Maternal perceptions of their child’s weight status: the GENESIS study

Μanios, Yannis; Kondaki, Katerina; Kourlaba, Georgia; Vasilopoulou, Emilia; Grammatikaki, Evangelia

doi:10.1017/s1368980008004412

Cited by 61 publications

(100 citation statements)

References 36 publications

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“…Boys themselves and parents of boys tended to underestimate to a higher extent boys' increased body weight compared with girls and parents of girls, respectively. This finding is in accordance with previous findings (9,32,35) and is usually explained by the fact that female adolescents are more concerned with their body image than male adolescents, enabling girls to more correctly classify themselves based on their weight status (36) . On the other hand, parents often explain body size differences between girls and boys as normal gender differences and in this context they also may be influenced by the social desirability for a lower body weight in girls and for a larger body size in boys.…”

Section: Discussionsupporting

confidence: 93%

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

Μanios

Moschonis

Karatzi

et al. 2015

Public Health Nutr.

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Objective: To 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. Design: Children'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. Setting: Eight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project. Subjects: A school-based survey among 6113 children aged 10-12 years and their parents. Results: In 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. Conclusions: Children 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.

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Section: Discussionsupporting

confidence: 93%

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

Μanios

Moschonis

Karatzi

et al. 2015

Public Health Nutr.

Self Cite

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“…In our LSES group, children's OWOB was strongly associated with maternal underestimation of child's weight status, a finding consistent with those in other populations (Maynard et al, 2003;Carnell et al, 2005;Manios et al, 2009). More than half of the mothers underestimated their children's weight status, and the rate of underestimation was higher among mothers of OWOB children.…”

Section: Discussionsupporting

confidence: 90%

“…The sample size calculation assumed a prevalence of 25% OWOB among the children. Previous data have indicated that the prevalence of the exposure variable (maternal underestimation of children's weight) among mothers of overweight children is 0.5 (Maynard et al, 2003;Manios et al, 2009). If the true odds ratio for OWOB in exposed subjects relative to unexposed subjects were 2.5, a sample size of 211 would allow the detection of an odds ratio of this magnitude, with 80% power in a two-sided test with Type I error set to 0.05.…”

Section: Discussionmentioning

confidence: 99%

“…Maternal misperception of child's weight status is another determinant of obesity that has been examined in mixed socioeconomic status (SES) populations. Overall 20-88% of preschool children's mothers underestimated their children's weight status (Maynard et al, 2003;Campbell et al, 2006;Manios et al, 2009). Parents' knowledge and role modeling of a healthy lifestyle were shown to be associated with healthy dietary habits and consumption of fruits and vegetables among children (Pearson et al, 2009;Vereecken and Maes, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Maternal weight misperceptions and smoking are associated with overweight and obesity in low SES preschoolers

et al. 2011

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Objectives: To identify modifiable risk factors for obesity among low socioeconomic status (LSES) children. Methods: Cross-sectional data were obtained from 238 4-7-year-old children and 224 mothers from LSES preschools. Anthropometric measurements were obtained; mothers were interviewed about sociodemographic characteristics, health behaviors, perceptions and beliefs. Results: The combined prevalence of overweight and obesity (OWOB) among children was 29.8% based on the new World Health Organization (WHO) growth standard. Prevalence of OWOB (body mass index X25) among mothers was 51.8%. Mean age, sleeping hours, gender distribution and poverty level were similar between normal and OWOB children. Over 82% of mothers underestimated their child's weight status. Of the 62 OWOB children, 74.2% were perceived by their mothers as having 'normal weight' (NW) and 8% were perceived as 'thin'. Mothers perceived 67 out of 158 NW children (42.4%) as 'thin' (Po0.001). Mediation analysis indicated that 10% of the effect of maternal underestimation on child's OWOB may be mediated through child's daily sedentary hours (P ¼ 0.06). In a multivariable logistic-regression analysis controlling for maternal obesity, knowledge regarding breakfast's importance and child's daily sedentary hours, maternal underestimation of the child's weight status (odds ratio ¼ 7.33; 95% confidence interval (CI):2.41-22.37; Po0.0001) and parental smoking (odds ratio ¼ 3.25; 95% CI: 1.26-8.40; P ¼ 0.015) were the only significant factors associated with OWOB in LSES children. Conclusions: Maternal perception of child's weight status and parental smoking are associated with childhood OWOB among LSES children. These parameters can help identify children at risk for obesity. Maternal perception may be amenable to intervention.

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“…If overweight is recognised early in life, prevention and treatment strategies are more likely to be successful. 14,15 On the other hand, maternal underestimation of their child's weight may promote an unfavourable weight gain, in both normal-weight children who are perceived as being too slim, and overweight children who are perceived as having a healthy weight. 14 Studies on the perception of the child's weight show that identification of overweight in offspring is commonly underestimated by mothers.…”

Section: Introductionmentioning

confidence: 99%

Ethnic differences in maternal underestimation of offspring's weight: the ABCD study

et al. 2011

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Objective: To determine the ethnic variation in maternal underestimation of their child's weight status and the explanatory role of socio-economic status (SES), acculturation and parental body mass index (BMI). Method: A multi-ethnic sample of 2769 normal or overweight/obese children (underweight children excluded) aged 5 -7 years was examined (The Amsterdam Born Child and their Development study), comprising five ethnic subgroups: Dutch (n ¼ 1744), African descent (n ¼ 184), Turkish (n ¼ 86), Moroccan (n ¼ 161) and other non-Dutch (n ¼ 592). Data on mothers' perception of their child's weight status (5-point scale from 'too low' to 'too high'), SES, acculturation, parental BMI and the children's height and weight were collected. Underestimation was defined by comparing maternal perception with the actual weight status of her child (International Obesity Task Force guidelines). Ethnic differences in underestimation were calculated in the normal weight and overweight/obese categories. Results: Underestimation ranged from 3.6 (Dutch) to 15.7% (Moroccan) in normal-weight children, and from 73.0 (Dutch) to 92.3% (Turkish) in overweight/obese children. After correction for ethnic differences in child's BMI, higher odds ratios (ORs) for underestimation were found in the Turkish (normal weight: OR 6.83; 95% confidence interval (CI) 2.33 -20.05 and overweight: OR 2.80; 95% CI 1.12 -6.98) and Moroccan (normal weight: OR 11.55; 95% CI 5.28 -25.26) groups (reference is the Dutch group). Maternal educational level and immigrant generation largely explained the ethnic differences, with a minor contribution of maternal age. After correction, ORs remained higher in the Moroccan group (OR 4.37; 95% CI 1.79 -10.62) among the normal-weight children. Conclusion: Mothers frequently underestimate the actual weight status of their child, especially mothers from Turkish or Moroccan origin. Having a lower SES, being first-generation immigrant and a young mother are important determinants in explaining these differences. As weight perceptions may affect weight gain and almost all mothers of overweight/obese children underestimate their child's weight, health professionals should help mothers (particularly those from ethnic minority groups) to acquire a realistic perception of their children's weight status.

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Maternal perceptions of their child’s weight status: the GENESIS study

Cited by 61 publications

References 36 publications

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

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

Maternal weight misperceptions and smoking are associated with overweight and obesity in low SES preschoolers

Ethnic differences in maternal underestimation of offspring's weight: the ABCD study

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