Refine
Document Type
- Article (10)
- Postprint (3)
- Doctoral Thesis (1)
Is part of the Bibliography
- yes (14)
Keywords
- Obesity (5)
- Attrition (3)
- Child (3)
- Predictors (3)
- Weight management trial (3)
- Children (2)
- Overweight (2)
- children (2)
- Adolescents (1)
- Child's emotional eating (1)
Institute
The preference for fruits and vegetables is the main predictor for the longtime healthy eating behavior. There are many factors which affect the development of food preferences. The familiarity with different foods seems to be a special aspect associated with the corresponding preference. To establish a preference for fruits and vegetables during early childhood, we need to know more about the factors that affect this preference development. So far, research has mostly concentrated on the food intake and less on the corresponding preference. Additionally, it is often based on studies of the mere-exposure effect or on older children and their ability to label fruits and vegetables correctly. Findings about the level of food familiarity in young children and its relation to the actual food preference are still missing. Our study focuses on different aspects of food familiarity as well as on their relationship to the child's preference and presents results from 213 children aged 2 to 10 years. Using standardized photos, the food preference was measured with a computer-based method that ran automatically without influence from parents or interviewer. The children knew fewer of the presented vegetables (66 %) than fruits or sweets (78 % each). About the same number of vegetables (63 %) had already been tasted by the children and were considered tasty. Only 48 % of the presented vegetables were named correctly - an ability that increases in older children. Concerning the relationship between the familiarity with vegetables and their preference, the different familiarity aspects showed that vegetables of lower preference were less often recognized, tasted, considered tasty, or named correctly.
Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC)
(2016)
Background
Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting.
Methods
Five hundred twenty-three parents and their 7–13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses.
Results
Objective weight data were available for 49.6 (67.0) % of the children 6 (12) months after the end of treatment. Completers and non-completers at the 6- and 12-month follow-up differed in the amount of weight loss during their inpatient stay, their initial BMI-SDS, educational level of the parents, and child’s quality of life and well-being. Additionally, completers supported their child more than non-completers, and at the 12-month follow-up, families with a more structured eating environment were less likely to drop out. On a multivariate level, only educational background and structure of the eating environment remained significant.
Conclusions
The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background.
Loss to follow-up in a randomized controlled trial study for pediatric weight management (EPOC)
(2016)
Background
Attrition is a serious problem in intervention studies. The current study analyzed the attrition rate during follow-up in a randomized controlled pediatric weight management program (EPOC study) within a tertiary care setting.
Methods
Five hundred twenty-three parents and their 7–13-year-old children with obesity participated in the randomized controlled intervention trial. Follow-up data were assessed 6 and 12 months after the end of treatment. Attrition was defined as providing no objective weight data. Demographic and psychological baseline characteristics were used to predict attrition at 6- and 12-month follow-up using multivariate logistic regression analyses.
Results
Objective weight data were available for 49.6 (67.0) % of the children 6 (12) months after the end of treatment. Completers and non-completers at the 6- and 12-month follow-up differed in the amount of weight loss during their inpatient stay, their initial BMI-SDS, educational level of the parents, and child’s quality of life and well-being. Additionally, completers supported their child more than non-completers, and at the 12-month follow-up, families with a more structured eating environment were less likely to drop out. On a multivariate level, only educational background and structure of the eating environment remained significant.
Conclusions
The minor differences between the completers and the non-completers suggest that our retention strategies were successful. Further research should focus on prevention of attrition in families with a lower educational background.
Background: Research concerning child's food intake have considered various influencing factors, for example parental feeding strategies, demographic and weight factors. At this time, however, there are few findings that explore these factors simultaneously. Accordingly, the aim of this study was to test a structural equation model regarding the associations between maternal feeding strategies and child's food intake. Methods: 556 mothers and their children between 1 and 10 years of age participated in this crosssectional study. Besides socio-demographic and weight data, the mothers were asked about their feeding strategies as well as their child's food intake. Results: The well-fitting model explained 73% of the variance in the child's consumption of healthy and 34% of unhealthy food. In addition to the effect of the mother's social status and the child's age, a rewarding and modeling feeding behavior significantly influenced the child's food intake. Conclusion: The results highlight the relevance of maternal feeding behavior on the child's food intake. In terms of preventing eating- or weight-related problems, the findings indicate the usefulness of training parents in explicit modeling behavior and avoiding food as a reward.
