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Abstract：
BACKGROUND: Child eating behaviors (CEBs) and parental feeding practices (PFPs) play critical roles in childhood obesity. However, the bidirectional relationships between CEBs and PFPs remain equivocal. This longitudinal study aimed to explore their bidirectional relationships.
METHODS: A convenience sample of 870 parents with preschoolers was recruited in this longitudinal study (Shanghai, China). Three non-responsive feeding practices (NFPs), three responsive feeding practices (RFPs), five CEBs, and covariates were collected using validated questionnaires at baseline and the 6-month follow-up. Cross-lagged analyses using structural equation modeling (SEM) were performed to examine their bidirectional relationships.
RESULTS: Eight hundred and fifty-three parents completed questionnaires, with a response rate of 98%. The mean age of their children at baseline was 4.39 years (standard deviation = 0.72 years). Eighteen out of sixty longitudinal cross-lagged paths were statistically significant. Parental encouragement of healthy eating and content-restricted feeding were found to be bidirectionally associated with child food fussiness. Four parent-driven associations and one child-driven association were identified between RFPs and CEBs. For example, monitoring was negatively associated with children\'s unhealthy eating habits (β = -0.066, standard error (SE) = 0.025, p < 0.01). Eight child-driven associations and one parent-driven association were observed between NFPs and CEBs. For example, higher child satiety responsiveness predicted a higher pressure to eat (β = 0.057, SE = 0.029, p < 0.01) and the use of food as a reward (β = 0.083, SE = 0.031, p < 0.01).
CONCLUSIONS: There were bidirectional, parent-driven, and child-driven associations. Parents should be encouraged to adopt RFPs to shape CEBs. Increasing parents\' understanding of CEBs and providing them with reasonable coping strategies would help optimize PFPs.
METHODS: A convenience sample of 870 parents with preschoolers was recruited in this longitudinal study (Shanghai, China). Three non-responsive feeding practices (NFPs), three responsive feeding practices (RFPs), five CEBs, and covariates were collected using validated questionnaires at baseline and the 6-month follow-up. Cross-lagged analyses using structural equation modeling (SEM) were performed to examine their bidirectional relationships.
RESULTS: Eight hundred and fifty-three parents completed questionnaires, with a response rate of 98%. The mean age of their children at baseline was 4.39 years (standard deviation = 0.72 years). Eighteen out of sixty longitudinal cross-lagged paths were statistically significant. Parental encouragement of healthy eating and content-restricted feeding were found to be bidirectionally associated with child food fussiness. Four parent-driven associations and one child-driven association were identified between RFPs and CEBs. For example, monitoring was negatively associated with children\'s unhealthy eating habits (β = -0.066, standard error (SE) = 0.025, p < 0.01). Eight child-driven associations and one parent-driven association were observed between NFPs and CEBs. For example, higher child satiety responsiveness predicted a higher pressure to eat (β = 0.057, SE = 0.029, p < 0.01) and the use of food as a reward (β = 0.083, SE = 0.031, p < 0.01).
CONCLUSIONS: There were bidirectional, parent-driven, and child-driven associations. Parents should be encouraged to adopt RFPs to shape CEBs. Increasing parents\' understanding of CEBs and providing them with reasonable coping strategies would help optimize PFPs.
摘要：
背景：儿童饮食行为（CEB）和父母喂养行为（PFP）在儿童肥胖中起关键作用。然而,CEB和PFP之间的双向关系仍然模棱两可。这项纵向研究旨在探索它们的双向关系。
方法：这项纵向研究招募了870名学龄前儿童父母的便利样本(上海，中国）。三种无反应的饲喂做法(NFP)，三种反应性喂养方法(RFP)，五个CEB，在基线和6个月随访时使用经过验证的问卷收集协变量.使用结构方程模型（SEM）进行交叉滞后分析，以检查它们的双向关系。
结果：853位家长填写了问卷，回复率为98%。他们的孩子在基线时的平均年龄为4.39岁（标准差=0.72岁）。60条纵向交叉滞后路径中有18条具有统计学意义。发现父母鼓励健康饮食和限制内容喂养与儿童食物烦躁双向相关。在RFP和CEB之间确定了四个父母驱动的关联和一个孩子驱动的关联。例如,监测与儿童不良饮食习惯呈负相关(β=-0.066,标准差(SE)=0.025,p<0.01)。在NFP和CEB之间观察到八个儿童驱动的关联和一个父母驱动的关联。例如,较高的儿童饱腹反应性预示着较高的进食压力（β=0.057，SE=0.029，p<0.01）和使用食物作为奖励（β=0.083，SE=0.031，p<0.01）。
结论：存在双向，父驱动，和儿童驱动的协会。应鼓励父母采用RFP来塑造CEB。增加父母对CEB的理解并为他们提供合理的应对策略将有助于优化PFP。
方法：这项纵向研究招募了870名学龄前儿童父母的便利样本(上海，中国）。三种无反应的饲喂做法(NFP)，三种反应性喂养方法(RFP)，五个CEB，在基线和6个月随访时使用经过验证的问卷收集协变量.使用结构方程模型（SEM）进行交叉滞后分析，以检查它们的双向关系。
结果：853位家长填写了问卷，回复率为98%。他们的孩子在基线时的平均年龄为4.39岁（标准差=0.72岁）。60条纵向交叉滞后路径中有18条具有统计学意义。发现父母鼓励健康饮食和限制内容喂养与儿童食物烦躁双向相关。在RFP和CEB之间确定了四个父母驱动的关联和一个孩子驱动的关联。例如,监测与儿童不良饮食习惯呈负相关(β=-0.066,标准差(SE)=0.025,p<0.01)。在NFP和CEB之间观察到八个儿童驱动的关联和一个父母驱动的关联。例如,较高的儿童饱腹反应性预示着较高的进食压力（β=0.057，SE=0.029，p<0.01）和使用食物作为奖励（β=0.083，SE=0.031，p<0.01）。
结论：存在双向，父驱动，和儿童驱动的协会。应鼓励父母采用RFP来塑造CEB。增加父母对CEB的理解并为他们提供合理的应对策略将有助于优化PFP。
