Leann Lipps Birch

Mothers use a range of feeding practices to limit children's intake of palatable snacks (eg, keeping snacks out of reach, not bringing snacks into the home), but less is known about the effects of these practices on children's eating and weight outcomes. The objective was to identify distinct feeding practice profiles and evaluate the interactive effects of these profiles and girls' temperament (inhibitory control and approach) on girls' eating behaviors and weight outcomes at 5 and 7 y. Participants included 180 mother-daughter dyads; measures were mothers' reports of controlling feeding practices and girls' height and weight, eating in the absence of hunger (EAH) at 5 y, and inhibitory control (a measure of behavioral inhibition) and approach (a measure of appetitive motivation) at 7 y. Latent profile analysis of maternal feeding practices showed 4 feeding profiles based on maternal use of limit-setting practices and keeping snacks out of girls' physical reach, a restrictive practice: Unlimited Access to Snacks, Sets Limits+Does Not Restrict Snacks, Sets Limits+Restricts High Fat/Sugar Snacks, and Sets Limits+Restricts All Snacks. Girls whose mothers used Sets Limits+Restricts All Snacks had a higher approach and EAH at 5 y. Low inhibitory control girls whose mothers used Sets Limits+Restricts All Snacks or Unlimited Access to Snacks had greater increases in EAH and body mass index (BMI) from 5 to 7 y. Effects of maternal control on girls' EAH and BMI may differ by the type of practice used (eg, limit-setting or restrictive practices). Girls with low inhibitory control were more susceptible to the negative effects of low and high control.

Obesity prevalence among infants and young children has increased rapidly during the past 4 decades, a disturbing trend given early obesity's association with later life obesity and its comorbidities. Fortunately, infancy is a period of great behavioral and metabolic plasticity offering numerous targets for preventive interventions. Modifiable factors that may affect early rapid weight gain and obesity risk include infant sleep duration, feeding to soothe infant distress, and the introduction of solid foods and transitional feeding. We discuss evidence linking these factors to weight outcomes, as well as results from behavioral obesity interventions in infancy, from our laboratory and others'. For example, in a recent pilot intervention, we focused on helping new mothers address three areas of infant behavior hypothesized to affect weight gain and early obesity risk: infant sleeping, crying, and feeding. First-time mothers were randomly assigned to receive either a Soothe/Sleep intervention, an Introduction of Solids intervention, both interventions, or no interventions. The interventions were delivered via home visits and showed positive effects on infant behaviors and weight outcomes at 1 year. Based on evidence from such pilot interventions, we assess the plausibility of targeting behavioral factors in infancy and suggest next steps for early prevention research.

Currently, children are developing in an obesity-promoting, or obesogenic, environment, which has emerged within the past 3 decades. This rapid change provides a rare opportunity to investigate the phenotypic outcomes that result from the expression of human genetic predispositions in a new environment. Unfortunately, the environmental changes that have occurred are associated with epidemic obesity rates in all age groups. Using a developmental perspective, this article argues that this probabilistic outcome is not predetermined, however. The article also provides examples of learning paradigms—familiarization and associative and observational learning—that present opportunities for parents and caregivers to restructure children’s environments in early life, increasing the likelihood of healthy weight-status outcomes in the context of the current obesogenic environment.

Most childhood obesity prevention efforts have focused on school-age children and adolescents and have had limited success. We argue that the first years of life, including the prenatal period, the postnatal suckling period and the transition to the modified adult diet, may provide opportunities for preventive interventions. These early periods are characterized by high plasticity and rapid transitions, and parents have a high degree of control over children's environments and experiences. Observational and experimental evidence reveal persistent effects of early environments on eating behavior and obesity risk, suggesting that interventions should be tested during these early periods. The central task parents have in early development points to their potential as key targets and agents of change in early preventive interventions. In this paper, we review evidence of early environmental effects on children's eating and obesity risk, highlighting ways that parental feeding practices and parents' own behaviors impact these outcomes and calling for further experimental research to elucidate whether these factors are indeed promising targets for childhood obesity preventive interventions.

