The Role of Food Insecurity and Caregiver Feeding Styles in Diet Quality and Weight Status in Head Start Children

Year: 2009

Research Center: Southern Rural Development Center, Mississippi State University

Investigator: Stuff, Janice E., Sheryl O. Hughes, Theresa Nicklas, and Richard M. Shewchuk

Institution: USDA, Agricultural Research Service

Project Contact:
Janice E. Stuff USDA, Agricultural Research Service, Children’s Nutrition Research Center
1100 Bates
Houston, TX 77030
Phone: 713-798-7066


Food insecurity may create family pressure and stress that affects parenting behaviors and parent-child interactions. Prior research indicates that economic hardship is linked to harsher and less responsive parent-child interactions, resulting in adverse outcomes for children. Therefore, food insecurity may reflect more hardship associated with less competent parenting and less competent feeding practices, including those that increase the risk of low-income children to be overweight or obese. A limited number of studies have explored the interrelationship between food insecurity, feeding styles, or parenting styles and health or feeding outcomes for infants and children.

Earlier studies that examined parents’ feeding styles and their influence on children’s diet quality or weight status focused on the restrictive (demandingness) and not the supportive (responsiveness) domains of parenting, without regard to food security status. Findings demonstrated that high parental control of a child’s food intake does not lower caloric intake compared with lower parental control. Parental attempts to restrict access to highly palatable foods may actually increase children’s demand for these foods. Parental pressure and restriction of food may promote children to focus on negative cues (emotional or external) rather than on positive cues (internal hunger and satiety).

Using the parenting-style typology as a framework, we developed an instrument that includes both the demandingness and responsiveness aspects of parenting to categorize how low-income parents fit into feeding styles. From these two domains, four feeding styles of authoritarian, authoritative, indulgent, and uninvolved emerged. Authoritarian parents encourage eating by using demanding and nonresponsive approaches, the authoritative type encourages eating by using nondirective and supportive behaviors, indulgent parents impose few demands but remain supportive, and uninvolved parents make few demands on their children to eat and are unsupportive. In this study, these variables were measured by using the instrument described.

The goal of this study was to determine the interrelationship between food insecurity and caregiver feeding styles in the outcomes of diet quality and weight status in Head Start children. To answer the research questions for this study, we completed a secondary analysis on data collected from a cross-sectional assessment of mother-child dyads (n=755) in Head Start families recruited from Head Start centers in three geographical areas: northern rural Alabama, northern urban Alabama, and southeastern urban Texas. We administered the feeding-style questionnaire to the primary caregiver and characterized the respondent in one of four styles in the feeding of their preschool child: authoritarian, authoritative, indulgent, or uninvolved. Demographic characteristics of the caregiver and child examined were age, marital status, and ethnicity. We interviewed the parent and used the Nutrient Database System (NDS) methodology to collect one complete 24-hour dietary recall for the child’s food intake on the weekend. Using the USDA Center for Nutrition Policy and Promotion guidelines for calculating the Healthy Eating Index-2005 (HEI-2005), we computed the 12 component and total scores of the HEI-2005 by using specific information from data files generated by the data analysis from NDS (nutrients, ingredients, and serving count). The food security status of the household was measured by the short six-question version of the U.S. Household Food Security Scale. Finally the height and weight of the child were measured and then converted to body mass index (BMI Z-score) according the Center for Disease Control standards for children.

The sample was comprised of African-American (43 percent), Hispanic (28 percent), and White (29 percent) children. Food insecurity was significantly associated with race/ethnicity; Hispanics had the highest prevalence of food insecurity (50 percent), whereas Blacks and Whites were 25 percent and 34 percent, respectively. The overall distribution of feeding style was 33 percent indulgent, 30 percent authoritarian, 19 percent uninvolved, and 16 percent authoritative. Food insecurity was significantly associated with feeding style; 37 percent of the food insecure were indulgent, and 38 percent were authoritarian. Significant differences by race were found by feeding style: 31 percent of Whites, 38 percent of Hispanics, and 40 percent of Blacks were authoritarian.

Evaluation of the impact of food insecurity on primary outcomes of weight status, or HEI-2005 total and component scores, revealed no significant differences. Race and feeding styles continued to influence weight and diet outcomes. White children had a mean BMI Z-score of 0.99, Hispanic 0.89, and African-American 0.50. Children with an indulgent parent had a mean Z-score of 1.05, authoritative 0.82, uninvolved 0.81, and authoritarian 0.68. The overall mean HEI-2005 score was 52.7 (out of the optimal 100.0 score). Hispanics had the highest mean score at 54.2, followed by Whites 50.7, and African-Americans 52.3.

The mean HEI-2005 scores by feeding styles were authoritative 53.0, authoritarian 52.9, indulgent 52.8, and uninvolved 51.9. No differences were detected for HEI-2005 until race was entered as a covariate, and a race and race feeding interaction was observed. The highest scores were African-American authoritarian (54.7), Hispanic indulgent (56.2), and Hispanic uninvolved (54.6). These findings show that race was a strong predictor of diet and weight status outcomes. Trends in feeding style and race show promising aspects for further research and interventions for health outcomes of low-income children.

Direct inquiries about this study to the Project Contact listed above.