URJHS Volume 7

URC

Parents’ Influence on Children’s Weight-Related Behaviors

Catherine McBride, Stephanie Collins, Connie Bell,
Casey Quinn, Sheri Lokken Worthy*

Mississippi State University


Abstract

The overall purpose of this study was to investigate whether parents serve as role models in influencing their children’s weight-related behaviors. Participants were 216 parents of children from four selected child care centers in a Southeastern university town. Correlation analyses indicated that the number of servings of fruits, vegetables, and junk foods parents ate per day was positively associated with the number of servings of fruits, vegetables, and junk foods their children ate per day. Children whose households were of low economic status, parents had low educational attainment, and were African American engaged in less healthy weight-related behaviors, such as more junk food and fast food consumption and more television viewing per day. This study supported the theory that children model adult eating behaviors.

Introduction

Nutrition at an early age can affect a person for the rest of his/her life. “Dietary habits formed in childhood are likely to persist into adulthood, so an unhealthy diet in childhood has implications for health throughout the life course” (Clark, Goyder, Bissell, Blank, & Peters, 2007, p. 132). This is an important issue because obesity currently is at its highest in the U.S. (Centers for Disease Control, 2006b). Overweight children are prone to more illness and diseases that may affect their quality of life. Parents are significant role models for the family; children watch and copy everything. Therefore, it is no surprise that parents influence their children’s eating behaviors. According to Keith Ayoob, a registered dietitian at the Albert Einstein College of Medicine in New York, “Parents are hands down, the biggest influence on their kids. They need to be good role models” (Hellmich, 2006, p. 1d). By eating healthfully and exercising themselves, parents will help their children adopt similar behaviors. Parents need to think about their children when making health and nutrition decisions.

Review of Related Literature

An extensive body of literature exists on the role of parents in their children’s food preferences. Benton (2004) summarized the literature and concluded that focusing on “styles of feeding the child, rather than on nutrition” might be more effective (p. 859). Benton also noted that the relationship between parental behavior and the child’s weight is not necessarily a causal relationship. Parents’ behaviors may be a reaction to the child’s weight.

A longitudinal study that followed 50 obese children over a seven-year period determined that parents play a large role in the weight management of their children (Golan & Crow, 2004; Golan, Weizman, Apter, & Fainaru, 1998). The study had one group in which the child received a prescribed diet program (child-only) and one group in which the parents participated in educational sessions (parent-only). Children of the parents in the parent-only group had greater weight loss than the child-only group.

After extensively reviewing the literature in the area, Clark et al. (2007) identified several factors that influence children and their food preferences/diets: parents, friends, school, and the media. Based on their findings, the authors determined the most influential factor on children’s early eating habits was parental influence. Several of the studies reviewed by Clark et al. observed parental restriction of junk foods often led to uninhibited eating of those foods in the absence of the parent and weight gain, especially for girls. Clark et al. concluded that parental restriction of these foods was counterproductive and interfered with children’s abilities to self-regulate their weight.

According to recent research, a child’s food preferences are influenced by the following factors: parent modeling of food intake and food-related behaviors, home food availability, television exposure, and the parents’ attitudes, beliefs, and practices regarding child feeding (Campbell, Crawford, & Ball, 2006). Campbell and her co-authors suggested some strategies parents can use to improve children’s eating habits, for example eating meals together as a family, reducing children’ television time, and use of non-coercive feeding strategies.

A study by Brown and Ogden (2004) investigated modeling and control theories of parental influence on their children’s eating habits. The results revealed relationships between parent and child snack intakes, eating motivations, and body dissatisfaction. The children of parents with high scores on the control measure were found to have higher consumption of both healthy and unhealthy snack foods.

Kleseges, Stein, Eck, Isbell, and Kleseges (1991) found evidence that showed parents played an important role in their child’s food preferences. Kleseges et al. found children selected different foods when they were being watched by their parents compared to when they were not. Oliveria et al. (1992) analyzed both the mothers’ and their preschool age children’s food intake of nutrients, and they suggested targeting parents to try to improve their children’s diets.

Hood et al. (2000) looked at 92 three to five year old children and their parents enrolled in the 1987 Framingham Children’s Study. The results of this study indicated how parents’ dietary habits and physical activity patterns affect their children. At the beginning of the study, parents were asked to complete a questionnaire including measures of three factors: dietary restraint, dietary disinhibition, and perceived hunger. At the end of six years, the researchers determined that the children’s body fat was positively related to parent dietary restraint if the parent also had high levels of dietary disinhibition. The researchers concluded that parents with disinhibited eating patterns along with dietary restraint may have children with a higher risk for obesity. According to Hood et al., parental modeling and discouragement of bad eating habits can help change this outcome. Programs today vary but most still use a great deal of parental involvement. For children to change their lifestyles, it is necessary to have parental support and encouragement (Golan & Crow, 2004).

