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This mixed-methods study endeavored to expand the current understanding of how early pandemic related disruptions impacted the home food environment and parent feeding practices of families with young children. Data for this study are taken from the Kids EAT! Study, a racially/ethnically diverse cohort of families with 2-5 year old children. Individual interviews were conducted by phone and video conference with mothers (n = 25) during August/September of 2020 and were coded using a hybrid deductive/inductive analysis approach. Parents also reported on their family's food insecurity status enabling qualitative findings to be stratified by family-level food security status. Two overarching themes were identified related to how families in this sample describe the COVID-19 pandemic's impact on their home food environment. Themes included 1) Impacts on obtaining food for one's family, and 2) Specific changes in parent feeding practices. Findings indicated variation within each theme by family food security status. Overall, families experiencing food insecurity more frequently discussed using various coping strategies, including stocking up, rationing food, and use of supplemental food resources, to overcome challenges associated with obtaining food brought on by COVID-19. Families with food insecurity also reported having more time for home cooked meals and more frequently discussed enforcing less structure (timing of meal, place) related to meals/snacks consumed at home during the pandemic. The impacts of the COVID-19 persist, ranging from ongoing economic challenges, inconsistent access to childcare for families, and the emergence of new, more contagious, variants. With this, interventions to address food insecurity amongst families with young children should consider how to optimize the home food environment and promote healthful parent feeding practices within the families they serve in the face of an evolving public health crisis.

Food insecurity (FI) may increase risk for binge eating through a "feast-or-famine" cycle, where fluctuations in food availability correspond to alternating periods of food restriction and opportunities for binge eating, but research on this topic is limited. To clarify the relationship between food availability and binge eating in the context of FI, this study examined the association between momentary food security level and subsequent binge-eating symptoms among individuals in food-insecure households and investigated how this association differs by factors that may modify the extent to which food availability fluctuates. Ecological momentary assessment data were collected in 2020-2021 from 75 young adults (M

The COVID-19 pandemic brought about many changes that potentially altered the home food environment, which has been associated with child health outcomes, such as dietary intake and weight status. There is also some evidence that changes due to the COVID-19 pandemic are associated with health behaviors in children, such as an increased intake of high-calorie snack food. The current study aimed to more deeply understand how the COVID-19 pandemic affected the home food environment of meal and snack time routines and patterns within families of young children. Data for this study are taken from the Kids EAT! Study, a racially/ethnically diverse cohort of families with 2-5 year old children. Qualitative interviews were conducted by phone and video conference with mothers (n = 25) during August/September 2020 and were coded using a hybrid deductive/inductive analysis approach. This allowed coders to identify themes using the interview questions as an organizational template (deductive) while also allowing unique themes to emerge from the qualitative data (inductive). Four overarching themes emerged with multiple sub-themes: 1) Mothers were more directive in the types of food and amounts of food eaten by children; 2) Mothers had less rules around mealtimes; 3) Mothers had increased meal responsibilities; 4) Changes to child snacking. When faced with a change in a structured schedule and increased stress-such as occurred with the COVID-19 pandemic, parents may benefit from advice on how to manage parent feeding practices, including tips on appropriate limit setting, establishing a schedule and routines, and improving accessibility of healthful snacks. Lessons learned during the COVID-19 pandemic may have relevance to other time periods when families face disruptions to routine and during other times of transition.

BACKGROUND: Current measures of parent feeding practices are typically survey-based and assessed as static/unchanging characteristics, failing to account for fluctuations in these behaviors across time and context. The current study uses ecological momentary assessment to examine variability of, and predictors of parent feeding practices within a low-income, racially/ethnically diverse, and immigrant sample. METHODS: Children ages 5–7 years old and their parents (n=150 dyads) from six racial/ethnic groups (n=25 from each; Black/African American, Hispanic, Hmong, Native American, Somali, White) were recruited for this mixed-methods study through primary care clinics. RESULTS: Among parents who used restriction (49%) and pressure-to-eat (69%) feeding practices, these feeding practices were utilized about every other day. Contextual factors at the meal associated with parent feeding practices included: number of people at the meal, who prepared the meal, types of food served at meals (e.g., pre-prepared, homemade, fast food), meal setting (e.g., kitchen table, front room), and meal emotional atmosphere (p

