Which lesson from the evaluation of parental perception of child's weight in an European cohort of 8 years old children

摘要

Background: Parental perception of child's weight may influence the development of overweight in childhood. We aim at describing parental perception of their child's weight status in a sample of 8 year-old healthy children from 5 European countries. Methods: This study was performed in families participating in the EU CHOP study. Children's weight and height were measured and Body Mass Index (BMI) was calculated (kg/m~2). Both parents were asked to judge their child's weight status using a scale of sketches#_ftn1 and the question : In your opinion, to which sketch does your child most resemble at the moment? The middle image of the sketches was developed to represent a child at the 50~th BMI percentile for the age. Ordinal logistic regression was used to describe the relationship between the actual BMI of the child and parental perception of it. Based on literature, we included gender, level of parental concern related to overweight, parental BMI, country and level of education in the model. Results: At eight years, 587 families (52.8% with girls) were included. Mean BMI was 16.8± 2.79 kg/m~2 in boys and 17.0 ± 2.55 in girls (n.s.). Based on WHO BMI standards 408 children (69.5%) were normal weight whereas 172 (29.3%) were overweight. The rest was in the category thinness. The choice of sketch by mothers and fathers was significantly related to the child's BMI (p < 0.0001). However, most of the parents underestimated the child's weight status: about 90% of the parents select a picture of their child lower or equal to the middle of the scale, despite that around 30% of the children were already overweight. Maternal and paternal perception was similar. Perception by both parents was significantly lower for boys than for girls. Mothers with higher BMI did perceive significantly their child thinner than mothers with a lower BMI. A higher paternal level of education enhanced the chance that the fathers selected a bigger sketch. Polish fathers differed significantly from those of the other countries. Conclusions: Our study shows a high level of underestimation of children's weight status by their parents. Girls and boys are perceived differently.