Parental Misperceptions of Children’s Underweight Status: A Meta-analysis
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Accurate parental perceptions of their children’s underweight status are needed to prevent overlooking potential disordered eating patterns or health conditions affecting growth.
The aim of this study is to determine overall proportion of parents who misperceive children’s underweight status and correlates of such misperceptions.
Original studies published to January 2013 were chosen through a literature search in established databases. Studies included assessed parental perceptions of their children’s underweight and then compared perceptions to recognized standards for defining underweight based on anthropometric measures. Random- and mixed-effects models were used.
Thirty-seven articles (representing 39 studies; N = 4,039) were included. Pooled effect sizes indicated that 46.58 % (95 % CI 40.90–52.35 %) of parents misperceive their children’s underweight status, though the extent of misperceptions depended on a number of moderators.
Nearly half of parents perceive their underweight children as weighing more than they actually do. Health care professionals are well positioned to take steps to remedy misperceptions and encourage healthy behaviors.
- de Onis M, Blossner M, Borghi E, Frongillo EA, Morris R. Estimates of global prevalence of childhood underweight in 1990 and 2015. JAMA. 2004; 291: 2600-2606. CrossRef
- Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA. 2010; 303(3): 242-249. CrossRef
- Chang SM, Walker SP, Grantham-McGregor S, Powell CA. Early childhood stunting and later behavior and school achievement. J Child Psychol Psych. 2002; 43: 775-783. CrossRef
- Martinez-Vizcaino V, Sanchez-Lopez M, Moya-Martinez P, et al. Trends in excess weight and thinness among Spanish schoolchildren in the period 1992–2004: the Cuenca study. Public Health Nutr. 2009; 12: 1015-1018. CrossRef
- Bjomelv S, Lydersen S, Mykletun A, Holmen TL. Changes in BMI-distribution from 1966–1969 to 1995–1997 in adolescents. The Young–HUNT study, Norway. BMC Public Health. 2007; 7: 279-284. CrossRef
- Sjoberg A, Lissner L, Albertsson-Wikland K, Marild S. Recent anthropometric trends among Swedish school children: evidence for decreasing prevalence of overweight in girls. Acta Paediatr. 2008; 97: 118-123. CrossRef
- Johnson JG, Cohen P, Kasen S, Brook JS. Eating disorders during adolescence and the risk for physical and mental disorders during early adulthood. Arch Gen Psych. 2002; 59: 545-552. CrossRef
- Mendez M, Adair L. Severity and timing of stunting in the first two years of life affect performance on cognitive tests in late childhood. J Nutr. 1999; 129: 1555-1562.
- Walker SP, Chang SM, Powell CA. Psychosocial consequences of early childhood growth retardation. In: Martorell R, Haschke R, eds. Nutrition and growth. Vevey: Nestec; 2001: 241-254.
- Whaley SE, Sigman M, Espinoss MP. Infant predictors of cognitive development in an undernourished Kenyan population. Dev Behav Pediatr. 1998; 19: 169-177. CrossRef
- Eriksson JG, Forsen T, Tuomilehto J, Osmond C, Barker DJ. Early growth and coronary heart disease in later life: longitudinal study. BMC. 2001; 332: 949-953. CrossRef
- Combs JL, Pearson CM, Zapolski TC, Smith GT. Preadolescent disordered eating predicts subsequent eating dysfunction. J Pediatr Psychol. 2013; 38: 41-49. CrossRef
- Hernandez RG, Cheng TL, Serwint JR. Parents’ healthy weight perceptions and preferences regarding obesity counseling in preschoolers: pediatricians matter. Clin Pediatr. 2010; 49(8): 790-798. CrossRef
- Lazzeri G, Casorelli A, Giallombardo D, et al. Nutritional surveillance in Tuscany: maternal perception of nutritional status of 8–9 y-old school-children. J Prev Med Hyg. 2006; 47: 16-21.
- Moschonis G, Iatridi V, Mavrogianni C, et al. Accuracy and correlates of visual and verbal instruments assessing maternal perceptions of children’s weight status: the Healthy Growth Study. Public Health Nutr. 2011; 14(11): 1979-1987. CrossRef
- Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009; 151(4): 264-269. CrossRef
- Greenland S. Quality scores are useless and potentially misleading: reply to “Re: A critical look at some popular analytic methods”. Am J Epidemiol. 1994; 140(3): 300-301.
- Abbott RA, Lee AJ, Stubbs CO, Davies PS. Accuracy of weight status perception in contemporary Australian children and adolescents. J Paediatr Child Health. 2010; 46: 343-348. CrossRef
- Akerman A, Williams ME, Meunier J. Perception versus reality an exploration of children’s measured body mass in relation to caregivers’ estimates. J Health Psych. 2007; 12(6): 871-882. CrossRef
- Arcan C, Hannan P, Himes J, et al. American Indian parents’ assessment of and concern and their kindergarten child’s weight status, South Dakota 2005–2006. Prev Chron Dis. 2012; 9: 1-10.
