Date of Award

Spring 2019

Document Type

Open Access Dissertation

Department

Health Promotion, Education and Behavior

First Advisor

Edward A. Frongillo

Abstract

Background: Food insecurity is both a nutritional problem and a stressful life experience of adults and children in households dealing with food shortage. Potential mechanisms of the associations between food insecurity and adverse outcomes in children’s health and development are through parenting and child self-regulation.

Objectives: We investigated parenting and child self-regulation as potential mechanisms for the relationship of food insecurity with child dietary behaviors with two specific aims. Specific aim 1 was to understand how food insecurity and its change over time relate to parenting in early childhood. Specific aim 2 was to understand the relationship of parenting in food-related and non-food-related settings with dietary intake of young children and the role of child self-regulation in this relationship.

Methods: Data were from the Early Childhood Longitudinal Study – Birth Cohort. Parent-child dyads with non-missing outcomes were included into the analysis. Analyses were done separately for boys and girls. Regression models with full information maximum likelihood were used accounting for clusters in Stata. For specific aim 1, the parenting outcomes were parent-child interaction, difficulty sticking with rules, harsh disciplinary practices, rules about watching television, rules about food, routines of eating evening meals as a family and at a regular time in years 2, 4, and 5. Each parenting outcome was first regressed on the earlier food insecurity and covariates, then additionally regressed on the concurrent food insecurity. For Specific aim 2, the child’s dietary outcomes were weekly frequency of intake of sugar-sweetened beverages, sweet foods and desserts, salty snack foods, fruits, and vegetables in year 5. Each child dietary outcome was regressed on food parenting variables at age 4 (i.e., rules about foods, and meal routines of eating as a family and at a regular time) and covariates. General parenting variables at age 4 (i.e., parent-child interaction, difficulty sticking with rules, harsh discipline, rules about watching television, and rules about bedtime), child difficulty in self-regulation at age 4, and their interactions were then added sequentially.

Results: For specific aim 1, earlier food insecurity was associated with using harsh disciplinary practices in year 5, having rules about food in year 4, and having evening meals at a regular time in years 2 and 4 among parents of girls. Among parents of boys, earlier food insecurity was associated with having evening meals at a regular time in years 2 and 4. Concurrent food insecurity was associated with parenting in years 2 and 4 for boys and girls but not in year 5. The magnitude of the associations over time of earlier and concurrent food insecurity with harsh disciplinary practices, rules about food, and meal routines were generally greater for girls than boys. For specific aim 2, better food parenting practices at age 4 were associated with less frequent intake of unhealthy and more frequent intake of healthy foods and beverages in both boys and girls at age 5, with some differences by gender. General parenting practices at age 4 were associated with dietary behaviors differently for boys and girls. Difficulty in self-regulation at age 4 significantly modified the association between parenting practices and child’s dietary behaviors for boys (evening meals at a regular time and intake of sweet foods and desserts) and girls (parent-child interaction and intake of sugar-sweetened beverages; difficulty sticking with rules and intake of sweet foods and desserts; rules about foods and intake of fruits and vegetables; and harsh discipline and intake of fruits).

Conclusions: In early childhood, earlier and concurrent food insecurity were linked with suboptimal parenting in structuring a general and food-related living environment for young children, particularly for girls and by the age of 5, through increased use of harsh discipline, lack of rules about foods, and irregular meal routines. Better food parenting and general parenting practices at age 4 were associated with children’s healthy dietary behaviors at age 5, and the child’s difficulty in self-regulation plays an important role in modifying this association, particularly in girls. Further investigations on the potential mechanisms for the relationship of earlier and concurrent food insecurity with parenting in early childhood and how these mechanisms change as the children reach age 5 are needed. Given that both parents and children could be active agents in the development of children’s dietary behaviors, further investigations will help to identify interventions and programs targeting both parents and children to promote positive parenting in food and non-food settings and support children with difficulty in self-regulation.

Rights

© 2019, Hoa Thi Mai Nguyen

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