207Clin. Pract. (2014) 11(2), 207–220 ISSN 2044-9038
part of
The prevalence of obesity and overweight in children has reached a concerning plateau
in the past three decades, with overweight or obesity impacting approximately a
third of youth. Unhealthy weight-related behaviors, such as dieting, skipping meals,
fasting and binge eating, are also a great public health concern for young people
given both their high prevalence and harmful consequences. Food-related parenting
practices, including food restriction and pressure-to-eat, have been associated with
higher weight status, as well as the use of unhealthy weight-related behaviors, in
children and adolescents. Physicians and other healthcare providers who work with
families should discourage parents from using food restriction and pressure-to-eat
parenting practices with their child or adolescent. Alternatively, parents should be
empowered to promote healthy eating by focusing on making nutritious food items
readily available within their home and modeling healthy food choices for their child
or adolescent.
Keywords:  adolescents • child feeding practices • children • disordered eating • food-related
parenting practices • food restriction • obesity • overweight • parenting • pressure-to-eat
Both obesity and engagement in unhealthy
weight-related behaviors, including meal
skipping, fasting or purging, are major public
health problems among children and adolescents
because of their high prevalence and
potentially serious physical and psychosocial
consequences [1]. Research suggests that obesity
and unhealthy weight-related behaviors
can occur simultaneously [2–5], increase in
severity over time, and lead to the onset of
Katie A Loth*,1
, Jayne A
Fulkerson2
& Dianne R
Neumark-Sztainer1
1
Division of Epidemiology & Community
Health, School of Public Health,
University of Minnesota, MN 55455, USA
2
School of Nursing, University of
Minnesota, MN 55455, USA
*Author for correspondence:
fall0075@umn.edu
Food-related parenting practices and child
and adolescent weight and weight-related
behaviors
Review
10.2217/CPR.14.5 © 2014 Future Medicine Ltd
ld &
rs
Practice Points
•	 The prevalence of overweight or obesity in children and adolescents has reached a
concerning plateau in the past three decades, impacting approximately a third of youth.
•	 Unhealthy weight-related behaviors, such as dieting, unhealthy weight control practices
and binge eating, are also a great public health concern for young people given both their
high prevalence and harmful consequences.
•	 The use of controlling food-related parenting practices, including food restriction and
pressure-to-eat, have been associated with an increased risk of being overweight, as well
as the use of unhealthy weight-related behaviors, in children and adolescents.
•	 Many parents may welcome recommendations from healthcare providers to help them
guide decisions about how to help their children maintain a healthy weight and a healthy
relationship with food.
•	 Physicians and other healthcare providers should discourage parents from using food
restriction and pressure-to-eat parenting practices with their child or adolescent.
Alternatively, parents should be empowered to promote healthy eating by focusing on
making nutritious food items readily available within their home and by modeling healthy
food choices for their children.
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208 Clin. Pract. (2014) 11(2)
severe health conditions (e.g., high blood pressure, diabetes
or clinically significant eating disorders). These
observations suggest a need for developing interventions,
clinical approaches and clinical messages aimed
to simultaneously prevent obesity and a spectrum of
weight-related problems. Such an integrated approach
could have advantages in terms of cost–effectiveness,
practicality and consistency of clinical health messages.
Understanding shared risk factors of obesity
and unhealthy weight-related behaviors and identifying
effective prevention strategies are critical for health
promotion. A growing body of evidence indicates that
the family environment plays an integral role in child
and adolescent weight status and unhealthy weightrelated
behaviors, such as dieting, unhealthy weight
control practices and binge eating. Specifically, foodrelated
parenting practices have been identified as
potentially significant correlates of weight status and
unhealthy weight-related behaviors in children and
adolescents [6].
This article focuses on discussing what is currently
known within the scientific literature about associations
between food restriction and pressure-to-eat foodrelated
parenting practices and youth weight status and
weight-related behaviors, including dietary intake patterns
and disordered eating behaviors. Furthermore,
this review explores observed inconsistencies within
the literature, highlights gaps within the current literature
and suggests areas for future research. Finally,
evidence-based recommendations for physicians and
other healthcare providers who work with parents of
young people are discussed. Studies described within
this review of the literature were obtained via searches
on both PubMed and Google Scholar using keywords
including: food-related parenting practices, parent
feeding practices, child feeding practices, food restriction,
pressure-to-eat and Child Feeding Questionnaire.
Table 1 should be referred to to guide your reading
of this review article and provides definitions and
examples for terms utilized throughout this article.
Overweight & obesity among children
& adolescents
The prevalence of overweight and obese in American
children and adolescents has reached a concerning plateau
after a dramatic rise throughout the past three
decades; being overweight or obese affects approximately
a third of youth [1]. Overweight and obesity
are widely accepted terms utilized to describe ranges
of BMI that are greater than what is generally considered
healthy for a given height [1]. Childhood obesity
is defined as a BMI at or above the 95th percentile for
children of the same age and sex; childhood overweight
is defined as a BMI at or above the 85th percentile and
lower than the 95th percentile for children of the same
age and sex [1].
Overweight and obesity are unequally distributed
among adolescents by family income and race; the
prevalence of overweight within certain subgroups
approaches 50% [1]. Children from lower socioeconomic
status (SES) families and neighborhoods have
higher prevalence rates of obesity than youth from
higher SES families and neighborhoods [1]. Within
race/ethnicity, the prevalence of obesity remains the
highest among children and adolescents from ethnic
minority groups, including African–American, Native
American and Hispanic young people [1]. These disparities
in weight status suggest that the long-term
consequences of this trend will disproportionately
affect those youth from low SES backgrounds and
minorities.
Significant health consequences exist for children
and adolescents whose weight-to-height ratio or
BMI, identifies them as obese or overweight. Physical
comorbidities of overweight/obesity during childhood
include metabolic syndrome, Type 2 diabetes,
hypertension, hyperlipidemia, sleep disorders, and
among adolescent girls, polycystic ovary syndrome
[7]. Research has demonstrated that children and adolescents
who are overweight/obese experience psychosocial
difficulties. Psychological and psychosocial
problems, such as depression, lower self-esteem, lower
quality of life and less perceived social acceptance, have
also been associated with being overweight during
childhood [8]. These psychological and psychosocial
challenges are thought to be a result of the weight bias
that overweight children experience, not the weight
status itself. Both the physical and emotional consequences
of being overweight/obese have the potential
to place a significant burden on the adolescent, family,
healthcare system and society in general when the
prevalence of overweight and obesity is so high.