Why do children prefer certain foods, particularly those that are not good for them? There have been many studies that have attempted to answer this question. One study by Craeynest, Crombez, Haerens, and Bourdeaudhuij (2006) analyzed whether overweight children preferred their hobbies to food and whether they preferred healthy to unhealthy foods. No effect was found for preferences of food and hobbies. Both the overweight children and a lean control group of children preferred unhealthy foods to healthy foods.

A recent Consumer Reports poll surveyed 609 parents with children between the ages of 5 and 17 (“Parents can’t always,” 2007). Only 4% of parents in this survey indicated their children were “obese or 20% or more above their ideal weight” when approximately 20% of the participants’ children fell into this category according to calculated body mass index (BMI). Parents in this study also under reported whether or not their children were overweight. According to Keith Ayoob, “Many parents are in denial about their children’s weight because they don’t want to change their own eating and exercise habits” (Hellmich, 2007, p. 7d).

Summary

One common theme in all the research is how important a parent’s influence is on a child’s eating habits. According to the literature, healthy weight-related behaviors of children include eating lots of fruits and vegetables (Craeynest et al., 2006), limiting junk foods (Brown & Ogden, 2004) and TV time (Campbell, Crawford, & Ball, 2006), and eating together as a family more frequently (Benton, 2004). The gap in the literature is whether the weight status of the parent influences the child’s current weight-related behaviors.

Research Questions

Obesity is a major issue in the U.S. today (Centers for Disease Control, 2006b). Studies show it is a major contributor to morbidity and mortality (Centers for Disease Control, 2006a). After reviewing the research, we predict that there are several factors that can contribute to or worsen a situation of childhood overweight. We predict that parents who consume fruits and vegetables will have children who are more likely to eat fruits and vegetables. We also predict that parents who consume junk foods (i.e., chips, cookies, candy) will more likely have children who will do the same. Also, we predict parents who are overweight and/or obese will be more likely to have children who do not engage in healthy weight-related behaviors. Finally, we will investigate the demographic characteristics of overweight and obese parents. The research questions for this study were:

1. Is there a relationship between the number of servings of fruits, vegetables, and junk foods consumed per day by parents and the number of servings of fruits, vegetables, and junk foods consumed per day by their children?

2. What demographic characteristics of the parent (education, income, BMI, single parent status, racial/ethnic group) are related to child weight-related behaviors (fruit, vegetable, junk food and fast food consumption, television viewing, meals together as a family)?

Methodology

Participants

The participants in this study were the parents of children at four separate child care centers in a Southeastern university community. Two of the facilities are associated with the university, one with a local church, and the fourth is a Head Start center. These four centers serve a variety of families representing a wide-range of socio-economic backgrounds, ethnicities, and educational levels. See Table 1 for a description of the sample. The children served by these child care facilities range in age from six months old to five years of age. If parents had more than one child in the center, they were asked to answer the child-related questions in reference to their oldest child at the center.

Instrument

The questionnaire was distributed during the fall semester of 2007 and was part of a class research project. The questionnaire consisted of 74 questions and took most parents approximately 10 minutes to complete. Selected questions were developed based on the literature. Parents were asked three separate questions about their eating habits, “In a typical day, how many servings of fruit/vegetables/junk foods do you consume?” The parent participants were asked the same three questions regarding their child’s eating habits, “In a typical day, how many servings of fruit/vegetables/junk foods does your child consume?” The parents were also asked how many hours of television they watched in an average day and how many hours of television their child watched per day. Other questions were “During a typical week, how many fast-food meals does your child eat?” and “How many evenings per week does your family sit down together and eat dinner?”

In order to calculate body mass index (BMI) for the parent, questions were asked about height and weight. This information was put into the formula “weight in pounds divided by height in inches squared multiplied by 703.” Adults with BMIs of 18.5 – 24.9 are considered normal weight. Individuals with BMIs of 25 – 29 are considered overweight, and individuals with BMIs of 30 or higher are considered obese (Centers for Disease Control, 2006b). Parents were also asked several demographic questions (see Table 1 for detail).

