Weight status in Chinese children: maternal perceptions and child self-assessments
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Inaccurate parental perceptions of child weight status as well as children’s own misperceptions can reduce motivation to adopt optimal nutritional and physical activity behaviors, thereby increasing overweight and obesity risk in child populations in the U.S. and elsewhere. Using population-based data from nine provinces of China, we analyzed the accuracy of maternal perceptions and children’s self-assessments of weight status.
The data were collected from 1265 children aged 6 to 18 years with self-reported weight status perceptions during the 2006 China Health and Nutrition Survey. Among these children, 863 had maternal estimation of child weight status. Descriptive and multiple regression analyses are conducted to find variations in the misperception of children’s weight status.
Among overweight children (n=176), 69% underestimated their weight status; 72% mothers of the overweight children (n=143) also underestimated their child’s weight status. Less than one-quarter of overweight children and their mothers chose the correct classification of weight status. Multiple regression analyses showed that as children’s body-mass-index (BMI)-for-age increased, the odds that mothers underestimated their weight status increased. Low maternal weight was significantly associated with maternal underestimation of child weight status but not with child’s underassessment.
Underestimation of childhood overweight is common among both mothers and children in China, particularly for children with the highest BMI. School-based BMI reporting may be beneficial in alerting parents and children to the problem and encouraging communication with health care providers.
- Hill, J.O., Trowbridge, F.L. (1998) Childhood obesity: future directions and research priorities. Pediatrics 101: pp. 570-574 CrossRef
- Ebbeling, C.B., Pawlak, D.B., Ludwig, D.S. (2002) Childhood obesity: public-health crisis, common sense cure. Lancet 360: pp. 473-482 CrossRef
- Weiss, R., Dziura, J., Burgert, T.S., Tamborlane, W.V., Taksali, S.E., Yeckel, C.W. (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350: pp. 2362-2374 CrossRef
- Magarey, A.M., Daniels, L.A., Boulton, T.J., Cockington, R.A. (2003) Predicting obesity in early adulthood from childhood and parental obesity. Int J Obes Relat Metab Disord 27: pp. 505-513 CrossRef
- Dietz, W.H. (1998) Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 101: pp. 518-525
- National Bureau of Statistics of China, 2011. http://www.stats.gov.cn/english/newsandcomingevents/t20110428_402722244.htm (accessed February 22, 2012).
- Cui, Z., Huxley, R., Wu, Y., Dibley, M.J. (2010) Temporal trends in overweight and obesity of children and adolescents from nine provinces in China from 1991–2006. Int J Pediatr Obes 5: pp. 365-374 CrossRef
- Li, Y., Yang, X., Zhai, F., Piao, J., Zhao, W., Zhang, J. (2008) Childhood obesity and its health consequence in China. Obes Rev 9: pp. 82-86 CrossRef
- Towns, N., D’Auria, J. (2009) Parental perceptions of their child’s overweight: an integrative review of the literature. J Pediatr Nurs 24: pp. 115-130 CrossRef
- Patrick, H., Nicklas, T.A. (2005) A review of family and social determinants of children’s eating patterns and diet quality. J Am Coll Nutr 24: pp. 83-92
- Golan, M., Crow, S. (2004) Targeting parents exclusively in the treatment of childhood obesity: long-term results. Obes Res 12: pp. 357-361 CrossRef
- Harnack, L., Lytle, L., Himes, J., Story, M., Taylor, G., Bishop, D. (2009) Low awareness of overweight status among parents of preschool-aged children, Minnesota, 2004-2005. Prev Chronic Dis 6: pp. A47
- Eckstein, K., Mikhail, L., Ariza, A., Thomson, J., Millard, S., Binns, H. (2006) Parents’ perceptions of their child’s weight and health. Pediatrics 117: pp. 681 CrossRef
- Jackson, D., McDonald, G., Mannix, J., Faga, P., Firtko, A. (2005) Mothers’ perceptions of overweight and obesity in their children. Aust J Adv Nurs 23: pp. 8-13
- Baughcum, A.E., Chamberlin, L.A., Deeks, C.M., Powers, S.W., Whitaker, R.C. (2000) Maternal perceptions of overweight preschool children. Pediatrics 106: pp. 1380-1386 CrossRef
- Genovesi, S., Giussani, M., Faini, A., Vigorita, F., Pieruzzi, F., Strepparava, M.G. (2005) Maternal perception of excess weight in children: a survey conducted by paediatricians in the province of Milan. Acta Paediatr 94: pp. 747-752 CrossRef
- Manios, Y., Kondaki, K., Kourlaba, G., Vasilopoulou, E., Grammatikaki, E. (2009) Maternal perceptions of their child’s weight status: the GENESIS study. Public Health Nutr 12: pp. 1099-1105 CrossRef
- Rhee, K., Lago, C., Arscott-Mills, T., Mehta, S., Davis, R. (2005) Factors associated with parental readiness to make changes for overweight children. Pediatrics 116: pp. e94 CrossRef
- Young-Hyman, D., Herman, L.J., Scott, D.L., Schlundt, D.G. (2000) Care giver perception of children’s obesity-related health risk: a study of African American families. Obes Res 8: pp. 241-248 CrossRef
