Glass half empty? Nutrition studies shouldn’t just focus on what parents do wrong

If it takes a village to raise a child, it also takes a village to care for children’s food needs.

Children’s health and nutrition outcomes are nurtured directly by family caregivers, but also by a broader “village” of policymakers and governments, health and education systems, social services and civil-society groups, as well as others working at both national and local levels.

Lessons learned from academic research studies help today’s multi-sector villages improve health policies, medical treatments and approaches for preventing children’s food- and eating-related problems.

Yet, medical research studies focus more on what parents are doing wrong than they do on the social conditions and resources that families and communities need to improve kids’ nutrition.

In our recent paper, we found that studies published in medical journals are stuck in a rut, repeating some outdated tropes and assumptions. The recipe to care well for school-aged children’s food needs is due for a refresh.

Food care

We are food and nutrition researchers and dietitians who have painstakingly reviewed a breadth of food and nutrition studies, including authoring rigorous reviews about childhood nutrition and family food practices.

Our team recently combed through two leading medical research databases to find out what questions, theories and measurements health researchers commonly use to study the processes involved in caring for school-aged children’s food and nutrition needs.

We couldn’t find a term that described exactly what we were looking for, so we proposed a concept and research framework called “food care.” We described the concept of food care as “the processes of feeling concern or interest about food, or taking action to provide food necessary for the health, welfare, maintenance, or protection of oneself or someone else.”

We found lots of valuable studies about what children eat, risk factors for sub-optimal diets and describing how parents feed their kids.

But overall, studies largely ignored the most important elements of our food care framework. This includes social and political factors and the emotional, cognitive and physical work that goes hand-in-hand with nourishing children.

These issues are well established in other fields of social science, but health research continues to largely overlook them.

Blaming parents

Health research about children’s food care largely centers on the family, including parents’ food practices and household conditions that shape what and how children eat. While this field is progressing, when (if at all) studies about school-aged children talked about food care, children’s eating and nutrition challenges were most often described as issues that stemmed from parents’ shortcomings.

Both the food care measures themselves and the child outcomes most commonly studied were more often than not described as harmful. Three-quarters of studies we analyzed focused on how parental actions increased children’s risks of feeding problems, disordered eating, excess weight or poor mental health.

The four main categories of food care that researchers focused on in the 20 studies analyzed included:

• Caregivers’ feeding practices
• Parents’ actions focused on children’s body size or weight
• Ways that parents cultivate healthy eating
• Mealtime interactions

In studies where many factors were measured, research conclusions often focused squarely on things parents were doing “wrong” or should improve.

Even when the size of the effects found were very small, or little meaningful impact of parental actions were identified, research conclusions were often still tinged with parent-blaming. Fingers were pointed at parents described as doing “too little” to foster healthy dietary choices, but also at those described as overzealous and trying too hard. Parents could seldom catch a break in these studies.

On the flip side, researchers rarely mentioned or tried to assess how parents’ food care efforts contributed to building healthy relationships, connections, trust or family traditions or bonds, psychological attachment, health benefits or mental well-being for children or other family members, or the benefits of food care for the wider community.

Assumptions baked into research

Researchers are currently working in an era in which “intensive parenting” is the cultural ideology and norm. Intensive mothering, as coined by sociologist Sharon Hayes, reflects ideas about “good” mothering that are child-centered, emotionally absorbing, labor-intensive and expert-guided.

While health studies seldom named their own assumptions about gender roles or parenting beliefs, intensive mothering approaches seeped into the types of recommendations found across many studies.

These ways of thinking sometimes lay beneath assumptions and recommendations that parents should always try harder, spend more time, money and labor. Or research language presumed that parents—and particularly mothers—are, or should be, the main party responsible for children’s health outcomes.

Such ideas also showed up in study recommendations that tended to blame parents for outcomes that may be out of their control, clinically irrelevant or benign, while overlooking the benefits of food care and the often invisible work of feeding a family.

Similar trends were called out in the field of psychology nearly 40 years ago when psychologist Paula Caplan suggested “blaming mothers for their children’s psychological problems has a long and, unfortunately, respected history.”

Parents, as children’s primary caregivers and first teachers, do influence children’s eating patterns, behaviors and habit development. But they do so in a broad and complex social context that is influenced by political, historical and community conditions. These conditions are under-examined in discussions of family food work in medical studies.

Recommendations from some of these studies suggested that medical professionals should provide parents with more guidance about healthy eating and food-related parenting strategies. But authors seldom mentioned structural supports such as policies, programs or tangible resources that would help parents succeed.

Yet parents contend with lots of conflicting factors and considerations when deciding what, when, where and how to feed their children. In many cases, it’s not as simple as just following available dietary advice.

What’s needed to provide quality food care

Evidence from medical research contributes to improved pediatric nutrition policies, programs and clinical practice. But research in leading medical journals about what and how to feed school-aged children remains largely disconnected from the complex realities of family life and the political forces that shape it.

The sample of studies we analyzed largely overlooked measuring and talking about the important ingredients needed to provide good quality food care for children. These include affording and accessing nutritious food, safe food storage and preparation facilities, resources, time, childcare and available school food programs, food literacy knowledge and skills, neighborhood food environments and overarching institutional and social policies and conditions that foster food care.

These topics were occasionally mentioned on the fringes and have long been topics of study in some corners of sociology, political science and food studies research.

But it’s time that medical researchers and those who read and use nutrition studies take a closer look at the unnamed assumptions baked into research to make sure we’re not perpetuating one-size-fits all tropes about how parents—namely mothers—can “do better” while discounting the effort parents are already putting into feeding their children.

Health researchers can progress by more actively reflecting on their own assumptions about gender roles, good parenting, healthy eating and idealized family meals, and how these understandings are infused into scholarly work and the ways we measure and talk about how to feed children well.

In the 1980s, family food researcher Marjorie DeVault pointed out how important it is to name and study the valuable daily work of feeding families, but there remains much work to be done.

This article is republished from The Conversation under a Creative Commons license. Read the original article.