The increased prevalence of childhood obesity has exploded into a global epidemic and public health issue during the last two decades. China is facing childhood obesity issue as approximately 22% of Chinese children, aged two to six, are overweight or obese. Early childhood is a critical period for the development of eating patterns and activity habits that may influence weight and health outcomes in later childhood and adulthood. However, a paucity of investigators has examined the influence of maternal factors on dietary habits and physical activity in their children, especially in Chinese preschool-aged children. Thus, the aims of this study in preschool-aged children and their mothers (mother-child dyads) were to describe: (1) maternal feeding practices, self-efficacy for healthy eating and physical activity level; (2) maternal factors that are associated with their child’s health behaviors.
Methods:
A cross-sectional study design was employed with mother-child dyad participants recruited from four preschools in Hunan Province in south central China. Individuals were eligible to participate in this study if they meet the following criteria: 1) Children between the ages of three and five years 2) Identified as Chinese, 3) Able to attend regular preschool activities, and 4), Mothers of these children were able to read and write in Mandarin Chinese. Potential eligible participants were contacted by research assistants who were trained by the research team on recruitment and data collection methodology. Participant children had their weight and height measured at preschool sites while mothers completed a set of questionnaires regarding family demographic information, family eating and activity habit, child feeding practices, and maternal self-efficacy regarding their ability to influence their child’s eating and sedentary behaviors. at home. Human subject approval was obtained at the University of California, San Francisco Committee on Human Research at the Central South University in China.
Multivariate regression was utilized to identify factors associated with children’s health behaviors including physical activity, TV and computer viewing time, eating behaviors, and stimulus home environment. Factors included in the model were age of the child, gender, maternal health behaviors (physical activity and eating behaviors), maternal self-efficacy, and maternal feeding practices. SPSS 23.0 software was used to conduct the analysis. A P value less than .05 was considered significant.
Results:
There were 222 mothers and their children included in this study with a mean age of 31.04 (SD + 4.28) and 3.68 (SD +.75), respectively. Approximately 52% of children were boys. More than half (54%) of the mothers completed college or graduate education and 29% completed high school education. About 53% of mothers worked outside of their home.
The average daily time children spent in physical activity and watching TV, playing computer/video games was 1.18 hours (71 minutes) and .75 hour (45 minutes). Higher maternal physical activity level, maternal self-efficacy for limiting screen viewing, and younger age children were related to less screen time in children. A child’s eating style was associated with his/her mother’s eating style (R2 =.44, p <.001). Low maternal self-efficacy for healthy eating, a low perceived maternal feeding responsibility, child female gender, an unhealthy maternal eating style in, and older child’s age was associated with a child’s unhealthy eating behavior (R2 =.20, p =.001).
Conclusion:
Maternal health-related behavior and attitudes regarding feeding practices and self-efficacy are associated with their child’s health-related behaviors including physical activity, sedentary activity, and eating behaviors. As the health of children is critical to the health of the nation and global development, understanding factors related to child’s health-behaviors in first step toward development of tailored and culturally sensitive intervention to promote healthy lifestyle and prevent obesity. Improvement of child’s health behaviors need to incorporate mothers by promoting healthy lifestyle of the mother and self-efficacy regarding providing health home environment for the child.
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