title: Parental feeding practices and associations with child weight status. Swedish validation of the Child Feeding Questionnaire finds parents of 4-year-olds less restrictive.
abstract: The Child Feeding Questionnaire (CFQ) assesses parental feeding attitudes, beliefs and practices concerned with child feeding and obesity proneness. The questionnaire has been developed in the U.S., and validation studies in other countries are limited. The aim of this study was to examine the psychometric properties of the CFQ in Sweden and the associations between parenting practices and children's weight status. Based on records from the Swedish population register, all mothers of 4-year-olds (n = 3007) from the third largest city in Sweden, Malmö, were contacted by mail. Those who returned the CFQ together with a background questionnaire (n = 876) received the CFQ again to enable test-retest evaluation; 564 mothers completed the CFQ twice. We used confirmatory factor analysis to test whether the original 7-factor model was supported. Good fit (CFI = 0.94, TLI = 0.95, RMSEA = 0.04, SRMR = 0.05) was obtained after minor modifications such as dropping 2 items on restriction and adding 3 error covariances. The internal reliability and the 2-week test-retest reliability were good. The scores on restriction were the lowest ever reported. When the influence of parenting practices on child BMI (dependent variable) was examined in a structural equation model (SEM), child BMI had a positive association with restriction and a negative association with pressure to eat. Restriction was positively influenced by concern about child weight. The second SEM treated parenting practices as dependent variables. Parental foreign origin and child BMI had direct effects on restriction, while pressure to eat was also influenced by parental education. While the results of the study support the usefulness of the CFQ in Sweden, carefully designed cross-cultural comparisons are needed to explain why the levels of restrictive feeding in Swedish families are the lowest reported.
authors: Division of Pediatrics, Department of Clinical Science, Intervention and Technology (CLINTEC), B62, Karolinska Institute, 141 86 Stockholm, Sweden. Electronic address: paulina.nowicka@ki.se.
authors: Paulina
authors: P
authors: Nowicka
authors: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institute, 171 65 Solna, Sweden.
authors: Kimmo
authors: K
authors: Sorjonen
authors: Pediatric Unit, Verona University Medical School, Policlinic GB. Rossi, P.le LA. Scuro, 1, 37134 Verona, Italy; Pennington Biomedical Research Center, Baton Rouge, LA, USA.
authors: Angelo
authors: A
authors: Pietrobelli
authors: Childhood Obesity Unit, Childhood Centre Malmö, Skåne University Hospital, 205 02 Malmö, Sweden.
authors: Carl-Erik
authors: CE
authors: Flodmark
authors: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 2211 McGavran Greenberg Hall, CB 7461, Chapel Hill, NC 27599-7461, USA.
authors: Myles S
authors: MS
authors: Faith
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004522:Educational Status; D005163:Factor Analysis, Statistical; D005247:Feeding Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009765:Obesity / Q000208:ethnology / Q000517:prevention & control; D010287:Parent-Child Relations; D016487:Parenting; D010290:Parents; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: Children; Obesity; Overweight; Parenting practices; Parents; Validation