The feeding siblings questionnaire (FSQ): Development of a self-report tool for parents with children aged 2-5 years.

Over the last decade, there have been repeated calls to expand the operationalisation of food parenting practices. The conceptualisation and measurement of these practices has been based primarily on research with parent-child dyads. One unexplored dimension of food parenting pertains to the evaluation of practices specific to feeding siblings. This study describes the development and validation of the Feeding Siblings Questionnaire (FSQ) - a tool designed to measure practices in which siblings are positioned as mediators in parents' attempts to prompt or persuade a child to eat. Item development was guided by a conceptual model derived from mixed-methods research and refined through expert reviews and cognitive interviews. These interviews were conducted in two phases, where parents responded to the questionnaire primarily to test i) the readability and relevance of each item, and ii) its overall feasibility. The instrument was completed by 330 parents (96.1% mothers) in Australia with two children aged 2-5 years, and repeated by 133 parents (40.3%) two weeks later. Exploratory factor analysis was performed on baseline data. Internal consistency and test re-test reliability of the subsequent subscales were examined. Construct validity was assessed through comparisons with existing measures of food parenting practices and child eating behaviours. The final FSQ scale included 22 items, reflecting five food parenting practices: sibling competitiveness, active sibling influence, threatening unequal division of food, sibling role modelling, and vicarious operant conditioning. Internal consistency and test re-test reliability estimates were high, and there was some evidence of convergent construct validity. While its factor structure should be confirmed in a different sample, the FSQ offers a novel tool for assessing, monitoring, and evaluating feeding interactions beyond those confined to the parent-child dyad.

Parental perceptions of body weight and appetite in infants and toddlers with cystic fibrosis.

Nutritional status has clinical relevance and is a target of guidance to parents of children with cystic fibrosis (CF). Growth is routinely monitored in CF clinics but there is no standardized way of assessing appetitive behaviors or parents' perceptions of their children's appetite. Greater understanding of these factors could improve clinical guidance regarding parent feeding behaviors. We therefore aimed to assess parent perceptions of child weight, and parent reports of child appetite using the Baby Eating Behavior Questionnaire (BEBQ), in a sample of infants and toddlers with CF, compared with a community sample. We additionally assessed relationships of parent perceptions of child weight with parent feeding behaviors in the sample with CF. Anthropometric and questionnaire data were collected for 32 infants and toddlers with CF, as well as 193 infants and toddlers drawn from RESONANCE, a community cohort study. Parents perceived children with CF to be lower in weight than their actual weight, to a greater extent than was evident in the community sample. Parents who perceived their children with CF to be underweight vs. right weight reported greater slowness in eating on the BEBQ. Parents perceived children with CF to have greater slowness in eating and lower enjoyment of food, compared to parents of children in the community sample, independent of sample differences in child weight, age, and sex. Our results demonstrate the potential utility of the BEBQ in a clinical sample and suggest it may be helpful for clinicians to assess parents' perceptions of their child's weight and appetite to promote a fuller understanding of the child's nutritional status, facilitate appropriate feeding behaviors and alleviate unnecessary concerns.

The role of fathers in child development from preconception to postnatal influences: Opportunities for the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) program.

A growing body of literature highlights the important role of paternal health and socioemotional characteristics in child development, from preconception through adolescence. Much of this research addresses the indirect effects of fathers, for instance, their influence on maternal behaviors during the prenatal period or via the relationship with their partner. However, emerging evidence also recognizes the direct role of paternal health and behavior for child health and adjustment across development. This critical review presents evidence of biological and sociocultural influences of fathers on preconception, prenatal, and postnatal contributions to child development. The National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) program incorporates in its central conceptualization the impact of fathers on family and child outcomes. This critical synthesis of the literature focuses on three specific child outcomes in the ECHO program: health outcomes (e.g., obesity), neurodevelopmental outcomes (e.g., emotional, behavioral, psychopathological development), and positive health. We highlight the unique insights gained from the literature to date and provide next steps for future studies on paternal influences.

FTO variation and early frontostriatal brain development in children.

