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Variation of parental feeding practices during the COVID-2019 pandemic: a systematic review

BMC Public Health volume 22, Article number: 1600 (2022) Cite this article

Abstract

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is highly contagious and has resulted in a protracted pandemic. Infections caused by new coronavirus strains, primarily Delta and Omicron and currently highly prevalent globally. In response to the epidemic, countries, and cities implemented isolation and quarantine guidance, such as limiting social contact, which have affected the lifestyles and quality of life of the population. Parental feeding behaviors may vary as a result of factors such as prolonged home isolation of parents and children, lack of supplies during isolation, and stress. This study was designed to assess the available evidence and its implications for parental feeding practices in the context of COVID-19. We screened and reviewed research published in five electronic databases between 2020 and 2022, and eight studies met the selection criteria. Parents were observed to use a variety of feeding practices, including high levels of coercive control and reduction of rules and limits according to Vaughn’s food parenting constructs. The findings suggest that parental feeding practices are changing as a result of the pandemic and that more research is needed to further explore how to provide supportive feeding guidance to parents during emergencies in order to jointly promote child health.

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Introduction

Coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, was first discovered in Wuhan, China in 2019, causing fever and cough [1]. It is highly contagious and affects a large portion of the world's population. Over the last two years, Delta and Omicron coronavirus variants have been identified, and now there have been over 530,266,292 confirmed cases and 6,299,364 deaths worldwide [2]. In order to control the spread of the virus various governments implemented a range of strategies including home isolation requiring people living through the COVID-19 pandemic to adapt their way of life.

Diet is an important part of a healthy lifestyle for children, and under COVID-19 home isolation, parents are responsible for the majority of their children’s feeding. Parental feeding behaviors are usually assessed in terms of feeding style and feeding practices. Feeding style is a relatively fixed form of behavior that combines parental perceptions, attitudes, behaviors, and emotional expressions concerning feeding their children. Feeding practices are goal-oriented, specific behaviors that parents adopt to influence their children's eating behaviors or intake [3], such as providing a healthy home food environment and modeling eating behaviors that children learn to imitate [4]. For this reason, feeding practices are more susceptible to change during the COVID-19 pandemic. This study categorized parental feeding practices into three categories based on the food parenting practices framework proposed by Vaughn et al. [5]: coercive control, structure, and autonomy support. Coercive control refers to parents imposing their ideas on their children (e.g., children eating when they are not hungry) and controlling them through pressure eating and restriction, and is associated with emotional eating and unhealthy dietary intake (high-fat and high-sugar foods) in children [4, 6, 7], which leads to obesity and disordered eating behaviors in children [8, 9]. Structure refers to the strategies parents used to help influence children's eating behaviors and organize the home environment, representing a type of parental control involving noncoercive practices [5]. The goal of autonomy support is to help children to develop their autonomy and independence in making nutritious choices. Children may benefit from structured practices (e.g., healthy food environments) and autonomy-supportive practices (e.g., praise) that promote healthy dietary intake (e.g., fruits, vegetables) and eating behaviors [10, 11].

Parent–child engagement time has risen as a result of pandemic home isolation measures, as have interactions between children and their parents over food and feeding practices [12]. However, according to the American Psychological Association survey, parents are under tremendous stress [13], possibly as a result of parents working from home, home-schooling, unemployment due to the economic downturn, or food insecurity due to the epidemic. Previous studies have found that different types of stress, such as maternal psychological stress [14], parental emotions [15], food insecurity [16], and parenting stress [17], can affect parental feeding practices. Stressed parents are more likely to exert feeding pressure on their children [18], in particular, parents who experienced stress in the daytime [19], which will influence the child's satiety response [20]. A qualitative study revealed that, despite having different goals for feeding their children (e.g., providing a healthy home food environment, limiting snack intake, etc.), parents are influenced by direct factors (e.g., stress) that make it difficult for them to implement feeding practices as expected [21], which may be a reason for the shift from structured and autonomy-supportive feeding practices to more coercive feeding practices.

It is unknown whether the COVID-19 outbreak or the isolation measures implemented to combat the disease impacts parental feeding practices. Therefore, the purpose of this study was to analyze changes in parental feeding practices during COVID-19 that may help shape future interventions and make parental guidance more targeted.

