Association of feeding and parenting styles with adiposity in young children: a systematic review and meta-analysis

Abstract

This systematic review and meta-analysis synthesises global evidence on the different feeding and parenting styles, i.e., authoritative, authoritarian, indulgent, and uninvolved, and their association with adiposity in children from 6 months to 5 years of age. We searched PubMed, Ovid EMBASE, PsycINFO and Web of Science from Jan 1, 1900 to September 1, 2023, and updated the search on June 13, 2025. The primary outcome of interest was childhood adiposity. Statistical synthesis was performed using vote counting based on direction of effect, a method used for synthesizing results, by categorizing the effect of each study as beneficial or harmful based on the direction of effect. The inverse variance heterogeneity (IVhet) model, an estimator under the fixed effect model assumption with a quasi-likelihood-based variance structure, was used to conduct a meta-analysis. Of the 10,683 records screened, eight were eligible for the systematic review. These studies were conducted in high-income countries and the sample size ranged from 67 to 1238 participants. Of the eight records, three studies were eligible for meta-analysis and five studies were only eligible for vote counting based on direction of effect, as no effect estimates/95% confidence intervals (CIs) were reported. Three of the five studies synthesized using the vote counting method, found demandingness, authoritative, permissive, neglectful and uninvolved styles to be negatively associated with adiposity in children. Meta-analysis revealed the estimated effects of authoritarian (β = 0·02, 95% CI − 0·07 to 0·11, I² = 22·2%, participants = 933), indulgent/permissive (β = 0·03, 95% CI − 0·02 to 0·26, I² = 58·9%, participants = 872) and uninvolved/neglectful (β = 0·05, 95% CI − 0·005 to 0·10, I² = 0·0%, participants = 835) styles on adiposity to be negligible. Conclusion: These findings suggest no consistent link between childhood adiposity and various feeding and parenting styles, including authoritarian, uninvolved, neglectful, and authoritative. Most studies had a high risk of bias, and the evidence quality was low. (Table presented.)