Observed parent–child feeding dynamics in relation to child body mass index and adiposity

Background: Restrictive feeding is associated with child overweight; however, the majority of studies used parent-report questionnaires. Objectives: The relationship between child adiposity measures and directly observed parent and child behaviours were tested using a novel behavioural coding system (BCS). Methods: Data from 109 children, participants in a twin study and their mothers, were analyzed. Parent–child dyads were video-recorded twice in the laboratory, while children ate ad libitum from a buffet lunch. Mother and child behaviours were assessed using the BCS. Height, body weight and body fat were directly measured for each child. Associations between child adiposity measures and average BCS behaviour (i.e. pooled across visits) were tested using partial correlations adjusting for child age. Results: Regarding discouragement prompts, child body mass index (BMI) z-score was significantly associated with a greater rate of total discouragements (per minute, min⁻¹), nonverbal discouragements (min⁻¹) and temporary (delay) discouragements (min⁻¹) (p < 0.05). Child percent body fat was associated with greater nonverbal discouragements (min⁻¹). Regarding encouragement prompts, child BMI z-score was significantly associated with a greater rate of total encouragements (min⁻¹), nonverbal encouragements (min⁻¹) and reward encouragements (min⁻¹). Child BMI z-score and percent body fat were both positively associated with greater maternal health encouragements (min⁻¹). Associations with encouragement to eat prompts were no longer significant when accounting for the dependence among twins (being part of the same family). Conclusions: Heavier children received greater maternal discouragements to eat and, with qualifications, encouragements to eat. The role of nonverbal parenting cues warrants further research regarding child eating regulation and obesity.