Materials and methods

Search strategy

The Preferred Reporting Items for Systematic Review and Meta-analysis guidelines [22] were followed for this systematic review. Researchers examined the PubMed, EMBASE, CINAHL, MEDLINE, and Web of Science databases for articles published in English between January 2020 and December 2021. To improve the degree of citation retrieval as much as possible, the following MESH subject headings were used as possible: child, child*, adolescent*, teen*, pediatric*, preschool*, feeding behavior, feeding-related behavior*, feeding practice, feeding pattern*, feeding style, etc. and COVID-19, SARS-CoV, coronavirus disease 2019, coronavirus, etc. to describe the epidemic situation. Additional file 1 contains the specific search strategies.

Inclusion and exclusion criteria

Selected studies included 1) parents of children aged 3–18 and 2) outcome indicators that met the parental feeding practices standards (filtered using Vaughn's framework). Meta-analyses, systematic reviews, reviews, case reports, and qualitative research were excluded since they were irrelevant to the research topic in a nonepidemic context.

Article screening and data extraction

Two reviewers (Luo and Cai) first performed a brief reading of the title and abstract. Studies that met the inclusion criteria were read in full and assessed for quality criteria. YZ, PYC, and ZHS extracted the following information, which was double-checked by RYZ and QC: 1) Study (authors, year, country), 2) Study population and setting, 3) Tool of assessment, 4) Study variables, 5) Primary Outcome, and 6) Total NOS. Any conflicts were resolved by consensus in a panel discussion dominated by another reviewer (Liao).

Quality assessment

To better evaluate the literature, the Ottawa–Newcastle (NOS) scale adapted from Herzog [23] was used to evaluate the quality of observational studies. The NOS is composed of three criteria: selection, comparability, and results. The NOS score [24] divides into three levels of quality: low, medium, and high, which are < 5 points, 5– < 8 points, and 8–9 points, respectively. The supplementary material contains the details of the quality assessment.

Results

Study characteristics

Figure 1 depicts the article selection flow diagram. Overall, 2388 publications were searched and identified in the database, with 880 being duplicates. After excluding the duplicates based on abstracts and titles, 17 articles were selected for full-text evaluation. Finally, eight publications were considered in this review, six of which were cross-sectional studies and two of which were cohort studies that employed self-reporting measures. The articles by Caroline et al. [25] and Jansende et al. [21]. were classified as high quality by the NOS standard, whereas the remaining six articles [26,27,28,29,30,31] were classified as medium quality (in Additional File 1). Table 1 shows the study’s characteristics and significant findings.

Fig. 1
figure 1

Flow diagram depicting the study search and selection protocol

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Table 1 Research characteristics and main results
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Measurement tools

The Child Feeding Questionnaire (CFQ), which is appropriate for parents of children aged 2–11 years [32], is increasingly and extensively used in research of feeding practices or feeding styles. The CFQ includes 7 dimensions: perceived responsibility, perceived parent weight, perceived child weight, concern about child weight (measures parents' perception and perception of weight), restriction, pressure to eat, and monitoring (evaluate the specific feeding behaviors and attitudes of parents). Three of the included investigations employed the CFQ, which demonstrated good internal consistency [25, 27, 28].

Musher-Eizenman developed a Comprehensive Feeding Practices Questionnaire (CFPQ) for children aged 2–8 years [33] by combining the CFQ with the Parental Feeding Style Questionnaire (PFQ). The CFPQ contains 49 items and 12 dimensions. The content becomes more comprehensive after incorporation of the evaluation of positive feeding behavior, such as modeling, teaching about nutrition, and the encouragement of balance and variety. The internal consistency and reliability of the subscales were 0.61–0.93 in the included articles [21].

Jansen et al. [34] developed the feeding practices and structure questionnaire (FPSQ) for mothers of 2-year-old children (21–27 months old), which has 9 dimensions and 40 items. Four of the dimensions (Distrust in Appetite, Reward for Behavior, Reward for Eating, and Persuasive Feeding) reflect nonresponsive feeding practices, and the other five dimensions (structured meal setting, structured meal timing, family meal setting, overt restriction, and covert restrictions) reflect the meal environment and restriction structure. The FPSQ has been validated in infants and toddlers (< 2 years) to track feeding practices from infancy to childhood; a parsimonious version of the FPSQ has been validated in children aged 2–5 years and has proven to be a reliable tool for usage [35, 36].

Vaughn et al. developed the Home Self-administered Tool for Environmental Assessment of Activity and Diet (HomeSTEAD), a brief and comprehensive psychometric evaluation tool for food-nurturing practices for children aged 3–12 years [37]. The tool has 86 items that address coercive control practices, autonomy supportive practices, and structural practices, all of which have good internal reliability (α > 0.62) [37].

