Maternal Underestimation of Child's Weight at Pre-School Age and Weight Development between Age 5 and 12 Years: The ABCD-Study

Enhancing physical activity levels in 9-11-year-old children of varied genders: strategies leveraging parental exercise consciousness

Objective

This study aimed to explore the predictive associations of parental exercise consciousness with the physical activity (PA) status and characteristics of 9-11-year-old children, in an attempt to identify effective strategies for addressing PA insufficiency in children from a parental standpoint.

Methods

The PA rating scale-3 and the Chinese Civic Exercise Consciousness Questionnaire were used to measure primary school students' PA and their parents' exercise consciousness from 361 families in Tianjin, China. The dimensions of exercise consciousness were cognition and identity (CI), sentiment and intention (SI), attitude and willingness (AW), and rights and responsibilities (RR) dimensions. Descriptive statistics, ANOVA with post-hoc test analysis, correlation analysis, and hierarchical regression analysis were performed.

Results

First, children's PA increased with age, with boys significantly exceeding girls (p < 0.01). Significant gender differences were observed in both PA intensity and frequency (boys higher than girls, p < 0.01), although this was not consistent across age groups. Variations in PA duration and frequency showed significant age-related changes (p < 0.01), whereas intensity showed significant changes at older ages (p < 0.01). Second, we observed moderate to above-average level of parental exercise consciousness, and a significantly positive correlation between parental exercise consciousness and children's PA levels (α = 0.601, p < 0.01); meanwhile, all four dimensions of parental exercise consciousness showed varying degrees of positive correlations with children's PA intensity, duration, and frequency (p < 0.01). Third, stratified linear regression analysis showed the varied predictive associations of the different dimensions of parental exercise consciousness with children's PA intensity, duration, and frequency. SI and AW significantly predictively associated with PA levels across different age groups and genders (p < 0.05).

Conclusion

Age and gender showed crucial associations with children's PA levels, resulting in distinct preferences and behaviors between boys and girls across various age groups. Parental exercise consciousness of exercise positively associated with the intensity, frequency, and overall volume of children's PA. Enhancing parental consciousness of exercise-related emotions, intentions, attitudes, and willingness may effectively associate with enhancements in the intensity, duration, and frequency of their children's PA, ultimately promoting greater engagement in physical exercise among the youth.

Maternal Perception and Childhood Overweight: Examining Parenting Styles and Eating Behaviors Among Preschoolers: A Cross-Sectional Study from Samsun, Türkiye

BACKGROUND

Accurate maternal perceptions of children's weight status are crucial for early childhood obesity prevention, with evidence suggesting that maternal misperception may delay timely interventions. This study investigated the accuracy of maternal perceptions of child weight and examined associations with parenting styles and children's eating behaviors and demographic factors among preschool-aged children in Samsun, Türkiye.

METHODS

This cross-sectional study included 318 mother-child pairs recruited from preschools in socio-economically diverse areas of Samsun. Maternal perceptions of child weight status were assessed using a visual scale, while children's anthropometric measurements (height, weight) were recorded to calculate BMI-for-age Z-scores. Parenting styles and children's eating behaviors were evaluated using the Parental Attitude Scale (PAS) and the Children's Eating Behavior Questionnaire (CEBQ), respectively. Data analysis involved chi-square tests and multiple logistic regression to explore associations between maternal perception accuracy, parenting styles, and children's eating behaviors.

RESULTS

Among 318 mother-child pairs, 59.7% underestimated their child's weight status, with this figure being 84.9% among overweight children. Authoritative parenting was the most common style (78%); no significant association was found between parenting style and maternal perception accuracy. Accurate estimators showed significantly higher scores for food responsiveness (median: 9 (7-12), p = 0.028) and the enjoyment of food (mean: 16.3 ± 4.8, p = 0.003), whereas underestimators scored higher for satiety responsiveness (mean: 23.2 ± 5.7, p = 0.042) and slowness in eating (mean: 11.2 ± 4.2, p = 0.004).

CONCLUSIONS

Maternal underestimations of child weight are prevalent, particularly for overweight children, are associated with children's specific eating behaviors. Targeted educational interventions focusing on improving maternal awareness and promoting responsive feeding practices are essential to combat childhood obesity.

Healthy Change Intervention: A Cluster RCT in Preschooler Mothers in Mexico and the United States

OBJECTIVE

To assess effects of Healthy Change intervention on maternal perception of her child's body weight (MPCW), maternal feeding style, and obesogenic home environment.