- Adams, A.K., Quinn, R.A., Prince, R.J. (2005) Low recognition of childhood overweight and disease risk among Native-American caregivers. Obes Res 13: pp. 146-152 CrossRef
- Boutelle, K., Fulkerson, J.A., Neumark-Sztainer, D., Story, M. (2004) Mothers’ perceptions of their adolescents’ weight status: are they accurate?. Obes Res 12: pp. 1754-1757 CrossRef
- Carnell, S., Edwards, C., Croker, H., Boniface, D., Wardle, J. (2005) Parental perceptions of overweight in 3-5 y olds. Int J Obes (Lond) 29: pp. 353-355 CrossRef
- Maynard, L.M., Galuska, D.A., Blanck, H.M., Serdula, M.K. (2003) Maternal perceptions of weight status of children. Pediatrics 111: pp. 1226-1231
- Jeffery, A.N., Voss, L., Metcalf, B., Alba, S., Wilkin, T. (2005) Parents’ awareness of overweight in themselves and their children: cross sectional study within a cohort (EarlyBird 21). BMJ 330: pp. 23-24 CrossRef
- Fisher, L., Fraser, J., Alexander, C. (2006) Caregivers’ inability to identify childhood adiposity: a cross-sectional survey of rural children and their caregivers’ attitudes. Aust J Rural Health 14: pp. 56-61 CrossRef
- Rich, S.S., DiMarco, N.M., Huettig, C., Essery, E.V., Andersson, E., Sanborn, C.F. (2005) Perceptions of health status and play activities in parents of overweight Hispanic toddlers and preschoolers. Fam Community Health 28: pp. 130-141
- Edwards, N.M., Pettingell, S., Borowsky, I.W. (2010) Where perception meets reality: self-perception of weight in overweight adolescents. Pediatrics 125: pp. e452-458 CrossRef
- Brener, N., Eaton, D., Lowry, R., McManus, T. (2004) The association between weight perception and BMI among high school students. Obesity 12: pp. 1866-1874 CrossRef
- Standley, R., Sullivan, V., Wardle, J. (2009) Self-perceived weight in adolescents: over-estimation or under-estimation?. Body Image 6: pp. 56-59 CrossRef
- Goodman, E., Hinden, B.R., Khandelwal, S. (2000) Accuracy of teen and parental reports of obesity and body mass index. Pediatrics 106: pp. 52-58 CrossRef
- Shi, Z., Lien, N., Nirmal Kumar, B., Holmboe-Ottesen, G. (2007) Perceptions of weight and associated factors of adolescents in Jiangsu Province, China. Public Health Nutr 10: pp. 298-305 CrossRef
- Xie, B., Chou, C.P., Spruijt-Metz, D., Reynolds, K., Clark, F., Palmer, P.H. (2006) Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents. Prev Med 42: pp. 229-234 CrossRef
- Wen, X., Hui, S. (2011) Chinese parents’ perceptions of their children’s weights and their relationship to parenting behaviours. Child Care Health Dev 37: pp. 343-351 CrossRef
- Popkin, B., Paeratakul, S., Ge, K., Zhai, F. (1995) Body weight patterns among the Chinese: results from the 1989 and 1991 China Health and Nutrition Surveys. Am J Public Health 85: pp. 690-694 CrossRef
- Wang, Y., Ge, K., Popkin, B. (2000) Tracking of body composition from childhood to adolescence: a six-year follow-up study in China. Am J Clin Nutr 72: pp. 1018-1024
- Carolina Population Center at The University of North Carolina at Chapel Hill, 2011. China Health and Nutrition Survey. http://www.cpc.unc.edu/projects/china (accessed February 23, 2012).
- World Health Organization, 1995. http://whqlibdoc.who.int/trs/WHO_TRS_854.pdf (accessed February 22, 2012).
- Ogden C, Flegal K. Changes in terminology for childhood overweight and obesity. National health statistics reports. Natl Health Stat Report 2010; (25):1–5.
- Cole, T.J., Bellizzi, M.C., Flegal, K.M., Dietz, W.H. (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320: pp. 1240-1243 CrossRef
- West, D.S., Raczynski, J.M., Phillips, M.M., Bursac, Z., Heath Gauss, C., Montgomery, B.E. (2008) Parental recognition of overweight in school-age children. Obesity (Silver Spring) 16: pp. 630-636 CrossRef
- Li, Y., Zhai, F., Yang, X., Schouten, E.G., Hu, X., He, Y. (2007) Determinants of childhood overweight and obesity in China. Br J Nutr 97: pp. 210-215 CrossRef
- Myers, S., Vargas, Z. (2000) Parental perceptions of the preschool obese child. Pediatr Nurs 26: pp. 23-30
- Hodges, E.A. (2003) A primer on early childhood obesity and parental influence. Pediatr Nurs 29: pp. 13-16
- Conis E. Mandating Body Mass Index Reporting in the Schools, 2010. http://www.hpm.org/en/Surveys/Emory_University_-_USA/15/Mandating_Body_Mass_Index_Reporting_in_the_Schools.html (accessed September 29, 2011).
- Story, M., Neumark-Stzainer, D., Sherwood, N., Holt, K., Sofka, D., Trowbridge, F. (2002) Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics 110: pp. 210-214
- Epstein, L.H., Myers, M.D., Raynor, H.A., Saelens, B.E. (1998) Treatment of pediatric obesity. Pediatrics 101: pp. 554-570
- Weight status in Chinese children: maternal perceptions and child self-assessments
World Journal of Pediatrics
Volume 8, Issue 2 , pp 129-135
- Cover Date
- Print ISSN
- Online ISSN
- SP Children’s Hospital, Zhejiang University School of Medicine
- Additional Links
- childhood obesity
- weight status
- Author Affiliations
- 1. Department of Health Policy and Administration, the Pennsylvania State University, University Park, USA
- 2. Department of Health Policy and Administration, College of Health and Human Development, the Pennsylvania State University, 604 Ford Building, University Park, PA, 16802, USA