Furthermore, some of these adverse health conditions
may persist into adulthood. Longitudinal studies
have shown that children who are overweight or obese
have an increased risk of becoming overweight or obese
adults [9]. Overweight or obesity during childhood has
been linked to an increased likelihood of hypertension
in adulthood [10]. Metabolic syndrome in childhood
has been linked to metabolic syndrome and Type 2
diabetes in adulthood [11]. High blood pressure and
cholesterol in childhood have also been associated with
poor cardiovascular outcomes in adulthood [7]. These
few longitudinal studies indicate that there are significant
long-term consequences of childhood overweight
and obesity, many of which currently may not yet be
fully understood as the rate of overweight and obesity
has rapidly increased over the past few decades.
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www.futuremedicine.com 209
Unhealthy weight-related behaviors among
children & adolescents
Unhealthy weight-related behaviors, including dieting,
unhealthy and extreme weight-control practices
and binge eating, are also a great public health concern
for adolescents within the USA, given both their
high prevalence and harmful consequences [12]. The
high prevalence of unhealthy weight control practices
future science group
Food-related parenting practices & child & adolescent weight & weight-related behaviors  Review
Table 1. Terms utilized within the present article: definitions and examples.
Term Definition Example(s)
Unhealthy weight-related
behaviors
A broad category of behaviors reported by children
and young people that stand in contrast to the
development of a healthy body weight and a
healthy relationship with food
Dieting, unhealthy weight control
practices, eating in the absence of
hunger, dietary restraint, emotional
disinhibition and binge eating
Unhealthy weight control
practices
Unhealthy behaviors an individual engages in with
the goal of weight loss or preventing healthy weight
gain
Fasting, skipping meals, smoking
more cigarettes, taking diet pills or
laxatives, or purging
Food-related parenting
practices
The techniques that parents use to influence
children’s eating, food choices or food intake
patterns
Parents encouraging children to eat,
or not eat, specific foods; requiring
children to clean their plate at
mealtimes; rewarding behaviors
with favorite foods; and restricting
the intake of particular foods (both
healthy and unhealthy)
Food restriction When parents limit or restrict their child’s intake of
certain foods or use a highly desired food item as a
reward for consuming a less desirable food item
Parents only allowing their child
to eat dessert after the child has
consumed a full serving of vegetables.
This results in restriction of child’s
access to the dessert item until a
particular requirement is met
Pressure-to-eat When parents prompt or pressure their child to
consume a certain amount of food or more of a
particular type of food
Parents requiring their child to eat
all of the food on their plate prior to
completing a meal
Dietary restraint Cognitive restriction of food intake Actively avoiding food despite feeling
hungry and enjoyment of the food
available
Eating in the absence of
hunger
Consumption of food despite feeling physically
satiated
Feeling satiated after consumption
of a meal, but continuing to seek out
food and/or eat food as it is made
available
Disinhibited eating Loss of inhibition and self-regulation resulting
in eating in response to external cues, including
emotional stressors or the sight or odor of foods
Feeling satiated after consumption
of a meal, but continuing to seek out
food and/or eat food as it is made
available, because you enjoy the way
it smells or tastes or in response to a
stressful event in your life
Negative self-evaluation of
food and eating
Negative judgment of and internalization of
associated negative feelings about choices made
with regard to food or eating
Feeling guilty or shameful after
eating a particular food item or a
certain amount of a food item
Emotional disinhibition Eating in response to emotions such as boredom,
anger or sadness
Experiencing a fight with a friend and
eating ice cream or another palatable
food in an effort to sooth hurt feelings
Disregulation of innate selfregulation
mechanisms
Disruption of an individual’s ability to respond
to physical hunger and satiety cues in a way that
results in overconsumption of the amount of calories
needed to maintain a healthy weight or promote
appropriate weight gain
An individual regularly eating more
food than needed to feel satiated so
that they can no longer sense physical
hunger and satiety cues
210 Clin. Pract. (2014) 11(2)
among youth has been well documented throughout
the literature [12] and research also suggests that,
as youth progress throughout adolescence to young
adulthood, their use of these behaviors persists or
even increases [13]. Although unhealthy weight-related
behaviors are most prevalent among adolescent girls,
adolescent boys are also affected in significant numbers
[12,14]. For example, a recently conducted populationbased
study found that approximately 50% of adolescent
girls and 30% of adolescent boys had engaged in
these unhealthy weight-control behaviors within the
past year [13].
Dieting, unhealthy and extreme weight-control
behaviors and binge eating have also been found to
predict several problematic health outcomes including
weight gain, obesity and eating disorders in adolescence
and adulthood [2,3]. For example, a 10-year
longitudinal study found that adolescents engaging in
dieting and those reporting unhealthy weight control
practices had significantly greater increases in BMI
from adolescence to young adulthood compared with
adolescents who did not engage in these behaviors [3].
For example, young women who engaged in unhealthy
weight control practices showed an increase of 4.6
BMI units over a 10-year period compared with an
increase of 2.3 BMI units among young women who
did not engage in unhealthy weight control practices.
The use of unhealthy weight control practices has also
been found to be associated with poorer dietary intake,
which is of particular concern given the high level of
nutrients required to support proper growth and development
during adolescence [15]. For example, youth
who engage in unhealthy weight control practices consume
fewer dairy products compared with youth who
do not engage in disordered eating behaviors [16]. This
places them at higher risk for calcium deficiency, which
can lead to inadequate bone density and increase risk
of bone fractures. Unhealthy weight-control behaviors
have also been associated with poorer psychosocial outcomes
for adolescents, including lower levels of body
image and self-esteem, and increased depressive symptoms
[17,18]. Youth who engage in unhealthy weight
control practices are also more likely to report using
drugs, alcohol and cigarettes [19]. Overall, the harmful
consequences associated with the use of unhealthy
weight-related behaviors and the high prevalence of
these behaviors during adolescence, demonstrate the
need to identify possible prevention strategies or modes
for intervention.