METHODS

A randomized control trial was conducted, consisting of two arms: the intervention group received the Healthy Change program, and the control group received the Hygiene and Accident Prevention program. A total of 356 mother-preschool child dyads participated, 182 in the intervention group and 174 in the control group, residing in Mexico and the United States. Data were collected at baseline and after the program through self-administered questionnaires completed by mothers and child anthropometric measurements.

RESULTS

Although no significant between-group difference in pre- and post-intervention change of MPCW was found, sub-analyses revealed that a higher proportion of mothers in the intervention group accurately perceived their child's body weight at the study endpoint using categorical (67% vs. 57.1%, p < 0.005) and visual scales (48.9% vs. 41.8%, p < 0.015). Additionally, more mothers of overweight children in the intervention group accurately perceived their children's overweight and obese status compared to those in the control group (29.8% vs. 10.3%, X2 = 4.26, df = 1, p < 0.039). The intervention group also displayed a higher proportion of mothers with authoritative feeding style (26.4% vs. 16.5%, p < 0.036) and significantly higher family nutrition and physical activity scores (29.1 vs. 28.0, p < 0.000) at the study endpoint.

CONCLUSIONS FOR PRACTICE

Healthy Change Intervention led to improved accuracy of MPCW, a shift toward maternal authoritative feeding styles, and positive changes in obesogenic home environments.

Determinants of dysmenorrhoea among female adolescents: results from a community-based cohort study in Amsterdam

RESEARCH QUESTION

What is the contribution of sociodemographic, psychosocial, lifestyle and reproductive factors up to the age of 11-12 years to the occurrence of dysmenorrhoea at age 15-16 years within the Amsterdam Born Children and their Development (ABCD) study?

DESIGN

Data of 1038 female adolescents were used. Participants' baseline characteristics were obtained using self-reported questionnaires up to the age of 11-12 years, as well as the obstetric information of their mothers during pregnancy. Dysmenorrhoea was assessed at the age of 15-16 years, and was deemed to be present if an adolescent reported menstrual abdominal and/or back pain and therefore took medication and/or hormonal contraception. Using a backward selection approach, potential determinants of dysmenorrhoea were selected and multivariable associations were determined.

RESULTS

The overall prevalence of dysmenorrhoea was 49.5% among the participants. Intake of 3-4.5 sugar-sweetened beverages/day (P = 0.035) and higher gynaecological age (i.e. years since menarche) (P < 0.001) were significantly associated with higher occurrence of dysmenorrhoea in the final model, which explained 8.1% of the total variance in the occurrence of dysmenorrhoea. No significant associations were found between the occurrence of dysmenorrhoea and sociodemographic or psychosocial factors.

CONCLUSIONS

This investigation of various potential risk factors for dysmenorrhoea suggests that diet and reproductive factors are particularly important predictors of the occurrence of dysmenorrhoea among young adolescents. Specifically, intake of sugar-sweetened beverages and higher gynaecological age were predictive of the occurrence of dysmenorrhoea. Other lifestyle factors were also identified as possible risk factors. Using this knowledge, effective strategies can be developed to reduce the burden of dysmenorrhoea among adolescents, and to provide appropriate care for those suffering from the condition.

Association between cardiovascular risk and maternal perception of BMI in Peruvian schoolchildren

Introduction

In the modern era, the maternal perception of children's nutritional status has emerged as a critical area of study, given its potential influence on nutritional interventions and long-term child health. The relationship between this perception and children's Body Mass Index (BMI) by age is particularly intriguing, as it may reveal discrepancies between perception and reality.

Objective

The aim of this study was to evaluate Peruvian mothers' perception of their children's Body Mass Index (BMI) in relation to age and to determine how this perception associates with the children's cardiovascular risk. The study also analyzed sociodemographic factors that might influence this perception.

Methods

The study included 130 mothers of schoolchildren aged 5 to 11 from a school in Lima. Mothers' perceptions of their children's weight were assessed using pictograms, and sociodemographic characteristics were collected through a questionnaire. Weight and height measurements were taken to calculate BMI, and waist circumference was measured to classify cardiovascular risk.

Results

A total of 57.4% of the schoolchildren presented with excess malnutrition, and 51.5% of the mothers incorrectly classified the actual BMI/Age of their children (kappa 0.11; p ≤ 0.05). Additionally, it was found that the schoolchild's age is associated with the mother's failure to accurately perceive her child's weight (OR 1.59). Lastly, there was a significant association between maternal perception and cardiovascular risk (p ≤ 0.05).

Conclusion

There is a significant discrepancy between maternal perception and the actual nutritional status of children, which can increase cardiovascular risk. It is necessary to implement intervention and education strategies targeted at parents to enhance the recognition and management of childhood overweight and obesity.

