Abstract
Background:
The gold standard for categorisation of weight status is clinically measured body mass index (BMI), but this is often not practical in large epidemiological studies.
Objectives:
To determine if a child’s weight perception or a mother’s perception of a child’s weight status is a viable alternative to measured height and weight in determining BMI classification. Secondary outcomes are to determine the influence of a mother’s BMI on her ability to categorise the child’s BMI and a child’s ability to recognise his/her own BMI.
Methods:
Cross-sectional analysis of the growing up in Ireland cohort study, a nationally representative cohort of 8568 9-year-old children. The variables considered for this analysis are the child’s gender, BMI (International Obesity Taskforce grade derived from measured height and weight) and self-perceived weight status, and the mother’s weight perception of the child, BMI (derived from measured height and weight) and self-perceived weight status. Cohen’s weighted-kappa was used to evaluate the strength of the agreement between pairwise combinations of the BMI variables. Cumulative and adjacent categories logistic regression were used to predict how likely a person rates themselves as under, normal or overweight, based on explanatory variables.
Results:
Mothers are more accurate at correctly classifying their child’s BMI (κ=0.5; confidence intervals (CI) 0.38–0.51) than the children themselves (κ=0.25; CI 0.23–0.26). Overweight mothers are better raters of their child’s BMI (κ=0.51; CI 0.49–0.54), compared with normal (κ=0.44; CI 0.41–0.47) or underweight mothers (κ=0.4; CI 0.22–0.58), regardless of whether the mother’s BMI is derived from measured height and weight or self-perceived. The mother’s perception of the child’s weight status is not an influencing factor on the child’s ability to correctly classify him/herself, but the child’s self-perceived weight status influences the mother’s ability to correctly classify the child.
Conclusions:
A mother’s BMI classification of her child is a viable alternative to BMI measurement in large epidemiological studies.
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References
Shiely F, Perry I, Lutomski J, Harrington J, Kelleher C, McGee H et al. Temporal trends in misclassification patterns of measured and self-report based body mass index categories—findings from three population surveys in Ireland. BMC Public Health 2010; 10: 1–13.
Shiely F, Hayes K, Perry IJ, Kelleher CC . Height and weight bias: the influence of time. PLoS One 2013; 8: e54386.
Connor Gorber S, Tremblay M, Moher D, Gorber B . A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obes Rev 2007; 8: 307–326.
Ezzati M, Martin H, Skjold S, Vander Hoorn S, Murray CJL . Trends in national and state-level obesity in the USA after correction for self-report bias: analysis of health surveys. J R Soc Med 2006; 99: 250–257.
Faeh D, Marques-Vidal P, Chiolero A, Bopp M . Obesity in Switzerland: do estimates depend on how body mass index has been assessed? Swiss Med Wkly 2008; 138: 204–210.
Oliveira A, Ramos E, Lopes C, Barros H . Self-reporting weight and height: misclassification effect on the risk estimates for acute myocardial infarction. Eur J Public Health 2009; 19: 548–553.
Connor Gorber S, Tremblay MS . The bias in self-reported obesity from 1976 to 2005: a Canada–US comparison. Obesity 2010; 18: 354–361.
Villanueva EV . The validity of self-reported weight in US adults: a population based cross-sectional study. BMC Public Health 2001; 1: 1–10.
Dubois L, Girad M . Accuracy of maternal reports of pre-schoolers’ weights and heights as estimates of BMI values. Int J Epidemiol 2007; 36: 132–138.
Huybrechts I, De Bacquer D, Van Trimpont I, De Backer G, De Henauw S . Validity of parentally reported weight and height for preschool-aged children in Belgium and its impact on classification into body mass index categories. Pediatrics 2006; 118: 2109–2118.
Warschburger P, Kröller K . Maternal perception of weight status and health risks associated with obesity in children. Pediatrics 2009; 124: 60–68.
Weden MM, Brownell PB, Rendall MS, Lau C, Fernandes M, Nazarov Z . Parent-reported height and weight as sources of bias in survey estimates of childhood obesity. Am J Epidemiol 2013; 178: 461–473.
Shields M, Gorber SC, Janssen I, Tremblay MS . Obesity estimates for children based on parent-reported versus direct measures. Health Rep 2011; 22: 47–58.
Rothman KJ . BMI-related errors in the measurement of obesity. Int J Obesity 2008; 32: 556–559.
Rietmeijer-Mentink M, Paulis WD, van Middelkoop M, Bindels PJE, van der Wouden JC . Difference between parental perception and actual weight status of children: a systematic review. Matern Child Nutr 2013; 9: 3–22.
Hudson E, McGloin A, McConnon A . Parental weight (mis) perceptions: factors influencing parents’ ability to correctly categorise their child’s weight status. Matern Child Health J 2012; 16: 1801–1809.
Doolen J, Alpert PT, Miller SK . Parental disconnect between perceived and actual weight status of children: a metasynthesis of the current research. J Am Acad Nurse Pract 2009; 21: 160–166.
Parry LL, Netuveli G, Parry J, Saxena S . A systematic review of parental perception of overweight status in children. J Ambul Care Manage 2008; 31: 253–268.
Eckstein KC, Mikhail LM, Ariza AJ, Thomson JS, Millard SC, Binns HJ . Parents' perceptions of their child's weight and health. Pediatrics 2006; 117: 681–690.
O'Connor DP, Gugenheim JJ . Comparison of measured and parents' reported height and weight in children and adolescents. Obesity 2011; 19: 1040–1046.
