Sensitive caregiving and child adiposity: a systematic review and meta-analysis of observational stuides and randomised controlled trials

Early-life caregiving environments play a critical role in shaping children's growth, eating regulation, and long-term obesity risk. Parental sensitivity—defined as prompt, contingent, and appropriate responses to children's cues—is thought to support the development of self-regulation, including appetite and energy balance. However, the evidence linking observationally measured parental sensitivity with child adiposity is scattered and has never been quantitatively synthesized. In parallel, a growing number of early-life interventions target parenting or specifically sensitive caregiving, yet their effects on adiposity outcomes remain unclear, with substantial variation in intervention focus, intensity, and timing. This systematic review and meta-analysis will provide the first comprehensive synthesis that (1) quantifies the correlation between observed parental sensitivity and children's adiposity outcomes, and (2) evaluates the effect of parental sensitivity-targeted interventions on child adiposity outcomes. By integrating correlational and experimental evidence, the review will clarify whether early relational caregiving represents a viable pathway for obesity prevention and identify underlying moderators including parent gender, parental adiposity status, parental education, socioeconomic status, ethnicity, child sex, child age, clinical conditions, sensitivity-related features, adiposity measures, intervention strategies, study characteristics, geographical region, and publication year. The findings will have the potential to provide key insights for global health initiatives and policymakers about the potential benefits of parenting interventions. The key questions we aim to address include: (1) What is the correlation magnitude between observed parental sensitivity and child adiposity outcomes? (2) Do parenting interventions that explicitly or partially target parental sensitivity have positive influence on child adiposity outcomes? (3) Are there any potential moderators influencing the above associations?