Systematic review of parental influence on pediatric obesity: Exploring dietary habits, physical activity, and intervention strategies

Abstract

Objectives

The purpose of this systematic review was to synthesize current evidence on the effectiveness of family-centered interventions that target parental behaviors such as dietary habits, physical activity, and sedentary patterns, in reducing childhood obesity risk. Rather than examining parental behaviors as independent predictors, this review focuses on interventions designed to modify them.

Material and methods

A comprehensive literature search was conducted using electronic databases including Medline/PubMed and EMBASE, supplemented by hand searching. Eligible studies included randomized controlled trials, quasi-experimental, observational, qualitative, and mixed-methods designs involving children aged 0–18 years. Interventions focused on parental behaviors related to diet, physical activity, and sedentary habits. Data extraction was performed independently by two reviewers, with risk of bias assessed using standard tools appropriate to study design. Narrative synthesis and meta-analyses, where appropriate, were conducted using random-effects models to account for study heterogeneity.

Results

Five randomized controlled trials met inclusion criteria, encompassing parent-only and family-based behavioral interventions across diverse populations. Parent-focused interventions with booster sessions consistently demonstrated significant reductions in children's body mass index z-scores compared to standard or no intervention. Secondary outcomes, including improvements in dietary habits and psychosocial factors, were reported but with less consistency. Risk of bias was low to moderate overall, though limitations included small sample sizes and variable follow-up durations.

Conclusions

Parental involvement is pivotal in pediatric obesity management. Family-centered behavioral interventions, particularly those incorporating booster supports, effectively reduce childhood obesity risk. Limitations of current evidence include methodological heterogeneity and limited long-term data. Future research should focus on paternal roles, diverse populations, and standardized outcome reporting. Systematic review registration: PROSPERO [CRD42025640314].