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3320.1: Monday, November 05, 2007 - 3:15 PM

Abstract #161692

A “bottom up” typology of parent feeding practices relates to Head Start child BMI and diet

Frank Franklin, MD MPH PhD1, Michelle Feese, MPH2, Mary Lou Lackey, BS2, Sheryl Hughes, PhD3, Richard Shewchuk, PhD4, John Bentley, PhD5, and Edmond Kabagambe, DVM6. (1) Maternal and Child Health, University of Alabama at Birmingham School of Public Health, 4831 Bridgewater Rd., Birmingham, AL 35243, 205-934-7161, frankln@uab.edu, (2) Maternal and Child Health, UAB School of Public Health, 1665 University Blvd., Birmingham, AL 35294-0022, (3) Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Street, Houston, TX 77030, (4) Health Services Administration, University of Alabama at Birmingham, Webb 560, 1530 3rd Ave S, Birmingham, AL 35294, (5) Biostatistics, UAB School of Public Health, 1665 University Blvd., Birmingham, AL 35294-0022, (6) Epidemiology, UAB School of Public Health, 1665 University Blvd., Birmingham, AL 35294-0022

We examined how parent practices for feeding preschool children relate to child BMI and diet in 4 year old Head Start (HS) children (n= 704). Feeding practices were derived from parents in structured focus groups. Parents grouped the parent-derived feeding practices into five clusters (teachable moments, practical methods, supervision/contingencies, junk foods/sweets restriction, and enhancing healthy foods availability) based on perceived similarity and rated the effectiveness of each practice with their child. Parents also rated the frequency of using parenting practices (authoritarian, authoritative, and permissive) from the Caregiver Feeding Styles Questionnaire. Parent reported child non-Head Start diet on 3 separate days. Energy-adjusted servings of sugar-sweetened beverages related positively (p< 0.05) while lean meats/eggs/beans (p< 0.05) and refined grains (p< 0.05) related negatively to child BMI z-score. Descending quartiles of sugar-sweetened beverages and increasing quartiles of lean meats/eggs/beans and refined grains were summed to create a composite diet score that related to child BMI z-score (p< 0.01). Factor analysis of the five parent-derived clusters and the three questionnaire-derived sets demonstrated three factors. Factor 1 was moderate on the supervision/contingency cluster and high for the other four parent-derived clusters. Factor 2 was high on authoritarian, authoritative, and permissive sets. Factor 3 was high on the supervision/contingency and moderate on authoritarian practices, practical methods, and junk foods/sweets restriction. Cluster analysis of the three factors demonstrated four parent feeding types. Type 1 was negative for factor 1, high for factor 2, and moderate for factor 3. Type 2 was low on factors 1 and 2 and negative for factor 3. Type 3 was low on 1, negative for factor 2 and moderate for factor 3. Type 4 was high on factor 1 and moderate on factors 2 and 3. Type 2 was associated with higher child BMI Z-score, lower composite diet score, and lower intake of fruit and non-fried vegetables and higher intake of fried vegetables, chips and cake/desserts than type 4. Types 1 and 3 were intermediate. A typology developed from parenting feeding practices defines children with adverse diets and BMI and may permit targeting interventions to limit increases in Head Start child BMI.

Learning Objectives:

Keywords: Food and Nutrition, Obesity

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Approaches to Improve Nutrition in School Settings (Jointly-organized by the Food and Nutrition, Epidemiology, & School Health Education and Services Sections)

The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA