Abstract

The prevalence of being overweight during childhood continues to increase in the USA and Canada and children living in rural areas are more at risk than their urban counterparts. The objectives of this study were to evaluate how well the parent’s perception of their child’s weight status correlated with objectively measured weight status among a group of rural children and to identify predictors of inaccurate parental perceptions of child’s weight status. Participants were children from the Saskatchewan Rural Health Study conducted in 2010. Self-administered questionnaires were distributed through rural schools to parents of children in grades one to eight. Parents reported their child’s height and weight and rated their child’s weight status (underweight, just about the right weight, or overweight). Standardized body mass index (BMI) categories were calculated for clinically measured height and weight and for parental report of height and weight for 584 children. Logistic regression analysis was performed to identify predictors of misclassification of the parent’s perception of child’s weight status adjusting for potential confounders. Clinically measured overweight was much higher (26.5%) compared to parental perceived overweight (7.9%). The misclassification of the child’s BMI was more likely to occur if the child was a boy (odds ratio (OR) = 1.58) or non-Caucasian (OR = 2.03). Overweight was high in this group of rural children and parental perception of weight status underestimated the actual weight status of overweight school-age children. Parental reporting of child weight status has implications for public health policy and prevention strategies. Future research should focus on assessing longitudinal effects of parental misperceptions of child’s weight status.

Highlights

  • Over the past three decades, the prevalence of childhood obesity has continued to increase in the USA and Canada [1,2,3,4,5,6]

  • Plotnikoff et al reported that the prevalence of overweight was higher in rural boys than urban boys (17.6% versus 12.4%) while the prevalence of obesity was higher among rural girls than urban girls (4.8% versus 2.3%) [9]

  • Bruner and others observed that the Canadian adolescents living in rural areas were more likely to be overweight and obese compared to urban adolescents [11]

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Summary

Introduction

Over the past three decades, the prevalence of childhood obesity has continued to increase in the USA and Canada [1,2,3,4,5,6]. According to Statistics Canada (http://www.statcan.gc.ca/eng/start), data from the 2009–2011 Canadian Health Measures Survey indicates that 19.8% of children (5–17 years old) were overweight and 11.7% were obese [7]. Previous Canadian studies [8,9,10,11] and USA research [12] reported that rural children are at a higher risk of being overweight or obese compared to Children 2016, 3, 13; doi:10.3390/children3030013 www.mdpi.com/journal/children. Bruner and others observed that the Canadian adolescents living in rural areas were more likely to be overweight and obese compared to urban adolescents [11]. In a recent Canadian study of rural Saskatchewan, the prevalence of being overweight and obese was reported at 25.5% and 7.1%, respectively, indicating that overweight rates are high among rural children [10]

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