The role of parents in a child’s obesity risk

More than 13 million children in the United States are considered obese. The number of obese adults is even more concerning at more than 93 million. Obesity is associated with other health risks such as heart disease and can even hinder a child’s development.

“Nutrition can impact children’s development in all kinds of areas including physical development and brain development,” said Dr. Jeffrey Liew, professor in the Department of Educational Psychology. “Both malnutrition and overnutrition can lead to childhood obesity so nutrition is important in terms of preventing childhood obesity.”

When looking at childhood nutrition, the focus is often on the head of the household. Young children rely on their parents or caregivers for feeding and dietary intake. However, a child’s appetitive traits also play a role.

Dr. Liew and Dr. Ledric Sherman, assistant professor in the Department of Health and Kinesiology, have both looked into the role of parents in their children’s dietary practices.

Impact of appetitive traits

Liew, along with his graduate student Zhiqing Zhou, took a closer look at children’s eating styles and childhood obesity. They focused on two different broad types of appetitive traits: food avoidance and food approach. Both have been found in research to be risk factors for pediatric obesity.

Children with food approach habits tend to enjoy foods and also have a tendency to engage in emotional eating. Children with food avoidance habits tend to be more fussy eaters and also slow eaters.

“These styles can really predispose people to certain food preferences and eating habits over time that could either have positive or negative impacts on their weight and their health,” said Dr. Liew.

While these traits have genetic and biological bases, parents also play a critical role in children’s dietary intake.

On the parental side, there are two prominently studied controlling feeding practices. Pressure to eat refers to parents’ encouragement of eating while restrictive feeding refers to parents’ control over their children’s eating, especially sugary or high-fat food.

The study found that child appetitive traits are linked to a child’s weight through restrictive feeding and pressure to eat.

“Parents have opportunities to empower their children to develop their own self-regulation. But, controlling feeding practices removes those opportunities for self-regulation which puts children at risk because they are not tuned to their hunger cues and satiety cues,” said Zhou. “They are more at risk to eat when they’re not hungry or not able to stop eating when they’re full. That puts children at risk.”

However, Liew and Zhou are confident, through parent education and intervention, this can be changed. Study findings show the importance of adopting a family-based approach in the development of prevention and intervention programs for childhood obesity.

“Parenting is a modifiable factor where we could make changes through parent training and meal education to help parents better regulate their kid’s eating behavior and to help them have a healthier lifestyle,” said Zhou.

A father’s impact

When we think about ways to improve nutrition at home, the focus tends to be on the female of the house. However, Sherman found more men are getting involved in those decisions, specifically African-American men.

“Unfortunately, a lot of men are absent from the home. In this study, we had a group of men who are keeping up with family nutrition and the responsibility of dietary shopping. What’s interesting is that these men want to have this role and not simply place it on their significant other,” said Sherman.

Prior research shows weight gain among fathers was positively associated with weight gain among children, which indicates fathers have a strong influence on eating behaviors. 

Using data collected by Dr. Matthew Lee Smith in the School of Public Health through a series of focus groups, Sherman and Smith found three sub themes regarding fathers’ perspectives.

• Teaching by Example. “For some men, they know if their kids see their parents eating candy and drinking sugar sweetened beverages frequently, they are going to want to emulate that behavior. If I try to tell them they shouldn’t do that, they’re going to come back and say ‘You did it and nothing is happening to you, so why can’t I?’,” said Sherman.
• Eating Healthy is Expensive. Fathers talked about financial costs as a barrier to purchasing healthier food options. While they knew inexpensive foods were less healthy, they were compelled to buy them because of financial reasons.
• Cooking and Eating at Home. “The men talked about cooking being therapeutic and cathartic because not only did it give them some educational time to really talk to their kids about nutrition, it was also an opportunity to have everyone involved in the kitchen,” said Sherman.

Another important aspect of eating healthy is food available to a family. Sherman said many communities across the country have food deserts within them. Food deserts are geographical areas that lack sufficient supply of fresh and healthy foods.

“One of the things we have to remember are the immediate food environments that are surrounding people near their residence. There are some who live in areas where they have access to a variety of grocery stores where fresh foods are available and prices are decent for the most part. But then, there are some people who live in communities where a decent grocery store is maybe 20 minutes away.”

Intervention through education

How can we make changes in these areas to better improve eating habits of families across the country? Sherman said the key is education. 

While fathers showed they want to be better examples for their children, they may not have the resources to initiate those dietary changes. Sherman said interventions are needed to help fathers, and families in general, with meal planning and preparation, which gives their children a variety of food options each week.

As for the cost of healthy food, Sherman said community efforts are needed to make healthier food options affordable. However, families can also make a difference by taking a more frugal approach to other household expenses.

The same is true for parental feeding practices. Liew and Zhou believe simply empowering parents with information to make healthy choices for their children and household when it comes to food, can have enduring impacts on their child’s health and development.