Role of families in child & adolescent weight
& weight-related behaviors
A strong body of empirical evidence has demonstrated
that parental behaviors and other factors within the
family environment are significant predictors of child
and adolescent weight status and unhealthy weightrelated
behaviors [20–28]. Research evidence indicates
that family-related factors are the strongest correlates
of weight-related outcomes in children and adolescents
[24]. Parents have the opportunity to positively influence
their child’s weight status through role modeling
of healthful eating and physical activity behaviors [29],
provision of healthful food choices within the home
environment [29,30] and establishment of family norms
around consistent meal and snack patterns [31–34],
including regular and frequent consumption of family
meals [35]. Research studies have also demonstrated
that parental weight-related attitudes and behaviors,
such as weight-based teasing [36–39], weight and
body talk [40], and parental modeling of dieting and
unhealthy weight control behaviors [41–44] are predictive
of an increased risk of adolescent’s engagement in
dieting, unhealthy and extreme weight-control behaviors
and binge eating [45]. In addition to the strong
body of evidence that exists indicating the important
role that parental behaviors and the family environment
plays in the development of the weight status and
weight-related behaviors of young people, parents have
also been identified within research studies as having
an integral role in the successful treatment of pediatric
obesity [46], as well as clinical eating disorders in young
people [47,48].
Food-related parenting practices, or the techniques
that parents use to influence children’s eating, are also
frequently discussed within the scientific literature as
another potentially important correlate of child weight
and weight-related behaviors [49]. Although the seminal
work of Birch and colleagues first examined the
relationship between food-related parenting practices
and child weight status and weight-related behaviors
and cognitions nearly 20 years ago within her research
laboratory at Penn State, more recent research examining
the use of food-related parenting practices within
larger, population-based samples has caused a resurgence
of interest within the field on impact of foodrelated
parenting practices on child and adolescent
outcomes [49]. The next section of this article will focus
exclusively on discussing what is currently known
within the scientific literature about associations
between food-related parenting practices and youth
weight status and weight-related behaviors, as well as
exploring observed inconsistencies and gaps that exists
within the literature to date. The recommendations for
healthcare providers and parents, which are presented
at the end of this review, are based on the best available
evidence from research studies, which have examined
the impact of factors within the broad family environment
on child and adolescent weight and weightfuture
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www.futuremedicine.com 211
related outcomes, including those research studies that
have specifically examined the impact of food-related
parenting practices.
Food-related parenting practices
Food-related parenting practices consist of a wide
range of behaviors including encouraging children
to eat, or not eat, specific foods; requiring children
to clean their plate at mealtimes; rewarding behaviors
with favorite foods; and restricting the intake of
particular foods (both healthy and unhealthy) [49].
The two most well-researched types of food-related
parenting practices are food restriction and pressureto-eat
[49]. Food restriction occurs when parents limit
or restrict their child’s intake of certain foods or use
a highly desired food item as a reward for consuming
a less desirable food item [49]. For example, parents
might only allow their child to eat dessert after
the child consumes a full serving of vegetables, thereby
restricting the child’s access to the dessert item until a
particular requirement is met. Pressure-to-eat occurs
when parents prompt or pressure their child to consume
a certain amount of food or more of a particular
type of food [49]. One common example of a pressure
technique would be parents requiring their child to eat
all of the food on their plate prior to being excused
from a meal. Decisions about what types of foods to
feed their children and what types of food-related parenting
practices to utilize are challenging choices to
make for many parents of young people. Parents want
their children to maintain healthy body weights, as
well as healthy relationships with food and eating, and
research has shown that parents often adopt controlling
food-related parenting practices (e.g., restriction
and pressure-to-eat) in response to concerns they have
about their children’s weight or weight-related behaviors.
Unfortunately, evidence to date suggests that use
of controlling food-related parenting practices might
have unexpected consequences, including children’s
weight gain and their use of unhealthy weight-related
behaviors [6].
Food-related parenting practices & child
weight status
Past cross-sectional studies conducted in samples of
white, high-income, mother–daughter dyads revealed
that food restriction is significantly and positively
associated with increased weight status in toddler and
early school-aged girls [50–54]. In these studies, compared
with mothers who reported lower levels of food
restriction, mothers who reported higher levels of food
restriction had daughters with a higher weight status.
Two separate longitudinal studies conducted within
comparable samples revealed similar associations; both
longitudinal studies found that 5-year-old girls exposed
to higher levels of food restriction at baseline, experienced
a greater increase in body weight by follow-up 2
years later, compared with girls exposed to lower levels
of food restriction [55,56]. However, results from more
recent studies challenge the simplicity of this association
revealing inconsistent and sometimes opposite
findings. A longitudinal, two-cohort study reported
that higher parental restriction at baseline was associated
with a lower child BMI z-score at follow-up within
the younger cohort (5–6 year olds); no association was
found within the cohort of preadolescents (10–12 year
olds) [57]. This null finding is consistent with another
study conducted within a sample of preadolescents
[58], but stands in contrast to a recent cross-sectional,
population-based study of older adolescents (16–18
year olds), which found parental use of food restriction
to be associated with higher weight status among
both male and female adolescents [59]. Finally, a study
conducted within a younger population (1–2 year olds)
found that high levels of food restriction at baseline
were protective against unhealthy weight gain at follow-up
[60].
Research has also explored the association between
parental pressure-to-eat and child weight-related outcomes.
A small number of cross-sectional studies have
found parental pressure-to-eat to be associated with a
lower BMI and fat mass in toddlers and young children
[50,61–66]. A possible explanation for this association
is that parents who have children with a lower
weight status, who are likely thin children, may pressure
them to eat more than parents of children who
are overweight. Parents of normal or underweight
children report using more pressure-to-eat than parents
of children who are overweight [62,64,67,68]. However,
some findings contradict the inverse relationship
between pressure-to-eat and BMI. Pressure-to-eat has
been positively associated with higher weight status in
a large, population-based sample of adolescents [59], as
well as positively associated with percentage body fat
in a separate sample of young girls [69]. Other studies
have found no association between pressure-to-eat and
children’s BMI [70–73].
The inconsistencies seen in the literature examining
the associations between food-related parenting practices
(food restriction and pressure-to-eat) and child
weight status, may be due to wide variability in the
racial/ethnic and socioeconomic diversity of samples
and vast differences in the age of children included
in samples (toddlers to adolescents). Additionally, it
is possible that parents from different backgrounds
(race/ethnicity, SES) might interpret questions on
food restriction and pressure-to-eat differently, adding
complexity to our ability to correctly interpret and
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212 Clin. Pract. (2014) 11(2)
compare participant responses both within and across
diverse samples. Finally, because the bulk of research
studies examining this association have been crosssectional,
the temporal direction of the association
between food-related parenting practices and child
weight status is unclear. For example, the relationship
between food restriction and child weight status
is recognized to be bidirectional; that is, while high
levels of food restriction have been shown to lead to an
increase in child weight status, parents of overweight
and obese children are also more likely to adopt restrictive
parenting practices in an effort to curb their child’s
food intake. Results from a small number of laboratory
studies indicate that parental restriction precedes
increased behavioral responses to restricted food items
[74,75] and excess weight gain in young children, suggesting
that the bidirectional path begins with parental
use of controlling feeding practices; this exposure
then leads to overconsumption of palatable foods (e.g.,
cookies, cakes and salty snack foods) and weight gain
over time for the child and creates a feedback cycle in
which both food-related parenting practices and the
child’s excess weight gain persist across time [51,53,76,77].
