256 - The Association of Pressure To Eat with Observed Feeding Practices, Food Consumption, and Dietary Quality

Poster Number: 256
Publication Number: 256.141

Caroline B. Lucas, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Virginia Samuels, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Jacksonville, FL, United States; Mara Z. Vitolins, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Joseph Skelton, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Edward H. Ip, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Callie L. Brown, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States

Background: Parents frequently report exerting pressure on their child during mealtimes, which may contribute to unhealthy eating habits.

Objective: To assess the associations of self-reported parental pressures on their child to eat with food consumption and feeding practices during a standardized feeding, and dietary quality of the child’s typical food consumption.

Design/Methods: As part of a larger study of healthy 3–5-year-old children, we conducted a pilot and feasibility study with 24 parent-child dyads who were selectively recruited because parents self-reported using high or low pressure to eat (mean Pressure to Eat subscale of the Child Feeding Questionnaire scores >3 and < 2, respectively, range 1-5). Dyads ate a standardized lunch consisting of familiar and novel foods (Table 1). Food was weighed before and after to assess the amount eaten. The meal was videotaped and later coded by standardized methods for instances of the parent exerting verbal or physical pressure, modeling, praise, reasoning, or encouragement toward their child in an effort to persuade them to eat. In the two weeks following, parents participated in three 24-hour dietary recalls conducted by a Registered Dietitian. The Healthy Eating Index (HEI) was calculated from recall data to examine the child’s dietary quality. Pearson’s chi square test was used to assess differences by pressure to eat with amount consumed and dietary quality; Wilcox rank sum assessed differences with observed feeding practices.

Results: Children were diverse with regards to race/ethnicity and socioeconomic status. 11 parents reported high pressure feeding practices and 13 low pressure. Amount of food consumed by parents and children during the standardized feeding study was not significantly different by pressure to eat status (Table 1). “High pressure” parents applied a median of 9 verbal pressures to their child during the standardized meal compared to 4 for low, although this was not statistically significant. Other feeding practices were similar between groups (Table 2). HEI scores were low ( < 60) for all children, however, there were no significant differences in dietary quality by pressure to eat status (Table 3).Conclusion(s): Parent self-reported pressure to eat is associated with observed pressure to eat during a standardized feeding but not associated with amount of food consumed during the feeding or the child’s dietary variety. Future work should assess if/how these relationships change over time.
Table 1 – Food Amounts Consumed by Parents and Children and Associations with Pressures to Eat
Table 2 – Observed Feeding Practices and Associations with Pressures to Eat