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Dear Doctor: I read that grandparents can increase a child's cancer risk by encouraging bad behaviors. Quite frankly, I'm offended by this. Couldn't they also improve a child's health? When our grandkids are visiting, we get them to eat much healthier food than they typically get at home.

Dear Reader: We confess that we cringed a bit as we read some of the headlines that the study you are referencing has generated. A very important message -- the rules of health and nutrition hold true no matter who is breaking them -- is getting buried beneath needless snark.

To answer your question: Yes, by offering the right nutritional guidance and making wise food choices, grandparents can absolutely have a positive effect on a child's health. We're happy to hear that you focus on a healthful diet when your grandkids are around, but suspect you are far from alone in this endeavor.

So how did this "grandparents may be bad for kids' health" conversation get started?

Researchers from the University of Glasgow in Scotland were interested in learning what role, if any, additional caregivers may have on the risk factors for non-communicable diseases in children. In the majority of cases, these secondary caregivers were grandparents.

The researchers noted that the positive habits and behaviors that can help avert up to 40 percent of the cancers that develop in adulthood are actually acquired in early childhood. These include sticking to a healthful diet, getting regular exercise, not using tobacco products, not abusing alcohol, limiting or mitigating sun exposure, and avoiding excess weight gain.

The question then became what sort of effect the grandparents' approach to those positive behaviors had on the children's cancer risk. To that end, researchers analyzed data collected in 56 studies that had been conducted in 18 different countries.

This new study, which was published last November in the journal PLOS One, found that the primary risky behavior that grandparents took part in was overfeeding their grandchildren. That is, the grandparents took a more indulgent approach to their grandchildren's diets. They offered them more treats than their parents did and provided larger portions during meals. This meant the kids were eating too many calories, many of them coming from sugar, fat and processed foods. This resulted in the grandchildren gaining weight.

Another factor was activity levels, which were lower among children when being cared for by grandparents than when they were with their parents. In some cases, the children were exposed to tobacco products and secondhand smoke in their grandparents' homes. The upshot of all these behaviors was a measurable increase in the risk factors that can lead to heart disease, diabetes and even cancer later in life.

One thing the researchers were careful to address, and which didn't appear in the stories we read, was why this was happening. In some countries, excess weight was a cultural sign of health and prosperity. For some grandparents who had been raised in wartime or in poverty, abundant food was a symbol of safety and stability.

Rather than being uncaring or careless, many of the grandparents in the study believed they were helping the children.

Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.

Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.

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