Abstract
Objective
Accurate parental weight perception of one's child is an important step in addressing
healthy behaviors, but its associations with socioeconomic status (SES) and household
food insecurity (HFI) are unclear. We aimed to assess the association of parental
weight perception with HFI.
Methods
This was a secondary data analysis of a cross-sectional study of 284 children ages
2 to 8 years whose parents completed surveys about weight perception, SES, and HFI.
Height and weight were measured to determine the children's body mass index scores
and were self-reported by parents. We performed chi-square tests to compare HFI and
accuracy of parental weight perception and used logistic regression to assess accuracy,
adjusting for significant covariates and stratifying by child weight category.
Results
Approximately two thirds of children had healthy weight, 18% had overweight, and 15%
had obesity. About one third of parents inaccurately identified their child's weight
category, almost always underestimating weight status. Twenty-eight percent of the
families were food insecure. HFI was not associated with parental weight perception
in bivariate analysis. When stratified by weight status, food insecure families with
children at healthy weight had 0.16 times the odds of accurately perceiving their
children's weight status. There was no association between HFI and accuracy of weight
perception in children with overweight or obesity.
Conclusions
Food insecurity was associated with a decrease in the accuracy of parental weight
perceptions in children with healthy weight. Pediatricians should clearly communicate
about weight status, as families with HFI may adopt unhealthy eating behaviors under
the incorrect assumption that their child is underweight.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic PediatricsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Parental underestimates of child weight: a meta-analysis.Pediatrics. 2014; 133: e689-e703
- Difference between parental perception and actual weight status of children: a systematic review.Matern Child Nutr. 2013; 9: 3-22
- Predictive factors for accuracy of perception of parents regarding their overweight or obese children in Taiwan.Asia Pac J Clin Nutr. 2016; 25: 571-577
- Parental perceptions of weight status in children: the Gateshead Millennium Study.Int J Obes (Lond). 2011; 35: 953-962
- Hispanic parental perceptions of child weight in preschool-aged children: an integrated review.Child Obes. 2015; 11: 549-559
- Mothers’ perceptions about the nutritional status of their overweight children: a systematic review.J Pediatr (Rio J). 2014; 90: 332-343
- Child obesity cut-offs as derived from parental perceptions: cross-sectional questionnaire.Br J Gen Pract. 2015; 65: e234-e239
- Household food security in the United States in 2014.Economic Research Service, US Department of Agriculture, Washington, DC2015
- Food insecurity is associated with adverse health outcomes among human infants and toddlers.J Nutr. 2004; 134: 1432-1438
- Hunger: its impact on children's health and mental health.Pediatrics. 2002; 110: e41
- Bounding the effects of food insecurity on children's health outcomes.J Health Econ. 2009; 28: 971-983
- Food insecurity is an ongoing national concern.Adv Nutr. 2013; 4: 36-41
- Measuring the food environment and its effects on obesity in the United States: a systematic review of methods and results.J Community Health. 2015; 40: 464-475
- Children's fruit and vegetable intake: associations with the neighbourhood food environment.Prev Med. 2008; 46: 331-335
- Ethnicity, household food security, and nutrition and activity patterns in families with preschool children.J Nutr Educ Behav. 2015; 47: 498-505.e1
- Parental feeding beliefs and practices and household food insecurity in infancy.Acad Pediatr. 2019; 19: 80-89
- The food insecurity-obesity paradox: a review of the literature and the role food stamps may play.J Am Diet Assoc. 2007; 107: 1952-1961
- Food insecurity and weight status among U.S. children and families: a review of the literature.Am J Prev Med. 2011; 40: 166-173
- Exploring mediators of food insecurity and obesity: a review of recent literature.J Community Health. 2012; 37: 253-264
- Dietary quality of Americans by supplemental nutrition assistance program participation status.Am J Prev Med. 2015; 49: 594-604
- Body weight perception is associated with socio-economic status and current body weight in selected urban and rural South Indian school-going children.Public Health Nutr. 2012; 15: 2348-2356
- Social inequality and age-specific gender differences in overweight and perception of overweight among Swedish children and adolescents: a cross-sectional study.BMC Public Health. 2015; 15: 628
- Development and validity of a 2-item screen to identify families at risk for food insecurity.Pediatrics. 2010; 126: e26-e32
- CDC growth charts: United States.Adv Data. 2000; : 1-27
- Color-coding improves parental understanding of body mass index charting.Acad Pediatr. 2009; 9: 330-338
Article Info
Publication History
Published online: April 25, 2019
Accepted:
April 20,
2019
Received:
January 15,
2019
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
Copyright © 2019 by Academic Pediatric Association
