The Child Feeding Questionnaire (CFQ) is a self-report questionnaire for assessing parental attitudes to child weight and parental feeding practices. revious evaluations of its psychometric properties were conducted primarily with small to medium-sized samples ( N < 500) and a small range of children's age. The present study aims to analyze the psychometric properties of the CFQ in a large German community sample and, for the first time, to establish normative data. Within the population-based LIFE Child study, the CFQ was administered to N - 982 mothers of 2- to 13-year-old children. Psychometric analyses on item statistics and internal consistency were conducted. Using structural equation modeling, four empirically-based factorial models of the CFQ were evaluated, and measurement invariance across child age groups and sex was examined. Age-specific norms for the CFQ subscales were computed. Item statistics were highly favorable for the majority of items, but floor and ceiling effects were found for 14 of 31 items. Internal consistency of the CFQ subscales ranged from acceptable to excellent (0.71< a < 0.91), except for the subscale Perceived Responsibility (a - 0.65). Regarding factorial validity, an eight-factor model with the newly created Reward subscale provided the best fit to the data. This model was factorial invariant across child sex and adjacent age groups. Maternal and child weight status showed large effects on CFQ subscale scores. The analyses established good psychometric properties for the German version of the CFQ and confirmed an eight-factor model. The provided norms allow for the comparison of individual parental feeding practices and change over time. The CFQ's sensitivity to change and longitudinal associations of parental feeding practices and child weight status warrant further research.

Overweight and obesity in children and adolescents are among the most crucial public health issues of the 21st century and are already determined in the prenatal period. In order to prevent the development of overweight and obesity, examining and changing their risk factors is important to reduce the current epidemic of overweight and obesity. Therefore, the aim of this thesis was to investigate risk factors of overweight and obesity from the prenatal period to childhood and to examine the preceding determinants of those risk factors. On the basis of three studies, the influence of maternal risk factors on maternal mental health during pregnancy (Study 1) and maternal mental health during pregnancy on birth outcomes and weight status in early childhood (Study 2), and the associations of parental feeding practices and weight status during childhood (Study 3) were examined. The results showed that pregnant women with higher pre pregnancy body mass index, sleep problems, and who did not plan pregnancy were at higher risk for mental health problems during pregnancy (Study 1), which in turn adversely affected birth weight and gestational age at birth (Study 2). Furthermore, weight status during childhood was found to be the cause of parents employing controlling feeding practices during childhood but weight status seemed to be largely unaffected by such practices (Study 3). Overall, study results were interpreted within the context of the current state of research and implications of the results for future research and practice were discussed.:Abbreviations Bibliographic summary 1 Introduction 1.1 Overweight and obesity in children and adolescents 1.1.1 Prevalence rates 1.1.2 Developmental dynamics 1.1.3 Consequences on health 1.1.4 Prevention and intervention 1.2 Parental predictors of overweight and obesity in children and adolescents 1.2.1 Prenatal predictors 1.2.1.1 Maternal anthropometric risk factors and medical conditions 1.2.1.2 Maternal behavioral risk factors 1.2.1.3 Maternal psychosocial and mental risk factors 1.2.2 Predictors during childhood 1.2.2.1 Parental feeding practices 2 Research needs and study objectives 2.1 Mental health in pregnant women and its influence on birth outcomes 2.1.1 Study objectives and hypotheses: Manuscript 1 2.1.2 Study objectives and hypotheses: Manuscript 2 2.2 Anthropometric development during childhood and parental feeding practices 2.2.1 Study objectives and hypotheses: Manuscript 3 3 Publication manuscripts 3.1 Gestational weight gain, physical activity, sleep problems, substance use, and food intake as proximal risk factors of stress and depressive symptoms during pregnancy 3.2 Maternal depressive symptoms and stress during pregnancy as predictors of gestational age at birth and standardized body mass index from birth up to 2 years of age 3.3 Stability, continuity, and bi directional associations of parental feeding practices and standardized child body mass index in children from 2 to 12 years of age 4 Summary 5 References 6 Appendix 6.1 Declaration of unaffiliation 6.2 Curriculum vitae and publication list 6.3 Acknowledgment

Childhood overweight and obesity are public health concerns that have negative health consequences and affect many children. Efforts are needed to identify children who are at a higher risk of developing overweight and obesity so that early detection and treatment may be offered. The intent of this study was to investigate the differences in the effects of postpartum depression on infant feeding practices and infant weight gain between Hispanic and African American women. Data were obtained from Infant Feeding Practices Study 11, a longitudinal study involving mothers in their third trimester through infants first year of life. The overall test of model coefficient of complete cases (N = 192, missing = 443) was not statistically significant (x-² = 4.842, df =2, p = 0.089). The result of the overall test after multiple imputation (n = 289) remained insignificant (on average x-² = 4.031, df = 2, p = 0.133). However, results indicated a significant association between excessive infant weight gain and feeding practices (breast feeding vs. formula feeding; r = 0.207, p = 0.01), supporting previous research on the protective effect of breast feeding on excess infant weight gain. Positive social change implications include an understanding of how maternal and infant characteristics may identify early symptoms of maternal depression, through increased awareness and reduced incidents of childhood obesity and maternal postpartum depression.

