Purpose: This study determined the preliminary effect of a wellness playgroup on diet, moderate to vigorous physical activity (MVPA), and sleep among toddlers.

Methods: Families with toddlers (12-36 months) were recruited from the community and randomly assigned to receive 10-weekly 90-minute sessions of the Families Understanding Nutrition and Physically Active Lifestyles (FUNPALs) Playgroup, or a health education program, Healthy Toddler Parent Group (HTPG). The FUNPALs Playgroup, was based on Social Cognitive, Family Systems, and Self Determination Theories. Facilitators created a fun environment where parents could learn about positive parenting and toddler health, play with their children, and connect with other families. HTPG included instruction and discussion on diet and activity recommendations for toddlers (children not included). Measures were completed pre (T1) and post program (T2). Snacks and sugar sweetened beverages (SSB) intake were assessed with the Kids Bite Food Frequency Questionnaire (FFQ) (Aquilar et al., 2014). Fruit and vegetable (FV) intake was assessed with the Kids Bite FFQ and with skin carotenoid concentration intensity measured by non-invasive reflection spectroscopy, which is a biomarker of intake of carotenoid rich FV. MVPA and sleep were assessed by 8-day actigraph wGT3x (Pensacola, Florida) accelerometers. Repeated measures ANOVA’s tested group differences on diet and activity variables.

Results: The sample (n=50) comprised toddlers (M_age = 27 months, 58% males) and parents (M_age = 31.7 years, 84% female), who were Non-Hispanic white (44%), Hispanic/Latino (38%), and/or African American (32%). There was a greater decrease in SSB consumption from T1 to T2 among FUNPALs Playgroup toddlers when compared to HTPG toddlers [Wilk’s Lambda = .802, F (1, 36) = 8.87, p = .005]. Both groups showed increased skin carotenoid concentrations from T1 to T2 [Wilk’s Lambda = .864, F (1, 33) = 5.206, p = .029]. Per Cohen (1988), the effect on SSB consumption (partial eta squared = .20) and on skin carotenoid intensity (partial eta squared = .14) represented large effects. There were no effects on snack, MVPA, or sleep.

Conclusions: This study provides preliminary evidence that a family wellness playgroup program may have a large positive effect on toddler diet quality.

Purpose: Co-parenting quality, which refers to the ways that parents do or do not coordinate with and support each other, has been shown to have a strong influence on child outcomes. However, little is known about how co-parenting quality may influence food parenting practices and few studies have considered fathers’ food parenting practices and their perspectives on co-parenting. This study aimed to investigate how co-parenting quality is associated with both mothers’ and fathers’ food parenting practices.

Methods: A cross-sectional analysis was conducted of 58 mothers and 40 fathers enrolled in a family-based health promotion intervention study. The Coparenting Relationship Scale was used to measure co-parenting quality and the Comprehensive Feeding Practices Questionnaire was used to measure coercive control, structure, and autonomy control food parenting practices. Linear regressions using generalized estimating equations were used to examine associations between co-parenting quality and food parenting practices in mothers and fathers. Household income, parent race/ethnicity, and intervention status were included in all models.

Results: Among mothers, higher co-parenting quality was associated with lower use of food for emotional regulation (β = -0.20, p = 0.01), restriction of food (β = -0.18, p = 0.02), and allowing children to control food intake (β = -0.14, p = 0.01), and with higher encouragement of a balanced and varied diet (β = 0.13, p = 0.01), provision of a healthy home environment (β = 0.25, p < 0.0001), and modelling of healthy eating behaviours (β = 0.12, p = 0.05). Among fathers, higher co-parenting quality was associated with lower pressure to eat (β = -0.19, p = 0.01) and with higher encouragement of a balanced and varied diet (β = 0.10, p = 0.05) and provision of a healthy home environment (β = 0.24, p = 0.0007). All results were independent of covariates.

