Modifications in parent feeding practices and child diet during family-based behavioral treatment improve child zBMI.
OBJECTIVE
To examine associations between modifications in parent feeding practices, child diet, and child weight status after treatment and to evaluate dietary mediators.


METHODS
Children classified as overweight or obese and 7-11 years old (N = 170) completed a 16-session family-based behavioral weight loss treatment (FBT) program. Anthropometrics (standardized body mass index (zBMI)), Child Feeding Questionnaire, and 24-hr dietary recalls were collected at baseline and post-FBT. Linear regression predicted child zBMI change. Single and multiple mediation tested child dietary modifications as mediators between change in parent feeding practices and child zBMI.


RESULTS
Restrictive parent feeding practices significantly decreased during FBT. Reductions in parent restriction, child weight concern, child's total energy intake, and percent energy from fat, and increases in parent perceived responsibility, and child percent energy from protein, predicted reductions in child zBMI. Change in child total energy intake mediated the relation between parent restriction and child zBMI change after accounting for covariates and additional dietary mediators.


CONCLUSIONS
FBT is associated with a decrease in parental restriction, which is associated with reductions in child relative weight, which was mediated by a decrease in child energy intake. Teaching parents to reduce children's energy intake without being overly restrictive may improve child weight.
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA.
Jodi Cahill
JC
Holland
Rachel P
RP
Kolko
Richard I
RI
Stein
R Robinson
RR
Welch
Michael G
MG
Perri
Kenneth B
KB
Schechtman
Brian E
BE
Saelens
Leonard H
LH
Epstein
Denise E
DE
Wilfley
D001521:Behavior Therapy; D015992:Body Mass Index; D002648:Child; D015930:Diet Records; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D016014:Linear Models; D008297:Male; D011939:Mental Recall; D009043:Motor Activity; D009765:Obesity / Q000628:therapy*; D016487:Parenting; D010290:Parents; D011795:Surveys and Questionnaires; D015431:Weight Loss; D061217:Weight Reduction Programs
D004041:Dietary Fats; D004044:Dietary Proteins