Parental Perception of Body Weight Status of Their 8-year-old Children: Findings from the European CHOP Study

Abstract Background Maternal perception of child weight status in children with overweight or obesity has received a lot of attention but data on paternal perception of children from presumably healthy cohorts are lacking. Objective We aimed to investigate paternal and maternal perception of child weight status at the age of 8 years in a cohort of 591 children from 5 European countries. Material and Methods Included were 8-year-old children and their parents participating in the European Childhood Obesity Project (EU CHOP). Weight and height of children and parents were measured and Body Mass Index (BMI, kg/m2) was calculated. Both parents were asked to assess their perception of child weight status using Eckstein scales and their concern about child overweight. The agreement between mother and father perceptions was assessed by Cohen kappa coefficient and their relationship was analyzed by linear mixed effects models based on ordinal logistic regression, accounting for country, child gender and BMI, parental BMI, level of education, concern and type of feeding during first year of life. Results Data from children and both parents were available for 432 girls and boys. Mean BMI was comparable in boys and girls (16.7 ± 2.31 vs. 16.9 ± 2.87 kg/m2, P = 0.55). In total, 172 children (29.3%) were overweight or obese. There was a high degree of agreement between mother and father perceptions of their child’s weight status (Cohen kappa 0.77). Multivariate modelling showed that perception levels significantly increased with child BMI but were globally lower than assessed. They differed between countries, gender and types of feeding during first year of life, were influenced by education level of the father but were not related to parental BMI and concern about childhood overweight. Conclusions The study showed no overall differences between mothers and fathers in rating their child’s weight status but both parents had a propensity to underestimate their child’s actual weight, particularly in boys. The EU CHOP trial registered at clinicaltrials.gov as NCT00338689.

Download Full-text

Inappropriate maternal perception of child’s weight status: a potential threat to nutrition

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193731 ◽

2019 ◽

Vol 6 (5) ◽

pp. 2091

Author(s):

Parima Dalal ◽

Rekha Thaddanee ◽

Arun Parikh ◽

Hasmukh Chauhan ◽

Shamim Morbiwala

Keyword(s):

Weight Status ◽

Tertiary Care ◽

P Value ◽

Potential Threat ◽

Factors Affecting ◽

Actual Weight ◽

Maternal Perception ◽

Significant Difference ◽

Correct Weight ◽

Child’S Weight

Background: This study was done to know the maternal perception of weight of their children and correlate it with exact weights. We also studied various factors affecting ability of a mother to perceive her child’s weight status.Method: This prospective study was done in Pediatric Department of a tertiary care teaching hospital of Western Gujarat, India, from January 2018 to September 2018. 897 mothers of children < 5 years of age were included. Socio-demographic and anthropometric details of child and mother were recorded. Maternal perception of their child’s weight status was enquired. A correlation between perceived and actual child weight status was estimated.Results: 897 patients <5 years of age had mean (SD) age of 28.66 (±17.04) months, weight 10.17 (±3.5) kg, height 0.81 (±0.15) meters and BMI 15.74 (±15.26) kg/m2. 34.7% of mothers perceived underweight erroneously as compared to actual weight status being normal (p value=0.00001). Misperception (under or over) of the mothers for their children weight status was significant for girls (p=0.011). Significant difference between perceived and actual weight status was seen in birth orders 1 to 4. 34. 6% actual UW children were perceived as NW by < 40 years age mothers (p=0.0018). 78.2% uneducated and 81% of primary or secondary educated mothers from lower SES felt their children were of NW status whereas actually 43.4% and 50.3% children were of NW status respectively (p=0.00001). Surprisingly, 91.3% of graduate or postgraduate mothers of middle SES perceived their children as NW status while actually only 39.1% were of NW and 52.1% of UW (p=0.00001).Conclusion: Half of the mothers were not able to perceive correct weight status of their children. Misperception was significant for girls. Significant difference between perceived and actual weight status was seen for birth orders 1 to 4. Mothers <40 years of age significantly failed to perceive actual UW status of the children. Both educated and uneducated mothers misclassified their children’s weight status significantly.

Download Full-text

Parental Perceptions and Behaviors Regarding Child Weight Status among Toddlers Born Preterm

American Journal of Perinatology ◽

10.1055/s-0039-1683959 ◽

2019 ◽

Vol 37 (05) ◽

pp. 525-533

Author(s):

Jessica Londeree Saleska ◽

Kelly Sheppard ◽

Abigail Norris Turner ◽

Kelly M. Boone ◽

Sarah A. Keim

Keyword(s):

Weight Status ◽

Controlled Trial ◽

Parental Perceptions ◽

Normal Weight ◽

Overweight Children ◽

Weight Estimation ◽

Child Feeding ◽

Actual Weight ◽

Child Weight ◽

Child’S Weight

Abstract Objective Childhood obesity is a significant determinant of adult obesity. Among children born preterm, rapid “catch-up growth” in infancy increases the risk of later obesity. Parental perceptions of their child's weight status may compound the child's biologically heightened risk of obesity. Study Design We performed a secondary analysis of data on parental perceptions of child weight status from a randomized controlled trial (2012–2017, n = 331 toddlers born preterm). We used the Child Feeding Questionnaire (CFQ) to measure parental child feeding behaviors and beliefs. We calculated the prevalence of incorrect weight estimation, and used t-tests and chi-square tests to compare sample characteristics by correct versus incorrect weight estimation. We calculated odds ratios (ORs) for factors associated with parental underestimation of child weight status. Results Most (90%) children were of normal weight, whereas 3% were underweight and 7% were overweight. A majority (75%) of parents correctly estimated their child's weight status. Incorrect weight estimation was only associated with child's actual weight. Parents of overweight children were more likely to underestimate their child's weight status than parents of normal weight children (OR: 2.23, 95% confidence interval: 2.00–2.49). Mean CFQ scores differed by the child's actual weight status but not by the child's estimated weight status. Conclusion Among these toddlers born preterm, significantly higher proportions of parents with underweight and overweight children incorrectly estimated their child's weight status relative to parents of normal weight children. Our findings suggest that weight underestimation could be a problem in this population, although it was not associated with changes in feeding practices.

Download Full-text

Maternal perception, concern and dissatisfaction with child weight and their association with feeding practices in the Generation XXI birth cohort

British Journal Of Nutrition ◽

10.1017/s0007114521001653 ◽

2021 ◽

pp. 1-28

Author(s):

Alexandra Costa ◽

Marion Hetherington ◽

Andreia Oliveira

Keyword(s):

Birth Cohort ◽

Weight Status ◽

Feeding Practices ◽

Linear Regression Models ◽

Child Feeding ◽

Control Scale ◽

Actual Weight ◽

Maternal Perception ◽

Child Weight ◽

Child Feeding Questionnaire

Abstract What a mother thinks about her child’s weight status, perceiving healthy or overweight might influence concern about child weight and in turn what and how she feeds her child. We examined the association between maternal perception, concern and dissatisfaction with child weight alongside feeding practices. Participants were from the Generation XXI birth cohort (n=3233). A validated version of the Child Feeding Questionnaire and the Overt/Covert Control scale were used. Mothers self-reported perception, level of concern and dissatisfaction with child weight using a Likert scale. Associations were evaluated cross-sectionally at ages 4 and 7 years by linear regression models (β̂ coefficients and 95% confidence intervals (95%CI) with Bonferroni correction). Perceived underweight was associated with practices promoting food intake, such as higher pressure to eat at ages 4 and 7 years (β̂=0.229;95%CI:0.059,0.398 and β̂=0.190;95%CI:0.005,0.376, respectively) and lower restriction at age 4 (β̂=-0.175;95%CI:-0.0310,-0.039). At age 7, perceived overweight was associated with higher covert control (β̂=0.203;95%CI:0.029,0.376). Mothers who were concerned about child weight reported higher restriction (β̂=0.226;95%CI:0.142,0.310 at 4y and β̂=0.261;95%CI:0.169,0.353 at 7y) and covert control (β̂=0.183;95%CI:0.083,0.282 at 4y and β̂=0.171;95%CI:0.073,0.269 at 7y). Maternal desire for a heavier child was associated with higher pressure to eat at both ages (β̂=0.285;95%CI:0.163,0.406 at 4y and β̂=0.393;95%CI:0.266,0.520 at 7y), while the desire for a thinner child was related to higher covert control at 7 years of age (β̂=0.158; 95%CI:0.001,0.316). Maternal perceptions and concern for child weight status are associated with feeding practices independently of actual weight status.