Also of note is a recent longitudinal research study
conducted by Rollins and colleagues, which found that
the association between parental food restriction and
change in child BMI over time was modified by the
child’s level of inhibitory control [74]. In this study, girls
with low levels of inhibitory control that were exposed
to high levels of parental restriction were found to have
the greatest increases in BMI from 5–7 years of age.
This same relationship between high levels of parental
restriction and BMI was not found among girls who
had higher levels of inhibitory control, suggesting that,
for some girls, exposure to high levels of parental control
does not result in excess weight gain. These study
findings, while novel, suggest that some of the inconsistencies
seen within the literature to date could be the
result of unmeasured confounders or effect measure
modifiers.
Despite the observed inconsistencies in the literature
examining the association between food-related
parenting practices and child and adolescent weight
status, the potential for controlling behaviors to lead to
excess weight gain over time among young people, coupled
with minimal evidence suggesting these parenting
behaviors are helpful, indicate that food restriction
and pressure-to-eat should be avoided when possible.
The strength of the evidence supporting the benefits of
parental modeling of healthy eating and the provision
of a healthful home food environment indicate these
are appropriate alternative methods for parents aiming
to have a positive impact on their child’s dietary intake
and weight status.
Food-related parenting practices & child
& adolescent weight-related behaviors
Controlling food-related parenting practices, including
food restriction and pressure-to-eat, have been
associated with negative dietary patterns and cognitions
related to food and eating in children. For example,
high levels of food restriction and pressure-to-eat
have been associated with increased levels of dietary
restraint [78], disinhibited eating [50,78,79], eating in the
absence of hunger [55,67] and negative self-evaluation of
food and eating [80] in young children. A longitudinal
cohort of young girls (5 years old), followed by Birch
and colleagues, provide the bulk of the information
available on associations between food-related parenting
practices and dietary patterns and cognitions
[53,55,77,78]. Pressure-to-eat was associated with girls’
emotional disinhibition, reports of dietary restraint
and disruption of innate self-regulation mechanisms
[53,78,79]. Food restriction by parents was associated
with disinhibition in the presence of palatable food,
increased eating in the absence of hunger, as well as
girls’ reports of negative emotions (e.g., shame or guilt)
in response to eating restricted foods [55,67,80]. It has
been theorized that exposure to a highly controlled
food environment results in children losing the ability
to self-regulate their food intake and also internalizing
feelings regarding the ‘goodness’ and ‘badness’ of foods
consumed, resulting in guilt or shame if they strayed
from parental control. The associations between parental
food restriction and pressure-to-eat and these negative
dietary patterns and cognitions among young children
is of particular concern given that these patterns
and cognitions have been identified as precursors to the
development of more serious behaviors, such as dieting,
disordered eating and binge eating in adolescent
and adult populations [31,81,82].
To date, to the best of the authors’ knowledge, only
one study has examined cross-sectional associations
between food-related parenting practices and adolescent
use of unhealthy weight control practices. Loth
and colleagues found that overall higher levels of pressure-to-eat
or food restriction was significantly and
positively associated with use of unhealthy weight control
practices among adolescent boys [83]. Examination
of the association between food-related parenting practices
and unhealthy weight control practices among
adolescent girls within this same sample revealed fewer
consistently significant associations; however, a significant
association was found between food restriction
reported by mothers and adolescent girls’ use of
extreme weight-control behaviors [83]. These study
findings provide preliminary evidence of an association
between controlling food-related parenting practices
and adolescent unhealthy weight control practices,
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www.futuremedicine.com 213
particularly in boys, and suggest the importance of
continued research in this older population.
Food-related parenting practices & parental
sociodemographic characteristics
The vast majority of research examining the use of
food-related parenting practices has been conducted
within white, high income populations [6]. Therefore,
discussion about how the use of food-related parenting
practices is influenced by demographic characteristics
(e.g., SES, race/ethnicity, child and parent gender,
and child age) is limited. However, a small number
of studies suggest that both the extent to which parents
adopt controlling food-related parenting practices
and the role that level of control plays in child weight
and weight-related behaviors may differ across families,
specifically with regard to race/ethnicity, parental
education or socioeconomic differences [58,84–87].
Ethnic differences in food-related parenting practices
have been reported between African–American
and non-Hispanic white parents [87,88], Hispanic and
African–America parents [86], and between Chinese–
American and non-Hispanic white parents [89], suggesting
that cultural values may influence food-related
parenting practices. For example, a small study that
included both non-Hispanic white (n = 74) and African–American
(n = 46) children with an average age
of 11 years, found that African–American mothers
reported higher levels of food restriction and pressureto-eat
compared with non-Hispanic white mothers [88].
These findings were consistent with another study conducted
within a sample of both African–American and
non-Hispanic white preadolescents (n = 120), which
also found that African–American mothers were more
likely to engage in high levels of food restriction and
pressure-to-eat [58,87]. Furthermore, Huang and colleagues
examined the use of food-related parenting
practices within a sample of Chinese–American and
non-Hispanic white parents (n = 168) and found that
Chinese–American parents had higher mean scores of
restriction and pressure-to-eat [89]. Interestingly, higher
mean scores of restriction and pressure-to-eat were
not found to be associated with higher child weight
status among the Chinese–American participants,
whereas this positive association existed among the
non-Hispanic white parent–child dyads [89]. Finally,
in a racially/ethnically diverse, population-based sample
of parent–adolescent pairs, Loth et al. found that
parents of minority racial/ethnic backgrounds were
significantly more likely to report both pressure-toeat
and food restriction compared with white parents
[90]. Overall, research findings indicate that a parent’s
racial/ethnic background may influence the types
of food-related parenting practices they engage in;
parents of minority racial/ethnic background are more
likely to engage in food restriction and pressure-to-eat
compared with their white counterparts.