This study examines associations between an expanded conceptualization of food-related parenting practices, specifically, directive and non-directive control, and child weight (BMI z-score) and dietary outcomes [Healthy Eating Index (HEI) 2010, daily servings fruits/vegetables] within a sample of parent-child dyads (8–12 years old; n = 160). Baseline data from the Healthy Home Offerings via the Mealtime Environment (HOME Plus) randomized controlled trial was used to test associations between directive and non-directive control and child dietary outcomes and weight using multiple regression analyses adjusted for parental education. Overall variance explained by directive and non-directive control constructs was also calculated. Markers of directive control included pressure-to-eat and food restriction, assessed using subscales from the Child Feeding Questionnaire; markers of non-directive control were assessed with a parental role modeling scale and a home food availability inventory in which an obesogenic home food environment score was assigned based on the types and number of unhealthful foods available within the child's home food environment. Directive control Food restriction and pressure-to-eat were positively and negatively associated with BMI z-scores, respectively, but not with dietary outcomes. Non-directive control An obesogenic home food environment was inversely associated with both dietary outcomes; parental role modeling of healthful eating was positively associated with both dietary outcomes. Neither non-directive behavioral construct was significantly associated with BMI z-scores. Total variance Greater total variance in BMI-z was explained by directive control; greater total variance in dietary outcomes was explained by non-directive control. Including a construct of food-related parenting practices with separate markers for directive and non-directive control should be considered for future research. These concepts address different forms of parental control and, in the present study, yielded unique associations with child dietary and weight outcomes.

Little is known about the association between parental perception of their child's weight as well as parent's current and future concerns regarding their child's weight and a broad range of food-related parenting practices. This study used the first wave of cross-sectional data from the longitudinal Family Matters study to examine the relationships between parental perception of child weight status, parent concern for child's current and future weight and parent use of different types of food-related practices. Parent/child dyads (n = 150) were recruited from primary care clinics. Multiple regression models were fit to examine cross-sectional relationships between parental perception and concern for their child's weight and food-related parenting practices (food restriction, pressure-to-eat, food control, food monitoring, nutrition education, and parent modeling). Parents who perceived their child to be underweight had lower scores for food restriction than parents who perceived their child to be overweight. Parents who reported concern about their child's current weight reported higher scores for food restriction and monitoring than parents who were not currently concerned. Parents who reported concern about their child's future weight status reported higher scores for pressure-to-eat and monitoring than parents who were not at all concerned about their child's future weight status. The relationship between parental perception of child's current weight status and parent use of food restriction, pressure-to-eat, and overall food control was modified by child sex. Overall, results suggest that parent's perceptions of and concerns about their child's current and future weight status were correlated with their feeding approaches. Health care providers may want to consider providing anticipatory guidance for parents that have concerns about their child's weight by teaching them about positive, evidence-based ways they can engage in healthy food-related parenting practices.

While there is some research examining frequency of family meals by food insecurity (FI) status, there is little research examining other family meal characteristics (e.g., type of food served at meal, emotional atmosphere) or parent feeding practices by FI status. If food and money is scarce, it may be that the broader family meal environment looks different in families with continuous access to food (food secure, FS) compared to families with FI. Using ecological momentary assessment (EMA) and qualitative data, this study explores meal characteristics and parent feeding practices at nearly 4000 family meals in a low-income, racially/ethnically diverse and immigrant/refugee sample. For 8 days, participants (i.e., parents of 5-7-year-old children) completed a survey every time they shared a meal with their child. Additionally, parents completed a qualitative interview regarding family meals. There were many meal characteristics statistically correlated with a family being FI, including: who prepared the meal and how the meal was prepared, the makeup of people at the meal, the meal location and meal atmosphere, and the food served at the meal. Qualitative data illuminated many of these findings from EMA meal surveys. Quantitatively, families with FI and FS reported similar parent feeding practices during family meals. Qualitatively, families with FI and FS reported differences in (1) parent feeding practices; (2) food served at family meals; (3) challenges to having family meals; and 4) adults' role in the family meal. This study provides suggestions for interventionists working with families, including helping families identify time management strategies, including fruits and vegetables into family meals on a budget, reducing screen time at family meals while improving the meal's emotional atmosphere, and developing positive parent feeding practice strategies.

