title: Association between parenting practices and children's dietary intake, activity behavior and development of body mass index: the KOALA Birth Cohort Study.
abstract: BACKGROUND
  Insights into the effects of energy balance-related parenting practices on children's diet and activity behavior at an early age is warranted to determine which practices should be recommended and to whom. The purpose of this study was to examine child and parent background correlates of energy balance-related parenting practices at age 5, as well as the associations of these practices with children's diet, activity behavior, and body mass index (BMI) development.
  
  
  METHODS
  Questionnaire data originated from the KOALA Birth Cohort Study for ages 5 (N = 2026) and 7 (N = 1819). Linear regression analyses were used to examine the association of child and parent background characteristics with parenting practices (i.e., diet- and activity-related restriction, monitoring and stimulation), and to examine the associations between these parenting practices and children's diet (in terms of energy intake, dietary fiber intake, and added sugar intake) and activity behavior (i.e., physical activity and sedentary time) at age 5, as well as BMI development from age 5 to age 7. Moderation analyses were used to examine whether the associations between the parenting practices and child behavior depended on child characteristics.
  
  
  RESULTS
  Several child and parent background characteristics were associated with the parenting practices. Dietary monitoring, stimulation of healthy intake and stimulation of physical activity were associated with desirable energy balance-related behaviors (i.e., dietary intake and/or activity behavior) and desirable BMI development, whereas restriction of sedentary time showed associations with undesirable behaviors and BMI development. Child eating style and weight status, but not child gender or activity style, moderated the associations between parenting practices and behavior. Dietary restriction and monitoring showed weaker, or even undesirable associations for children with a deviant eating style, whereas these practices showed associations with desirable behavior for normal eaters. By contrast, stimulation to eat healthy worked particularly well for children with a deviant eating style or a high BMI.
  
  
  CONCLUSIONS
  Although most energy balance-related parenting practices were associated with desirable behaviors, some practices showed associations with undesirable child behavior and weight outcomes. Only parental stimulation showed desirable associations with regard to both diet and activity behavior. The interaction between parenting and child characteristics in the association with behavior calls for parenting that is tailored to the individual child.
authors.affiliation: Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, the Netherlands.
authors.forename: Jessica S
authors.initials: JS
authors.lastname: Gubbels
authors.forename: Stef P J
authors.initials: SP
authors.lastname: Kremers
authors.forename: Annette
authors.initials: A
authors.lastname: Stafleu
authors.forename: Sanne I
authors.initials: SI
authors.lastname: de Vries
authors.forename: R Alexandra
authors.initials: RA
authors.lastname: Goldbohm
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
authors.forename: Nanne K
authors.initials: NK
authors.lastname: de Vries
authors.forename: Stef
authors.initials: S
authors.lastname: van Buuren
authors.forename: Carel
authors.initials: C
authors.lastname: Thijs
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D031204:Caloric Restriction; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D015331:Cohort Studies; D004032:Diet; D002149:Energy Intake; D004734:Energy Metabolism; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000517:prevention & control*; D010287:Parent-Child Relations; D016487:Parenting; D011446:Prospective Studies; D012044:Regression Analysis; D011795:Surveys and Questionnaires