Perception Of Child Weight Status Research Articles

Dietary patterns and child, parental, and societal factors associated with being overweight and obesity in Vietnamese children living in Ho Chi Minh city.

Childhood overweight and obesity are rapidly increasing in urban Vietnam. Dietary patterns are understudied for their association with obesity risk in these children, and it is unclear which parental and societal factors should be targeted in prevention efforts. The study assessed child characteristics, dietary patterns, parental and societal factors for associations with childhood overweight and obesity status in Ho Chi Minh City, Vietnam. A sample of 221 children aged 9-11 years was randomly selected from four Ho Chi Minh City primary schools. Weight, heightand waist circumference were measured using standardized methods. Three 24-hdietary recalls were collected from 124 children, which were used to assess dietary patterns using principal component analysis (PCA). Parents completed a questionnaire about child, parentaland societal factors. The overall prevalence of obesity was 31.7% and of combined overweight and obesity 59.3%. Three main dietary patterns from 10 food groups were identified by PCA: traditional (grains, vegetables, meat and meat alternatives), discretionary (snacks and sweetened beverages), and industrialized (fast food and processed meat). Children with higher discretionary diet scores had higher odds of being overweight. Being a boy, screen time over 2 h/day, parental underestimation of child weight status, father's obesity, and household income in the lowest quintile were positively associated with childhood obesity. Future intervention programmes in Vietnam need to consider targeting children's unhealthy diets and parental perceptions of child weight status, as well as focusing on upstream approaches that reduce inequities contributing to childhood obesity and concomitant dietary patterns.

Maternal-child overweight relationship, assessment of maternal perception of child weight status and feeding behaviours.

Parents play a key role in constructing children' behaviours. We studies maternal-child overweight relationship and compared maternal perception of child weight status and feeding behaviours between groups of normal-weight and overweight children. The cross-sectional study was conducted on 192 girls aged 10-13 years and their mothers. They were divided to two groups of overweight (n = 94) and normal-weight (n = 98) children. Anthropometric characteristics were measured for children and mothers. Logistic regression analysis was used to examine the association between child overweight and tertiles of maternal body mass index (BMI). Maternal perception of child's weight status and her engagement in promoting child's healthy behaviours was assessed. BMI and waist circumference was significantly higher in children (P < 0.001) and mothers (P < 0.01) of overweight compared to normal-weight group. There was a significant relationship between children's overweight and tertiles of maternal BMI, which remained significant after adjusting for potential confounders. Mothers of overweight children were more concerned for their child's overeating and overweight, and for compelling the child to diet to maintain a desirable weight (P < 0.001). In contrast, mothers of normal-weight children restricted sugar-sweetened drinks (P = 0.008), offered fruit and vegetables (P = 0.035), and helped their children to get enough physical activity (P = 0.022) and night sleep (P = 0.001) more than mothers in other group. This study showed a strong relationship between children and mothers' overweight. Despite being more concerned about their child weight status, mothers of overweight children reported behaviours which were less encouraging the children for healthy eating and lifestyle than mothers of normal-weight children.

Parents’ Perception of Child Weight Status, Risk Factors and Health Concern of Childhood Obesity: A Systematic Review

The increased prevalence of childhood obesity is becoming a public health concern as it is related to numerous health implications. Parental perception of child’s weight status is an important factor for reducing childhood obesity burden. Parental perception of the risk factors and health outcomes of obesity are important in prevention and management of childhood obesity. However, previous reviews focused mainly on parental perceptions about healthy behaviors to reduce the burden of childhood obesity. Thus, this systematic review was carried out to investigate parental perceptions of their child weight status as well as risk factors and health concern of childhood obesity. A systematic review was conducted and was reported in accordance with PRISMA statement on studies between 2012 and 2017 through a variety of database like CINAHL, PubMed, Science Direct, Scopus and Cochrane Library. However, out of 2,334 articles identified, only 35 studies were included, which originate mostly from high-income countries. The results revealed that parents’ misperception rate of their children’s weight varies from 9.6% to 90%, while parents perceptive that only genetic factors, non-vegetable-consumption or low physical activity and environmental factors are the key risk factors of childhood obesity. Hence, parents’ of obese children estimate their children to be at risk at having hypertension, heart disease, depression, and diabetes. In conclusion, parents have difficulty in correctly perceiving the obesity status of their children. Health care workers should be aware of the parents’ wrong perception of their children’s weight status. The result of this review may be used to develop an effective intervention programs aimed at reducing the burden of childhood obesity which focus on the parental perception of the risk factors contributing to childhood obesity.

