Abstract
Introduction: Childhood overweight/obesity is associated with poor physical and psychosocial health in clinical samples. However, there is little information on the health status of overweight and obese children in the community, who now represent a large proportion of the child population. We examined parent-reported child health and well-being and parent concern about child weight by body mass index (BMI) category in a population sample of primary school children.
Design: A stratified two-stage random cluster sample of 24 primary schools representative of the state of Victoria, Australia.
Measures: BMI (weight/height2) transformed to normalised Z-scores using the 1990 UK Growth Reference; the Child Health Questionnaire (CHQ), a 13-scale 50-item parent-completed measure of health and well-being; parent self-reported height and weight; parent concern about child's weight.
Results: Data were available for 2863 children aged 5–13 y (50.5% male), of whom 17% were overweight and 5.7% obese. Using logistic regression analyses with ‘normal weight’ as the referent category, obese boys were at greater risk of poor health (ie <15th centile) on seven of the 12 CHQ scales: Physical Functioning (odds ratio (OR) 2.8), Bodily Pain (OR 1.8), General Health (OR 3.5), Mental Health (OR 2.8), Self Esteem (OR 1.8), Parent Impact—Emotional (OR 1.7) and Parent Impact—Time (OR 1.9). Obese girls were at greater risk of poor health on only two scales: General Health (OR 2.1) and Self Esteem (OR 1.8). Forty-two percent of parents with obese children and 81% with overweight children did not report concern about their child's weight. Parents were more likely to report concern if the child was obese (OR 21.3), overweight (OR 3.5) or underweight (OR 5.4) than normal weight (P<0.05). Concern was not related to child gender, parental BMI or parental education after controlling for child BMI. Perceived health and well-being of overweight/obese children varied little by weight category of the reporting parent (overweight vs non-overweight).
Conclusions: Parents were more likely to report poorer health and well-being for overweight and obese children (particularly obese boys). Parental concern about their child's weight was strongly associated with their child's actual BMI. Despite this, most parents of overweight and obese children did not report poor health or well-being, and a high proportion did not report concern. This has implications for the early identification of such children and the success of prevention and intervention efforts.
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References
Schonfeld-Warden N, Warden C . Pediatric obesity Pediat Endocrinol 1997 44: 339–361.
Power C, Lake JK, Cole T . Measurement and long-term health risks of child and adolescent fatness Int J Obes Relat Metab Disord 1997 21: 507–526.
Stunkard AJ, Wadden TA . Psychological aspects of severe obesity Am J Clin Nutr 1992 55 (Suppl 2): 524S–532S.
Stunkard AJ, Mendelson M . Obesity and the body image. 1. Characteristics of disturbances in the body image of some obese persons Am J Psychiat 1967 123: 1296–1300.
Dietz WH . Health consequences of obesity in youth: childhood predictors of adult disease Pediatrics 1998 101 (Suppl 3): 518–525.
Strauss RS . Childhood obesity and self esteem Pediatrics 2000 105: e15.
Eck LH, Klesges RC, Hanson CL, Slawson D . Children at familial risk for obesity: an examination of dietary intake, physical activity and weight status Int J Obes Relat Metab Disord 1992 16: 71–78.
Davies PSW, Gregory J, White A . Physical activity and body fatness in preschool children Int J Obes Relat Metab Disord 1995 19: 6–10.
Booth M, Wake M, Armstrong T, Chey T, Hesketh K, Mathur S . The epidemiology of overweight and obesity among Australian children and adolescents, 1995–1997 Aust NZ J Public Health 2001 25: 162–169.
Braet C, Mervielde i, Vandereycken W . Psychological aspects of childhood obesity: A controlled study in a clinical and nonclinical sample J Pediat Psychol 1997 22: 59–71.
Fontaine K, Bartlett S . Estimating health-related quality of life in obese individuals Dis Mgmt Health Outcomes 1998 3: 61–70.
Baughcum AE, Chamberlain LA, Deeks CM, Powers SW, Whitaker RC . Maternal perceptions of overweight preschool children Pediatrics 2000 106: 1380–1386.
