The Relationship between Structure-Related Food Parenting Practices and Children's Heightened Levels of Self-Regulation in Eating

Abstract

Background:

Food parenting practices influence children's eating behaviors and weight status. Food parenting practices also influence children's self-regulatory abilities around eating, which has important implications for children's eating behaviors. The purpose of the following study is to examine use of structure-related food parenting practices and the potential impact on children's ability to self-regulate energy intake.

Methods:

Parents (n = 379) of preschool age children (M = 4.10 years, SD = 0.92) were mostly mothers (68.6%), Non-White (54.5%), and overweight/obese (50.1%). Hierarchical Multiple Regression was conducted to predict child self-regulation in eating from structure-related food parenting practices (structured meal setting, structured meal timing, family meal setting), while accounting for child weight status, parent age, gender, BMI, race, and yearly income.

Results:

Hierarchical Multiple Regression results indicated that structure-related feeding practices (structured meal setting and family meal setting, but not structured meal timing) are associated with children's heightened levels of self-regulation in eating. Models examining the relationship within children who were normal weight and overweight/obese indicated the following: a relationship between structured meal setting and heightened self-regulation in eating for normal-weight children and a relationship between family meal setting and heightened self-regulation in eating for overweight/obese children.

Conclusions:

Researchers should further investigate these potentially modifiable parent feeding behaviors as a protective parenting technique, which possibly contributes to a healthy weight development by enhancing self-regulation in eating.

Introduction

Children's ability to self-regulate their intake of food is an important phenomenon to examine due to its relationship with children's weight status.¹ While children are born with the ability to regulate their intake,^2,3 parent–child interactions around food can have a significant impact on this ability.^4,5 Generally, research focuses on the detrimental effects of controlling food parenting practices on self-regulation. However, the examination of beneficial food parenting practices that could warrant promotion through intervention is another critical avenue of research which is all too often overlooked.⁶ Specifically, the current investigation proposes that structure-related food parenting practices, including the timing and setting of mealtimes, may be beneficial food parenting practices due to their hypothesized relationship with child self-regulatory abilities.⁷

Child Self-Regulation

Throughout the first years of life, parents exert a significant amount of influence over their children's dietary intake in that they are often responsible for when and what the infant consumes.⁸ As children age, the amount of autonomy that they have over their own consumption increases. Although infants express hunger by cues such as mouthing,⁹ parents decide when, what, and how much to feed. As children grow up and, in particular, when they reach school age, they gain autonomy over decisions and actions within their food environment. For example, a parent might feed an 8-month-old a jar of baby food, but they might have very little control over what and how much that same child chooses to eat when the child is 5 years old and at school.

Some research indicates that at birth, infants are able to self-regulate what they consume.^2,3 By preschool age, differences exist in children's ability to self-regulate their eating.¹⁰ Thus, as children age and make decisions about what they eat, their capability for self-regulation in eating becomes increasingly important. This importance is compounded by the fact that portion sizes continue to increase and are currently larger than they have ever been.¹¹ The ability to self-regulate eating has been found to moderate the amount consumed when children are faced with unhealthy foods and unhealthy portion sizes.¹ Those with higher self-regulatory abilities in eating consume less than those with lower self-regulatory abilities in eating when faced with unhealthy foods and larger portion sizes.

Food Parenting Practices

Food parenting practices influence children's eating behaviors and weight status.¹² Historically, researchers have focused on behaviors such as parental use of control or restriction.¹³ Control and restriction have been associated with lower child ability to self-regulate energy intake¹⁴ and consequently, obesogenic eating behaviors and child weight status.^1,10 Isolating parenting practices that are related to the risk of or prevention of obesity is especially important at this age because obesity rates nearly double from the time children are in preschool to school-aged¹⁵ despite researchers' and clinicians' focus on control and restriction.¹³ Parents need guidance about positive food parenting to foster optimal child eating behaviors,¹⁶ and providing structure through food parenting has been suggested as beneficial.⁶ Structure-related feeding behaviors are behaviors related to imposing structure around mealtime, including the “what, when, and where of food provision.”⁷

