216 - Proactive Parenting is Associated with Discordant Maternal-Child Fruit and Vegetable Intake at 19 Months of Age

Publication Number: 4213.216

Robin Ortiz, NYU Grossman School of Medicine, New York, NY, United States; Carol Duh-Leong, Hassenfeld Children's Hospital at NYU Langone, New York, NY, United States; Christina N. Kim, New York University Grossman School of Medicine, New York, NY, United States; Mary Jo Messito, New York University Grossman School of Medicine, New York, NY, United States; Rachel S. Gross, New York University Grossman School of Medicine, New York, NY, United States

Background: It remains unknown why some maternal-child dyads share dietary eating patterns, while others demonstrate discordance. Prior research has shown that positive parenting strategies are associated with maternal wellbeing and optimal child development outcomes, but it remains unknown how positive parenting relates to healthy eating behaviors like fruit and vegetable (FV) intake. Understanding the contributing factors to dyadic dietary concordance may help to inform interventions that optimize healthy FV intake for the dyad while still prioritizing optimal parenting strategies.

Objective: To assess the relationship between positive parenting strategies and concordance or discordance in maternal-child FV intake.

Design/Methods: We conducted secondary cross-sectional analysis using data from the Starting Early Program (StEP) single-arm feasibility trial of a prenatal and pediatric primary care child obesity prevention intervention. Maternal diet at child age 19 months was assessed according to the Behavioral Risk Factor Surveillance System. Mothers reported on child FV intake in the past week. Mother-child (dyad) pairs were categorized into 4 groups based on daily FV intake (mother: ≥5 servings/day; child: top quartile vs. not): high concordant (both mother and child with high FV intake), high mother-low child discordant FV intake, low mother-high child discordant FV intake, and low concordant (both mother and child with low FV intake). Using the Parenting Young Children scale, 2 positive parenting strategies were assessed: proactive parenting and limit setting. Multinominal logistic regression models examined associations between parenting behaviors (independent variable) and dyadic dietary patterns (dependent variable).

Results: Mothers of 152 dyads (Table 1) were on average 30.1 (SD=6.2) years old; 75.0% had completed at least high school education, 77.6% were born outside of the United States, and 28.3% reported food insecurity. About one in five mothers (17.8%) met the recommended ≥5 daily FV servings. The most common dyadic pattern was high child, low maternal, FV intake (60.5%, 92/152). Higher proactive parenting attitudes, but not limit setting, was associated with greater likelihood to be in this discordant group compared to the high concordant group (RRR=1.8, 95% CI=1.2 – 2.7, Table 2).

Conclusion(s): Proactive parenting is associated with greater likelihood of being in a dyad characterized by high child, but low maternal, FV intake. Future work should aim to understand of how positive parenting practices relate to parental health behaviors.

Table 1. Maternal and Child Characteristics by Dietary Concordance Groups
2025.11.3_PAS abstract_proactive parenting and dyadic FV_TABLE 1.pdfP-values were obtained from analysis of variance (ANOVA) and chi-square tests. **p <.01.

Table 2. Multinomial Logistic Regression Between Parenting Behaviors and Maternal-Child Diet Concordance
2025.11.3_PAS abstract_proactive parenting and dyadic FV_TABLE 2.pdfReference Group: High Concordant; Adjusted model controls for maternal age, pre-pregnancy obesity, parity, nativity, education, household food security, WIC participation, depressive symptoms, child sex, ever breastfed, and intervention dose. * p<.05, ** p <.01.