Children consume nearly one-third of their daily energy intake as snacks (i.e., eating occasions that occur between meals); thus there is a growing interest in understanding what snacking occasions look like in the homes of young children. This study makes use of ecological momentary assessment (EMA) to 1) examine differences in the contextual factors, including location, food preparation style, people present, presence of media devices, and overall atmosphere, between meal and snack occasions; and 2) explore differences in the context of snacking occasions across children's gender and weight status. Data for the current study came from the Family Matters Study, which included 150 families with children aged 5–7 years old (n = 25 from each of the following groups: Black/African American, Hispanic, Hmong, Native American, Somali, White). Parents completed an 8-day EMA observation period, during which they were surveyed after each eating occasion with the study child; questions explored contextual factors including location, food preparation style, people present, presence of media devices, and the overall atmosphere of each eating occasion. Differences between meals and snacks were observed; a smaller percentage of snacks (compared to meals) were prepared by the parent, consisted of only homemade food, and were planned ahead of time, as opposed to being served in response to a child's request. Snacks were more likely than other meals to be eaten on the couch and in the presence of a screen. Furthermore, important differences in snacking context were observed by child gender and weight status. Findings illuminate opportunities to improve children's overall dietary intake via interventions focused on improving the quality of foods served during snacks, as well as the contextual environment in which snacks are eaten.

Food parenting practices have been identified as a potentially significant correlate of weight status and weight-related behaviors in children. The extent to which food parenting practices fluctuate across time and context is not well known. In particular, situational factors are thought to shape the types of food parenting practices used in the moment, but the nature of those factors remain unclear. In this paper data from interviews with parents (n = 40) of preschoolers was used to: 1) describe parents' day-to-day lived experiences of food parenting within the broad theoretical domains of coercive control, structure and autonomy support; 2) identify salient momentary factors that influence use of these food parenting practices; and 3) understand how these momentary factors impact the use of different types of food parenting practices. The feeding practices described by parents align well with the three overarching themes described within the literature: coercive control, autonomy support, and structure. Parents described using a combination of practices from within each of these domains; they also indicated that their feeding practices were easily influenced by momentary factors that impacted their food parenting within and across eating occasions. For the most part, parents described momentary factors (e.g. schedule changes, parental stress, child behavior) that shifted them away from structure and autonomy support feeding practices, towards indulgent and coercive feeding practices. Researchers should be aware of the likely interplay between different types of feeding practices as well as the potential that momentary factors may shift parents from one type of practice towards another. The use of novel data collection methods, such as ecological momentary assessment, that allow for exploration of food parenting practices as dynamic, rather than static, behaviors should be explored.

The purpose of this study was to examine the prevalence of health-focused (healthy eating, physical activity) and weight-focused (weight, dieting) parent-child conversations, and to understand who is talking and who is listening, by exploring the associations these conversations have with parent and child characteristics. The study population included 546 parents (age 27–36 years) who participated in Project EAT (Eating and Activity in Teens and Young Adults)-IV (2015–2016) and had a child aged 2–17 years. Cross-sectional prevalence ratios were calculated to identify associations between parent and child characteristics and the parent-child conversations. Conversations about healthy eating (82%) and physical activity (75%) were more prevalent than those about the child's weight (30%), and dieting (25%). In adjusted models, parents meeting physical activity recommendations had a higher prevalence of health-focused conversations (healthy eating PR = 1.10, 95% CI = 1.01, 1.20; physical activity PR = 1.12, 95% CI = 1.02, 1.24); whereas, weight-focused conversations were more common among parents who had recently dieted and perceived their child to be overweight. Health-focused and weight-focused conversations were highly common among the oldest children aged 9–17 years (health-focused = 90–93% and weight-focused = 42–53%); though, a substantial prevalence of health- and weight-focused conversations (>50% and ≥10%, respectively) also occurred with the youngest children (2–4 years). Findings suggest that parent-child health- and weight-focused conversations are common and that characteristics, including child's age and parents' physical activity, dieting, and perceptions of child weight, may be useful to consider in public health messaging, interventions, and family education that address parent-child communication.

To understand how parents of adolescents attempt to regulate their children’s eating behaviors, the prevalence of specific food-related parenting practices (restriction, pressure-to-eat) by sociodemographic characteristics (parent gender, race/ethnicity, education level, employment status, and household income) were examined within a population-based sample of parents (n=3709) of adolescents. Linear regression models were fit to estimate the association between parent sociodemographic characteristics and parental report of food restriction and pressure-toeat. Overall, findings suggest that use of controlling food-related parenting practices , such as pressuring children to eat and restricting children’s intake, is common among parents of adolescents, particularly among parents in racial/ethnic minority subgroups, parents with less than a high school education, and parents with a low household income. Results indicate that that social or cultural traditions, as well as parental access to economic resources, may contribute to a parent’s decision to utilize specific food-related parenting practices. Given that previous research has found that restriction and pressure-to-eat food-related parenting practices can negatively impact children’s current and future dietary intake, differences in use of these practices by sociodemographic characteristics may contribute, in part, to the disparities that exist in the prevalence of overweight and obesity among adolescents by their race/ethnicity and socioeconomic status.

Objectives To examine individual associations between aspects of the family eating environment (home food availability, parental modeling, and food restriction) and adolescent dietary intake and explore the combined relationship (i.e., environment profiles) between these aspects of the family eating environment and adolescent dietary intake. Methods Adolescents [14.4 years old (SD = 2.0)] and their parents (N = 2383 parent–adolescent pairs] participated in 2 coordinated, population-based studies. Adolescent surveys were completed at school and parent surveys were conducted via mail or phone. Results Healthy home food availability was positively associated with fruit/vegetable intake and negatively associated with soda and snack food intake in adolescents. Healthy parental modeling was negatively associated with adolescent soda consumption. Food restriction was positively associated with fruit/vegetable consumption and snack food intake. Examination of family eating environment profiles revealed that it was the home food availability component of the profiles that was associated with observed differences in fruits/vegetable consumption, whereas the parental modeling and food restriction components contributed to differences in soda and snack foods consumption. Conclusions Findings indicate that among the three aspects of the family eating environment explored, making healthy food available at home was most consistently associated with healthy dietary intake in adolescents.

Intuitive eating (i.e., reliance on physiologic hunger and satiety cues to guide eating) has been proposed as a healthier, more effective, and more innate alternative to current strategies of weight management. The current study explored intuitive eating among young adults according to socio-demographic characteristics and body mass index (BMI), and examined associations between intuitive and disordered eating behaviors. Data were drawn from Project EAT-III, a population-based study of 2,287 young adults (mean age: 25.3 years). More males reported trusting their bodies to tell them how much to eat than did females. Intuitive eating was inversely associated with BMI in both genders. Males and females who reported trusting their body to tell them how much to eat had lower odds of utilizing disordered eating behaviors compared to those that did not have this trust. Females who reported that they stop eating when they are full had lower odds of chronic dieting and binge eating than those who do not stop eating when full. Overall, this study found that intuitive eating practices are inversely associated with a number of harmful outcomes. Clinicians should discuss the concept of intuitive eating with their young adult patients to promote healthier weight-related outcomes.

Few studies have looked at the relationship between family meals and adult weight and health behaviors. The current study investigates the association between frequency of family meals and mothers’ and fathers’ body mass index (BMI), dietary intake, dieting behaviors and binge eating. Data from Project F-EAT (Families and Eating and Activity in Teens) were used for the current analysis. Socio-economically and racially/ethnically diverse mothers and fathers ( n = 3488) of adolescents participating in a multi-level population-based study (EAT 2010) completed surveys mailed to their homes. Predicted means or probabilities were calculated for each outcome variable at each level of family meal frequency. Interactions between race/ethnicity and marital status with family meals were evaluated in all models. Overall, results indicated that having more frequent family meals was associated with increased consumption of fruits and vegetables for mothers and fathers, after adjusting for age, educational attainment, marital status and race/ethnicity. Other findings including less fast food intake for fathers and fewer dieting and binge eating behaviors for mothers were significantly associated with family meal frequency, but not consistently across all family meal categories or with BMI. Interactions by race/ethnicity and marital status were non-significant, indicating that family meals may be important for more healthful dietary intake across race and marital status. Future research should confirm findings in longitudinal analyses to identify temporality and strength of associations.