The Trust model¹⁷ emphasizes that both parents and children play a role in developing positive eating behaviors. This paradigm suggests that children are able to self-regulate their intake within the context of regular and structured meals and snacks. Specifically, caregivers are responsible for providing the structure of the meal setting, including foods presented, timing, and location, and the child is responsible for what to eat and how much to eat. Therefore, parental provision of a structured meal environment may facilitate children's maintenance of self-regulatory abilities by helping children attend and respond to hunger and satiety cues. This then potentially assists children in learning to eat for reasons of hunger and in response to physiological cues.¹⁷ Family meals are an example of a structured meal environment.¹⁸

Researchers have posited that structure-related food parenting practices are tied to better self-regulation in energy intake by the child and more optimal eating behaviors.¹⁹ An important indicator of this association is that children engaging in three or more family meals a week have decreased obesity risk and better eating behaviors than children who engage in less than three family meals a week.²⁰ Evidence from developmental literature suggests that routines and structure, including timing of family meals, are also beneficial to children's self-regulation of emotions.^21,22 Berge et al.²³ have found an association between behavior control during family meals and increased vegetable intake in adolescents.¹⁷ However, little is known about what mechanisms behind family meals reduce obesity risk,²⁰ and there is currently limited empirical research evidence beyond this to support the fact that structure-related feeding behaviors are related to children's ability to self-regulate in eating. Given the dearth of research, especially with younger children, this study set out to empirically examine how structure-related food parenting practices are related to children's ability to self-regulate energy intake. Our hypothesis was that structure-related food parenting practices would be associated with higher self-regulation in eating.

A shift to a strength-based approach in empowering parents around optimal food parenting practices is necessary in light of the fact that, despite current public health efforts, obesity rates are alarmingly high.¹⁵ It is important to identify food parenting practices that can foster children's healthy eating behaviors, such as self-regulation.

Methods

Participants and Procedures

The current study was a cross-sectional secondary data analysis that combined two separate samples from two larger studies that focused on understanding how parenting practices relate to child eating behaviors. Both studies followed the same recruitment protocol (see Powell et al.²⁴ for more on protocol). Parents of preschool-aged children (N = 420) were recruited for both studies through a link on Amazon Mechanical Turk (MTurk). MTurk is a useful tool for data recruitment because it allows researchers to set criteria to filter who is able to participate,²⁵ samples tend to be more diverse than convenience samples,²⁶ and it has been used in other studies of parent feeding.^27,28 Both samples were limited to those residing within the United States and only allowed each Internet Protocol (IP) address to participate once. Criteria for eligibility included being over 18 years of age, living in the United States, having a preschool-aged child, and being able to fill out surveys in English on a computer. Participants provided consent before receiving the link to take the survey and were compensated 50 cents to their account upon completion. This study was approved by the Institutional Review Board at The University of Houston.

Measures

Parent and child weight

Parents reported their own weight and height and that of their child. Cutoff scores for child BMI percentiles were established in accordance with CDC overweight/obesity guidelines. Children with BMI percentiles at or above the 85th percentile were categorized as overweight/obese, and children with BMI percentiles below the 85th percentile were categorized as normal weight. Participants with biologically invalid values were excluded.

The feeding practices and structure questionnaire-28

The feeding practices and structure questionnaire (FPSQ-28) was created to measure food parenting practices that potentially impact children's capability to self-regulate energy intake. This broad, theory-driven conceptualization of parental feeding diverges from most previously used measures that focused primarily on control.⁷ The FPSQ was originally validated with a sample of Australian mothers and their children aged 21 to 27 months⁷ and has shown good reliability and validity,^7,29 including longitudinal measurement invariance between the age of 2 and 5 years.³⁰

The FPSQ is a 28-item parent-report questionnaire containing 8 subscales. Three subscales focused on structure-related food parenting practices were used for the present investigation: The structured meal setting scale (three items, “I allow my child to wander around during the meal (reverse coded), How often are you firm about where your child should eat? I insist my child eats meals at the table,” α = 0.80 in current sample), the structured meal timing scale (three items, “I decide when it is time for my child to have a snack, I let my child decide when (s)he would like to have her meal (reverse coded), I decide times when my child eats his/her meals,” α = 0.62 in current sample), and the family meal setting scale (one item, “My child eats the same food as the rest of the family,” no α). All structure subscales have 5-point response scales (never to always).³⁰ Mean scores were used in analysis per established protocols.⁷

Self-regulation in eating

The Self-Regulation in Eating measure is an 8-item parent report of their child's ability to regulate their food intake.³¹ Parents respond to survey questions on a 5-point Likert scale (disagree to agree), including items such as “My child knows when s/he is full,” “My child stops eating when s/he is full,” and “My child knows when s/he should stop eating.” This scale has good internal consistency, as demonstrated with the original Cronbach's α = 0.87, and α = 0.84 in the current sample. Concurrent validity has been established.³¹ The mean scale score was used in analysis per established protocols.³⁰

Analyses

Our hypothesis was that structure-related food parenting practices would predict better self-regulation in eating. Analyses were conducted using SPSS 24. Bivariate correlations between structure-related food parenting practices and child self-regulation in eating were examined first. Next, Hierarchical Multiple Regression was conducted to predict child self-regulation in eating from structure-related food parenting practices (structured meal setting, structured meal timing, family meal setting), while accounting for covariates typically associated with child self-regulation in eating in the literature.^31,32 These included: child weight status, parent age, parent gender, parent BMI, parent race, and yearly income. Independence of residuals was confirmed using Durbin–Watson statistic, which revealed a value of 2.024 (acceptable range = 1.5–2.5).³³ Case diagnostics in SPSS revealed an outlier which was examined closely. Since exclusion did not alter the results, the outlier was included in analyses. Homoscedasticity was confirmed by visual inspection of standardized residuals vs. standardized predicted values, and visual inspect of residuals in the normal probability plot revealed normal distribution. Missing data were deleted listwise. The sample size available for all analyses was n = 379.

Results

About half of the parent sample was White (n = 171; 45.1%), most were married or living together (n = 310; 81.8%), and reported household income above $50,000 (n = 204; 53.8%). Fathers comprised 31.4% of the sample (n = 119). Children were on average 4.1 years. Sample demographics can be found in Table 1. On average, it took participants around 25 minutes and 25 seconds to complete the survey.

Table 1.

Demographics of Sample (n = 379)

Variables	N (%) or mean ± SD
Child age	4.10 ± 0.92
Child weight
Underweight/normal	172 (45.4)
Overweight/obese	207 (54.6)
Child sex
Male	204 (53.8)
Female	175 (46.2)
Self-regulation in eating	3.74 ± 0.79
Parent age	32.48 ± 6.02
Parent weight
Underweight/normal	189 (49.9)
Overweight/obese	190 (50.1)
Parent gender
Male	119 (31.4)
Female	260 (68.6)
Race (n = 376)
White	171 (45.5)
Non-White^a	205 (54.5)
Relationship status
Single, never married, separated, divorced, widowed, relationship—not living together	65 (17.2)
Married, relationship—living together	310 (81.8)
Rather not say	4 (1.0)
Yearly household income
0–25K	53 (14.0)
>25–50K	122 (32.2)
>50K	204 (53.8)
Parental feeding practices
Structured meal setting	3.88 ± 0.91
Structured meal timing	3.61 ± 0.77
Family meal setting	3.94 ± 0.98

This category included the following responses: African American, American Indian/Alaska Native, and Asian.

Bivariate correlations between food parenting practices and child self-regulation in eating are presented in Table 2. All three structure-related variables were positively significantly correlated with child self-regulation. Model 1 examined associations between demographic covariates (specifically, child weight status, parent age, parent gender, parent BMI, race, and yearly income) and child self-regulation in eating, and was statistically significant, R² = 0.096, F(6, 378) = 6.55, p < 0.001. The full model examining associations between structured meal setting, structured meal timing, family meal setting, and child self-regulation in eating, accounting for covariates was statistically significant as well, R² = 0.142, F(9, 378) = 6.79, p < 0.001, adjusted R² = 0.121 (model 2). The addition of structure-related food parenting practices led to a statistically significant change in R² of 0.047, ΔF = 6.67, p < 0.001 indicating that model 2 is the preferred model. As hypothesized, structured meal setting and family meal setting were significantly associated with heightened child self-regulation of eating (β = 0.16, p = 0.009 and β = 0.12, p = 0.019) but, contrary to the hypothesis, structured meal timing was not (Table 3). In other words, higher use of structured meal setting and family meal setting were related to higher levels of child self-regulation of eating.

Table 2.

Bivariate Correlations between Food Parenting Practices and Child Self-Regulation of Eating

	Structured meal setting	Structured meal timing	Family meal setting
Self-regulation of eating	0.220^**	0.118^*	0.218^**
Structured meal setting		0.487^**	0.369^**
Structured meal timing			0.227^**

p < 0.001, ^*p < 0.05.

Table 3.

Multiple Regression Examining Associations between Structured Meal Setting, Structured Meal Timing, Family Meal Setting, and Child Self-Regulated Eating Adjusting for Covariates—for Total Sample, Children with Normal Weight Status, and Overweight/Obese Weight Status

	Child self-regulated eating
	Total sample (n = 379)^a				Normal weight (n = 172)				Overweight/obese (n = 207)
Variable	B	B	p	95% CI	B	β	p	95% CI	B	β	p	95% CI
Child weight status (normal weight)^b	−0.22	−0.14	0.006	−0.37 to −0.06
Parent age	0.01	0.08	0.119	−0.01 to 0.02	0.01	0.07	0.381	−0.01 to 0.03	0.01	0.08	0.228	−0.01 to 0.03
Parent gender (male)	0.37	0.22	<0.001	0.21 to 0.53	0.35	0.21	0.006	0.10 to 0.59	0.42	0.25	<0.001	0.20 to 0.64
Parent BMI	−0.01	−0.04	0.406	−0.01 to 0.01	−0.01	−0.04	0.599	−0.02 to 0.01	−0.01	−0.04	0.526	−0.01 to 0.01
Parent race (Non-White)^c	0.02	0.01	0.846	−0.14 to 0.17	0.05	0.04	0.645	−0.17 to 0.28	0.01	0.01	0.996	−0.21 to 0.21
Yearly income	−0.05	−0.03	0.523	−0.21 to 0.11	0.02	0.01	0.882	−0.22 to 0.26	−0.10	−0.06	0.348	−0.31 to 0.11
Structured meal setting	0.13	0.16	0.009	0.03 to 0.23	0.17	0.21	0.024	0.02 to 0.31	0.10	0.11	0.170	−0.04 to 0.24
Structured meal timing	−0.01	−0.01	0.812	−0.13 to 0.10	−0.07	−0.07	0.408	−0.24 to 0.10	0.02	0.02	0.768	−0.13 to 0.18
Family meal setting	0.10	0.12	0.019	0.02 to 0.18	0.04	0.05	0.522	−0.09 to 0.17	0.15	0.19	0.010	0.04 to 0.26
R ² (R ² adj)	0.142 (0.121)				0.099 (0.033)				0.142 (0.108)
F (p-value)	6.79 (<0.001)				2.25 (0.026)				4.11 (<0.001)

Sample size without missing data.

Under or normal weight = BMI percentiles below the 85 percentile using CDC reference data, overweight/obese = BMI percentiles at or above the 85 percentile.

This category included the following responses: African-American, American Indian/Alaska Native and Asian.

Based on the significant relationship between child weight status and self-regulation in eating (β = −0.14, p = 0.006) and the possibility for child weight status to also influence food parenting practices, it was decided to also examine regression models separately for the normal and overweight/obese groups. As presented in Table 3, higher use of structured meal setting was related to higher levels of child self-regulation of eating in the normal-weight group (β = 0.21, p = 0.024), whereas higher use of family meal setting was related to higher levels of child self-regulation of eating in the overweight/obese-weight group (β = 0.19, p = 0.010). As such, the associations between mealtime structure and self-regulation looked slightly different for the normal-weight vs. overweight children.

Discussion

The aim of the current study was to examine the relationship between structure-related food parenting practices and children's ability to self-regulate eating. Results demonstrate that structured meal setting and family meal setting food parenting practices are positively associated with children's levels of self-regulation in eating with some differences seen depending on child weight status.

This finding is in line with the Trust model,¹⁷ which emphasizes the shared division of responsibility between parents and children. Parents provide structure related to the feeding environment, whereas children decide what and how much they want to eat. By imposing some limits around mealtimes (such as providing the same food as the rest of the family is eating and encouraging the child to eat at the table), preschool-aged children are able to operate largely autonomously within that structure, which might facilitate maintaining their ability to regulate their own food intake.

Although structured meal timing is a form of structure, it is different than family meal setting (families eat meals together, sharing the same food) and structured meal setting (structure around location and behavior during meals) because it deals with when families eat and focuses on the parent as decision maker regarding the timing of meals and snacks, rather than how and where families eat. During the preschool period in which this study took place, many children's meal times are stipulated by their school or day care,³⁴ and this might not be captured in the wording of the question (e.g., “I decide the times when my child eats his/her meals”). Perhaps children have a routine and parents follow that on weekends, but parents do not feel powerful over a child's meal timing when children are not in their care. The mean score for this variable was the lowest of all three structure subscales, and it had the smallest range (M = 3.61, SD = 0.77).

Results from the current study extend previous research by specifically examining the association between structure-related food parenting practices that are hypothesized to potentially impact children's ability to self-regulate energy intake⁷ and an explicit measure of self-regulation in eating.³¹ Finnane et al.³⁴ did not find an association between structure-related food parenting practices and children's ability to self-regulate energy intake, using the Children's Eating Behavior Questionnaire (CEBQ) subscales of Satiety Responsiveness and Slowness in Eating.³⁵ Although both studies used the FPSQ-28 to measure structure-related food parenting practices, differences in findings may be due to differences in measures used to assess self-regulation in eating. The Self-Regulation in Eating measure by Tan and Holub,³¹ used in the current study, was specifically created to measure children's ability to self-regulate eating and likely does this more holistically than the CEBQ, which assesses a variety of child eating behaviors, or arguably “appetitive styles”³⁶ rather than their self-regulatory abilities around eating. Use of the Self-Regulation in Eating measure³¹ in this study might therefore provide a more comprehensive approach to understanding this phenomenon. It should be noted that although our findings are significant, the effect sizes are relatively small.

Self-regulation of eating was chosen as the variable of interest over child weight status. Self-regulation of eating is a more proximal child outcome than weight status and has the potential to influence children's weight as they age. Findings from this study show an association between self-regulation and child weight status at preschool age. Healthy-weight children showed higher self-regulation compared with overweight and obese children indicating that it possibly serves as a protective factor in children's weight outcomes. While food parenting practices are likely shaping children's eating behaviors at this age, their impact on child weight may take longer to surface.³⁷ For this reason, researchers have agreed that it is problematic to solely focus on weight as an outcome when studying food parenting practices.^13,38 A longitudinal study design is therefore warranted as it allows researchers to examine associations between food parenting practices, children's eating behaviors, self-regulation of energy intake, and child weight status over time.

Although structured meal setting and family meal setting feeding practices are both related to self-regulation in eating, when analyses were conducted separately by child weight status, differences appeared. Structured meal setting was only significant in the model of normal-weight children and family meal setting was only significant in the model of overweight or obese children. Future studies should investigate if this phenomenon is a function of lower sample size when dividing the sample into groups based on child weight or if differential relationships exist based on child weight status. If future studies replicate the findings that differential relationships exist based on child weight status, this could indicate that the role modeling component of eating the same food, together with the rest of the family helps children who are overweight and obese listen to their hunger and satiety cues. For families with children who are of normal weight status, eating meals while seated at a table with decreased distraction, may be beneficial to tune into hunger and satiety cues.

Interestingly, mothers and fathers rated their children as having different levels of self-regulation in eating [fathers rated self-regulation in eating lower, M = 3.48 (n = 119, SD = 0.72), whereas mothers rated it at M = 3.86 (n = 260, SD = 0.79)]. As fathers are becoming more involved in feeding,³⁹ additional studies are needed to understand how their differential perceptions about children's abilities and behaviors across mothers and fathers (1) come about and (2) impact feeding behaviors. For example, Blissett et al. found that fathers monitor food intake less than mothers.⁴⁰ These kinds of gender-based differences in food parenting strategies might be influenced by differences in perceptions of self-regulatory abilities across parent gender.

A limitation of the current study is that data were gathered through parental self-report through MTurk rather than more robust data collection methods such as observational research. This is of particular consideration regarding the parent-reported child anthropometrics data. Given the online method of data collection and our inclusion of fathers, it is possible that both parents from a family participated in data collection. We did ensure that each IP address could only fill out the survey once; however, we did not ask questions to determine whether two individuals from the same family were participating in the study from different devices. Future studies should include questions related to whether cohabiting parents are both taking the survey and weigh the costs and benefits of disallowing multiple attempts at the survey from the same IP address. Ideally, responses are gathered from both parents in the household. The cross-sectional nature of this study prevented us from making any statement about the directionally of associations. Researchers should replicate this study in the future with observational data or longitudinal study designs to confirm the findings, determine direction of effects, and to get a better sense of the child's contributions to parent behaviors in the moment. In line with these considerations, examination of how structure-related food parenting practices are used in combination with other types of food parenting practices, particularly those considered controlling and possibly maladaptive, is warranted. A researcher might also want to examine how the relationship between structure-related food parenting practices and children's heightened levels of self-regulation in eating relates to parent feeding styles.⁴¹ One interesting research question is: do feeding styles moderate this relationship or are feeding styles actually predicting which parents use structure (presumably authoritarian and authoritative) and which parents do not (presumably indulgent and uninvolved)?

Implications

This study provides initial evidence that structure-related food parenting practices are related to better child self-regulation of energy intake which can be a protective factor against later overeating and other obesogenic behaviors. Structure-related food parenting practices have also been related to reduced food fussiness and increased enjoyment of food in a sample of infants and toddlers.³⁴ In addition to these suggested benefits through the use of structure in feeding interactions, research has provided evidence linking mealtime routines and rituals to overall child mental health.⁴² Structure around family meals provides a foundation for increased communication between parents and their children. Family meals are also something that parents generally desire, for reasons related to increased time for conversation, feelings of togetherness, shared nutrition, and ceremony.⁴³ Therefore, there are not only positive benefits to be gained from family meals, but the promotion of these practices may also be more successful because it aligns with their desires and values. These findings have the potential to shift feeding interventions to be strength based. Research evidence suggests that mothers prefer positive parenting advice,⁴⁴ implying that a strength-based approach may be more readily accepted by parents.

Finnane et al.³⁴ put forth that structure-related food parenting practices have the potential to be an important area for clinicians to promote in prevention and intervention efforts, if those food parenting practices prove to be related to better child eating behaviors. Once these relationships are established, researchers can (1) examine if teaching parents to implement appropriate structure and routine related to the feeding environment leads to maintenance of children's self-regulatory abilities around eating and long-term weight effects, and (2) examine the effectiveness of a strength-based approach to obesity prevention.

Discussing the benefits of structure-related food parenting practices with parents is more strength-based than a more common research and intervention focus, control, or even coercive control. Developmental psychologists have urged researchers to conceptualize structure and control as two separate concepts.⁴⁵ In the domain of food parenting, structure can be a positive form of parental control^6,46 and very different from coercive control parents use around food.⁴⁷ This is confusing to food parenting scholars, clinicians, and parents. Although the concept of coercive control is well defined in the feeding literature, especially in a recent review by Vaughn et al.,⁴⁷ there are “optimal” amounts of control that are suggested to be beneficial for children's developmental outcomes.⁴⁸ However, it is difficult to teach parents how to recognize when they are using “optimal” amounts of control rather than too little, too much, or the wrong kind. While it is important to continue identifying food parenting practices to avoid, it is equally important to focus on positive food parenting practices and strategies that are related to beneficial child outcomes. This may be particularly useful for clinicians and interventionists in providing information to parents related to feeding strategies they could implement with their children. As Rollins et al. point out, parenting practices that impose some structure and limits to mealtimes may represent an example of using control in a beneficial way and as such might even reduce the amount of restriction parents use in the feeding context.⁶

Footnotes

Acknowledgment

The authors would like to thank Kendall Pfeffer for formatting assistance and feedback on the article.

Author Disclosure Statement

No competing financial interests exist.

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