Abstract
BackgroundMaternal perception of child weight status in children with overweight or obesity has received a lot of attention but data on paternal perception of children from presumably healthy cohorts are lacking.ObjectiveWe aimed to investigate paternal and maternal perception of child weight status at the age of 8 years in a cohort of 591 children from 5 European countries.Material and MethodsIncluded were 8-year-old children and their parents participating in the European Childhood Obesity Project (EU CHOP). Weight and height of children and parents were measured and Body Mass Index (BMI, kg/m2) was calculated. Both parents were asked to assess their perception of child weight status using Eckstein scales and their concern about child overweight. The agreement between mother and father perceptions was assessed by Cohen kappa coefficient and their relationship was analyzed by linear mixed effects models based on ordinal logistic regression, accounting for country, child gender and BMI, parental BMI, level of education, concern and type of feeding during first year of life.ResultsData from children and both parents were available for 432 girls and boys. Mean BMI was comparable in boys and girls (16.7 ± 2.31 vs. 16.9 ± 2.87 kg/m2, P = 0.55). In total, 172 children (29.3%) were overweight or obese. There was a high degree of agreement between mother and father perceptions of their child’s weight status (Cohen kappa 0.77). Multivariate modelling showed that perception levels significantly increased with child BMI but were globally lower than assessed. They differed between countries, gender and types of feeding during first year of life, were influenced by education level of the father but were not related to parental BMI and concern about childhood overweight.ConclusionsThe study showed no overall differences between mothers and fathers in rating their child’s weight status but both parents had a propensity to underestimate their child’s actual weight, particularly in boys.The EU CHOP trial registered at clinicaltrials.gov as NCT00338689.
Highlights
Maternal perception of child weight status in children with overweight or obesity has received a lot of attention but data on paternal perception of children from presumably healthy cohorts are lacking
The present study used data collected in children participating in the European Childhood Obesity Project (EU CHOP), a prospective randomized clinical trial with the primary aim to study effects of infant feeding with different protein intakes on later obesity risk (Koletzko et al, 2009; Weber et al, 2014)
Overweight and underweight were defined according to World Health Organization (WHO) references: overweight at 8 years was defined as a Body Mass Index (BMI) at least one standard deviation (SD) above the mean for age (z-score ≥ 1), and underweight as BMI was at least 2 SD below WHO the mean (z-score ≤ -2) (RollandCachera et al, 1991; WHO, n.d.)
Summary
Maternal perception of child weight status in children with overweight or obesity has received a lot of attention but data on paternal perception of children from presumably healthy cohorts are lacking. Multivariate modelling showed that perception levels significantly increased with child BMI but were globally lower than assessed They differed between countries, gender and types of feeding during first year of life, were influenced by education level of the father but were not related to parental BMI and concern about childhood overweight. Concern about weight is viewed as an important factor related to feeding practices and childhood obesity (Birch & Davison, 2001; Birch et al, 2001; Crawford et al, 2006; Francis et al, 2001) In this context, most studies focus on mothers’ perception and little is known about fathers’ perception (Doolen et al, 2009; Robinson & Sutin, 2016). We aimed to characterize both paternal and maternal perception of their child’s weight status in a group of five hundred ninety-one 8-year-old children from five European countries
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