Does it make a difference if parents or other adult caregivers are involved in interventions to encourage children to eat healthier or be more physically active?

Diet and physical activity behaviors are important determinants of health. Parents and other adult caregivers have an essential role in shaping children's health habits by controlling availability of and access to healthy foods and opportunities to be active; supporting, encouraging, and role‐modeling healthy behaviors; and adopting supportive feeding styles and practices. For these reasons, it often is argued that parent and caregiver involvement in children's diet and physical activity interventions is important; however, it remains unclear if involvement of parents and caregivers actually provides benefit. This was the focus of a new Cochrane review led by Emily Morgan, assistant professor in the Department of Nutrition and Food Sciences. 

Together with colleagues in the US and South Africa, Dr. Morgan assessed the effects of involving parents or other adult caregivers in children's healthy eating and physical activity interventions compared to the effects of the same child interventions without a parent or caregiver component. The researchers were particularly interested in understanding effects on children's dietary intake, children's physical activity levels, and adverse effects of interventions.

 After a comprehensive search the team identified 23 studies that met the review’s inclusion and exclusion criteria. These were published between 1982 and 2019 involving over 12,000 children aged 2 to 18 years. More than half of the studies took place in North America, and all but two were conducted in high‐income countries. Most studies were school‐based and involved the addition of healthy eating or physical education classes, or both, sometimes in tandem with other changes to the school environment.

The findings suggest that adding a parent or caregiver component to healthy eating or physical activity interventions may make little or no difference to children's dietary intake or physical activity levels. For interventions that target both diet and physical activity behaviors, involving a parent or caregiver probably slightly reduces children's sugar‐sweetened beverage intake by the end of the intervention.

It is unclear whether any of these types of interventions can result in adverse effects because the included studies did not have data on this. Overall, the review team concluded that more well-done studies on this topic are needed to increase the certainty of the findings, because many of the existing studies either have design flaws or their methods have not been fully and clearly reported.

You can read the full study here: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012547.pub2/full