Associations between parental feeding practices, maternal stress, and body mass index in children aged 3–11 years

Abstract

Childhood obesity remains a major public health concern, with early-life nutritional environments and family-related factors playing important roles in children’s weight outcomes. Parental feeding practices and maternal psychological well-being have been associated with children’s eating behaviors and body mass index (BMI). However, evidence regarding whether maternal stress moderates the relationship between parental feeding practices and children’s BMI remains limited and inconsistent. This study examined the associations between parental feeding practices (restriction, pressure to eat, and monitoring), maternal stress, and children’s BMI, and investigated whether maternal stress moderates these relationships. This cross-sectional study included 441 children aged 3–11 years and their mothers in Samsun, Türkiye. Parental feeding practices were assessed using the restriction, pressure to eat, and monitoring subscales of the Child Feeding Questionnaire, whereas maternal stress was measured using the Parental Stress Scale. Children’s height and weight were measured by trained researchers, and BMI was calculated according to World Health Organization standards. Data were analyzed using IBM SPSS Statistics 26 and Hayes’ PROCESS Macro (Model 1). Separate moderation analyses were performed for each feeding practice while controlling for maternal education, maternal age, and child sex. Pressure to eat was significantly and negatively associated with children’s BMI (B = − 0.120, p < 0.001), whereas restriction and monitoring were not significantly associated with BMI. Maternal stress showed a small but significant negative association with BMI in the restriction (B = − 0.031, p = 0.026) and monitoring (B = − 0.032, p = 0.024) models, but not in the pressure to eat model. Interaction terms for parental feeding practices and maternal stress were not statistically significant in any model ( p > 0.05), indicating no moderating effect. The models explained between 3.5% and 7.2% of the variance in BMI. Within this study sample, parental feeding practices and maternal stress were independently associated with children’s BMI rather than interacting. Pressure to eat was associated with lower BMI, whereas maternal stress showed modest associations with BMI in some models. These findings improve understanding of family-related factors associated with childhood obesity and should be interpreted within the context of this cross-sectional study.