Maternal perceptions and concerns about children’s weight status and diet quality: a study among Black immigrant families

Abstract Objective: To identify factors influencing Black immigrant mothers’ perceptions and concerns about child weight, and to compare children’s diet quality according to these perceptions and concerns. Design: Mothers’ perceptions and concerns about child weight were assessed with sex-specific figure rating scales and the Child Feeding Questionnaire, respectively. Participants’ weights and heights were measured and characterized using World Health Organization references. Children’s dietary intakes were estimated using a 24-hour dietary recall. Children’s diet quality was evaluated using the relative proportion of their energy intake provided by ultra-processed products, which were identified with the NOVA classification. Chi-square tests, multivariate logistic regressions and t-tests were performed. Setting: Ottawa, Ontario, Canada. Participants: Black immigrant mothers of Sub-Saharan African and Caribbean origin (n=186) and their 6-12-year-old children. Results: Among mothers, 32.4% perceived their child as having overweight while 48.4% expressed concerns about child weight. Girls and children with overweight or obesity were significantly more likely to be perceived as having overweight by their mothers than boys and normal-weight children, respectively. Mothers of children living with obesity, but not overweight, were significantly more likely to be concerned about their child’s weight than mothers of normal-weight children. Children’s diet quality did not differ according to mothers’ perceptions and concerns. Conclusion: Children’s gender and weight status were major determinants of perceptions and concerns about child weight among Black immigrant mothers. Including knowledge about mothers’ perceptions and concerns about child weight will help nutrition professionals develop interventions tailored to specific family needs within the context of their cultural backgrounds.

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Differential Effects of Weight Status on the Relations Between Diet Quality, Socioemotional Development, and Academic Performance in U.S. Schoolchildren (P14-008-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz052.p14-008-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Dorothy Chiu ◽

Youfa Wang ◽

Anne Riley ◽

Kristen Hurley

Keyword(s):

Academic Performance ◽

Peer Relations ◽

Diet Quality ◽

Significant Interaction ◽

Weight Status ◽

Child Growth ◽

Normal Weight ◽

Socioemotional Development ◽

The Body ◽

Child Weight

Abstract Objectives Child obesity, a risk factor for adverse health and functioning, can foster a heightened stress state in the body that may affect relations between nutritional status and cognitive development. We investigated if associations between diet quality (DQ), socioemotional development (SED), and academic performance (AP) varied by child weight status in U.S. 5th graders. Methods Nationally representative data from 7755 U.S. children (mean age 11–11.5 years) were analyzed using survey-weighted, multiple linear regression models adjusted for relevant factors. DQ was calculated by applying a novel short Diet Quality Index (sDQI) on a brief food frequency questionnaire. Established measures for SED (Self-Description Questionnaire scaled scores for internalizing and externalizing problem behaviors [IPB, EPB] and peer relations competency) and AP (standardized reading, math, and science test scores) served as dependent variables. Children's weight status was classified based on their BMI compared against sex-age-specific BMI percentiles of CDC Child Growth Charts. Results Some relations between DQ and SED and AP were slightly moderated by child weight status. A borderline significant interaction between DQ and IPB (overall F = 2.48; P = 0.06) revealed better socioemotional health with higher diet quality for both underweight (β = −0.02 [SE = 0.01]; P < 0.01) and overweight children (β = −0.01 [SE = 0.00]; P = 0.01) that was not observed in children of normal weight (β = −0.00 [SE = 0.00]; P = 0.07) or obese (β = −0.01 [SE = 0.00]; P = 0.16) status. Another borderline significant interaction between DQ and math scores (overall F = 2.39; P = 0.07) highlighted higher scores with higher diet quality in underweight (β = 0.18 [SE = 0.07]; P = 0.01) and normal weight children (β = 0.10 [SE = 0.02]; P < 0.01) not observed in overweight (β = 0.00 [SE = 0.04]; P = 0.96) or obese (β = 0.02 [SE = 0.05]; P = 0.75) children. Significant interactions were not observed between DQ and EPB or peer relation competency, or DQ and reading or science scores, by child weight status. Conclusions The moderating effects of child weight status here underscore a need for more research on the stress of malnutrition (non-normal weight status) in child development. Interventions to improve cognitive health through diet should heed underlying vulnerabilities within population groups to optimize success. Funding Sources n/a.

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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.

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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.