Rietmeijer‐Mentink M, Paulis WD, Middelkoop M, Bindels PJ, Wouden JC . Difference between parental perception and actual weight status of children: a systematic review. Matern Child Nutr 2013; 9: 3–22.
Elgar FJ, Roberts C, Tudor-Smith C, Moore L . Validity of self-reported height and weight and predictors of bias in adolescents. J Adolesc Health 2005; 37: 371–375.
International Obesity Task Force. Obesity in Europe. IOTF: Brussels, 2005.
Ebbeling CB, Pawlak DB, Ludwig DS . Childhood obesity: public-health crisis, common sense cure. Lancet 2002; 360: 473–482.
Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004; 350: 2362–2374.
Wang Y, Lobstein T . Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006; 1: 11–25.
Irish Social Sciences Data Archive. Sample design and response in wave 1 of the nine-year cohort of growing up in Ireland. Dublin, Ireland, 2010. Available at: http://www.ucd.ie/t4cms/GUI-SampleDesign9YearCohort.pdf.
Williams J, Greene S, Doyle E, Harris E, Layte R, McCoy S et al. Growing Up in Ireland. The Lives of 9-Year-Olds. Report 1. Office of the Minister for Children and Youth Affairs: Dublin, Ireland, 2009.
Murray A, McCrory C, Thornton M, Williams J, Quail A, Swords L et al. Growing Up in Ireland: Design, Instrumentation and Procedures for the Child Cohort: Technical Report No.1. Department of Health and Children: Dublin, Ireland, 2011.
Sanson A, Nicholson J, Ungerer J, Zubrick S, Wilson K, Ainley J et al. Introducing the Longitudinal Study of Australian Children-LSAC Discussion Paper No. 1. Australian Institute of Family Studies: Melbourne, 2002.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. Br Med J 2000; 320: 1240.
Cohen J . A coefficient of agreement for nominal scales. Educ Psychol Meas 1960; 20: 37–46.
Cohen J . Weighted kappa: nominal scale agreement provision for scaled disagreement or partial credit. Psychol Bull 1968; 70: 213.
Fleiss JL, Levin B, Paik MC . Statistical Methods for Rates and Proportions. John Wiley & Sons: New York, NY, USA, 2013.
Altman DG . Practical Statistics for Medical Research. Chapman and Hall: London, UK, 1991.
Keane E, Layte R, Harrington J, Kearney PM, Perry IJ . Measured parental weight status and familial socio-economic status correlates with childhood overweight and obesity at age 9. PLoS One 2012; 7: 1–9.
Young PC, DeBry S, Jackson WD, Metos J, Joy E, Templeman M et al. Improving the prevention, early recognition, and treatment of pediatric obesity by primary care physicians. Clin Pediatr 2010; 49: 964–969.
Ahern T, Doherty K, Kapeluto D, Davis M, Mulholland U, Rossiter E et al. Body mass index estimation and measurement by healthcare professionals. Open J Prev Med 2012; 2: 265.
Stommel M, Schoenborn CA . Accuracy and usefulness of BMI measures based on self-reported weight and height: findings from the NHANES & NHIS 2001–2006. BMC Public Health 2009; 9: 421.
Parkinson K, Drewett R, Jones A, Adamson A . Mothers' judgements about their child's weight: distinguishing facts from values. Child Care, Health Dev 2013; 39: 722–727.
Carnell S, Edwards C, Croker H, Boniface D, Wardle J . Parental perceptions of overweight in 3–5 y olds. Int J Obes 2005; 29: 353–355.
Keane E, Kearney PM, Perry IJ, Kelleher CC, Harrington JM . Trends and prevalence of overweight and obesity in primary school aged children in the Republic of Ireland from 2002-2012: a systematic review. BMC Public Health 2014; 14: 974.
Wedderkopp N, Froberg K, Hansen HS, Andersen LB . Secular trends in physical fitness and obesity in Danish 9‐year‐old girls and boys: Odense School Child Study and Danish substudy of the European Youth Heart Study. Scand J Med Sci Sports 2004; 14: 150–155.
Rokholm B, Baker JL, Sørensen TIA . The levelling off of the obesity epidemic since the year 1999–a review of evidence and perspectives. Obes Rev 2010; 11: 835–846.
Warschburger P, Kröller K . Maternal perception of weight status and health risks associated with obesity in children. Pediatrics 2009; 124: e60–e68.
Freedman DS, Khan LK, Serdula MK, Dietz WH, Srinivasan SR, Berenson GS . The relation of childhood BMI to adult adiposity: the Bogalusa Heart Study. Pediatrics 2005; 115: 22–27.
Schwartz RP, Hamre R, Dietz WH, Wasserman RC, Slora EJ, Myers EF et al. Office-based motivational interviewing to prevent childhood obesity: a feasibility study. Arch Pediatr Adolesc Med 2007; 161: 495–501.
Acknowledgements
We would like to acknowledge Professor Patricia Kearney for reading and providing comments on the paper. Kevin Hayes was supported by Science Foundation Ireland Research Investigator's Award SFI-12/IA/1683.
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Shiely, F., Ng, H., Berkery, E. et al. The association between weight perception and BMI: report and measurement data from the growing up in Ireland Cohort Study of 9-year olds. Int J Obes 41, 46–53 (2017). https://doi.org/10.1038/ijo.2016.162
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DOI: https://doi.org/10.1038/ijo.2016.162
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