L’alimentation infantile est très encadrée par les instances médicales. Elle constitue donc un point d’observation privilégié de la médicalisation du quotidien et des conditions de diffusion des cultures savantes. Afin d’expliciter les déterminants sociaux de l’alimentation infantile, deux ensembles de données sont mobilisés : d’une part, un corpus documentaire, composé d’articles scientifiques, de publications à destination des parents et des échanges tenus sur un forum en ligne consacré à la puériculture, d’autre part, les données de l’Étude longitudinale française depuis l’enfance. Cette enquête aborde les thématiques du développement, de la santé et de l’alimentation d’un échantillon d’environ 18300 nourrissons, elle renseigne également le détail des caractéristiques sociodémographiques des parents. La première partie de la thèse est consacrée aux conditions de production et de diffusion des recommandations médicales en matière d’alimentation infantile. Nous montrons que, d’une part, les luttes pour le monopole de l’autorité scientifique à l’intérieur de l’espace de la recherche en nutrition pédiatrique, d’autre part, les demandes particulières des pouvoirs publics et des industriels adressées aux experts de l’alimentation infantile, révèlent l’incertitude et la variabilité des recommandations médicales en matière d’alimentation infantile. La réception par les parents de ces recommandations peut alors prendre la forme d’une appropriation des recommandations dominantes, d’une appropriation des recommandations dominées considérées comme mieux actualisées ou d’une mise à distance, parfois très critique, des recommandations médicales voire de la résistance au principe même d’une puériculture médicalisée. La deuxième partie montre que la conformité aux recommandations médicales de l’alimentation des nourrissons est fonction de l’interaction entre le niveau de diplôme des mères et les conditions de leur socialisation au maternage (notamment, leurs pratiques de recherche d’information en matière de diversification alimentaire). Ainsi, la réception de la puériculture médicalisée apparaît dépendante autant du rapport entretenu, par les parents, à la médecine comme système abstrait que du rapport qu’ils entretiennent aux représentants de ce système. Ces rapports étant fonction de l’expérience scolaire des parents. Dans une troisième partie, nous montrons que les répertoires alimentaires maternels ont un effet propre ainsi qu’un effet conditionné aux caractéristiques sociales des mères sur l’alimentation des enfants durant leur première année. / Medical instances strongly control infant feeding. Then parental feeding practices are a means of observing medicalization of everyday life and diffusion of science-based practices. In order to explain the social determinants of parental feeding practices, two sets of data are used: a corpus of documents composed of scientific articles, publications aimed at parents and conversations held on an online forum that concerns childcare and, on the other hand, the French longitudinal study from childhood. This study gathers information on 18300 infants. The study broaches questions of infant development, health and feeding. It also gives details on parents’ socio-demographic characteristics. The first part of this thesis is confined to conditions of production and diffusion of medical recommendations concerning infant feeding. We demonstrate that, firstly the struggle for the monopoly on scientific authority within the field of research in pediatric nutrition and secondly the specific demands of public authorities and industries transferred to experts of infant nutrition, reveals the uncertainty and the variations of the medical recommendations concerning infant nutrition. Parents receptiveness of those medical recommendations can take the form of an appropriation of the mainstream recommendations, an assimilation of minor recommendations considered as the most up to date, or a distancing, sometimes very critical, of the medical recommendations, or even more the resistance to the very idea of medicalised parental practices. The second part shows that the conformity to medical recommendations of infant feeding is a product of the interaction between mothers’ education levels and the conditions of their socialisation to maternity (in particular their methods of researching information on complementary feeding). Therefore, the receptiveness of medicalised childcare appears to be dependent as on the relationship between the parents and medicine, as an abstract system, as on the relationship between parents and representatives of that system. These relationships are a product of the educational experience of the parents. In the third part, we demonstrate that the mother’s feeding repertoires have a proper effect, and an effect conditioned by parents' social characteristics, on infant feeding during their first year.

