Research Research and Professional Briefs| Volume 112, ISSUE 12, P2007-2013, December 2012

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Maternal Misconceptions of Weight Status among Nepean Adolescents

Published:November 20, 2012DOI:


      Adolescence is characterized by rapid physical growth and sexual maturation. These changes may alter parents' beliefs about their adolescent's weight status. This study aimed to examine the changes between early and mid-adolescence in: (a) the accuracy of maternal perception regarding her adolescent's weight status, (b) the degree of maternal concern about her adolescent's weight status, and (c) the predictors of maternal misclassification of adolescent overweight as average weight. A secondary analysis of the longitudinal Nepean Study data was conducted. Participants were Australian, free-living 13-year-olds in 2002-2003 (n=347) followed up at age 15 years (n=279) and their mothers. Participants' body mass index (BMI) status (overweight, normal, or underweight) was calculated from measured height and weight. Maternal perceptions and concerns about adolescent's weight status were determined by items adapted from the Child Feeding Questionnaire. Sex-adjusted binary logistic regression models assessed potential predictors of maternal misclassification of adolescent overweight. Data were available on 224 adolescent-mother dyads. Approximately one fourth of mothers misclassified their adolescent's weight status, but this varied across groups (age 13 years [%]; age 15 years [%], respectively) underweight (75%; 70%), overweight (54%; 59%), and normal weight (12%; 9%). The endpoint data show that between 13 and 15 years of age, maternal concern regarding their adolescent's weight decreased in all weight-status groups. Predictors of maternal misclassification of adolescent overweight were adolescent BMI z score, recent weight-management practices, weight history, sex, and maternal concern regarding her adolescent's weight. These results reinforce the need for strategies in primary care that are implemented throughout adolescence to improve maternal awareness of childhood overweight.