Research exploring the use of food-related parenting
practices within socioeconomically diverse populations
is also limited and existing results are inconsistent. Preliminary
evidence from a handful of studies conducted
with relatively small samples suggest that levels of food
restriction are higher among parents with greater access
to economic resources (e.g., higher SES and education
level), whereas recently, in a large (n = 3741) population-based
study of parents and adolescents, Loth et al.
found that both food restriction and pressure-to-eat
were highest among parents with the lowest SES [90].
The inconsistencies seen in the literature examining
the role of sociodemographic characteristics in the use
of specific food-related parenting practices are likely
due to wide variability in the diversity of samples and
the use of convenience sampling techniques. Furthermore,
because research to date has often explored the
role of race/ethnicity or SES, and not both, on the
association between food-related parenting practices
and weight-related outcomes, studies have lacked the
ability to completely separate out the potential role of
race/ethnicity from the potential role of SES in the use
of food-related parenting practices. Because race/ethnicity
and SES are highly correlated among families
within the USA, it is important for research studies to
examine and understand the separate influences of both
of these variables on food-related parenting practices.
These limitations, in combination with the unequal
distribution of overweight and other weight-related
behaviors by race/ethnicity and SES, underscore the
importance of future research aimed at understanding
how food-related parenting practices might differ
across these important demographic characteristics in
more complex ways.
Conclusion
Overweight, obesity and unhealthy weight-related
behaviors are major public health problems among
children and adolescents; they are both prevalent and
have potentially serious physical and psychosocial
consequences. Understanding factors influencing the
weight and weight-related behaviors of young people
is imperative to the development of effective strategies
aimed at helping young people achieve a healthy
weight and associated healthy weight-related behaviors
and, thus, has become a focus of scientific exploration
in recent years.
As discussed in this review, food-related parenting
practices have been identified as a potentially significant
correlate of both child weight and weight-related
behaviors. The development and dissemination of
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214 Clin. Pract. (2014) 11(2)
research-based recommendations for healthcare providers
is particularly important given the high prevalence
of overweight and unhealthy weight-related
behaviors among children and adolescents, and the
complexity parents of young people encounter when
making food-related parenting decisions. Many parents
may welcome recommendations from healthcare
providers to help them guide decisions about how to
help their children maintain a healthy weight and a
healthy relationship with food. The recommendations
to follow stem from a synthesis of the current literature
on food-related parenting practices; of course, further
research in this area is encouraged.
Implications for clinical practice
Dietitians, physicians and other healthcare providers
working with children, adolescents and their families
could benefit from increased awareness of the important
role that food-related parenting practices may have
on young people’s weight and weight-related behaviors.
Decisions about what types of foods to feed their children
and what types of food-related parenting practices
to utilize are challenging choices to make for many
parents of young people. Parents want their children to
maintain a healthy body weight and a healthy relationship
with food and eating, and it can be difficult for
them to sift through all of the information available
to make the best choices for their children and families.
This makes it critical for dietitians, physicians and
other healthcare providers working with children and
families to have an informed understanding of what
the research concludes about the relationship between
food-related parenting practices and young people’s
weight and weight-related behaviors. This understanding
will allow clinicians to offer parents up-to-date
information on research-based best practices and recommendations
with regard to appropriate food-related
parenting practices. Healthcare providers should be
aware that, overall, current evidence does not support
parental use of food restriction or pressure-to-eat foodrelated
parenting practices as appropriate methods of
parental influence over child or adolescent food intake.
The potential for controlling behaviors (e.g., pressureto-eat
or food restriction) to lead to excess weight gain
or the development of disordered eating behaviors over
time among young people, coupled with minimal evidence
suggesting these parenting behaviors are helpful
for weight maintenance, indicate that food restriction
and pressure-to-eat should be avoided when possible.
The strength of the evidence supporting the benefits
of parental modeling of healthy eating and the provision
of a healthful home food environment indicate
that these are appropriate alternative methods for parents
aiming to have a positive impact on their child’s
dietary intake and weight status, and healthcare providers
should be encouraged to discuss the benefits of
these alternative methods of influence with parents.
Discussion of appropriate food-related parenting
practices and anticipatory guidance regarding how to
implement suggested practices into daily living should
be included as a regular part of all well-child visits.
Bright Futures is a book published by the American
Academy of Pediatrics that aims to teach pediatric
and family medicine physicians about the anticipatory
guidance topics to be covered during routine wellchild
visits with youth and their families; anticipatory
guidance involves discussions between physicians and
their patients aimed at preparing a patient or parent for
something that is to come. For example, a physician
might have a discussion with a parent about ways to
create a safe home environment for their baby in preparation
for that baby becoming more mobile, making
more in-home safety precautions (i.e., baby gates or
outlet plugs) necessary. The goal of anticipatory guidance
is to help a patient or parent anticipate an event
that is to come, and to provide them with guidance for
how they might best navigate this event safely. Unfortunately,
currently within Bright Futures, there is no
mention of engaging parents in anticipatory guidance
about appropriate food-related parenting practices.
Instead, the guidelines focus on instructing physicians
to talk with parents about what specific foods
should be consumed (e.g., fruits and vegetables, and
whole grains) or avoided (e.g., chips, candy and soda)
by children and adolescents. It is important for physicians
to discuss, with parents, age-appropriate dietary
intake for their children; however, this review of the
current scientific literature would suggest that a discussion
of appropriate food-related parenting practices
is also a necessary part of helping young people achieve
a healthy weight and appropriate weight-related behaviors.
Clinicians should be encouraged to engage parents
in discussions related to how they might best
create a home food environment that is conducive to
their child’s maintenance of a healthy weight and a
healthy relationship with food and eating. Clinicians
should seek to empower parents through anticipatory
guidance to promote healthy eating by making nutritious
food items readily available within their home,
modeling healthy food choices, and encouraging adolescent’s
autonomy in self-regulation of food intake.
Parents should be encouraged to utilize covert control
(limiting the availability of palatable snacks within the
home) as opposed to overt control (placing restrictions
or invoking rules on the intake of available food) to
help make healthy food choices the default for their
child, while still allowing their child independence
regarding choices about food and eating.
future science group
Review  Loth, Fulkerson & Neumark-Sztainer
www.futuremedicine.com 215
Clinicians should take time to explore the types
of food-related parenting practices currently utilized
within the home of their patients, as well as the motivation
behind the feeding practices (e.g., concerns
regarding child’s current weight status or food security)
prior to engaging in a conversation about food-related
parenting practices with parents. Previous research has
demonstrated that parents often utilize food restriction
and pressure-to-eat feeding practices in response
to feeling concerned about their child’s weight status.
