Precision nutrition is an evolving field, but considers a person’s health/disease status, genetics, metabolomics, microbiome, current food availability (e.g., grocery store, restaurant, home), and personal characteristics (e.g., previous food consumption that day, food preferences, etc.) to inform individualized guidance regarding the optimum nutrient intake to promote health for a child. Many factors influence child dietary intake, the most important of which need to be taken into consideration when making personalized dietary change prescriptions.
Construct | Relationship to PFP | What Is Known? | What Research Is Needed? |
---|---|---|---|
Feeding styles | The complex interplay between the parent and the child defined by two dimensions: the parents’ demaningness and responsiveness, both in regard to the child’s food behavior | Crossing the two dimensions yields four categories of relationship: authoritative, authoritarian, permissive, and uninvolved [29]. Indulgent practices lead to worse outcomes (diet, BMI) [30]. Authoritarian practices lead to the lowest BMI [31]. |
How consistently are the categories related to FPP, especially among goal-oriented FPP?
|
Habitual FPP | The specific behaviors that parents use without forethought with the intent to influence their child to eat specific foods, whether successful or not. | There are 17 proposed categories of FPP [23]. Some practices are likely to increase child intake of parent specified foods, and some are not [32,33][32][33]. | To what extent do FPP reflect habit, and require a habit modification approach to change? Under what circumstances do FPP result in desired child intake? What are the longer term consequences of consistent or frequent use of FPP? What are the interrelationships among use of FPP? |
Parent predisposition to select FPP | Diverse variables may predict a parent’s use of FPP. Among these are personality characteristics and models of behavior, e.g., model of goal-directed behavior. | The model of goal-directed behavior predicted the use of categories of effective and ineffective FPP [34,35,36][34][35][36]. Little other research has addressed prediction of parent selection of FPP. |
Which variable or combinations of variables predict parent use of FPP? What are the limiting factors (e.g., stress, time constraints, depression, lack of financial resources) on the predictiveness of these variables? |
Selection and use of FPP | Parents must select and use specific FPP in specific contexts/situations to influence child dietary intake | Parents tend to select FPP that are easy to use, provide benefit for their child, and/or have worked in the past [37]. | Under what circumstances do parents select to use specific FPP? How consistent are parents in the use of joint FPP and what are the implications of consistency/inconsistency for child intake? |
Parent perception of eating event/context | Parents may vary in their perception of the context of an eating event (e.g., a special or usual event) and the extent to which the event dictates specific FPP. | Little research has addressed parent perception of eating events or FPP appropriate to the perception [37]. | What are the most common categories of parents’ perception of eating events? What do parents perceive as the most appropriate FPP for each category of eating event? |
Child receptiveness | Some children are receptive to any/all/some FPP, and some are not | Children are not passive recipients of FPP [37,38][37][38]. | Are there effective FPP to which children are universally receptive? |
Child response predisposition | Children may be receptive to an FPP or not, based on appetitive, temperament, taste sensitivities, and other characteristics. | A large number of factors (e.g., child social/cultural, neighborhood) influence child dietary intake [39]. | How do children with different response predispositions respond to different FPP in different situations? |
Developmental characteristics | Influences on FPP and child intake vary by age and age-related characteristics of the child/adolescent. | Child temperament and appetitive and food avoidant characteristics were related to BMI [40]. Some child developmental characteristics, e.g., food neophobia or picky eating were not related to child BMI [41]. |
More precise definitions and operationalizations of developmental characteristics are needed. Under what circumstances are child developmental characteristics related to dietary intake and BMI, at what ages? |
Child perception of eating event/context | Children may vary in their perception of the context of the eating event (e.g., a special or usual event) and the extent to which the event dictates specific behavior | Little research has addressed child perception of eating events or child behaviors appropriate to the perception. | What are the most common categories of child perception of eating events? What do children perceive as the most appropriate behavior for each category of eating event? |
Child dietary intake | This objective of PFP is to enable children to consume a healthier diet. | While many possible influences on child dietary intake have been proposed, and some supported, there are no consistent findings on the relation of FPP and child dietary intake [42]. | Under what circumstances do FPP influence child dietary intake? |
What did the parent learn? | As a result of the use of one or more FPP on a particular occasion, the parent will have learned one or more things, and this will serve to confirm or induce change in the parent predisposition to select and employ FPP. | Little research has addressed what parents learn from employing FPP or how it influences their predispositions to use FPP in the future. | How does use of FPP in interaction with their child, peers, or other sources of parenting information influence their predisposition to select, and how to employ FPP in the future? |
What did the child learn? | As a result of being on the receiving end of one or more FPP, the child could be oblivious, or adapt/modify some aspect of their receptiveness, including defensive behaviors for future attempts. Different children will likely respond to the same FPP in different ways. | Little research has addressed what children learn from receiving FPP or how the experience results in changes in their receptiveness. | Under what circumstances, what and how does a child learn from a parent’s use of FPP, and how does this experience of related comments from peers and the media impact their future receptiveness. |
Social determinants context | All parent and child behaviors and their interactions are performed in cultural and socioeconomic-demographic contexts. | There are inconsistent findings regarding how context influences any of the above, perhaps due to complexity [43]. | How, and under what circumstances, do any of the above outcomes, relationships or other vary by cultural and socioeconomic-demographic context? |