The relationship between family diet consumption, family environment, parent anxiety and nutrition status children during the COVID-19 pandemic: a longitudinal study

Abstract

BackgroundThe COVID-19 pandemic has exacerbated the trends of childhood overweight, obesity, and malnutrition, as well as increased psychological stress and family conflicts among family members. It is important to explore the relationship between changes in the family environment during the COVID-19 on child nutrition.ObjectiveThis study aims to analyze the nutritional status of Chinese children during the COVID-19 pandemic and its relationship with family diet, family environment, and parental anxiety, in order to provide evidence for further interventions in children’s nutritional status.MethodThis study included 7,645 primary and secondary school students and their parents from five schools in Chengdu, China. Chi-square tests were used to analyze the categorical variables of children’s malnutrition, overweight, obesity, and parental anxiety. T-tests were used to assess changes in the continuous variable of family environment between two rounds of follow-up surveys. Multiple logistic regression analysis was employed to examine the impact of changes in family diet during the COVID-19 pandemic on children’s nutritional status. Generalized estimating equations were used to analyze the effects of family environment and parental anxiety on childhood obesity.ResultThe prevalence of malnutrition and obesity decreased from 11.64% and 11.60% in wave 1 to 4.96% and 10.50% in wave 2, and the rate of overweight increased from 13.11% in wave 1 to 13.73% in wave 2. Children whose families reduced consumption of staple foods during the COVID-19 were more likely to be frail, and families increased consumption of sugary drinks, take-out or meal delivery services, living in towns, family environmental barriers, and parental anxiety were risk factors for overweight obesity. Mother’s education level in middle and high school and low age were protective factors for overweight obesity.ConclusionThe physical environment of the family, the emotions of family members, and children’s perceptions of the family’s soft environment can influence children’s eating behaviors, children’s nutritional intake, and malnutrition and obesity in children under public health emergencies, and family-based dietary interventions may be effective. Parents can increase consumption of healthy foods and improve the family environment, which improve their growth.

The Role of Parental Adherence to the Mediterranean Diet and Family Time Together in Children’s Weight Status: The BeE-School Project

“…As already mentioned, the family's diet significantly influences the food consumption of children [13]. Therefore, parents adhering to the Mediterranean diet could influence the health outcomes of their children.…”

“…According to Brannen and colleagues [38], this is one of the best moments for family 'togetherness'. Additionally, mealtime serves as a moment when family members gather to share food, engage in emotional communication, and impart valuable knowledge to children [13]. This family time is classified as 'non-active family time', similar to activities like watching TV or a video together, playing indoor games together, visiting friends or relatives together, and sitting and talking about things together.…”

“…The impact of family dietary patterns on children's eating habits and intake has been firmly documented [13]. Consequently, the crucial role of families in enhancing their children's nutritional health by increasing the consumption of wholesome foods and decreasing the intake of low-nutrition and energy-dense items such as sweetened beverages is well established [13,14].…”

“…Despite the well-established associations between family time, adherence to the Mediterranean diet, and children's health outcomes [13,15], there is limited evidence about their associations in children from schools prone to vulnerability. It is possible that children attending these disadvantaged schools are at a higher risk of overweight or obesity than children from non-disadvantaged schools [25].…”

Examining the association of family environment and children emotional/behavioral difficulties in the relationship between parental anxiety and internet addiction in youth

“…Parental anxiety can manifest within the family atmosphere, influencing the emotions and behaviors of the child ( 33 ). During the COVID-19 pandemic, one study focused on investigating the overall impact of the family environment on children’s diet and nutritional status ( 34 ). In contrast, research examining the role of family intimacy in collaborative esports using the Switch device concentrated on the dimension of family relationship intimacy ( 35 ), aiming to understand its specific effects on the gaming experience.…”