A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Key Variables and Measurements
2.2.1. Outcome Variables
2.2.2. Exposure Variables
2.2.3. Covariates
2.3. Statistical Analysis
3. Results
3.1. Demographic Characteristics and Health Outcomes across Parental Feeding Practice Tertiles
3.2. Child Age- and Sex-, and Parental Educations-Stratified Longitudinal Associations between Concern and Child Weight Status
3.3. Child Age- and Sex-, and Parental Educations-Stratified Longitudinal Associations between Pressure to Eat and Child Weight Status
3.4. Child Age- and Sex-, and Parental Educations-Stratified Longitudinal Associations between Control and Child Weight Status
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Items | Factors | ||
---|---|---|---|
Concern | Pressure to Eat | Control | |
1. My child should always eat all the food on his/her plate. | 0.77 | ||
2. I have to make sure my child eats enough. | 0.70 | ||
3. I have to be sure my child eats during meal time. | 0.52 | ||
4. I will often encourage my child to eat healthy foods that they don’t like | 0.46 | ||
5. I offer snacks as a reward for good behavior. | 0.75 | ||
6. I have to be sure my child does not eat too much. | 0.61 | ||
7. If I don’t regulate my child’s eating, he/she would eat less or more. | 0.55 | ||
8. I am worried that my child will suffer from some diseases in the future due to poor diet, such as diabetes, heart disease. | 0.76 | ||
9. I am worried that my child will be overweight due to poor diet | 0.79 | ||
10. I allow my children to watch TV while eating. | 0.61 | ||
11. I have to know when and what food my child eats every day. | 0.53 | ||
Eigenvalue | 2.76 | 1.31 | 1.22 |
% Variance a | 25.10 | 11.90 | 11.10 |
Cronbach Alpha of “concern”, “pressure to eat”, and “control” | 0.66 | 0.56 | 0.32 |
Mean±SD of all three subscales in all children | 16.24 ± 2.25 | 16.00 ± 2.20 | 7.53 ± 1.95 |
Mean±SD of all three subscales in boys | 16.29 ± 2.25 | 16.09 ± 2.26 | 7.53 ± 1.99 |
Mean±SD of all three subscales in girls | 16.19 ± 2.25 | 15.90 ± 2.14 | 7.52 ± 1.92 |
Characteristics | Concern a | Pressure to Eat a | Control a | ||||||
---|---|---|---|---|---|---|---|---|---|
Tertile 1 | Tertile 2 | Tertile 3 | Tertile 1 | Tertile 2 | Tertile 3 | Tertile 1 | Tertile 2 | Tertile 3 | |
Age (years) | 11.30 ± 2.21 | 10.77 ± 2.16 | 10.83 ± 2.22 | 10.95 ± 2.23 | 10.92 ± 2.20 | 11.04 ± 2.19 | 10.90 ± 2.16 | 10.86 ± 2.24 | 11.14 ± 2.21 |
School type (%) | |||||||||
Primary | 46.09 | 57.91 | 58.28 | 53.68 | 56.20 | 52.38 | 55.90 | 57.36 | 49.00 |
Secondary | 53.91 | 42.09 | 41.72 *** | 46.32 | 43.80 | 47.62 | 44.10 | 42.64 | 51.00 ** |
