Family influence on the nutritional status and eating habits of six to nine year-old children

SILVA, Gabriela Pap da; ALMEIDA, Sebastião de Sousa; BRAGA COSTA, Telma Maria

doi:10.1590/1678-9865202134e200165

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Sumário

Original • Rev Nutr 34 • 2021 • https://doi.org/10.1590/1678-9865202134e200165 copy

Family influence on the nutritional status and eating habits of six to nine year-old children

Influência familiar no estado nutricional e hábito alimentar de crianças de seis a nove anos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To investigate whether caregivers’ attitudes, beliefs, practices, alimentary habits, and nutritional status influence the alimentary habits and nutritional status of children aged six to nine years.

Methods

This cross-sectional study included 164 children and a family member (caregiver) each (n=164), carried out in the family health units of the municipality of Ribeirão Preto (SP), Brazil. Weight and height measurements were performed; each child was then evaluated by the application of both the Child Feeding Questionnaire and 24h recall (for calculating the Healthy Eating Index Revised), in addition to the assessment of adherence to healthy eating steps of the Ministry of Health, through a questionnaire.

Results

The results showed that the prevalence of being overweight was 18.3% in children and 32.9% in caregivers, and the prevalence of obesity was 15.9% and 37.9%, respectively. Most of the 56 children categorized as overweight also had overweight caregivers (82.1%; n=46). Concerns regarding children’s weight control were higher among caregivers responsible for overweight children (3.6±1.29). In contrast, caregivers responsible for children below or at normal weight demonstrated a greater tendency toward getting children to eat (3.3±0.97 and 3.9±0.99, respectively). The average score; of the children’s Brazilian Healthy Eating Index Revised (50.0±13.6) was similar to that of their caregivers (56.5±12.1).

Conclusions

Caregivers have a direct influence on the nutritional status and eating habits of children; therefore, they should be targeted in the processes of nutritional intervention for the prevention and treatment of childhood obesity.

Keywords
Child nutrition; Feeding behavior; Food consumption; Nutritional status; Pediatric obesity

Nutritional status		n	%
Children		164	100
	Severe thinness	1	00.6
	Thinness	5	03.0
	Normal	102	62.2
	Overweight	30	18.3
	Obesity	18	11.0
	Severe obesity	8	04.9
Caregivers		164	100
	Underweight	1	00.6
	Normal weight	47	28.6
	Pre-obesity	54	32.9
	Obesity class I	37	22.6
	Obesity class II	16	09.8
	Obesity class III	9	05.5

Nutritional status (Children)	Nutritional status (Caregivers)
	Under-weight		Normal weight		Over-weight		Total		p-value^* * McNemar’s test: a significance level of 5%.
	n	%	n	%	n	%	n	%	p-value^* * McNemar’s test: a significance level of 5%.
Underweight	0	0.0	3	06.4	3	02.6	6	03.7	<0.01
Normal weight	1	100	34	72.3	67	57.8	102	62.2
Overweight	0	0.0	10	21.3	46	39.6	56	34.1
Total	1	100	47	100	116	100	164	100

Factors of the CFQ	Child NS	n	Min	Q1	M	Q3	Max	p-value^* * Kruskal-Wallis test: a significance level of 5%; CFQ: Child Feeding Questionnaire; M: Median; Max: Maximum; Min: Minimum; NS: Nutritional Status; Q1: 1º Quartile; Q3: 3º Quartile.
Perceived Responsibility	Below weight	6	3.3	4.0	4.8	5.0	5.0	<0.50
	Suitable weight	102	1.3	4.0	4.3	5.0	5.0
	Overweight	56	1.3	3.7	4.3	5.0	5.0
Perceived Parent Weight	Below weight	6	2.5	3.0	3.1	3.2	3.5	<0.25
	Suitable weight	102	2.0	3.0	3.0	3.2	4.7
	Overweight	56	2.2	3.0	3.2	3.5	5.0
Perceived Child Weight	Below weight	6	2.0	2.3	2.8	3.0	3.0	<0.01
	Suitable weight	102	1.7	3.0	3.0	3.0	3.7
	Overweight	56	2.3	3.0	3.0	3.3	5.0
Concern About Child Weight	Below weight	6	2.0	2.7	3.5	4.3	4.7	<0.01
	Suitable weight	102	1.0	1.7	2.7	3.7	5.0
	Overweight	56	1.0	2.5	3.7	5.0	5.0
Restriction	Below weight	6	1.6	2.5	2.7	3.7	4.0	<0.44
	Suitable weight	102	1.0	2.6	3.2	3.6	4.6
	Overweight	56	1.0	2.7	3.5	3.9	4.6
Pressure to Eat	Below weight	6	2.2	2.2	3.5	4.0	4.5	<0.01
	Suitable weight	102	1.0	3.5	4.0	4.7	5.0
	Overweight	56	1.0	2.0	2.5	4.0	5.0
Monitoring	Below weight	6	1.0	1.7	3.5	5.0	5.0	<0.85
	Suitable weight	102	1.0	3.0	4.0	5.0	5.0
	Overweight	56	1.0	3.0	4.0	5.0	5.0

Level of adherence to the steps of healthy eating		Nutritional status								p-value^* * Fisher’s exact test: significance level 5%.
		Under-weight		Normal weight		Over-weight		Total
		n	%	n	%	n	%	n	%
Child										<0.01
	High adherence(7-9)	0	00.0	38	37.3	7	12.5	45	27.4
	Average adherence (4-6)	5	83.3	64	62.7	41	73.2	110	67.1
	Little adherence (0-3)	1	16.4	0	00.0	8	14.3	9	05.5
Total		6	100	102	100	56	100	164	100
Caregivers										<0.01
	High adherence (7-9)	0	00.0	22	46.8	21	18.1	43	26.2
	Average adherence (4-6)	1	100	24	51.1	87	75.0	112	68.3
	Little adherence (0-3)	0	00.0	1	02.1	8	06.9	9	05.5
Total		1	100	47	100	116	100	164	100

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[1] Correspondence to: S.S. ALMEIDA. E-mail: sebalm@usp.br.