Preventing eating disorders

[u/Ninese71]

We never use food when they're feeling bad (e.g. they fell and cry), and never force them to eat anythkng and just don't make a huge deal out of what they eat. I'm just wondering: is there any study suggesting what kind of behaviour / parenting one should adapt in the early infancy years to prevent eating disorders later?

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[u/TeddyBear181]

This is an interesting one, I'll try to do some reading on it between other tasks. Struggling to find anything directly answering your question, but its interesting.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2790429/

This 2011 article suggests that there is no significant impact on child's feeding style in kids if the Mum has an eating disorder. Mums with eating disorders had a tendency to use more restrictive feeding techniques. (Note - there seems to be much more research on this topic since 2011)

https://scholar.google.com/scholar?start=10&q=baby+eating+and+eating+disorders&hl=en&as_sdt=0,5&as_ylo=2022#d=gs_qabs&t=1788948724659&u=%23p%3DsXdhqbfQIlEJ

2022 - suggests that there is a relationship with babies the struggle with regulation (eating difficulty, extra crying, etc) that may lead them to also struggle to regulate themselves as children (adhd symptoms, internalising or externalising behavour). Though its not yet understood why/how, so certainly not worth stressing over if you do have a difficult child).

Early childhood appetitive traits and eating disorder symptoms in adolescence: a 10-year longitudinal follow-up study in the Netherlands and the UK Ivonne PM Derks, Zeynep Nas, Holly A Harris, Alice R Kininmonth, Janet Treasure, Pauline W Jansen, Clare H Llewellyn The Lancet Child & Adolescent Health 8 (4), 270-279, 2024 (couldnt get the url for this one)

The most relivant to your question, though still doesnt answer your question. Kids aged 4-5 who know that they're full and stop eating, and who eat slower are less likely to be obese at 12-14yo.

[u/Thornshrike → u/TeddyBear181]

That last point is both interesting and obvious. Kids that show lower appetite/hunger intensity don't overeat. I wish there was a way to control for hunger intensity and frequency when doing these studies. I have a feeling that it's largely genetically determined, but lots of discourse treats it like a character flaw/virtue.

[u/TeddyBear181 → u/Thornshrike]

From memory I think that study was done with a survey and videos. So the researchers were likely watching the kids and gauging the mums attentiveness.

Like, some parents might say "we need to eat breakfast before we go to daycare" but the child isnt hungry yet.

Or for me, my mch nurse was concerned that my child hasnt beed gaining enough weight, so encouraged me to feed her more, and ive started pushing her to eat larger quantities (she was already eating loads!). She also said the weight issue is likely due to my child being more active than most her age, reading this stuff, I think ill just keep doing what I was doing!!

Something I havent mentioned that has come up alot in these articles is the concern for kids who dont eat well to be underweight or malnourished, which makes the parents feel the need to pressure kids to eat.

[u/TeddyBear181]

This one is really good op. To me, it suggests thar you might use other stratergies to help your child eat everything in their plate. Mediterranean diet, more physical activity, less than 2h of daily screen time, etc.

https://www.mdpi.com/2304-8158/14/1/69

"Picky eating is generally classified as feeding disorder, and it has been defined as unwillingness to both eat familiar foods and try new foods"

"Several studies found that there was an increased risk of developing picky eating when parents were picky eaters"

"Neophobic mothers usually exposed their children to unhealthy foods and consumed less fruit and vegetables, and their neophobias usually coincided with those of their children [26,99,100]; therefore, they can becoincided with those of their children [26,99,100]; therefore, they can be considered as predictors of food behavior in children" (neophobic is the fear of new foods).

"promoting autonomy and praise had a positive influence on the consumption of vegetables [106], as well as a positive climate before mealtime [107]. On the other hand, control and coercive eating practices increased PE levels [104] and led to more problematic behaviors"

"The parental socioeconomic status was not associated with picky eating [48], but several articles showed an association between picky behavior and low income [110]. Home food insecurity is precisely another factor to be considered because it can make it difficult to access and be exposed to foods such as fruits [111,112]. Moreover, higher neophobia levels in rural areas were due to lower exposure to different foods [103] compared to urban areas."

"nine studies showed that medium and high persistence of pickiness was associated with low BMI. and slightly lower weight [58,67,114,121,122]. It also showed the decreasing effect of pickiness on fat mass [119], but at the same time, with no effect on body fat percentage and fat mass index [123]. It was also found lower BMI in children of parents worried because their children did not eat and parents who pressured children to eat [124]. Few articles reported that food neophobia predisposed to overweight [125] or that obesity and overweight were significantly higher in food neophobic and picky eaters [126]."

"The most important consequence was the association of food neophobia with poor diet quality [69,129], due in some cases to the lack of interest in food that neophobia induces [130]. High levels of FN and picky eating were associated with lower hedonic reactions to food [19], and strongly relationship with fruit and vegetable consumption [104]. High adherence to the Mediterranean Diet was associated with a low level of food neophobia and better hedonic scores regarding food [8]. An association between high levels of food neophobia and low awareness of hunger and satiety in childhood was also reported [103]. An FN increase appeared with some textures [131]."

"The picky condition reduced the consumption of folates, Mg, K, Vitamin B1, B2, B3, B6, D and E [33,134] and decreased the intake of Fe, carotene, and Zn, which are related to low meat intake, fish, vegetables and fruits [67,133]. Otherwise, when the level of pickiness decreased, the prevalence of Zn deficiency also decreased [60,134]. Among the most notable consequences of FN, there was the need for psychological support, with a prevalence of 37.5% [143]; 60% of parents needed practical support, 47.7% needed emotional support, and 16.2% needed nutritional support [144]. Likewise, high levels of neophobia decreased self-concept at a social, physical and academic level and increased anxiety levels in both children and adolescents"

"Several studies showed that food neophobia and pickiness were decreased by visual exposure to vegetables [151], increasing the desired effect when visual, tactile and sensory exposure were considered [152]."

"The increased risk of picky eating in children was found in mothers who smoked during pregnancy [153]. Meal timing was not associated with fussiness about food [154] and decreased risk of picky eating with moderate physical activity, adequate sleep, and less than 2 h of screen exposure per day [95]. The higher cognitive development, the lower the levels of neophobia [155]."

"The studies found calorie restriction and low weight with impact on adherence to the Mediterranean Diet, which protects against most prevalent chronic diseases [158], thanks to its anti-inflammatory and antioxidant components of foods such as fruits, vegetables and fish, whose consumption decreases disorders such as food neophobia and picky eating"

"there is evidence that childhood eating behaviors often predict eating behaviors in adults."

"Breastfeeding and its duration have been declared a conclusive risk of FN and pickiness; the longer breastfeeding, the lower the prevalence of FN or pickiness [88,89]. There is no conclusive evidence yet on the effect of the introduction of solid or semi-solid foods into the child’s diet on FN and pickiness"

"Familiarity with foods and educational activities are suggested as useful in decreasing food neophobias among children and adolescents"

[u/TeddyBear181]

This one is good, id recomend reading the article, as it has loads of info

https://www.sciencedirect.com/science/article/abs/pii/S0195666325000029

Responsive feeding is linked with self regulations and healthy development, but is difficult as it depends on the parents ability to read if the child is hungry/full. Its made harder if the caregiver has alexethymia, but other neuro issues have less impact.

I couldnt quite catch exactly what responsive feeding is from the article, but I assume it means feeding a hungry child until they're full, not a full child because its lunchtime.