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Tylka T.L.,Ohio State University | Eneli I.U.,Center for Healthy Weight and Nutrition | Eneli I.U.,Ohio State University | Kroon Van Diest A.M.,Texas A&M University | Lumeng J.C.,University of Michigan
Eating Behaviors | Year: 2013

Researchers have started to explore the detrimental impact of maladaptive maternal eating behaviors on child feeding practices. However, identifying which adaptive maternal eating behaviors contribute to lower use of negative and higher use of positive child feeding practices remains unexamined. The present study explored this link with 180 mothers of 2- to 5-year-old children. Hierarchical regression analyses (controlling for recruitment venue and maternal demographic characteristics, i.e., age, education, ethnicity, and body mass index) examined mothers' intuitive eating and eating competence as predictors of four feeding practices (restriction, monitoring, pressure to eat, and dividing feeding responsibilities with their child). Mothers who gave themselves unconditional permission to eat were less likely to restrict their child's food intake. Mothers who ate for physical (rather than emotional) reasons and had eating-related contextual skills (e.g., mindfulness when eating, planning regular and nutritious eating opportunities for themselves) were more likely to monitor their child's food intake. Mothers who had eating-related contextual skills were more likely to divide feeding responsibilities with their child. No maternal eating behavior predicted pressure to eat. Interventions to help mothers develop their eating-related contextual skills and eat intuitively, in particular, may translate into a more positive feeding environment for their young children. © 2012 Elsevier Ltd. Source

Tylka T.L.,Ohio State University | Lumeng J.C.,University of Michigan | Eneli I.U.,Center for Healthy Weight and Nutrition | Eneli I.U.,Ohio State University
Appetite | Year: 2015

Mothers who are concerned about their young child's weight are more likely to use restrictive feeding, which has been associated with increased food seeking behaviors, emotional eating, and overeating in young children across multiple prospective and experimental studies. In the present study, we examined whether mothers' intuitive eating behaviors would moderate the association between their concern about their child's weight and their use of restrictive feeding. In a sample of 180 mothers of young children, two maternal intuitive eating behaviors (i.e., eating for physical reasons, trust in hunger and satiety cues) moderated this association after controlling for maternal age, body mass index, years of education, race/ethnicity, awareness of hunger and satiety cues and perceptions of child weight. More specifically, concern about child weight was unrelated to restrictive feeding for mothers with higher levels of eating for physical reasons and trust in hunger and satiety cues. However, concern about child weight was positively related to restrictive feeding among mothers with lower or average levels of eating for physical reasons and trust in hunger and satiety cues. These findings indicate that it may be important address maternal intuitive eating within interventions designed to improve self-regulated eating in children, as mothers who attend these interventions tend to be highly concerned about their child's weight and, if also low in intuitive eating, may be at risk for using restrictive feeding behaviors that interfere with children's self-regulated eating. © 2015 Elsevier Ltd. Source

Ramstetter C.L.,University of Cincinnati | Murray R.,Center for Healthy Weight and Nutrition | Garner A.S.,Rainbow Hospitals
Journal of School Health | Year: 2010

BACKGROUND: Recess is at the heart of a vigorous debate over the role of schools in promoting optimal child development and well-being. Reallocating time to accentuate academic concerns is a growing trend and has put recess at risk. Conversely, pressure to increase activity in school has come from efforts to combat childhood obesity. The purpose of this review was to examine the value of recess as an integral component of the school day. METHODS: A comprehensive review of recess-specific literature was conducted, beginning with a Google Scholar search, to cull definitions, position statements, and policy recommendations from national/international associations and organizations. A multi-database search followed. Additional articles were selected from reference lists. RESULTS: The search yielded a range of articles, from those focused on specific aspects of recess to those that examined multiple factors, including how to structure and conduct recess. Several themes emerged supporting recess as beneficial for children's cognitive, social, emotional, and physical functioning. Optimal recess was well-supervised and safe. Crucial components were well-maintained playground equipment and well-trained supervisors. CONCLUSION: Recess serves a critical role in school as a necessary break from the rigors of academic challenges. Recess is a complement to, not a replacement for, physical education. Both promote activity and a healthy lifestyle; however, recess-particularly unstructured recess and free play-provides a unique contribution to a child's creative, social, and emotional development. From the perspective of children's health and well-being, recess time should be considered a child's personal time and should not be withheld for academic or punitive reasons. © 2010, American School Health Association. Source

Eneli I.U.,Center for Healthy Weight and Nutrition | Wang W.,Center for Innovation in Pediatric Practice
Obesity | Year: 2013

Objective To examine identification and counseling for obesity at pediatric office visits associated with psychotropic medications. Design and Methods Analysis of ambulatory care visits by children 2-17 years in the National Ambulatory Medical Care Surveys and outpatient component of the National Hospital Ambulatory Medical Care Surveys from 2005 to 2008. Physician identification of obesity was determined using ICD-9 CM diagnostic codes. Results In 2005-2008, there were 38,539 pediatric ambulatory care visits weighted to represent 600 million pediatric visits nationally. Psychotropic medications were associated with 5.2% of visits. The prevalence of overweight/obesity (BMI ≥ 85th%tile) was 15.9% for visits without psychotropic medication, 19.4% and 16.8% for visits associated with nonobesogenic and obesogenic psychotropic medications, respectively. Controlling for age, gender, and BMI, obesity was more likely to be identified at visits associated with psychotropic medications (OR 5.2, 95% CI 3-8.8), among females (OR 1.6, 95% CI 1.1-2.3) and non-Hispanics (OR 1.5, 95% CI 1.0-2.4). At visits with psychotropic medications, dietary counseling was provided at 11.4%, while blood pressure and cholesterol screening were obtained at 6.9% and 6.8% of these visits, respectively. Conclusions Our results indicate suboptimal identification and counseling for obesity children who are prescribed psychotropic medications, despite their increased risk for weight gain. Copyright © 2013 The Obesity Society. Source

Bass R.,Childrens Hospital of Philadelphia | Eneli I.,Center for Healthy Weight and Nutrition
Postgraduate Medical Journal | Year: 2015

Childhood obesity is a serious and urgent public health problem. In the last 10 years, there has been a concerted effort in the USA and globally to develop and implement educational, medical and public health interventions designed to attenuate its growth. The success of these efforts was probably responsible for the plateau in the prevalence rate of childhood obesity noted in the last two years. While the attenuation of the overall prevalence of childhood obesity is promising, data from the same cohort reveal a concerning upward trend in the number of children with severe obesity. The consequences of severe childhood obesity can be devastating. When compared to their moderately obese peers, children with severe obesity are at greater risk for adult obesity, early atherosclerosis, hypertension, type 2 diabetes, metabolic syndrome, fatty liver disease and premature death. The determinants for severe obesity include the same lifestyle, environmental, familial and societal risk factors reported for overweight or obesity. While all these risk factors must be screened for, genetic influences are distinct considerations that may have greater bearing especially with early-onset obesity. Treatments for severe childhood obesity include lifestyle intervention, specialised low-calorie diets and bariatric surgery. Outcomes of these treatments vary, with bariatric surgery clearly the most successful of the three for both short-term and long-term weight loss. Severe obesity in children and adolescents remains a challenging health condition. The enormous medical, emotional and financial burden these children and their families endure signals an urgent need to further investigate and standardise treatment modalities and improve outcomes. © 2015, BMJ Publishing Group. All rights reserved. Source

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