Parent mealtime actions that mediate associations between children's fussy-eating and their weight and diet

The present study evaluated parent mealtime actions that mediate associations between children's fussy-eating and their weight and diet. Participants included 236 feeding-clinic children in three diagnostic groups: 50 with autism, 84 with other special needs, and 102 without special needs. Children's weight was measured as body mass index percentile (BMI%), with only 26.4% of the present sample found to be underweight (BMI% less than 10). Parents reported children's diet variety as the number of 139 common foods accepted, children's FUSSINESS with the Child Eating Behavior Questionnaire, and their own use of four actions from the Parent Mealtime Action Scale: POSITIVE PERSUASION, INSISTENCE ON EATING, SNACK MODELING, SPECIAL MEALS. Multiple regression found that only SPECIAL MEALS explained variance in children's BMI% and diet variety. For children without special needs, mediation analysis revealed that variance in children's BMI% explained by FUSSINESS was accounted for entirely by the parent's preparation of SPECIAL MEALS. For all diagnostic groups, mediation analyses revealed that variance in children's diet variety explained by FUSSINESS was accounted for by the parent's use of SPECIAL MEALS. We conclude that although the parent's use of SPECIAL MEALS may improve BMI% in fussy-eating clinic children, it may also perpetuate their limited diet variety.