IRB #18342 Supported by NIH grants HD32973 & M01 RR10732

1. The Girls' NEEDS Project Goodness of Fit Between Child Temperament and Parent Feeding Practices Predicts Weight Outcomes in a Longitudinal Sample of Girls Stephanie L. Anzman & Leann L. Birch The Center for Childhood Obesity Research, The Department of Human Development and Family Studies; The Pennsylvania State University BACKGROUND PARTICIPANTS RESULTS cont’d • There was a significant interaction between inhibitory control and restriction, such that girls with lower inhibitory control and higher restriction demonstrated more weight gain over time (p<.05) and the highest BMIs at study termination (p<.01), compared to girls with higher inhibitory control. • On average, the girls with lower inhibitory control and higher restriction cross into the overweight range over time (greater than the 85th percentile for age and sex, CDC Growth Charts; see Figure 1). On average, the girls with higher inhibitory control remain below the 85th percentile at all time points. • Results were similar when adjusting for girls’ BMI at age 5, family income, and maternal and paternal education and BMI at study entry. • Mother-rated inhibitory control and child-rated restriction were not significantly correlated (p=.58). • Inhibitory control is the ability to restrain a dominant response and execute a sub-dominant response. • This behavioral construct is an aspect of temperament that overlaps with impulse control, self-regulation, and executive function and is an important contributor to many aspects of healthy development. • However, little is known about its implications for weight outcomes in the current environment. • The current environment has been conceptualized as obesogenic, promoting excessive intake and sedentary behavior in many individuals. • Individual differences in behavioral styles could help to explain why some individuals become obese in such an environment, whereas others do not. • Additionally, parents’ restrictive feeding practices have been implicated in problems with self-regulation, particularly children’s overeating and overweight. Inhibitory control may have different implications for weight outcomes depending on parents’ levels of restriction. • 197 non-Hispanic White girls • Assessed at age 5, 7, 9, 11, 13, and 15 • 2/3 of parents reported some college education • Most commonly reported income category - $51,000 to 75,000 MEASURES • Inhibitory control: mother reported when girls were 7 years old, using the Child Behavior Questionnaire (CBQ; Rothbart et al., 2001) • BMI: calculated from measured heights and weights at all time points • BMI change scores: individual slopes calculated from BMI at ages 7, 9, 11, 13, and 15 (calculated only for participants with four of the five data points, including age 15; n=167) • Restriction: girls’ reports of parents’ restrictive feeding at age 7, using the Child Feeding Questionnaire (Birch et al., 2001) • Demographic covariates were measured at study entry (girls’ age 5): family income, maternal and paternal education level and BMI BMI =Weight (kg) Height (m)2 DISCUSSION RESULTS • Whereas a positive energy balance is necessary for growth, many children experience a positive energy balance that is too high, as evidenced by increasing rates of childhood overweight. • In addition to predicting social, intellectual, and moral development, this study showed that inhibitory control predicted weight outcomes. • The combination of lower inhibitory control and high parental restriction predicted the least healthy weight outcomes over time. Overtly restrictive practices are not a good fit for children who already struggle with inhibitory control. • These results cannot demonstrate causality, although the findings related to change and adjustment for age 5 BMI suggest that inhibitory control temporally preceded weight outcomes. • Goodness of fit between temperament and parenting practices could attenuate the risk of obesity in the current environment. • Potential avenues for intervention include shifts from overt to covert restriction in feeding (i.e., focus on the availability of healthy foods from which children can choose), especially in cases where children are low on inhibitory control. a ab b b OBJECTIVES • To investigate whether girls’ inhibitory control levels predicted weight outcomes, including • concurrent weight status • weight change from age 7 to 15 • subsequent weight status • To examine whether girls’ reports of parental restrictive feeding at age 7 moderated the relation between inhibitory control and weight outcomes (i.e., a goodness of fit hypothesis). Figure 1. Average BMI change by inhibitory control and restriction groups, with corresponding BMI percentiles. Overall differences in the four groups’ age 15 BMI (F(148,3)=4.83, p<.01) and average BMI change scores (F(145,3)=3.42, p<.05) were demonstrated. Different subscripts to the right of the lines indicate statistically significant differences between groups on BMI change and age 15 BMI. Birch, L. L., Fisher, J. O., Grimm-Thomas, K., Markey, C. N., Sawyer, R., & Johnson, S. L. (2001). Confirmatory factor analysis of the Child Feeding Questionnaire: A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite, 36, 201-210. Rothbart, M. K., Ahadi, S. A., Hershey, K., & Fisher, P. (2001). Investigations of temperament at three to seven years: The Children's Behavior Questionnaire. Child Development, 72, 1394-1408. 1Inhibitory control and restriction were continuous variables (range 1-7; 1-3) but were split at the middle of their response scales to create categories that would facilitate interpretation (low IC / low res n=15; low IC / high res n=21; high IC / low res n=69; high IC / high res restriction n=62). Results were similar when using the continuous and categorical variables in analyses. When using continuous variables, predictors were centered to avoid Heywood cases. IRB #18342 Supported by NIH grants HD32973 & M01 RR10732