Tired, Hungry, and Grumpy: Understanding the Direct and Indirect Relationships among Child Temperament, Sleep Problems, Feeding Styles, and Weight Outcomes

Research indicates that temperament is related to later obesity risk in both childhood and adulthood (e.g., Anzman-Frasca et al., 2012; Darlington & Wright, 2006), but less research has examined the mechanisms underlying this relationship. It is likely that temperament influences factors that increase one’s risk for obesity, such as parental feeding practices and child sleep problems. As such, the primary aim of the present study was to provide rigorous concurrent and longitudinal examinations of temperament, feeding practices, sleep problems, and child zBMI in a sample of healthy preschool children. In addition, the moderating role of SES was examined. A secondary aim of this study was to conduct confirmatory factor analysis on two measures assessing feeding practices and childhood sleep problems. Preschoolers aged 3 to 5 (49.5% female, 75.7% European American) presenting to a pediatric dentistry office were recruited to participate in the study (N = 297). Measures of child temperament, sleep, and parental feeding practices were collected Time 1 (T1) and again six months later at Time 2 (T2) (N = 188). Moreover, child and parent demographics, as well as objective measurements of child height and weight were assessed at both time points. Robust maximum likelihood confirmatory factor analyses were conducted on the Parental Feeding Style Questionnaire (Wardle et al., 2002) and the Children’s Sleep Habits Questionnaire-Preschool Version (Goodlin-Jones et al., 2008). Results provided preliminary support for a five-factor solution for each measure. Next, path analyses were conducted with both concurrent and longitudinal data. Overall, results indicate that greater reactivity/negativity is associated with parental feeding styles (i.e., emotional feeding) and children’s sleep problems both concurrently and longitudinally. zBMI was not significantly predicted by temperament, sleep, or feeding styles, however, and SES did not moderate any of the paths. Results indicate the importance for obesity prevention and treatment efforts to include a focus on child temperament, sleep, and parental feeding practices. In addition to providing important treatment implications, results provide a variety of areas for future research to further examine how temperament, feeding, and sleep relate and increase risk for obesity. Adviser: Timothy D. Nelso