Parental Perception of Body Weight Status of Their 8-year-old Children: Findings from the European CHOP Study

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.

Associations between parental perception of- and concern about-child weight and use of specific food-related parenting practices

Little is known about the association between parental perception of their child's weight as well as parent's current and future concerns regarding their child's weight and a broad range of food-related parenting practices. This study used the first wave of cross-sectional data from the longitudinal Family Matters study to examine the relationships between parental perception of child weight status, parent concern for child's current and future weight and parent use of different types of food-related practices. Parent/child dyads (n = 150) were recruited from primary care clinics. Multiple regression models were fit to examine cross-sectional relationships between parental perception and concern for their child's weight and food-related parenting practices (food restriction, pressure-to-eat, food control, food monitoring, nutrition education, and parent modeling). Parents who perceived their child to be underweight had lower scores for food restriction than parents who perceived their child to be overweight. Parents who reported concern about their child's current weight reported higher scores for food restriction and monitoring than parents who were not currently concerned. Parents who reported concern about their child's future weight status reported higher scores for pressure-to-eat and monitoring than parents who were not at all concerned about their child's future weight status. The relationship between parental perception of child's current weight status and parent use of food restriction, pressure-to-eat, and overall food control was modified by child sex. Overall, results suggest that parent's perceptions of and concerns about their child's current and future weight status were correlated with their feeding approaches. Health care providers may want to consider providing anticipatory guidance for parents that have concerns about their child's weight by teaching them about positive, evidence-based ways they can engage in healthy food-related parenting practices.

Perceived child weight status, family structure and functioning, and support for health behaviors in a sample of bariatric surgery patients.

The purpose of this study is to describe the associations between bariatric surgery patients' perspectives of their child's weight status, family support for eating and exercise behavior change, and family structure and functioning. A cross-sectional descriptive design with pre- and postsurgery (N = 224) patients was used. Demographics, perceptions of child weight status, family support for eating habits and exercise, and family functioning were assessed from patients at a University Bariatric Clinic. Patients who perceived their child to be overweight/obese reported more impaired family functioning, less family exercise participation, and more discouragement for eating habit change in the family compared to patients who did not perceive their child to be overweight/obese. Single parents more often perceived their children to be overweight/obese, and had more impaired family functioning, and less support for changing eating habits and family exercise participation. Patients with impaired family functioning reported less support for changing eating habits and family exercise participation. Bariatric patients who perceived their child to be overweight/obese and identified as single parents reported more impaired family functioning and less support for eating habits and family participation in exercise. Assessing pre- and postsurgery measures from parents and children will allow the further identification of relationship variables that can be targeted to promote positive family changes that benefit parents and children long-term. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Determinants of accurate visual perception of child anthropometric phenotype among ethnically diverse preschool parents in the United States.

The literature reports that regardless of the high obesity prevalence estimates in young children, parents often do not accurately perceive their child's weight status. The purpose of this analysis was to examine the association between parent/child demographic characteristics including ethnicity, country of birth and years living in the United States and the perception of child's anthropometric phenotype status based on a visual silhouette instrument. Caregiver (n=456) and child sociodemographic, perception of child anthropometric phenotype status and height/weight measurements were collected in 2015, from 24 childcare centres in Miami, Florida, among children ages 2-to-5years old. Chi-square analysis determined parent perception accuracy by actual child healthy (<body mass index [BMI] 85th percentile) or unhealthy (≥ BMI 85th percentile) status. Multivariable linear regression modelled phenotype trends by caregiver perception. Twenty-eight per cent of the sample was of unhealthy weight. Overall, 74.6% of caregivers did not accurately identify their child's BMI phenotype category versus 25% who did (p<.001); 8% of Hispanic and 13% of non-Hispanic parents of a child with an unhealthy BMI correctly identified their child's anthropometric phenotype. A higher proportion of Cuban (22%) caregivers of a child with an unhealthy BMI percentile versus Mexican caregivers (13.9%) visually identified their child as healthy weight. Child BMI percentile was significantly associated with parent perception of child healthy phenotype (OR: 1.05, 95% CI 1.04, 1.06). Findings here add evidence to the existing body of literature that emphasise parent perception of child weight status as a critical lynchpin in the childhood obesity epidemic. Intervention efforts must continue to educate parents on healthy weight development strategies.

Weight status and diets of children aged 1-12 years attending a tertiary public paediatric outpatient clinic.

To assess the weight status and diets of a sample of paediatric outpatients, explore the relationship between the two and compare child weight status with parental perception of child weight and parents' self-reported weight. Parents/carers of 1-12-year-olds attending paediatric outpatients at Flinders Medical Centre, South Australia, between October 2015 and May 2016 completed a demographic and validated age-based dietary questionnaire (toddlers (1-3 years), pre-schoolers (>3 to <5 years) or children (5-12 years)). Dietary risk scores (low/moderate/high/very high) were calculated for toddlers and pre-schoolers and diet quality and food behaviours scores for children. Body mass index (BMI) z-score and weight status were determined from measured height and weight. Of 114 toddlers, 115 pre-schoolers and 250 children, 65% were of a healthy weight, 10% underweight and 25% overweight or obese. Most (~80%) toddlers and pre-schoolers had diets classified as 'moderate' risk, and the diets (35-90%) and behaviours (90%) of most 5-12-year-olds fell short of the guidelines. There was no significant relationship between overall diet risk or quality and BMI z-score. Healthier food behaviours scores were inversely correlated with BMI z-scores (ß -0.061, 95% confidence interval (CI) -0.089, -0.033, P < 0.005). Parents' perception of child weight status was inaccurate. Parent's self-reported weight status was significantly associated with the BMI z-scores of toddlers (ß 0.301, 95% CI 0.189-1.174, P = 0.007) and pre-schoolers (ß 0.220, 95% CI 0.032-0.859, P = 0.035). Poor diets and high rates of overweight/obesity highlight the need for screening within the paediatric outpatient setting. Parents' own weight status, and their inaccurate perception of their child's, should be considered future intervention targets for improving child and parent health.

Parent Underestimation of Child Weight Status and Attitudes towards BMI Screening.

In this study, we identify predictors of parental underestimation of child weight status and support for school-based BMI screening and reporting. Parents of 3rd through 7th grade students (N = 1002) participating in The Fit Study completed mailed surveys assessing parent race/ethnicity, weight status, perception of child weight status, and preference for BMI screening and reporting. Only 33% and 6% of parents classified their overweight child as somewhat overweight and their obese child as very overweight, respectively. Support for BMI screening was stronger among Hispanic (OR = 2.3, p < .001), Asian (OR = 3.7, p < .001), and black (OR = 2.3, p = .04) parents than white parents and weaker among overweight versus normal-weight parents (OR = 0.6, p = .01). Compared to parents of 3rd grade students, parents of older children reported less support for BMI reporting (4th grade: OR = 0.4, p = .04; 6th grade: OR = 0.3, p = .02; 7th grade: OR = 0.3, p = .03). Parent race/ethnicity, parent weight status, and child age are associated with support for BMI screening and reporting..

Parental Perceptions and Behaviors Regarding Child Weight Status among Toddlers Born Preterm.

Childhood obesity is a significant determinant of adult obesity. Among children born preterm, rapid "catch-up growth" in infancy increases the risk of later obesity. Parental perceptions of their child's weight status may compound the child's biologically heightened risk of obesity. We performed a secondary analysis of data on parental perceptions of child weight status from a randomized controlled trial (2012-2017, n = 331 toddlers born preterm). We used the Child Feeding Questionnaire (CFQ) to measure parental child feeding behaviors and beliefs. We calculated the prevalence of incorrect weight estimation, and used t-tests and chi-square tests to compare sample characteristics by correct versus incorrect weight estimation. We calculated odds ratios (ORs) for factors associated with parental underestimation of child weight status. Most (90%) children were of normal weight, whereas 3% were underweight and 7% were overweight. A majority (75%) of parents correctly estimated their child's weight status. Incorrect weight estimation was only associated with child's actual weight. Parents of overweight children were more likely to underestimate their child's weight status than parents of normal weight children (OR: 2.23, 95% confidence interval: 2.00-2.49). Mean CFQ scores differed by the child's actual weight status but not by the child's estimated weight status. Among these toddlers born preterm, significantly higher proportions of parents with underweight and overweight children incorrectly estimated their child's weight status relative to parents of normal weight children. Our findings suggest that weight underestimation could be a problem in this population, although it was not associated with changes in feeding practices.

Parents’ Perceptions of 5210 Nutrition Messaging and Child Weight Status

ObjectiveTo explore parent perceptions of child weight status and 5210 nutrition messaging recommendations, including daily consumption of 5 fruits and vegetables, limiting child screen time to ≤2 hours, incorporating 1 hour of daily physical activity, and no consumption of sugary, sweetened beverages. MethodsUsing the Convergence Model of Communication as a framework, qualitative focus groups (n = 5) were conducted at 4 Head Start sites across 1 Ohio County. Twenty-eight parents aged 20–60 years comprised the groups. A deductive analysis technique with respondent validation was used. ResultsParents have limited understanding of 5210 messages delivered by the program. Parent food preferences, family finances, and children's picky eating were identified as barriers to integrating healthy eating habits at home. Parents prefer practical strategies regarding how to integrate healthy eating habits into the home environment. Participants expressed concern about children's psychological health and happiness vs weight status. Conclusions and ImplicationsUnderstanding parental perceptions of 5210 messaging and program-reported weight status may assist Head Start programs in addressing childhood obesity through focused parent education and support.

Impact of a complementary feeding intervention and mother's perceptions of child weight status in infants.

Introduction: if complementary feeding is not introduced at six months or if it is inadequate, the child's growth will be affected. Objective: to evaluate the impact of a complementary feeding intervention and the mothers' perceptions of child weight status (MPCW) on growth indicators. Method: this was a quasi-experimental intervention in 19 mother-child dyads with seven workshops given to the intervention group (IG). Mothers were asked when, why, and how food groups should be introduced according to their beliefs and experience. Growth indicators were Z-scores for length-for-age (ZLA) and weight-for-length (ZWL). MPCW was measured using the question: "do you think your child is: 'a little underweight or underweight', 'more or less at a normal weight', 'a little overweight' or 'definitely overweight'?" Number of breastfed times, number of feeding times and minimal dietary diversity was determined by two 24-hour dietary recalls. Results: mothers believed that children could eat all foods by two years of age in 52.6% of cases. In the IG, a significant change was observed in its own growth in both indicators. The average ZLA was from -0.05 ± 0.5 to -0.73 ±1.0 Z-score (p < 0.03), and the average ZWL was from 0.74 ± 0.9 to 0.29 ± 0.5 (p < 0.05). For the indicator classification weight-for-length, in the final measurement 90.0% of children from the IG were classified at a normal weight and 10.0% at overweight, while in the control group (CG) 55.6% were classified at a normal weight and 44.4% at overweight (p < 0.08). Adequate MPCW was 80.0% in the IG and 33.3% in the CG (p < 0.04). Inadequate MPCW in the IG from underestimation was 20.0% and in the CG 55.6%. Conclusion: knowledge about introducing food and having an adequate MPCW has a positive impact on growth in children.

Asian Parents’ Perception of Child Weight Status: A Systematic Review

Parental perception of a child’s weight is important in determining parenting and feeding styles, which relate to childhood obesity. Evidence suggests this perception can vary by ethnicity. The purpose of this review was to explore Asian parents’ child weight perception and examine factors related to Asian parents’ child weight misperception. A systematic literature review was conducted on eight studies between 2000 and 2016 through the databases of CINAHL, Cochrane Reviews, PsycINFO, Medline, and PubMed. Searching key words were Asians, Asian-Americans, weight perception, and parents. The review revealed that all eight studies identified child weight misperception, but with highly varying results (ranging from 29.7 to 89.2%). Factors that influenced the accuracy of a parent’s child weight perception included maternal BMI, parental gender and age, child’s BMI, child’s own weight perception, child’s gender and age, and child’s birth order and birth weight. Misperception about their children’s weight is prevalent among Asian parents. Anthropometric measurement of a child, rather than a parent’s reporting of a child’s weight, should be used to educate Asian parents regarding childhood obesity. Health care professionals should be aware of misperceptions when developing and providing a culturally appropriate intervention to address overweight/obesity among Asian children, which might include improving weight perception.

Parent Perceptions of Child Weight Status in Mexican-Origin Immigrant Families: An Investigation of Acculturation, Stress, and Coping Factors.

Parents often underestimate their child's weight status, particularly when the child is overweight or obese. This study examined acculturation, stress, coping, and involuntary responses to stress and their relation to estimation of child's weight status among Mexican-origin immigrant families. Eighty-six families provided data on child's height and weight, caregiver's perception of their child's weight status, and caregiver's responses to acculturation, stress, and coping scales. Parents underestimated their child's weight status, particularly when the child was overweight or obese. Although acculturation and stress were not associated with accuracy, parents' responses to stress were linked to parent perceptions. Parents who reported more frequent use of involuntary engagement (e.g., rumination, physiological arousal) were more accurate. Future research, as well as healthcare providers, should consider how parents manage and respond to stress in order to fully understand the factors that explain weight perceptions among Mexican-origin immigrant parents.

Mothers' perceptions of child weight status and the subsequent weight gain of their children: a population-based longitudinal study

Background:There is a plethora of cross-sectional work on maternal perceptions of child weight status showing that mothers typically do not classify their overweight child as being overweight according to commonly used clinical criteria. Awareness of overweight in their child is regarded as an important prerequisite for mothers to initiate appropriate action. The gap in the literature is determining whether, if mothers do classify their overweight child’s weight status correctly, this is associated with a positive outcome for the child’s body mass index (BMI) at a later stage.Objective:To explore longitudinal perceptions of child weight status from mothers of a contemporary population-based birth cohort (Gateshead Millennium Study) and relationships of these perceptions with future child weight gain.Methods:Data collected in the same cohort at 7, 12 and 15 years of age: mothers’ responses to two items concerning their child’s body size; child’s and mother’s BMI; pubertal maturation; demographic information.Results:Mothers’ perceptions of whether their child was overweight did not change markedly over time. Child BMI was the only significant predictor of mothers’ classification of overweight status, and it was only at the extreme end of the overweight range and in the obese range that mothers reliably described their child as overweight. Even when mothers did appropriately classify their child as overweight at an earlier stage, this was not related to relatively lower child BMI a few years later.Conclusions:Mothers tend to classify their child as overweight in only more extreme cases. It is an important finding that no beneficial impact was shown on later child BMI in overweight children whose mothers classified their child’s weight status as overweight at an earlier stage.

Parental Perception of Weight Status and Weight Gain Across Childhood.

Parents of children who are overweight often fail to accurately identify their child's weight status. Although these misperceptions are presumed to be a major public health concern, little research has examined whether parental perceptions of child weight status are protective against weight gain during childhood. Our objective was to examine whether parental perceptions of child weight status are associated with weight gain across childhood. Data from the Longitudinal Study of Australian Children were used to assess parental perceptions of child weight status and to examine changes in researcher measured child BMI z scores across childhood, from 4 to 13 years old. Participants included 3557 Australian children and their parents. Children whose parents perceived their weight as being "overweight," as opposed to "about the right weight," gained more weight (increase in BMI z score) from baseline to follow-up in all analyses. This finding did not depend on the actual weight of the child; the association between perceiving one's child as being overweight and future weight gain was similar among children whose parents accurately and inaccurately believed their child was overweight. Contrary to popular belief, parental identification of child overweight is not protective against further weight gain. Rather, it is associated with more weight gain across childhood. Further research is needed to understand how parental perceptions of child weight may counterintuitively contribute to obesity.

Parental Perception of Weight Status: Influence on Children's Diet in the Gateshead Millennium Study.

ObjectiveRecognising overweight and obesity is critical to prompting action, and consequently preventing and treating obesity. The present study examined the association between parental perceptions of child weight status and child’s diet.MethodsParticipants were members of the Gateshead Millennium Study. Parental perception of their child’s weight status was assessed using a questionnaire and compared against International Obesity Task Force cut-offs for childhood overweight and obesity when the children were aged 6–8 years old. Diet was assessed at age 6-8years old using the FAST (Food Assessment in Schools Tool) food diary method. The association between parental perception and dietary patterns as defined by Principal Components Analysis, was assessed using multivariate regression after adjustment for child’s gender, child’s weight status, maternal body mass index (BMI), maternal education and deprivation status.ResultsOf the 361 parents who provided complete data on confounders and on their perception of their child’s weight status, 63 (17%) parents perceived their child as being of ‘normal’ weight or ‘overweight’ when they were actually ‘overweight’ or ‘obese’, respectively. After adjustment for confounders, parents who misperceived their child’s weight had children with a lower ‘healthy’ dietary pattern score compared to children whose parents correctly perceived their weight (β = -0.88; 95% CI: -1.7, -0.1; P-value = 0.028). This association was found despite higher consumption of reduced sugar carbonated drinks amongst children whose parents incorrectly perceived their weight status compared to children whose parents perceived their weight correctly (52.4% vs. 33.6%; P-value = 0.005).ConclusionsIn conclusion, children whose parents did not correctly perceive their weight status scored lower on the ‘healthy’ dietary pattern. Further research is required to define parents’ diets based on their perception status and to examine if a child’s or parent’s diet mediates the association between parental perception and child weight.

Agreement between parental perception of child weight status and actual weight status is similar across different ethnic groups in New Zealand.

INTRODUCTION Accurate parental perception of their child's weight is poor. Accuracy may be influenced by differences in ethnicity but this is currently unknown. AIM To determine whether agreement between parental perception of child weight status and actual child weight status differs according to ethnic group (NZ European, Māori, Pacific, Asian), and to investigate whether it is influenced by various demographic and behavioural factors. METHODS A total of 1093 children (4-8 years old) attended a weight screening initiative. Parents completed questionnaires on demographics, beliefs about child weight, parenting style, parental feeding practices and social desirability. Actual measured weight status was compared with parental perception of weight status (underweight, normal weight, overweight). RESULTS Agreement about child weight status was apparent in 85% of NZ European, 84% of Māori, 82% of Pacific and 88% of Asian children. However, adjusting for chance led to kappas of 0.34, 0.38, 0.41 and 0.53, respectively, indicating only fair-to-moderate agreement. Overall, agreement between measured body mass index and parental perception was not related to ethnic group, child sex and age, maternal age and education, and household deprivation (k ranged from 0.16 to 0.47). However, agreement about weight status was higher in parents who reported higher levels of restrictive feeding than in parents who reported less restriction (P < 0.01) but agreement was only fair. CONCLUSION Agreement between parental perception and actual weight status was fair and did not differ between the ethnic groups examined.

