Influence of grandparents on the dietary intake of their 2-12-year-old grandchildren: A systematic review.

AIM: Grandparents are assuming increased child-caregiving responsibilities, which potentially influences the dietary intake of grandchildren. The aim of this systematic review is to determine the influence of grandparental care on the dietary intake, food-related behaviours, food choices and weight status of their preschool and school-aged grandchildren.

METHODS: Six electronic health databases were searched in January 2017. Inclusion criteria were publication in English language, peer-reviewed journal between 2000 and 2017; children aged 2-12 years; study outcomes included child dietary intake/weight status, grandparent nutrition knowledge/beliefs or grandparent/parent feeding practices. Included studies were appraised for quality and bias. The review was registered with PROSPERO, number CRD42016047518.

RESULTS: Sixteen studies were identified in the review, published between 2007 and 2016, with 15 assessed as moderate or high quality. Nine studies reported grandparental child feeding attitudes and behaviours that are considered to negatively influence child dietary intake, while three studies identified positive influences. Seven studies identified that differences in child feeding attitudes and behaviours between parents and grandparents created conflict and tensions between caregivers, often resulting in poor feeding practices. Statistically significant positive associations (odds ratio 1.47-1.72) between grandparent cohabitation and increased rates of child overweight and obesity were found in four studies.

CONCLUSIONS: Grandparents in caregiving roles may negatively influence the dietary intake and weight status of their grandchildren. More rigorous, targeted studies are required to further define the mechanisms by which grandparents' knowledge, attitudes and feeding behaviours may influence child dietary intake. This review suggests that grandparents may be an important audience to target in future child nutrition interventions.