Table 1. Description of Sample (N = 216)

   

n

%

Family Type

Single Parent Family

Two Parent Family

Missing

51

164

1

23.6

75.9

.5

Annual Income

Less than $10,000

$10,000 - $19,999

$20,000 - $29,999

$30,000 - $39,999

$40,000 - $49,999

$50,000 - $74,999

$75,000 - $99,999

$100,000 or higher

Missing

46

21

19

12

11

34

28

42

3

21.3

9.7

8.8

5.6

5.1

15.7

13.0

19.4

1.4

Highest Level of Education

Did not complete high school

High school diploma or GED

Some College

Associates Degree

Bachelors Degree

Masters Degree

Ph.D./M.D.

Missing

6

43

9

39

64

19

35

1

2.8

19.9

4.2

18.0

29.6

8.8

16.2

.5

Ethnicity

White/Caucasian

African American/Black

Asian American

Hispanic/Latino

Native American

Other

Missing

106

87

11

5

2

4

1

49.1

40.3

5.1

2.3

.9

1.8

.5

Marital Status

Single, never married

Divorced

Married

Other

Missing

48

15

149

3

1

22.2

6.9

69.0

1.4

.5

Gender

Male

Female

58

158

26.9

73.1

Procedure

Approval for this study was received from the university’s Institutional Review Board for the Protection of Human Subjects on October 25, 2007 (IRB Docket # 07-289). A total of 980 questionnaires were delivered to the four child care centers between October 29 and 31, 2007. Two packets were placed in each child’s box at the centers, one packet for each parent. Each packet included an informed consent letter for the parent to keep and the questionnaire. The IRB approved waiver of signature on the informed consent since there was no identifying information on the questionnaires. The informed consent letter indicated participation was voluntary and the parent could choose not to participate without penalty. The letter gave the parents instructions to complete the survey, place it back in the manila envelope, seal it, and return it to the center director no later than October 31, 2007 or November 2, 2007, depending on the center. To remind the parents about the survey deadline, signs were put up at each center in certain areas.

Data Analysis

Pearson’s correlations were computed to answer the first research question, whether or not there was a relationship between parent eating habits and their child’s eating habits. The second research question concerned demographic characteristics of the parent (such as education, income, BMI, single parent status, and race/ethnicity) related to child weight-related behaviors (such as fruit, vegetable, junk food and fast food consumption, television viewing, meals together as a family). To investigate this question, Pearson’s correlations and a series of analysis of variance (ANOVA) were computed. Pearson’s correlations analyzed family income; parent education; parent BMI; child fruit, vegetable, and junk food intake; television viewing; fast food consumption; and meals together as a family. For the ANOVA procedure, race/ethnicity and family type were the independent/factor variables and child fruit, vegetable, and junk food intake; television viewing; fast food consumption; and meals together as a family were the dependent variables. ANOVA assumes equal means of dependent variables.

Results and Discussion

The purpose of this study was to determine whether parents influence their child’s nutrition and weight-related behaviors. The research groups used were children under the age of 6 and their parents from selected child care centers.

Similar Eating Behaviors

Parents who consume fruits and vegetables have children that are more likely to eat fruits and vegetables, and parents who consume junk food will more likely have children who do the same. Pearson’s correlations were used for analyses related to research question one. Table 2 details the results. The number of servings of fruit the parent ate per day was significantly correlated with the number of servings of fruit their oldest child in the center ate per day (r = .343, p = .000). The number of servings of vegetables the parent ate per day was also significantly correlated with the number of servings of vegetables their child ate per day (r = .399, p = .000). The servings of junk foods eaten by the parent in a day was significantly correlated with the servings of junk foods the child ate in a day (r = .452, p = .000).

Table 2. Pearson’s Correlations of Parent Demographics and Child’s Weight-Related Behaviors (N = 216)

 

Family Annual Income

r

Parent Education Level

r


Parent BMI

r

Servings of fruit your child consumes per day

-.033

-.063

-.011

Servings of vegetables your child consumes per day

-.125

-.148*

.146*

Servings of junk foods your child consumes per day

-.235***

-.225**

.103

Number of hours child watches TV per day

-.427***

-.384***

.151*

Number of fast food meals your child eats per week

-.212**

-.169*

.067

Number of dinners your family eats together per week

.000

-.030

-.001

*p ≤ .05, **p ≤ .01, ***p ≤ .001

Relationship of Parent Demographics to Child Weight-Related Behaviors

ANOVA was used to determine whether there were any differences in child weight-related behaviors between African American and White parents. Results are shown in Table 3. Children of African American parents had higher mean scores on servings of junk foods per day (F = 11.754, p = .001), number of hours of television viewed per day (F = 15.846, p =.000), and number of fast food meals eaten per week (F = 12.051, p = .001).

