"Over-control of eating leads to fat children, study warns",
NYT, 10 Nov 94, p. A10.

Parents who try to prevent their children from getting fat end
up with overweight children, because these children do not
learn to stop eating when they have had enough.  Children that
are allowed to be the most spontaneous about food intake are
better at regulating their own caloric intake.

"Parents' and children's adiposity and eating style", S. J.
Johnson and L. L. Birch, Pediatrics, Nov 1994, Vol. 94, No. 5,
pp. 653-661.

Background:  Approximately 25% of all children in the U.S. are
obese, and the prevalence of obesity in children has increased
by 50% in the past two decades.  Once a person becomes obese,
it is very hard for that person to lose the weight; in
addition, overweight children tend to become overweight adults.
Therefore, preventing obesity in children is an important step
in the effort to reduce the rate of obesity in the U.S.
In addition, past studies have shown that children are able to
adjust their energy intake in response to the caloric density
of the diet.

Objective:  To study children's abilities to regulate their
caloric intake and to see if differences in their ability are
related to the food-controlling practices of the their parents.

Kind of study:  experiment

Subjects:  77 3-5-year-old children who attended a university
preschool, in addition to their parents

Setting:  Preschool in Urbana, IL

Treatments:  Children completed two controlled, two-part meals
(part 1:  fruit juice; part 2:  lunch) in order to estimate
their ability to adjust their food intake relative to changes
in the caloric density of the diet.  The first meal either had
a high or low caloric intake, and the second meal was the same
for all children.  The children took part in this study twice:
once with the high calorie meal and once with the low calorie
one.

Treatment assignment:  One half of the children consumed the
low-calorie drink on the first day and the others received the
other high-calorie drink.  Two days later, each of the children
received the other version of the drink.

Outcome measurements:  For each child, the total amount of
calories consumed on each of the two days was measured.  A
measure (COMPX) of the ability to self regulate calories was
calculated.

Control variables:  Parents were asked to complete Stunkard and
Messick's Three-Factor Easting Questionnaire, which assesses
dietary restraint, disinhibition, and perceived hunger.  The
researchers also recorded the sex, height, weight, triceps and
subscapula skinfold thickness of the children.

Blindness:  Double-blindness

Population:  Children aged 3-5 who attend nursery school

Statistical methods used:  Descriptive statistics for each
variable were calculated including means, standard errors,
ranges, skewness, kurtosis, and Wilk's test of normality.  An
eating index (COMPX), which related the children's ability to
regulate their diets, was correlated to children's
anthropometric measures and to the parents Three-Factor Eating
Questionnaire score.  The models were tested using multivariate
regression analysis, along with other statistical methods, such
as Cook's D and the Durbin-Watson test.  Five tables, two
figures.

Stated conclusions:  The study found that there was a
correlation between children's body fat stores and the ability
to respond to changes in caloric density.  Pearson correlation
coefficients showed that the children with greater body fat
stores were less able to regulate energy intake accurately.
The best indicator of children's ability to regulate energy
intake was parental control in the feeding situation, as the
children with more controlling mothers showed less ability to
self-regulate energy intake.  (r=-.67, P<.0001)  Therefore, the
optimal environment for children's development of self control
of energy intake is where the parents provide healthy food
choices but allow children to control the amount of food they
eat.

Nonresponse:  Children of parents that did not wish for their
child to take part in the study; children who did not finish
their complete first meal.

Difficulties of generalizing to the real world:  The children
almost all belonged to families with highly-educated parents,
and therefore, the family incomes of the study subjects were
higher than the national average income.

How does this relate to the rest of the scientific literature:
Past studies have suggested that obese parents may use child-
feeding techniques that result in the development of obesity in
their children.  However, there has not been any substantial
studies on exactly how the family environment shapes the
development of children's eating and exercise behaviors.