Ecological momentary assessment (EMA) is a method of recording subjects' behaviors in real-time using smart devices such as cell phones to minimize recall bias and capture fluctuations in behavior over time more precisely [38]. The Real-Time Parent Feeding Practices Measurement Tool, developed in Loth’s study [26], was used to assess food-related parenting practices in EMA, including the CFQ, CFPQ, and other questionnaires.

Changes in coercive control

In this review, the features of coercive control include increased restriction (Parent-centered restriction of children's food intake), pressure to eat, threats and bribes(rewards), and the use of food to control negative emotions.

A total of six studies referred to elements of parental coercive control practices. Four studies found increased parental usage of restrictive practices and pressure to eat [26, 27], two of which concluded that the negative effects of COVID-19 on parents and distress would increase feeding restrictions and pressure to eat [25, 29]. According to a longitudinal study [28], parental restricted usage increased from before COVID-19 to T1 (May 2020) and returned to pre-pandemic levels at T2 (September 2020). Two studies found that parents used food to reward behaviors with children than pre-COVID-19, and soothed children with food based on their emotions. Preschoolers’ parents also claimed to support snack parenting practices and general feeding practices [21], and higher COVID-19-specific stress was associated with more emotion-based snack feeding.

Changes in structural practices

The article reports an increase in monitoring practices (parents concerned about their children's diet), food preparation, meal and snack routines, a decrease in rules and limits (parents prescribing when and how much children should eat), and the implementation of unstructured practices.

Five studies explored structural practice elements; two showed an increase in monitoring, while one found that monitoring utilization declined to pre-COVID-19 levels as the pandemic progressed [27, 28]. There was no difference in monitoring utilization in the context of food security status [28]. Three studies showed household food preparation. Among families, 66% of parents said they would cook more than before; 62% of families would consume less take-out fast food [27] and spend more time cooking with their children; and parents with higher levels of education would buy healthier, more comfortable, and more sustainable foods [31]. However, 56% of households with extremely low food security reported a decrease in fresh food. [27]. The ability of COVID-19 to maintain people's fundamental quality of life reduced supply scarcity, and the amount of fresh and unprocessed food in the household began to increase [28]. Four studies showed that rules and limits on unhealthy foods have been reduced, and feeding practices have become more tolerant of meeting the needs of children (e.g., what and how much to eat, etc.) [21, 26]. The frequency of snacking between meals increased in 36% of children [31], while the total amount of food, high-calorie snacks, and desserts/candy in the household varied depending on food security status [27].

Changes in autonomy support practices

Two studies on parental autonomy support were reported. According to one research [21], parental autonomy support practices, such as actively encouraging children to participate in food preparation and teaching about nutrition at mealtime have increased. Unlike other studies, this study compared three practices (i.e., positive mealtime practices, general feeding practices, and snack parenting practices) in preschool and school-age children separately. In all, 10 practices were found to be different in the two populations when examining a total of 15 routines. The study found, for example, that preschoolers were less likely to prepare food and their parents were more likely to eat with their children. In another study, the use of autonomy support practices was lower than before COVID-19 [26].

Discussion

This study attempted to summarize the changes in parental feeding practices during COVID-19, analyze existing and potential problems, and provide behavioral and nutritional guidance to parents and children. The results showed that parental coercive control practices (e.g., pressure to eat, restricted diets, and food rewards) increased during the COVID-19 pandemic, and that structure and autonomy support practices had different outcomes depending on the content of the study (e.g., structural practices in which parents monitored children more but were not overly prescriptive about children's snack intake).

COVID-19 has had negative short- or long-term effects on parents, children, and families [39], resulting in increased levels of stress and depression [40]. Negative parental emotions and stress can affect parents' enthusiasm for feeding practices, leading to an increase in coercive control feeding practices [26, 27]. This is consistent with previous studies [17, 41]. Stress can effectively interfere with parents' ability to observe children's behavior and limit children's ability to regulate their energy intake [29]. Coercive control practices, for example, can reduce vegetable intake over time [42]. Moreover, to alleviate children’s boredom and distress due to COVID-19 or parents' lack of energy to restrict food provision [18, 26], stressed parents use food to compensate for the impact on children’s life aspects [43]; this could also explain why parental stress is associated with increased emotional and snack feeding practices. As a result, parents are less likely to have specific rules or limits on their children's snacks and to provide them on an emotional basis [21], resulting in greater intake of high-calorie foods such as potato chips and sugar-sweetened beverages among children in home isolation [44, 45]. Mothers who experienced greater COVID-19 life changes had more rewarding diet-related behaviors and pressure to eat, and mothers with a high body mass index were more likely to use food to control their child's negative emotions [30]. It has been reported that utilizing snacks as a reward may increase external factors associated with children's diets and may also influence children's eating behaviors by increasing exposure to unhealthy snacks, resulting in childhood overeating and obesity [46]. Although parents provide proper guidance to their children during a pandemic (e.g., explaining nutrition, involving children in daily meal preparation, and encouraging positive and healthy eating habits), it may be difficult for parents to maintain a stable environment to ensure children's health and nutritional support under economic and life stress. As a result, parents experiencing stress during the pandemic can be advised on how to cope with stress and sustain supportive feeding.

