Expert Answer:Restricting Access to Foods and Children’s Eatin


Solved by verified expert:esponse paper questions to consider:What is the author’s central claim, argument, or point? (This may be a place to start from in your response papers.)What evidence does the author provide to support their arguments?What could be added to the work to make it more complete?For instance, is there other media, especially empirical research, that we can use to support/refute/or add to the evidence?What assumptions does the author make?What did you find surprising, important, interesting, or relevant?What do these arguments mean for children?Response paper “Dos and Don’ts”:DOBackup your claims with science and relevant material discussed in classBuild off ideas mentioned in class, adding your own thoughts and insightsUse specific examples from the paper and, potentially, from other sourcesThink deeply: Analyze, Evaluate, CreateDON’TOnly summarize the paperMake superficial, obvious insightsSimply repeat ideas mentioned by others in class

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Appetite, 1999, 32, 405–419
Article No. appe.1999.0231, available online at on
Restricting Access to Foods and Children’s Eating
Departments of Nutrition and Human Development and Family Studies,
The Pennsylvania State University
This study evaluated maternal restriction of children’s access to snack foods as
a predictor of children’s intake of those foods when they were made freely
available. In addition, child and parent eating-related “risk” factors were used to
predict maternal reports of restricting access. Participants were 71, 3-to-5-yearold children (36 boys, 35 girls) and their parents. Children’s snack food intake
was measured immediately following a meal, in a setting offering free access to
palatable snack foods. Child and maternal reports of restricting children’s access
to those snack foods were obtained. In addition, information on child and parent
adiposity as well as parents’ restrained and disinhibited eating was used to examine
“risk” factors for restricting access. For girls only, child and maternal reports of
restricting access predicted girls’ snack food intake, with higher levels of restriction
predicting higher levels of snack food intake. Maternal restriction, in turn, was
predicted by children’s adiposity. Additionally, parents’ own restrained eating
style predicted maternal restriction of girls’ access to snack foods.
 1999 Academic Press
A challenge of child feeding is to understand how to foster patterns of food
intake that promote dietary moderation and adequacy of the total diet. Restricting
children’s access to foods may appeal to parents as a straightforward and logical
way to limit children’s intake of foods high in sugar and fat. In this instance,
children’s access to food may be restricted by limiting the amount of food provided
or opportunities to consume the food. For example, certain foods may be kept out
of reach, allowed in limited quantities, allowed only after eating another food (i.e.
“finish your vegetables”) or allowed only at special occasions. When in place,
restricting access to palatable foods presumably limits children’s intake by constraining opportunities to consume those foods. Whether restricting access to palatable foods encourages moderate patterns of intake when children are allowed to
make their own choices about food selection and intake, however, is less clear. This
research examines the association between mothers’ restriction of children’s access
to palatable foods and young children’s intake when given free access to those foods.
Parents may restrict their child’s access to palatable foods in an attempt to
promote moderate patterns of eating. Rozin et al. (1996) reported adults have
Address correspondence to: Dr Jennifer Orlet Fisher, Department of Human Development and
Family Studies, 110 Henderson South Bldg., The Pennsylvania State University, University Park, PA
16802, U.S.A.
0195–6663/99/030405+15 $30.00/0
 1999 Academic Press
difficulty operationalising concepts involving dietary moderation. Their research
indicates that even well-educated adults tend to engage in the categorical nutrition
belief that foods are either “good” or “bad”. Thus, parents may attempt to promote
healthy eating patterns in children by restricting access of “bad” foods and encouraging intake of “good” foods. For instance, parents may refuse to provide
children with snack cakes because “they’re bad for you” while encouraging the
consumption of vegetables because “they’re good for you”. Limited evidence indicates
that parents frequently use child feeding strategies that restrict children’s access to
foods. In a study of 427 parents of pre-school children, 56% reported promising a
special food, such as dessert, for eating a meal; 55% reported withholding a food as
punishment; and 48% reported rewarding good behavior with food (Stanek et al.,
1990). In related work on the efficacy of using various child feeding practices to
modify children’s food preferences, 40% of parents spontaneously reported their belief
that restricting access to certain foods should decrease their children’s preferences for
those foods (Casey & Rozin, 1989).
