Helping parents—and their kids—eat better

The dietary habits of parents affect how children eat, but a new study investigated just how much influence a parent’s food preferences and patterns pass on to their kids.

The study, published in Nutrition, used data from the Family Life, Activity, Sun, Health, and Eating Study from 2014.¹ The study examined parenting practices and interventions that benefit or harm healthy eating practices in a household. Parents are key to setting the stage for good behaviors, the report concludes.

“Our takeaway message is that parents should be encouraged to model healthful eating with their children by eating nutritious foods, such as fruits and vegetables, and making these foods readily available in their homes. They should also avoid unhealthy junk foods and sugar drinks, and keep these foods from being readily available to children,” says Jessica L. Thomson, PhD, a research epidemiologist and biostatistician in the Delta Human Nutrition Program for the USDA Agricultural Research Service, and lead author of the report.

Six parenting practices were observed in the nearly 1700 parent-child dyads—negative emotions, restriction, monitoring, availability, modeling, and child involvement. Five patterns arose from these practices. These were complete influencers, indifferent influencers, negative influencers, minimal influencers, and disagreeing influencers.

The consumption of added sugars has been linked to a number of poor health outcomes, including obesity, increased risk for cardiovascular disease and diabetes, as well as dental problems and low energy levels. National dietary guidelines in the United States recommend limited sugar intake to less than 10% of one’s daily energy intake, and the World Health Organization took that recommendation a step further by suggesting that no more than 5% of daily energy should be from added sugars.

Whereas added sugar consumption appears to be trending down among some groups, according to the report, sugar intake for children and adults is still too high—at 14% and 17%, respectively. Junk food consumption has dropped, as well by about 10% between 2003 and 2016—but more than 70% of total calories and 90% of total sugars consumed by children and teens respectively were from junk foods.

Parents’ feeding and eating practices have a huge influence over their children’s eating habits and weight status, the report explains. Structure and autonomy are practices that are generally associated with healthy dietary behaviors and coercive control—including pressure to eat certain things, restricting foods, or using foods as a reward—have a more negative effect on a child’s eating habits. Pressure to eat and food restriction habits were observed mainly by age, gender, and weight status, with fathers having a greater role in feeding older children and pressuring their sons on diet more, and mothers more often taking the primary role in feeding young children and praising their daughters for eating. Food restriction, on the other hand, happens more often where there is an overweight or obese child.

A lot of research has focused on the actions of parents in regard to diet habits, but the researchers point out that there is a big child element at play, too. How much does the child believe the parent has the right to set rules about their eating habits? This idea—called legitimacy of parental authority—influences whether the child believes they should obey their parents or not. This concept is especially important because children usually seek more autonomy and less parental guidance as they age.

Younger child dyads were not likely to fall into the indifferent or minimal influencers groups compared to older children. Children whose parents added sugars had higher chances of being in the indifferent and negative influencers groups—about 5% higher odds for every teaspoon increase, but greater child added sugars lowered the odds of being in the minima, influencers groups—dropping about 6% for every teaspoon of sugar added. Parental authority was also a deciding factor on eating habits, with dyads that had lower child scores for legitimacy of parental authority regarding junk foods and sugary drinks being 18 times more likely to belong to the disagreeing influencers.

Overall, patterns and parenting styles that were a mix of the 3 major practices—coercive control, structure, and autonomy support—were associated with lower added sugar intake in both parents and their children. Patterns that centered on coercive control, or little guidance whatsoever, were more often associated with higher sugar intake by both parents and their children.

The key to modeling healthy eating, the report notes, is a combination of good behaviors and access.

“The combination of not buying a lot of junk food or sugary drinks for children—availability—and avoiding eating junk food and sugar drinks when children are around—modeling—were observed to have the most positive impact on children’s added sugars consumption,” Thomson says.

Counseling or intervening with parents to support some autonomy, as well as some guidance and positive influence may be the most effective strategy—or at least more effective than coercive strategies, the report concludes.

Thomson says outpatient providers like pediatricians should educate parents about healthy foods and encourage their children to eat them. Fruits and vegetables should be easily accessible and encouraged, whereas junk foods and sugary drinks are better off having a limited presence in the home.

“It could be phrased in terms of ‘foods necessary for proper growth’ and ‘foods with negative effects on proper growth,’” Thomson says. “Parents should be encouraged to eat ‘growing foods’ with their children and when their children are around.”

Nutrition counseling can be tricky, because providers must educate parents just as much as children. This can be uncomfortable, but it’s necessary.

“We hope our research encourages pediatric clinicians to have conversations with parents of their patients about healthful dietary intake, as well as ways they can encourage or enable their children to eat healthfully,” she says. “We also hope our research helps clinicians understand the importance of parenting practice effects, both positive and negative, on children’s diet and ultimately children’s weight status.”

Reference

1. Thomson J, Hennessy E, Landry A, Goodman M. Patterns of food parenting practices regarding junk food and sugary drinks among parent-child dyads. Nutr J. 2020;19(1). doi:10.1186/s12937-020-00610-3