Associations Between Grandparental Involvement and Children's Diet-Related Behaviors and Weight Status: A Systematic Review.

CONTEXT:Grandparents' evolving role as informal caregivers for their grandchildren is likely to influence child nutrition and health outcomes. OBJECTIVE:This systematic review aimed to synthesize the current evidence on the influence of grandparents on diet-related behaviors and body weight of children aged 0-12 years. DATA SOURCES:A 6-databases search (Medline, Embase, PsychINFO, CINAHL, ProQuest, and the Cochrane Library) was conducted for studies published between 2000 and June 2024. Experimental or observational studies were included if they reported outcomes relating to grandparents' child-feeding practices, grandchildren's diet, or body weight status of children. DATA EXTRACTION:Data were extracted into a standard template and were critically appraised using the Quality Criteria Checklist. DATA ANALYSIS:Twenty-four studies were included; the majority were observational studies (n = 21) published between 2006 and 2024, with participant numbers ranging from 45 to 19 734. The most frequently reported grandparents' outcomes were involvement in childcare (n = 15), child-feeding practices (n = 8), co-residing (n = 6), and time spent with grandchildren (n = 3). Grandparental outcomes assessed were predominantly associated with obesogenic dietary practices (n = 14), with 3 studies reporting negative impact on grandchildren's body weight. The diet-related behaviors used by grandparents were using snacks as rewards (n = 4), providing unhealthy snacks (n = 2), higher energy intake (n = 1), fruit juice consumption (n = 1), increased between-meal eating (n = 1), and screen time during meals (n = 1). CONCLUSIONS:Grandparental caregiving roles related to food and feeding were found to be associated with higher weight status, energy intake, and discretionary food intakes of grandchildren. Study heterogeneity and the predominance of cross-sectional and observational studies limited a quantitative meta-analysis of grandparents' involvement in feeding. Future studies focusing on system approaches and considering cultural contexts are needed. SYSTEMATIC REVIEW REGISTRATION:PROSPERO registration No. CRD42024592327.