Table 3.

Studies examining the associations between parental feeding practices, child eating behaviors and risk of overweight and obesity in children 2–12 years of age included in systematic review (n = 14).

Author (Year) Country	Sample’s Characteristics and Study Design	Study Aim(s)	Measures of Feeding Practices and Eating Behaviors	Measures of Overweight and Obesity	Main Findings
Preschool-Age Children
Dieu et al. (2007); Vietnam [25]	n = 670 preschool-aged children (4–5 years) in the kindergarten system: 49.6% boys, 50.4% girls. Children’s mean age = 56.2 months Cross-sectional	To assess the magnitude of overweight and obesity, and identify associated socio-demographic factors in a population of preschool-aged children in the kindergarten system of Vietnam’s largest city.	Breast-feeding was defined as being breastfed at any time. Breastfeeding duration was measured in months using an interviewer-administered, pre-coded questionnaire.	Height and weight were measured using standard methods and used to calculate child’s body mass index (BMI) using age- and sex-specific BMI cutoff points proposed by International Obesity Task Force (IOTF)	The odds of being obese significantly decreased by 5% for each additional month of breastfeeding. However, the association between breastfeeding duration was not significant after controlling for confounding factors.
Huynh et al. (2011); Vietnam [26]	n = 526 children aged 4–5 years in urban preschools 49% boys and 51% girls. Longitudinal	To identify risk factors associated with obesity at the community and family environment levels, and to identify individual parental and child characteristics associated with changes in adiposity indicators over a one-year period.	Interviewer-administered food frequency questionnaire (FFQ).	Height and weight were measured using standard methods and used to calculate child’s BMI using cutoff points for overweight in Asian populations (of >23 kg/m2)	Breast-feeding was associated with reduced risk of child obesity. The protective effect of breast-feeding appeared to be more obvious in boys than in girls (reduced BMI in boys by 0.05 units).
Thongbai et al. (2011); Thailand [27]	n = 615 primary caregivers of 102 overweight children (cases) and 513 normal-weight children (controls) age 3 to 5 years old. Case-control	To investigate family environmental factor as determinants of overweight among preschool children.	The Food Parenting Practices [39] were used to measure the primary caregivers’ food practices and frequency of being (a) permissive, (b) authoritarian, and (c) authoritative. The Children’s Eating Behavior Questionnaire (CEBQ) [40] to measure—food responsiveness, enjoyment of food, emotional overeating, desire to drink, satiety responsiveness, slowness in eating, emotional under-eating, and food fussiness.	Height and weight were measured using the standard methods. Child nutritional status was classified by using a Ministry of Public Health growth reference for two- to seven-year-old Thais.	Three maternal feeding practices were associated with child overweight (low pressure, low encouragement through material reward, and low negotiation) without adjusting for confounding factors. Low maternal pressure was associated with child overweight adjusting for confounding factors.
Do et al. (2015); Vietnam [28]	n = 2677 children (rural 1313; urban 1364), aged 3–6 years. Cross-sectional	To describe the use of parental non-responsive feeding practices (i.e., restriction, pressure to eat, and monitoring of child food intake). To identify associations between the parental feeding practices and children’s diet and BMI.	The Child Feeding Questionnaire (CFQ) [41] was used to assess parental attitudes, beliefs and practices related to feeding children. Children’s diet question was used to assess children’s level of food consumption including (1) amount of food and (2) fatty food, sweets and snacks consumption.	Height and weight were measured using standard methods and used to calculate child’s BMI.	Child’s BMI and the mother’s perception of the child’s weight was negatively associated with pressure to eat and positively associated with monitoring. Restriction was positively associated with mother’s perception of the child’s weight. High consumption of fatty foods, sweets, and snacks was associated with high restriction and monitoring in rural areas and high restriction and pressure to eat but low monitoring in urban areas. The amount of food consumed was negatively associated with pressure to eat in rural areas, but positively associated with monitoring in urban areas.
Do et al. (2015); Vietnam [29]	n = 2677 children (rural 1313; urban 1364), aged 3–6 years. Cross-sectional	To estimate prevalence of overweight and obesity for preschool children in both urban and rural areas and to identify risk factors of overweight and obesity among children.	Structured questionnaires included amount of food, food consumption, fast eating, irregular snacks, outdoor physical activity, indoor physical activity, sedentary time, family economy, mother’s education, household size, watching food advertisements, and snack availability. These questionnaires were used to assess child eating habits and lifestyle by interviewing parents or caregivers.	Height and weight were measured using standard methods and used to calculate child’s BMI. Overweight and obesity were defined using World Health Organization (WHO) standards.	In urban areas, overweight or obesity in children were significantly associated with age, large amounts of food, fast eating, and indoor activity. In rural areas, overweight or obesity in children was significantly associated with age, frequent consumption of fatty, and mothers watching food advertisements on television (TV).
Aziz et al. (2012); Malaysia [30]	n = 142 children (urban 100; rural 42): aged 4–6 years, 45.8%; 52.8% boys and 47.2% girls. Cross-sectional	To compare and investigate the relationship between the nutritional status and eating practice.	Parental feeding practices questions were used to measure parental feeding practices. Children’s dietary habit questions and the three-day diet record were used to assess children’s diet intake.	Height and weight were measured using standard methods and used to calculate child’s BMI, which was used to determine weight status using the WHO and Centers for Disease Control and Prevention (CDC) 2000 growth chart as a reference.	There were significant differences in nutrient intake between children in rural and urban areas. Children’s BMI had a positive relationship with fast food intake (r = 0.274, p < 0.05) and eating out (r = 0.207, p < 0.05)
School-Age Children
Sabanayagam et al. (2009); Singapore [31]	n = 797 school children aged 10–12; 49% girls and 51% boys. Longitudinal	To evaluate the association between breastfeeding and overweight and obesity.	Parents completed an interviewer- administered survey that assessed whether the participating child was ever breast-fed, duration of breastfeeding and type of breastfeeding. Breastfeeding was dichotomized (yes/no). Breastfeeding duration was categorized into two groups (≤3 months, >3 months). Type of breastfeeding was defined as exclusive (fed no food other than breast milk); mostly (breast milk and non-formula supplements such as water, sweetened water or juices); or partly (breast milk supplemented with formula milk or other complementary foods).	Height and weight were measured using standard methods and used to calculate child’s BMI using the IOTF cutoff points to determine weight status.	There were no significant associations between breastfeeding status (yes/no), duration of breastfeeding ≤3 months, >3 months) and type of breastfeeding and overweight and/or obesity for the cohort and by sex.