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The health and well-being of U.S. children is challenged by the immense crisis of obesity. The obesity proneness model, first described by Costanzo and Woody (1985), describes one mechanism by which parents influence obesity development. This model suggests that parents become concerned about their children's weight if their children show signs of becoming overweight and parents value weight highly. Parents communicate their concerns to their children and restrict their children's eating. Children internalize parents' concerns and become unable to regulate their eating. Hence, parents socialize children to be concerned about their weight but do not equip them to regulate eating, thus contributing to the development of obesity. Previous research has examined model components, primarily from parents' perspectives. This study examined the model from the adolescents' perspectives and employed structural equation modeling to test and refine a modified model and determine the best predictors of obesity among adolescents. The study was non-experimental in design, employing a secondary analysis of cross-sectional data collected as part of a modified Youth Risk Behavior Survey (YRBS) administered in Sarasota County, Florida, high schools during fall 2006. Models were tested and modified in a training sample, Sample A (N = 784); final models were cross-validated in a hold-out sample, Sample B (N = 749). Findings suggested that a refined model was plausible (χ²/df = 331.97/64, TLI = 0.94, RMSEA = 0.07; χ²/df = 226/64, TLI = 0.95, RMSEA = 0.06, Samples A and B, respectively). Many paths were statistically significant; e.g., students who perceived mothers to be concerned about their weight were likely to think mothers perceived them as heavier, valued weight highly, had restrictive feeding practices, and made comments about their weight. Students with greater internalized concern about weight were likely to think mothers made comments about their weight and were heavier. Girls were more likely than boys to think mothers were concerned about their weight. Internalized concern about weight, but not inability to self-regulate eating, was predictive of weight status. Interventions addressing some of the model's constructs may provide a partial solution to problems of weight and inability to self-regulate eating behaviors.

The purpose of this study was to describe the nutrition knowledge and child care feeding practices of Early Childhood Education students in a university setting. Thirty-three Early Childhood Education students from seven geographically diverse universities completed a web-based survey assessing nutrition knowledge and child feeding practices. A nutrition knowledge instrument was developed and validated to measure knowledge of nutrition for preschool-aged children. The Comprehensive Feeding Practices Questionnaire, which has been previously validated in parents, was slightly modified and used to assess child feeding practices. Mean scores for the nutrition knowledge and child feeding practices were determined. Multivariate analyses were conducted to determine differences in mean nutrition knowledge and feeding practices scores across sample characteristics. Early Childhood Education students were found to have more knowledge of MyPyramid food groups and dietary sources of nutrients than dietary intake recommendations for preschool-aged children. Students who had completed a college-level nutrition course scored higher on MyPyramid food groups and food sources of nutrients than those who had not, although these differences were not statistically significant. A nonsignificant trend was observed in knowledge of dietary recommendations according to practicum status. Additionally, students who had not started a practicum reported using food as a reward significantly more than students who had completed a practicum. Results suggest roles for both nutrition coursework and practicum training in optimizing nutrition knowledge and child feeding practices among future leaders in early childhood education. Further research is needed to more clearly identify nutrition knowledge and child feeding practices in this population.

Early life factors play important roles in disease susceptibility in later life. However, the relationship between dietary factors in early life on childhood growth, especially linear growth, remains unclear. This research aimed to improve our understanding of the associations between dietary factors in early life (i.e., infant feeding practices and age of introduction of solid foods) and childhood growth, especially using ulnar length as a surrogate measure of length/height, in a cross-sectional study of 1634 mother-child dyads across eight study centers in the National Children's Study Formative Research in Anthropometry in the United States from 2011-2012 (Chapter 1). Chapter 2 described the data acquisition and preprocessing procedures used in this research and provide practical guidelines of data quality control. In Chapter 3, predictive models for exclusive breastfeeding (XBR) initiation and duration was developed. Discriminant analysis revealed maternal sociodemographic factors had greater discriminating abilities to predict XBR initiation and XBR for 6 months, compared to child birth characteristics and maternal perinatal factors. Chapter 4 demonstrated that ulnar length can serve as an accurate and reliable surrogate measure of recumbent length in healthy infants/children aged 0-1.9 years and of height in healthy children aged 2-5.9 years, respectively. Bland-Altman plots and mixed-effects linear regression analyses showed that the three simple and portable tools (i.e., caliper, ruler, and grid) used to measure ulnar length could be used interchangeably in terms of prediction accuracy. Chapter 5 focused on assessing the interplay among gestational weight gain (GWG), birthweight, infant feeding practices, and childhood anthropometrics. Longer duration of breastfeeding reduced the positive associations of GWG and birthweight with weight-for-age z-scores, weight-for-height/length z-scores, and body mass index-for age z-scores in non-Hispanic Whites. These findings underscore the importance of promoting breastfeeding among women with excessive GWG to mitigate childhood obesity. Longer breastfeeding and a later age at introduction of solid foods had positive effects on ulnar length, a linear growth parameter of upper extremity, in Hispanics. Future prospective research aiming to investigate the underlying mechanisms that drive ethnic variation in these associations between early life dietary factors and childhood growth is warranted (Chapter 6). / text