In addition, the pandemic’s lockdown policy made fresh fruits and vegetables more difficult to obtain, and food insecurity during covid-19 was cited in all three included studies, with the same results as in previous studies [47, 48]. We found that families with food insecurity used coercive control practices more frequently, including highly stressed parents who may force children to eat to avoid wasting [49] or restrict intake to avoid food consumption [50], causing children to overeat when food is plentiful and affecting their dietary regulation [51]. Meanwhile, children's dietary intake is influenced by their home food environment [52], children living in food insecurity status have poorer availability, affordability, and accessibility to nutritious foods [53]. Parents experience various barriers in implementing structured practices [54], leading to the children receiving poor-quality diet [55], which results in a rise in the incidences of diet-related chronic childhood diseases such as obesity [56]. Despite the relaxation of epidemic prevention measures in many regions, food security issues continue to arise, whether as a result of the outbreak or other economic shocks. Food insecurity has been considered now as detrimental to force-feeding [57, 58]. As educators, we may provide timely and supportive feeding instructions to food insecure families to reduce the negative impact on nutrition from COVID-19 or similar stressful events later in life, which is within our power.

When subsequently creating more rational feeding practices to promote the usage of positive health-related behaviors in children and parents, the age of the child should be considered first. Children had a wide age range throughout the research, with clear distinctions between preschoolers and school-age children. School-age children who acquire a sense of diligence have rapid cognitive and ability development, are more likely to develop healthy eating behaviors, are more inclined to help prepare food at mealtime, and have greater autonomy and skills than preschool children [21, 59]. Preschoolers are more dependent on their parents for food. Since parents have no specific rules or restrictions on food, the use of treats to reward and comfort behaviors is more frequent [60]. Consistent with the findings of Yee's research, praise and rewards were dominant for children aged < 6 years, while setting rules or limits was more effective for children aged > 7 years [4]. There are studies showing that the type of feeding practices parents used is associated with child mood, with positive child mood associated with greater use of autonomy-supportive practices [26], child boredom with parental use of soothing food or less restriction [31]. Parents’ behavior may be affected by their children’s emotions. As a result of the elevated negative emotions of children, parents who want their children to be more active but are unable to achieve their goals are likely to be less restrictive to their children's diets and exhibit more tolerant feeding practices. Both of their emotions have a potential impact on feeding practices. Understanding the two-way link between parent and child may be useful in implementing better feeding practices. Future research should strive to explore the long-lasting effects of COVID-19 on parental feeding practices and children, particularly changes in children's eating habits and eating behaviors, as well as the effects on body weight. Children's sedentary behavior [61], screen time [62], and dietary changes [63] are all likely to increase obesity rates in children in the post-pandemic era. Consequently, it might be beneficial to detect these changes in time for child development.

Although we summarized variations in parental feeding practices in this systematic review, some points need to be considered. First, the included studies did not specifically explore whether feeding practices were associated with child outcomes (e.g., changes in diet, eating behaviors, or body composition) to further explore the impact of changes in parental feeding practices. Second, in the included studies, the CFQ and FPSQ were employed beyond the age-applicable range of the questionnaire and may not have correctly assessed children outside the applicable range. The age range of the children surveyed also spanned a wide range and did not fully reflect the feeding practices of children in a particular age group. In addition, the use of self-report questionnaires in all study design methods may have resulted in parental recall bias, and changes in the current social pressures and the feeding practice dynamics may have been underrepresented. The heterogeneity of the study instruments used in the study made direct comparisons of our results impossible during our integration procedure. A reliable method that investigates differences in parental feeding practices would be potentially valuable to the study of parental feeding practices. Finally, the included literature in the study does not specify the government epidemic policies in place when the studies were conducted. In terms of chronology, almost all participating areas were under lockdown, making our results comparable. However, most of the articles included in this study were from cross-sectional surveys conducted in the United States; therefore, studies from other country regions may be a useful addition to the future research. Nevertheless, this study summarizes the variations in parental feeding practices during COVID-19 and serves as a foundation for further exploration of the long-term impacts of the COVID-19 pandemic on children (e.g., dietary regulation/behavior, body weight).

