This research seems to suggest that allowing children to choose their own foods and intake amounts will help them to maintain a healthy weight as they get older. However, these findings have an interesting twist, known in epidemiology as confounding. While children with restricted food intake are more likely to be overweight later on, this relationship may actually result from the effect of a third factor – the child’s weight status at the time of feeding restriction. This is because parents may be more likely to restrict food intake if their infant or toddler is already overweight – and overweight infants and toddlers are more likely to become overweight children and adults. Project Viva researchers used data on 837 mother-infant pairs to examine maternal feeding restriction and the child’s weight status at age 1 and BMI at age 3. They found that maternal feeding restriction at age 1 was associated with child BMI at age 3, but the association disappeared after adjusting for the child’s weight-for-length at age 1, the same time that feeding restriction was measured. These results suggest that feeding restriction could predict later overweight due to its association with concurrent weight status.
The relationships between caregiver control over children’s food intake, eating behaviors, and weight status are complex. In the absence of clear scientific evidence to support an alternate strategy, I will continue to trust my child’s natural ability to figure out how much he needs to eat while doing my best to encourage a nutritious diet. However, the best method of achieving this is also up for debate. If parents should allow their children to choose their own foods and self-regulate the quantity of food consumed, how can we promote good nutrition and a healthy relationship with food? One factor that does seem to influence children’s food preferences is modeling positive eating behaviors. Not surprisingly, if I want my son to snack on carrot sticks, I should not sit next to him and eat a cookie. I can certainly take a careful look at my own behavior and be aware of the general attitude toward food that my husband and I are promoting. But as I realized the other night watching my son feed his graham crackers to the dog to make more room on his plate for kiwi, his preferred dessert, he seems to be figuring this out pretty well on his own.