Made available in DSpace on 2015-05-14T12:43:25Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1299945 bytes, checksum: 8aef972702cd5d88622fdfbc88f35a71 (MD5) Previous issue date: 2009-10-09 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study discusses about food practice speeches of cook women in Belo Jardim, Pernambuco, in rural and urban zone, analyzing, in voices of these women, the meanings produced in the discursive practice of orality, their stories, the identity marks of the city through food practices. The research material is, in essence, interviews on the making of these women, as well as information from other people of the community. It examines aspects relating to historical memory, revived by the subjects in this city and their daily, the spaces of silence in the voices of the interviewees, as well as crossed cultural aspects and/or directly connected to what is conservative and innovative in doing and/or the resistance to new, to the new technology and its use in kitchens. Get records of historical heritage of food, emphasizing its importance in society and in academic circles, which promotes a better dialogue multi, inter and transdisciplinary. It shows, through the cultural history, the gastronomic sensitivity, and its social dynamic, explained by social and cultural events: the eating like a social act constitutes attitudes linked to the habits and customs, behaviors and situations. It also discourses about issues such as the identity crisis, occurred with the structural change in modern societies in compliance with food practices on women's voices cooks. Inventions and reinventions in daily women in times of crisis and abundance. Theoretical and methodological basics that guide the search is based on studies examining of Discourse Analysis of french guidance, particularly Michel Pêcheux, Michel Foucault and also Eni Orlandi. Other sources support this study, like Eclea Bosi on the interrelations between memory and society, Jacques Le Goff, Michel de Certeau, Louis da Câmara Cascudo, Jean-Louis Flandrin, Roberto DaMatta, José Carlos Sebe Bom Meihy. It is noted by this research that the oral narratives say much about the history of everyday life, cultural practices and identities of a place, recalled for ideological discourses, translated in the construction of the senses. Keywords: Discourse Analysis. Feeding practices. Culture. Identity. / O presente estudo versa sobre os discursos das práticas alimentares das mulheres cozinheiras de Belo Jardim, interior de Pernambuco, no espaço rural e urbano, analisando, nas vozes dessas mulheres, os sentidos produzidos na prática discursiva da oralidade, suas histórias, as marcas identitárias da cidade através das práticas alimentares. O material de pesquisa constitui-se, na sua essência, de entrevistas sobre o fazer dessas mulheres, além de informações de outras pessoas da comunidade. Analisa os aspectos referentes à memória histórica, revivida pelos sujeitos nessa cidade e o seu cotidiano, os espaços do silêncio nas vozes das entrevistadas, bem como os aspectos culturais atravessados e/ou diretamente ligados ao que é conservador e inovador no fazer e/ou a resistência ao novo, à nova tecnologia disponível no mercado e o seu uso nas cozinhas. Levanta registros de patrimônios históricos da alimentação, destacando a sua importância na sociedade e nos meios acadêmicos, o que impulsiona um maior diálogo multi, inter e transdisciplinar. Mostra, através da história cultural, a sensibilidade gastronômica e sua dinâmica social, explicada pelas manifestações culturais e sociais: o comer como um ato social que constitui atitudes ligadas aos usos e costumes, condutas e situações. Trata também de questões como a crise de identidade, ocorrida com a mudança estrutural nas sociedades modernas na observância das práticas alimentares nas vozes das mulheres cozinheiras. As invenções e reinvenções no cotidiano dessas mulheres em tempo de crise e de fartura. Os fundamentos teórico-metodológicos que norteiam a pesquisa baseiam-se nos estudos da Análise do Discurso de orientação francesa, especialmente Michel Pêcheux, Michel Foucault, e também Eni Orlandi. Outras fontes fundamentam este estudo, a exemplo de Eclea Bosi sobre as relações existentes entre memória e a sociedade, Jacques Le Goff, Michel de Certeau, Luís da Câmara Cascudo, Jean- Louis Flandrin, Roberto DaMatta, José Carlos Sebe Bom Meihy. Constata-se, pela presente investigação, que as narrativas orais dizem muito sobre a história do cotidiano, as práticas culturais e as identidades de um lugar, relembradas pelos discursos ideológicos, convertidos na construção dos sentidos.