Maternal Executive Function, Family Routines, and Feeding Practices: Implications for Obesity Prevention

• In Event: 3-242 - Two-Generation Approaches to Intervention in Early Childhood

Integrative Statement

Introduction. Children from families with consistent routines and where parents engage in responsive, non-coercive, feeding practices have healthier diets and are less likely to experience obesity. While most parents desire to engage in parenting practices such as implementing regular family meals, providing consistent mealtime rules and structure, and avoiding engaging in coercive feeding practices, it is increasingly evident that not all parents have equal capacity to do so. Poor executive function (EF), or a limited ability to control thoughts, impulses, and actions, may be an important factor that interferes with parents’ ability to engage in practices that support children’s healthy nutrition and weight. Understanding such associations may offer critical insights for obesity prevention intervention programming. Yet, we know little about parents’ EF in relation to their nutrition and weight-related parenting practices, as no studies have examined such associations to date. This was the goal of the current study.

Hypothesis: Parents with lower EF will be less likely to report that their families have consistent nutrition-related routines and will be less likely to report engaging in responsive, non-coercive child feeding practices.

Study Population: US-based mothers of 492 children ages 2 to 9-years (M=4.8 (SD 2.1) years) were recruited via Amazon MTurk in August 2017 (mothers were selected for study as they remain primarily responsible for feeding of young children).

Methods: Mothers’ EF was measured using the Behavior Rating of Executive Function-Adult Version (BRIEF-A) with higher Global Executive Composite (GEC) T-scores indicating greater EF problems. Nutrition-related family routines and child feeding practices were measured via established, self-report surveys. Standardized, linear regression models were used to examine covariate-adjusted associations. A Bonferroni-adjusted p-value (<.004) was used to indicate statistical significance.

Results: A socio-demographically diverse sample of mothers was recruited via MTurk (mean age = 34.2 (6.7) years, 77% non-Hispanic white, 47% with no college degree). Mothers demonstrating greater EF problems reported fewer family meals per week (Beta (SE)=-0.16 (0.05), p<.001), more frequently eating family meals out of the home (Beta (SE)=0.23 (0.05), p<.001), and having less structure (Beta (SE)=-0.30 (0.04), p<.001) and scheduling (Beta (SE)=-0.20 (0.05), p<.001) of family meals. Mothers’ GEC T-scores were also positively associated with using food to regulate children’s emotions (Beta (SE)=0.23 (0.05), p<.001) and negatively associated with monitoring children’s intake of unhealthy foods (Beta (SE)=-0.21 (0.05), p<.001).

Discussion and Implications. Across nearly all outcomes assessed, mothers with greater EF problems reported lower participation in recommended family routines and feeding practices, suggesting that mothers with lower EF may experience unique barriers to supporting their children’s healthy eating and growth. Adults with poorer EF skills likely require greater scaffolding and support in order to change behavior and engage in recommended practices. Novel interventions are demonstrating promise in strengthening adults’ EF, with positive impacts on adults’ own weight-related behaviors. Integrating strategies to strengthen parent EF and scaffold adoption of recommended family routines and feeding practices may result in more effective family-focused nutrition promotion and obesity-prevention interventions. This research team will additionally present preliminary work they have done to develop such an intervention.

Authors

• Katherine Bauer, University of Michigan, School of Public Health
  Presenting Author

• Alison L. Miller, University of Michigan School of Public Health
  Non-Presenting Author

• Jess Haines, University of Guelph
  Non-Presenting Author

• Julie Lumeng, University of Michigan
  Non-Presenting Author

• Ashley N Gearhardt, University of Michigan
  Non-Presenting Author