1. Associations Between Feeding Practices and Maternal and Child Weight Among Mothers Who Do Not Correctly Identify Child’s Weight Status
Rachel Tabak, PhD, RD; Leah Gable, MSW/MPH expected 2016; Cindy Schwarz MPH, MS, RD; Karen Steger-May, MA; and Debra Haire-Joshu, PhD
Center for Obesity Prevention and Policy Research, George Warren Brown School of Social Work and Department of Internal Medicine, Washington University, St. Louis, MO
Background & Methods
Results
Background
Child dietary behaviors are associated with parent feeding practices including dietary modeling, food rules, and encouragement.
Mothers play an important role in shaping children’s eating patterns, but many are unaware of their children’s weight status, particularly for young children.
A mother who underestimates her child’s weight status may be less motivated to promote healthier behaviors (Figure 1).
Table 2. Accuracy of mother’s perceptions of child’s weight by category of mother’s weight status (n=230)
Accuracy of Categorization
Overweight (>=25)
Obese (>=30)
Morbid obesity 1 (>=35)
Morbid obesity 2 (>=40)
Total
Correct
61.5% (24)
56.8% (50)
53.2% (33)
57.5% (23)
56.8% (130)
Healthy Weight
56.4% (22)
48.9% (4)
43.5% (27)
45.0% (18)
84.6% (110)
Overweight
5.1% (22)
3.4% (3)
3.2% (2)
2.5% (1)
6.1% (8)
Obese
0.0% (0)
4.5% (4)
6.5% (4)
10.0% (4)
9.2% (12)
UnderEstimate
38.5% (15)
39.8% (35)
40.0% (16)
40.6% (16)
7.7% (3)
10.2% (9)
16.1% (15)
15.4% (6)
22.7% (20)
19.4% (12)
20.0% (8)
49.5% (46)
6.8% (6)
21.0% (13)
17.5% (7)
34.4% (32)
Overestimate*
2.6% (6)
100.0% (39)
100.0% (88)
100.0% (62)
100.0% (40)
100.0% (229)
Table 1. Demographics (n=230)
Mother
Child
Age
MN = 32
(SD 6)
MN = 3.4
(SD 0.8)
Race
White
African American
Other
51%
31%
18%
48%
32%
20%
BMI/BMI%ile category
Overweight
Obese
17%
83%
24%
Income
<$19,999
$20,000-$49,999
$50,000-$74,999
>=$75,000
27%
19%
22%
Purpose
To explore factors associated with accuracy of maternal weight perception
To determine whether maternal feeding practices are associated with maternal and/or child weight status
*It was only possible for mothers to over-estimate the weight of their child if the child was normal weight (BMI<85th %ile)
Table 3. Correlations between PFQ factors scores and child BMI percentile for the total sample, and among mothers accurately perceiving and underestimating her child’s BMI
Total Sample
Underestimate of child's weight
Correct perception of child's weight
Difficulty in Child Feeding
-0.03
-0.11
-0.09
Concern about Child Overeating or Being Overweight
.32*
0.16
0.52*
Pushing the Child to Eat More
-0.07
-0.30*
-0.10
Using Food to Calm the Child
0.04
0.01
-0.05
Methods & Measures
The HEALTH (Healthy Eating and Active Living Taught at Home) study evaluates the translation of the Diabetes Prevention Program (DPP) into a child development program with obese mothers and their preschool –aged child.
Mothers recruited to HEALTH were located in the St. Louis region and had a preschool-aged child at-risk for obesity (60th%ile to 84%ile for BMI) or already overweight or obese (≥85%ile for BMI).
Height and weight of the mother and preschooler were collected by trained staff.
Mothers completed the Preschooler Feeding Questionnaire (PFQ)
32-items
Response options: 1 to 5; never, always, neutral, disagree a lot, agree a lot
Values significant at P< 0.05
Conclusions
Results
Table 1 describes the demographic characteristics
Mothers with higher BMI and children who were overweight showed a non-significant trend to over estimate the child’s weight (Table 2)
Several correlations between PFQ scales and child BMI% were significant in the total sample or separately for underestimating and correctly perceiving mothers (Table 3)
Nearly half of the mothers asked underestimated their child’s weight, considering them to be about the right weight, when they were actually overweight or obese.
There were different associations between a child’s actual weight status and the mother’s reported feeding practices among mothers accurately and inaccurately perceiving her child’s weight.
Intervention studies should explore targeting education on feeding practices based on these perceptions.
Funded by: National Institutes of Health