Influence of Grandparental Child Care on Childhood Obesity: A Systematic Review and Meta-Analysis

Abstract

Objective: This study systematically reviewed the scientific literature on the relationship between grandparental child care and childhood obesity. Methods: Keyword/reference search was performed in CINAHL, PsycINFO, PubMed, and Web of Science. Meta-analysis was conducted to estimate the pooled effect of grandparental child care on children's weight outcomes. Results: A total of 23 studies were identified, including 9 longitudinal, 9 cross-sectional, 2 case-control, and 3 qualitative studies. Eight studies were conducted in China, five in Japan, three in the United Kingdom, two in the United States, and one in five other countries each. Twelve studies focused on grandparents' roles as a main caregiver in the family, and seven on grandparents' coresidence. Data from 14 studies were used in meta-analysis, 10 focusing on childhood overweight/obesity and the other 4 on children's BMI z-scores. Meta-analysis found that grandparental child care was associated with a 30% (95% confidence interval = 21-40) increase in childhood overweight/obesity risk. Grandparental child care was not associated with children's BMI z-scores after correcting for publication bias. Meta-regressions revealed no difference in the estimated effect of grandparental child care on children's weight outcomes by country or grandparents' specific roles (main caregiver in the family vs. co-residence). Conclusions: Preliminary evidence links grandparental child care to elevated risk of childhood overweight/obesity, but not BMI z-scores. Future research should focus on a specific child age group within a country, adopt systematic and field-validated measures on grandparental child care, and elucidate the pathways linking grandparental child care to children's weight outcomes.

Associations of mothers' source of feeding information with longitudinal trajectories of sugar‐sweetened beverage intake, 100% juice intake and adiposity in early childhood

“…Our grandmother subgroup findings are supported by existing literature on grandparent involvement, caregiving and/or cohabitation in three‐generation households in relation to children's poor dietary quality and adverse weight‐related outcomes 33‐36 . Toward understanding the mechanisms of these influences, extant studies have examined grandparent attitudes and practices related to child feeding and other weight‐related behaviors, 33 differences in attitudes and practices among parents vs grandparents, 33,37‐39 grandparent social support, 40 and grandparent adiposity in relation to maternal and child adiposity 41 .…”

Parental Leave, (In)formal Childcare, and Long-Term Child Outcomes

“…For instance, recent epidemiological research suggests that grandparent-provided care to children under the age of 3 is related to elevated risks of childhood obesity(Black et al, 2017;Lidgate et al, 2018;An et al, 2020).2Zhang and Managi (2020) show that a parental leave extension from 18 to 24 months to Japanese parents with childcare arrangement difficulties reduced maternal stress.…”

Engaging family members in maternal, infant and young child nutrition activities in low‐ and middle‐income countries: A systematic scoping review

“…Notably, none of the studies directly addressed obesity prevention, other than a follow‐up study with participants from a breastfeeding intervention engaging grandmothers in Brazil (Schwartz et al, 2015 ). In high‐income countries, there is growing attention to the need for interventions to engage fathers, and to a lesser extent grandparents and other family members, in obesity prevention interventions during the first 1,000 days (An et al, 2020 ; Ciampa et al, 2010 ; Davison et al, 2020 ; Jansen et al, 2018 ; Wasser et al, 2013 ). As the nutrition transition accelerates in LMICs and the double burden of malnutrition increases, expanding family support to address both undernutrition and overweight and obesity through double‐duty actions for nutrition (Hawkes et al, 2020 ; World Health Organization, 2017 ) will be important (Williams et al, 2019 ).…”