OBJECTIVE: Common obesity-associated genetic variants at the fat mass and obesity-associated (FTO) locus have been associated with appetitive behaviors and altered structure and function of frontostriatal brain regions. The authors aimed to investigate the influence of FTO variation on frontostriatal appetite circuits in early life. METHODS: Data were drawn from RESONANCE, a longitudinal study of early brain development. Growth trajectories of nucleus accumbens and frontal lobe volumes, as well as total gray matter and white matter volume, by risk allele (AA) carrier status on FTO single-nucleotide polymorphism rs9939609 were examined in 228 children (102 female, 126 male) using magnetic resonance imaging assessments obtained from infancy through middle childhood. The authors fit functional concurrent regression models with brain volume outcomes over age as functional responses, and FTO genotype, sex, BMI z score, and maternal education were included as predictors. RESULTS: Bootstrap pointwise 95% CI for regression coefficient functions in the functional concurrent regression models showed that the AA group versus the group with no risk allele (TT) had greater nucleus accumbens volume (adjusted for total brain volume) in the interval of 750 to 2250 days (2-6 years). CONCLUSIONS: These findings suggest that common genetic risk for obesity is associated with differences in early development of brain reward circuitry and argue for investigating dynamic relationships among genotype, brain, behavior, and weight throughout development.

Biobehavioral susceptibility for obesity in childhood: Behavioral, genetic and neuroimaging studies of appetite.

Modern food environments are conducive to overeating and weight gain, but not everyone develops obesity. One reason for this may be that individuals differ in appetitive characteristics, or traits, that manifest early in life and go on to influence their behavioral susceptibility to gain and maintain excess weight. Classic studies showing that eating behavior in children can be measured by behavioral paradigms such as tests of caloric compensation and eating in the absence of hunger inspired the development and validation of psychometric instruments to assess appetitive characteristics in children and infants. A large body of evidence now suggests that food approach traits increase obesity risk, while food avoidant traits, such as satiety responsiveness, decrease obesity risk. Twin studies and genetic association studies have demonstrated that appetitive characteristics are heritable, consistent with a biological etiology. However, family environment factors are also influential, with mounting evidence suggesting that genetic and environmental risk factors interact and correlate with consequences for child eating behavior and weight. Further, neuroimaging studies are revealing that individual differences in responses to visual food cues, as well as to small tastes and larger amounts of food, across a number of brain regions involved in reward/motivation, cognitive control and other functions, may contribute to individual variation in appetitive behavior. Growing evidence also suggests that variation on psychometric measures of appetite is associated with regional differences in brain structure, and differential patterns of resting state functional connectivity. Large prospective studies beginning in infancy promise to enrich our understanding of neural and other biological underpinnings of appetite and obesity development in early life, and how the interplay between genetic and environmental factors affects appetitive systems. The biobehavioral susceptibility model of obesity development and maintenance outlined in this narrative review has implications for prevention and treatment of obesity in childhood.

Parent-reported child appetite moderates relationships between child genetic obesity risk and parental feeding practices.

Background: Food parenting practices are associated with child weight. Such associations may reflect the effects of parents' practices on children's food intake and weight. However, longitudinal, qualitative, and behavioral genetic evidence suggests these associations could, in some cases, reflect parents' response to children's genetic risk for obesity, an instance of gene-environment correlation. We tested for gene-environment correlations across multiple domains of food parenting practices and explored the role of parent-reported child appetite in these relationships. Materials and methods: Data on relevant variables were available for N = 197 parent-child dyads (7.54 ± 2.67 years; 44.4% girls) participating in RESONANCE, an ongoing pediatric cohort study. Children's body mass index (BMI) polygenic risk score (PRS) were derived based on adult GWAS data. Parents reported on their feeding practices (Comprehensive Feeding Practices Questionnaire) and their child's eating behavior (Child Eating Behavior Questionnaire). Moderation effects of child eating behaviors on associations between child BMI PRS and parental feeding practices were examined, adjusting for relevant covariates. Results: Of the 12 parental feeding practices, 2 were associated with child BMI PRS, namely, restriction for weight control (ß = 0.182, p = 0.011) and teaching about nutrition (ß = -0.217, p = 0.003). Moderation analyses demonstrated that when children had high genetic obesity risk and showed moderate/high (vs. low) food responsiveness, parents were more likely to restrict food intake to control weight. Conclusion: Our results indicate that parents may adjust their feeding practices in response to a child's genetic propensity toward higher or lower bodyweight, and the adoption of food restriction to control weight may depend on parental perceptions of the child's appetite. Research using prospective data on child weight and appetite and food parenting from infancy is needed to further investigate how gene-environment relationships evolve through development.

