Rural Food Environment, Caregiver Influence and School-Aged Children’s Unhealthy Food Choice: New Evidence From Rural China

Background: A large number of unhealthy foods with low nutrition content and safety issues exist in the rural food consumption environment of China. Guiding rural children to avoid eating unhealthy foods through family intervention has become much more critical. However, when current rural caregivers are once left behind by their parents and lack of family education in their childhood, how would they affect their children’s unhealthy food choices? The purpose of this study is to highlight the new evidence of current rural caregivers’ influences on children’s unhealthy food choices in China. Methods Based on a survey of 5611 pairs of rural school-aged children and their caregivers in seven provinces, the significant effects of caregivers’ types, parenting attitudes, and socio-demographic characteristics on children’s unhealthy food choices were evaluated through an ordered probit model. Results This study found that rural parents did not perform positive influence than rural grandparents as conventionally believed. When the caregiver type changing from parents to grandparents, the percentage of children who mildly accept unhealthy foods increased 6.94%, while the percentage of children who moderately and severely accept unhealthy foods decreased 6.48% and 0.46%, respectively. In addition, this study underscored the significance of caregivers’ neglectful parenting attitudes on the impact of children’s unhealthy eating behavior. When caregivers’ parenting attitudes changing from doting attitude to neglectful attitude, the percentage of children who mildly accept unhealthy foods decreased 9.75%, while the percentage of children who moderately and severely accept unhealthy foods increased 8.77% and 0.99%, respectively. Conclusions Our study proposes new evidence that the current rural parents’ inherent intention and preference for those unhealthy foods formed in their childhood would be much higher than rural grandparents and might have performed a significantly negative influence on their children. Our findings also have policy implications for health promotion professionals who look for intervention targets of caregivers to improve their health education effectiveness for children. For the health education toward rural caregivers, instead of focusing on the caregiver types, segmenting those rural caregivers with neglectful parenting attitude would be the key step to identify the intervention targets.