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Maternal perceptions of their child’s weight status: the GENESIS study

  • Yannis Manios (a1), Katerina Kondaki (a1), Georgia Kourlaba (a1), Emilia Vasilopoulou (a1) and Evangelia Grammatikaki (a1)...



The objective of the present work was to quantify mothers’ misclassification of pre-school children’s weight status and to determine factors associated with the maternal misperception.


A representative sample of 2287 children aged 2–5 years was examined (GENESIS study). Mothers’ perceptions of their child’s weight status and the children’s and mothers’ anthropometric and other characteristics (sociodemographic and lifestyle) were recorded.


Almost 38 % of mothers underestimated their child’s weight status. The frequency of underestimation was much higher among ‘at risk of being overweight’ and ‘overweight’ children (88·3 % and 54·5 %, respectively) compared with ‘underweight/normal-weight’ children (18·0 %, P < 0·001). Multiple logistic regression modelling revealed that the likelihood of mothers’ underestimation of their child’s weight status was significantly higher in boys, in children engaging in physical activity for less than 3 h/week and in children whose mothers had low education status, compared with their counterparts. Moreover, the higher the BMI-for-age Z-score, the greater the odds that the mother would underestimate her child’s weight status.


The current study demonstrated that more than one-third of mothers misclassify their children’s weight status as being lower than the actual. Given that mother’s weight perception might be an important determinant of child’s body weight development, clinicians and health professionals should help mothers correctly classify their children’s weight status, which could potentially help in the early prevention of overweight and obesity.