Population trajectories and age-dependent associations of obesity risk factors with body mass index from childhood to adolescence across European regions: A two-cohort study

OBJECTIVE

To investigate population trajectories of behavioural risk factors of obesity from childhood to adolescence and their associations with body mass index (BMI) in children across European regions.

METHODS

Data were harmonised between the European multi-centre IDEFICS/I.Family and the Amsterdam Born Children and their Development Cohort. Participants were aged 2.0-9.9 and 5.0-7.5 years at baseline, respectively, and were followed until age 18 years. Behavioural risk factors of interest included diet, physical activity, media use and sleep. Mixed effects models were used for statistical analyses to account for repeated measurements taken from the same child.

RESULTS

The study included a total of 14 328 individuals: 4114, 4582, 3220 and 2412 participants from Northern, Southern, Eastern Europe and Amsterdam, respectively. Risk factor means and prevalences changed with age, but the trajectories were mostly similar across regions. Almost no associations between behavioural factors and BMI were found at the age of 6 years. At 11 years, daily sugar-sweetened foods consumption, use of active transport, sports club membership and longer nocturnal sleep duration were negatively associated with BMI in most regions; positive associations were found with media use. Most associations at 11 years of age persisted to 15 years.

CONCLUSIONS

Whilst population trajectories of media use and nocturnal sleep duration are similar across European regions, those of other behavioural risk factors like active transport and daily vegetable consumption differ. Also, associations between behavioural risk factors and BMI become stronger with age and show similar patterns across regions.

Parental Perception of Their Child's Weight Status in Portugal: An Observational Study

INTRODUCTION

Parental perceptions of a child's weight status may influence family readiness to foster healthy behaviors. Our aim was to observe parental perceptions of their child's weight status in two time periods and in multiple population subgroups.

METHODS

Data were collected in two national projects, 2009 - 2010 (n = 6577) and 2016 - 2017 (n = 7594), in public and private kindergartens and primary schools in Portugal (children aged three to 10 years old). Parents filled out a questionnaire regarding their perception of their child's weight status, namely: 1) too thin, 2) thin, 3) normal weight, 4) with some excess weight, or 5) with a lot of excess weight. Children's height and weight were objectively collected, and the International Obesity Task Force cut-offs were used to classify overweight and obesity. Accurate and misclassification levels were calculated for children according to their sex, age, as well as child and parental weight status, while considering differences within and between the two time periods.

RESULTS

Overall, accuracy in parental perception of their child's weight was higher in 2016 - 2017 than in 2009 - 2010, regardless of children's sex, age, parental weight status, and education (65.7% and 60.5%, respectively). However, the ability of parents to detect obesity was ~ 50% lower in 2016 - 2017 compared with 2009 - 2010.

CONCLUSION

Even though parental perception of their child's weight was better in 2016 - 2017 than in 2009 - 2010 , the inverse result was found among children with obesity. Strategies are needed to encourage parents to improve their perception of the appropriate weight for their child.

Accuracy of Syrain Refugee Mothers' Perceptions of Newborn's Birth Size: Insights from a National Survey in Turkey

This study aims to assess the accuracy of maternally perceived birth size and its associated factors among the Syrian refugees in Turkey, using the data from 2018 Turkey Demographic and Health Survey Syrian Migrant Sample (TDHS-SM-18). The study includes information on the last-born child, singleton pregnancies, births in healthcare facilities, children under 5 living with their mothers, with recorded birth weight (n = 969). The study categorizes the mother's perception of size into three groups : compatible, overestimated, and underestimated. Various factors, including sociodemographic characteristics, financial aspects, maternal characteristics, and child characteristics, are considered as explanatory variables. The analysis employs a complex sample multiple logistic regression model. The findings reveal that the majority of mothers accurately perceive the birth size, but 17.1% of them do not. Maternal factors such as region of residence, literacy, occupation, age at birth, and child factors such as birth order, birth interval, gender, and birth weight are identified as associated factors with maternal misperception. This study provides valuable insights into the accuracy of maternally perceived birth size and sheds light on the factors influencing this perception among Syrian refugee mothers in Turkey.

Associations between parental and pre-adolescents' physical activity and diet quality: The role of parental child care involvement and child's sex

BACKGROUND

Research has demonstrated the importance of the family environment in the eating and activity levels of offspring. We examined the cross-sectional associations between moderate-to-vigorous physical activity (MVPA) and diet quality of parents and the MVPA and diet quality of pre-adolescents. Interactions were tested to assess whether the child's sex and the parental level of involvement in daily child care moderated these associations.

