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Parental perceptions of and concerns about child's body weight in eight European countries – the IDEFICS study
Nordic School of Public Health NHV, Gothenburg, Sweden.
Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Public Health and Community Medicine, Public Health Epidemiology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany & BIPS-Institute for Epidemiology and Prevention Research, Bremen, Germany.
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2013 (English)In: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 8, no 2, 118-129 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To evaluate parental perceptions of and concern about child's body weight and general health in children in a European cohort.

DESIGN: Cross-sectional multi-centre study in eight European countries.

PARTICIPANTS: 16,220 children, ages 2-9 years.

METHODS: Parents completed a questionnaire regarding children's health and weight and concern about overweight and underweight. Objective children's weight categories from the International Obesity Task Force were used. Logistic regression models were utilized to identify predictors of accurate weight perception.

RESULTS: Parental weight perception corresponded overall to children's mean body mass index (BMI) z-scores, with important exceptions. About one-third of the total indicated concern about underweight, paradoxically most often parents of children in the overweight or obesity categories. In 63%, parents of children in the overweight category marked 'proper weight'. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z-score (odds ratio [OR] = 7.2, 95% confidence interval [CI] 6.1-8.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.3-6.0) in Northern Europe and 3.4 (95% CI 2.7-4.2) in Central Europe.

CONCLUSION: Parents of children categorized as being overweight or obese systematically underestimated weight. Parents differed regionally regarding accurate weight perception and concern about overweight and underweight.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell, 2013. Vol. 8, no 2, 118-129 p.
Keyword [en]
Cohort of European children, obesity, parent, weight concern, weight perception
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hh:diva-29118DOI: 10.1111/j.2047-6310.2012.00093.xISI: 000316328400007PubMedID: 23001999Scopus ID: 2-s2.0-84878146826OAI: oai:DiVA.org:hh-29118DiVA: diva2:845047
Note

Funding: The European Community within the sixth Research, Technological Development and Demonstration (RTD) framework programme under contract no. 016181, Food Quality and Safety projects in FP6 (FOOD), Västra Götalandsregionen research funds, Forskningsrådet för arbetsliv och socialvetenskap (FAS), and the Nordic School of Public Health NHV.

Available from: 2015-08-10 Created: 2015-08-10 Last updated: 2015-08-11Bibliographically approved
In thesis
1. Barriers and Facilitators of Health Promotion and Obesity Prevention in Early Childhood: A Focus on Parents, Results from the IDEFICS Study
Open this publication in new window or tab >>Barriers and Facilitators of Health Promotion and Obesity Prevention in Early Childhood: A Focus on Parents, Results from the IDEFICS Study
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Childhood obesity has increased dramatically during the past thirty years. Parents are key persons in their children’s lives and their efforts to create healthy lifestyles are very important. However, social and economic determinants of health also affect parents’ opportunities to promote a healthy lifestyle.

Aims: To explore barriers and facilitators in promoting healthy lifestyles and preventing childhood obesity, focusing on parental roles.

Methods and main findings: Three studies originated from the Identification and Prevention of Dietary- and Lifestyle-induced health Effects in Children and InfantS (IDEFICS) study of determinants for two to nine-year-old children’s health in eight European countries. The fourth study was a qualitative interview study conducted in southwest Sweden.

Paper I: In focus group discussions (20 focus groups with children and 36 with parents), parents described lack of time, financial constraints, availability and food marketing techniques as barriers for promoting healthy eating. School policies about food varied; only Sweden and Estonia provided free school lunches. Children described great variation in the availability of unhealthy foods and beverages in their homes.

Paper II: Objectively measured Body Mass Index (BMI) of children (n=16 220) were compared to parents’ perception of and concern for their children’s health and weight status. In all weight categories and all countries, a substantial proportion of parents failed to accurately judge their child’s weight status. In general, parents considered their children to be healthy, irrespective of their weight status. Parents of children with overweight or obesity systematically underestimated their children’s weight status across eight European countries. Accurate parental weight perception in Europe differed according to geographic region.

Paper III: Swedish IDEFICS participants (n=1825) were compared with an age- and sex-matched referent population (n=1825), using registers from Statistics Sweden and the Swedish Medical Birth Register. Longitudinal child growth data (n=3650) were collected from child health centers and school health services. Families with low income, less education, foreign background or single parenthood were underrepresented in the IDEFICS study. BMI at inclusion had no selection effect but, at eight years of age, the obesity prevalence was significantly greater among referents.

Paper IV: A qualitative content analysis was used to interpret the findings from interviews with nurses (n=15) working at child health centers in the southwest of Sweden. The BMI Chart to identify overweight and obesity in children facilitated greater recognition but nurses used it inconsistently, a barrier to prevention. Other barriers were obesity considered a sensitive issue and that some parents wanted overweight children.

Conclusion: Parents may not perceive their child’s growth trajectory from overweight to obesity, and the preschool years may pass without effort to change lifestyle. Therefore, objective measurement and information of children’s BMI weight status by healthcare professionals is of great importance. To reach all parents and avoid selection bias, health surveys or health promoting activities must be tailored. Health promoting activities at the family level as well as the societal level should start early in children’s lives to prevent childhood obesity.

Place, publisher, year, edition, pages
Göteborg: Department of Public Health and Community Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, 2014. 75 p.
Keyword
parents, children, obesity, weight perception, registers, prevention, health promotion
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-29130 (URN)978-91-628-8926-5 (ISBN)
Public defence
2014-02-28, Aulan, Nordic School of Public Health NHV, Nya Varvet, Fredrik Bloms väg 25, Göteborg, 13:00 (Swedish)
Opponent
Supervisors
Projects
IDEFICS (EU-project)
Available from: 2015-08-11 Created: 2015-08-10 Last updated: 2015-08-11Bibliographically approved

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