The extent to which parents adopt a restrictive approach over children’s eating
may differ across families. In particular, eating- and weight-related characteristics
of both parents and children may provide an impetus to restrict children’s access to
foods. Costanzo and Woody (1985) contend that parents are most likely to exert
control over children’s behavior in areas that are important and potentially problematic for parent or child. For instance, parents who have problems regulating
their own eating and/or weight may be particularly concerned about their child’s
intake of “unhealthy” or “fattening” foods. This concern may be particularly evident
in families where both parents exhibit problematic regulation of food intake or
weight. Alternatively, parents might restrict access to foods in response to their
child’s adiposity or snacking behavior. As weight issues and eating problems are
more prevalent in girls and women, this area of child behavior may constitute a
greater source of monitoring, evaluation and perceived problems for parents of girls
than for those parents of boys. Especially for females in our society, overweight is
strongly stigmatised and dieting is highly prevalent (Striegel-Moore, 1996). As a
result, societal values placed on thinness may cause parents to be particularly aware
of the types of foods to which their daughters have access and consume.
The effects of restricting access to palatable foods on children’s eating behavior
are not well characterised. Restricting children’s access to foods may create an eating
environment in which children are focused on restricted, palatable foods and respond
with an increased desire to consume those foods when available. Several studies
indicate that restricting access to foods may increase children’s preferences for and
intake of restricted foods while diminishing self-control in eating. For instance,
making a food’s availability contingent on the completion of another task (i.e. you
can have cookies only after you clean up your room) can increase children’s
preferences for those “reward” foods (Birch et al., 1980; Lepper et al., 1982).
Additionally, research on children’s ability to delay gratification demonstrated that
children show less self-control when they can see, but cannot physically access, a
preferred food relative to when that food is “out of sight” (Mischel & Ebbesen,
A central dimension of child feeding strategies that restrict access to palatable
foods is that access to specific foods, but not total energy in the diet is restricted.
Another property of this child feeding strategy is that the restriction is not selfimposed. These characteristics differentiate the present work from research examining
energy restriction in animal models and the extensive body of work on restrained
eating in adults. Additionally, while restraint theory holds that the self-imposed
dietary restrictions may predispose individuals to over-consumption (Heatherton et
al., 1990; Herman & Mack, 1975; Herman & Polivy, 1980; Polivy & Herman, 1985;
Ruderman, 1986; Tulsch, 1990; Wilson, 1993), less is known about whether the
restriction of specific foods promotes elevated intakes of those particular restricted
foods. As Wardle (1990) observes, there are “. . . few studies which actually
demonstrate that so-called “forbidden” fruit is more tempting” (p. 134). A noteworthy
exception is research conducted in rats on the determinants of voluntary alcohol
ingestion in the absence of energy deprivation. As the frequency of access to alcohol
became more restricted, rats increased their alcohol intake during those periods in
which the substance was freely available (Files et al., 1994; Marcucella & Munro,
1987; Pinel et al., 1976; Samson et al., 1992; Wise, 1973). These general findings
were replicated using other sapid fluids as the restricted entity (Wayner & Fraley,
1972; Wayner et al., 1972). In a more recent study, rats fed chow ad libitum were
given access to an option of fat sources more or less frequently. Those rats with less
frequent access had higher fat intakes during periods in which the fat was made
freely available (Corwin et al., 1999).
The primary objective of this research was to evaluate the relationship between
mothers’ restriction of children’s access to foods and children’s eating. Specifically,
this research examined whether maternal and child reports of restriction were related
to children’s consumption of restricted foods in a setting where those foods were
freely available. A second objective of the study was to determine whether mothers’
reports of restricting their children’s access to snack foods could be predicted by
weight and eating “risk” factors of the parent or child. The “risk” factors included:
(1) child adiposity and (2) parents’ own eating styles and adiposity, examined
separately for mothers and fathers, and as a parental composite. The parent composite
variables were included in this analysis because they provide information regarding
the familial style that the child experiences in contrast with that obtained when
separately examining mothers’ or fathers’ scores.