If parents are concerned that their child is overweight
or obese or at risk for either, they are more likely to
report utilizing food restriction techniques. On the
other hand, if parents are concerned that their child has
a small stature or is underweight, they are more likely
to engage in pressure-to-eat behaviors. Unfortunately,
there is accumulating evidence for the detrimental
effects of controlling food-related parenting practices
on children’s ability to self-regulate energy intake,
resulting in unhealthy weight gain over time and the
development of unhealthful eating patterns and behaviors.
This information may be counterintuitive for some
parents, making it necessary for physicians and other
healthcare providers to understand and acknowledge
the parent’s motivation to help promote health in their
child through the use of particular food-related parenting
practices prior to engaging parents in a conversation
about a more appropriate approach to child feeding.
It may also be important for practitioners working
with young people and their parents to ask about the
level of food security within the home and the role that
the availability of food and overall household income
has on a parent’s decision to exert control over their adolescents’
eating behaviors. Understanding the potentially
wide variation in parental motivations behind
the use of specific food-related parenting practices will
allow clinicians the best opportunity to engage parents
in an open conversation about how their current
feeding practices might be influencing their adolescent.
Clinicians should also be aware of how to identify
parents that are more at risk for using controlling foodrelated
parenting practices (e.g., parents with obesity or
parents with eating disorders). Parents have been found
to be more likely to use controlling food-related parenting
practices when they have their own eating or weight
concerns, symptoms of psychopathology, or are overweight
themselves. Thus, it may be particularly important
for physicians to have open discussions about foodrelated
parenting practices and make recommendations
for parents to avoid the use of controlling food-related
parenting practices in families where the parents are at a
higher risk for use of controlling food-related parenting
practices (e.g., parents with obesity of parents with eating
disorders). Physicians should be thoughtful about
providing parents with specific guidance regarding
alternative ways to guide their children’s decisions about
food and eating, while remaining aware and sensitive to
the parents own weight-related struggles.
A summary of these implications for clinical practice
can be found in Box 1. Finally, specific research-based
recommendations regarding appropriate ways for parents
to help children and adolescents achieve a healthy
weight and healthy weight-related behaviors can be
found in Table 2.
The recommendations for parents of young people
are based on the best available evidence from research
studies that have examined the impact of factors within
the broad family environment on child and adolescent
weight and weight-related outcomes, including those
research studies that have specifically examined the
impact of food-related parenting practices.
Future perspective
Future research on food-related parenting practices
should focus on teasing out what initiates the complex
lifelong interaction between food-related parenting
practices and child weight status and weight-related
outcomes. The relationship between parental restriction
and child weight status and weight-related behaviors
is recognized to be bidirectional. However, it is
unclear if this bidirectional relationship is initiated
first by a parent’s choice to use particular food-related
future science group
Food-related parenting practices & child & adolescent weight & weight-related behaviors  Review
Box 1. Summary of implications for clinical practice.
•	 Clinicians could benefit from increased awareness of the important role that food restriction and
pressure-to-eat may have on young people’s weight and weight-related behaviors.
•	 Discussion of appropriate food-related parenting practices†
and anticipatory guidance regarding how to
implement suggested practices into daily living should be included as a regular part of all well-child visits, as
well as other doctor’s appointments addressing nonlife threatening health issues.
•	 Clinicians should consider parental motivation (e.g., food security, concerns regarding child’s current weight
status) for use of food-related parenting practices prior to making clinical recommendations.
•	 Clinicians should also be aware of how to identify parents that are more at risk for using controlling
food-related parenting practices (e.g., parents with obesity or parents with eating disorders).
†
Table 2 contains specific recommendations for parents to help children and adolescents achieve a healthy weight and healthy
weight-related behaviors. These recommendations can be utilized as a guideline for the development of clinic-based recommendations.
216 Clin. Pract. (2014) 11(2)
parenting practices or, alternatively, if it is initiated first
by a child’s weight status or weight-related behaviors,
which then evoke a response from parents in the form
of utilization of particular food-related parenting practices
(e.g., a parent is more controlling because their
child is overweight). Additional qualitative research
aimed at understanding parental motivation for use
of particular food-related parenting practices in conjunction
with longitudinal research is needed to help
understand both temporality and causation and to
shed light on appropriate next steps in the development
of public health and clinical interventions aimed at the
interruption of this bidirectional relationship.
The development of a longitudinal mixed-methods
research study within a racially/ethnically and socioeconomically
diverse sample of parent–child pairs,
consisting of both in-depth interviews of parents,
as well as survey and anthropometric data collection
future science group
Review  Loth, Fulkerson & Neumark-Sztainer
Table 2. Evidence-based recommendations for families: using what we know about food-related parenting practices
to improve the weight and weight-related behaviors of young people.
Food-related parenting
practices to avoid
Recommended alternative Supportive research
Avoid actively restricting
your child’s consumption of
food you have available in
your home
“No eating those cookies –
you can have one if you eat
enough dinner.”
Create a home food environment conducive
to making healthy choices:
•	 Make nutritious foods easily accessible
within your home (e.g., put fruit and
vegetables at eye level in the refrigerator
and put healthful snacks in easy to access
locations such as on the countertop or table)
•	 Make desserts, snack foods or other favorite
foods available on occasion, allowing your
child to choose them when they are made
available
•	 Home food availability is one of the strongest
correlates of fruit, vegetable and low-fat dairy
intakes [29,30]
•	 Research shows that complete restriction
of desserts and snack foods prompts
overconsumption when these foods become
available [32,77,91]
•	 Exposure to food restriction has been associated
with excess weight gain over time [55,56]
Avoid using food restriction
and pressure-to-eat to
control what your child eats
at mealtimes
“This meal is healthy for you,
you have to eat everything
on your plate before you can
be done.”
