Parental Perceptions of Childrens Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017

Ramos Salas X. Buoncristiano M. Williams J. Kebbe M. Spinelli A. Nardone P. Rito A. Duleva V. Musić Milanović S. Kunesova M. Braunerová R.T. Hejgaard T. Rasmussen M. Shengelia L. Abdrakhmanova S. Abildina A. Usuopva Z. Hyska J. Burazeri G. Petrauskiene A. Pudule I. Santangelo V.F. Kujundzic E. Fijałkowska A. Cucu A. Brinduse L.A. Peterkova V. Bogova E. Gualtieri A. Solano M.G. Gutiérrez-González E. Rakhmatullaeva S. Tanrygulyyeva M. Yardim N. Weghuber D. Mäki P. Russell Jonsson K. Starc G. Juliusson P.B. Heinen M.M. Kelleher C. Ostojic S. Popovic S. Kovacs V.A. Akhmedova D. Farpour-Lambert N.J. Rutter H. Li B. Boymatova K. Rakovac I. Wickramasinghe K. Breda J.
5 December 2021 S. Karger AG

Obesity Facts
2021 #14 Issue 6 658 - 674 pp.

Introduction: Parents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their childs weight status. The purpose of this study was to measure parental perceptions of their childs weight status and to identify predictors of potential parental misperceptions. Methods: We used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their childrens weight status as underweight,normal weight,a little overweight,or extremely overweight.We categorized childrens (6-9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of childs weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1. Results: Overall, 64.1% of parents categorized their childs weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their childs weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their childs weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28-1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26-1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98-1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99-1.24). Overall, parents BMI was not strongly associated with the underestimation of childrens weight status, but there was a stronger association in some countries. Discussion/Conclusion: Our study supplements the current literature on factors that influence parental perceptions of their childs weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents knowledge and perceptions, as well as the sociocultural contexts in which children and families live.

Childhood obesity , Childhood Obesity Surveillance Initiative , Parental perceptions , Weight , World Health Organization/Europe

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Who European Office for Prevention and Control of NCDs, Country Health Programmes, Who Regional Office for Europe, Copenhagen, Denmark
European Association for the Study of Obesity, Teddington, United Kingdom
Pennington Biomedical Research Center, Baton Rouge, LA, United States
Istituto Superiore di Sanità, Rome, Italy
National Institute OfHealth Dr. Ricardo Jorge I.P., Lisbon, Portugal
National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria
University of Zagreb, School of Medicine, Croatian Institute of Public Health, Zagreb, Croatia
Obesity Management Centre, Institute of Endocrinology, Prague, Czech Republic
Danish Health Authority, Copenhagen, Denmark
National Institute of Public Health, University of Southern Denmark, Odense, Denmark
National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
Centre for Health Promotion, Bishkek, Kyrgyzstan
Institute of Public Health, Tirana, Albania
Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
Centre for Disease Prevention and Control, Riga, Latvia
Primary Health Care, Ministry of Health, Floriana, Malta
Institute of Public Health, Podgorica, Montenegro
Department of Cardiology, Institute of Mother and Child, Warsaw, Poland
Department of Public Health and Management, University of Medicine and Pharmacy Carol Davila Romania, Bucharest, Romania
Institute of Pediatric Endocrinology, Endocrine Research Centre, Moscow, Russian Federation
Istituto per la Sicurezza Sociale, Cailungo, San Marino
Observatory of Nutrition and Study of Obesity, Spanish Agency for Food Safety & Nutrition, Ministry of Health, Madrid, Spain
Department for Organization of Health Services to Children, Mothers, Adolescents and Family Planning, Ministry of Health and Social Protection of the Population, Dushanbe, Tajikistan
Internal Diseases Department of the Scientific Clinical Centre of Mother and Child Health, Ashgabat, Turkmenistan
Ministry of Health, Public Health General Directorate, Ankara, Turkey
Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
National Institute for Health and Welfare, Helsinki, Finland
Public Health Agency of Sweden, Solna, Sweden
Faculty of Sport, University of Ljubjana, Ljubjana, Slovenia
National Institute of Public Health, Oslo, Norway
National Nutrition Surveillance Centre, University College Dublin, Dublin, Ireland
Faculty of Sport and Pe, University of Novi Sad, Novi Sad, Serbia
Faculty for Sport and Physical Education, University of Montenegro, Niksic, Montenegro
Hungarian School Sport Federation, Budapest, Hungary
School for Health in Europé, Ministry of Health, Tashkent, Uzbekistan
European Association for the Study of Obesity, United Kingdom, and Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology and Therapeutic Education, Department of Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
Centre for Exercise, Nutrition and Health Sciences (ENHS), University of Bristol, Bristol, United Kingdom
World Health Organization, Country Office, Dushanbe, Tajikistan
Who European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation

Who European Office for Prevention and Control of NCDs
European Association for the Study of Obesity
Pennington Biomedical Research Center
Istituto Superiore di Sanità
National Institute OfHealth Dr. Ricardo Jorge I.P.
National Center of Public Health and Analyses
University of Zagreb
Obesity Management Centre
Danish Health Authority
National Institute of Public Health
National Center for Disease Control and Public Health of Georgia
National Center of Public Health of the Ministry of Health of the Republic of Kazakhstan
Centre for Health Promotion
Institute of Public Health
Department of Preventive Medicine
Centre for Disease Prevention and Control
Primary Health Care
Institute of Public Health
Department of Cardiology
Department of Public Health and Management
Institute of Pediatric Endocrinology
Istituto per la Sicurezza Sociale
Observatory of Nutrition and Study of Obesity
Department for Organization of Health Services to Children
Internal Diseases Department of the Scientific Clinical Centre of Mother and Child Health
Ministry of Health
Department of Pediatrics
National Institute for Health and Welfare
Public Health Agency of Sweden
Faculty of Sport
National Institute of Public Health
National Nutrition Surveillance Centre
Faculty of Sport and Pe
Faculty for Sport and Physical Education
Hungarian School Sport Federation
School for Health in Europé
European Association for the Study of Obesity
Department of Social and Policy Sciences
Centre for Exercise
World Health Organization
Who European Office for the Prevention and Control of Noncommunicable Diseases

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