The Development of Appetite: Tracking and Age-Related Differences in Appetitive Traits in Childhood.

Appetitive traits are associated with body weight. Increased understanding of how appetitive traits evolve from early life could advance research on obesity risk and inform intervention development. We report on tracking and age-related differences in appetitive traits in childhood within the RESONANCE cohort. Parents of RESONANCE children aged 6.02 ± 2.99 years completed the Child Eating Behavior Questionnaire (CEBQ). Pearson correlations of appetitive traits and age were tested for all participants contributing at least one observation, using each participant's first observation (N = 335). Children's first and second observations of the CEBQ (n = 127) were used to test tracking (paired correlations) and age-related differences (paired t-tests) within individuals. CEBQ correlations with age suggested that satiety responsiveness, slowness in eating, emotional undereating, and desire to drink decreased with age (r = -0.111 to r = -0.269, all p < 0.05), while emotional overeating increased with age (r = 0.207, p < 0.001). Food fussiness demonstrated a quadratic relationship with age. Paired t-tests further supported an increase in emotional overeating with age (M: 1.55 vs. 1.69, p = 0.005). All CEBQ subscales demonstrated moderate to high tracking (r = 0.533 to r = 0.760, p < 0.001). Our initial findings within the RESONANCE cohort suggest that food avoidant traits are negatively related with age, while emotional overeating increases with age, and that appetitive traits track through childhood.

Children's eating behaviours and related constructs: conceptual and theoretical foundations and their implications.

BACKGROUND: There is a substantial body of research on children's eating behaviours (e.g., food responsiveness and fussiness) and related constructs (e.g., eating in the absence of hunger, appetite self-regulation). This research provides a foundation for understanding children's dietary intakes and healthy eating behaviours, as well as efforts at intervention, whether in relation to food avoidance, overeating and/or trajectories to excess weight gain. The success of these efforts and their associated outcomes is dependent on the theoretical foundation and conceptual clarity of the behaviours and constructs. This, in turn contributes to the coherence and precision of the definitions and measurement of these behaviours and constructs. Limited clarity in these areas ultimately creates uncertainty around the interpretation of findings from research studies and intervention programs. At present there does not appear to be an overarching theoretical framework of children's eating behaviours and associated constructs, or for separate domains of children's eating behaviours/constructs. The main purpose of the present review was to examine the possible theoretical foundations of some of the main current questionnaire and behavioural measures of children's eating behaviours and related constructs. METHODS: We reviewed the literature on the most prominent measures of children's eating behaviours for use with children aged ~ 0-12 years. We focused on the explanations and justifications for the original design of the measures and whether these included theoretical perspectives, as well as current theoretical interpretations (and difficulties) of the behaviours and constructs. RESULTS: We found that the most commonly used measures had their foundations in relatively applied or practical concerns rather than theoretical perspectives. CONCLUSIONS: We concluded, consistent with Lumeng & Fisher (1), that although existing measures have served the field well, to advance the field as a science, and better contribute to knowledge development, increased attention should be directed to the conceptual and theoretical foundations of children's eating behaviours and related constructs. Suggestions for future directions are outlined.

Bidirectional associations between parental feeding practices, infant appetitive traits and infant BMIz: a longitudinal cohort study.

BACKGROUND: Little is known about the pathways linking parent feeding practices with appetitive traits and BMIz throughout infancy. This study examined bidirectional associations between parental feeding practices, infant appetitive traits, and infant BMIz. METHODS: Parents (n = 380) of infants aged less than 6 months at baseline reported their feeding practices (using the Feeding Practices and Structure Questionnaire (FPSQ) for infants and toddlers), infant appetitive traits (using the Baby Eating Behaviour Questionnaire) and infant BMIz (parent-reported) at three timepoints (< 6 months, ~ 9 months, ~ 12 months) up to 12 months of age. Cross-lagged models examined bidirectional associations between parent feeding practices, infant appetitive traits and infant BMIz. RESULTS: There was strong continuity across the three timepoints for maternal feeding practices, infant appetitive traits, and infant BMIz. Infant food avoidance was prospectively associated with higher parental persuasive feeding. Infant BMIz was prospectively associated with higher parent-led feeding. Parent use of food to calm was prospectively associated with lower infant BMIz, and infant BMIz was prospectively associated with higher infant food approach. Feeding on demand was prospectively associated with lower infant food approach. CONCLUSION: This study highlights the complex associations between parental feeding practices, infant appetitive traits and infant BMIz. The study demonstrated that both child and parent effects are important, suggesting a need for tailored programs beginning in infancy to promote and support infant appetitive traits and parent feeding practices that support healthy development.

