The objective was to examine the association between parenting practices, toddler’s dietary intake and BMI. In addition, potential moderation of these associations by general parenting and child temperament was examined.

The current cross-sectional study assessed parenting practices using the Comprehensive Feeding Practices Questionnaire, general parenting using the Comprehensive General Parenting Questionnaire, child temperament using the Child Behavior Check List, and children’s dietary intake through parental questionnaires. Children’s weight and length were objectively measured to determine BMI z-scores. Associations were examined using multiple linear regression analyses. Moderation was examined using interaction terms.

Home setting.

393 Dutch toddlers (age 1–3 years) and their parents recruited through fifty childcare centres and preschools in the Netherlands.

Various practices were related to children’s diet and BMI. For instance, the availability of healthy foods is the most important predictor of healthy dietary intake (e.g. β = –0·35 for sweets; β = 0·18 for fruit). The association of availability with a healthier diet was strongest when parents scored low on the positive parenting style dimensions, including nurturance, structure and/or behavioural control. In addition, it seemed that a high availability of healthy foods and low availability of unhealthy foods is especially beneficial for children showing withdrawal/depressive, anxious or overactive behaviour, while encouraging balance and variety is not beneficial for these children. All other practices were related to children’s diet and/or BMI as well.

The findings underline the importance of viewing the impact of parenting practices in the context of general parenting and child temperament.

The high energy intake from energy-dense foods among children in developed countries is undesirable. Improving food parenting practices has the potential to lower snack intakes among children. To inform the development of interventions, we aimed to predict food parenting practice patterns around snacking (i.e. ‘high covert control and rewarding’, ‘low covert control and non-rewarding’, ‘high involvement and supportive’ and ‘low involvement and indulgent’).

A cross-sectional survey was conducted. To predict the patterns of food parenting practices, multinomial logistic regression analyses were run with 888 parents. Predictors included predisposing factors (i.e. parents’ and children’s demographics and BMI, parents’ personality, general parenting, and parenting practices used by their own parents) and parents’ cognitions (i.e. perceived behaviour of other parents, subjective norms, attitudes, self-efficacy and outcome expectations).

The Netherlands (October–November 2014).

Dutch parents of children aged 4–12 years old.

After backward elimination, nineteen factors had a statistically significant contribution to the model (Nagelkerke R2=0·63). Overall, self-efficacy and outcome expectations were among the strongest explanatory factors. Considering the predisposing factors only, the general parenting factor nurturance most strongly predicted the food parenting clusters. Nurturance particularly distinguished highly involved parents from parents employing a pattern of low involvement.

Parental cognitions and nurturance are important factors to explain the use of food parenting practices around snacking. The results suggest that intervention developers should attempt to increase self-efficacy and educate parents about what constitute effective and ineffective parenting practices. Promoting nurturance might be a prerequisite to achieve prolonged change.

To develop and validate a questionnaire to measure food-related and activity-related practices of child-care staff, based on existing, validated parenting practices questionnaires.

A selection of items from the Comprehensive Feeding Practices Questionnaire (CFPQ) and the Preschooler Physical Activity Parenting Practices (PPAPP) questionnaire was made to include items most suitable for the child-care setting. The converted questionnaire was pre-tested among child-care staff during cognitive interviews and pilot-tested among a larger sample of child-care staff. Factor analyses with Varimax rotation and internal consistencies were used to examine the scales. Spearman correlations, t tests and ANOVA were used to examine associations between the scales and staff’s background characteristics (e.g. years of experience, gender).

Child-care centres in the Netherlands.

The qualitative pre-test included ten child-care staff members. The quantitative pilot test included 178 child-care staff members.

The new questionnaire, the Child-care Food and Activity Practices Questionnaire (CFAPQ), consists of sixty-three items (forty food-related and twenty-three activity-related items), divided over twelve scales (seven food-related and five activity-related scales). The CFAPQ scales are to a large extent similar to the original CFPQ and PPAPP scales. The CFAPQ scales show sufficient internal consistency with Cronbach’s α ranging between 0·53 and 0·96, and average corrected item–total correlations within acceptable ranges (0·30–0·89). Several of the scales were significantly associated with child-care staff’s background characteristics.

Scale psychometrics of the CFAPQ indicate it is a valid questionnaire that assesses child-care staff’s practices related to both food and activities.

To describe the energy-dense snack food (EDSF) and energy-dense drink (EDD) consumption of children in the Netherlands and investigate subgroup differences. The amounts consumed, eating occasions, places of consumption and consumed types are reported.