Conclusions: Higher co-parenting quality was associated with more positive food parenting practices among both mothers and fathers; however, more consistent results were found among mothers and for structure-based food parenting practices. These findings suggest that co-parenting quality should be considered in child feeding research.

Purpose: Despite expert recommendations against serving added sugars and non-nutritive sweeteners to young children, many children consume drinks with these ingredients. Confusing labelling and misleading claims may contribute to parents’ misperceptions of the healthfulness of children’s drinks. Our objective was to assess parents’ perceptions regarding sweetened drinks and unsweetened juices they serve their children, including accurate understanding of product ingredients.

Methods: A cross-sectional online survey (n=1,614) to parents of young children (1-5 y) assessed perceptions regarding sweetened fruit-flavored drinks (fruit drinks and flavored water) and unsweetened juices (100% juice and water/juice blends) they provided their child in the past month, including product healthfulness, reasons for providing, and knowledge of product ingredients (added sugar, non-nutritive sweeteners, percent juice). Analysis of variance was used to compare perceived healthfulness of drinks and ingredients. Logistic regression models were used to estimate association between nutrition label reading practices and accuracy in ingredient perceptions, accounting for potential confounders. 

Results: Top reasons for providing included child liking and being healthy for unsweetened drinks, and being inexpensive, child’s request, and being a special treat for sweetened drinks. On average, parents perceived unsweetened juices to be healthier than flavored waters and fruit drinks (p<0.05). Misperceptions regarding added sugar, non-nutritive sweeteners and percent juice contained in drinks were common, and more frequent in fruit drinks and flavored water. Parents who reported reading the nutrition label more often were not more accurate in assessing product ingredients.

Conclusions: Inaccurate understanding of ingredients contained in drinks parents served their young children are widespread. Public health efforts should seek to improve labelling and nutrition education to better inform parents. 

Purpose: Research has demonstrated the importance of specific family meal characteristics such as family member presence, fast-food consumption and media usage in relation to health outcomes. However, analyses typically do not identify heterogeneous subgroups that could inform targeted interventions. This study aimed to identify empirically-derived subgroups using family-dinner (FD) practice data and examine their associations with child and parent diet quality and body weight to better understand the impact of various family-dinner practices on diet quality and health.

Methods: This secondary data analysis used baseline data from the NU-HOME randomized controlled trial with 114 7-to 10-year-old children and their parents in rural Minnesota. Guided by the Social Cognitive Theory, the following parent survey data were analyzed: FD frequency, presence of parents/most family members, serving fast-food and fruits and vegetables (FV), and media usage at dinner. Children’s Healthy Eating Index-2015 scores were calculated using two 24-hour dietary recalls. Trained staff measured percent body fat, weight/height for body mass index (BMI) and BMI z-score calculations. Latent Class Analyses (LCA) and linear regressions (controlled for child/parent age, parent education) were performed.

Results/findings: LCA model fit indices (G²=368.96, AIC=456.96, BIC=577.35, Entropy=0.92) supported a 3-class model. Class 1 (C1) families (21%) filled their children’s plates half full of FV less than half the week and watched TV during their infrequent FDs (≤ 3 times/week). Class 2 (C2) families (43%) had FDs 4-6 times/week with no other distinctive characteristics. Class 3 (C3) families (36%) ate daily FDs together without using media. Children and parents in C1 had significantly lower HEI-2015 scores (47.9±2.1 (C1), 50.7±1.5 (C2), 54.4±1.6 (C3), p=0.04) and FV intake (2.2±0.6 (C1), 3.2±0.5 (C2), 3.2±0.5 (C3), p=0.03), respectively. No class differences in BMI and percent body fat were found, however, child percent body fat was the highest in C1 and lowest in C3 (24.8±1.5 (C1), 22.8±1.1 (C2), 22.0±1.1 (C3), p=0.31).  

Conclusion: Distinctly different patterns of FD practices suggest a need for tailoring family-meal interventions. C1 families may benefit from more intense interventions that focus on establishing structures/routines for family meals. Interventions for C2 or C3 families should primarily focus on improving quality of foods served. 

