Abstract

Adherence to certain dietary patterns influences obesity status in both children and adults. Weight perception influences dietary habits. The aim of this study was to examine children’s dietary habits and obesity status, in relation to weight perception. One thousand seven hundred Greek students enrolled in this study during 2014–2016. Children’s characteristics were assessed through validated questionnaires, and weight status was classified according to the criteria of the International Obesity Task Force. Dietary patterns were assessed through exploratory factor analysis. Overall, 52.2% of children characterized themselves as normal weight, 34.5% as low weight, and 13.3% as overweight/obese; 52.5% of children were in accordance with their actual weight status, with girls being more likely to overestimate their weight. Children followed three dietary patterns, i.e., starchy and protein foods, unhealthy/high-fat foods, and healthy foods. Children who followed the healthy dietary pattern and had accurate weight perception (in accordance with their actual weight), had lower odds of being overweight/obese (p < 0.001). Accurate weight perception in conjunction with healthy dietary habits may play a determinant role in the prevention of obesity. From a public health perspective, early identification of children’s weight misperception along with healthy dietary habit promotion shape a crucial role in childhood obesity confrontation.

Highlights

  • Gender-specific analysis revealed that 32.4% of boys and 23.3% of girls were categorized as overweight/obese (p < 0.001 for gender difference)

  • Boys were more likely to be overweight/obese compared to girls, and both boys and girls engaged in physical activities were less likely to be overweight/obese compared to those followed sedentary behaviors

  • Girls compared to boys showed higher accordance regarding their weight perception and actual weight status (54.3% for girls and 50.3% for boys, p = 0.04) There was a fair agreement between children’s perception and their actual obesity status (Cohen’s kappa = 0.207, p < 0.001)

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Summary

Introduction

Obesity is a “modern world” disease with increasing rates in both children and adults, constituting a major public health problem as it adversely affects health, starting in early childhood [1]. It has been characterized as a multifactorial disease [2,3]. Healthy and balanced eating habits, as well as a variety of lifestyle behaviors, mainly physical activity, play an important role and have proven as effective means to control obesity [4,5]. The vast majority of previous studies have focused on the associations between obesity and single foods, nutrients, and eating behaviors. The current trend in nutritional epidemiology is the dietary patterns’ approach, based on a posteriori-

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