The effect of nutritional attitudes of mothers as health care professionals on their children’s eating behaviors

Ergün, Sibel; Bozdemir, Büşra

doi:10.1590/1678-9865202336e230028

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ORIGINAL | Nutritional Assessment • Rev Nutr 36 • 2023 • https://doi.org/10.1590/1678-9865202336e230028 copy

The effect of nutritional attitudes of mothers as health care professionals on their children’s eating behaviors

O efeito das atitudes nutricionais de mães que trabalham como profissionais de saúde sobre os hábitos alimentares de seus filhos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

This study aimed to determine the effects of the attitudes of mothers as health care professionals and their sociodemographic characteristics on their children’s eating habits.

Methods

The data of this descriptive and cross-sectional study were collected between January and March 2022, using a web-based survey of 386 mothers.

Results

The mean age of the mothers was 32.88±4.96 years, and the mean age of the children was 38.78±18.24 months. Regarding educational status, 62.7% of the mothers were university graduates, while 54.4% were nurses. A significant and positive correlation was found between the sub-dimensions of the Mother’s Attitudes towards the Feeding Process Scale and the Behavioral Pediatric Feeding Assessment scale (p=0.000). According to the multiple regression analysis, the main determinant of the picky eaters sub-dimension of the Behavioral Pediatric Feeding Assessment scale was the mother’s occupation (β=0.28; 95% Cl: 3.07, 6.50), the main determinant of the toddler refusal-general sub-dimension was negative affect during the meal (β=0.38; 95% Cl: 0.19, 0.32), the main determinant of the older children refusal - general sub-dimension was negative affect during the meal (β=0.30; 95% Cl: 0.16, 0.33), and the main determinant of the toddler refusal – textured foods sub-dimension was forced feeding (β=0.48; 95% Cl: 0.41, 0.63).

Conclusion

The study found that problems related to mothers’ attitudes toward the nutrition process were moderate and that these problems were mainly caused by mothers’ attitudes toward inadequate/unbalanced nutrition. It was also found that the children had moderate problematic eating behavior and eating habits.

Keywords
Child; Eating habits; Health personnel; Mothers

Characteristics		M±SD	n	%
Maternal age (years)		32.88±4.96
Educational status
	High school		82	21.2
	University		242	62.7
	Postgraduate		62	16.1
Occupation
	Midwifery		147	38.1
	Nurse		210	54.4
	Physician		29	7.5
Family type
	Nuclear family		386	100.0
Employment status of spouses
	Working		386	100.0
Weekly working time
	36-40 hours		386	100.0
	Child age (months)	38.78±18.24
Child gender
	Girl		199	51.6
	Boy		187	48.4
Number of children
	1-2		386	100.0
Time of starting solid food
	Before six months		81	21.0
	After six months		305	79.0
Caregiver while the mother was at work
	Caregiver		272	70.5
	Kindergarten		114	29.5

Variables / Sub-dimension		Min-Max^* * These are the lowest and highest values obtained in this study. High scores on the scales indicate that eating problems are increasing and that the mother’s attitudes towards the feeding process are problematic. M: Mean; SD: Standard Deviation.	M	SD	Skewness	Kurtosis
Mother’s attitudes towards the feeding process scale
	Negative affect during the meal	6-30	15.53	5.70	0.447	-0.532
	Attitudes about insufficient/unbalanced feeding	8-40	25.60	7.09	-0.310	-0.607
	Negative feeding strategies	5-25	11.42	4.71	0.846	0.307
	Forced feeding	4-20	6.44	3.80	1.911	2.912
	Reaction to the viewpoints of others	4-20	10.33	4.01	0.412	-0.563
Behavioral pediatric feeding assessment scale
	Picky eaters	8-33	18.87	4.45	0.269	-0.075
	Toddler refusal-general	5-23	11.99	3.89	0.799	0.023
	Toddler refusal– textured foods	5-22	9.10	4.09	1.131	0.696
	Older children refusal - general	7-34	17.12	4.63	0.777	0.655