Twenty-four hour dietary recall data were used to describe the EDSF and EDD consumption. Subgroup differences concerning these intakes were identified with ANCOVA.

Dutch National Food Consumption Survey 2007–2010.

Children (n 860) aged 7–12 years.

The mean number of EDSF events was 3·3 (sd 1·6) per day, yielding 1569·7 (sd 928·7) kJ. Average EDD consumption was 594·2 (sd 342·3) ml/d, yielding 737·2 (sd 495·9) kJ. Over 90 % of the children consumed more energy from non-core foods per day than recommended. Differences in EDSF and EDD consumption were found between several subgroups. Most importantly, we found higher intakes among older children and children with low educated mothers. Almost half of the EDSF events took place in the afternoon and at home. Cookies and sweets were consumed during half of the EDSF events. Almost one-third of the EDD were consumed in the afternoon. The majority of these drinks were consumed at home and most were soft drinks.

The results demonstrate that snack food and drink consumption is highly prevalent among Dutch children. Health promotion efforts addressing these behaviours are warranted and the present study could accelerate these initiatives. Focusing on children with low educated parents and on snacking at home after school offers the greatest potential to reduce snack food and drink intakes.

To examine cross-sectional and longitudinal (one-year follow-up) associations of parental feeding styles with child snacking behaviour and weight in the context of general parenting, taking into account the multidimensionality of the controlling feeding style.

Linear regression analyses were performed. Parents completed a questionnaire to measure five feeding style dimensions (Instrumental Feeding, Emotional Feeding, Encouragement, Overt Control and Covert Control) and children's fruit, energy-dense snack and sugar-sweetened beverage (SSB) intakes. Children's height and weight were measured to calculate their BMI Z-scores. Moderation by parenting style was tested by adding interaction terms to the regression analyses.

Observational study in the Netherlands.

Parent–child dyads (n 1275) participating in the INPACT (IVO Nutrition and Physical Activity Child cohorT) study; children were (on average) 9 years of age.

Instrumental Feeding and Emotional Feeding were negatively related to child fruit intake one year later and positively to (changes in) child energy-dense snack intake. Encouragement was negatively related to child energy-dense snacking and SSB intake one year later. Overt Control was cross-sectionally and prospectively related to (changes in) child energy-dense snacking and SSB intake in a negative direction. Covert Control showed similar associations with child energy-dense snacking and SSB intake as Overt Control. Although Covert Control was also positively related to child fruit intake and (changes in) child BMI Z-score, bootstrapping analyses revealed only a differential effect of Overt Control and Covert Control on child BMI Z-score one year later, with Covert Control displaying a stronger, positive association. Moderation analyses showed that some significant associations between parental feeding styles and outcome measures were dependent on the degree of psychological control and behavioural control.

Instrumental Feeding and Emotional Feeding may have a detrimental impact on children's snacking behaviour, while Encouragement, Overt Control and Covert Control may lead to less energy-dense snacking and less SSB intake. Overt Control and Covert Control have differential effects on child BMI Z-score one year later, which supports the idea that they should be treated as separate constructs. Prospective studies with a longer follow-up may elucidate the causal pathways between the various feeding styles and children's snacking behaviour and weight, as well as the moderating influences of psychological and behavioural control.

The current study examined clustering of dietary intake and activity behaviours (i.e. physical activity (PA) and sedentary behaviour) in 5-year-old children, as well as the longitudinal association with BMI and overweight development.

Principal component analysis (PCA) was used to identify behavioural patterns. Backward regression analyses were used to examine the association of behavioural patterns with parent and child background characteristics, as well as the association of the patterns with BMI Z-score and overweight development up to ages 7 and 8 years.

The Netherlands.

Data originated from the KOALA Birth Cohort Study (n 2074 at age 5 years).

Four patterns emerged: a ‘sedentary-snacking’ pattern (including television viewing and snack consumption), a ‘healthy intake’ pattern (including healthy items such as fruit, vegetables and fish), a ‘sandwich’ pattern (including bread and sandwich fillings) and a ‘sporty-traditional meal’ pattern (including sports, meat and potatoes). The patterns were related to child gender, general appetite and various parental characteristics. The sedentary-snacking pattern was positively associated with longitudinal BMI development.

Cross-behavioural energy balance-related behavioural patterns exist at age 5 years. Different activity types (e.g. sports, television viewing) clustered differently with the behavioural patterns, indicating the need to incorporate these different types instead of one general PA measure in energy balance-related pattern analyses. The clustering and potential synergy between activity behaviours and dietary intake, as well as the associations with weight status development, stress the importance of an integrated approach to PA and healthy nutrition promotion in preventing childhood overweight.