PROVIDENCE, RI - A new study published online in the journal Obesity provides further evidence that strict maternal control over eating habits - such as determining how much a child should eat and coaxing them to eat certain foods - during early childhood may not lead to significant future weight gain in boys or girls. Instead, this behavior may be a response to concerns over a child's increasing weight.
"Our findings suggest that controlling maternal feeding practices probably do not cause increased weight gain, as some previous studies have proposed. In fact, some degree of control may actually be beneficial in helping certain children maintain their weight," says lead author Kyung E. Rhee, MD, MSc, a researcher with the Weight Control and Diabetes Research Center at The Miriam Hospital. Rhee is also a pediatrician with Hasbro Children's Hospital and an assistant professor of pediatrics (clinical) at The Warren Alpert Medical School of Brown University.
Controlling or restrictive feeding practices have been associated with disinhibited child eating, increased caloric intake and excessive weight gain, prompting some experts to recommend that parents avoid these overly restrictive behaviors when helping children control their weight. However, as the study authors point out, research on the relationship between controlling feeding practices and child weight has been inconsistent and has not conclusively determined whether these practices cause, or are a consequence of, weight gain.
In the study, researchers examined the data of 789 children who participated in the National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development. The group included almost equal numbers of girls and boys, which the authors say is significant, since many prior studies have only focused on girls.
Child heights and weights were obtained at ages 4, 7 and 9 and changes in body mass index (BMI) were measured between 4-7 years and 7-9 years. Maternal feeding practices were measured at each age interval by asking mothers the question, "Do you let your child eat what he/she feels like eating?"
Although statistical analyses did not find an association between increases in controlling maternal feeding practices and later child weight gain, it did reveal some interesting gender differences. Researchers found that in boys, increases in restrictive feeding practices between the ages of 4 and 7 were associated with a decreased risk of increased BMI by the time the boys were 7-9 years old. But on the flip side, mothers seemed to increase their control when it appeared their daughters had gained significant amounts of weight between the ages of 4 and 7.
"Our findings mirror those of other studies that have found that parents are much less likely to recognize or be concerned about the overweight status of sons compared to daughters," says Rhee. "These behaviors may represent a sensitivity to societal values that girls should be slim while boys have a physical or social advantage in being larger."
Based on these findings, the researchers say restrictive feeding practices may actually be necessary for some children to help regulate their food intake, promote healthier eating habits and limit excessive weight gain. "There has been some concern about the negative impact of restrictive feeding practices and that we should be more lax and let the child determine how much, when and what to eat. However, some degree of control may not be harmful and may actually help certain children maintain their weight," says Rhee.
However, she adds that further research is needed to define what this type of control looks like. The researchers also call for additional definition and exploration of restrictive feeding practices and their relationship with child weight gain to better inform recommendations for obesity treatment and prevention.
The study was supported by grants from the Hasbro Pediatric Research Fund and the American Heart Association. Co-authors include Sharon Coleman and Danielle P. Appugliese from the Boston University School of Public Health; Julie C. Lumeng, Niko A. Kaciroti and Natalie Davidson from the University of Michigan; Robert F. Corwyn from the University of Arkansas at Little Rock, and Robert H. Bradley from the University of Arizona.
The Miriam Hospital, established in 1926 in Providence, RI, is a private, not-for-profit hospital affiliated with The Warren Alpert Medical School of Brown University and a founding member of the Lifespan health system. For more information about The Miriam Hospital, please visit www.miriamhospital.org