Maternal attitudes and child-feeding practices: relationship with the BMI of Chilean children

BACKGROUND Chile has experienced the nutritional transition due to both social and economic progress. As a consequence, higher rates of overweight and obesity have been observed in children. In western countries, researchers have tried to determine pathways by which parents influence their children's eating behavior; up to now findings have been inconsistent. The objective of this study was to evaluate the cross-sectional and retrospective relationship between maternal attitudes and child-feeding practices and children's weight status in children who had been subject of an obesity prevention intervention for two years. METHODS In 2006, for a cross-sectional study, a random sample of 232 children (125 girls, mean age 11.91 +/- 1.56 y and 107 boys mean age 11.98 +/- 1.51 y) was selected from three primary schools from a small city called Casablanca. Weight and height were determined to assess their nutritional status, using body mass index (BMI) z scores. Child-feeding practices and attitudes were determined cross-sectionally in 2006, using the Child Feeding Questionnaire (CFQ). To analyze the relationship between trends in weight change and child-feeding practices and attitudes, BMI z scores of all the 232 children in 2003 were used. RESULTS Cross-sectionally, mothers of overweight children were significantly more concerned (P < 0.01) about their child's weight. Mothers of normal weight sons used significantly more pressure to eat (P < 0.05). Only in boys, the BMI z score was positively correlated with concern for child's weight (r = 0.28, P < 0.05) and negatively with pressure to eat (r = -0.21, P < 0.05). Retrospectively, the change in BMI z score between age 9 and 12 was positively correlated with concern for child's weight, but only in boys (r = 0.21, P < 0.05). Perceived child weight and concern for child's weight, explained 37% in boys and 45% in girls of the variance in BMI z score at age 12. CONCLUSION Mothers of overweight children were more concerned with their children's weight; this indicated the Western negative attitude towards childhood overweight. None of the child-feeding practices were significantly correlated with a change in BMI z score.