Associations of food parenting practices in early childhood with dietary intake, BMI, and weight status in young adulthood: the KOALA Birth Cohort Study

BACKGROUND: Little is known about how early food parenting practices (FPPs) influence long-term diet and weight. This study examined associations of FPPs in early childhood- specifically restriction, pressure to eat, monitoring, and stimulation of healthy eating-with dietary intake, BMI, and weight status in young adulthood. METHODS: We used data from the KOALA Birth Cohort Study in the Netherlands. At age 5 years, mothers reported FPPs using a 5-point Likert scale based on the Child Feeding Questionnaire (scale 1-5). At age 19 years, young adults self-reported their dietary intake and BMI via an online questionnaire, including a food frequency questionnaire. Food intake was categorized as 0-1, 2-3, or 4-7 days per week (scale 1-3). Associations were analyzed using ordinal logistic, binary logistic, linear, and robust regression models. RESULTS: Questionnaires at both ages were available for 824 participants. The stimulation FPP "I make sure that my child eats enough healthy food products" was associated with lower unhealthy (B = -0.06), and higher healthy (B = 0.07) food intake. Regarding individual food categories, pressure to eat was associated with consuming more fried snacks (OR = 1.34), and less cooked vegetables (OR = 0.77). Restriction was associated with consuming more fried snacks (OR = 1.41), cookies (OR = 1.34), and pastries (OR = 1.42). Monitoring was associated with higher soda intake (OR = 1.29). The stimulation FPP was associated with consuming less fried snacks (OR = 0.67), cookies (OR = 0.70), and more fruits (OR = 1.65) and cooked vegetables (OR = 1.35). Regarding weight, pressure to eat was associated with lower BMI (B = -0.37) and reduced overweight risk (OR = 0.66), but these associations were nonsignificant after adjusting for BMI z-scores at age 5. CONCLUSIONS: Early FPPs may shape long-term dietary behaviors. Supportive, structured practices that stimulate healthy eating without coercion appear more beneficial than restrictive or pressuring practices. Longitudinal studies considering mediating and moderating factors are needed to clarify long-term associations between FPPs, dietary, and weight outcomes.