Grandparents’ affection makes Chinese children obese

New research has revealed that affection from grandparents towards their grandchildren may play a major role in contributing to the childhood obesity pandemic in China.

A study by the University of Birmingham (UK) shows that grandparents tend to indulge, overfeed and protect grandchildren in their care from physical chores, thus increasing their risk of obesity. The underlying motive for the action of grandparents is affection for their treasured grandchild and stems from their personal experiences, misunderstanding and poor recognition of the adverse health effects of childhood obesity.

As a result, Chinese children who are mainly cared for by their grandparents are more than twice as likely to be overweight or obese, compared with those who are mainly looked after by their parents or other adults. Children who are mainly cared for by a grandparent also consume unhealthy snacks and drinks more frequently.

The research showcases the first qualitative study in China to explore the views of a wide range of stakeholders on causes of childhood obesity. The study was conducted in the southern Chinese cities of Guangzhou and Hechi, and participants invited to focus groups included parents, grandparents, teachers, school nurses, PE teachers, catering staff responsible for children’s school meals and shop retailers. The qualitative study was complemented by a cross-sectional study examining the association between children’s weight and health behaviours, and the presence and role of grandparents in the household.

Current knowledge regarding childhood obesity is predominantly based on studies in western populations and the focus of the family environment has been the role of parents in obesity prevention. However, in many countries, particularly in China, grandparents are key providers of child care. Culturally, Chinese grandparents are held in great respect and often live in three-generation households.

Co-author of the study, Dr Bai Li, Postdoctoral Research Fellow in Public Health, Epidemiology and Biostatistics at the University of Birmingham said:

‘Our study reveals that grandparents contribute to childhood obesity in China through inappropriate perception, with many sharing the belief that fat children are healthy and inaccurate knowledge, believing that obesity-related diseases only happen in adults. Grandparents will often assess weight status by comparing their grandchildren with their peers, rather than seeking professional opinion.’

 ‘The inappropriate behaviour of grandparents, including overfeeding and indulging through excusing the children from household chores, is another contributing factor, and differs greatly from that of parents, carers and school teachers. Conflicting child care beliefs and practise between grandparents and parents, and between grandparents and school teachers, are felt to undermine efforts to promote healthy behaviours in children.’

It is thought that the lag in health-related knowledge among China’s older generation also stems from the fact that many experienced underweight, under-nutrition, food shortage, physical hardship and deprivation in their early lives before China’s economic reform. This older generation are the grandparents of the current cohort of Chinese children, predominantly in single child families (widely known as the ‘single family treasure’). As a result of China’s One-Child Family Planning Policy being introduced in 1979, there are nearly 150 million single-child households in the country.

Professor of Public Health, Peymane Adab, University of Birmingham and co-author of the study said:

‘Childcare provided through grandparents is a growing social trend across the world and, in China, around half of urban families have grandparents involved in the care of children. Our study highlights the need to include grandparents in future interventions to promote healthy behaviours among children.’

‘The rate of increase in childhood obesity over the last decade in Chinese urban areas exceeds that seen in many Western populations. Therefore, it is imperative that we now work with families, stakeholders and Chinese governmental bodies to tackle this pandemic.’


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