Change in Misperception of Child's Body Weight among Parents of American Preschool Children

By Duncan, Dustin T.; Hansen, Andrew R. et al. | Childhood Obesity, August 2015 | Go to article overview

Change in Misperception of Child's Body Weight among Parents of American Preschool Children


Duncan, Dustin T., Hansen, Andrew R., Wang, Wei, Yan, Fei, Zhang, Jian, Childhood Obesity


[Author Affiliation]

Dustin T. Duncan. 1 Department of Population Health, New York University School of Medicine, New York, NY.

Andrew R. Hansen. 2 Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA.

Wei Wang. 3 Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China.

Fei Yan. 3 Department of Social Medicine, School of Public Health, Fudan University, Shanghai, China.

Jian Zhang. 4 Department of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA.

Address correspondence to: Jian Zhang, MD, DrPH, Associate Professor of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, PO Box 8015, Statesboro, GA 30460, E-mail: jianzhang@georgiasouthern.edu

Introduction

Despite some evidence of a plateauing or decline in obesity prevalence among preschool-aged children, obesity prevalence among this population remains high.1-3 Moreover, a recent study among a nationally representative sample of elementary school children found that incidence of obesity between the ages of 5 and 14 years was more likely to have occurred at younger ages, primarily among children who had entered kindergarten overweight,4 suggesting that obesity prevention needs to be conducted in preschool or earlier.5

Preschool age is the life stage when attitudes and behaviors, including food preferences, eating behavior, and physical activity, are shaped,6 and parents are the primary models7,8 ; therefore, a critical factor to maintain a healthy parental style and foster a healthy family environment in childhood obesity prevention is parental recognition of their child's overweight status.9-12 For instance, some recent research using data from the Quebec Longitudinal Study of Child Development (1998-2010) concluded that parental misperception of their child's body weight status and lifestyle habits constitutes an unfavorable context for healthy body weight management.9 However, numerous epidemiological studies have demonstrated that most mothers with overweight preschool children do not perceive their children as overweight.13 Though informative, most previous studies were conducted among populations with special needs,14 with small sample size,15-18 and/or were conducted cross-sectionally.16-19 No study has been conducted that examines the overtime change of parents' perception of weight status among their preschool child, allowing an evaluation of whether the parent's recognition has been improved. Some studies have, however, reported that "perceived" normal weight has increased with the increased prevalence of adult obesity.20,21 Evidence exists to support this trend of misperceptions,19,22-25 but only among adults.

The current study aims to fill important gaps in the literature on parental perception of their preschool children's weight over time, recognizing that parental perception of their children's weight can be important for childhood obesity prevention. The primary aim of the current study is to examine the misconception of parental perceptions of the weight status of their preschool-aged child overtime. We also sought to identify the subpopulation among which misperceptions are most prevalent. By thoroughly examining the evolution of parental perceptions of their child's weight, we can help to identify effective strategies for childhood obesity prevention.

Methods

Study Design and Population

Data for this study came from the National Health and Nutrition Examination Survey (NHANES) conducted by the National Center for Health Statistics of the CDC. Participants were preschool children ages 2-5 years and their primary caregivers in the NHANES III conducted during 1988-1994 (early survey) or the continuous NHANES conducted during 2007-2012 (recent survey). …

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