The Relationship among Maternal Characteristics, Maternal Dietary Self-Regulation, and the Dietary Intake and Body Weight Status of Two to Five-Year-Old Children

Abstract

Background: Eating preferences and practices are established early in life, yet we have little knowledge about how mothers make food decisions on behalf of their children. These decisions, however, lay the foundation for their child’s lifelong food preferences and eating behaviors. Almost one-third of all children in the U.S. are overweight or obese putting them at high risk for becoming an overweight or obese adult. To make a difference in the ongoing obesity epidemic, we must better understand the relationship among characteristics of the mother who controls the young child’s access to food, food choices, and feeding practices. This knowledge will undergird future interventions. Purpose: This study explored associations among mothers’ dietary self-regulation, stress, feeding practices and body mass index (BMI) and her child’s BMI and dietary intake, and, identified influential contextual factors in a sample of mothers of preschool children ages 2-5 years. Inclusion criteria: mothers > 18 years of age with a child 2-5 years of age, able to read English, and self-identify as the primary parent caregiver. Exclusion criteria: child with a previously diagnosed medical condition affecting their ability to eat, and mothers who did not have access to a device to complete the electronic survey. Methods: Two-phase study with sequential explanatory design: cross-sectional, correlational design using quantitative methods; qualitative approach using individual interviews. Study sample included 419 who completed a survey and a subset of the sample (N=10) completed in-depth interviews. Mothers were recruited from daycare centers and CloudResearch, a participant sourcing platform. Results: Median maternal age was 34.1 years (IQR 29-38) with median education of 13 years (IQR 12-16). About 94% of the mothers in the study were overweight or obese. Median child BMI z-score was .56 (IQR -.8 – 2.1). After controlling for maternal demographics, perceived child weight variables, maternal perceived stress, and maternal BMI, the addition of dietary self-regulation and child feeding practices demonstrated a statistically significant increase in explained variance in child BMI (R2 change = .08, p < .001). Qualitative data revealed barriers to child positive feeding practices including maternal competing obligations and lack of guidance from the pediatric healthcare provider.