Conclusions

This review suggests that parents changed their feeding practices during the COVID-19 pandemic. The findings of increased coercive control and changes in structure and autonomy support practices may assist researchers in further exploring the impact on children's eating habits and healthy eating behaviors, and providing accurate targets for future interventions. The review also attempted to explore the factors that influence parental feeding practices and revealed that stress (whether caused by unemployment, financial instability, or food insecurity) is one of the more critical factors noted during COVID-19. In the post-epidemic age, we must consider and implement measures to assist parents in coping with these challenges and provide guidance on healthy feeding strategies.

Availability of data and materials

The datasets supporting the conclusions of this article are included within the article and its additional files.

References

  1. Mayo Foundation for Medical Education and Research (MFMER). Available online:https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-20479963. Accessed 18 Mar 2022.

  2. World Health Organization.2022. WHO Coronavirus (COVID-19) Dashboard. Available online: https://covid19.who.int/. Accessed 7 Jun 2022.

  3. Baranowski T, O'Connor T, Hughes S, Sleddens E, Beltran A, Frankel L, et al. Houston... We have a problem! Measurement of parenting. Childhood obesity (Print). 2013;9 Suppl(Suppl 1):S1–4.

  4. Yee AZ, Lwin MO, Ho SS. The influence of parental practices on child promotive and preventive food consumption behaviors: a systematic review and meta-analysis. Int J Behav Nutr Phys Ac. 2017;14(1):47.

    Article  Google Scholar 

  5. Vaughn AE, Ward DS, Fisher JO, Faith MS, Hughes SO, Kremers SP, et al. Fundamental constructs in food parenting practices: a content map to guide future research. Nutr Rev. 2016;74(2):98–117.

    Article  PubMed  Google Scholar 

  6. Quattlebaum M, Wilson DK, Sweeney AM, Zarrett N. Moderating Effects of Parental Feeding Practices and Emotional Eating on Dietary Intake among Overweight African American Adolescents. Nutrients. 2021;13(6):1920.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Beckers D, Karssen LT, Vink JM, Burk WJ, Larsen JK. Food parenting practices and children’s weight outcomes: A systematic review of prospective studies. Appetite. 2021;158: 105010.

    Article  PubMed  Google Scholar 

  8. Rodgers RF, Paxton SJ, Massey R, Campbell KJ, Wertheim EH, Skouteris H, et al. Maternal feeding practices predict weight gain and obesogenic eating behaviors in young children: a prospective study. Int J Behav Nutr Phys Ac. 2013;10:24.

    Article  Google Scholar 

  9. Braet C, Claus L, Goossens L, Moens E, Van Vlierberghe L, Soetens B. Differences in eating style between overweight and normal-weight youngsters. J Health Psychol. 2008;13(6):733–43.

    Article  PubMed  Google Scholar 

  10. Larsen JK, Beckers D, Karssen LT, Fisher JO. Food Parenting and Children's Diet and Weight Outcome: Food Science, Technology and Nutrition for Babies and Children; 2020.

  11. Beltran A, Demet R, Hughes SO, Wood AC, Thompson D, O’Connor TM, et al. Selection and use of vegetable parenting practices did not vary by parent feeding styles: Mixed methods investigation. Appetite. 2022;170: 105883.

    Article  PubMed  Google Scholar 

  12. Trofholz A, Hersch D, Norderud K, Berge JM, Loth K. Changes to the home food environment and parent feeding practices during the COVID-19 pandemic: A qualitative exploration. Appetite. 2022;169: 105806.

    Article  PubMed  Google Scholar 

  13. American Psychological Association. 2020. Stress in America 2020: A National Mental Health Crisis. Available online: https://www.apa.org/news/press/releases/stress/2020/report-october. Accessed 18 Mar 2022.

  14. Swyden K, Sisson SB, Morris AS, Lora K, Weedn AE, Copeland KA, et al. Association Between Maternal Stress, Work Status, Concern About Child Weight, and Restrictive Feeding Practices in Preschool Children. Matern Child Health J. 2017;21(6):1349–57.