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        • Ogden C.L.
        • Carroll M.D.
        • Kit B.K.
        • Flegal K.M.
        Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010.
        JAMA. 2012; 307: 483-490
        • Garnett S.P.
        • Baur L.A.
        • Cowell C.T.
        The prevalence of increased central adiposity in Australian school children 1985 to 2007.
        Obes Rev. 2011; 12: 887-896
        • Reilly J.J.
        • Methven E.
        • McDowell Z.C.
        • et al.
        Health consequences of obesity.
        Arch Dis Child. 2003; 88: 748-752
        • Doolen J.
        • Alpert P.T.
        • Miller S.K.
        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
        • Towns N.
        • D'Auria J.
        Parental perceptions of their child's overweight: An integrative review of the literature.
        J Pediatr Nurs. 2009; 24: 115-130
        • Eckstein K.C.
        • Mikhail L.M.
        • Ariza A.J.
        • Thomson J.S.
        • Millard S.C.
        • Binns H.J.
        Parents' perceptions of their child's weight and health.
        Pediatrics. 2006; 117: 681-690
        • Boa-Sorte N.
        • Neri L.A.
        • Leite M.E.
        • et al.
        Maternal perceptions and self-perception of the nutritional status of children and adolescents from private schools.
        J Pediatr (Rio J). 2007; 83: 349-356
        • Akerman A.
        • Williams M.E.
        • Meunier J.
        Perception versus reality: An exploration of children's measured body mass in relation to caregivers' estimates.
        J Health Psychol. 2007; 12: 871-882
        • MacFarlane A.
        • Crawford D.
        • Worsley A.
        Associations between parental concern for adolescent weight and the home food environment and dietary intake.
        J Nutr Educ Behav. 2010; 42: 152-160
        • Field A.E.
        • Austin S.B.
        • Striegel-Moore R.
        • et al.
        Weight concerns and weight control behaviors of adolescents and their mothers.
        Arch Pediatr Adolesc Med. 2005; 159: 1121-1126
        • Boutelle K.
        • Fulkerson J.A.
        • Neumark-Sztainer D.
        • Story M.
        Mothers' perceptions of their adolescents' weight status: Are they accurate?.
        Obes Res. 2004; 12: 1754-1757
        • Mamun A.A.
        • McDermott B.M.
        • O'Callaghan M.J.
        • Najman J.M.
        • Williams G.M.
        Predictors of maternal misclassifications of their offspring's weight status: A longitudinal study.
        Int J Obes (Lond). 2008; 32: 48-54
        • Goodman E.
        • Hinden B.R.
        • Khandelwal S.
        Accuracy of teen and parental reports of obesity and body mass index.
        Pediatrics. 2000; 106: 52-58
        • Fay R.A.
        • Dey P.L.
        • Saadie C.M.
        • Buhl J.A.
        • Gebski V.J.
        Ponderal index: A better definition of the 'at risk' group with intrauterine growth problems than birth-weight for gestational age in term infants.
        Aust N Z J Obstet Gynaecol. 1991; 31: 17-19
        • Garnett S.P.
        • Baur L.A.
        • Srinivasan S.
        • Lee J.W.
        • Cowell C.T.
        Body mass index and waist circumference in midchildhood and adverse cardiovascular disease risk clustering in adolescence.
        Am J Clin Nutr. 2007; 86: 549-555
        • Garnett S.P.
        • Cowell C.T.
        • Baur L.A.
        • et al.
        Abdominal fat and birth size in healthy prepubertal children.
        Int J Obes Relat Metab Disord. 2001; 25: 1667-1673
        • Garnett S.P.
        • Cowell C.T.
        • Baur L.A.
        • et al.
        Increasing central adiposity: The Nepean longitudinal study of young people aged 7-8 to 12-13 y.
        Int J Obesity (Lond). 2005; 29: 1353-1360
        • Birch L.L.
        • Fisher J.O.
        • Grimm-Thomas K.
        • Markey C.N.
        • Sawyer R.
        • Johnson S.L.
        Confirmatory factor analysis of the Child Feeding Questionnaire: A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness.
        Appetite. 2001; 36: 201-210
        • Norton K.
        • Whittingham N.
        • Carter L.
        • Kerr D.
        • Gore C.
        • Marfell-Jones M.
        Measurement techniques in anthropometry.
        in: Norton K. Olds T. Anthropometrica. University of NSW Press, Sydney, Australia1996
        • Cole T.J.
        Software for LMS method.
        (Accessed: January 22, 2012)
        • Cole T.J.
        • Flegal K.M.
        • Nicholls D.
        • Jackson A.A.
        Body mass index cut offs to define thinness in children and adolescents: International survey.
        BMJ. 2007; 335: 194
        • Cole T.J.
        • Bellizzi M.C.
        • Flegal K.M.
        • Dietz W.H.
        Establishing a standard definition for child overweight and obesity worldwide: International survey.
        BMJ. 2000; 320: 1240-1243
      1. Obesity: Preventing and managing the global epidemic.
        Report of a WHO Consultation on Obesity. World Health Organization, Geneva, Switzerland1998
        • Duke P.M.
        • Litt I.F.
        • Gross R.T.
        Adolescents self-assessment of sexual maturation.
        Pediatrics. 1980; 66: 918-920
        • Tam C.S.
        • de Zegher F.
        • Garnett S.P.
        • Baur L.A.
        • Cowell C.T.
        Opposing influences of prenatal and postnatal growth on the timing of menarche.
        J Clin Endocrinol Metab. 2006; 91: 4369-4373
        • Centers for Disease Control and Prevention
        Youth Risk Behavior Survey Results—United States High School Survey Codebook.
        (Accessed: January 22, 2012)
        • Commonwealth of Australia
        2007 Australian National Children's Nutrition and Physical Activity Survey—Main Findings.
        (Accessed April 6, 2012)
        • Neumark-Sztainer D.
        • Wall M.
        • Story M.
        • van den Berg P.
        Accurate parental classification of overweight adolescents' weight status: Does it matter?.
        Pediatrics. 2008; 121: e1495-e1502
        • Dorn L.D.
        • Dahl R.E.
        • Woodward H.R.
        • Biro F.
        Defining the boundaries of early adolescence: A user's guide to assessing pubertal status and pubertal timing in research with adolescents.
        Applied Developmental Science. 2006; 10: 30-56


      V. A. Shrewsbury is a research officer, Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; at the time of the study, she was a PhD student, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia.


      S. P. Garnett is a senior research fellow and a senior lecturer, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia, at the Institute of Endocrinology and Diabetes, and at the Kids Research Institute, The Children's Hospital at Westmead, Sydney, Australia.


      K. Campbell is a senior lecturer, Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia.


      A. Carver is a research fellow, Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia.


      S. Torvaldsen is senior lecturer and academic program codirector, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.


      K. S. Steinbeck is professor and chair in Adolescent Medicine, University of Sydney, Australia.


      C. T. Cowell is a professor, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia, and acting director of research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, Australia.


      L. A. Baur is a professor and director of Weight Management Services, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia.