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. 2020 Nov;15(11):e12662.
doi: 10.1111/ijpo.12662. Epub 2020 Jun 16.

Associations of parents' use of food as reward with children's eating behaviour and BMI in a population-based cohort

Pauline W Jansen  1   2 , Ivonne P M Derks  2 , Yuchan Mou  3   4 , Elisabeth H M van Rijen  2 , Romy Gaillard  5 , Nadia Micali  6   7   8 , Trudy Voortman  4 , Manon H J Hillegers  1
Affiliations

Associations of parents' use of food as reward with children's eating behaviour and BMI in a population-based cohort

Pauline W Jansen et al. Pediatr Obes. 2020 Nov.

Abstract

Background: Parents' use of food as reward has been linked to children's dietary intake, but the association with children's eating behaviour and overweight risk is less clear.

Objectives: To examine the temporal association of using food as reward with eating behaviour, body mass index (BMI) and weight status of children.

Methods: Participants were 3642 children of the population-based Generation R Study in the Netherlands (8.3% overweight/obese). Repeated assessments were collected at child ages 4 and 9 years, including measured anthropometrics and parent reports on feeding practises and eating behaviour.

Results: Linear regressions and cross-lagged models indicated that parents' use of food as reward at child age 4 years predicted Emotional Overeating and Picky Eating at age 9 years. Reversely, higher Emotional Overeating and Food Responsiveness scores were associated with more use of food as reward over time. Using food as reward was not associated with children's satiety response, BMI or overweight risk.

Conclusions: A vicious cycle may appear in which children who display food approach behaviour are rewarded with food by their parents, which in turn might contribute to the development of unhealthy eating habits (emotional eating, fussiness). These findings warrant further research, to facilitate evidence-based recommendations for parents.

Keywords: BMI; eating behaviour; emotional eating; fussy; instrumental feeding; using food as reward.

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Conflict of interest statement

The authors declare no potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Cross‐lagged model of association between the use of food as reward with child Emotional Overeating. Values represent standardized linear regression coefficients (95% confidence intervals) and are adjusted for covariates. N = 3511, model fit: RMSEA = 0.022, CFI = 0.959 and TLI = 0.907. Wald test comparing lagged pathways: P = .016
FIGURE 2
FIGURE 2
Cross‐lagged model of association between the use of food as reward with child Food Responsiveness. Values represent standardized linear regression coefficients (95% confidence intervals) and are adjusted for covariates. N = 3624, model fit: RMSEA = 0.035, CFI = 0.923 and TLI = 0.826. Wald test comparing lagged pathways: P = .004
FIGURE 3
FIGURE 3
Cross‐lagged model of association between the use of food as reward with child Satiety Responsiveness. Values represent standardized linear regression coefficients (95% confidence intervals) and are adjusted for covariates. N = 3616, model fit: RMSEA = 0.027, CFI = 0.966 and TLI = 0.923. Wald test comparing lagged pathways: P = .43
FIGURE 4
FIGURE 4
Cross‐lagged model of association between the use of food as reward with child Food Fussiness/Picky Eating. Values represent standardized linear regression coefficients (95% confidence intervals) and are adjusted for covariates. N = 3620, model fit: RMSEA = 0.026, CFI = 0.970 and TLI = 0.932. Wald test comparing lagged pathways: P = .501
FIGURE 5
FIGURE 5
Cross‐lagged model of association between the use of food as reward with child BMI. Values represent standardized linear regression coefficients (95% confidence intervals) and are adjusted for covariates. N = 3486, model fit: RMSEA = 0.144, CFI = 0.300 and TLI = 0.000. Wald test comparing lagged pathways: P = .771
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