Table 3. ANOVAs of Parent Demographics and Child’s Weight-Related Behaviors

Weight-Related Behavior

Parent Demographic

N

m

SD

F

Servings of fruit your child consumes per day

White

African American a

95

75

2.54

2.51

.67

.65

.089

Servings of vegetables your child consumes per day

White

African American

95

77

2.38

2.55

.72

.66

2.461

Servings of junk foods your child consumes per day

White

African American

95

76

1.93

2.22

.57

.56

11.754***

Number of hours child watches TV per day

White

African American

92

72

1.67

3.56

3.13

2.83

15.846***

Number of fast food meals your child eats per week

White

African American

93

71

1.32

2.01

1.18

1.37

12.051***

Number of dinners your family eats together per week

White

African American

105

84

4.87

5.10

1.67

1.92

.766

Servings of fruit your child consumes per day

Single Parent

Two Parent Family

43

142

2.53

2.51

.59

.66

.034

Servings of vegetables your child consumes per day

Single Parent

Two Parent Family

44

143

2.57

2.44

.70

.69

1.152

Servings of junk foods your child consumes per day

Single Parent

Two Parent Family

43

143

2.12

1.99

.45

.63

1.413

Number of hours child watches TV per day

Single Parent

Two Parent Family

41

138

4.54

1.75

5.22

1.49

31.284***

Number of fast food meals your child eats per week

Single Parent

Two Parent Family

41

138

1.85

1.56

.937

1.40

1.616

Number of dinners your family eats together per week

Single Parent

Two Parent Family

49

162

5.14

5.07

1.72

1.83

.065

p ≤ .05, **p ≤ .01, ***p ≤ .001
a White and African American parents only were used for the ANOVA of race/ethnicity.

ANOVA was used to determine whether there were any differences in child weight-related behaviors between single and two-parent families. Children of single parents had higher mean scores on number of hours of television viewed per day (F = 31.284, p = .000).

Pearson’s correlations were computed for family income; parent education; parent BMI; child fruit, vegetable, and junk food intake; television viewing; fast food consumption; and meals together as a family. Family annual income was inversely related to servings of junk food the child consumed in a day (r = -.235, p = .001), number of hours of television watched per day (r = -.427, p = .000), and number of fast food meals eaten per week (r = -.212, p = .005). Parent’s education was inversely related to servings of vegetables the child consumed per day (r = -.148, p = .043), servings of junk food the child consumed in a day (r = -.225, p = .002), number of hours of television watched per day (r = -.384, p = .000), and number of fast food meals eaten per week (r = -.169, p = .024). Parent’s BMI was positively correlated to servings of vegetables the child consumed per day (r = .146, p = .050) and number of hours of television watched per day (r = .151, p = .046).

Limitations

There are some limitations that must be taken into consideration when studying this topic. The sample only included parents from child care facilities in one Southeastern city. The participants were also all parents of children between the ages of 6 weeks and 5 years old. Due to the young age of the children in the sample, we were unable to accurately calculate child BMI. A final limitation is that the parents were completing the questionnaires and answering questions regarding their children’s nutrition habits. Observation may have been a more accurate data collection technique for the child data.

Conclusions

This research is relevant to today’s society because of the massive increase in obesity over the past years. The main finding of this study is that parents and children have similar eating habits. We found positive correlations between child and parent’s consumption of fruits, vegetables, and junk foods. As stated earlier, children watch and will imitate their parents’ actions. Parents need to set a good example for their children to promote good eating habits and prevent obesity. It is especially important for children to develop these good eating habits at a young age before they are influenced by outside sources. This finding supports previous research (Benton, 2004; Brown & Ogden 2004; Campbell, Crawford, & Ball, 2006; Clark et al., 2007; Golan & Crow, 2004; Golan et al., 1998; Hood et al., 2000; Kleseges et al., 1991; Oliveria et al., 1992).

The second major finding of this research was the relationship of parent demographic characteristics to healthy child weight-related behaviors. Children of African American parents had higher mean scores on servings of junk foods eaten per day and number of fast food meals eaten per week. Children of African American and children of single parents had higher mean scores on number of hours of television viewed per day.

Family annual income and parent’s education were inversely related to servings of junk food the child consumed in a day, number of hours of television watched per day, and number of fast food meals eaten per week. Parent’s education was also inversely related to servings of vegetables the child consumed per day. Parent’s BMI was positively correlated to servings of vegetables the child consumed per day and number of hours of television watched per day. These findings indicate that lower income, lower educated, and African American parents may be the most appropriate audience to target with nutritional education programming.

