A laboratory-based assessment of mother-child snack food selections and child snack food consumption: Associations with observed and maternal self-report of child feeding practices

Highlights

• Observed child control positively related to higher-energy-density snack choices.

• Reported teaching about nutrition positively related to higher-ED snack choices.

• Reported encourage balance and variety negatively related to higher-ED snack choices.

• Reported encourage balance and variety positively related to lower-ED snack choices.

• The assessed child feeding practices did not relate to child snack consumption.

Abstract

This study explored how mothers' observed and self-reported child feeding practices (child control over food choices, encouragement of balance and variety, and teaching about nutrition) were associated with mother-child snack food selections and child snack food consumption in a laboratory setting. Mothers (N = 107) and their 4.5-year-old children (52% female) selected up to 5 snack foods (out of 9 snack foods: 6 higher-energy-density [ED] and 3 lower-ED) for optional child consumption throughout a one-hour laboratory visit. Mothers’ in-the-moment child feeding practices during the snack food selection task were coded using observational coding schemes, and mothers’ global child feeding practices (i.e., across meals and snacking occasions) were self-reported using the Comprehensive Feeding Practices Questionnaire (Musher-Eizenman & Holub, 2007). Results of multiple linear regression analyses with covariates showed that higher-ED snack food selections were positively associated with observed child control over food choices (B = 0.35, SE = 0.12, p = .006) and self-reported teaching about nutrition (B = 0.49, SE = 0.19, p = .010), and negatively associated with self-reported encouragement of balance and variety (B = −0.66, SE = 0.24, p = .007). Lower-ED snack food selections were positively associated with self-reported encouragement of balance and variety (B = 0.53, SE = 0.20, p = .008). Child consumption of higher-ED or lower-ED snack foods were not significantly associated with mothers’ child feeding practices (observed or self-reported). We discuss the implications of these findings for future research on children’s snack food selection and consumption.

Introduction

Accumulating evidence suggests that snacking behaviors are associated with total dietary energy intake (Deming et al., 2017, Shriver et al., 2018), overall dietary quality (Kachurak, Bailey, Davey, Dabritz, & Fisher, 2019), and obesity risk (Kachurak, Davey, Bailey, & Fisher, 2018) among preschool-aged children (aged 2–5 years) in the United States. Therefore, it is important to identify factors that are associated with preschoolers’ snacking behaviors, including their selection and consumption of snack foods. Snacking is broadly defined as consuming foods or beverages between meals, and items consumed between these occasions are labeled, “snack foods” (Blaine et al., 2017, Hess et al., 2016). Although snack foods are sometimes defined by their nutritional value (e.g., low-nutrient, high-energy-density foods/beverages; Hess et al., 2016), our definition includes all foods/beverages in order to identify factors associated with variations in the energy density of preschoolers’ snack food selections and consumption.

Over the past four decades, the average number of snacking occasions among preschoolers’ in the United States has increased from one to three snacking occasions per day (Dunford & Popkin, 2018). Preschoolers currently consume over 25% of their average daily calories during snacking occasions (Shriver et al., 2018), primarily from high-energy-density foods, such as cookies, potato chips and sugar-sweetened beverages (Deming et al., 2017, Shriver et al., 2018, Welker et al., 2018). Developmental research suggests that preschoolers naturally prefer foods that are high in fat and sugar, which tend to be higher in energy density, and dislike foods with strong bitter flavors, which tend to be lower in energy density, such as green vegetables (Anzman-Frasca et al., 2018, Birch, 1999). Problematically, consuming high-energy-density snack foods has been linked to lower overall dietary quality among preschoolers (Kachurak et al., 2019). Higher overall dietary energy density (i.e. across meals and snacking occasions) has in turn been associated with greater obesity risk among children aged 2–8 years (Vernarelli, Mitchell, Hartman, & Rolls, 2011), which highlights the importance of research to identify factors associated with the energy density of preschoolers’ snack food selections and consumption (Rolls & Leahy, 2010). Such research stands to inform strategies to improve preschoolers’ dietary quality and reduce their obesity risk, and is critical in light of evidence demonstrating poor dietary quality (Hamner & Moore, 2020) and recent increases in the prevalence of severe obesity (Skinner, Ravanbakht, Skelton, Perrin, & Armstrong, 2018) among preschoolers in the United States.

