Controlling and less controlling feeding practices are differentially associated with child food intake and appetitive behaviors assessed in a school environment

Background. Child food intake and appetitive behaviors show an inconsistent pattern of associations with parental feeding practices. Relationships likely vary depending on parent feeding style, and on the method by which child eating behaviors are measured. Objectives. We tested relationships of controlling and less controlling forms of parental promotion and limitation of eating with food intake and appetitive behaviors assessed in preschoolers' normal school environments. Methods. As part of a 5-day protocol, preschoolers consumed standardized lunches, and caloric compensation, eating rate and eating in the absence of hunger were assessed. Feeding practices were measured using the Child Feeding Questionnaire (CFQ) and Parent Feeding Styles Questionnaire (PFSQ). CFQ-Pressure to eat and CFQ-Restriction were controlling forms of promotion/limitation of child intake, and CFQ-Monitoring and PFSQ-Prompting to eat were less controlling forms. Results. Children (3–5y, n = 70) of parents with higher CFQ-Pressure to eat scores showed lower total intake, consuming significantly fewer calories from bread, snacks and fruits and vegetables. Higher PFSQ-Prompting to eat was associated with lower fruit and vegetable intake only. CFQ-Restriction and CFQ-Monitoring scores were unassociated with food intake. Higher CFQ-Pressure to eat was associated with slower eating rate, while higher CFQ-Monitoring was associated with lower intake in absence of hunger. Conclusions. Parental promotion and limitation of intake were associated with preschoolers' eating behaviors assessed in an ecologically valid setting, without parents present. Controlling and less controlling forms showed differential patterns of associations. Results were consistent with child-to-parent and parent-to-child effects, but research using longitudinal designs is needed to test bidirectional relationships.This research project was funded by a PhD studentship from the Medical Research Council, with support from core funding from Cancer Research UK. Further support for SC and EJ from R01DK113286. Additional support for SC from UG3OD023313 and R00DK088360. The authors are grateful to Jane Wardle for her close collaboration on study design