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Mealtime Interactions Relate to Dietary Adherence and Glycemic Control in Young Children With Type 1 Diabetes

¹ Division of Child Behavioral Health, Department of Pediatrics and Communicable Diseases, C.S. Mott Children’s Hospital and the University of Michigan, Ann Arbor, Michigan
² Division of Endocrinology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
³ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio

Address correspondence and reprint requests to Susana R. Patton, PhD, Division of Child Behavioral Health, University of Michigan, 1924 Taubman Ctr., Box 0318, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0318. E-mail: susanap{at}med.umich.edu

OBJECTIVE—This study examined the relationships between parent-child mealtime interactions and dietary adherence and glycemic control in young children with type 1 diabetes. It was hypothesized that young children who exhibited disruptive mealtime behaviors would have more dietary deviations (poorer dietary adherence) and poor glycemic control. It was also hypothesized that parents of young children who used ineffective/coercive parenting strategies at mealtimes would have children with more dietary deviations and poor glycemic control.

RESEARCH DESIGN AND METHODS—A total of 35 families of children (aged 2.2–7.9 years) with type 1 diabetes were recruited from a pediatric hospital. Families had at least three meals videotaped in their home, which were coded for parent, child, and eating behaviors, using the Dyadic Interaction Nomenclature for Eating. Children’s dietary adherence was assessed according to deviations from the prescribed number of carbohydrate units per meal. Children’s average glycemic excursion was assessed prospectively for 2 weeks, using a standardized home blood glucose meter.

RESULTS—Findings demonstrated significant positive relationships between children’s mealtime behavior, dietary deviations, and glycemic control. An examination of parent behaviors revealed significant positive correlations between parents’ use of ineffective/coercive parenting strategies and children’s dietary deviations and glycemic control.

CONCLUSIONS—This was the first study to examine the relationship between parent-child mealtime interactions and health outcomes in young children with type 1 diabetes. The mealtime problems examined can be improved through specific behavioral interventions. Future research is needed to examine how parent-child interactions at mealtimes relate to children’s health outcomes to inform clinical care.

Abbreviations: BPFAS, Behavioral Pediatrics Feeding Assessment Scale • DINE, Dyadic Interaction Nomenclature for Eating

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				S. R. Patton, L. M. Dolan, and S. W. Powers Differences in Family Mealtime Interactions between Young Children with Type 1 Diabetes and Controls: Implications for Behavioral Intervention J. Pediatr. Psychol., September 1, 2008; 33(8): 885 - 893. [Abstract] [Full Text] [PDF]