Yamborisut et al. (2006); Thailand [32]	n = 199 children aged 6–10. Mean age was 8.2 years. Cross-sectional	To examine the influence of family characteristics and maternal feeding practices on eating behaviors, food consumption, and nutritional status of children.	Used an FFQ and 24-h food recall to assess the food consumption patterns of the children for two days.	Height and weight were measured using standard methods and used to classify child’s nutritional status using weight-for-height Z score (WHZ). The Thai growth reference was used to classify weight status.	Maternal control over the consumption of high caloric food and large amounts of food consumed by the children was associated with childhood obesity. Compared to normal-weight children, a higher proportion of obese children were not breastfed.
Zaini et al. (2005); Malaysia [33]	n = 1405 students aged 9–10 years old. Mean age 9.68 years old. Cross-sectional	To examine factors affecting the nutritional status of the sample.	Questionnaire administered to students, with confirmation by mothers whenever possible. Dietary practices assessed included having breakfast, regularity of having the three main meals, types, and quantities of each food item consumed during each meal in a typical day, and the frequency of eating fast food.	Height and weight were measured using standard methods and used to calculate child’s BMI; the IOTF standard was used to classify weight status.	There was association between the proportion of students who were breastfed for more than six months and classified as overweight and obese and the proportion of students who were breastfed for less than six months and classified as overweight and obese (21.9% vs. 20.4%). Students who consumed fast food more 4+/week were more likely to be overweight/obese (24%) than those who consumed fast food less <4/week (20%).
Serene et al. (2011); Malaysia [34]	n = 1430 Children ages 9–12 years. Mean age for children was 10.3+/−0.8 years. Cross-sectional	To explore the association between familial and socio-environmental factors and childhood obesity.	The CFQ [41] was used to monitor parental feeding strategies and ideas (perceived parent weight, perceived child weight, perceived responsibility, concern about child’s weight, and restriction and pressure to eat).	Height and weight were measured using standard methods and used to calculate the child’s BMI, which was used to determine the weight status using the WHO growth reference for children aged 5–19 years of age.	Pressure to eat showed a reverse association with child’s risk of overweight and obesity.
Wan et al. (2012); Malaysia [35]	n = 175 children aged 7–8 years old. Mean age of children was 7.4+/−0.5 years. Cross-sectional	To examine the association between parental children feeding practices and child’s weight status.	Used the CFQ [41] to measure several practices including perceived weight status, food restriction and pressure to eat.	Height and weight were measured using standard methods and used to calculate child’s BMI using the BMI-for-age WHO Growth chart as standard reference.	Perception of child’s weight, perceived parental weight, and food restriction factors were positively associated with the child’s BMI, whereas pressure to eat was negatively associated with child’s BMI.
Tay et al. (2016); Malaysia [36]	n = 1782 children aged 7–12 years old; 48.6% boys and 51.4% girls. Cross-sectional	To determine the association between eating behaviors and BMI, BMI-for-age Z-score (BAZ), waist circumference (WC), and percentage body fat (%BF) as indicators of nutritional status and body composition the sample.	The CEBQ [40] to measure - food responsiveness, enjoyment of food, emotional overeating, desire to drink, satiety responsiveness, slowness in eating, emotional under-eating, and food fussiness.	Height and weight were measured using standard methods and used to calculate the child’s BMI using the WHO growth standards. WC was measured using standard methods. %BF was measured by bioelectrical impedance.	Food responsiveness was positively associated with body adiposity for both sexes. Desire to drink was positively associated with BMI and WC for girls. Satiety responsiveness was negatively associated with body adiposity in both sexes except for %BF of boys. Slowness in eating was negatively associated with WC in girls. Emotional under-eating was negatively associated with the body adiposity (BMI) of boys.
Gonzalez-Suarez et al. (2015); The Philippines [37]	n = 396 elementary school students aged 10–12 years old. Cross-sectional.	To assess the associations between snacking (e.g., time, frequency, amount, type of snacks) and risk of overweight and obesity.	Data about mid-morning, mid-afternoon (both at school during the week), and nighttime snacks were collected using an interviewer-administered 24-h food recall.	Height and weight were measured using standard methods and used to calculate the child’s BMI. The IOTF’s gender- and age-specific cutoff points were used to determine weight status.	The odds of being overweight were associated with high total snack servings of 2.12. The odds of being obese (both males and females) were associated with calories obtained from snacking.
Soo et al. (2011); Malaysia [38]	n = 278 urban Chinese primary school children aged 10–12; 51.8% boys and 48.2% girls. Cross-sectional	To assess the relationship between nutritional statuses and dietary habits among sample.	Dietary habits were assessed using a three-day food record. Children were asked to record the type of foods, quantity, and portion size of all food consumed.	Height and weight were measured using standard methods and used to calculate the child’s BMI, which was used to determine the weight status using the WHO BMI-for-age growth chart as a reference.	Children classified as obese skipped breakfast more frequently than those classified as having a normal weight group.