    Article  PubMed  Google Scholar 

  15. Loth KA, Uy M, Neumark-Sztainer D, Fisher JO, Berge JM. A qualitative exploration into momentary impacts on food parenting practices among parents of pre-school aged children. Appetite. 2018;130:35–44.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bauer KW, MacLehose R, Loth KA, Fisher JO, Larson NI, Neumark-Sztainer D. Eating- and weight-related parenting of adolescents in the context of food insecurity. J Acad Nutr Diet. 2015;115(9):1408–16.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Gouveia MJ, Canavarro MC, Moreira H. How can mindful parenting be related to emotional eating and overeating in childhood and adolescence? The mediating role of parenting stress and parental child-feeding practices. Appetite. 2019;138:102–14.

    Article  CAS  PubMed  Google Scholar 

  18. Berge JM, Tate A, Trofholz A, Fertig AR, Miner M, Crow S, et al. Momentary Parental Stress and Food-Related Parenting Practices. Pediatrics. 2017;140(6).

    Article  PubMed  Google Scholar 

  19. Berge JM, Tate A, Trofholz A, Fertig AR, Miner M, Crow S, et al. Momentary Parental Stress and Food-Related Parenting Practices. Pediatrics. 2017;140(6): e20172295.

    Article  PubMed  Google Scholar 

  20. Hurley KM, Black MM, Papas MA, Caulfield LE. Maternal symptoms of stress, depression, and anxiety are related to nonresponsive feeding styles in a statewide sample of WIC participants. J Nutr. 2008;138(4):799–805.

    Article  CAS  PubMed  Google Scholar 

  21. Jansen E, Thapaliya G, Aghababian A, Sadler J, Smith K, Carnell S. Parental stress, food parenting practices and child snack intake during the COVID-19 pandemic. Appetite. 2021;161: 105119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ (Clinical research ed). 2009;339: b2535.

    Article  Google Scholar 

  23. Herzog R, Álvarez-Pasquin MJ, Díaz C, Del Barrio JL, Estrada JM, Gil Á. Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review BMC public health. 2013;13:154.

    Article  PubMed  Google Scholar 

  24. GA Wells BS, D O'Connell, J Peterson, V Welch, M Losos, P Tugwell. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.

  25. West CE, Shields CV, Hultstrand KV, Frank ML, Sato AF. Pandemic-related parental distress: examining associations with family meals and child feeding practices during the COVID-19 pandemic. Child Health Care. 2022;51(1):79–100.

    Article  Google Scholar 

  26. Loth KA, Ji Z, Wolfson J, Berge JM, Neumark-Sztainer D, Fisher JO. COVID-19 pandemic shifts in food-related parenting practices within an ethnically/racially and socioeconomically diverse sample of families of preschool-aged children. Appetite. 2021.

  27. Adams EL, Caccavale LJ, Smith D, Bean MK. Food Insecurity, the Home Food Environment, and Parent Feeding Practices in the Era of COVID-19. Obesity. 2020;28(11):2056–63.

    Article  CAS  PubMed  Google Scholar 

  28. Adams EL, Caccavale LJ, Smith D, Bean MK. Longitudinal patterns of food insecurity, the home food environment, and parent feeding practices during COVID-19. Obes Sci Pract. 2021;7(4):415–24.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Frankel LA, Kuno CB, Sampige R. The relationship between COVID-related parenting stress, nonresponsive feeding behaviors, and parent mental health. Current psychology (New Brunswick, NJ). 2021:1–12.

  30. Wang SD, Devjani S, Chillakanti M, Dunton GF, Mason TB. The COMET study: Examining the effects of COVID-19-related perceived stress on Los Angeles Mothers’ dysregulated eating behaviors, child feeding practices, and body mass index. Appetite. 2021;163.

  31. Philippe K, Chabanet C, Issanchou S, Monnery-Patris S. Child eating behaviors, parental feeding practices and food shopping motivations during the COVID-19 lockdown in France: (How) did they change? Appetite. 2021;161.

  32. Birch LL, Fisher JO, Grimm-Thomas K, Markey CN, Sawyer R, Johnson SL. Confirmatory factor analysis of the Child Feeding Questionnaire: a measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite. 2001;36(3):201–10.

    Article  CAS  PubMed  Google Scholar 

  33. Musher-Eizenman D, Holub S. Comprehensive Feeding Practices Questionnaire: Validation of a New Measure of Parental Feeding Practices. J Pediatr Psychol. 2007;32(8):960–72.

