Tracing Family Links to Restrained Eating

Restrained eating, or limiting intake to either lose weight or avoid gaining weight, is a risk factor for body dissatisfaction and eating pathology. Two recent studies examined the links between parental food restriction and restricted eating among their children.

A study of 404 Dutch families

In the first study, Dr. Harriëtte M. Snoek and researchers at Radboud University, Nijmegen, The Netherlands, recently sought to learn if parents could influence eating behaviors, especially restricted eating, by their children (Appetite 2009; 52:461).

It is generally believed that parents can have an important influence on eating behaviors of their children by modeling and transmitting preferences, beliefs, and attitudes toward eating. Also, family members often resemble each other in weight, food choices, and preferences. However, the link between restrained eating among parents and their children was not clear-cut.

The study included 404 Dutch families of both parents and two teenaged siblings recruited from the general community. Boys and girls were equally represented (boys: 50.3%; girls: 49.7%) and the average age was 15.2 years for older teens and 13.4 years for younger teens. The parents were generally well educated, and 36% of mothers and 49.6% of fathers had a college or university degree.

Restrained eating was assessed in three “waves,” using the Dutch Eating Behaviour Questionnaire (DEBQ), which includes 33 items that measure emotional, external, and restrained eating.

An example of a restrained eating question is, “Do you try to eat less at mealtimes than you would like?” Height, weight, and body mass index were recorded for all family members at each session. At baseline, the average body mass index (BMI, kg/m2) was 25.64 for fathers, 24.39 for mothers, 19.90 for older boys and girls, and 18.66 for younger boys and girls. Also at baseline, the parent-child relationship was described by the adolescents about both parents separately.

Over the three waves, increases or decreases in restrained eating were tested with paired t-tests. And, an alternative model, with a smaller subset of teens and parents was tested in which baseline (wave 1) BMI of the parents and BMI z-scores for the teens were included.

Results suggested a connection but were not clear-cut

Over the three waves, girls scored higher on restrained eating than did boys, and mothers had higher scores than did fathers; all differences were statistically significant. The authors reported modestly significant cross-sectional correlations at all measurements between spouses, between siblings, between mothers and both adolescents, between fathers and older teens, and between fathers and younger teens. Stronger correlations with mothers’ restrained eating scores were found for younger daughters at waves 2 and 3 and for older daughters at wave 3.

While significant cross-sectional associations were found between parents’ and adolescents’ restrained eating, over time the parents’ behavior did not predict adolescents’ restrained eating, or vice versa. Thus, although the teens resembled their parents in restrained eating, there was no direct evidence of familial transmission of this behavior. According to the authors, the explanation may be that familial influences start at an earlier age, before adolescence, or that factors other than transmission, such as genetics and peer influences, are involved.

A second study: few links found

In the second study, researchers at Sanford Research/USD, Sioux Falls, SD, and the University of Minnesota surveyed 116 overweight adolescents and their parents or guardians at an urban Midwest adolescent health clinic (Appetite 2009; 52:266). No significant associations were found between dissatisfaction with body shape or parental food monitoring and adolescent food hiding and weight control behaviors after controlling for demographic factors. The authors did find that adolescent food hiding behaviors were positively associated with parental food restriction.

According to the authors, interventions with parents of overweight adolescents should focus on helping parents talk with their children about weight concerns in a nonjudgmental way. Such interventions can teach parents strategies to both create a healthful home environment and to guide and support their children to lose weight in a healthy way.