Analysis of the Longitudinal Association Between Parental Feeding Practices and Body Composition Among Children in Shenzhen

Abstract

Background: A national study from China in 2023 predicted that the prevalence of overweight and obesity among children aged 7-18 will increase from 23.4% in 2019 to 32.7% by 2030. Objectives: This study aimed to investigate the longitudinal association between parental feeding practices and children's body composition and weight status, and to assess the mediation effect of parental feeding practices in the relationship between socioeconomic status and childhood body composition. Methods: This longitudinal observational study was conducted between September and November 2021 in eight primary schools located in Luohu District, Shenzhen. Baseline and two follow-up surveys were administered annually during the same period from 2021 to 2023 (with one-year intervals). A total of 620 third-grade students (aged 8-10 years at baseline) and their parents were ultimately included in the study. Associations between parental feeding practices and children's weight status and body composition were analyzed using mixed-effects models. The mediation effect of parental feeding practices on the relationship between socioeconomic status and childhood body composition was assessed through bootstrapping analysis. Results: At follow-up, a significant upward trend in the prevalence of central obesity among children was observed. Among all parental feeding dimensions, perceived child weight (PCW) demonstrated a strong association with central obesity after Bonferroni correction (OR = 1.33, 95% CI = 1.16, 1.51); similarly, monitoring (MN) and concern about child weight (CN) were both significantly associated with central obesity as risk factors for central obesity (OR = 1.14, 95% CI = 1.06, 1.23; OR = 1.16, 95% CI = 1.07, 1.27), both p < 0.001. These associations were modified by baseline child sex, parental BMI, and maternal and paternal education levels. However, restriction (RST) was not significantly associated with either body composition or weight status. The relationship between family socioeconomic status (SES) and childhood overweight and obesity was mediated by pressure to eat (PE) (p < 0.05). Conclusions: MN, PCW, and CN are associated with an increased risk of obesity in children. However, no significant association was found between parental feeding practices and changes in children's body composition.

Keywords: body composition; children; obesity; parental feeding practices.

Figure 1

Intermediate path.