A systematic examination of the association between parental and child obesity across countries

Childhood obesity has become a global epidemic. Parents can have an important influence on their children's health behaviors and weight status. Many studies have examined the association between parental and childhood weight status. However, much heterogeneity between studies exists, and the parent-child (P-C) association in obesity has varied. The purpose of this systematic examination and meta-analysis was to examine the strength and variation of the P-C association in obesity and to identify factors (e.g., demographic characteristics and country's economic level) that may influence this association. PubMed was searched for relevant studies published between January 2000 and July 2015. Thirty-two studies from 21 countries met inclusion criteria; 27 reported ORs for the P-C obesity association and were included in a meta-analysis. The meta-analysis showed a strong P-C obesity association (pooled OR: 2.22; 95% CI: 2.09, 2.36), which varied by type of P-C pair (i.e., parentschild, father-child, and mother-child), child age, parent and child weight status, and the country's economic level. Stronger associations were shown in older children than in younger children (β ± SE: 0.02 6 0.01), in both parents than in father only (β ± SE: 0.51 6 0.11) or mother only (β ± SE: 0.38 6 0.11), in parental obesity (β ± SE: 0.26 6 0.10) and child obesity (β ± SE: 0.28 6 0.12) than in parental and child overweight, and in high- than in middle-income countries (β ± SE: 0.23 6 0.08). Thus, research from multiple countries shows significant P-C associations in weight status, but this association varies by child age, type of P-C pair, weight status, and the country's economic level. Results suggest that families and parents should be a key target for obesity intervention efforts.