Molitor F, Doerr C
Purpose: To investigate the empirical support for the Supplemental Nutrition Assistance Program-Education’s (SNAP-Ed) focus on mothers versus fathers by examining children’s risk and protective behaviors for obesity, and obesity status, by gender of primary caregiver and by caregiver-by-child gender dyads. Approach: Cross-sectional survey. Setting: Random sample of SNAP-Ed eligible households (≤ 185% of the federal poverty level) across California. Participants: 2,242 children and their caregivers (17.8% male): the adult who prepares the meals or buys the food for the children. Measures: Cups of fruits and vegetables, water, sugar-sweetened beverages; teaspoons of added sugars; kilocalories; and food-only energy density, assessed through 24-hour dietary recall interviews. Dichotomous outcome was childhood obesity. Covariates were children’s race/ethnicity and age, and caregivers’ obesity status. Results: Only one outcome was related to caregiver gender: male versus female caregivers’ children consumed fewer kilocalories (P = 0.053). Caregiver-by-child gender analyses revealed female caregivers’ sons consumed more kilocalories overall (Ps < 0.02), and added sugars than female caregivers’ daughters (P = 0.001) and male caregivers’ sons (P = 0.018). Female caregivers’ daughters versus sons reported diets lower in food-only energy density (P = 0.004) and were less likely to be obese (23.7% versus 28.7%; aOR = 0.78, P = 0.035). Conclusion: Our findings suggest that SNAP-Ed’s focus on mothers rather than fathers is justified, but more effective childhood nutrition education and obesity prevention efforts should target families with female caregivers of male children.