Mothers and other primary caregivers influence the development of preschoolers’ eating behavior through their child feeding practices (Savage et al., 2007, Scaglioni et al., 2018, Vaughn et al., 2016). In the context of snacking, child feeding practices (also known as food parenting practices) include parenting behaviors such as determining the level of child control over snack food choices, encouraging balance and variety in children’s snack food choices, and teaching children about nutritional proprieties of different snack foods (Davison et al., 2015, Gevers et al., 2014). Numerous studies have investigated mothers’ child feeding practices during meals, while relatively fewer have examined mothers’ child feeding practices during snacking occasions (see Blaine et al., 2017 for a review). This is an important gap in the literature because associations between child feeding practices and children’s eating behavior may differ in the context of snacking occasions compared to meals. Indeed, results of two qualitative studies suggest that mothers perceive snacking occasions as distinct from meals, and that parents vary both what and how they feed their children depending on the context (Fisher et al., 2015, Loth et al., 2018). For example, parents reported giving preschoolers more control over what and when they ate during snacking occasions compared to during meals (Loth, Nogueira de Brito, et al., 2018). These findings highlight the need for additional research on associations between mothers’ child feeding practices and preschoolers’ snacking behavior.

Although there are numerous child feeding practices that warrant further investigation (see Davison et al., 2015, Vaughn et al., 2016) child control over food choices, encouragement of balance and variety, and teaching about nutrition are especially relevant to studies of preschoolers’ snacking behavior; these child feeding practices can be observed during snack food selections and have corresponding self-report measures of global child feeding practices. Assessing child feeding practices using both observational and self-report measures can allow for more nuanced insights into associations between mothers’ child feeding practices and preschoolers’ snacking behavior (Fries et al., 2019, Pesch and Lumeng, 2017). For example, observational measures during snacking occasions can capture “in-the-moment” child feeding practices, while global self-report measures can capture parents’ perceptions of their child feeding practices across meals and snacking occasions. Importantly, associations between mothers’ child feeding practices and children’s eating behavior may differ by measurement approach due to the strengths and limitations that are unique to observational and self-report measures (Pesch & Lumeng, 2017). A number of studies conducted during meals have shown inconsistencies between observational and self-report measures of child feeding practices (e.g., Bergmeier et al., 2015, Farrow et al., 2011, Fries et al., 2019). The extent to which observational and self-report measures of mothers’ child feeding practices differentially predict preschoolers’ snacking behavior is currently unknown, which limits the development of nutrition education programming that aims to improve preschoolers’ dietary quality and reduce obesity risk through modifying mothers’ child feeding practices during snacking occasions.

A few studies have examined why parents offer snacks to children (e.g., Blaine et al., 2015, Damen et al., 2019, Damen et al., 2020), while much remains to be explored regarding how parents affect preschoolers’ snacking behavior through their child feeding practices. A few studies have linked variations in parents’ self-reported child feeding practices to the energy density of children’s snack food preferences and consumption. Regarding high-energy-density (ED) snack foods, children’s liking (Boots, Tiggemann, & Corsini, 2019) and consumption (Boots et al., 2018, Corsini et al., 2018, Fisher and Birch, 1999) of high-ED snack foods have been linked to higher self-reported global coercive parental control over preschoolers’ eating behavior (e.g., restriction). However, similar associations with self-reported global restriction have not been found in some other studies (e.g., Bauer et al., 2017, Harris et al., 2014). On the other end of the spectrum, parental self-reports of granting children higher control over their own eating behavior have been positively associated with preschoolers’ selection (Wellard et al., 2014) and consumption (Chaidez, McNiven, Vosti, & Kaiser, 2014) of high-ED foods, although these associations were not specific to snacking occasions. Lastly, parents of 4- to 12-year-olds who reported lower child consumption of high-ED snack foods also highly endorsed globally encouraging healthy food and teaching children about food (Gevers, Kremers, de Vries, & van Assema, 2015).

Few studies have examined how parents’ child feeding practices are associated with children’s selection and consumption of low-ED foods, both generally and specific to snacking (see Yee, Lwin, & Ho, 2017 for a review). There are two notable exceptions: In one study, parents of 3- to 7-year-olds reported lower child liking of fruits when they also reported higher global child control over food choices (Vollmer & Baietto, 2017). Another study found that parents of 2- to 5-year-olds reported higher child fruit and vegetable consumption when they reported higher global encouragement of balance and variety and teaching about nutrition (Shim, Kim, Lee, Kids, & Team, 2016). Additional research is needed to clarify associations between mothers’ child feeding practices and preschoolers’ selection and consumption of snack foods that vary in energy density.

In the current study, we pursued two related aims on associations between mothers’ child feeding practices and preschoolers’ snacking behavior. This study adds uniquely to the literature through our use of both observational and self-report measures of mothers’ child feeding practices (specifically, child control over food choices, encouragement of balance and variety, and teaching about nutrition). First, we explored the correspondence between mothers' observed feeding practices in the context of a mother-child snack food selection task, and mothers’ self-report of global child feeding practices (i.e., across meals and snacking occasions). Next, we explored how mothers’ child feeding practices (observed and self-reported) were associated with mother-child selections, and child consumption, of higher-energy-density and lower-energy-density snack foods in a laboratory setting. Given the mixed and/or limited findings on these associations in the literature, all analyses were exploratory.