Does maternal concern about children's weight affect children's body size perception at the age of 6.5?--A community-based study

Actual Weight, Perceived Weight and Desired Weight of Romanian School Children by Parents and Children

Background and Objectives: The perception of the body weight by children and parents influences the consequent actions undertaken for children’s body weight management. This study investigated the correspondence between objective evaluations of Romanian school children (actual weight) and perceptions about weight (perceived weight), preoccupation with body weight management (desired weight) and parents’ perceptions on children’s weight. Materials and Methods: A cross sectional study was performed among 344 children aged 11 to 14 and 147 parents from Cluj-Napoca, Romania. We made anthropometric measurements of children, and short questionnaires were completed by the children and the parents. Results: The results show that 3.8% of children were underweight, 68.3% had a normal weight and 27.9% were overweight. Of this sample, 61.5% of underweight children, 20% of normal weight children and 43.7% of overweight children had misperceptions about their weight. The percentage of parents who did not estimate their children’s weight correctly was 50%, 11.9% and 41.5%, respectively, for each of the three weight groups. The results of the logistic regression analyses showed that several factors were associated with the misclassification of their own body weight by the children, such as body mass index, gender, weight management practices, misclassification by the parents as well as parent–child discussions on these issues. Conclusions: Education for both Romanian parents and children is needed with regard to correctly identifying and managing children’ body weight.

Eating frequency and weight status in Portuguese children aged 3-9 years: results from the cross-sectional National Food, Nutrition and Physical Activity Survey 2015-2016

OBJECTIVE

To evaluate daily eating frequency (main meals and snacks) in relation to weight status in children aged 3-9 years, representative of the Portuguese population.

DESIGN

Cross-sectional study. Dietary intake was estimated as the mean of two non-consecutive days of food diaries, followed by face-to-face interviews. Weight and height were measured by trained observers. Eating occasions (EO) were defined by the children's caregiver; an EO was considered separate if the time of consumption was different from other EO and it provided at least 209 kJ (50 kcal). Main meals defined as 'breakfast', 'lunch' and 'dinner' could be selected only once per day. The remaining EO were considered snacks. The association between eating frequency and overweight/obesity was evaluated through logistic regressions weighted for the population distribution.

SETTING

National Food, Nutrition and Physical Activity Survey of the Portuguese population, 2015-2016.

PARTICIPANTS

Portuguese children aged 3-9 years with complete dietary data and anthropometric measurements (n 517).

RESULTS

Overall, the number of daily EO ranged from 3·5 to 11, and on average children had 5·7 daily EO. After adjustment for child's sex, age and total energy intake, and considering only plausible energy intake reporters, having < 3 snacks/d was positively associated with being overweight/obese (OR = 1·98; 95 % CI 1·00, 3·90), compared with having ≥ 3 snacks/d.

CONCLUSIONS

Lower daily frequency of EO was associated with increased odds of being overweight or obese in children. A higher eating frequency, maintaining the same energy intake, seems to contribute to a healthy body weight in children.

Association between eating frequency and eating behaviours related to appetite from 4 to 7 years of age: Findings from the population-based birth cohort generation XXI

The examination of specific characteristics of eating habits in childhood and its influence on eating behaviours is needed to better understand the establishment of appetite-related eating behaviours. This study aimed to assess the association between eating frequency (EF) (main meals vs. snacks) at 4 and 7y and problematic eating behaviours and appetite-related eating behaviours at 7y. The analysis included 1359 children from the birth cohort Generation XXI who provided 3-day food diaries, at both ages, and complete information on the Child Eating Behaviour Questionnaire, at 7y. Problematic eating behaviours were assessed using parental perception of child's poor eating (including not eating enough, eating too slow or overeating) at both ages. A time-of-day approach was used to distinguish main meals from snacks. A cross-lagged analysis was performed to check the direction of the association between EF and parental concerns regarding problematic eating behaviours. Associations between EF and appetite-related eating behaviours were evaluated through linear regression models. Between 4 and 7y a moderate tracking of EF was described as well as a strong tracking of parental concerns. We found a bidirectional relationship between EF and parental concerns. Prospectively, a higher frequency of snacks at 4y was independently associated with higher scores in 'Desire to Drink' at 7y (β = 0.051, 95%CI:0.009; 0.093). At 7y, a higher EF had a positive association with 'Satiety Responsiveness' but an inverse association with 'Enjoyment of Food'. A higher number of main meals had a positive association with 'Enjoyment of Food' and 'Food Responsiveness'. In conclusion, children who had more eating occasions seem to have more food-avoidance behaviours, traits that might protect these children from gaining excessive weight.