Download Full-text

Parental perception of child weight and its association with weight-related parenting behaviours and child behaviours: a Chinese national study

Public Health Nutrition ◽

10.1017/s136898001800006x ◽

2018 ◽

Vol 21 (9) ◽

pp. 1671-1680 ◽

Cited By ~ 6

Author(s):

Ting Zhang ◽

Li Cai ◽

Jin Jing ◽

Lu Ma ◽

Jun Ma ◽

...

Keyword(s):

Weight Status ◽

Cross Sectional Study ◽

National Study ◽

Parental Perception ◽

Healthy Weight ◽

Cross Sectional ◽

Actual Weight ◽

Child Weight ◽

Parenting Behaviours ◽

Child’S Weight

AbstractObjectiveParents commonly fail to correctly recognize the weight status of their child. Whether parental perception of child weight is associated with weight-related parenting behaviours and child behaviours is unclear. The present study aimed to investigate the distribution of parental perception of child weight and its associations with weight-related parenting behaviours and child behaviours in China.DesignCross-sectional study.SettingSeven provinces in China.SubjectsA total of 47 417 children aged 6–17 years and their parents were included from a national survey in 2013. Parental perception of child weight, weight-related parenting behaviours and child behaviours were self-reported. Child’s weight and height were objectively measured.ResultsA total of 30·5 % of parents underestimated and 8·7 % overestimated the child’s weight. Parental underestimation was more common among younger children, boys and children with a lower BMI Z-score. Parents who perceived that their child had a healthy weight (accurately or inaccurately) were more likely to prepare breakfast for the child, exercise with him/her, set apart his/her exercise time, restrict his/her screen time, and were less likely to store soft drinks for the child. Children perceived to have a healthy weight, regardless of their actual weight status, behaved healthier on dietary intake, physical activity and homework time.ConclusionsParental underestimation of their child’s weight was prominent in China, especially among younger children, boys and children with a lower BMI Z-score. Parental recognition of their child being overweight did not appear to translate into healthy changes in weight-related parenting behaviours or child behaviours.

Download Full-text

Maternal Underestimation of Child’s Weight at Pre-School Age and Weight Development between Age 5 and 12 Years: The ABCD-Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17145197 ◽

2020 ◽

Vol 17 (14) ◽

pp. 5197

Author(s):

Tanja G. M. Vrijkotte ◽

Tina M. C. K. Varkevisser ◽

Daniel B. van Schalkwijk ◽

Marieke A. Hartman

Keyword(s):

