Global relationship between parent and child obesity: a systematic review and meta-analysis

Abstract

Background: The growing prevalence of overweight and/or obese children is an important public health problem in both developed and developing countries. Although the association of obesity between parents and their children is well known, its underlying mechanisms are not well established.

Purpose: This meta-analysis examined parent-child (PC) relationships in obesity and identified factors such as world region and country income level that may influence this relationship.

Methods: We identified all related studies published between January 1, 2015 and May 31, 2020 by conducting a literature search using the MeSH terms "obesity," "overweight," "body mass index," "parent," "child," "associate," and "relate" in the PubMed database in English.

Results: The meta-analysis of 23 studies that reported an odds ratio (OR) for parent and child obesity associations found a significant association between parents and children who were overweight or obese (pooled OR, 1.97; 95% confidence interval, 1.85-2.10). A meta-regression analysis was used to examine the sources of interstudy heterogeneity. The association between parent and child obesity was higher in Asia than in Europe and the Middle East and higher in high-income countries than in middle-or low-income countries. In addition, a higher association between parent and child obesity was found when both parents were obese than when only the father or mother was obese. This study from multiple countries indicates a significant PC relationship in weight status that varies according to PC pair type, parent and child weight statuses, world region, and country income level.

Conclusion: These results demonstrate that the risk of childhood obesity is greatly influenced by parental weight status and indicate that parents could play an important role in preventing child obesity.

Keywords: Child; Obesity; Parent.

Fig. 1.

Flow diagram of the literature search.

Fig. 2.

Risk of bias. (A) Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across all included studies. (B) Risk of bias summary: review authors’ judgements about each risk of bias item for each included study.

Fig. 3.

Meta-analysis results of reported odds ratio (OR) of the correlation between parent and child obesity in 23 studies for parent-child pairs. Pooled estimation with 18 data points from 23 studies. Multiple OR for same studies reflect OR for different subgroups (middle- and low-income country OR: 2.08 [95% CI, 1.66–2.59]; test for heterogeneity: Cochrane Q=229.44 [df=10], P<0.001; vs. high-income country OR: 8.74 [95% CI, 5.54–13.78]; test for heterogeneity: Cochrane Q=58.74 [df=6], P<0.001). CI, confidence interval; df, degrees of freedom.

Fig. 4.

Meta-analysis results of reported odds ratio (OR) of the correlation between parent and child obesity in 23 studies for the father-child pair. Pooled estimation with 38 data points from 23 studies. Multiple OR for same studies reflect OR for different subgroups (middle- and low-income country OR: 1.69 [95% CI, 1.44–1.99]; test for heterogeneity: Cochrane Q=212.63 [df=18], P<0.001 vs. high-income country OR: 1.47 [95% CI, 1.34–1.62]; test for heterogeneity: Cochrane Q=128.10 [df=18], P<0.001). CI, confidence interval; df, degrees of freedom.

Fig. 5.

Meta-analysis results of reported odds ratio (OR) of the correlation between parent and child obesity in 23 studies for the mother-child pair. Pooled estimation with 46 data points from 23 studies. Multiple OR for same studies reflect OR for different subgroups (middle- and low-income country OR: 1.47 [95% CI, 1.34–1.61]; test for heterogeneity: Cochrane Q=165.63 [df=19], P<0.001 vs. high-income country OR: 1.90 [95% CI, 1.72–2.10]; test for heterogeneity: Cochrane Q=313.66 [df=25], P<0.001). CI, confidence interval; df, degrees of freedom.