Childhood obesity treatment involving parents is most effective during the preschool age. However, the mechanisms of change are not known. The present study reports on secondary outcomes (changes in parental feeding practices and child food habits) of early obesity treatment. The More and Less study is a randomized controlled trial conducted in Stockholm County, Sweden. Children with obesity (n = 174, mean BMI SDS 3.0, mean age 5 years, 56% girls) and their parents (60% with foreign background, 40% with a university degree) were randomized to: 1) standard treatment focusing on lifestyle recommendations (ST), 2) a parent support program with boosters (PGB), and 3) a parent support program without boosters (PGNB). The Child Feeding Questionnaire (CFQ) was used to measure parental feeding practices. Child food habits were assessed with a Food Frequency Questionnaire (FFQ). We calculated the monthly changes in CFQ practices and FFQ items based on four measurements. We did not find any significant between-group differences in parental feeding practices and child food habits over time. However, general linear models showed that changes in certain feeding practices predicted changes in child food habits. When ST was compared to the parent support groups, some associations moved in opposite directions. For example, increasing maternal restriction predicted increased consumption of cookies/buns in PGNB (b = 2.3, p < 0.05) and decreased consumption of cookies/buns in ST (b = -2.1, p < 0.05). This is the first study to examine the effect of parental feeding practices on child food habits and weight status after obesity treatment among preschoolers. We found no evidence that changes in feeding practices or changes in child food habits mediated child weight loss. Future studies should consider other intermediary processes related to general parenting practices and parent-child interactions.

中文翻译：

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随机对照儿童肥胖试验后父母喂养方式和学龄前儿童饮食习惯的变化

涉及父母的儿童肥胖治疗在学龄前最有效。然而，变化的机制尚不清楚。本研究报告了早期肥胖症治疗的次要结果（父母喂养方式和儿童饮食习惯的变化）。More and Less 研究是一项在瑞典斯德哥尔摩县进行的随机对照试验。肥胖儿童（n = 174，平均 BMI SDS 3.0，平均年龄 5 岁，56% 为女孩）和他们的父母（60% 有外国背景，40% 有大学学历）被随机分配到：1）注重生活方式的标准治疗建议 (ST)，2) 带助推器的家长支持计划 (PGB)，和 3) 不带助推器的家长支持计划 (PGNB)。使用儿童喂养问卷 (CFQ) 来衡量父母的喂养做法。使用食物频率问卷 (FFQ) 评估儿童的饮食习惯。我们根据四次测量计算了 CFQ 实践和 FFQ 项目的月度变化。随着时间的推移，我们没有发现父母喂养方式和儿童饮食习惯的任何显着组间差异。然而，一般线性模型表明，某些喂养方式的变化预示着儿童饮食习惯的变化。当 ST 与父母支持团体进行比较时，一些协会朝着相反的方向发展。例如，增加产妇限制预测 PGNB 中饼干/面包的消费量增加（b = 2.3，p < 0.05），而 ST 中饼干/面包的消费量减少（b = -2.1，p < 0.05）。这是第一项研究父母喂养方式对学龄前儿童肥胖治疗后儿童饮食习惯和体重状况的影响。我们没有发现任何证据表明喂养方式的变化或儿童饮食习惯的变化会介导儿童体重减轻。未来的研究应考虑与一般养育实践和亲子互动相关的其他中介过程。