Weight Status ◽

Child Growth ◽

Normal Weight ◽

Birth Cohort Study ◽

Actual Weight ◽

Maternal Perception ◽

Healthcare Monitoring ◽

The Relationship ◽

Univariate Analyses ◽

Child’S Weight

Background: Healthcare monitoring of child growth reduces with age, which may increase parental influences on children’s weight development. This study aimed to examine the association between maternal underestimation of child’s weight at age 5/6 and weight development between 5 and 12 years. Methods: We performed univariate and multivariate linear regression analyses with data on maternal perception of child’s weight and weight development (∆SDS body-mass index; BMI) derived from the Amsterdam Born Children and their Development (ABCD) birth-cohort study. Underestimation was defined by comparing maternal perception of child’s weight with the actual weight status of her child. Associations were studied in two groups: children with overweight (n = 207) and children with normal weight (n = 1982) at baseline (children with underweight were excluded). Results: Underestimation was 5.5% in children with normal weight and 79.7% in children with overweight. Univariate analyses in children with normal weight and overweight showed higher weight development for children with underestimated vs. accurately estimated weights (respectively: β = 0.19, p < 0.01; β = 0.22, p < 0.05). After adjusting for child sex and baseline SDS BMI, the effect size became smaller for children with a normal weight (β = 0.15, p < 0.05) and overweight (β = 0.18, p > 0.05). Paternal and maternal BMI, ethnicity, and educational level explained the association further (remaining β = −0.11, p > 0.05 in children with normal weight; β = 0.06, p > 0.05 in children with overweight). Conclusions: The relationship between maternal underestimation of child’s weight and higher weight development indicates a need for promoting a realistic perception of child’s weight, this is also the case if the child has a normal weight.

Download Full-text

Maternal perceptions of 5-year-old child weight status and factors influencing perceptions: Findings from the ROLO Kids Study

Proceedings of The Nutrition Society ◽

10.1017/s0029665120001676 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Anna Gouldson ◽

Aisling Geraghty ◽

Eileen O'Brien ◽

Mary Horan ◽

Jean Donnelly ◽

...

Keyword(s):

Health Care Providers ◽

Weight Status ◽

Normal Weight ◽

Care Providers ◽

Maternal Perceptions ◽

Kappa Score ◽

Weight Category ◽

Child Weight ◽

Factors Influencing ◽

Child’S Weight

AbstractIntroductionObesity is a global condition affecting both adults and children. Mothers play an important role in identifying problems with their child's weight. However, studies are limited on the accuracy of maternal perceptions of her child's weight status in early childhood. The aim of this study was to look at maternal perceptions of her child's weight status in 5-year-old children and to investigate factors influencing this.Materials and Methods339 mother and child pairs were followed up from the ROLO Kids study in the National Maternity Hospital, Dublin, Ireland. Height and weight of the mother and the child were measured, and BMI was calculated. Demographic details were collected and questionnaires asked mothers to assign their child to a weight category and to give the reason they put their child in this particular category. KAPPA analysis and student t tests were used to analyse the data.ResultsIn this cohort over 75% of the children were normal weight, 14.7% were in the overweight category, and 8.5% in the obese category. The KAPPA score for maternal-perceived category and actual weight status was 0.037 which is a low level of agreement. Mothers were more likely to underestimate their child's weight, with 28.5% underestimating the appropriate weight category for their child compared with 2.4% who overestimated. Maternal age, education, and child sex did not influence accurate weight assessments; however, mothers with a higher BMI were more likely to inaccurately assess their child's weight (P < 0.05).DiscussionMaternal perception of their child's weight status is not an accurate indication of child weight, particularly for mothers with a raised BMI. This research highlights the important role of health care providers in assessing child weight status, rather than relying on parental reports alone, in order to appropriately intervene to reduce the incidence of childhood obesity.

Download Full-text

Assessing the Moderating Effect of Parental Feeding Styles on the Association Between Satiety Responsiveness and Child BMI Z-Scores in Chilean Preschoolers Aged 3–5 Years

Current Developments in Nutrition ◽

10.1093/cdn/nzaa063_064 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1666-1666

Author(s):

Adeyosola Oke ◽

Marcela Vizcarra Catalan ◽

Maria Stecher ◽

Carolina Navarro ◽

Andiara Schwingel

Keyword(s):

