Self-reported and parent-reported body size perception of Dutch children at the age of 11 and 14.

Abstract

Background: Accurate body size perceptions may help decreasing childhood overweight, however children and parents are poor in estimating BMI. Aims:To investigate if the questions: ‘Would you describe yourself/your child as slim/skinny?’ and ‘Would you describe yourself/your child as heavy/chubby?’ can be used to identify underweight and overweight children. Additionally, age and gender differences are investigated and whether children and parents gave identical answers. Method: In the Prevention and Incidence of Asthma and Mite Allergy (PIAMA-)cohort, children and their parents received questionnaires when the child was 11 (n=2379) and 14 (n=2164). Children were classified into underweight, normal-weight and overweight/obesity (using parent-reported height/weight). Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of the questions were assessed. Age and gender differences were evaluated and agreement between children and parents was calculated. Results: For the question ‘Would you describe yourself/your child as slim/skinny?’ sensitivity was moderate in parents of 11-year-old boys (71.7%), poor in 11-year-old girls (47.7%) and low in the rest (51.7%-67.4%). Specificity was good (82.0%-87.3%), but excellent in girls’ parents (91.3%-93.2%). PPVs were low in girls’ parents (54.5%-55.1%), poor in boys’ parents and children (34.7%-40.3%). For the question ‘Would you describe yourself/your child as heavy/chubby?’ sensitivity was low in boys and parents (53.8%-66.1%), but moderate in girls (70.2%-78.6%). Specificity was good in girls (84.6%-88.6%) and excellent in boys and parents (93.4%-97.8%). PPVs were poor in girls (27.0%-38.2%), moderate in parents of 14-year-old boys (72.8%), low in boys and in girls’ parents (50.4%-60.8%). All NPVs were excellent (89.9%-98.2%). Agreement was better between boys (κ=0.504-0.658), than between girls (κ=0.373-0.541) and their parents. Conclusion: The questions cannot be used for identifying underweight or overweight children. Agreement between children and their parents was moderate/good. Yet, parents are more accurate. Implications: Dutch children and their parents need assistance for accurate body size perceptions.