Secular trends in the prevalence of childhood overweight and obesity across Australian states: A meta-analysis

OBJECTIVE

To describe secular trends in the prevalence of overweight and obesity in Australian children in each state and territory.

DESIGN

Systematic search and numerical meta-analysis.

METHODS

A systematic search was conducted to identify all sources that objectively measured the height and weight of Australian children (aged 2-18 years) and had a sample size of at least 300. Raw and summary data were requested from authors and divided into age×sex×state×yearly slices to derive estimates of the prevalence of overweight and obesity. Following a double arcsine transformation to facilitate meta-analysis, all estimates were standardised for age, stratified by sex and analysed using sample-weighted non-linear regressions.

RESULTS

The systematic search identified 73 eligible sources (47 raw and 26 summary datasets), with 72.8% of data sourced from Victoria and South Australia. Prevalence trends varied from state to state, with three states or territories showing a marked plateau, two showing a decline in the more recent years and three showing continued linear increases. Tasmania and Northern Territory generally had the highest prevalence (30.2% and 24.3% overweight and obesity respectively), and the Australian Capital Territory had the lowest (12.4% overweight and obesity).

CONCLUSIONS

Prevalence, as well as prevalence trends, varied amongst Australian states and territories. At a national level, the prevalence trend has nearly plateaued for the past 15 years. However, upward prevalence trends appear to be persisting in Western Australia, South Australia and Tasmania. Findings highlight the need for ongoing efforts to address the issue of childhood obesity.

Esthetic Concerns and Acceptability of Treatment Modalities in Primary Teeth: A Comparison between Children and Their Parents

Background and Aim. Esthetic concerns in primary teeth have been studied mainly from the point of view of parents. The aim of this study was to study compare the opinions of children aged 5–8 years to have an opinion regarding the changes in appearance of their teeth due to dental caries and the materials used to restore those teeth. Methodology. A total of 107 children and both of their parents (n = 321), who were seeking dental treatment, were included in this study. A tool comprising a questionnaire and pictures of carious lesions and their treatment arranged in the form of a presentation was validated and tested on 20 children and their parents. The validated tool was then tested on all participants. Results. Children had acceptable validity statistics for the tool suggesting that they were able to make informed decisions regarding esthetic restorations. There was no difference between the responses of the children and their parents on most points. Zirconia crowns appeared to be the most acceptable full coverage restoration for primary anterior teeth among both children and their parents. Conclusion. Within the limitations of the study it can be concluded that children in their sixth year of life are capable of appreciating the esthetics of the restorations for their anterior teeth.

Perceptions of Weight and Health Practices in Hispanic Children: A Mixed-Methods Study

Background. Perception of weight by parents of obese children may be associated with willingness to engage in behavior change. The relationship between parents' perception of their child's weight and their health beliefs and practices is poorly understood, especially among the Hispanic population which experiences disparities in childhood obesity. This study sought to explore the relationship between perceptions of weight and health beliefs and practices in a Hispanic population. Methods. A cross-sectional, mixed-methods approach was used with semistructured interviews conducted with parent-child (2–5 years old) dyads in a primarily Hispanic, low-income population. Parents were queried on their perceptions of their child's health, health practices, activities, behaviors, and beliefs. A grounded theory approach was used to analyze participants' discussion of health practices and behaviors. Results. Forty parent-child dyads completed the interview. Most (58%) of the parents of overweight and obese children misclassified their child's weight status. The qualitative analysis showed that accurate perception of weight was associated with internal motivation and more concrete ideas of what healthy meant for their child. Conclusions. The qualitative data suggest there may be populations at different stages of readiness for change among parents of overweight and obese children, incorporating this understanding should be considered for interventions.

Maternal body image dissatisfaction and BMI change in school-age children

Objective

Parental body image dissatisfaction (BID) is associated with children’s weight in cross-sectional studies; however, it is unknown whether BID predicts development of adiposity. The objective of the present study was to investigate the associations between maternal dissatisfaction with her or her child’s body and children’s BMI trajectories.

Design

Longitudinal study. Maternal dissatisfaction (BID) with her and her child’s body was calculated based on ratings of Stunkard scales obtained at recruitment, as current minus desired body image. Children’s height and weight were measured at baseline and annually for a median of 2·5 years. Mixed-effects models with restricted cubic splines were used to construct sex- and weight-specific BMI-for-age curves according to maternal BID levels.