The purpose of this study was to explore whether differences in patterns of weight control strategies predict 4‐year weight change among women. Participants (N = 176), were assessed at baseline and biennially on three occasions. Weight control strategies were assessed by the Weight Loss Behavior Scale. Height and weight were measured to calculate BMI. Latent class analysis (LCA) identified groups of women differing in their reported weight control strategies. Repeated measures were employed to examine the relationship between using different types of weight control strategies and weight change before and after adjusting for education, income, and initial BMI. LCA yielded a three‐group solution: use of none (N), healthy (H), and healthy plus unhealthy (H+U) weight control strategies. The N group had the lowest initial BMIs. Women's pattern of weight gain differed by latent group membership after adjusting for covariates: H+U group gained significantly more weight (4.56 kg) than the N group (1.51 kg) and H group (1.02 kg). Similar patterns emerged predicting weight change between years 2 and 4: H+U group gained significantly more weight (2.86 kg) than the H group (0.03 kg) and N group (0.44 kg). H+U weight control group had higher scores on weight concerns, dietary restraint, and eating attitudes than women in the H or N groups. These findings provide evidence that self‐reported weight control attempts do not necessarily lead to large weight gains; rather the amount of weight gain may depend on the type of weight control strategies that women are practicing.

This study describes qualitatively distinct trajectories of BMI change among girls participating in a longitudinal study of non‐Hispanic, white girls (n = 182) and their parents, assessed at daughters' ages 5, 7, 9, 11, 13, and 15 years. Height, weight, body fat, fasting blood glucose and lipids, blood pressure, waist circumference, and pubertal status were measured, and participants self‐reported dietary, physical activity, and television (TV) viewing patterns. Growth mixture models were used to model heterogeneity in girls' BMI trajectories over 10 years. Statistical support was strongest for four distinct BMI trajectories: (i) upward percentile crossing (UPC; n = 25, 14%); (ii) delayed downward percentile crossing (DDPC; n = 37, 20%); (iii) 60th percentile tracking (60PT; n = 52, 29%); and (iv) 50th percentile tracking (50PT; n = 68, 37%). Girls in the UPC group had more metabolic risk factors at age 15 years, even after adjusting for concurrent weight status. Girls in the UPC group had mothers with the highest BMIs at study entry and were breast‐fed for a shorter duration. This novel approach for examining differences in growth trajectories revealed four distinct BMI trajectories that predicted adolescent metabolic health outcomes in girls. The present study provides support for BMI monitoring in girls and for the potential utility of combining data on BMI tracking with data on familial characteristics for the early identification of girls at elevated risk for obesity and metabolic syndrome.

Background: Increased consumption of sweetened beverage has been linked to higher energy intake and adiposity in childhood.Objective: The objective w

Although disinhibited eating is positively associated with higher weight in women, it is not known whether restrained eating and dieting moderate the influence of disinhibited eating on weight change. The objective was to investigate over 6 y the interactive effects of restrained and disinhibited eating and self-reported dieting to lose weight as predictors of weight gain in women. Data were collected from non-Hispanic white women (n = 163) every 2 y. Height and weight were measured in triplicate. Dietary restraint and disinhibition were assessed by using the Eating Inventory. Participants were also asked if they were "currently dieting to lose weight." Multilevel modeling was used to examine change in weight as a function of time-invariant and time-varying predictors, including dietary restraint, dietary disinhibition, and self-reported dieting. After covariates were adjusted for, growth curve models showed that within-person increases in restraint over time were associated with concurrent decreases in weight and that higher levels of restraint moderated the positive association between dietary disinhibition and weight. Women who reported dieting at study entry were heavier at study entry and gained more weight over time than did nondieters. Finally, a significant interaction between restraint, disinhibition, and dieting showed that restraint moderated the effect of disinhibition on weight differently in nondieters than in dieters. Increasing levels of dietary restraint may be beneficial in moderating weight by attenuating the positive association between disinhibition and weight in dieting women. An understanding of weight and weight change requires examination of the interactive effects of restraint, disinhibition, and dieting.