Understanding preschool children's emotional eating

: exploring the role of emotion regulation and feeding practices in the development of childhood obesity

Abstract

Background: Emotional eating (EE) is a negative, non-homeostatic trait, found in some individuals when dealing with stress-eliciting events, leading to changes in food intake. It is defined as either emotional undereating (EUE) or emotional overeating (EOE). Previous research suggests parent feeding styles (PFS), a sub-category of a parenting behavioural construct in feeding, and parental feeding practices (PFP), a goal-directed behaviour used to influence child’s eating, play a role in the development of EE in preschool aged children, however their relationship alongside other factors regarding parent and child emotionality remains unclear. 

Aim and Objectives: To investigate the role of parental and child emotionality, specifically, parental emotion regulation(ER), parent affect in feeding, parental EE, and child temperament, on the use of PFS and PFP and on the development of children’s EE behaviours. The main objectives are:(1)To pool current evidence of associations between PFS and PFP and the development of EE in children,(2)To investigate interplay and relationships of these variables within across-sectional study using path analysis,(3)To explore the experience of parents’ and child’s emotionality and behaviours that illuminate these factors within the family environment.

Methods and ResultsStudy 1 A systematic review and meta-analysis of the existing evidence was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Six papers were included from search results of 10,269, with PFP; restriction, pressure to eat (PTE), emotional feeding, and use of food as a reward (UFAR)associated with higher levels of EOE, and monitoring with lower levels. Restriction and PTE were associated with higher levels of EUE and monitoring with lower levels. Meta-analyses found significant positive associations between Restriction and EOE(0.149, p<0.001), and negative associations between Monitoring and EOE(-0.148, p<0.001) respectively. Authoritative and indulgent PFS were associated with higher and lower EOE levels respectively. No associations were found between PFS and EUE.
Study 2 A cross-sectional study following the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guidelines. 1,712 non-randomly sampled parents of preschool aged children completed an online survey. Path analysis showed that whilst controlling for all variables, significant positive associations were found between both children’s EOE and EUE and poor parental ER strategies (0.200[0.365,0.035] and 0.153 [0.210,0.096] respectively), children’s food responsiveness (0.342 [0.493,0.191] and 0.188 [0.239,0.137] respectively), as well as parents’ EE (0.176[0.301,0.051] and 0.134 [0.177,0.091] respectively).Results showed positive associations between children’s EUE and controlling feeding practices UFAR (0.189 [0.246, 0.132]) and ‘PTE’(0.116[0.173, 0.059])’, children’s own negative affectivity (0.102[0.139, 0.065]), parents’ negative AF(0.175[0.212, 0.138]). Negative associations were found between EUE and parents’ positive AF (-0.176 [-0.139, -0.213]),and children’s enjoyment of food (-0.238 [-0.185, -0.291]). Lastly, positive associations were found with EOE and controlling PFP ‘restriction for weight’ (0.333[0.586,0.080]), and although the largest of the associations found, this was relatively weak.

Study 3 A qualitative semi-structured interview study with 21 parents was conducted, following COREQ (Consolidated criteria for reporting qualitative research) guidelines. Thematic analysis found themes; ‘The Mealtime Battleground’, ‘Food for Non-nutritive Purposes’, ‘The Mirroring of Emotional Eating’, ‘Who’s in Charge’, ‘Realisation of Behaviours’, and ‘The Catalyst of Emotion’. The findings highlight the challenges parents discuss regarding their own emotionality and the child’s individual characteristics in the feeding and eating environment.

Conclusion: The development of EE is not solely dependent on the parents actions, such as PFS and PFP, but may be explained in part by a combination of parental ability to regulate one’s own emotions during the mealtime experience, and the children’s own temperament regarding emotional situations and circumstances. Experientially, these give rise to emotionally charged parent/child encounters.

Date of Award	Oct 2021
Original language	English
Awarding Institution	Coventry University
Supervisor	Deborah Lycett (Supervisor), Cain Clark (Supervisor), Jacqueline Blissett (Supervisor), Stefanie Williams (Supervisor) & Kristina Curtis (Supervisor)