A multilevel analysis of the relationship between parental migration and left-behind children's macronutrient intakes in rural China

TY - JOUR

T1 - A multilevel analysis of the relationship between parental migration and left-behind children's macronutrient intakes in rural China

AU - Zhang, Nan

AU - Bécares, Laia

AU - Chandola, Tarani

N1 - Funding Information: This study uses data from the CHNS. The authors thank the National Institute of Nutrition and Food Safety, China Centre for Disease Control and Prevention, the Carolina Population Centre (grant number 5 R24 HD050924), the University of North Carolina at Chapel Hill, the National institutes of Health (NIH; grant numbers R01-HD30880, DK056350, R24 HD050924 and R01-HD38700) and the Fogarty International Centre, NIH for financial support for the CHNS data collection and analysis files from 1989 to 2011 and future surveys, and the China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009. Publisher Copyright: © Copyright The Authors 2015.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Objective China's internal migration has left 61 million children living apart from their parent(s) in rural areas. The present study aimed to examine whether the relative contributions of macronutrients (protein, fat and carbohydrate) to total energy intake differ between children left behind by the father or mother, compared with children from intact families. Design Drawing on a longitudinal study, the China Health and Nutrition Survey (1997-2009), multilevel modelling analyses (level 1: occasions; level 2: children; level 3: villages) were performed. Setting Data from rural communities in nine provinces in China. Subjects Rural children (n 975; 555 boys and 420 girls) from 140 villages. Results Among boys of school age, being left behind by the father tended to reduce the relative protein intake by 0·70 % (P<0·01) compared with boys from intact families. Being left behind by at least the mother was more detrimental for young boys under the age of 6 years than paternal migration, reducing relative protein intake by 1·14 % (P<0·05). Parental migration was associated with a significant increase in young boys' relative fat intake by 2·60 % (P<0·05). No significant associations were found for girls. Results suggest left-behind boys, especially in early life, are subject to a higher-fat and lower-protein diet compared with non-left-behind boys. This may put them at increased risk of being overweight or obese, or of suffering from stunted growth, when they grow up. Conclusions Public health policies should recognise the influences of parental migration on boys, especially maternal migration, and encourage a more balanced diet for children in rural China.

AB - Objective China's internal migration has left 61 million children living apart from their parent(s) in rural areas. The present study aimed to examine whether the relative contributions of macronutrients (protein, fat and carbohydrate) to total energy intake differ between children left behind by the father or mother, compared with children from intact families. Design Drawing on a longitudinal study, the China Health and Nutrition Survey (1997-2009), multilevel modelling analyses (level 1: occasions; level 2: children; level 3: villages) were performed. Setting Data from rural communities in nine provinces in China. Subjects Rural children (n 975; 555 boys and 420 girls) from 140 villages. Results Among boys of school age, being left behind by the father tended to reduce the relative protein intake by 0·70 % (P<0·01) compared with boys from intact families. Being left behind by at least the mother was more detrimental for young boys under the age of 6 years than paternal migration, reducing relative protein intake by 1·14 % (P<0·05). Parental migration was associated with a significant increase in young boys' relative fat intake by 2·60 % (P<0·05). No significant associations were found for girls. Results suggest left-behind boys, especially in early life, are subject to a higher-fat and lower-protein diet compared with non-left-behind boys. This may put them at increased risk of being overweight or obese, or of suffering from stunted growth, when they grow up. Conclusions Public health policies should recognise the influences of parental migration on boys, especially maternal migration, and encourage a more balanced diet for children in rural China.

KW - China

KW - Gender

KW - Left-behind children

KW - Malnutrition

KW - Nutritional intakes

UR - http://www.scopus.com/inward/record.url?scp=84976902090&partnerID=8YFLogxK

U2 - 10.1017/S1368980015003341

DO - 10.1017/S1368980015003341

M3 - Article

C2 - 26641518

AN - SCOPUS:84976902090

SN - 1368-9800

VL - 19

SP - 1913

EP - 1927

JO - Public Health Nutrition

JF - Public Health Nutrition

IS - 11

ER -