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Previous studies in China showed large sex differences in childhood overweight and obesity (OW/OB) rates. However, limited research has examined the cause of these sex differences. The present study aimed to examine individual and parental/familial factors associated with sex differences in childhood OW/OB rates in China.
Variables associated with child weight status, beliefs and behaviours, and obesity-related parenting practices were selected to examine their sex differences and association with a sex difference in child OW/OB outcomes using logistic regression analysis.
Cross-sectional data analysis using the 2011 China Health and Nutrition Survey.
Children aged 6–17 years (n 1544) and their parents.
Overall child OW/OB prevalence was 16·8 %. Adolescent boys (AB; 12–17 years) were about twice as likely to be overweight/obese as adolescent girls (AG; 15·5 v. 8·4 %, P<0·05). AB more likely had energy intake exceeding recommendations, self-perceived underweight, underestimated their body weight and were satisfied with their physical activity level than AG. AG more likely practised weight-loss management through diet and self-perceived overweight than AB. Mothers more likely identified AG’s weight accurately but underestimated AB’s weight. Stronger associations with risk of childhood OW/OB were found in boys than girls in dieting to lose weight (OR=6·7 in boys v. 2·6 in girls) and combined maternal and child perception of the child’s overweight (OR=35·4 in boys v. 14·2 in girls).
Large sex differences in childhood obesity may be related to the sex disparities in weight-related beliefs and behaviours among children and their parents in China.
Childhood obesity has increased rapidly in China, but understanding is limited on how parents perceive their child’s weight status and how this perception affects weight-related parenting practices. We examined maternal perception of her child’s weight status and its association with demographics, subsequent weight-related parenting practices, the child’s health behaviours and weight change.
Maternal perception of child’s weight status and health behaviours from the China Health and Nutrition Surveys were assessed at baseline and in follow-up surveys for 816 children aged 6–18 years during 2004–2011. Associations were tested using mixed models.
Overall, maternal and child perceptions of the child’s weight status were fairly consistent (κw=0·56), 63·8 % of mothers had correct perception. While 9·6 % of mothers perceived their child as overweight, 10·9 % of children did so, and 13·6 % of children were indeed overweight. Compared with mothers who viewed their children as normal weight, mothers who thought their children were overweight were more likely to encourage their children to increase their physical activity (OR; 95 % CI: 1·8; 1·0, 3·3) and to diet (4·3; 2·3, 7·8). Children perceived as overweight by their mothers were more likely to have insufficient physical activity (2·8; 1·6, 4·7) and gain more weight during follow-up (BMI Z-score, β (se): 1·0 (0·1); P<0·01) than children perceived by their mothers as normal weight.
In China, mothers who perceive their child as overweight are more likely to encourage their child to exercise and modify their diet for weight management, but this encouragement does not seem to improve the child’s health behaviours and weight status.
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