As discussed by Benton (2004), there are many techniques parents can use to encourage healthy eating behaviors in their children. Parents should serve children a variety of foods and repeatedly offer children healthy foods they may dislike. Even if a parent does not like certain healthy food they should encourage their child to eat it. Parents should not restrict access to desired unhealthy foods and should not force children to eat. Providing an emotionally healthy atmosphere at meal times and modeling eating healthy foods has an impact on children. Benton also advises parents to keep plenty of healthy low-calorie foods on hand and to avoid using calorie-dense foods as rewards or treats.

There are several children’s cookbooks available that make food preparation fun for children. These offer creative ways for parents to improve their child’s dietary intake. Cookbooks for parents that include recipes for healthy “kid-friendly” meals are also good resources. Often child care centers offer tips to parents to help with food issues (i.e., a recipe of the week handout) and also Parent Teacher Association (PTA) meetings will frequently feature nutrition information.

Parents should want their children to lead healthy lifestyles by eating properly and exercising, even if they do not choose to do the same for themselves. Decisions made when children are young and in their parents’ care are habits they will carry with them for the rest of their lives.


References

Benton D. (2004). Role of parents in the determination of the food preferences of children and the development of obesity. International Journal of Obesity, 28, 858-869.

Birch, L.L. (1980). Effects of peer models’ food choices and eating behaviors on preschoolers’ food preferences. Child Development, 51, 489-496.

Brown, R., & Ogden, J. (2004). Children’s eating attitudes and behaviour: A study of the modeling and control theories of parental influence. Health Education Research, 19 (3), 261-271.

Campbell, K.J., Crawford, D.A., & Ball, K. (2006). Family food environment and dietary behaviors likely to promote fatness in 5-6 year old children. International Journal of Obesity, 30 , 1272-1280.

Centers for Disease Control and Prevention. (2006a). Overweight and obesity: Contributing factors. Retrieved May 15, 2007 from http:// www.cdc.gov/nccdphp/dnpa/obesity/contributing_factors.htm

Centers for Disease Control and Prevention. (2006b). Overweight and obesity: Introduction. Retrieved May 16, 2007 from http://www.cdc.gov/nccdphp/dnpa/obesity/index.htm

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Craeynest, M., Crombez, G., Haerens, L., & De Bourdeaudhuij, I. (2007). Do overweight youngsters like food more than lean peers? Assessing their implicit attitudes with a personalized Implicit Association Task. Food Quality and Preference, 18 (8), 1077-1084.

Golan, M., Weizman, A., Apter, A., & Fainaru, M. (1998). Parenting as the exclusive agents of change in the treatment of childhood obesity. American Society for Clinical Nutrition, 67, 1130-1135.

Golan, M., & Crow, S. (2004). Targeting parents exclusively in the treatment of childhood obesity: Long-term results. Obesity Research, 12 (2), 357-361.

Hellmich, N. (September 13, 2006). Danger signs of obesity: Nutrition experts urge parents to lead the way to healthful eating. USA Today. Life section, 1d. Retrieved October 24, 2007 from Academic Search Premier database.

Hellmich, N. (September 4, 2007). Why are parents in denial about kids’ weight? They may not want to change own habits. USA Today. Life section, 7d. Retrieved October 24, 2007 from Academic Search Premier database.

Hood, M.Y., Moore, L.L., Sundarajan-Ramamurti, A., Singer, M., Cupples, L.A., & Ellison, R.C. (2000). Parental eating attitudes and the development of obesity in children. The Framingham Children’s Study. International Journal of Obesity, 24, 1319-1325.

Kleseges, R. C., Stein, R. J., Eck, L. H., Isbell, T. R., & Kleseges, L. M. (1991). Parental influence on food selection in young children and its relationships to childhood obesity. American Journal of Clinical Nutrition, 53 , 859-864.

Oliveria, S. A., Ellison, R. C., Moore, L. L., Gillman, M. W., Garrahie, E. J., & Singer, M. R. (1992). Parent-child relationships in nutrient intake: The Framingham Children’s Study. American Journal of Clinical Nutrition, 56, 593-598.

Parents can’t always tell if their kids are overweight, CR survey finds. (July 2007). Consumer Reports. Retrieved April 8, 2008 online at http://www.consumerreports.org/cro/search.htm?query=parents+can%27t+always+tell


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