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 JO, Trowbridge FL. Childhood obesity: future directions and research priorities. Pediatrics 1998;101:570–574. CrossRef
- Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet 2002;360:473–482. CrossRef
- Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362–2374. CrossRef
- Magarey AM, Daniels LA, Boulton TJ, Cockington RA. Predicting obesity in early adulthood from childhood and parental obesity. Int J Obes Relat Metab Disord 2003;27:505–513. CrossRef
- Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998;101:518–525.
- 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 MJ. Temporal trends in overweight and obesity of children and adolescents from nine provinces in China from 1991–2006. Int J Pediatr Obes 2010;5:365–374. CrossRef
- Li Y, Yang X, Zhai F, Piao J, Zhao W, Zhang J, et al. Childhood obesity and its health consequence in China. Obes Rev 2008;9 Suppl 1:82–86. CrossRef
- Towns N, D’Auria J. Parental perceptions of their child’s overweight: an integrative review of the literature. J Pediatr Nurs 2009;24:115–130. CrossRef
- Patrick H, Nicklas TA. A review of family and social determinants of children’s eating patterns and diet quality. J Am Coll Nutr 2005;24:83–92.
- Golan M, Crow S. Targeting parents exclusively in the treatment of childhood obesity: long-term results. Obes Res 2004;12:357–361. CrossRef
- Harnack L, Lytle L, Himes J, Story M, Taylor G, Bishop D. Low awareness of overweight status among parents of preschool-aged children, Minnesota, 2004-2005. Prev Chronic Dis 2009;6:A47.
- Eckstein K, Mikhail L, Ariza A, Thomson J, Millard S, Binns H. Parents’ perceptions of their child’s weight and health. Pediatrics 2006;117:681. CrossRef
- Jackson D, McDonald G, Mannix J, Faga P, Firtko A. Mothers’ perceptions of overweight and obesity in their children. Aust J Adv Nurs 2005;23:8–13.
- Baughcum AE, Chamberlin LA, Deeks CM, Powers SW, Whitaker RC. Maternal perceptions of overweight preschool children. Pediatrics 2000;106:1380–1386. CrossRef
- Genovesi S, Giussani M, Faini A, Vigorita F, Pieruzzi F, Strepparava MG, et al. Maternal perception of excess weight in children: a survey conducted by paediatricians in the province of Milan. Acta Paediatr 2005;94:747–752. CrossRef
- Manios Y, Kondaki K, Kourlaba G, Vasilopoulou E, Grammatikaki E. Maternal perceptions of their child’s weight status: the GENESIS study. Public Health Nutr 2009;12:1099–1105. CrossRef
- Rhee K, De Lago C, Arscott-Mills T, Mehta S, Davis R. Factors associated with parental readiness to make changes for overweight children. Pediatrics 2005;116:e94. CrossRef
- Young-Hyman D, Herman LJ, Scott DL, Schlundt DG. Care giver perception of children’s obesity-related health risk: a study of African American families. Obes Res 2000;8:241–248. CrossRef
- Adams AK, Quinn RA, Prince RJ. Low recognition of childhood overweight and disease risk among Native-American caregivers. Obes Res 2005;13:146–152. CrossRef
- Boutelle K, Fulkerson JA, Neumark-Sztainer D, Story M. Mothers’ perceptions of their adolescents’ weight status: are they accurate? Obes Res 2004;12:1754–1757. CrossRef
- Carnell S, Edwards C, Croker H, Boniface D, Wardle J. Parental perceptions of overweight in 3-5 y olds. Int J Obes (Lond) 2005;29:353–355. CrossRef
- Maynard LM, Galuska DA, Blanck HM, Serdula MK. Maternal perceptions of weight status of children. Pediatrics 2003;111:1226–1231.
- Jeffery AN, Voss L, Metcalf B, Alba S, Wilkin T. Parents’ awareness of overweight in themselves and their children: cross sectional study within a cohort (EarlyBird 21). BMJ 2005;330:23–24. 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;14:56–61. CrossRef
- Rich SS, DiMarco NM, Huettig C, Essery EV, Andersson E, Sanborn CF. Perceptions of health status and play activities in parents of overweight Hispanic toddlers and preschoolers. Fam Community Health 2005;28:130–141.
- Edwards NM, Pettingell S, Borowsky IW. Where perception meets reality: self-perception of weight in overweight adolescents. Pediatrics 2010;125:e452–458. CrossRef
- Brener N, Eaton D, Lowry R, McManus T. The association between weight perception and BMI among high school students. Obesity 2004;12:1866–1874. CrossRef
- Standley R, Sullivan V, Wardle J. Self-perceived weight in adolescents: over-estimation or under-estimation? Body Image 2009;6:56–59. CrossRef
- Goodman E, Hinden BR, Khandelwal S. Accuracy of teen and parental reports of obesity and body mass index. Pediatrics 2000;106:52–58. CrossRef
- Shi Z, Lien N, Nirmal Kumar B, Holmboe-Ottesen G. Perceptions of weight and associated factors of adolescents in Jiangsu Province, China. Public Health Nutr 2007;10:298–305. CrossRef
- Xie B, Chou CP, Spruijt-Metz D, Reynolds K, Clark F, Palmer PH, et al. Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents. Prev Med 2006;42:229–234. CrossRef
- Wen X, Hui S. Chinese parents’ perceptions of their children’s weights and their relationship to parenting behaviours. Child Care Health Dev 2011;37:343–351. CrossRef
- Popkin B, Paeratakul S, Ge K, Zhai F. Body weight patterns among the Chinese: results from the 1989 and 1991 China Health and Nutrition Surveys. Am J Public Health 1995;85:690–694. CrossRef
- Wang Y, Ge K, Popkin B. Tracking of body composition from childhood to adolescence: a six-year follow-up study in China. Am J Clin Nutr 2000;72:1018–1024.
- 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 TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000;320:1240–1243. CrossRef
- West DS, Raczynski JM, Phillips MM, Bursac Z, Heath Gauss C, Montgomery BE. Parental recognition of overweight in school-age children. Obesity (Silver Spring) 2008;16:630–636. CrossRef
- Li Y, Zhai F, Yang X, Schouten EG, Hu X, He Y, et al. Determinants of childhood overweight and obesity in China. Br J Nutr 2007;97:210–215. CrossRef
- Myers S, Vargas Z. Parental perceptions of the preschool obese child. Pediatr Nurs 2000;26:23–30.
- Hodges EA. A primer on early childhood obesity and parental influence. Pediatr Nurs 2003;29:13–16.
- 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, et al. Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics 2002;110:210–214.
- Epstein LH, Myers MD, Raynor HA, Saelens BE. Treatment of pediatric obesity. Pediatrics 1998;101:554–570.
- 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