Provide consistent structure to your meals,
while encouraging your child’s autonomy
over eating choices during mealtime:
•	 Eat three meals daily. Whenever possible,
eat these meals as a family
•	 Parents should be responsible for choosing
when meals will be served and what foods
will be served at meals (parents can involve
children to teach them about meal planning
and how to make healthful choices)
•	 Children and teens should be responsible for
choosing how much food they eat for each
meal given a range of healthful options
without verbal restriction or pressure-to-eat
from parents
•	 Consumption of regular meals is associated with
healthier dietary intake patterns and fewer
unhealthy weight control practices [31–34]
•	 Family meals are strongly correlated with better
dietary intake and lower risk of engagement in
unhealthy weight-control practices [35]
•	 Food restriction is associated with dietary
disinhibition, increased eating in the absence of
hunger, and increased prevalence of unhealthy
weight control practices among adolescent girls
and boys [50,54,67,78–79]
•	 Higher levels of food restriction has been
associated with higher BMI [54–56,59]
•	 Pressure-to-eat can result in dislike of target
food items, emotional disinhibition, reports of
dietary restraint, and disruption of innate selfregulation
mechanisms [78,79]
Avoid using food restriction
or pressure-to-eat in an
effort to teach your child
about healthy eating or
healthy weight maintenance
“No more chips for you
today – you’ve been gaining
too much weight lately.”
Provide a supportive environment with
in which you model a focus on healthful
behaviors, not on weight or shape:
•	 Model healthy and balanced food choices
and eating patterns, including consumption
of desserts, snack foods and other favorite
foods in moderation
•	 Focus conversations with your child on
making food choices for overall health, not
weight or shape
•	 Do not allow weight teasing within your
home
•	 Parental modeling of eating, activity and
diet-related behaviors have been shown to be
significantly associated with child and adolescent
behaviors [22,29,92]
•	 Parent conversations focused on weight/
size are associated with increased risk for
adolescent disordered eating behaviors,
whereas conversations focused on healthful
eating are protective against disordered eating
behaviors [93]
•	 Exposure to weight-teasing within the home
environment is associated with decreases in selfesteem,
increased in depression and an increased
risk in unhealthy weight control practices [36–39]
www.futuremedicine.com 217
from both parents and children would be an appropriate
next step. Information gleaned from this type of
mixed-methods study would allow for a deeper understanding
of the broad range of food-related parenting
practices utilized by parents of children, as well as the
longitudinal impact of these parenting practices on a
child’s weight-related outcomes. Ideally, this type of
longitudinal mixed-methods research would be initiated
within parent–child pairs when the child is still
young (toddler or early elementary school-aged), with
long term, frequent, follow-up into adolescence. This
life-course approach would allow for a better understanding
of the bidirectional nature of the relationship
between food-related parenting practices and weightrelated
outcomes in children by shedding light on how
this relationship changes overtime.
It is also important that research be pursued exploring
the degree to which food-related parenting practices
can be modified through intervention. While
food-related parenting practices are often described
within the extant literature as a modifiable factor of the
home-food environment, research aimed at intervening
on and changing these parenting practices is limited.
Along these lines, it is also important that public health
researchers pursue research to test the effectiveness of
different types of parent feeding approaches aimed at
promoting a healthy weight and healthy weight-related
behaviors among children and adolescents. Given the
high prevalence of overweight and use of unhealthy
weight control practices among children and adolescents,
it is important that researchers begin to explore,
and rigorously test, parent-led approaches to promoting
a healthful weight and healthful eating behaviors
among children. This type of rigor will afford clinicians
the opportunity to provide parents with research-based
recommendations regarding how to best approach
feeding with their children and adolescents.
Disclaimer
The contents of this presentation are solely the responsibility
of the authors and do not necessarily represent the official
views of the National Institute of Mental Health.
Financial & competing interests disclosure
K Loth’s time was funded by grant T32 MH082761-01 from
the National Institute of Mental Health. The authors have no
other relevant affiliations or financial involvement with any
organization or entity with a financial interest in or financial
conflict with the subject matter or materials discussed in the
manuscript apart from those disclosed.
No writing assistance was utilized in the production of this
manuscript.
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adiposity in children. J. Pediatr. 148(3), 314–320 (2006).
•	 Examined the longitudinal influences of child-feeding
practices with time on total fat mass in white and
African–American boys and girls. Results indicate that
pressure-to-eat and concern for the child’s weight in
white participants and restriction and concern for the
child’s weight in African–American participants were
significantly related to total fat mass at baseline. Concern
for the child’s weight was negatively related to the change
of total fat mass with time in white participants. No
longitudinal effects of child feeding practices on the
change of total fat.
59	 Loth KA, MacLehose RF, Fulkerson JA, Crow S, NeumarkSztainer
D. Food-related parenting practices and adolescent
weight status: a population-based study. Pediatrics 131(5),
e1443–e1450 (2013).
•	 This study was conducted within a population-based
sample of adolescents and their parents and examined
cross-sectional associations between food restriction/
pressure-to-eat and adolescent weight status. Results
indicate that parental food restriction was associated
with higher adolescent weight status, whereas parental
pressure-to-eat was associated with lower adolescent
weight status.
60	 Farrow CV, Blissett J. Controlling feeding practices: cause
or consequence of early child weight? Pediatrics 121(1),
e164–e169 (2008).
61	 Hennessy E, Hughes SO, Goldberg JP, Hyatt RR,
Economos CD. Parent behavior and child weight status
among a diverse group of underserved rural families.
Appetite 54(2), 369–377 (2010).
62	 Kröller K, Warschburger P. Associations between maternal
feeding style and food intake of children with a higher risk
for overweight. Appetite 51(1), 166–172 (2008).
63	 Powers SW, Chamberlin LA, van Schaick KB, Sherman SN,
Whitaker RC. Maternal feeding strategies, child eating
behaviors, and child BMI in low-income African–American
preschoolers. Obesity 14(11), 2026–2033 (2006).
64	 Wardle J, Carnell S. Parental feeding practices and
children’s weight. Acta Paediatr. 96, 5–11 (2007).
65	 Costa FS, Pino DLD, Friedman R. Caregivers’ attitudes and
practices: influence on childhood body weight. J. Biosoc.
Sci. 43(3), 369–378 (2011).
66	 Kaur H, Li C, Nazir N et al. Confirmatory factor analysis
of the child-feeding questionnaire among parents of
adolescents. Appetite 47(1), 36–45 (2006).
67	 Birch LL, Fisher JO, Davison KK. Learning to overeat:
maternal use of restrictive feeding practices promotes girls’
eating in the absence of hunger. Am. J. Clin. Nutr. 78(2),
215 –220 (2003).
68	 Gregory JE, Paxton SJ, Brozovic AM. Pressure to eat and
restriction are associated with child eating behaviours and
maternal concern about child weight, but not child body
mass index, in 2-to 4-year-old children. Appetite 54(3),
550–556 (2010).
69	 Johannsen DL, Johannsen NM, Specker BL. Influence of
parents’ eating behaviors and child feeding practices on
children’s weight status. Obesity 14(3), 431–439 (2006).
