Pocket money, eating behaviors, and weight status among Chinese children: The Childhood Obesity Study in China mega-cities

- Mother's fulfillment of caregiving role and concern over child health influenced pocket money.
- Pocket money was associated with unhealthy eating and increased risks for overweight/obesity.
- School unhealthy food restriction reduced the above associations.

Both the obesity rate and pocket money are rising among children in China. This study examined family correlates of children's pocket money, associations of pocket money with eating behaviors and weight status, and how the associations may be modified by schools' unhealthy food restrictions in urban China. Data were collected in 2015 from 1648 students in 16 primary and middle schools in four mega-cities in China (4 schools/city): Beijing, Shanghai, Nanjing, and Xi'an. Cluster robust negative binomial regression models were fit to assess family correlates of pocket money, associations of pocket money with child eating behaviors and weight outcomes, and possible modifying effects of schools' unhealthy food restrictions. Sixty-nine percent of students received pocket money weekly. Students received more pocket money if mothers frequently ate out of home (IRR = 2.28 [1.76, 2.94]) and/or family rarely had dinner together (IRR = 1.42, 95% = [1.01, 1.99]). Students got less pocket money if parents were concerned about child's future health due to unhealthy eating (IRR = 0.56 [0.32,0.98]). Students with more pocket money more frequently consumed (by 25-89%) sugary beverages, snacks, fast food, or at street food stalls, and were 45-90% more likely to be overweight/obese. Associations of pocket money with unhealthy eating and overweight/obesity were weaker in schools with unhealthy food restrictions. Pocket money is a risk factor for unhealthy eating and obesity in urban China. School policies may buffer pocket money's negative influence on students' eating and weight status.