A cluster randomised trial testing an intervention to improve parents' recognition of their child's weight status: study protocol.

BackgroundParents typically do not recognise their child’s weight status accurately according to clinical criteria, and thus may not take appropriate action if their child is overweight. We developed a novel visual intervention designed to improve parental perceptions of child weight status according to clinical criteria for children aged 4–5 and 10–11 years. The Map Me intervention comprises age- and sex-specific body image scales of known body mass index and supporting information about the health risks of childhood overweight.DesignThis cluster randomised trial will test the effectiveness of the Map Me intervention. Primary schools will be randomised to: paper-based Map Me; web-based Map Me; no information (control). Parents of reception (4–5 years) and year 6 (10–11 years) children attending the schools will be recruited. The study will work with the National Child Measurement Programme which measures the height and weight of these year groups and provides feedback to parents about their child’s weight status. Before receiving the feedback, parents will complete a questionnaire which includes assessment of their perception of their child’s weight status and knowledge of the health consequences of childhood overweight. The control group will provide pre-intervention data with assessment soon after recruitment; the intervention groups will provide post-intervention data after access to Map Me for one month. The study will subsequently obtain the child height and weight measurements from the National Child Measurement Programme. Families will be followed-up by the study team at 12 months. The primary outcome is any difference in accuracy in parental perception of child weight status between pre-intervention and post-intervention at one month. The secondary outcomes include differences in parent knowledge, intention to change lifestyle behaviours and/or seek advice or support, perceived control, action planning, coping planning, and child weight status at 12 month follow-up.DiscussionThe Map Me tool has potential to make a positive impact on children’s health at a population level by introducing it into current intervention programmes to improve accuracy of parental perception of child’s weight status. This trial will inform the action of researchers, educators, health professionals and policy makers.Trial registrationCurrent Controlled Trials ISRCTN91136472. Registered 3 May 2013

Parental perception of weight status: Influence on children's diet in the Gateshead Millennium Study

Objective Recognising overweight and obesity is critical to prompting action, and consequently preventing and treating obesity. The present study examined the association between parental perceptions of child weight status and child’s diet. Methods Participants were members of the Gateshead Millennium Study. Parental perception of their child’s weight status was assessed using a questionnaire and compared against International Obesity Task Force cut-offs for childhood overweight and obesity when the children were aged 6–8 years old. Diet was assessed at age 6-8years old using the FAST (Food Assessment in Schools Tool) food diary method. The association between parental perception and dietary patterns as defined by Principal Components Analysis, was assessed using multivariate regression after adjustment for child’s gender, child’s weight status, maternal body mass index (BMI), maternal education and deprivation status. Results Of the 361 parents who provided complete data on confounders and on their perception of their child’s weight status, 63 (17%) parents perceived their child as being of ‘normal’ weight or ‘overweight’ when they were actually ‘overweight’ or ‘obese’, respectively. After adjustment for confounders, parents who misperceived their child’s weight had children with a lower ‘healthy’ dietary pattern score compared to children whose parents correctly perceived their weight (β = -0.88; 95% CI: -1.7, -0.1; P-value = 0.028). This association was found despite higher consumption of reduced sugar carbonated drinks amongst children whose parents incorrectly perceived their weight status compared to children whose parents perceived their weight correctly (52.4% vs. 33.6%; P-value = 0.005). Conclusions In conclusion, children whose parents did not correctly perceive their weight status scored lower on the ‘healthy’ dietary pattern. Further research is required to define parents’ diets based on their perception status and to examine if a child’s or parent’s diet mediates the association between parental perception and child weight.