Latin American ◽

Weight Status ◽

Moderating Effect ◽

Z Score ◽

Feeding Styles ◽

Child Weight ◽

Z Scores ◽

Child Bmi ◽

Satiety Responsiveness ◽

Effect Of Feeding

Abstract Objectives To evaluate the moderating effect of feeding styles on the association between satiety responsiveness and child BMI z-scores in children aged 3-to-5 in Santiago, Chile. Methods Participants were recruited from childcare centers serving low- and middle-income families in 2017 and 2018. During a face-to-face individual interview, the Caregiver Feedings styles Questionnaire and food responsiveness subscale of the Child Eating Behavior Questionnaire were applied to parents. Weight and height were obtained for children and caregivers. Multiple linear regressions were conducted to test the moderating effect of feeding styles on the relationship between satiety responsiveness and child BMI z-scores. Results 92.5% of caregivers were mothers, the parent BMI was 29.2 (SD = 5.7). No feeding style moderated the association between satiety responsiveness and BMI z-score Satiety responsiveness had a significant main effect on child BMI z score. None of the feeding styles was significantly associated with child BMI z-score. Only satiety responsiveness was significantly associated with child BMI z score (B = –.32, P < 0.05) after controlling for parent BMI (B = .047, P < .05). This model accounted for 12% of the variance of the child BMI z-score. 1.1% of the children were underweight, 22.4% normal, 37.9% overweight and 38.5% obese Conclusions Parent perceptions of higher satiety responsiveness suggests an association with lower child BMI z-scores. This study suggests that how children respond to food may play an important role in explaining child weight status. than the parent's or caregiver style of feeding in determining a child's weight status. Further research is required to discard interaction effects between appetite traits and feeding styles to explain child weight status. Funding Sources National Comission of scientific Research and Technology (CONICYT) and its Becas Chile program 2016 (#72,110,561) Center of Latin American Studies (CLACS) University of Illinois at Urbana-Champaign.

Download Full-text

Large proportions of overweight and obese children, as well as their parents, underestimate children’s weight status across Europe. The ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project

Public Health Nutrition ◽

10.1017/s136898001400305x ◽

2015 ◽

Vol 18 (12) ◽

pp. 2183-2190 ◽

Cited By ~ 19

Author(s):

Yannis Manios ◽

George Moschonis ◽

Kalliopi Karatzi ◽

Odysseas Androutsos ◽

Mai Chinapaw ◽

...

Keyword(s):

Weight Gain ◽

Energy Balance ◽

Weight Status ◽

Behavioural Change ◽

Family Characteristics ◽

Obese Children ◽

Excessive Weight Gain ◽

Actual Weight ◽

Excessive Weight ◽

Child’S Weight

AbstractObjectiveTo investigate the magnitude and country-specific differences in underestimation of children’s weight status by children and their parents in Europe and to further explore its associations with family characteristics and sociodemographic factors.DesignChildren’s weight and height were objectively measured. Parental anthropometric and sociodemographic data were self-reported. Children and their parents were asked to comment on children’s weight status based on five-point Likert-type scales, ranging from ‘I am much too thin’ to ‘I am much too fat’ (children) and ‘My child’s weight is way too little’ to ‘My child’s weight is way too much’ (parents). These data were combined with children’s actual weight status, in order to assess underestimation of children’s weight status by children themselves and by their parents, respectively. Chi-square tests and multilevel logistic regression analyses were conducted to examine the aims of the current study.SettingEight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project.SubjectsA school-based survey among 6113 children aged 10–12 years and their parents.ResultsIn the total sample, 42·9 % of overweight/obese children and 27·6 % of parents of overweight/obese children underestimated their and their children’s weight status, respectively. A higher likelihood for this underestimation of weight status by children and their parents was observed in Eastern and Southern compared with Central/Northern countries. Overweight or obese parents (OR=1·81; 95 % CI 1·39, 2·35 and OR=1·78, 95 % CI 1·22, 2·60), parents of boys (OR=1·32; 95 % CI 1·05, 1·67) and children from overweight/obese (OR=1·60; 95 % CI 1·29, 1·98 and OR=1·76; 95 % CI 1·29, 2·41) or unemployed parents (OR=1·53; 95 % CI 1·22, 1·92) were more likely to underestimate children’s weight status.ConclusionsChildren of overweight or obese parents, those from Eastern and Southern Europe, boys, younger children and children with unemployed parents were more likely to underestimate their actual weight status. Overweight or obese parents and parents of boys were more likely to underestimate the actual weight status of their children. In obesity prevention such underestimation may be a barrier for behavioural change.

Download Full-text