    Article  PubMed  Google Scholar 

  34. Jansen E, Mallan KM, Nicholson JM, Daniels LA. The feeding practices and structure questionnaire: construction and initial validation in a sample of Australian first-time mothers and their 2-year olds. Int J Behav Nutr Phys Act. 2014;11:72.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Jansen E, Russell CG, Appleton J, Byrne R, Daniels LA, Fowler C, et al. The Feeding Practices and Structure Questionnaire: development and validation of age appropriate versions for infants and toddlers. Int J Behav Nutr Phys Act. 2021;18(1):13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Jansen E, Williams KE, Mallan KM, Nicholson JM, Daniels LA. The Feeding Practices and Structure Questionnaire (FPSQ-28): A parsimonious version validated for longitudinal use from 2 to 5 years. Appetite. 2016;100:172–80.

    Article  PubMed  Google Scholar 

  37. Vaughn AE, Dearth-Wesley T, Tabak RG, Bryant M, Ward DS. Development of a Comprehensive Assessment of Food Parenting Practices: The Home Self-Administered Tool for Environmental Assessment of Activity and Diet Family Food Practices Survey. J Acad Nutr Diet. 2017;117(2):214–27.

    Article  PubMed  Google Scholar 

  38. Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4:1–32.

    Article  PubMed  Google Scholar 

  39. Solmi M, Estradé A, Thompson T, Agorastos A, Radua J, Cortese S, et al. Physical and mental health impact of COVID-19 on children, adolescents, and their families: The Collaborative Outcomes study on Health and Functioning during Infection Times - Children and Adolescents (COH-FIT-C&A). J Affect Disord. 2022;299:367–76.

    Article  CAS  PubMed  Google Scholar 

  40. Xiong J, Lipsitz O, Nasri F, Lui LMW, Gill H, Phan L, et al. Impact of COVID-19 pandemic on mental health in the general population: A systematic review. J Affect Disord. 2020;277:55–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Fulkerson JA, Telke S, Larson N, Berge J, Sherwood NE, Neumark-Sztainer D. A healthful home food environment: Is it possible amidst household chaos and parental stress? Appetite. 2019;142: 104391.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Gregory JE, Paxton SJ, Brozovic AM. Maternal feeding practices, child eating behaviour and body mass index in preschool-aged children: a prospective analysis. International Journal of Behavioral Nutrition and Physical Activity. 2010;7.

  43. Flesia L, Fietta V, Colicino E, Segatto B, Monaro M. Stable psychological traits predict perceived stress related to the COVID-19 outbreak. 2020.

  44. Pietrobelli A, Pecoraro L, Ferruzzi A, Heo M, Faith M, Zoller T, et al. Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity (Silver Spring, Md). 2020;28(8):1382–5.

    Article  CAS  Google Scholar 

  45. Dondi A, Candela E, Morigi F, Lenzi J, Pierantoni L, Lanari M. Parents’ Perception of Food Insecurity and of Its Effects on Their Children in Italy Six Months after the COVID-19 Pandemic Outbreak. Nutrients. 2020;13(1):121.

    Article  PubMed Central  CAS  Google Scholar 

  46. Sleddens EF, Kremers SP, De Vries NK, Thijs C. Relationship between parental feeding styles and eating behaviours of Dutch children aged 6–7. Appetite. 2010;54(1):30–6 (Epub 2009/09/15).

    Article  PubMed  Google Scholar 

  47. Arlinghaus KR, Laska MN. Parent Feeding Practices in the Context of Food Insecurity. Int J Environ Res Public Health. 2021;18(2):366.

    Article  PubMed Central  Google Scholar 

  48. Berge JM, Fertig AR, Trofholz A, Neumark-Sztainer D, Rogers E, Loth K. Associations between parental stress, parent feeding practices, and child eating behaviors within the context of food insecurity. Prev Med Rep. 2020;19: 101146.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Foster JS, Adamsons K, Vollmer RL, Mobley AR. A pilot study of low-income mothers and fathers of preschool age children to determine the relationship of food security and nutrition assistance on feeding style and child body weight. J Hunger Environ Nutr. 2019;14(5):698–708.

    Article  Google Scholar 

  50. Crawford PB, Lamp C, Nicholson Y, Krathwohl S, Hudes M, Townsend MS. Food insecurity may be linked to childhood obesity in low-income Mexican-American families. Calif Agric. 2007;61(3):106–11.

    Article  Google Scholar 

  51. Jansen E, Williams KE, Mallan KM, Nicholson JM, Daniels LA. Bidirectional associations between mothers’ feeding practices and child eating behaviours. Int J Behav Nutr Phys Ac. 2018;15(1):3.

