Association between parenting practices and children's dietary intake, activity behavior and development of body mass index: the KOALA Birth Cohort Study
1 NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Health Promotion, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, the Netherlands
2 Department of Biosciences, TNO Quality of Life, PO Box 360, 3700 AJ Zeist, the Netherlands
3 Department of Prevention & Health, TNO Quality of Life, PO Box 2215, 2301 CE Leiden, the Netherlands
4 School for Public Health and Primary Care (CAPHRI), Department of Epidemiology, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, the Netherlands
5 Department of Statistics, TNO Quality of Life, PO Box 2215, 2301 CE Leiden, the Netherlands
6 Department of Methodology and Statistics, FSW, University of Utrecht, PO Box 80125, 3508 TC Utrecht, the Netherlands
International Journal of Behavioral Nutrition and Physical Activity 2011, 8:18 doi:10.1186/1479-5868-8-18Published: 14 March 2011
Insights into the effects of energy balance-related parenting practices on children's diet and activity behavior at an early age is warranted to determine which practices should be recommended and to whom. The purpose of this study was to examine child and parent background correlates of energy balance-related parenting practices at age 5, as well as the associations of these practices with children's diet, activity behavior, and body mass index (BMI) development.
Questionnaire data originated from the KOALA Birth Cohort Study for ages 5 (N = 2026) and 7 (N = 1819). Linear regression analyses were used to examine the association of child and parent background characteristics with parenting practices (i.e., diet- and activity-related restriction, monitoring and stimulation), and to examine the associations between these parenting practices and children's diet (in terms of energy intake, dietary fiber intake, and added sugar intake) and activity behavior (i.e., physical activity and sedentary time) at age 5, as well as BMI development from age 5 to age 7. Moderation analyses were used to examine whether the associations between the parenting practices and child behavior depended on child characteristics.
Several child and parent background characteristics were associated with the parenting practices. Dietary monitoring, stimulation of healthy intake and stimulation of physical activity were associated with desirable energy balance-related behaviors (i.e., dietary intake and/or activity behavior) and desirable BMI development, whereas restriction of sedentary time showed associations with undesirable behaviors and BMI development. Child eating style and weight status, but not child gender or activity style, moderated the associations between parenting practices and behavior. Dietary restriction and monitoring showed weaker, or even undesirable associations for children with a deviant eating style, whereas these practices showed associations with desirable behavior for normal eaters. By contrast, stimulation to eat healthy worked particularly well for children with a deviant eating style or a high BMI.
Although most energy balance-related parenting practices were associated with desirable behaviors, some practices showed associations with undesirable child behavior and weight outcomes. Only parental stimulation showed desirable associations with regard to both diet and activity behavior. The interaction between parenting and child characteristics in the association with behavior calls for parenting that is tailored to the individual child.