Comparison of eating behaviors between single-child and child with siblings: an analytical cross-sectional study

The importance of accurately understanding school-aged children (7-12 years) and implementing efforts to safeguard and promote their physical and psychological health is widely recognized. Changes in family structure, including the rise of single-child households, may influence children's eating behaviors; however, evidence from Iran is limited. The present study aimed to determine and compare eating behaviors among children (aged 7-12 years) from single-child and multi-child families.

To assess eating behaviors among elementary school children in Khalkhal City, 318 boys and girls from urban and rural primary schools were selected using cluster random sampling. Demographic questionnaire, Physical Activity Questionnaire for Older Children (PAQ-C), and Children's Eating Behavior Inventory (CEBI) were applied. SPSS software (IBM SPSS Statistics, Armonk, USA) was used for data analysis.

The mean age was 9.55 ± 1.77 years in the single-child group and 9.71 ± 1.70 years in the multi-child group, with no statistically significant difference between groups (P = 0.42). The mean global CEBI score was significantly higher in the multi-child group compared to the single-child group (113.91 ± 6.76 vs. 105.47 ± 8.31; P < 0.001). Similarly, the mean scores of skill (35.30 ± 3.33 vs. 32.29 ± 4.57), compliance (52.85 ± 3.85 vs. 49.45 ± 4.57), and preferences (25.75 ± 3.15 vs. 23.72 ± 3.62) were significantly higher in the multi-child group (all P < 0.001). Multivariable logistic regression analysis demonstrated that multi-child participants had significantly higher odds of being in the "normal or good" category compared to single children. For skill, the fully adjusted model showed an OR of 19.49 (95% CI: 2.25-168.80; P = 0.007). For compliance, the adjusted OR was 19.23 (95% CI: 5.43-68.05; P < 0.001). For preferences, the adjusted OR was 2.77 (95% CI: 1.64-4.69; P < 0.001).

We found that having siblings was associated with more scores across all measured domains, including skills, compliance, and preferences. These differences remained even after controlling for confounders.