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Associations between diet quality and physical activity measures among a southern Ontario regional sample of grade 6 students

Applied Physiology Nutrition and Metabolism ◽

10.1139/h10-085 ◽

2010 ◽

Vol 35 (6) ◽

pp. 826-833 ◽

Cited By ~ 8

Author(s):

Sarah J. Woodruff ◽

Rhona M. Hanning

Keyword(s):

Physical Activity ◽

Healthy Eating ◽

Diet Quality ◽

Odds Ratio ◽

Weight Status ◽

Positive Association ◽

Healthy Eating Index ◽

Normal Weight ◽

Future Research ◽

Ordinal Logistic Regression Analysis

The purpose of this study was to determine diet quality and physical activity behaviours of grade 6 students by sex and body weight status, and to determine the associations between diet quality and physical activity behaviours. The Web-based Food Behaviour Questionnaire, which included a 24-h diet recall and the modified Physical Activity Questionnaire for Older Children (PAQ-C), was administered to a cross-section of schools (n = 405 students from 15 schools). Measured height and weight were used to calculate body mass index and weight status (Cole et al. 2000). A Canadian version of the Healthy Eating Index (HEI-C) was used to describe overall diet quality. The mean HEI-C was 69.6 (13.2) with the majority (72%) falling into the needs improvement category. The overall mean physical activity score was 3.7 out of a maximum of 5, with obese subjects being less active compared with normal weight and overweight (p < 0.001). Ordinal logistic regression analysis (of HEI-C vs. all measures of the PAQ-C, sex, and weight status) revealed that HEI-C ratings were likely to be higher in students that walked to and from school 5 days per week (vs. 0 days per week; odds ratio 3.18, p = 0.010); and were active 1 evening per week (vs. none; odds ratio 3.48, p = 0.039). The positive association between diet quality and some aspects of physical activity suggests possible clustering of health behaviours. Future research should test the potential benefits of promoting 1 health behaviour (e.g., healthy eating) with another (e.g., physical activity).

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Unhealthy food options in the school environment are associated with diet quality and body weights of elementary school children in Canada

Public Health Nutrition ◽

10.1017/s1368980020004437 ◽

2020 ◽

pp. 1-10

Author(s):

Shannon Sim ◽

Paul J Veugelers ◽

Rachel Prowse ◽

Candace IJ Nykiforuk ◽

Katerina Maximova

Keyword(s):

Diet Quality ◽

School Environment ◽

Weight Status ◽

Relative Proportion ◽

Absolute Number ◽

Healthy Eating Index ◽

Unhealthy Food ◽

Cross Sectional ◽

Food Outlets ◽

The Absolute

Abstract Objective: Increasing evidence links unhealthy food environments with diet quality and overweight/obesity. Recent evidence has demonstrated that relative food environment measures outperform absolute measures. Few studies have examined the interplay between these two measures. We examined the separate and combined effects of the absolute and relative densities of unhealthy food outlets within 1600 m buffers around elementary schools on children’s diet- and weight-related outcomes. Design: This is a cross-sectional study of 812 children from thirty-nine schools. The Youth Healthy Eating Index (Y-HEI) and daily vegetables and fruit servings were derived from the Harvard Food Frequency Questionnaire for Children and Youth. Measured heights and weights determined BMI Z-scores. Food outlets were ranked as healthy, somewhat healthy and unhealthy according to provincial paediatric nutrition guidelines. Multilevel mixed-effects regression models were used to assess the effect of absolute (number) and relative (proportion) densities of unhealthy food outlets within 1600 m around schools on diet quality and weight status. Setting: Two urban centres in the province of Alberta, Canada. Participants: Grade 5 students (10–11 years). Results: For children attending schools with a higher absolute number (36+) of unhealthy food outlets within 1600 m, every 10 % increase in the proportion of unhealthy food outlets was associated with 4·1 lower Y-HEI score and 0·9 fewer daily vegetables and fruit. Conclusions: Children exposed to a higher relative density of unhealthy food outlets around a school had lower diet quality, specifically in areas where the absolute density of unhealthy food outlets was also high.

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Caregiver feeding practices and child weight outcomes: a systematic review

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy276 ◽

2019 ◽

Vol 109 (Supplement_1) ◽

pp. 990S-1002S ◽

Cited By ~ 19

Author(s):

Maureen K Spill ◽

Emily H Callahan ◽

Myra J Shapiro ◽

Joanne M Spahn ◽

Yat Ping Wong ◽

...