Purpose: Relationships between single parenting practices regarding physical activity and children’s body weight and physical activity amounts have been reported. However, parenting practices are not used in isolation and some practices may influence the need for others. Hence, the purpose of this study was to determine patterns of parenting practices regarding physical activity and their associations with body weight, legitimacy of parental authority, and physical activity measures in parents and their adolescent children.

Methods: Dyadic data from the cross-sectional, Internet-based Family Life, Activity, Sun, Health and Eating Study, conducted in 2014 were analyzed using latent class analysis. Parents and adolescents (12-17years of age) completed demographic, diet, and physical activity surveys. Self-report model covariates included adolescent age and parent and adolescent sex, body mass index category (based on height and weight), moderate-to-vigorous physical activity (MVPA, minutes/day), and legitimacy of parental authority regarding physical activity (PA-LPA).

Results/findings: Based on 1166 parent-adolescent dyads, 4 latent classes were identified representing different levels of practice use – Complete Influencers (26%, reference class), Positive Influencers (23%), Negative Influencers (25%), and Indifferent Influencers (27%). Compared to dyads with parent underweight/healthy weight, dyads with parent overweight/obesity were twice as likely to belong to Indifferent Influencers. Conversely, compared to dyads with adolescent overweight/obesity, dyads with adolescent underweight/healthy weight were twice as likely to belong to Positive and Indifferent Influencers. Compared to dyads with high PA-LPA agreement, dyads with low agreement were 3 to 19 times as likely (parent agreement) and 5 to 28 times as likely (adolescent agreement) to belong to Positive, Negative, and Indifferent Influencers. Decreasing amounts of both parent and adolescent physical activity increased the likelihood of belonging to Negative and Indifferent Influencers.

Conclusions: The findings suggest that parents utilize distinct patterns of physical activity related practices ranging from use of all practices to use of some practices to low use of any practice and these patterns are differentially associated with body weight, PA-LPA, and physical activity. In particular, low use of all practices or use of pressuring in the absence of modeling are associated with less optimal outcomes.

Purpose: Parents play a critical role in shaping their adolescents’ dietary behaviours. Little work has explored how adolescents’ transition into secondary school may influence food parenting practices (FPPs) and their subsequent impact on healthy eating. This study explored how household factors facilitated a shift in FPPs as adolescents’ transition into secondary school and how this impacted adolescents’ dietary habits. Gender-based norms in family food-related responsibilities were also investigated.

Methods: Semi-structured interviews were conducted by trained research staff among 28 families from Canada (67% mothers, 63% 2-parent households). An adolescent (11-13 years) and parent from each family were interviewed separately. Participants were probed for changes in adolescents’ dietary environment. All codes were inductively derived, triangulated between 3 researchers and collapsed into higher order themes using a gender lens.

Results: The analysis suggested that adolescents’ transition into secondary school is a time of rapid change for families and subsequently, FPPs. Three themes emerged: 1. Busier schedules and healthy eating - More hectic family schedules challenged family meal routines and parents’ ability to provide healthy foods. Greater maternal commitments outside of the home were specifically highlighted to increase the instances of families eating out or eating meals on the go; 2. Meal planning for athletic adolescents – Adolescents who participated in structured physical activity programs were encouraged by their parents to consume both energy and nutrient dense foods to optimize athletic performance. In some cases, parents resorted to eating out more often to ensure their athletes were fed before practices; 3. Increased competency, reduced rules and control – Parents reassessed and changed their FPPs as they perceived their adolescents to be becoming more competent in the domain of eating decisions. Mothers predominantly pioneered these family adaptations during adolescents’ transition to secondary school.   

Conclusion: Greater support for families during adolescents’ entry into secondary school may help increase diet quality in busy households. Targeting the FPPs of mothers may have merit as mothers largely bear the food-related responsibilities within the home during the transition. Future work is needed to understand how families can be supported to counteract the trade-off between busier schedules and healthy eating.