BMI (kg/m2) | 18.30 ± 3.23 | 18.55 ± 3.57 | 19.18 ± 3.91 *** | 19.08 ± 3.61 | 18.63 ± 3.64 | 18.32 ± 3.50 | 18.52 ± 3.33 | 18.58 ± 3.72 | 18.93 ± 3.72 ** |
WHtR | 0.42 ± 0.05 | 0.43 ± 0.05 | 0.44 ± 0.06 *** | 0.44 ± 0.06 | 0.43 ± 0.05 | 0.43 ± 0.05 | 0.43 ± 0.05 | 0.43 ± 0.06 | 0.43 ± 0.06 *** |
Central obesity (%) b | 12.71 | 18.74 | 23.47 *** | 20.09 | 17.15 | 17.67 | 16.54 | 18.10 | 20.28 |
General obesity (%) c | 21.88 | 29.17 | 36.63 *** | 34.67 | 27.47 | 25.50 *** | 27.38 | 30.71 | 29.57 |
Maternal BMI (kg/m2) | 22.00 ± 3.38 | 22.13 ± 3.39 | 22.11 ± 3.67 | 22.15 ± 3.85 | 22.08 ± 3.09 | 22.02 ± 3.48 *** | 22.16 ± 4.19 | 21.89 ± 2.83 | 22.20 ± 3.29 *** |
Paternal BMI (kg/m2) | 23.79 ± 2.76 | 24.10 ± 2.91 | 24.05 ± 2.80 | 24.00 ± 2.78 | 24.05 ± 2.91 | 23.87 ± 2.78 | 23.95 ± 2.85 | 24.10 ± 2.87 | 23.87 ± 2.75 |
Maternal education (%) | |||||||||
Middle school or lower | 25.94 | 20.34 | 15.35 | 20.06 | 21.02 | 20.47 | 17.83 | 17.67 | 26.14 |
High or vocational school | 30.03 | 27.80 | 26.05 | 27.80 | 27.51 | 28.53 | 27.60 | 28.84 | 27.40 |
College or above | 44.03 | 51.86 | 58.60 *** | 52.13 | 51.47 | 51.01 | 54.57 | 53.49 | 46.46 *** |
Paternal education (%) | |||||||||
Middle school or lower | 20.97 | 14.20 | 12.23 | 16.30 | 14.88 | 16.19 | 14.22 | 14.98 | 18.23 |
High or vocational school | 29.73 | 30.44 | 25.08 | 25.71 | 30.39 | 29.09 | 24.88 | 28.86 | 31.54 |
College or above | 49.30 | 55.36 | 62.69 *** | 57.99 | 54.73 | 54.72 | 60.90 | 56.16 | 50.24 ** |
BMI z-Score (Beta, 95% CI) a | Waist-to-Height Ratio (Beta, 95% CI) a | |||
---|---|---|---|---|
≤12 years (n = 1449) | >12 years (n = 692) | ≤12 years (n = 1449) | >12 years (n = 692) | |
Among all | ||||
Concern | 0.13 (0.09, 0.17) *** | 0.11 (0.07, 0.16) *** | 0.01 (0.005, 0.01) *** | 0.01 (0.004, 0.01) *** |
Pressure to eat | −0.08 (−0.12, −0.04) *** | −0.04 (−0.09, 0.01) | −0.004 (−0.01, −0.001) ** | −0.002 (−0.005, 0.001) |
Control | 0.01 (−0.03, 0.05) | 0.03 (−0.02, 0.09) | 0.001 (−0.002, 0.003) | 0.002 (−0.001, 0.006) |
Among boys | ||||
Concern | 0.16 (0.10, 0.23) *** | 0.15 (0.08, 0.23) *** | 0.01 (0.01, 0.02) *** | 0.01 (0.005, 0.01) *** |
Pressure to eat | −0.08 (−0.14, −0.02) * | 0.01 (−0.09, 0.07) | −0.003 (−0.01, 0.001) | −0.0002 (−0.01, 0.005) |
Control | 0.04 (−0.02, 0.10) | 0.05 (−0.03, 0.13) | 0.002 (−0.002, 0.01) | 0.005 (−0.0002, 0.01) |
Among girls | ||||
Concern | 0.09 (0.04, 0.14) *** | 0.08 (0.02, 0.14) * | 0.01 (0.002, 0.01) *** | 0.003 (−0.0001, 0.01) |
Pressure to eat | −0.08 (−0.13, −0.03) ** | −0.08 (−0.14, −0.01) * | −0.004 (−0.01, −0.001) * | −0.005 (−0.01, −0.001) * |
Control | −0.03 (−0.08, 0.02) | 0.02 (−0.05, 0.08) | −0.001 (−0.004, 0.002) | −0.0001 (−0.004, 0.004) |
Children with maternal education lower than college | ||||
Concern | 0.15 (0.08, 0.22) *** | 0.09 (0.03, 0.15) ** | 0.01 (0.005, 0.01) *** | 0.01 (0.002, 0.01) ** |
Pressure to eat | −0.03 (−0.09, 0.03) | −0.04 (−0.11, 0.02) | 0.001 (−0.003, 0.005) | −0.003 (−0.01, 0.001) |
Control | −0.02 (−0.08, 0.04) | 0.02 (−0.04, 0.09) | −0.002 (−0.01, 0.002) | 0.002 (−0.002, 0.01) |
Children with maternal education of college or above | ||||
Concern | 0.11 (0.06, 0.17) *** | 0.12 (0.05, 0.19) *** | 0.01 (0.004, 0.01) *** | 0.01 (0.002, 0.01) ** |
Pressure to eat | −0.10 (−0.15, −0.05) *** | −0.06 (−0.13, 0.02) | −0.01 (−0.01, −0.003) *** | −0.003 (−0.01, 0.001) |
Control | 0.03 (−0.02, 0.08) | 0.07 (−0.01, 0.14) | 0.002 (−0.001, 0.01) | 0.004 (−0.001, 0.01) |
Children with paternal education lower than college | ||||
Concern | 0.13 (0.06, 0.20) *** | 0.10 (0.03, 0.16) ** | 0.01 (0.004, 0.01) *** | 0.01 (0.002, 0.01) ** |
Pressure to eat | −0.06 (−0.12, 0.01) | −0.03 (−0.11, 0.04) | −0.002 (−0.01, 0.002) | −0.002 (−0.01, 0.002) |
Control | 0.004 (−0.06, 0.07) | 0.04 (−0.03, 0.11) | 0.0004 (−0.004, 0.004) | 0.003 (−0.001, 0.01) |
Children with paternal education of college or above | ||||
Concern | 0.12 (0.07, 0.17) *** | 0.13 (0.07, 0.20) *** | 0.01 (0.005, 0.01) *** | 0.01 (0.004, 0.01) *** |
Pressure to eat | −0.09 (−0.14, −0.04) *** | −0.06 (−0.13, 0.01) | −0.01 (−0.01, −0.002) *** | −0.002 (−0.01, 0.002) |
Control | 0.03 (−0.02, 0.08) | 0.04 (−0.03, 0.11) | 0.001 (−0.002, 0.005) | 0.002 (−0.002, 0.01) |
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Ma, L.; Yan, N.; Shi, Z.; Ding, Y.; He, S.; Tan, Z.; Xue, B.; Yan, Y.; Zhao, C.; Wang, Y. A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities. Nutrients 2022, 14, 2797. https://doi.org/10.3390/nu14142797
Ma L, Yan N, Shi Z, Ding Y, He S, Tan Z, Xue B, Yan Y, Zhao C, Wang Y. A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities. Nutrients. 2022; 14(14):2797. https://doi.org/10.3390/nu14142797
Chicago/Turabian StyleMa, Lu, Na Yan, Zumin Shi, Yixin Ding, Siran He, Zhengqi Tan, Bo Xue, Yating Yan, Cai Zhao, and Youfa Wang. 2022. "A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities" Nutrients 14, no. 14: 2797. https://doi.org/10.3390/nu14142797
APA StyleMa, L., Yan, N., Shi, Z., Ding, Y., He, S., Tan, Z., Xue, B., Yan, Y., Zhao, C., & Wang, Y. (2022). A 3-Year Longitudinal Study of Effects of Parental Feeding Practices on Child Weight Status: The Childhood Obesity Study in China Mega-Cities. Nutrients, 14(14), 2797. https://doi.org/10.3390/nu14142797