Keyword(s):

Systematic Review ◽

Weight Gain ◽

Cohort Studies ◽

Weight Status ◽

Feeding Practices ◽

Normal Weight ◽

Controlled Trials ◽

Moderate Evidence ◽

Child Weight ◽

Weight Outcomes

ABSTRACT Background As part of the USDA–Department of Health and Human Services Pregnancy and Birth to 24 Months Project, we conducted systematic reviews (SRs) on topics important for health and nutrition of young children. Objectives The purpose of the present SR was to examine the relation between caregiver feeding practices in children from birth to 24 mo and child weight gain, size, and body composition. Methods A search of articles published from January 1980 to January 2017 in 4 databases identified 8739 references. Nutrition Evidence Systematic Review (NESR) analysts used the Nutrition Evidence Library Risk of Bias Assessment Tool to assess potential bias in the studies, and a Technical Expert Collaborative graded the body of evidence using the NESR grading rubric. Results Twenty-seven articles were included in this review (8 controlled trials, 19 longitudinal cohort studies). Moderate evidence from randomized controlled trials suggests that providing responsive feeding guidance to teach mothers to recognize and respond appropriately to children's hunger and satiety cues can lead to “normal” weight gain and/or “normal” weight status in children aged ≤2 y compared with children whose mothers did not receive responsive feeding guidance. Moderate evidence from longitudinal cohort studies indicates an association between maternal feeding practices and the child's weight status and/or weight gain, but the direction of effect has not been adequately studied. Restrictive feeding practices are associated with increased weight gain and higher weight status, and pressuring feeding practices are associated with decreased weight gain and lower weight status. Evidence suggests that a mother's feeding practices are related to concerns about her child's body weight. Conclusions This review highlights the importance of the interaction between caregivers and infants and toddlers related to child feeding practices on children's weight outcomes. Research is needed on more diverse populations with consistent methodological app-roaches and objective measures.

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Weight Matters—Factors Influencing Eating Behaviors of Vulnerable Women

Nutrients ◽

10.3390/nu11081809 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1809 ◽

Cited By ~ 1

Author(s):

Marcela Vizcarra ◽

Ana María Palomino ◽

Lorena Iglesias ◽

Alejandra Valencia ◽

Patricia Gálvez Espinoza ◽

...

Keyword(s):

Health Care Providers ◽

Low Income ◽

Weight Status ◽

Eating Behaviors ◽

Normal Weight ◽

World Health ◽

Photo Elicitation ◽

Obese Women ◽

Care Providers ◽

Qualitative Approaches

Women from low socioeconomic backgrounds are more affected by obesity than men. The influence of weight as a determinant of women’s eating behaviors has seldom been studied, especially in Latin America. In this study, we analyzed the food choices of vulnerable women according to their weight status. We conducted photo-elicitation interviews with 31 women from low-income neighborhoods in Santiago, Chile. Weight and height were measured and participants were divided into normal weight (n = 9), overweight (n = 15), and obese groups (n = 7) according to World Health Organization (WHO) body mass index (BMI) categories (p < 0.001). Quantitative and qualitative approaches were used for the analysis. Women in overweight and obese groups described more about their families, temporality, financial issues, and food perception. When weight groups were analyzed separately, more factors explaining eating behaviors were found (mental and physical health, body dissatisfaction, gender role, and obstacles for eating healthy) in the obese group. Results suggest that women with obesity or overweight based their diets on more internal and external factors than did normal weight women. This study contributes to our understanding of why changing behaviors can be difficult in women with obesity. Health care providers should consider these factors in the implementation of programs to address the need for a healthy diet for overweight and obese women.

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Agreement between parental perception of child weight status and actual weight status is similar across different ethnic groups in New Zealand

Journal of Primary Health Care ◽

10.1071/hc16002 ◽

2016 ◽

Vol 8 (4) ◽

pp. 316 ◽

Cited By ~ 4

Author(s):

Kim Meredith-Jones ◽

Sheila Williams ◽

Rachael Taylor

Keyword(s):

Ethnic Group ◽

Ethnic Groups ◽

Weight Status ◽

Normal Weight ◽

Parental Perception ◽

Actual Weight ◽

Child Weight ◽

Measured Weight ◽

Parental Feeding ◽

Behavioural Factors

ABSTRACT INTRODUCTION Accurate parental perception of their child's weight is poor. Accuracy may be influenced by differences in ethnicity but this is currently unknown. AIM To determine whether agreement between parental perception of child weight status and actual child weight status differs according to ethnic group (NZ European, Māori, Pacific, Asian), and to investigate whether it is influenced by various demographic and behavioural factors. METHODS A total of 1093 children (4–8 years old) attended a weight screening initiative. Parents completed questionnaires on demographics, beliefs about child weight, parenting style, parental feeding practices and social desirability. Actual measured weight status was compared with parental perception of weight status (underweight, normal weight, overweight). RESULTS Agreement about child weight status was apparent in 85% of NZ European, 84% of Māori, 82% of Pacific and 88% of Asian children. However, adjusting for chance led to kappas of 0.34, 0.38, 0.41 and 0.53, respectively, indicating only fair-to-moderate agreement. Overall, agreement between measured body mass index and parental perception was not related to ethnic group, child sex and age, maternal age and education, and household deprivation (k ranged from 0.16 to 0.47). However, agreement about weight status was higher in parents who reported higher levels of restrictive feeding than in parents who reported less restriction (P < 0.01) but agreement was only fair. CONCLUSION Agreement between parental perception and actual weight status was fair and did not differ between the ethnic groups examined.

