Poster Presentation ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018

Changes in parental feeding practices and children’s food intake: A randomized control trial of obesity treatment in preschoolers  (#348)

Maria Somaraki 1 , Karin Eli 2 , Anna Ek 3 , Pernilla Sandvik 1 , Kimmo Sorjonen 4 , Paulina Nowicka 1 3
  1. Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
  2. Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
  3. Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
  4. Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden

BACKGROUND: Intensive childhood obesity treatment targeting parents is most effective during the preschool age; however, the mechanisms of change are unknown. To identify possible mechanisms, we examined changes in parental feeding practices, child dietary intake, and child weight following a parenting intervention.  

METHODS: The More and Less study is a randomized controlled trial conducted in Sweden. Parents of children with obesity (n=174), aged 4-6, were randomized to: 1) standard treatment (lifestyle modifications); 2) a parenting program with booster sessions; 3) the same program without booster sessions. Parents reported on their feeding practices (four timepoints) and their child’s obesogenic food intake (baseline and after 12 months). Data were analysed using linear mixed models and one-way ANOVA. Interactions between changes in parental practices and child food intake over 12 months, and their effect on changes in child weight during the same period, were examined through general linear models in the total sample.

RESULTS: No significant differences in parental feeding practices and child food intake emerged between treatment groups at the 12-month follow-up; however, differences within groups emerged compared to baseline.  Mothers in all groups uniformly decreased pressure to eat and increased monitoring compared to baseline. Fathers in all groups showed uniform improvements only in monitoring compared to baseline. In the group with booster sessions, children’s obesogenic food intake decreased in more aspects compared to baseline. Across all groups, increased parental monitoring over 12 months predicted a decrease in child weight, while higher pressure to eat after 12 months predicted an increase in weight among children who increased their consumption of obesogenic foods (juice and sweets).

CONCLUSION: Effective early obesity treatment may operate through changes in proximal outcomes (child food intake), influenced by parental feeding practices. Aspects of the home environment and the cumulative effect of maternal and paternal practices warrant further investigation.