Intergenerational differences in beliefs about healthy eating among carers of left-behind children in rural China: A qualitative study

Abstract

China's internal migration has left 61 million rural children living apart from parents and usually being cared for by grandparents. This study aims to explore caregivers' beliefs about healthy eating for left-behind children (LBC) in rural China. Twenty-six children aged 6-12 (21 LBC and 5 non-LBC) and 32 caregivers (21 grandparents, 9 mothers, and 2 uncles/aunts) were recruited in one township in rural China. Children were encouraged to keep food diaries followed by in-depth interviews with caregivers. Distinct intergenerational differences in beliefs about healthy eating emerged: the grandparent generation was concerned about not having enough food and tended to emphasise the importance of starchy foods for children's growth, due to their past experiences during the Great Famine. On the other hand, the parent generation was concerned about food safety and paid more attention to protein-source foods including meat, eggs and milk. Parents appeared to offer children high-energy food, which was viewed as a sign of economic status, rather than as part of a balanced diet. Lack of remittances from migrant parents may compromise LBC's food choices. These findings suggest the potential for LBC left in the care of grandparents, especially with experience of the Great Famine, may be at greater risk of malnutrition than children cared for by parents. By gaining an in-depth understanding of intergenerational differences in healthy eating beliefs for children, our findings could inform for the development of nutrition-related policies and interventions for LBC in rural China.

Patterns and Determinants of Double-Burden of Malnutrition among Rural Children: Evidence from China

“…Studies have found that left-behind children are more vulnerable to malnutrition compared to their counterparts from intact families [ 34 , 84 , 85 – 87 ]. Grandparents as caregivers often have poorer nutritional knowledge [ 88 ] and beliefs on healthy eating unflavoured for children’s nutritional development [ 89 ] than parental caregivers in rural China. Chinese evidence also shows that high rates of malnutrition among children are largely due to a lack of knowledge regarding healthy dietary intake rather than food shortages [ 7 , 90 ].…”

The impact of maternal employment on children's adiposity: Evidence from China's labor policy reform

“…The decline in the price of meat and cooking oil contributed to the trend (Lu & Goldman, 2010;Wang, Zhai, Du, & Popkin, 2008). Because meat is still relatively expensive in China, families view consumption of meat as a status symbol and thus, consume more of it when their income rises (Zhang, Becares, Chandola, & Callery, 2015). Meanwhile, Chinese children consume most of their meals at home (approximately 91% in 1997), even though eating out has become more popular.…”

Food preferences, personality and parental rearing styles: analysis of factors influencing health of left-behind children

“…However, the average level of education of the parent/guardian of LBC was less than for non-LBC, and they may lack knowledge of nutrition. These caregivers tend to adopt a higher-calorie (higher-fat and carbohydrate) diet, eat fewer fruits and vegetables than recommended and may take the same approach to their children [7]. Guardians, particularly grandparents, may compensate or even overcompensate the children for the absence of their parents, for example, by offering children only the foods they like [35], thereby encouraging bad habits to develop.…”

“…Their guardians have been reported as worried about not having enough food and so have tended to emphasize the importance of starchy foods to improve growth, rather than a balanced diet [7]. LBC are therefore significantly more likely to become ill or develop chronic conditions than children living with their parents [8].…”