Family Eating Habits and Dietary Quality of Spanish Children and Adolescents: The PASOS Study

Background: Childhood nutrition is essential for development and disease prevention. Parental dietary practices and sociodemographic factors shape children's eating habits. Objective: To assess the association between parental diet quality, children's diet, and nutritional status, as well as the influence of caregiver sociodemographic factors. Design: Cross-sectional analyses were conducted using data from two waves of the PASOS study (2019-2020 and 2022-2023), which are nationally representative multicentre observational surveys. The analyses were restricted to participants with complete information on parental diet quality, children's diet quality, and relevant covariates. Methods: Participants aged 8-16 years from the PASOS 2019-2020 (n = 1028) and 2022-2023 (n = 572) studies were included. Caregivers provided sociodemographic information and completed the Short Diet Quality Screener (SDQS), a validated questionnaire to assess parental diet quality. Children's diet quality was assessed using the validated KIDMED index. Based on parental SDQS scores, participants were classified into low (≤50th percentile) or adequate/high (>50th percentile) diet quality groups. Associations were analysed using logistic regression and Pearson correlation. Results: Higher parental diet quality was consistently associated with greater adherence to the Mediterranean diet and higher consumption of fruit, breakfast cereals, and fish among children in both study waves. Children whose caregivers had better diet quality also showed a lower prevalence of abdominal obesity. Parental diet quality was positively associated with children's diet quality and inversely related to several adiposity indicators, although associations with anthropometric measures were generally weak. Conclusions: Family-based approaches are essential for improving diet quality and preventing childhood obesity.