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1.Caprio, S & Genel, M (2005) Confronting the epidemic of childhood obesity. Pediatrics 115, 494495.
2.Hedley, AA, Ogden, CL, Johnson, CL, Carroll, MD, Curtin, LR & Flegal, KM (2004) Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 291, 28472850.
3.Manios, Y, Magkos, F, Christakis, G & Kafatos, AG (2005) Twenty-year dynamics in adiposity and blood lipids of Greek children: regional differences in Crete persist. Acta Paediatr 94, 859865.
4.Lobstein, T & Jackson-Leach, R (2006) Estimated burden of paediatric obesity and co-morbidities in Europe. Part 2. Numbers of children with indicators of obesity-related disease. Int J Pediatr Obes 1, 3341.
5.Tzotzas, T & Krassas, GE (2004) Prevalence and trends of obesity in children and adults of South Europe. Pediatr Endocrinol Rev 1, Suppl. 3, 448454.
6.Power, C, Lake, JK & Cole, TJ (1997) Measurement and long-term health risks of child and adolescent fatness. Int J Obes Relat Metab Disord 21, 507526.
7.Serdula, MK, Ivery, D, Coates, RJ, Freedman, DS, Williamson, DF & Byers, T (1993) Do obese children become obese adults? A review of the literature. Prev Med 22, 167177.
8.Gortmaker, SL, Must, A, Perrin, JM, Sobol, AM & Dietz, WH (1993) Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 329, 10081012.
9.Must, A & Strauss, RS (1999) Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord 23, Suppl. 2, S2S11.
10.Dietz, WH (1998) Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 101, 518525.
11.Sinha, R, Fisch, G, Teague, B et al. (2002) Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 346, 802810.
12.Sorof, J & Daniels, S (2002) Obesity hypertension in children: a problem of epidemic proportions. Hypertension 40, 441447.
13.van Putte-Katier, N, Rooman, RP, Haas, L, Verhulst, SL, Desager, KN, Ramet, J & Suys, BE (2008) Early cardiac abnormalities in obese children: importance of obesity per se versus associated cardiovascular risk factors. Pediatr Res 64, 205209.
14.Mallory, GB Jr, Fiser, DH & Jackson, R (1989) Sleep-associated breathing disorders in morbidly obese children and adolescents. J Pediatr 115, 892897.
15.Schwimmer, JB, Burwinkle, TM & Varni, JW (2003) Health-related quality of life of severely obese children and adolescents. JAMA 289, 18131819.
16.Maynard, LM, Galuska, DA, Blanck, HM & Serdula, MK (2003) Mothers’ perceptions of weight status of children. Pediatrics 111, 12261231.
17.Birch, LL & Fisher, JO (1998) Development of eating behaviors among children and adolescents. Pediatrics 101, 539549.
18.Satter, EM (1996) Internal regulation and the evolution of normal growth as the basis for prevention of obesity in children. J Am Diet Assoc 96, 860864.
19.Moore, LL, Lombardi, DA, White, MJ, Campbell, JL, Oliveria, SA & Ellison, RC (1991) Influence of parents’ physical activity levels on activity levels of young children. J Pediatr 118, 215219.
20.Sallis, JF, Simons-Morton, BG, Stone, EJ et al. (1992) Determinants of physical activity and interventions in youth. Med Sci Sports Exerc 24, S248S257.
21.Barlow, SE & Dietz, WH (1998) Obesity evaluation and treatment: Expert Committee recommendations. The Mothers’ and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics 102, E29.
22.Elder, JP, Ayala, GX & Harris, S (1999) Theories and intervention approaches to health-behavior change in primary care. Am J Prev Med 17, 275284.
23.Baughcum, AE, Chamberlin, LA, Deeks, CM, Powers, SW & Whitaker, RC (2000) Mothers’ perceptions of overweight preschool children. Pediatrics 106, 13801386.
24.Kroke, A, Strathmann, S & Gunther, AL (2006) Mothers’ perceptions of her child’s body weight in infancy and early childhood and their relation to body weight status at age 7. Eur J Pediatr 165, 875883.
25.Eckstein, KC, Mikhail, LM, Ariza, AJ, Thomson, JS, Millard, SC & Binns, HJ (2006) Parents’ perceptions of their child’s weight and health. Pediatrics 117, 681690.
26.Etelson, D, Brand, DA, Patrick, PA & Shirali, A (2003) Childhood obesity: do parents recognize this health risk? Obes Res 11, 13621368.
27.Jeffery, AN, Voss, LD, Metcalf, BS, Alba, S & Wilkin, TJ (2005) Parents’ awareness of overweight in themselves and their children: cross sectional study within a cohort (EarlyBird 21). BMJ 330, 2324.
28.Carnell, S, Edwards, C, Croker, H, Boniface, D & Wardle, J (2005) Parental perceptions of overweight in 3–5 y olds. Int J Obes (Lond) 29, 353355.
29.Huang, JS, Becerra, K, Oda, T, Walker, E, Xu, R, Donohue, M, Chen, I, Curbelo, V & Breslow, A (2007) Parental ability to discriminate the weight status of children: results of a survey. Pediatrics 120, e112e119.
30.Manios, Y (2006) Design and descriptive results of the ‘Growth, Exercise and Nutrition Epidemiological Study In preSchoolers’: the GENESIS study. BMC Public Health 6, 32.
31.National Center for Health Statistics (2000) 2000 CDC Growth Charts: United States. Hyattsville, MD: NCHS.
32.Cole, TJ, Faith, MS, Pietrobelli, A & Heo, M (2005) What is the best measure of adiposity change in growing children: BMI, BMI %, BMI Z-score or BMI centile? Eur J Clin Nutr 59, 419425.
33.National Institutes of Health (1998) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults – The Evidence Report. Obes Res 6, Suppl. 2, 51S209S.
34.Fisher, L, Fraser, J & Alexander, C (2006) Caregivers’ inability to identify childhood adiposity: a cross-sectional survey of rural children and their caregivers’ attitudes. Aust J Rural Health 14, 5661.
35.Campbell, MW, Williams, J, Hampton, A & Wake, M (2006) Mothers’ concern and perceptions of overweight in Australian preschool-aged children. Med J Aust 184, 274277.
36.Stevens-Simon, C, Roghmann, KJ & McAnarney, ER (1992) Relationship of self-reported prepregnant weight and weight gain during pregnancy to mothers’ body habitus and age. J Am Diet Assoc 92, 8587.
37.Stewart, AL (1982) The reliability and validity of self-reported weight and height. J Chronic Dis 35, 295309.



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