Informing Infant Nutrition: Timing of Infant Formula Advice, Infant Formula Choice and Preparation in the First 6 Months of Life.

OBJECTIVE: To examine the sources and timing of advice formula feeding parents receive and how this and other factors influence the choice of formula product and formula preparation. DESIGN: Components of a cross-sectional survey. SETTING: A child and family health service in New South Wales, Australia. PARTICIPANTS: Parents (n = 153) who were fully or partially formula feeding infants aged 0-6 months and who visited the service's facilities or its social media site. VARIABLES MEASURED: Type of formula, preparation of formula, and use and sources of formula feeding advice. ANALYSIS: Descriptive statistics, Mann-Whitney U or Pearson's chi-square tests, and inductive content analysis. RESULTS: The most common source of formula feeding advice was the formula tin/packet (96.6%). Although 79.2% received advice from a health professional, only 18.9% reported receiving this advice before using formula. Approximately half (48.0%) of the parents chose a standard cow's milk-based formula. The most common reason for their choice of formula type/brand was a personal recommendation (53.0%). Parents' responses indicated that nearly half (46.3%) incorrectly prepared the formula. CONCLUSION AND IMPLICATIONS: Although health professional advice was widely received, this was rarely before starting formula. Despite the current national infant feeding regulations, parents who were not exclusively breastfeeding their infants did not always receive timely, health professional advice about formula feeding.

Associations of mothers' and fathers' structure-related food parenting practices and child food approach eating behaviors during the COVID pandemic.

BACKGROUND: During the COVID-19 pandemic, many mothers and fathers have spent more time at home with their children, warranting consideration of parenting practices around food during the pandemic as influences on obesogenic eating behaviors among children. Structure-related feeding practices, particularly around snacking, may be particularly challenging yet influential in the pandemic setting. Parent sex and levels of feeding-related co-operation among parents (co-feeding) are understudied potential influences on parent-child feeding relationships. METHODS: We investigated relationships between structure-related parent feeding and child food approach behaviors during the COVID-19 pandemic, while considering potential moderating influences of parent sex and co-feeding levels. An online survey was completed by 318 parents (206 mothers and 112 fathers) of 2-12-year-olds who were living in states with statewide or regional lockdowns in May/June 2020 within the US. Mothers and fathers were drawn from different families, with each survey corresponding to a unique parent-child dyad. Parental stress/mental health, co-feeding (Feeding Coparenting Scale), structure-related food and snack parenting (Feeding Practices and Structure Questionnaire and Parenting around SNAcking Questionnaire), and child eating behaviors (Child Eating Behaviour Questionnaire) were assessed. Relationships of parents' structure-related food and snack parenting practices with their child's emotional overeating and food responsiveness behaviors were examined using structural equation modelling. Further, we investigated whether these relations were moderated by parent sex or level of co-feeding. RESULTS: Parent sex differences were seen in parental stress, mental health, and co-feeding, but not in structure-related food and snack parenting or child food approach eating behaviors. Structure-related food parenting was negatively associated with emotional overeating. However, structure-related snack parenting was positively associated with emotional overeating and food responsiveness. While regression paths varied between mothers vs. fathers, as well as by co-feeding levels, neither parent sex nor co-feeding levels significantly moderated relationships between parent feeding and child eating variables. CONCLUSIONS: Future studies of food and snack parenting and co-operation in relation to feeding among mothers and fathers within a familial unit may be critical to identify intervention strategies that draw on all family resources to better navigate future disruptive events such as the COVID-19 pandemic.

Acculturation, food-related and general parenting, and body weight in Chinese-American children.