    Article  Google Scholar 

  52. Adams EL, Caccavale LJ, LaRose JG, Raynor HA, Bean MK. Home Food Environment Changes and Dietary Intake during an Adolescent Behavioral Weight Loss Intervention Differ by Food Security Status. Nutrients. 2022;14(5):976.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Calloway EE, Parks CA, Byker Shanks C, Bowen DJ, Yaroch AL. A special issue addressing healthful food access and food insecurity: risk factors, behavioral variables, interventions, and measurement. Transl Behav Med. 2020;10(6):1249–54.

    PubMed  Google Scholar 

  54. Rosemond TN, Blake CE, Shapiro CJ, Burke MP, Bernal J, Adams EJ, et al. Disrupted Relationships, Chaos, and Altered Family Meals in Food-Insecure Households: Experiences of Caregivers and Children. J Acad Nutr Diet. 2019;119(10):1644–52.

    Article  PubMed  Google Scholar 

  55. Landry MJ, van den Berg AE, Asigbee FM, Vandyousefi S, Ghaddar R, Davis JN. Child-Report of Food Insecurity Is Associated with Diet Quality in Children. Nutrients. 2019;11(7):1574.

    Article  CAS  PubMed Central  Google Scholar 

  56. Fleming MA, Kane WJ, Meneveau MO, Ballantyne CC, Levin DE. Food Insecurity and Obesity in US Adolescents: A Population-Based Analysis. Childhood obesity (Print). 2021;17(2):110–5.

    Article  Google Scholar 

  57. Gross RS, Mendelsohn AL, Messito MJ. Additive effects of household food insecurity during pregnancy and infancy on maternal infant feeding styles and practices. Appetite. 2018;130:20–8.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Nguyen HT, Frongillo EA, Blake CE, Shapiro CJ, Frith AL. Earlier and Concurrent Food Insecurity Are Associated with Suboptimal Parenting in Early Childhood. J Nutr. 2020;150(6):1590–9.

    Article  PubMed  Google Scholar 

  59. Romero E, López-Romero L, Domínguez-Álvarez B, Villar P, Gómez-Fraguela JA. Testing the Effects of COVID-19 Confinement in Spanish Children: The Role of Parents’ Distress, Emotional Problems and Specific Parenting. Int J Environ Res Public Health. 2020;17(19):6975.

    Article  PubMed Central  Google Scholar 

  60. Blaine RE, Fisher JO, Taveras EM, Geller AC, Rimm EB, Land T, et al. Reasons Low-Income Parents Offer Snacks to Children: How Feeding Rationale Influences Snack Frequency and Adherence to Dietary Recommendations. Nutrients. 2015;7(7):5982–99.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Runacres A, Mackintosh KA, Knight RL, Sheeran L, Thatcher R, Shelley J, et al. Impact of the COVID-19 Pandemic on Sedentary Time and Behaviour in Children and Adults: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2021;18(21):11286.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Musa S, Elyamani R, Dergaa I. COVID-19 and screen-based sedentary behaviour: Systematic review of digital screen time and metabolic syndrome in adolescents. PLoS ONE. 2022;17(3): e0265560.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Farello G, D’Andrea M, Quarta A, Grossi A, Pompili D, Altobelli E, et al. Children and Adolescents Dietary Habits and Lifestyle Changes during COVID-19 Lockdown in Italy. Nutrients. 2022;14(10):2135.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

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Funding

This research was supported by Postgraduate Research & Practice Innovation Program of Jiangsu Province (project No. KYCXX21_3297).

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  1. Wen Luo and Qian Cai contributed equally to this work.

Authors and Affiliations

  1. School of Nursing, School of Public Health, Yangzhou University, Yangzhou, Jiangsu, China

    Wen Luo, Qian Cai, You Zhou, Yepeng Cai, Huizi Song, Yiran Zhang & Yuexia Liao

  2. Nursing Department, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China

    Yuying Chen

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  1. Wen Luo
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Contributions

WL: drafted the manuscript; QC: helped with literature screening; YZ, PYC, ZHS: information extraction; RYZ, QC: reviewed the paper; YYC: designed the study; XYL: gave theoretical guidance and amendments. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Yuexia Liao.

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Luo, W., Cai, Q., Zhou, Y. et al. Variation of parental feeding practices during the COVID-2019 pandemic: a systematic review. BMC Public Health 22, 1600 (2022). https://doi.org/10.1186/s12889-022-14027-6

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BMC Public Health

ISSN: 1471-2458

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