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Children's eating behavior, feeding practices of parents and weight problems in early childhood: results from the population-based Generation R Study

Pauline W Jansen12*, Sabine J Roza23, Vincent WV Jaddoe145, Joreintje D Mackenbach2, Hein Raat6, Albert Hofman4, Frank C Verhulst2 and Henning Tiemeier234

Author Affiliations

1 The Generation R Study Group, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands

2 Department of Child & Adolescent Psychiatry / Psychology, Erasmus MC-University Medical Center Rotterdam, PO-BOX 2060, Rotterdam, 3000 CB, The Netherlands

3 Department of Psychiatry, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands

4 Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands

5 Department of Pediatrics, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands

6 Department of Public Health, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands

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International Journal of Behavioral Nutrition and Physical Activity 2012, 9:130  doi:10.1186/1479-5868-9-130

Published: 30 October 2012

Abstract

Background

Weight problems that arise in the first years of life tend to persist. Behavioral research in this period can provide information on the modifiable etiology of unhealthy weight. The present study aimed to replicate findings from previous small-scale studies by examining whether different aspects of preschooler’s eating behavior and parental feeding practices are associated with body mass index (BMI) and weight status -including underweight, overweight and obesity- in a population sample of preschool children.

Methods

Cross-sectional data on the Child Eating Behaviour Questionnaire, Child Feeding Questionnaire and objectively measured BMI was available for 4987 four-year-olds participating in a population-based cohort in the Netherlands.

Results

Thirteen percent of the preschoolers had underweight, 8% overweight, and 2% obesity. Higher levels of children’s Food Responsiveness, Enjoyment of Food and parental Restriction were associated with a higher mean BMI independent of measured confounders. Emotional Undereating, Satiety Responsiveness and Fussiness of children as well as parents’ Pressure to Eat were negatively related with children’s BMI. Similar trends were found with BMI categorized into underweight, normal weight, overweight and obesity. Part of the association between children’s eating behaviors and BMI was accounted for by parental feeding practices (changes in effect estimates: 20-43%), while children’s eating behaviors in turn explained part of the relation between parental feeding and child BMI (changes in effect estimates: 33-47%).

Conclusions

This study provides important information by showing how young children’s eating behaviors and parental feeding patterns differ between children with normal weight, underweight and overweight. The high prevalence of under- and overweight among preschoolers suggest prevention interventions targeting unhealthy weights should start early in life. Although longitudinal studies are necessary to ascertain causal directions, efforts to prevent or treat unhealthy child weight might benefit from a focus on changing the behaviors of both children and their parents.

Keywords:
Overweight; Underweight; BMI; Eating behavior; Feeding; Parenting; Children