Elsevier

Appetite

Volume 48, Issue 3, May 2007, Pages 377-383
Appetite

Research Report
Influence of grandparents on eating behaviors of young children in Chinese three-generation families

https://doi.org/10.1016/j.appet.2006.10.004Get rights and content

Abstract

Aim

To investigate how grandparents influence their young grandchildren's eating behaviors in Chinese three-generation families.

Methods

This qualitative study used semi-structured in-depth interviews with 12 parents (3 male and 9 female) and 11 grandparents (4 male and 7 female) in Beijing, China.

Results

Three domains emerged in this study: (1) grandparents were the primary caretakers of children in the three-generation families. They played an important role in planning and cooking family meals; (2) grandparents’ attitudes influenced young children's nutrition and eating habits. They held the belief that children being heavy at a young age would assure that they had a good nutrition status and would become tall in the future. They showed a tendency towards urging the children to eat more meals and larger portions at served meals; (3) grandparents used food as an educational and emotional tool. They shaped the behavior of their grandchildren and expressed love and caring through food.

Conclusions

Grandparents were dominant in shaping children's eating behavior in some three-generation families in Chinese urban areas. Nutrition education involving grandparents is a potential framework for developing a healthy dietary behavior in young children.

Introduction

Childhood obesity has been a growing health problem in many countries in recent years (James, Leach, Kalamara, & Shayeghi, 2001; Ogden, Flegal, Carroll, & Johnson, 2002). The fast economic development in China has added the country to those experiencing the world epidemic of obesity (Iwata, Hara, Okada, Harada, & Li, 2003; Luo & Hu, 2002). Obesity in childhood is associated with an increased risk for chronic illnesses, such as cardiovascular diseases and diabetes mellitus (Freedman, 2002), and it also has a profoundly negative effect on the psychological health of children (Davison & Birch, 2001). Although childhood obesity is a multi-factorial problem, food intake and dietary behavior are key aspects (Richketts, 1997). Children's eating habits, in turn, are influenced by a variety of factors, one of the most important of these being family food environment (Klesges, Stein, Eck, Isbell, & Klesges, 1991; Nicklas et al., 2001; Tiggemann & Lowes, 2002) as dietary habits acquired in childhood tend to persist throughout adulthood (Nicklas, 1995).

For young children the most influential aspect of the immediate social context is the family. The family eating environment includes parents’ actual child feeding practices, their own dietary habits, as well as the beliefs and attitudes they verbally convey concerning healthy nutrition and promoted eating behavior. There is naturally an interaction between the above factors, therefore parental influences can be transmitted directly (through the food served) and indirectly (through conveying behavioral models and social norms) to children (Cook et al., 2004; Gibson, Wardle, & Watts, 1998). The food environment that parents provide during early childhood undoubtedly helps shape children's food preference as well as their subsequent selection patterns and eating styles (Birch & Fisher, 1998). A highly influential component of the home food environment is obviously what is served at and between meals, i.e. parents’ child feeding practices. Children eat more of what is available: preschoolers whose families served more fruits and vegetables were shown to have higher consumption of the above (Hannon, Bowen, Moinpour, & McLerran, 2003).

Parents also influence their children's food preferences through their verbal dietary comments and restrictions employed (Baker, Whisman, & Brownell, 2000; Wardle, Sanderson, Guthrie, Rapoport, & Plomin, 2002). In terms of restrictions, either of the extremes—excessive control or excessive permissiveness—of children's eating can negatively affect a child's healthy eating behavior. A previous study has shown that parents’ restriction of palatable snacks promoted consumption of restricted foods in the absence of hunger in young girls, while at the same time this type of behavior led to negative self-evaluation in these children (Fisher & Birch, 2000). Permissiveness, at the other end of the scale, was associated with a higher likelihood of frequent soft drink- and sweets consumption (Vereecken, Keukelier, & Maes, 2004).

