Parental Perception of Body Weight Status of Their 8-year-old Children: Findings from the European CHOP Study

Annick Xhonneux, Jean-Paul Langhendries, Françoise Martin, Laurence Seidel, Adelin Albert, Elena Dain, Martina Totzauer, Veit Grote, Veronica Luque, Ricardo Closa-Monasterolo, Alice Re Dionigi, Elvira Verduci, Darius Gruszfeld, Piotr Socha, Berthold Koletzko, European Childhood Obesity Trial Study group, Annick Xhonneux, Jean-Paul Langhendries, Françoise Martin, Laurence Seidel, Adelin Albert, Elena Dain, Martina Totzauer, Veit Grote, Veronica Luque, Ricardo Closa-Monasterolo, Alice Re Dionigi, Elvira Verduci, Darius Gruszfeld, Piotr Socha, Berthold Koletzko, European Childhood Obesity Trial Study group

Abstract

Background: Maternal perception of child weight status in children with overweight or obesity has received a lot of attention but data on paternal perception of children from presumably healthy cohorts are lacking.

Objective: We aimed to investigate paternal and maternal perception of child weight status at the age of 8 years in a cohort of 591 children from 5 European countries.

Material and methods: Included were 8-year-old children and their parents participating in the European Childhood Obesity Project (EU CHOP). Weight and height of children and parents were measured and Body Mass Index (BMI, kg/m2) was calculated. Both parents were asked to assess their perception of child weight status using Eckstein scales and their concern about child overweight. The agreement between mother and father perceptions was assessed by Cohen kappa coefficient and their relationship was analyzed by linear mixed effects models based on ordinal logistic regression, accounting for country, child gender and BMI, parental BMI, level of education, concern and type of feeding during first year of life.

Results: Data from children and both parents were available for 432 girls and boys. Mean BMI was comparable in boys and girls (16.7 ± 2.31 vs. 16.9 ± 2.87 kg/m2, P = 0.55). In total, 172 children (29.3%) were overweight or obese. There was a high degree of agreement between mother and father perceptions of their child's weight status (Cohen kappa 0.77). Multivariate modelling showed that perception levels significantly increased with child BMI but were globally lower than assessed. They differed between countries, gender and types of feeding during first year of life, were influenced by education level of the father but were not related to parental BMI and concern about childhood overweight.

Conclusions: The study showed no overall differences between mothers and fathers in rating their child's weight status but both parents had a propensity to underestimate their child's actual weight, particularly in boys. The EU CHOP trial registered at clinicaltrials.gov as NCT00338689.

Keywords: BMI; Healthy children; Parental child weight perception; Scale of sketches.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Eckstein scale of sketches (boys and girls, aged 6–9 years) (Production with permission of authors)
Fig. 2
Fig. 2
Child BMI mean values according to mother and father perception of body weight status in boys and girls (the dotted line represents the IOTF threshold for overweight)

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