Jian Wang1,2, Daqiao Zhu1, Xuwen Cheng3, Yicong Liuzhou4, Bingqian Zhu1, Scott Montgomery5,6,7, Yang Cao5. 1. Shanghai Jiao Tong University School of Nursing, 200025Shanghai, People's Republic of China. 2. Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK. 3. Department of Children's Disease Prevention, Jinyang Community Health Service Center, Shanghai, People's Republic of China. 4. Department of Nursing, Shanghai Children's Medical Center, Shanghai, People's Republic of China. 5. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden. 6. Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden. 7. Department of Epidemiology and Public Health, University College London, London, UK.
Abstract
OBJECTIVE: To examine the mediating effects of maternal perception of child weight (weight perception) and concern about overweight (weight concern) on the paths between child weight and maternal feeding practices. SETTING: Pudong District, Shanghai, China. PARTICIPANTS: A convenience sample of 1164 mothers who were primary caregivers of preschool children. RESULTS: Sixty per cent of the mothers perceived their overweight/obese children as normal weight or even underweight. The disagreement between actual child weight and maternal weight perception was statistically significant (Kappa = 0·212, P < 0·001). Structural equation modelling indicated that weight perception fully mediated the relationship between child BMI Z-scores and pressure to eat. Weight concern fully mediated the relationships between child BMI Z-scores and the other three feeding practices. The serial mediating effects of weight perception and concern were statistically significant for the paths between child BMI Z-score and monitoring (β = 0·035, P < 0·001), restriction (β = 0·022, P < 0·001), and food as a reward (β = -0·017, P < 0·05). CONCLUSION: Child weight may influence maternal feeding practices through weight perception and concern. Thus, interventions are needed to increase the accuracy of weight perception, which may influence several maternal feeding practices and thereby contribute to child health.
OBJECTIVE: To examine the mediating effects of maternal perception of child weight (weight perception) and concern about overweight (weight concern) on the paths between child weight and maternal feeding practices. SETTING: Pudong District, Shanghai, China. PARTICIPANTS: A convenience sample of 1164 mothers who were primary caregivers of preschool children. RESULTS: Sixty per cent of the mothers perceived their overweight/obese children as normal weight or even underweight. The disagreement between actual child weight and maternal weight perception was statistically significant (Kappa = 0·212, P < 0·001). Structural equation modelling indicated that weight perception fully mediated the relationship between child BMI Z-scores and pressure to eat. Weight concern fully mediated the relationships between child BMI Z-scores and the other three feeding practices. The serial mediating effects of weight perception and concern were statistically significant for the paths between child BMI Z-score and monitoring (β = 0·035, P < 0·001), restriction (β = 0·022, P < 0·001), and food as a reward (β = -0·017, P < 0·05). CONCLUSION: Child weight may influence maternal feeding practices through weight perception and concern. Thus, interventions are needed to increase the accuracy of weight perception, which may influence several maternal feeding practices and thereby contribute to child health.