Die Etablierung eines gesunden Ernährungsverhaltens unserer Kinder ist die wichtigste Voraussetzung für ihre körperliche, kognitive und emotionale Entwicklung. Dabei sind neben einer genetischen Disposition und kulturellen Gegebenheiten vor allem die Einflüsse der jeweiligen Betreuungspersonen ausschlaggebend. Die Eltern steuern sowohl direkt (durch Aufforderungen, Verbote u.ä.) als auch indirekt (durch die Förderung eigenverantwortlicher Entscheidungen u.ä.) das Ernährungsverhalten ihres Kindes. Untersuchungen zum mütterlichen Steuerungsverhalten konzentrierten sich bisher vorwiegend auf die Betrachtung direkter Strategien sowie auf altershomogene und sozial besser gestellte Gruppen. Aufgrund möglicher Verzerrungen durch die Betrachtung einzelner Ausschnitte des Zusammenhangs zwischen Steuerung und Ernährung wurde in der vorliegenden Arbeit ein Gesamtmodell spezifiziert, welches den Zusammenhang zwischen elterlicher Steuerung und kindlicher Ernährung unter Berücksichtigung von Sozial- und Gewichtsfaktoren abbildet. Dazu wurden drei Erhebungen mit insgesamt über 900 Müttern 1 – 10-jähriger Kinder durchgeführt. Innerhalb dieser Untersuchungen ist es gelungen, erstmalig ein deutschsprachiges Instrument zur Messung elterlicher Steuerungsstrategien in der Essenssituation (ISS) zu entwickeln. Die Analysen zeigten, dass bisher nur selten untersuchte Strategien, wie das explizite Bemühen um Vorbildwirkung und das Erlauben von eigenverantwortlichen Entscheidungen des Kindes, von den Müttern häufig angewandt werden. Die Analyse des komplexen Wirkungsgefüge von Steuerung, kindlicher Ernährung sowie sozialer und gewichtsbezogener Faktoren zeigte weiterhin, dass neben stabilen Faktoren, wie dem mütterlichen Status und dem Alter des Kindes, ein entscheidender Anteil der mütterlichen Steuerungsstrategien für die kindliche Ernährung verantwortlich ist. Die berichteten Ergebnisse zeigen auf, wie relevant die gemeinsame Betrachtung von gesunden und problematischen Nahrungsmitteln sowie die den Zusammenhang zwischen Steuerung und Ernährung beeinflussenden Faktoren innerhalb eines Modells ist. Zusammengefasst scheint vor allem die Steuerung durch Belohnung von und mit bestimmten Nahrungsmitteln eine für das kindliche Ernährungsverhalten und das Übergewichtsrisiko besonders kritische Strategie zu sein. Dies ist umso bedeutender, als bisherige Untersuchungen dieses Verhalten häufig in restriktive Strategien integriert betrachteten. Die separate Analyse wies jedoch darauf hin, dass vor allem die belohnenden Verhaltensanteile relevant sind. Dies zeigt, dass es für die Entwicklung einer gesunden kindlichen Ernährung tatsächlich veränderbare Verhaltensweisen gibt, die Eltern in Präventionsprogrammen oder anderen mit Kursen zum kindlichen Wohl assoziierten Einrichtungen vermittelt werden können.
Vorgestellt wird ein Instrument zur Erhebung muetterlicher Steuerungsstrategien in der Essenssituation (ISS), fuer deren Erfassung bislang kein deutschsprachiges, ueberprueftes Instrument vorliegt. Dazu wurde an 163 Muettern mit Vorschulkindern ein auf Grundlage bereits existierender englischsprachiger Instrumente (CFQ, CFSQ) sowie Fokusinterviews mit Experten und Muettern entstandener Itempool ueberprueft. Die Studie berichtet ueber die faktoren- und itemanalytischen Ergebnisse, nach denen sich 21 Items als trennscharf und verstaendlich erwiesen. Eine explorative Faktorenanalyse ergab sechs Faktoren, die zusammen 68% der Varianz aufklaerten. Sie umfassen aktive Strategien, wie Restriktion, Draengen und Belohnung, aber auch passive Steuerung durch Vorbild, Monitoring und die Staerkung der Eigenverantwortung des Kindes. Analysen zu Unterschieden im Steuerungsverhalten der Mutter bestaetigten die Faehigkeit des Instrumentes zur Differenzierung zwischen Muettern mit verschiedenem soziooekonomischen Status und Kindern unterschiedlichen Gewichts.
Background: Research concerning child's food intake have considered various influencing factors, for example parental feeding strategies, demographic and weight factors. At this time, however, there are few findings that explore these factors simultaneously. Accordingly, the aim of this study was to test a structural equation model regarding the associations between maternal feeding strategies and child's food intake. Methods: 556 mothers and their children between 1 and 10 years of age participated in this cross-sectional study. Besides socio-demographic and weight data, the mothers were asked about their feeding strategies as well as their child's food intake. Results: The well-fitting model explained 73% of the variance in the child's consumption of healthy and 34% of unhealthy food. In addition to the effect of the mother's social status and the child's age, a rewarding and modeling feeding behavior significantly influenced the child's food intake. Conclusion: The results highlight the relevance of maternal feeding behavior on the child's food intake. In terms of preventing eating- or weight-related problems, the findings indicate the usefulness of training parents in explicit modeling behavior and avoiding food as a reward.
Are maternal weight, eating and feeding practices associated with emotional eating in childhood?
(2013)
Background: Research concerning children's emotional eating behavior has shown its negative impact on weight-related problems. Taking the model of Birch and Davison (2001) into account, we focus on the role of maternal feeding behavior on the association between emotional eating of the mother and the child. Methods: 482 mothers and their children participated in this cross-sectional study. The mothers were asked about their feeding strategies, their children's and their own emotional eating and weight. We tested a structural equation model for different feeding strategies. Results: In addition to an expected direct association between the mother's and child's emotional eating, the maternal feeding strategies are related to the child's eating behavior. A higher maternal restriction of food or its monitoring was associated with a higher level of children's emotional eating, while allowing the child more control about their eating was linked to less pronounced emotional eating behavior. Conclusions: The results highlight the relevance of maternal feeding behavior on emotional eating in childhood. In terms of preventing weight-related problems, the findings indicate the necessity of training parents in allowing their children more control and avoiding the restriction of food.