- Baughcum AE, Chamberlin LA, Deeks CM, Powers SW, Whitaker RC. Maternal perceptions of overweight preschool children. Pediatrics. 2000; 106(6): 1380-1386. CrossRef
- Binkin N, Spinelli A, Baglilo G, Lamberti A. What is common becomes normal: the effect of obesity prevalence on maternal perception. Nutr Metab Cardiovasc Dis. 2013. doi:10.1016/j.numecd.2011.09.006.
- Boa-Sorte N, Neri L, Leite M, et al. Maternal perceptions and self-perception of the nutritional status of children and adolescents from private schools. J Pediatr (Rio J). 2007; 83: 349-356.
- Bossink-Tuna H, L’hoir M, Beltman M, Boere-Boonekamp M. Parental perception of weight and weight-related behaviour in 2- to 4-year-old children in the eastern part of the Netherlands. Eur J Pediatr. 2009; 168(3): 333-339. CrossRef
- Boutelle K, Fulkerson JA, Neumark‐Sztainer D, Story M. Mothers’ perceptions of their adolescents’ weight status: are they accurate? Obes Res. 2004; 12(11): 1754-1757. CrossRef
- Brannon JG, Ahlers-Schmidt CR, Harrison M. Perceptions of child weight status by parents of children on Medicaid. Kansas J Med. 2009; 2: 78-86.
- de La OA, Jordan KC, Ortiz K, et al. Do parents accurately perceive their child’s weight status? J Pediatr Health Care. 2009; 23(4): 216-221. CrossRef
- Esenay FI, Yigit R, Erdogan S. Turkish mothers’ perceptions of their children’s weight. J Spec Pediatr Nurs. 2010; 15(2): 144-153. CrossRef
- Fisher L, Fraser J, Alexander C. Caregivers’ inability to identify childhood adiposity: a cross‐sectional survey of rural children and their caregivers’ attitudes. Aust J Rural Health. 2006; 14(2): 56-61. CrossRef
- Garrett-Wright D. Parental perception of preschool child body weight. J Pediatr Nurs. 2011; 26(5): 435-445. CrossRef
- Genovesi S, Giussani M, Faini A, et al. Maternal perception of excess weight in children: a survey conducted by paediatricians in the province of Milan. Acta Paediatr. 2005; 94(6): 747-752. CrossRef
- Ha Y, Vann JCJ, Choi E. Prevalence of overweight and mothers’ perception of weight status of their children with intellectual disabilities in South Korea. J School Nurs. 2010; 26(3): 212-222. CrossRef
- Hager ER, Candelaria M, Latta LW, et al. Maternal perceptions of toddler body size: accuracy and satisfaction differ by toddler weight status. Arch Pediatr Adolesc Med. 2012; 166(5): 417. CrossRef
- Harnack L, Lytle L, Himes JH, Story M, Taylor G, Bishop D. Peer reviewed: Low awareness of overweight status among parents of preschool-aged children, Minnesota, 2004–2005. Prev Chronic Dis. 2009;6(2):A47.
- He M, Evans A. Are parents aware that their children are overweight or obese? Do they care? Can Family Phys. 2007; 53(9): 1493-1499.
- Jones AR, Parkinson KN, Drewett RF, Hyland RM, Pearce MS, Adamson AJ. Parental perceptions of weight status in children: the Gateshead Millennium Study. Int J Obes. 2011; 35(7): 953-962. CrossRef
- Júlíusson PB, Roelants M, Markestad T, Bjerknes R. Parental perception of overweight and underweight in children and adolescents. Acta Paediatr. 2011; 100(2): 260-265. CrossRef
- Lopes L, Santos R, Pereira B, Lopes V. Maternal perceptions of children’s weight status. Child Care Health Dev. 2012; 39(5): 728-736. CrossRef
- Mamun AA, McDermott B, O’Callaghan M, Najman JM, Williams GM. Predictors of maternal misclassifications of their offspring’s weight status: a longitudinal study. Int J Obes. 2007; 32(1): 48-54. CrossRef
- Mathieu M, Drapeau V, Tremblay A. Parental misperception of their child’s body weight status impedes the assessment of the child’s lifestyle behaviors. Int J Pediatr. 2010; 2010: 9. CrossRef
- Maynard LM, Galuska DA, Blanck HM, Serdula MK. Maternal perceptions of weight status of children. Pediatrics. 2003; 111: 1226-1231.
- Molina Mdel C, de Faria CP, Montero P, Cade NV. Correspondence between children’s nutritional status and mothers’ perceptions: a population-based study. Cad Saude Publica. 2009; 25(10): 2285-2290. CrossRef
- Muhammad NA, Omar K, Shah SA, Muthpalaniappen L, Arshad F. Parental perception of their children’s weight status, and its association with their nutrition and obesity knowledge. Asia Pacific J Clin Nutr. 2008; 17: 597-602.
