Associations between child weight and maternal feeding styles are mediated by maternal perceptions and concerns

Objective: To determine whether controlling parental feeding practices are associated with children's adiposity and test the hypothesis that any associations are mediated by maternal perception of their child's weight. Method: Children aged 7-9 years (n405) were weighed and measured at school as part of the Physical Exercise and Appetite in CHildren Study (PEACHES). Adiposity was indexed with body mass index s.d. scores. The Child Feeding Questionnaire was completed by 53% of mothers of participating children (n213). Mothers reported whether they thought their child was overweight, normal weight or underweight, and rated their concern about future overweight on a 5-point scale. Results: Higher child adiposity was associated with lower pressure to eat and higher restriction scores. Restriction increased linearly with maternal concern about overweight, and maternal concern about overweight fully mediated the association between child adiposity and restriction. Use of pressure increased as mothers perceived their child to be thinner, but perceived weight did not mediate the association between child weight status and maternal pressure to eat. Monitoring was not associated with child adiposity, maternal perception of weight or concern about overweight. Conclusion: Restriction appears to be a consequence of mothers' concern about their child becoming overweight rather than a cause of children's weight gain. Pressure may be a more complex response that is influenced by the desire to encourage consumption of healthy foods as well as ensure adequate energy intake and appropriate weight gain.