Participants were 70 children (30 girls, 40 boys) ages 3–6, attending day-care
programs at The Pennsylvania State University, and their parents. The sample
consisted of Caucasian, 3 African American, 1 Hispanic and 6 Asian children. Mean
age of children was 5·0±0·1 years. Exclusion criteria for children were the presence
of food allergies, lactose intolerance or unwillingness to participate. Forty-seven
mothers (mean age 35±5) and 37 fathers (mean age 39±7) participated in data
collection. Mothers and fathers were well-educated (16·6±2·9 and 17·2±2·5 years
of education, respectively) and currently employed (36 of 36 fathers; 46 of 47
Mothers’ reports of restricting children’s access to snack foods
Maternal restriction of children’s access to palatable foods was measured by
using a series of questions designed to assess the extent to which mothers typically
restrict their child’s access to 10 snack foods used in the experimental procedure.
Mothers were asked 9 questions about each of the 10 snack foods used in the
experimental procedure: (1) limiting the availability of the food to special occasions;
(2) getting upset if the child obtained the food without asking; (3) monitoring the
child’s consumption of the food; (4) generally limiting the amount consumed; (5)
specifically limiting the portion size; (6) generally limiting opportunites to consume
the food; (7) specifically limiting when the food is available; (8) keeping the food
out of reach; and (9) limiting how often the food is in the home. For each of the
questions, responses were then summed across the 10 experimental foods, so that
each question included information about all 10 foods used in the experimental
procedure. The internal consistency for these 9 aspects of restriction, as measured
by Cronbach’s alpha, was 0·87. The 9 aspects of restriction were standardised and
weighted using principal components analysis to create a total score. Maternal
reports of restricting access were expressed as standard scores with high scores
indicating high levels of maternal restriction.
Three Factor Eating Questionnaire
The Three Factor Eating Questionnaire, developed by Stunkard and Messick
(1985), was used to measure parents’ restrained eating, or the cognitively-based
restriction of food intake, and parents’ disinhibited eating, involving eating in
response to external influences. The factor of restraint (21 items) consists of items
such as “When I have my quota of calories, I am usually good about not eating any
more” and “I often stop eating when I am not really full as a conscious means of
limiting the amount that I eat”. Scores on the restraint scale may range from 0 to
21 with high scores indicating high levels of the construct. The Eating Inventory
Restraint scale has demonstrated good criterion validity (Laessle et al., 1989) and
high internal consistency, with a Cronbach’s alpha ranging from 0·79 to 0·93 (Gorman
& Allison, 1995, p. 175). The factor of disinhibition (16 items) consists of items such
as “Sometimes things just taste so good that I keep on eating even when I am no
longer hungry” and “Being with someone who is eating often makes me hungry
enough to eat”. Scores on the disinhibition scale may range from 0 to 16 with high
scores indicating high levels of the construct. In this sample the internal consistency
for both the restraint scale and disinhibition scale was 0·85.
Restraint and disinhibition scores were calculated separately for mothers and
fathers. In addition to scores for each parent, a single score representing the influence
of both parents was created by aggregating mother–father dyad scores using principal
components. This composite score allowed the investigators to examine the combined
influence of both parents’ restraint or disinhibition on maternal restriction. Mother–
father composites for parental restraint and parental disinhibition explained 63 and
51% of variance in item responses, respectively. Each pair of eigenvectors for the
maternal and paternal scores were positive and of equal weights, suggesting equal
contributions to the composites.