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Temporal Eating Patterns and Weight Status Among US Adults in the American Time Use Survey (ATUS)

Current Developments in Nutrition ◽

10.1093/cdn/nzaa047_012 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 592-592

Author(s):

Sydney O'Connor ◽

Jill Reedy ◽

Barry Graubard ◽

Ashima Kant ◽

Susan Czajkowski ◽

...

Keyword(s):

Diet Quality ◽

Time Use ◽

Weight Status ◽

Normal Weight ◽

Misclassification Error ◽

Eating Patterns ◽

Eating Pattern ◽

Single Observation ◽

American Time Use Survey ◽

Time Use Survey

Abstract Objectives In addition to diet quality and quantity, the timing of eating in relation to the circadian rhythm may impact weight status and overall health. Experimental studies suggest that a shorter eating window and extended overnight fast may promote metabolic health and weight loss. Additionally, eating early in alignment with the circadian peak in metabolism may be protective, while eating close to the biological night may promote weight gain. This study examined cross-sectional associations of temporal eating patterns with weight status. Methods This study used the Eating & Health Module of the 2006–08 and 2014–16 American Time Use Survey (ATUS), a nationally-representative sample of US adults with a 24hr time use diary (4am – 4am). Respondents ages 18–64 years with a body mass index (BMI) 18.5–50.0 kg/m2 were included. Sleep and primary/secondary eating activities were used to define three temporal eating patterns: duration between (a) end of sleep and first eating activity (morning fast); (b) first and last eating activity (eating window); and (c) last eating activity and beginning of sleep (evening fast). Multinomial logistic regression models, accounting for ATUS survey design, were used to examine associations between each temporal eating pattern and BMI (normal weight, overweight, obese), controlling for age, sex, education, employment, household size, race/ethnicity, total sleep time, weekend, season, and year. Results A total of 38,717 respondents were included. For each hour increase in morning fast, the odds of being normal weight (vs. obese) was 0.95 (95% CI: 0.94–0.97). For each one hour increase in eating window, the odds of normal weight (vs. obese) was 1.05 (95% CI: 1.04 – 1.06), and for each hour increase in evening fast, the odds of normal weight (vs. obese) was 0.96 (95% CI: 0.95 – 0.98) (all P < 0.0001). Similar trends were seen for overweight (vs. obese) (all P < 0.05). Conclusions Though findings for morning fast are consistent with hypotheses, findings for eating window and evening fast are not. Limitations include a single observation day, which may not reflect usual eating patterns and does not consider dynamic weight trajectories, potential influence of bias and misclassification error, and lack of information on diet quality and quantity, which should be considered in future studies. Funding Sources N/A

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Pregravid body mass index is negatively associated with diet quality during pregnancy

Public Health Nutrition ◽

10.1017/s1368980007657991 ◽

2007 ◽

Vol 10 (9) ◽

pp. 920-926 ◽

Cited By ~ 93

Author(s):

Barbara A Laraia ◽

Lisa M Bodnar ◽

Anna Maria Siega-Riz

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Diet Quality ◽

Weight Status ◽

Multinomial Logistic Regression ◽

Normal Weight ◽

Self Report ◽

Folate Intake ◽

Institute Of Medicine ◽

Logistic Regression Models

AbstractObjectiveTo investigate the association between pregravid weight status and diet quality.DesignInstitute of Medicine body mass index (BMI) cut-off points of < 19.8 kg m− 2 for underweight, 19.8–26.0 kg m− 2 for normal weight, >26.0–29.0 kg m− 2 for overweight and >29 kg m− 2 for obese were used to categorise women's weight status. Dietary information was obtained by self-report at 26–28 weeks' gestation using a modified Block food-frequency questionnaire. The Diet Quality Index for Pregnancy (DQI-P) included: servings of grains, vegetables and fruits, folate, iron and calcium intake, percentage calories from fat, and meal pattern score. Multinomial logistic regression models were used to estimate the association between weight status and tertiles of DQI-P controlling for potential individual confounders.SettingA clinical-based population recruited through four prenatal clinics in central North Carolina.SubjectsA total of 2394 women from the Pregnancy, Infection and Nutrition study were included in this analysis.ResultsEvidence of a dose–response relationship was found between BMI and inadequate servings of grains and vegetables, and iron and folate intake. Pregravid obesity was associated with 76% increased odds of falling into the lowest diet quality tertile compared with underweight women after controlling for potential confounders.ConclusionA modest association was found between pregravid weight status and diet quality. If corroborated, these findings suggest that overweight pregnant women should be targeted for nutrition counselling interventions aimed to improve diet quality.

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