Parents Matter: Associations of Parental BMI and Feeding Behaviors With Child BMI in Brazilian Preschool and School-Aged Children

Brazil is undergoing nutritional transition and rates of obesity in preschool and school-aged children are increasing. Excess weight in the first years of life could predict excess weight in adulthood, making it essential to study risk factors in this population. Our goal was to investigate associations of parent feeding behaviors, as well as more distal familial influences including family SES and maternal and paternal weight, with BMI -score in preschool and school-aged children in a Brazilian sample. Cross-sectional study. Data were collected in 14 Brazilian private schools. Parents of children aged 2-8 years ( = 1,071) completed a questionnaire assessing parent feeding behaviors, as well as sociodemographic and anthropometric information. Hierarchical linear regression models were fitted to investigate relationships between parent and child characteristics and child BMI -score in preschool (2-5 years, = 397) and school-aged (6-8 years, = 618) children. Final models indicated that higher maternal BMI and "restriction for weight control" were associated with higher child BMI -score in both age groups (excessive weight, i.e., BMI ≥ +1 -score, in preschoolers and school-aged children: 24.4 and 35.9%, respectively). In preschoolers only, "healthy eating guidance" and "pressure" were associated with lower child BMI -score. For school-aged children, male sex, higher father BMI, and "restriction for health" were associated with higher child BMI -score. Parent feeding behaviors and parent weight, as well as child sex, are associated with child BMI -score, with evidence for differential relationships in preschool and school-aged children. Optimal obesity prevention and treatment strategies may differ by child age.