Relationships Among Parental Psychological Distress, Parental Feeding Practices, Child Diet, and Child Body Mass Index

Background Parents often play a main role in establishing the dietary patterns of preschool children, but there is no clear understanding about the relationship between parental psychological distress and child diet and body mass index (BMI). Objective The aim of this study was to examine the relationships among parental psychological distress, parental feeding practices, child diet, and child BMI in families with young children. Methods We conducted a mixed-methods study with families (parent-child dyad) of children aged 2-5 years. Measures included demographic data, parental general stress, parenting stress, parental sleep quality, parental depressive symptoms, social support for parents, mealtime environment, child feeding practice, child diet, and child BMI, with well-validated questionnaires completed by parents. Using structural equation models, we examined the path relationships of these factors. We also interviewed a subsample of 13 parents. Results A total of 256 families participated. Higher parental psychological distress was associated with higher parental unhealthy feeding practices (B = 0.31, p <.01). However, a parental unhealthy practice in feeding was not associated with child's unhealthy diet or BMI. There was no direct relationship between parental psychological distress and child BMI. Social support for parents was significantly inversely related to parental psychological distress (B = -11.59, p <.01), and the relationship between social support for parents and parental unhealthy feeding practices approached significance (B = 6.11, p =.05). A main theme from analysis of parent interview was that parent stress and fatigue influenced their feeding and food preparation. Discussion Parental psychological distress is a critical influential factor in parental feeding practices. This finding highlights potential foci in intervention programs to address parental psychological distress.