Weight status in Chinese children: Maternal perceptions and child self-assessments

Background: Inaccurate parental perceptions of child weight status as well as children's own misperceptions can reduce motivation to adopt optimal nutritional and physical activity behaviors, thereby increasing overweight and obesity risk in child populations in the U.S. and elsewhere. Using population-based data from nine provinces of China, we analyzed the accuracy of maternal perceptions and children's self-assessments of weight status. Methods: The data were collected from 1265 children aged 6 to 18 years with self-reported weight status perceptions during the 2006 China Health and Nutrition Survey. Among these children, 863 had maternal estimation of child weight status. Descriptive and multiple regression analyses are conducted to fi nd variations in the misperception of children's weight status. Results: Among overweight children (n=176), 69% underestimated their weight status; 72% mothers of the overweight children (n=143) also underestimated their child's weight status. Less than one-quarter of overweight children and their mothers chose the correct classifi cation of weight status. Multiple regression analyses showed that as children's body-mass-index (BMI)-for-age increased, the odds that mothers underestimated their weight status increased. Low maternal weight was significantly associated with maternal underestimation of child weight status but not with child's underassessment. Conclusions: Underestimation of childhood overweight is common among both mothers and children in China, particularly for children with the highest BMI. School-based BMI reporting may be benefi cial in alerting parents and children to the problem and encouraging communication with health care providers.