METHODS

Data from 2467 pre-adolescents (age 11.5 ± 0.2 years; collected in 2015-2016) and their parents or caregivers from a large-scale prospective birth cohort study in Amsterdam (ABCD-study) was used. Parents and pre-adolescents individually reported their diet quality and physical activity. Child care involvement was assessed using the Caregiver Child Interaction Scale. With hierarchical linear regression analyses, we assessed the independent contribution of fathers and mothers.

RESULTS

An association between mother-child MVPA was found (β = 0.013; 95 % CI: 0.006;0.021). The association between father-child MVPA was only significant for highly involved fathers (β = 0.014; 95 % CI: 0.004;0.023). The child's sex did not change these MVPA associations. Regarding diet quality, associations were found between mother-child diet quality score (DQS) (β = 0.254; 95 % CI: 0.192;0.316) and father-child DQS, with stronger associations between fathers and sons (β = 0.234; 95 % CI: 0.169;0.298) than between fathers and daughters (β = 0.114; 95 % CI: 0.047;0.181). Parental levels of involvement did not change these associations.

CONCLUSION

These findings demonstrate that both parental behaviours represent an important factor in physical activity and diet quality in pre-adolescents in a sex-specific manner. As such, it is essential to include both parents in research to obtain the necessary insights for developing effective interventions to promote children's healthy eating and physical activity behaviours.

Effect of migrant parents' bodyweight perception on children's body bodyweight: A longitudinal analysis of population cohort study

Children of migrants in Australia are disproportionally affected by overweight/obesity. Their parents, however, are likely to put little effort into lifestyle changes if unable to recognise their children's suboptimal bodyweight. We examined the potential impact of migrant parents' bodyweight perception on their children's bodyweight over time and whether the region-of-birth of parents and acculturation to the host nation's way of life moderated the relationship, as very little is known about these in the Australian context. We analysed a sample of 2046 children of migrant parents drawn from 8 waves of population-based cohort data, the Longitudinal Study of Australian Children, capturing their lived experience from ages 2 to 17. After controlling for child, parent, family, and neighbourhood factors influencing children's bodyweight, multilevel models showed higher children's bodyweight in subsequent waves if their parents perceived children's bodyweight as lower than their actual bodyweight (i.e., underestimation). However, the rate of increase in children's bodyweight attenuated over time. The effect of migrant parents' underestimation on children's subsequent bodyweight differed by region-of-birth, with higher children's bodyweight in successive waves if their parents were from the Americas, compared to migrant parents from North/West Europe. Parents' acculturation, however, did not have a discernible effect. Although migrant parents' bodyweight perception of their children's bodyweight status influenced children's bodyweight in subsequent waves, this factor was not enough to explain the extent of disparities in children's bodyweight observed in the Australian migrant population. Further research is needed to assess the effects of other types of perception (such as perceptions of healthy weight and physical exercise) on bodyweight disparities in children of migrants.

Underestimation of overweight weight status in children and adolescents aged 0-19 years: A systematic review and meta-analysis

BACKGROUND

Perceptions of children's weight status may be important in obesity prevention and treatment.

AIMS

This review identifies the prevalence of the underestimation of overweight status in children by parents/main carers, children, and healthcare professionals (HCP). The review critically synthesized both quantitative and qualitative evidence to explore the factors associated with this underestimation. The diverse methods used to assess this phenomenon are reported.

METHODS

Pooled effect sizes were calculated using random-effects model. Published studies, up to 2020, were accessed using the following search engines: CINAHL, EMBASE, PUBMED, and Psych-Info and including the "Cited by" and "Related Articles" functions. Hand-searching was used to retrieve further articles. Publication language and location had no bearing on the nature of the included studies.

RESULTS

A total of 91 articles were included. In the quantitative studies, 55% (95% CI 49%-61%) of caregivers underestimated their child's level of overweight and obesity using a verbal scale and 47% (95% CI 36%-55%) using visual scales. Of the children studied, 34% (95% CI 25%-43%) underestimated their own level of overweight and obesity using both scales. In (n = 3) articles, HCPs reflected this misperception, but limited studies prevented meta-analysis. Underestimation was associated with the child's age, gender, BMI and parental weight status, ethnicity and education. In the qualitative studies, parents/main carers of children with overweight and obesity described their child's weight in terms other than overweight, for example, "big boned," "thick," and "solid."

CONCLUSION

The results confirm the prevalence of underestimation of child overweight status across international studies. Understanding the factors which lead to this inaccuracy may help to improve communication within the therapeutic triad and facilitate the recognition and management of children's overweight status.