 0.00 | 1.00 | 0.99 | 0.92 | 1.08 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Osaili, T.M.; Attlee, A.; Naveed, H.; Maklai, H.; Mahmoud, M.; Hamadeh, N.; Asif, T.; Hasan, H.; Obaid, R.S. Physical Status and Parent-Child Feeding Behaviours in Children and Adolescents with Down Syndrome in The United Arab Emirates. Int. J. Environ. Res. Public Health 2019, 16, 2264. https://doi.org/10.3390/ijerph16132264
Osaili TM, Attlee A, Naveed H, Maklai H, Mahmoud M, Hamadeh N, Asif T, Hasan H, Obaid RS. Physical Status and Parent-Child Feeding Behaviours in Children and Adolescents with Down Syndrome in The United Arab Emirates. International Journal of Environmental Research and Public Health. 2019; 16(13):2264. https://doi.org/10.3390/ijerph16132264
Chicago/Turabian StyleOsaili, Tareq M., Amita Attlee, Hira Naveed, Huda Maklai, Menna Mahmoud, Noor Hamadeh, Tooba Asif, Hayder Hasan, and Reyad S. Obaid. 2019. "Physical Status and Parent-Child Feeding Behaviours in Children and Adolescents with Down Syndrome in The United Arab Emirates" International Journal of Environmental Research and Public Health 16, no. 13: 2264. https://doi.org/10.3390/ijerph16132264