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Kids' Obesity Tied to Mom's Feeding Approach

Study: Ordering child to eat everything on plate may backfire

FRIDAY, Feb. 22, 2002 (HealthDayNews) -- Could telling your kid to eat everything on his plate help make obesity his fate?

The alarming increase in childhood obesity in the Western world has been blamed on many factors, including a less physically active lifestyle and the availability of high-fat foods. Now a new study says there's a link between how parents approach weight issues and the feeding of their children -- and the young generation's waistline.

According to the researchers, the findings suggest that changing parental feeding behaviors could have an impact on the growing epidemic of childhood obesity in the United States.

The findings appear in the March issue of the American Journal of Clinical Nutrition.

A team led by Donna Spruijt-Metz, an assistant professor of research at the University of Southern California's Institute of Health Promotion and Disease Prevention, looked at the relationship between mothers' child-feeding practices and children's fat mass. The researchers studied 46 black and 74 white boys and girls, all about 11 years old.

Each mother filled out a questionnaire about her child-feeding practices, which looked at whether they pressured their children to eat, such as telling a child to "eat everything on their plate."

The questionnaire also measured each mother's concern over her child's weight, including fears that the child is or will become overweight and have to go on a diet. At the same time, each child's body fat mass was measured used a technique called dual-energy X-ray absorptiometry (DXA).

The data available for this study was special because it provided information of DXA and it also looked at both boys and girls, while most research on nutrition and feeding practices have focuses on girls. "The whole onus of body image issues and overweight is thrown onto this relationship between mom and the girl," says Spruijt-Metz.

Spruijt-Metz was surprised that socioeconomic status appeared to have no effect on either pressuring a child to eat or concern over a child's weight. "Philosophically, you might say that if you don't have [wealth or food], you want your child to clean the plate once you do have it," she says.

To Spruijt-Metz, it suggests that child-feeding practices may be modifiable across all socioeconomic groups, perhaps making it possible to "stem this incredible tide of childhood obesity."

But the best way to change feeding behavior to reduce the risk of obesity is still not clear, says Spruijt-Metz.

Public service announcements might change awareness of the issue, but they're unlikely to change behavior, says Spruijt-Metz, although some theories suggest that awareness must change before behavior can be modified.

"Different cultural groups require different interventions tailored to match the food that they're feeding their kids or to match their particular style," says Spruijt-Metz.

One major question, she says, is whether it's necessary to change how parents eat. According to Spruijt-Metz, physical activity research has shown that it's much harder to get parents to change their own activity levels, and that it's more important for parents to support their children's activities.

"What this research might be saying is that we can go in an educate parents about how they approach feeding their child and what they feed their child, without also pointing the finger at the parents and saying, 'You have to change, too.'"

Brian Saelens, a clinical psychologist at the Children's Hospital Medical Center of Cincinnati, who works with children who are already overweight, says that his approach is to help parents provide a healthful eating environment. He says a moderate approach is best.

"You can't be too extreme, in terms of being so over-controlling that the kids have no choice," says Saelens. "You can't also be neglectful to the point where parents are unaware of what they're eating."

He says that one of the main problems in the fight against childhood obesity is the unprecedented access to high-fat, high-calorie foods in the last two decades. He says that portion sizes in out-of-home food have increased substantially, and that American families are spending more of their food budget eating out.

At the same time, he says, children are less active. "We've made their lives more sedentary," he says. "We keep them in school longer, we eliminate gym classes from school, and we encourage them to be sedentary and in the house so we can feel that they safe."

Spruijt-Metz and her colleagues hope to perform a long-term study of a group of children, as well as study the body fat relationship between mothers and children. Her team is currently studying how these parental feeding behaviors begin.

What to Do: Find out more about obesity in children from the Office of the Surgeon General or the American Academy of Family Physicians. The American Dietetic Association has tips for making the most of family mealtime.

SOURCES: Interviews with Donna Spruijt-Metz, Ph.D., assistant professor of research, Institute of Health Promotion and Disease Prevention, Department of Preventive Medicine, University of Southern California, Alhambra; Brian E. Saelens, Ph.D., assistant professor, Division of Psychology, Department of Pediatrics, Children's Hospital Medical Center, Cincinnati; March 2002 American Journal of Clinical Nutrition
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