Setting

Public primary schools in Bogotá, Colombia.

Subjects

Children (n 1523) aged 5–12 years and their mothers.

Results

After multivariable adjustment, heavy boys and thin girls whose mothers desired a thinner child gained an estimated 1·7 kg/m2 more BMI (P=0·04) and 2·4 kg/m2 less BMI (P=0·004), respectively, between the age 6 and 14 years, than children of mothers without BID. Normal-weight boys whose mothers desired a thinner child’s body gained an estimated 1·8 kg/m2 less BMI than normal-weight boys of mothers without BID (P=0·02). Maternal BID with herself was positively related to children’s BMI gain during follow-up.

Conclusions

Maternal BID is associated with child’s BMI trajectories in a sex- and weight-specific manner.

Parental feeding patterns and child weight status for Latino preschoolers

OBJECTIVE

To examine the relationships between parental patterns regarding child feeding and child body mass index (BMI) percentile in Latino parent€-preschooler dyads participating in a clinical trial.

METHODS

This secondary analysis examined data collected during a randomized clinical trial of a culturally tailored healthy lifestyle intervention focused on childhood obesity prevention, Salud Con La Familia. We analyzed 77 Latino parent-child dyads who completed baseline and 3-month follow-up data collection, assessing associations between preschool child BMI percentile and parental response to the Child Feeding Questionnaire (CFQ) over time.

RESULTS

Higher child BMI was related to higher parental CFQ concern scores (r = 0.41, p < .001). A general inverse association between child BMI percentile and parental responsibility was also observed (r = -0.23, p = .040). Over the 3-month period, no statistically significant associations between changes in the CFQ subscale scores and changes in child BMI percentile were identified.

CONCLUSIONS

Child BMI percentile consistent with overweight/obese is associated with parental concern about child weight and child BMI percentile consistent with normal weight is associated with perceived responsibility for feeding. Emphasizing parental responsibility to help children to develop healthy eating habits could be an important aspect of interventions aimed at both preventing and reducing pediatric obesity for Latino preschoolers.

Bidirectional associations between mothers' and fathers' parenting consistency and child BMI

BACKGROUND

Research suggests that general parenting dimensions and styles are associated with children's BMI, but directionality in this relationship remains unknown. Moreover, there has been little attention to the influences of both mothers' and fathers' parenting. We aimed to examine reciprocal relationships between maternal and paternal parenting consistency and child BMI.

METHODS

Participants were 4002 children and their parents in the population-based Longitudinal Study of Australian Children. Mothers and fathers self-reported parenting consistency, and children's BMI was measured at 4 biennial waves starting at age 4 to 5 years in 2004. Bidirectionality between parenting and child BMI was examined by using regression analyses in cross-lagged models.

RESULTS

The best-fitting models indicated a modest influence from parenting to child BMI, whereas no support was found for bidirectional influences. For mothers, higher levels of parenting consistency predicted lower BMI in children from Waves 1 to 2 and 3 to 4; for example, for every SD increase in mothers' parenting consistency at Wave 1, child BMIz fell by 0.025 in Wave 2 (95% confidence interval: -0.05 to -0.003). For fathers, higher levels of parenting consistency were associated with lower child BMI from Waves 1 to 2 and 2 to 3.

CONCLUSIONS

Parenting inconsistency of mothers and fathers prospectively predicted small increases in offspring BMI over 2-year periods across middle childhood. However, child BMI did not appear to influence parenting behavior. These findings support recent calls for expanding childhood overweight interventions to address the broad parenting context while involving both mothers and fathers.

Factors contributing to weight misperception in obese children presenting for intervention

OBJECTIVE

To assess weight stigma, self-perception of weight status, and factors contributing to accurate self-perception of weight status in obese youth presenting for treatment at a hospital-based multidisciplinary weight management program.

METHODS

Participants (N = 97; mean age = 8.56 +/- 1.66 years) used a figural rating scale to assess weight stigma and their current and ideal body type, and Sizing Me Up, a measure of obesity-specific health-related quality of life (HRQOL).

RESULTS

The majority endorsed negative/stereotypical attributes toward an obese body type, chose an average or underweight figure as their ideal, and 39% misperceived their weight status. Older child age and greater HRQOL impairment were significant predictors (P < .01) of correct self-perception.

CONCLUSION

Pediatricians may find that talking with the elementary school-aged patient and family about whether weight/size affects their day-to-day life will prove to be a salient and neutral opening to discussing the child's obesity and need for intervention.