Associations Between Caregiver Eating Competence, Caregiver Weight Status, and Child Obesity in Toddlerhood

• In Event: Poster Session 12
  In Poster Session: PS 12 Topic - Health, Growth, Injury

Abstract

Background:
Satter (2007) conceptualized an eating competence framework as eating attitudes and behaviors that balance the body’s need to be fed with the pleasure of eating a variety of desired foods. Although several studies provide evidence for a negative association between eating competence and obesity risk among adults (Lohse et al., 2010), none have investigated a relationship between caregiver eating competence and offspring obesity. Given that caregiver and child obesity are highly interrelated (Reilly et al., 2005), and that past research points to a tenuous relationship between caregiver eating behaviors and child obesity (Hood et al., 2000), the association between caregiver eating competence and child obesity warrants further exploration.

The present study aims to examine the relationship between caregiver eating competence at child age 18 months and child obesity status at age 24 months.
Methods:
Staff recruited 300 child-caregiver dyads (Columbus, OH) and measured caregiver weight and height at the first study visit when children were 18 months old and again at a visit when the children were 24 months old. At the 18-month visit, caregivers completed the ecSatter (Satter, 2007), a 16-item measure assessing adult eating competence (e.g. “I am relaxed about eating”).
Child obesity variables were calculated using Body Mass Index (BMI) z-scores per World Health Organization standards (>2 Standard Deviations above the mean denoted obesity). Caregivers with ecSatter scores >32 were considered eating competent. Child obesity status and eating competence were examined in relation to child sex, gestational age, and caregiver weight status (underweight/ healthy, BMI<25; overweight, BMI ≥25 and <30; obese, BMI ≥30). Simple log-binomial regression models were built to examine the relationship between binary caregiver eating competence scores and child obesity status. Cumulative logit models were built to examine the relationship between caregiver eating competence and caregiver obesity status. Past evidence suggests gender differences in the relationship between caregiver eating behavior and child BMI (Cutting et al., 1999), thus child gender was evaluated as a potential effect modifier.
Results:
Caregivers who were not eating competent were twice as likely (2.11, 95% CI: 1.30, 3.42) to have a higher BMI category than caregivers who were eating competent, when adjusted for caregiver sex, race, and education.
Caregiver eating competence at 18 months was not associated with child obesity status at 24 months (RR = 1.10; 95% CI: 0.57 to 2.11). The interaction between child obesity status and child gender was not statistically significant, therefore, child gender was included in the model as a confounder rather than an effect modifier.

Conclusion:
This study supports past evidence for an inverse relationship between eating competence and obesity among adults. It is possible that age 24 months was too early to detect a relationship between caregiver eating competence and child obesity because the relationship between caregiver obesity and child obesity strengthens as children approach school age. (Safer et al., 2001). Longitudinal studies following children to school-age would help clarify the relationship between caregiver eating competence and child obesity status.

Authors

• Melissa Kravets, Nationwide Children's Hospital
  Presenting Author

• Jacqueline Sullivan, Nationwide Children’s Hospital
  Non-Presenting Author

• Andria Parrott, Nationwide Children’s Hospital
  Non-Presenting Author

• Sarah Anderson, The Ohio State University
  Non-Presenting Author

• Rebecca R. Andridge, The Ohio State University
  Non-Presenting Author

• Bharathi Jayanthi Zvara, University of North Carolina at Chapel Hill
  Non-Presenting Author

• Sarah Keim, The Research Institute at Nationwide Children’s Hospital
  Non-Presenting Author