Quek CM, Koh K, Lee J . Parental body mass index: a predictor of childhood obesity? Ann Acad Med Singapore 1993 22: 342–347.
Young-Hyman D, Herman LJ, Scott DL, Schlundt DG . Care giver perception of children's obesity-related health risk: a study of African American families Obes Res 2000 8: 241–248.
Waters E . Assessing quality of life In: Moyer V, Elliot E, Davis R, Glbert R, Klassen T, Logan S et al (eds) Evidence based pediatrics and child health BMJ Books: London 2000 pp 79–90.
Australian Bureau of Statistics. Victoria 1998 yearbook Commonwealth of Australia: Canberra 1998.
Australian Council for Health Physical Education and Recreation. Australian health and fitness survey 1985 ACHPER Publications: Adelaide 1985.
Bailey BJ, Voss LD . Accuracy of height measurements Arch Dis Child 1991 66: 1101.
Cole TJ, Freeman JV, Preece MA . Body mass index reference curves for the UK Arch Dis Child 1995 73: 25–29.
Cole TJ, Bellizzi MC, Fiegel KM, Dietz WH . Body mass index in children: worldwide cut-off points for overweight and obesity Br Med J 2000 320: 1240.
Willett WC, Dietz WH, Colditz GA . Guidelines for healthy weight New Engl J Med 1999 341: 427–434.
Waters E, Salmon L, Wake M, Hesketh K, Wright M . The Child Health Questionnaire Australia: reliability, validity and population means Aust NZ J Public Health 2000 24: 207–210.
Waters E, Salmon L, Wake M . The parent-form Child Health Questionnaire in Australia: comparison of reliability, validity, structure and norms J Pediat Psychol 2000 25: 381–391.
SPSS Inc. SPSS for Windows: Release 6.1.3 (Standard Version Copyright) SBS Inc.: Chicago, IL 1995.
StataCorp. Stata Statistical Software, Release 5.0 Stata Corporation: College Station, TX 1997.
Waters E, Doyle J, Wolfe R, Wright M, Wake M, Salmon L . The influence of parental gender, health, and illness on child health reports Pediatrics 2000 106: 1422–1428.
Goodman E, Hinden BR, Khandelwal Z . Accuracy of teen and parental reports of obesity and body mass index Pediatrics 2000 106: 52–58.
Wake M, Hesketh K, Waters E, Wright M . Functional health status in six paediatric clinical populations: extending the use of the Child Health Questionnaire for Australian children Catalogue No. HOC 3 Canberra: Australian Institute of Health and Welfare 1999.
Sawyer M, Antoniou G, Toogood I, Rice M . A comparison of parent and adolescent reports describing the health-related quality of life of adolescents treated for cancer Int J Cancer 1999 12: 39–45.
Edmunds L, Waters E . Childhood obesity In: Moyer V, Elliot E, Davis R, Glbert R, Klassen T, Logan S et al (eds) Evidence based pediatrics and child health BMJ Books: London 2000 pp 141–153.
Gortmaker SL, Cheung LWY, Peterson KE, Chomitz G, Cradle JH, Dart H et al.. Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving Arch Pediat Adolesc Med 1999 153: 975–983.
Landgraf JM, Abetz L, Ware JA . The CHQ user's manual. 1 edn The Health Institute, New England Medical Centre: Boston, MA 1996.
Acknowledgements
We would like to acknowledge the Victorian Department of Human Services Division of Public Health for providing funding for the project, Dr Rory Wolfe for providing statistical consultation to the paper, and Dr Malcolm Rosier for providing statistical consultation to the study. We thank Lisa Templeton and John Birchall for assisting with field work.
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Wake, M., Salmon, L., Waters, E. et al. Parent-reported health status of overweight and obese Australian primary school children: a cross-sectional population survey. Int J Obes 26, 717–724 (2002). https://doi.org/10.1038/sj.ijo.0801974
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DOI: https://doi.org/10.1038/sj.ijo.0801974
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