- Nazario Rodriguez IJ, Figueroa WI, Rosado J, Parrilla Idel C. Perception of parents regarding their children’s weight. Bol Asoc Med P R. 2008; 100(2): 33-38.
- Petricevic N, Puharic Z, Posavec M, Simetin IP, Franelic IP. Family history and parental recognition of overweight in Croatian children. Eur J Pediatr. 2012; 171(8): 1209-1214. CrossRef
- Regber S, Novak M, Eiben G, et al. Parental perceptions of and concerns about child’s body weight in eight European countries—the IDEFICS study. Pediatr Obes. 2012; 8(2): 118-129. CrossRef
- Rivera-Soto WT, Rodríguez-Figueroa L. Childhood obesity among Puerto Rican children: discrepancies between child’s and parent’s perception of weight status. Int J Environ Res Pub Health. 2012; 9(4): 1427-1437. CrossRef
- Shrewsbury VA, Garnett SP, Campbell K, et al. Maternal misconceptions of weight status among Nepean adolescents. J Acad Nutr Diet. 2012; 112(12): 2007-2013. CrossRef
- Webber L, Hill C, Cooke L, Carnell S, Wardle J. Associations between child weight and maternal feeding styles are mediated by maternal perceptions and concerns. Eur J Clin Nutr. 2010; 64(3): 259-265. CrossRef
- Wen X, Hui S. Chinese parents’ perceptions of their children’s weights and their relationship to parenting behaviours. Child Care Health Dev. 2011; 37(3): 343-351. CrossRef
- Yao N, Hillemeier MM. Weight status in Chinese children: maternal perceptions and child self-assessments. World J Pediatr. 2012; 8(2): 129-135. CrossRef
- Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 1977: 159-174. CrossRef
- Lipsey MW, Wilson D. Practical meta-analysis. Thousand Oaks: Sage; 2000.
- Hedges LV. Fitting categorical models to effect sizes from a series of experiments. J Educ Behav Stat. 1982; 7(2): 119-137. CrossRef
- Bakermans-Kranenburg MJ, Van Ijzendoorn MH, Juffer F. Less is more: meta-analyses of sensitivity and attachment interventions in early childhood. Psychol Bull. 2003; 129(2): 195. CrossRef
- Duval S, Tweedie R. Trim and fill: a simple funnelplot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000; 56: 455-463. CrossRef
- Duval S, Tweedie R. A nonparametric “trim and fill” method of accounting for publication bias in meta-analysis. J Am Stat Assoc. 2000; 95(449): 89-98.
- Jain A, Sherman SN, Chamberlin LA, Carter Y, Powers SW, Whitaker RC. Why don’t low-income mothers worry about their preschoolers being overweight? Pediatrics. 2001; 107(5): 1138-1146. CrossRef
- Brewis A. Biocultural aspects of obesity in young Mexican schoolchildren. Am J Hum Biol. 2003; 15(3): 446-460. CrossRef
- Jezewski MA, Poss J. Mexican American’s explanatory model of type 2 diabetes. Western J Nurs Res. 2002; 24: 840-858. CrossRef
- Story M, Stevens J, Himes J, et al. Obesity in American-Indian children: prevalence, consequences, and prevention. Prev Med. 2003; 37: 3-12. CrossRef
- Singh GK, Kogan MD, van Dyck PC. Changes in state-specific childhood obesity and overweight prevalence in the United States from 2003 to 2007. Arch Pediatr Adoles Med. 2010; 164: 598-607.
- Bordo S. Unbearable weight: feminism, western culture, and the body (10th ed). Berkeley: University of California Press; 2003.
- Al-Sendi AM, Shetty P, Musaiger AO. Body weight perception among Bahraini adolescents. Child Care Health Dev. 2004; 30: 369-376. CrossRef
- Davison KK, Birch LL. Weight status, parent reaction, and self-concept in five-year-old girls. Pediatrics. 2001; 107: 46-53. CrossRef
- Lock J, Le Grange D, Agras WS, Moye A, Bryson SW, Jo B. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psych. 2010; 67: 1025. CrossRef
- Weaver L, Sit L, Liebman R. Treatment of anorexia nervosa in children and adolescents. Current Psych Rep. 2012; 14: 96-100. CrossRef
- Krebs NF, Jacobson MS. Prevention of pediatric overweight and obesity. Pediatrics. 2003; 112(2): 424-430. CrossRef
- Glacken M, Evans DS. Measuring height and weight in school children as a public health indicator. Department of Public Health, Health Service Executive West, Galway, Ireland.2006. Available at: http://lenus.ie/hse/bitstream/10147/44887/1/6540.pdf, 2006.
- Parental Misperceptions of Children’s Underweight Status: A Meta-analysis
Annals of Behavioral Medicine
Volume 48, Issue 2 , pp 184-193
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