Most research on risk factors for childhood obesity originates from a Western cultural context where a sedentary lifestyle and the excessive consumption of soft drinks and fatty foods have been implicated as major contributing factors. Given that the social structure in China is quite different, it is plausible that additional or other culture-bound risk factors play a role in the growing rate of childhood obesity. While there is certainly a lack of research with such a specific focus, given the magnitude of the problem of childhood obesity in China, there is a definite need for effective and culturally sensitive prevention strategies. To tailor such strategies, a genuine knowledge is needed about factors influencing children's lifestyles in China.

Most families in Chinese urban areas only have one child due to the “family planning policy” implemented in the 1980s. We investigated 5608 families with children between 0 and 6 years of age, who were selected randomly from 12 communities and 5 kindergartens in urban Beijing in 2004. One-child families covered 92.8% of the whole sample (data not shown). According to the report of the Fifth Population Census of China, 90% of the children between 0 and 6 years of age were ‘only child’ in urban Beijing (Statistics Bureau of Beijing, 2002). Therefore, these ‘only child’ tend to be over-cared for and often overfed by adult caregivers, especially in three-generation families. In these families children share a household with both their parents and grandparents; in Chinese urban areas 50–70% of young children are mainly looked after by their grandparents (Li, 2005; Lu, 2004). Therefore, a specific culture-bound factor influencing children's eating behaviors in China would entail the attitudes, feeding practices and dietary styles of grandparents. Indeed, significant correlations have been observed between the grandparents’ lifestyle and children's BMI (Cullen et al., 2001).

The aim of the present study was to investigate how grandparents influence their young grandchildren's eating behaviors in Chinese three-generation families. Because the objective of this study was to explore the complex and multifaceted topic of feeding practices and eating behaviors, a qualitative research design was used. Qualitative data can provide a rich description of how people think and understand the world around them, allowing a unique insight into attitudes and factors that motivate certain forms of behavior. The findings may be useful for a framework of childhood obesity prevention.

Section snippets

Sample

We interviewed 12 parents (3 male and 9 female) and 11 grandparents (4 male and 7 female) from 23 different families in the Beijing urban area. To enhance the transferability of our findings, we selected the sample from parents and grandparents of children who attended four kindergartens in two different districts in Beijing. We chose participants to reflect a range of different characteristics in terms of income levels, occupational status and place of residence. From the 23 interviewees 13

Results

The three domains identified through the seven themes included: (1) grandparents as primary caretakers of children in the three-generation family, (2) grandparents’ attitudes to child nutrition and healthy eating habits, and (3) the role of food as an educational and emotional tool.

Domain 1. Grandparents as primary caretakers of children in the three-generation family: The grandparents were the ones to look after the child in all of the interviewed families. Most grandparents had retired and

Methodological considerations

Credibility, a commonly used term addressing the validity of qualitative studies, was enhanced by giving the reader the full interview guide and by using respondent validation, i.e. interview participants were invited to evaluate and comment on the findings. The sample was purposively chosen to represent all stakeholders in a three-generation family, and 23 interviews provide a sound base for thematic analysis within the qualitative research tradition. The fact that the interviewer was a

Acknowledgments

We thank Dr. Xia Xiulan, Dr. Xin Guiru and Dr. Liu Guizhen for their contributions and the parents, grandparents who participated in this study. We thank Prof. Ding Zongyi for his advice on the study design.

References (28)

  • C.W. Baker et al.

    Studying intergenerational transmission of eating attitudes and behaviors: Methodological and conceptual questions

    Health Psychology

    (2000)
  • L.L. Birch

    Children's preferences for high-fat foods

    Nutrition Review

    (1992)
  • L.L. Birch et al.

    Development of eating behaviors among children and adolescents

    Pediatrics

    (1998)
  • T.J. Cole et al.

    Establishing a standard definition for child overweight and obesity worldwide: International survey

    British Medical Journal

    (2000)
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