Parental Perception of Child Weight Status Before Age 2 is Associated With Preschoolers Diet

Abstract

Nearly a quarter of 2-5 year-olds in the U.S. are overweight or obese. Early intervention is key to preventing childhood obesity. However, parents must accurately perceive their child's weight status in order to be receptive to preventive messages. Herein, the association of parental perception of child weight in the first 24 months with current child body mass index (BMI) and diet at 39.0±8.2 months-of-age was assessed. Families of 497 children ages 2-5 years from the Synergistic Theory and Research on Obesity and Nutrition Group (STRONG) Kids cross-sectional cohort. Parents completed the Child Feeding Questionnaire (CFQ) and Comprehensive Feeding Practices Questionnaire (CFPQ) items. Child dietary intake in past 7 days was estimated using items from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) interview protocol. Child BMI percentiles were calculated using measured height and weight. The majority (79.8%) of currently overweight (OW) children were perceived as non-overweight (NO) by parents in the first 24 months (P<0.001). Children perceived to be NO consumed more fatty/sugary foods and milk than those perceived to be OW (P<0.03); differences persisted irrespective of BMI percentile. Higher child fruits/vegetables intake was associated with child-centered parental feeding practices (e.g., modeling; involvement) and more monitoring; higher child fatty/sugary foods intake was associated with controlling parental feeding practices (e.g., pressure to eat; emotion regulation) and less monitoring (P<0.05). Parental perception of child weight in the first 24 months does not reflect subsequent child BMI, and may lead to less healthy diets by affecting parental feeding practices.