1. Better maternal diet and a covert style of control over children’s eating habits improve the quality of young children’s diets Megan Jarman MSc, APHNutr MRC Lifecourse Epidemiology Unit mj@mrc.soton.ac.uk

2. Maternal and child diet Mother’s quality of diet Young child’s quality of diet What other factors are associated with children’s diet quality?

3. Control over children’s eating habits Covert control methods cannot be detected by the child Overt control methods can be detected by the child Previous findings: Mother reports more covert control = child eats fewer ‘unhealthy’ snacks More covert and overt control = child consumes more fruit and vegetables Brown, K et al (2008) Appetite 50:252-259

4. Covert and Overt Control Scale* –E.g. participants are asked how often…. Covert: “…do you avoid buying sweets and crisps and bringing them into the house?” “…do you try not to eat unhealthy foods when your child is around?” Overt: “…are you firm about what your child should eat?” “…do you encourage your child to eat more if you feel they haven’t had enough that day or mealtime?” *Ogden et al, (2006) Appetite 47: 100-106 10-item scale; 5 reflecting covert and 5 reflecting overt styles of control

5. Cross-sectional Survey Women who take part in the Southampton Initiative for Health and have a child aged 2-4 years Questionnaire administered over the telephone Measures include: 25-item Food Frequency Questionnaire Covert and overt control scale Demographics Photos © Magda Segal (2000)

6. Children’s Characteristics N = 348 Children characteristics Age (mean (SD))3 (1) Gender:N% Girls17149 Number of siblings 06619 119556 25416 3+329 Maternal characteristics Age (mean (SD))32 (5) Educational level :N% Low ≤ GCSE13439 High >GCSE21461

7. Mother and child’s diet quality

8. Child’s diet quality (z-score) by control style and maternal diet quality Coefficients95% Confidence Intervals P-value Covert control (z-score)0.250.15, 0.35<0.001 Overt control (z-score)0.04-0.05, 0.130.43 Coefficients95% Confidence Intervals P-value Covert control (z-score)0.180.08, 0.27<0.001 Maternal diet score (z- score) 0.450.35, 0.56<0.001 Adjusted for maternal factors and child characteristics

9. Child’s diet quality by control style and maternal diet quality

10. Conclusions and Future Work Maternal quality of diet and use of covert control over her children’s eating habits have independent effects on the quality of her child’s diet Interventions designed to improve the quality of young children’s diets could consider the style of control that the mother uses over her child’s eating habits Follow-up survey post-intervention and qualitative work

11. Acknowledgements Thank you: To the women who took part in our survey. To my colleagues in the Southampton Initiative for Health Study Group Those who support our work: Louis Bonduelle Foundation