Ximena Ramos Salas1,2, Marta Buoncristiano2, Julianne Williams2, Maryam Kebbe3, Angela Spinelli4, Paola Nardone4, Ana Rito5, Vesselka Duleva6, Sanja Musić Milanović7, Marie Kunesova8, Radka Taxová Braunerová8, Tatjana Hejgaard9, Mette Rasmussen10, Lela Shengelia11, Shynar Abdrakhmanova12, Akbota Abildina12, Zhamyila Usuopva13, Jolanda Hyska14, Genc Burazeri14, Aušra Petrauskiene15, Iveta Pudule16, Victoria Farrugia Sant'Angelo17, Enisa Kujundzic18, Anna Fijałkowska19, Alexandra Cucu20, Lacramioara Aurelia Brinduse20, Valentina Peterkova21, Elena Bogova21, Andrea Gualtieri22, Marta García Solano23, Enrique Gutiérrez-González23, Sanavbar Rakhmatullaeva24, Maya Tanrygulyyeva25, Nazan Yardim26, Daniel Weghuber27, Päivi Mäki28, Kenisha Russell Jonsson29, Gregor Starc30, Petur Benedikt Juliusson31, Mirjam M Heinen32, Cecily Kelleher32, Sergej Ostojic33, Stevo Popovic34, Viktoria Anna Kovacs35, Dilorom Akhmedova36, Nathalie J Farpour-Lambert37, Harry Rutter38, Bai Li39, Khadichamo Boymatova40, Ivo Rakovac2, Kremlin Wickramasinghe41, Joao Breda2. 1. WHO European Office for Prevention and Control of NCDs, Country Health Programmes, WHO Regional Office for Europe, Copenhagen, Denmark. 2. European Association for the Study of Obesity, Teddington, United Kingdom. 3. Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA. 4. Istituto Superiore di Sanità, Rome, Italy. 5. National Institute of Health Dr. Ricardo Jorge I.P., Lisbon, Portugal. 6. National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria. 7. University of Zagreb, School of Medicine/Croatian Institute of Public Health, Zagreb, Croatia. 8. Obesity Management Centre, Institute of Endocrinology, Prague, Czechia. 9. Danish Health Authority, Copenhagen, Denmark. 10. National Institute of Public Health, University of Southern Denmark, Odense, Denmark. 11. National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia. 12. National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan. 13. Centre for Health Promotion, Bishkek, Kyrgyzstan. 14. Institute of Public Health, Tirana, Albania. 15. Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania. 16. Centre for Disease Prevention and Control, Riga, Latvia. 17. Primary Health Care, Ministry of Health, Floriana, Malta. 18. Institute of Public Health, Podgorica, Montenegro. 19. Department of Cardiology, Institute of Mother and Child, Warsaw, Poland. 20. Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Romania, Bucharest, Romania. 21. Institute of Pediatric Endocrinology, Endocrine Research Centre, Moscow, Russian Federation. 22. Istituto per la Sicurezza Sociale, Cailungo, San Marino. 23. Observatory of Nutrition and Study of Obesity, Spanish Agency for Food Safety & Nutrition, Ministry of Health, Madrid, Spain. 24. Department for Organization of Health Services to Children, Mothers, Adolescents and Family Planning, Ministry of Health and Social Protection of the Population, Dushanbe, Tajikistan. 25. Internal Diseases Department of the Scientific Clinical Centre of Mother and Child Health, Ashgabat, Turkmenistan. 26. Ministry of Health, Public Health General Directorate, Ankara, Turkey. 27. Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria. 28. National Institute for Health and Welfare, Helsinki, Finland. 29. Public Health Agency of Sweden, Solna, Sweden. 30. Faculty of Sport, University of Ljubjana, Ljubjana, Slovenia. 31. National Institute of Public Health, Oslo, Norway. 32. National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland. 33. Faculty of Sport and PE, University of Novi Sad, Novi Sad, Serbia. 34. Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro. 35. Hungarian School Sport Federation, Budapest, Hungary. 36. School for Health in Europé, Ministry of Health, Tashkent, Uzbekistan. 37. European Association for the Study of Obesity, United Kingdom, and Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology and Therapeutic Education, Department of Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland. 38. Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom. 39. Centre for Exercise, Nutrition and Health Sciences (ENHS), University of Bristol, Bristol, United Kingdom. 40. World Health Organization, Country Office, Dushanbe, Tajikistan. 41. WHO European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation.
Abstract
INTRODUCTION: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child's weight status. The purpose of this study was to measure parental perceptions of their child's weight status and to identify predictors of potential parental misperceptions. METHODS: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children's weight status as "underweight," "normal weight," "a little overweight," or "extremely overweight." We categorized children's (6-9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child's weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. RESULTS: Overall, 64.1% of parents categorized their child's weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child's weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child's weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28-1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26-1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98-1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99-1.24). Overall, parents' BMI was not strongly associated with the underestimation of children's weight status, but there was a stronger association in some countries. DISCUSSION/ CONCLUSION: Our study supplements the current literature on factors that influence parental perceptions of their child's weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents' knowledge and perceptions, as well as the sociocultural contexts in which children and families live.
INTRODUCTION: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child's weight status. The purpose of this study was to measure parental perceptions of their child's weight status and to identify predictors of potential parental misperceptions. METHODS: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children's weight status as "underweight," "normal weight," "a little overweight," or "extremely overweight." We categorized children's (6-9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child's weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. RESULTS: Overall, 64.1% of parents categorized their child's weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child's weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child's weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28-1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26-1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98-1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99-1.24). Overall, parents' BMI was not strongly associated with the underestimation of children's weight status, but there was a stronger association in some countries. DISCUSSION/ CONCLUSION: Our study supplements the current literature on factors that influence parental perceptions of their child's weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents' knowledge and perceptions, as well as the sociocultural contexts in which children and families live.
Authors: William H Dietz; Louise A Baur; Kevin Hall; Rebecca M Puhl; Elsie M Taveras; Ricardo Uauy; Peter Kopelman Journal: Lancet Date: 2015-02-19 Impact factor: 79.321
Authors: Christina A Roberto; Boyd Swinburn; Corinna Hawkes; Terry T-K Huang; Sergio A Costa; Marice Ashe; Lindsey Zwicker; John H Cawley; Kelly D Brownell Journal: Lancet Date: 2015-02-19 Impact factor: 79.321
Authors: Jared P Reis; Catherine M Loria; Cora E Lewis; Tiffany M Powell-Wiley; Gina S Wei; J Jeffrey Carr; James G Terry; Kiang Liu Journal: JAMA Date: 2013-07-17 Impact factor: 56.272
Authors: K N Parkinson; J J Reilly; L Basterfield; J K Reilly; X Janssen; A R Jones; L R Cutler; A Le Couteur; A J Adamson Journal: Int J Obes (Lond) Date: 2017-01-25 Impact factor: 5.095