Body mass index (BMI)
Mothers’ and fathers’ self-reported height and weight data were used to calculate
body mass index scores [weight (kg)/height (m2)]. Logarithmic transformations were
used on the positively skewed variables of maternal and paternal BMI to better
approximate normal univariate distributions on these variables. To examine the
combined influence of parents’ adiposity on maternal restriction, mother–father dyad
scores were also created. The first principal component for parental BMI explained
57% of variance in item responses. Eigenvectors for the maternal and paternal BMI
scores were both positive and of equal weights, suggesting equal contribution to the
Children’s perceptions of restricted access
Children’s perceptions of restricted access to food at home were assessed in a
structured interview with a trained interviewer. Each child was asked three questions
about each of the 10 snack foods used in the experimental procedure: (1) Do mommy
or daddy let you have these foods?; (2) Would your parents be upset if you didn’t
ask before you got these foods?; and (3) Are you allowed to eat as much of these
foods as you want? Responses for each of the three questions were then summed
across the 10 experimental foods, so that each question included information about
all 10 foods used in the experimental procedure. The internal consistency of these
three questions was 0·73, and was determined by calculating Cronbach’s alpha. The
three questions were then standardised and weighted using principal components
analysis to create a total score. Children’s reports of parental restriction were
expressed as standardised scores, with high scores indicating high levels of children’s
perceived restriction.
Children’s anthropometric measurements
Children’s adiposity was evaluated using measurements obtained by a trained
anthropometrist. Weight-and-height measurements were obtained in duplicate. Subscapular and triceps skinfold measures were obtained in triplicate on the right side
of the body using a skinfold caliper. Weight for stature and skinfold measurements
were converted to percentile scores using age- and gender-appropriate reference data
from National Center for Health Statistics (Hamill et al., 1979) and National Health
and Nutrition Examination Survey II, 1984 (Frisancho, 1990), respectively.
Snack foods offered
Children’s energy intake of restricted foods was measured using weighed intake
of snack foods. Generous portions of 10 sweet and savory snack foods varying in
fat content were presented to children during the procedure: popcorn (6 g), potato
chips (58 g), pretzels (39 g), nuts (44 g), fig bars (51 g), chocolate chip cookies (66 g),
fruit-chew candy (66 g), chocolate bars (66 g), ice cream (168 g) and frozen yogurt
(168 g). Manufacturers’ information was used to convert gram weight consumption
into caloric intakes.
Free Access Procedure
Children’s intake in an unrestricted setting
Children were seen individually in a setting where they were provided free access
to toys and to generous quantities of the 10 snack foods listed above. To minimise
the influence of hunger on snack food intake children were seen immediately after
eating their usual lunch. Each child was observed eating lunch by one trained staff
member to confirm that a meal was consumed prior to participation in the experimental procedure. In addition, children also had to indicate that they were “full”
in order to participate. Each child was asked to indicate the extent to which they
were hungry using three cartoon figures depicting an empty stomach, half empty
stomach and full stomach. Only those children who indicated that they were not
hungry (full stomach) participated in the procedure. To ensure that each child had
an opportunity to taste the snack foods, a rank-order food preference assessment
was performed prior to the free access portion of the procedure (Birch, 1979a,b). In
this procedure, the child takes small tastes of foods and places them in front of
cartoon faces depicting “yummy”, “yucky” and “just okay”. Following the preference
assessment, the child was shown various toys that were available for a play session.
Containers holding generous portions of the snack foods described above were also
made available. The child was told that he/she could play with the toys or eat any
of the foods while the experimenter did some work in the adjacent room. The
experimenter then left the room for 10 min and the child was observed using a oneway mirror from the adjacent room. When the experimenter returned, each child
was asked about the extent to which his/her parents restricted access to each of the
10 snack foods. Snack food intake was measured by comparing the pre- and postweights of the snack foods. Anthropometric data were obtained during a separate
session. Parents completed a set of questionnaires at home.
Statistical Analyses
Of those 70 children participating, 2 did not complete the snack food session, 8
children did not provide complete information regarding parents’ restriction and 4
children did not provide skinfold measurements. Univariate statistics were generated
for all variables. Independent t-tests were used to compare each variable across boys
and girls. Regression analyses was used to test the primary hypotheses that: (1)
maternal and (2) child reports of restricted access to 10 snack foods were related to
children’s intake of those foods in an unrestricted setting. Pearson’s rank-order
correlations generated in preliminary data analysis revealed distinct differences in
patterns of association across boys and girls. Therefore, first-order gender interactions
were used in each regression model. No second-order interactions were tested. In a
number of instances, the interaction between the main predictor variable and child
gender was a good predictor of the criterion variable, although no main effects were
apparent. In these cases, the interaction between thes …
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