Parents' food-related and general parenting behaviors may vary according to cultural background, with consequences for child eating behavior and weight. A better understanding of food-related and general parenting behaviors adopted by Chinese-American parents, and the relationships of all of these behaviors with child weight, is essential to aid the development of culturally appropriate interventions to prevent obesity in Chinese-American children. We investigated cross-sectional relationships of acculturation with parental feeding behaviors assessed with the Child Feeding Questionnaire, Parent Feeding Styles Questionnaire and Caregiver's Feeding Styles Questionnaire, and general parenting behaviors assessed with the Parenting Styles and Dimensions Questionnaire, in a sample of Chinese-American parents of 5-12 year-old children (n = 233). Parental level of acculturation was assessed using the Suinn-Lew Asian Self-Identity Acculturation scale. We performed generalized linear regressions to explore associations of acculturation levels with parental feeding and general parenting subscales and also associations of these factors with child body mass index (BMI) z-score. Acculturation was associated with higher scores on Responsiveness in feeding, lower scores on subscales assessing controlling feeding behaviors (Restriction, Pressure to eat, Demandingness in feeding), lower scores on non-nutritive feeding behaviors (Emotional feeding, Instrumental feeding), and greater likelihood of an indulgent feeding style. With regard to general parenting, acculturation was associated with lower scores on subscales assessing authoritarian parenting. Parental Prompting/Encouragement to eat was associated with lower child BMI z-score, while authoritarian parenting subscales were associated with higher BMI z-score. An appreciation of the impact of cultural variation on food-related and general parenting may help to inform the development of culturally-sensitive obesity prevention interventions.

Preventing child mental health problems in southeastern Europe: Feasibility study (phase 1 of MOST framework).

The prevalence of child emotional and behavioral problems is an international problem but is higher in low- and middle-income countries (LMIC) where there are often less mental health supports for families. Parenting programs can be an effective means of prevention, but must be low-cost, scalable, and suitable for the local context. The RISE project aims to systematically adapt, implement, and evaluate a low-cost parenting program for preventing/reducing child mental health problems in three middle-income countries in Southeastern Europe. This small pre-post pilot study is informed by the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework and tested the feasibility of the intervention, the implementation, and evaluation procedures: Phase 1 of the three-phase Multiphase Optimization Strategy (MOST) for program adaptation. Local facilitators delivered the Parenting for Lifelong Health (PLH) for Young Children program to parents of children aged 2-9 in North Macedonia, the Republic of Moldova and Romania in 2018. Parents completed assessments pre- and post-program. Results demonstrated positive pre-post change for participating families (N = 140) on various outcomes including child externalizing and internalizing symptoms and parenting behavior, in all three countries, all in the expected direction. Program participation was associated with positive outcomes in participating families. Based on the experiences of this pilot study, we outline the practical implications for the successful implementation of parenting programs in the three countries that will inform our next study phases, factorial experiment, and RCT.

El predominio de los problemas emocionales y conductuales de los niños es un problema internacional, pero es mayor en los países de ingresos bajos y medios donde generalmente hay menos asistencia para la salud mental de las familias. Los programas de crianza pueden ser un medio de prevención eficaz, pero deben ser de bajo costo, escalables y adecuados para el contexto local. El proyecto RISE tiene como finalidad adaptar, implementar y evaluar sistemáticamente un programa de crianza de bajo costo para prevenir o reducir los problemas de salud mental infantil en tres países de ingresos medios del Sudeste de Europa. Este pequeño estudio piloto previo y posterior está fundamentado por el marco de Alcance, Eficacia, Adopción, Implementación y Mantenimiento (RE-AIM, por sus siglas en inglés) y evaluó la viabilidad de los procedimientos de intervención, de implementación y de evaluación: Fase 1 de la Estrategia de Optimización Multifase (MOST) de tres fases para la adaptación del programa. Un grupo de moderadores locales impartió el programa Crianza para la Salud Durante Toda la Vida (Parenting for Lifelong Health, PLH) para Niños Pequeños a padres de niños de entre 2 y 9 años en Macedonia del Norte, República de Moldavia, y Rumania en 2018. Los padres completaron evaluaciones antes y después del programa. Los resultados demostraron cambios positivos después del programa para las familias participantes (N = 140) en varias respuestas, entre ellas, los síntomas de exteriorización y de interiorización de los niños y la conducta de crianza, en los tres países, todos en la dirección esperada. La participación en el programa estuvo asociada con resultados positivos en las familias participantes. Sobre la base de las experiencias de este estudio piloto, describimos las consecuencias prácticas para la implementación satisfactoria de los programas de crianza en los tres países que servirán como base para las fases de nuestro próximo estudio, del experimento factorial y del ensayo controlado aleatorizado.

Binge Watching during COVID-19: Associations with Stress and Body Weight.

Binge watching is becoming increasingly common and may impact energy balance and body weight. The COVID-19 pandemic has created conditions conducive to binge watching and increased stress. We investigated relationships between COVID-related stress and binge watching behaviors, and potential variation in this relationship by body weight. Adults (n = 466) completed a cross-sectional online survey assessing binge watching behaviors during and before the pandemic, COVID-related stress, and body weight. Participants reported an increase in binge watching frequency from before to during the pandemic (F1,401 = 99.970, p < 0.001), with rates of high binge watching ("3-4 times per week" to "3 or more times per day") increasing from 14.6% to 33.0%. Binge watching episode duration increased from 3.26 ± 1.89 h to 3.92 ± 2.08 h (p < 0.001). The increase in binge watching frequency was greatest in individuals with obesity and high stress (F 4,401 = 4.098, p = 0.003). Participants reporting high stress reported higher frequency of eating while binge watching, as well as higher levels of negative emotional triggers, consequences to binge watching, and lack of control over binge watching (all p < 0.001). Our results show that binge watching increased during the pandemic, with greater increases among individuals reporting higher COVID-related stress, especially those with obesity, and concomitant effects on eating, and highlight a need for interventions to minimize the obesogenic impact of binge watching during the pandemic.

Qualitative Exploration of Dimensions of Restrictive Feeding With Australian Mothers of 6-Year-Olds.

OBJECTIVE: Explore the nature and dimensions of restrictive feeding with mothers of 6-year-olds. DESIGN: Semistructured interviews with mothers. Conversations were audio-recorded and transcribed verbatim. SETTING: Brisbane and Adelaide, Australia. PARTICIPANTS: Twenty-nine mothers of 6-year-olds. PHENOMENON OF INTEREST: Mothers' restrictive feeding practices. ANALYSIS: Qualitative thematic analysis. RESULTS: This study revealed 6 key themes relating to the restrictive feeding phenomenon: restriction of specific foods and drinks; restrictive feeding practices; mothers' motivation; mothers' preferences for restricted foods; patterns over time; and relationships with other controlling feeding practices. Parents' restrictive feeding practices are likely to be inherently inconsistent, with mothers reportedly varying their practices across different restricted foods, contexts, day to day, and as children age. Mothers intended to either totally restrict or restrict a food/drink in moderation, and these intentions presented qualitatively distinct characteristics across themes. Mothers commonly referred to foods/drinks restricted in moderation as treats, and their liking for these restricted foods/drinks was related to higher child access. CONCLUSIONS AND IMPLICATIONS: This study provides insights into the nature and dimensions of restrictive feeding. Further research is proposed to clarify these findings and examine the effects of child access, types of restrictive feeding practices, and parent communication on child preferences for restricted foods and drinks across a range of cultural groups.

COVID-19 Stress and Food Intake: Protective and Risk Factors for Stress-Related Palatable Food Intake in U.S. Adults.

(1) Background: The coronavirus (COVID-19) pandemic has caused disruptions to what people eat, but the pandemic's impact on diet varies between individuals. The goal of our study was to test whether pandemic-related stress was associated with food intake, and whether relationships between stress and intake were modified by appetitive and cognitive traits. (2) Methods: We cross-sectionally surveyed 428 adults to examine current intake frequency of various food types (sweets/desserts, savory snacks, fast food, fruits, and vegetables), changes to food intake during the pandemic, emotional overeating (EOE), cognitive flexibility (CF), and COVID-19-related stress. Models tested associations of stress, EOE, and CF with food intake frequency and changes to intake. (3) Results: Models demonstrated that the positive relationship between stress and intake of sweets/desserts was stronger with higher EOE, while the positive relationship between stress and intake of chips/savory snacks was weaker with higher CF. Higher EOE was associated with greater risk of increased intake of palatable foods. (4) Conclusions: Findings suggest that emotional overeating may escalate stress-associated intake of high-sugar foods, and cognitive flexibility may attenuate stress-associated intake of high-fat foods. Differences in appetitive and cognitive traits may explain changes to and variability in food intake during COVID-19, and efforts to decrease emotional overeating and encourage cognitive flexibility could help lessen the effect of COVID-19-related stress on energy dense food intake.

The influence of COVID-19-related stress on food motivation.

The COVID-19 pandemic and public health measures to reduce its transmission have increased stress. Stress is associated with alterations in eating behavior which may be partly driven by effects on food-related motivation. To investigate effects of COVID-related stress on food motivation, we recruited adults (N = 429; 272 F, 157 M) to complete an online survey via Amazon MTurk in May 2020. Current COVID-related stress, retrospective pre-COVID stress, and motivation in relation to individualized preferred foods from five categories (sweet snacks, fruit, savory snacks, vegetables, and fast food) were assessed. Food motivation measures included willingness to wait, willingness to expend low effort [finger taps], willingness to expend high effort [jumping jacks], and willingness to pay for hypothetical delivery of the food item. Food motivation for each food type was assessed using a novel instrument designed for brief assessment of multiple aspects of food motivation across multiple food types. Participants were willing to pay the most for fast food followed by sweet snacks, and willing to wait longer for sweet snacks relative to other food types. While fast food and sweets also generated the most willingness to expend high and low effort, willingness to expend low effort for fruit was similar to that for fast food and sweets, and willingness to expend high effort for fruit was comparable to that for fast food. Participants were least willing to pay or expend low effort for vegetables. Higher COVID-related stress levels were associated with willingness to expend more effort and pay more for food items. These data collected during the pandemic demonstrate that highly processed and sweet foods have high motivating value across multiple measures of motivation, and COVID-related stress increases food motivation across food categories. Interventions to mitigate stress and target the link between stress and overeating may help to limit the effects of the COVID-19 pandemic on obesity.

Interparental Relationship Adjustment, Parenting, and Offspring's Cigarette Smoking at the 10-Year Follow-up.

Familial influences on children's cigarette smoking have been established, yet little is known about whether these influences in childhood relate to offspring's smoking behavior in adolescence. Drawing on prior work showing that children's emotional and behavioral problems (i.e., internalizing and externalizing behavior problems) are influenced by both interparental and parent-child relationships, we examined whether children's emotional and behavioral problems would further predict their smoking behavior in adolescence. Two hundred and twenty-one families were followed from early childhood (Mage  = 4.05 years) to the 10-year follow-up. Interparental relationship adjustment and disagreement, dysfunctional parenting, and children's emotional and behavioral problems were reported by both mothers and fathers. Adolescents' self-reported cigarette smoking status was assessed along with other demographic variables. Using structural equation modeling, the hypothesis was only supported based on mothers' reports, suggesting that early couple relationship adjustment and parenting relate to children's emotional and behavioral problems, which associate with smoking behavior in adolescence. When the hypothesized model was tested with emotional and behavioral problems separately, only behavioral problems were related to adolescent smoking for both parents. Findings from this study support models of family environment and children's behavioral problems, providing evidence of the long-term links with adolescent cigarette smoking behaviors. Further family-focused research and preventive work, for instance, testing the combination of partner support and parent training, are needed.

Se han establecido las influencias familiares en el consumo de cigarrillos de los niños, sin embargo, se sabe poco acerca de si estas influencias en la niñez se relacionan con la conducta de consumo de cigarrillos de los niños en la adolescencia. Teniendo en cuenta trabajos anteriores que demuestran que los problemas conductuales y emocionales de los niños (p. ej.: los problemas de conductas de exteriorización e interiorización) están influenciados tanto por las relaciones interparentales como por las relaciones entre padres e hijos, analizamos si los problemas emocionales y conductuales de los niños predecirían, además, su conducta de consumo de cigarrillos en la adolescencia. Se siguió a doscientas veintiuna familias desde la primera infancia (edad promedio = 4.05 años) hasta el control a los diez años. Tanto las madres como los padres informaron adaptación y desacuerdo en las relaciones interparentales, crianza disfuncional y problemas conductuales y emocionales de los niños. Se evaluó la situación de consumo de cigarrillos autoinformada por los adolescentes junto con otras variables demográficas. Utilizando modelos de ecuaciones estructurales, se respaldó la hipótesis solo sobre la base de los informes de las madres, lo cual sugiere que la adaptación temprana en la relación de pareja y la crianza se relacionan con los problemas emocionales y conductuales de los niños, los cuales se asocian con la conducta de fumar en la adolescencia. Cuando el modelo hipotetizado se probó con problemas conductuales y emocionales por separado, solo los problemas conductuales se relacionaron con el consumo de cigarrillos de los adolescentes para ambos padres. Los hallazgos de este estudio respaldan los modelos de entorno familiar y los problemas conductuales de los niños, ya que ofrecen indicios de los vínculos a largo plazo con las conductas de consumo de cigarrillos en los adolescentes. Se necesitan más investigaciones centradas en la familia y trabajos preventivos, por ejemplo, la evaluación de la combinación de apoyo para padres y de capacitaciones para padres.

Infant Appetitive Phenotypes: A Group-Based Multi-Trajectory Analysis.

Background: Examining appetitive traits with person-centered analytical approaches can advance the understanding of appetitive phenotype trajectories across infancy, their origins, and influences upon them. The objective of the present study was to empirically describe appetitive phenotype trajectories in infancy and examine the associations with infant and parent factors. Materials and Methods: In this longitudinal cohort study of Australian infants, parents completed three online surveys ~3 months apart, beginning when the infant was <6 months. Appetitive traits were assessed with the Baby Eating Behavior Questionnaire (BEBQ) and parent feeding practices with the Feeding Practices and Structure Questionnaire (FPSQ) infant and toddler version. Parent demographics and cognitions were also collected. Infant weight and length were transcribed from health records and converted to a BMI z-score. Group-based trajectory modeling identified appetitive phenotype trajectories using the BEBQ. Multilevel modeling examined change in feeding practices and child BMI z-score over time by appetitive phenotype trajectories. Results: At time 1, 380 participants completed the survey (mean infant age 98 days), 178 at time 2 (mean infant age 198 days), and 154 at time 3 (mean infant age 303 days). Three multi-trajectory appetitive phenotype groups were identified and labeled as (Phenotype 1) food avoidant trending toward low food approach (21.32% of infants), (Phenotype 2) persistently balanced (50.53% of infants), and (Phenotype 3) high and continuing food approach (28.16% of infants). Formula feeding was more common in Phenotype 1 (p = 0.016). Parents of infants in Phenotype 1 were more likely to rate them as being more difficult than average, compared to infants with phenotypes 2 or 3. Phenotype 2 had the greatest increase in persuasive feeding over time [0.30; 95% CI (0.12, -0.47)]. Conclusions: Distinct multi-trajectory appetitive phenotype groups emerge early in infancy. These trajectories appear to have origins in both infant and parent characteristics as well as parent behaviors and cognitions. The infant multi-trajectory appetitive phenotype groups suggest that for some infants, difficulties in self-regulating appetite emerge early in life. Investigation of infant multi-trajectory appetitive phenotype groups that utilize a range of measures, examine relationships to key covariates and outcomes, and extend from infancy into childhood are needed.

Familial Obesity Risk and Current Excess Weight Influence Brain Structure in Adolescents.

OBJECTIVE: Obesity risk transmits from parents to children. Underlying neural mechanisms were investigated in this study by evaluating influences of familial obesity risk defined by maternal obesity and influences of current overweight on three indices of brain structure in adolescents. METHODS: In total, 22 lean adolescents with lean mothers (lean low-risk), 25 lean adolescents with mothers with obesity/overweight (lean high-risk), and 36 adolescents with obesity/overweight underwent structural MRI scans for estimation of regional gray and white matter volume and cortical thickness. RESULTS: The lean high-risk compared with the lean low-risk group demonstrated lower gray and white matter volume and cortical thickness in the postcentral gyrus (somatosensory cortex), lower gray and white matter volume in the opercular cortex (taste cortex), lower gray matter volume and cortical thickness in the anterior cingulate cortex, and lower cortical thickness in the precuneus. Comparisons of the lean and obesity/overweight groups revealed further structural alterations in the postcentral gyrus, posterior cingulate gyrus, and middle temporal gyrus. CONCLUSIONS: Familial obesity risk and current obesity/overweight were associated with overlapping and distinct patterns of brain structure alterations. Longitudinal studies are warranted to investigate whether structural changes associated with familial obesity risk predict future weight trajectories.