Current studies have been inconsistent on the relationship between grandparental care and childhood obesity. Furthermore, when it comes to Chinese-American families, there is a gap in the literature concerning grandparents’ impact on children’s health. Culturally, grandparents play a vital role in the lives of Chinese-American children, particularly when it comes to caregiving and preparation of meals. Chinese grandparents often plan and cook meals for the family, use food as an educational and emotional tool, and encourage children to eat more and have larger portions.

Researchers at the Charles B. Wang Community Health Center sought to examine the association between grandparental caretaking and weight in Chinese-American children in New York City. Based on other studies that showed Chinese grandparents tend to underestimate weight in children and associate weight with strong health, the research team hypothesized that caretaking by a grandparent would be associated with a higher prevalence of overweight and obesity among Chinese-American children.

Using 2016 data from patients seen for annual visits at the health center, findings showed that:

  • Children cared for by grandparents were more likely to be overweight (BMI≥85th %ile) but not more likely to be obese (BMI≥95th %ile) than those who were not cared for by a grandparent. It may be because the ideal child’s weight for many grandparents is in the overweight range.
  • This was true for school-aged children (ages 6-11) and adolescents (ages 12-19), but not for preschoolers (ages 2-5). Weight gain from grandparental influences may be gradual and not yet apparent in preschool children.
  • The association between grandparental caretaking and weight was the same in girls and boys. Modern-day Chinese-American grandparents may not favor boys over girls as they have done in past generations.

All in all, in order to better inform a culturally and linguistically diverse community, it is vital that extended family members, especially grandparents, are incorporated in future health education and nutrition programs for Chinese-American families. The care managers and providers at the Pediatrics Department will continue to address cultural barriers to healthy eating with caregivers at each medical and nutrition visit. Efforts will be made to reach out to grandparent caretakers in the community to provide education on appropriate nutrition and exercise for children.

This research project was conducted by Jennifer Lau, Loretta Au, Eda Chao, Laminasti Elbaar, and Raymond Tse. The paper was published online in September of 2018 in Childhood Obesity.

Citation: Lau JD, Au LY, Chao E, Elbaar L, Tse R. The association of grandparent care with childhood overweight and obesity in Chinese American families. Child Obes. 2018 Sep 26. doi: 10.1089/chi.2018.0113


Posted by Charles B. Wang Community Health Center

The Charles B. Wang Community Health Center is a nonprofit and federally qualified health center, established in 1971. Our mission is to provide high quality and affordable health care to the undeserved, with a focus on Asian Americans. Our vision is to ensure that everyone has full and equal access to the highest level of health care. Learn more at

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