Abstract
Background/ObjectivesTo describe trends in overweight/obesity in early childhood for all children and those whose parents are concerned about their weight. To describe parents’ perceptions of their child’s weight and differences by their child’s anthropometric and sociodemographic factors.Subjects/MethodsAnalysis of the Kindergarten Health Check, a survey of all children enrolled in their first year of primary education in the Australian Capital Territory. Analysis of detailed data for 2014–2017, including qualitative analysis of parents’ comments on weight, and trends for 2001–2017.Results71,963 children participated in the survey between 2001 and 2017 (20,427 between 2014 and 2017). The average age of children (2001–2017) was 5 years and 9.6 months at the time of their physical health check. 2377 children (3.5%) were classified as obese based on measured body mass index (BMI) between 2001 and 2017, and a further 7766 (11.6%) overweight. Similar proportions were seen for 2014–2017. Among children with overweight/obesity in 2014–2017, 86.4% of parents (2479/2868) described their children’s weight as healthy and 13.3% (382/2868) as overweight/obese. Just 11.5% (339/2946) of parents whose children were later measured with overweight/obesity identified having a concern about their child’s weight.Parental comments varied widely and were often incongruent with the known health risks associated with their child’s measured BMI. Comments from parents whose children were measured as obese often were normalising e.g., “born big, always big. Definitely NOT overweight, just bigger all over”, whilst parents of children in the healthy range expressed concerns about underweight.ConclusionParents do not accurately perceive their child’s weight and few document concerns, even among children measuring in the obese BMI category. This lack of concern makes early interventions challenging as parents are in the “pre-contemplative” stage of behaviour change and may see public health campaigns or clinicians’ attempts to address their child’s weight as irrelevant or unhelpful.
Highlights
Overweight and obesity is a problem in Australia and worldwide, for children and adults, and the prevalence is increasing [1–3]
A systematic review of obesity in Australian children found children and adolescents with obesity to be at increased risk of multiple physical and psychological comorbidities compared to healthy-weight children [7]
Quantitative analysis There were 81,420 children enrolled in Australian Capital Territory (ACT) Kindergartens between 2001 and 2017, of whom 71,963 (88.1%) participated in the Kindergarten Health Check (KHC) (Table 1 and Academic Unit of General Practice unpublished analysis of ACT Education Directorate school census data). 22,569 children were enrolled in Kindergarten in ACT schools during the period 2014–2017, of whom 20,427 (90.5%) participated in the KHC
Summary
Overweight and obesity is a problem in Australia and worldwide, for children and adults, and the prevalence is increasing [1–3]. One in five (20.2%) Australian children aged 5–7 years were classified as overweight or obese in 2007–08 compared to 24.1% in 2011–12, increasing to over one in four (27.5%) in 2017–18 [4–6]. Children with overweight are at increased risk of both physiological and psychological difficulties [3]. A systematic review of obesity in Australian children found children and adolescents with obesity to be at increased risk of multiple physical and psychological comorbidities compared to healthy-weight children [7]. The causes of childhood obesity are complex, and include the interplay of environmental factors with maternal health, genetics and epigenetics, physiological factors and some medications [3, 8–10]
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