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70	 Haycraft E, Blissett J. Predictors of paternal and maternal
controlling feeding practices with 2-to 5-year-old children.
J. Nutr. Educ. Behav. 44(5), 390–397 (2011).
71	 Montgomery C, Jackson DM, Kelly LA, Reilly JJ. Parental
feeding style, energy intake and weight status in young
Scottish children. Br. J. Nutr. 96(6), 1149–1153 (2006).
72	 Kasemsup R, Reicks M. The relationship between maternal
child-feeding practices and overweight among preschool
children. Ethn. Dis. 16(1), 187 (2006).
73	 Webber L, Cooke L, Hill C, Wardle J. Child adiposity and
maternal feeding practices: a longitudinal analysis. Am.
J. Clin. Nutr. 92(6), 1423 (2010).
74	 Rollins BY, Loken E, Savage JS, Birch LL. Maternal
controlling feeding practices and girls’ inhibitory control
interact to predict changes in BMI and eating in the absence
of hunger from 5 to 7 y. Am. J. Clin. Nutr. 99(2), 249–257
(2014).
75	 Rollins BY, Loken E, Savage JS, Birch LL. Effects of
restriction on children’s intake differ by child temperament,
food reinforcement, and parent’s chronic use of restriction.
Appetite 73, 31–39 (2014).
76	 Savage JS, Fisher JO, Birch LL. Parental influence on eating
behavior: conception to adolescence. J. Law. Med. Ethics.
35(1), 22–34 (2007).
77	 Birch LL. Development of food acceptance patterns in the
first years of life. Proc. Nutr. Soc. 57(04), 617–624 (1998).
78	 Carper JL, Orlet Fisher JO, Birch LL. Young girls’ emerging
dietary restraint and disinhibition are related to parental
control in child feeding. Appetite 35(2), 121–129 (2000).
•	 Investigated the origins of dietary restraint and
disinhibition in young girls by considering how parents’
control in child feeding and their daughters’ perceptions
of these practices relate to girls’ dietary restraint and
disinhibition. The results indicated that girls’ dietary
restraint and emotional disinhibition were related to their
perceptions of parental pressure to eat more, while their
external disinhibition was related to their perceptions of
having restrictions placed on their eating.
79	 Cutting TM, Fisher JO, Grimm-Thomas K, Birch LL. Like
mother, like daughter: familial patterns of overweight are
mediated by mothers’ dietary disinhibition. Am. J. Clin.
Nutr. 69(4), 608–613 (1999).
80	 Fisher JO, Birch LL. Parents’ restrictive feeding practices are
associated with young girls’ negative self-evaluation of eating.
J. Am. Diet. Assoc. 100(11), 1341–1346 (2000).
81	 Mussell MP, Mitchell JE, De Zwaan M et al. Clinical
characteristics associated with binge eating in obese females:
a descriptive study. Int. J. Obes. Relat. Metab. Disord. J. Int.
Assoc. Study Obes. 20(4), 324 (1996).
82	 Yanovski SZ. Binge eating disorder: current knowledge and
future directions. Obes. Res. 1(4), 306 (1993).
83	 Loth K, MacLehose R, Fulkerson JA, Crow S, NeumarkStzainer
DR. Are food-related parenting practices associated
wiht adolescent disordered eating behaviors? A populationbased
study. Int. J. Eat. Disord. doi:10.1002/eat.22189 (2013)
(Epub ahead of print).
•	 This study was conducted within a population-based sample
of adolescents and their parents and examined cross-sectional
associations between food restriction/pressure-to-eat and
adolescent disordered eating behaviors. Results indicate the
adolescent boys exposed to high levels of food restriction
and pressure-to-eat were more likely to engage in disordered
eating behaviors compared with boys exposed to lower levels
of these food-related parenting practices. Results among girls
were less consistent.
84	 Baughcum AE, Powers SW, Johnson SB et al. Maternal feeding
practices and beliefs and their relationships to overweight in
early childhood. J. Dev. Behav. Pediatr. 22(6), 391 (2001).
85	 Robinson TN, Kiernan M, Matheson DM, Haydel KF.
Is parental control over children’s eating associated with
childhood obesity? Results from a population-based sample of
third graders. Obesity 9(5), 306–312 (2001).
86	 Hughes SO, Power TG, Orlet Fisher J, Mueller S, Nicklas
TA. Revisiting a neglected construct: parenting styles in a
child-feeding context. Appetite 44(1), 83–92 (2005).
87	 Spruijt-Metz D, Lindquist CH, Birch LL, Fisher JO, Goran
MI. Relation between mothers’ child-feeding practices and
children’s adiposity. Am. J. Clin. Nutr. 75(3), 581 (2002).
88	 Sherry B, McDivitt J, Birch LL et al. Attitudes, practices, and
concerns about child feeding and child weight status among
socioeconomically diverse white, Hispanic, and African–
American mothers. J. Am. Diet. Assoc. 104(2), 215–221
(2004).
89	 Huang SH, Parks EP, Kumanyika SK et al. Child-feeding
practices among Chinese–American and non-Hispanic white
caregivers. Appetite 58(3), 922–927 (2012).
90	 Loth KA, MacLehose RF, Fulkerson JA, Crow S, NeumarkSztainer
D. Eat this, not that! Parental demographic correlates
of food-related parenting practices. Appetite 60, 140–147
(2013).
•	 Explores the use of food restriction and pressure-to-eat
within a racially/ethnically and socioeconomically diverse
population of parents of adolescents. Results indicate the
parents of racial/ethnic minority and those with low access to
economic resources (income, education, employment) were
more likely to engage in food restriction and pressure-to-eat
compared with white parents and parents with greater access
to economic resources.
91	 Birch LL. Development of food preferences. Nutrition. 19,
41–62 (1999).
••	 Using a developmental systems perspective, this review
focuses on how genetic predispositions interact with aspects
of the eating environment to produce phenotypic food
preferences.
92	 Davison KK, Birch LL. Childhood overweight: a contextual
model and recommendations for future research. Obes. Rev.
2(3), 159–171 (2001).
93	 Berge JM, MacLehose R, Loth KA, Eisenberg M,
Bucchianeri MM, Neumark-Sztainer D. Parent conversations
about healthful eating and weight: associations with adolescent
disordered eating behaviors. JAMA Pediatr. 167(8), 746–753
(2013).
future science group
Review  Loth, Fulkerson & Neumark-Sztainer