Variables		Picky eaters	Toddler re-fusal – general	Toddler refusal – textured foods	Older children r efusal – general
Maternal age
	r	-0.046	-0.113^* * p is significant at the p<0.05 level,	-0.046	0.004
	p	0.371	0.027	0.365	0.942
Educational status
	r	-0.101^* * p is significant at the p<0.05 level,	-0.197^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	-0.216^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	-0.201^ p is significant at the p<0.001. r: Spearman Correlation Analysis.
	p	0.048	0.000	0.000	0.000
Occupation
	r	0.022	-0.243**	-0.188^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	-0.228^ p is significant at the p<0.001. r: Spearman Correlation Analysis.
	p	0.673	0.000	0.000	0.000
Child age
	r	0.108^* * p is significant at the p<0.05 level,	-0.042	-0.038	0.099
	p	0.033	0.411	0.454	0.051
Child gender
	r	-0.030	-0.138^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	-0.031	-0.039
	p	0.557	0.007	0.545	0.440
Caregiver while the mother was at work
	r	0.041	-0.110^* * p is significant at the p<0.05 level,	-0.051	0.003
	p	0.422	0.031	0.317	0.957
Time of starting solid food
	r	-0.163^* * p is significant at the p<0.05 level,	-0.411^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	-0.355^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	-0.465**
	p	0.001	0.000	0.000	0.000
Negative affect during the meal
	r	0.408^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.732^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.559^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.671^ p is significant at the p<0.001. r: Spearman Correlation Analysis.
	p	0.000	0.000	0.000	0.000
Attitudes about insufficient/ unbalanced feeding
	r	0.276^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.547^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.355^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.500^ p is significant at the p<0.001. r: Spearman Correlation Analysis.
	p	0.000	0.000	0.000	0.000
Negative feeding strategies
	r	0.415^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.681^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.648^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.670^ p is significant at the p<0.001. r: Spearman Correlation Analysis.
	p	0.000	0.000	0.000	0.000
Forced feeding
	r	0.405^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.651^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.725^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.641^ p is significant at the p<0.001. r: Spearman Correlation Analysis.
	p	0.000	0.000	0.000	0.000
Reaction to the view points of others
	r	0.273^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.561^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.511^ p is significant at the p<0.001. r: Spearman Correlation Analysis.	0.544^ p is significant at the p<0.001. r: Spearman Correlation Analysis.
	p	0.000	0.000	0.000	0.000

Variables	Model	Unstandardized Coefficients		Standardized Coefficients	t	p	95% CI		R²
Variables	Model	B	SD	β	t	p	Lower	Upper	R²
Picky eaters	Constant	12.200	1.728		7.060	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	8.802	15.598	0.26
	Occupation (Reference: Midwifery)
	Physician	4.791	0.871	0.28	5.497	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	3.077	6.504
	Nurse	0.357	0.436	0.04	0.819	0.413	- 0.500	1.215
	Negative affect during the meal	0.216	0.055	0.27	3.911	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.107	0.325
	Negative feeding strategies sub-dimension	0.222	0.075	0.23	2.949	0.003^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.074	0.369
Toddler re-fusal-general	Constant	2.875	1.029		2.795	0.005^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.852	4.898	0.65
	Child age	-0.017	0.007	-0.08	-2.321	0.021^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	-0.032	-0.003
	Child gender (Reference: Boy)	0.747	0.239	0.09	3.122	0.002^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.276	1.217
	Time of starting solid food (Reference: After six months)	0.888	0.326	0.09	2.724	0.007^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.247	1.530
	Negative affect during the meal	0.264	0.033	0.38	8.025	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.199	0.329
	Negative feeding strategies	0.100	0.045	0.12	2.238	0.026^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.012	0.188
	Forced feeding	0.289	0.049	0.28	5.902	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.192	0.385
Toddler refusal - textured foods	Constant	1.452	1.190		1.220	0.223	-0.888	3.4791	0.58
	Maternal age	0.065	0.031	0.07	2.116	0.035^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.005	0.125
	Child age	-0.029	0.009	-0.13	-3.377	0.001^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	-0.046	-0.012
	Negative affect during the meal	0.119	0.038	0.16	3.117	0.002^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.044	0.193
	Attitudes about Insufficient/ Unbalanced Feeding	-0.059	0.029	-0.10	-2.023	0.044^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	-0.116	-0.002
	Negative feeding strategies	0.184	0.052	0.21	3.557	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.082	0.286
	Forced feeding	0.525	0.057	0.48	9.281	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.414	0.636
Older children refusal - general	Constant	4.469	1.316		3.395	0.001^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	1.881	7.057	0.60
	Maternal age	0.085	0.034	0.09	2.498	0.013^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.018	0.151
	Time of starting solid food (Reference: After six months)	2.215	0.417	0.19	5.309	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	1.394	3.035
	Negative affect during the meal	0.248	0.042	0.30	5.887	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.165	0.331
	Negative feeding strategies	0.181	0.057	0.18	3.166	0.002^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.069	0.294
	Forced feeding	0.257	0.063	0.21	4.106	0.000^* * p is significant at the p<0.05 level. B: unstandardized regression coefficients; R2: variance explained; SE B, standard error of B; t: Student's t; β: standardized regression coefficients.	0.134	0.380

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[1] Correspondence to: S ERGÜN. E-mail: sibel.ergun@balikesir.edu.tr.