A new study published online in the journal Obesity provides
further evidence that strict maternal control over eating
habits – such as determining how much a child should
eat and coaxing them to eat certain foods – during early
childhood may not lead to significant future weight gain in
boys or girls. Instead, this behavior may be a response to
concerns over a child's increasing weight.
"Our findings suggest that controlling maternal feeding
practices probably do not cause increased weight gain, as
some previous studies have proposed. In fact, some degree
of control may actually be beneficial in helping certain children
maintain their weight," says lead author Kyung E. Rhee,
MD, MSc, a researcher with the Weight Control and Diabetes
Research Center at The Miriam Hospital. Rhee is also a pediatrician
with Hasbro Children's Hospital and an assistant professor
of pediatrics (clinical) at The Warren Alpert Medical School
of Brown University.
Controlling or restrictive feeding practices have been associated
with disinhibited child eating, increased caloric intake and
excessive weight gain, prompting some experts to recommend
that parents avoid these overly restrictive behaviors when
helping children control their weight. However, as the study
authors point out, research on the relationship between controlling
feeding practices and child weight has been inconsistent and
has not conclusively determined whether these practices cause,
or are a consequence of, weight gain.
In the study, researchers examined the data of 789 children
who participated in the National Institute of Child Health
and Human Development's Study of Early Child Care and Youth
Development. The group included almost equal numbers of girls
and boys, which the authors say is significant, since many
prior studies have only focused on girls.
Child heights and weights were obtained at ages 4, 7 and
9 and changes in body mass index (BMI) were measured between
4-7 years and 7-9 years. Maternal feeding practices were measured
at each age interval by asking mothers the question, "Do
you let your child eat what he/she feels like eating?"
Although statistical analyses did not find an association
between increases in controlling maternal feeding practices
and later child weight gain, it did reveal some interesting
gender differences. Researchers found that in boys, increases
in restrictive feeding practices between the ages of 4 and
7 were associated with a decreased risk of increased BMI by
the time the boys were 7-9 years old. But on the flip side,
mothers seemed to increase their control when it appeared
their daughters had gained significant amounts of weight between
the ages of 4 and 7.
"Our findings mirror those of other studies that have
found that parents are much less likely to recognize or be
concerned about the overweight status of sons compared to
daughters," says Rhee. "These behaviors may represent
a sensitivity to societal values that girls should be slim
while boys have a physical or social advantage in being larger."
Based on these findings, the researchers say restrictive
feeding practices may actually be necessary for some children
to help regulate their food intake, promote healthier eating
habits and limit excessive weight gain. "There has been
some concern about the negative impact of restrictive feeding
practices and that we should be more lax and let the child
determine how much, when and what to eat. However, some degree
of control may not be harmful and may actually help certain
children maintain their weight," says Rhee.
However, she adds that further research is needed to define
what this type of control looks like. The researchers also
call for additional definition and exploration of restrictive
feeding practices and their relationship with child weight
gain to better inform recommendations for obesity treatment
and prevention.