Prospective BMI changes in preschool children are associated with parental characteristics and body weight perceptions: the ToyBox-study.

Yannis Manios, Katrina A Lambert, Eva Karaglani, Christina Mavrogianni, Luis A Moreno Aznar, Violeta Iotova, Anna Świąder-Leśniak, Berthold Koletzko, Greet Cardon, Odysseas Androutsos, George Moschonis

Journal: Public health nutrition 2022;25(6):1552-1562

PMID: 33843562

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Abstract

OBJECTIVE

To examine the effect of the intervention implemented in the ToyBox-study on changes observed in age- and sex-specific BMI percentile and investigate the role of perinatal factors, parental perceptions and characteristics on this change.

DESIGN

A multicomponent, kindergarten-based, family-involved intervention with a cluster-randomised design. A standardised protocol was used to measure children's body weight and height. Information was also collected from parents/caregivers via the use of validated questionnaires. Linear mixed effect models with random intercept for country, socio-economic status and school were used.

SETTING

Selected preschools within the provinces of Oost-Flanders and West-Flanders (Belgium), Varna (Bulgaria), Bavaria (Germany), Attica (Greece), Mazowieckie (Poland) and Zaragoza (Spain).

PARTICIPANTS

A sample of 6268 preschoolers aged 3·5-5·5 years (51·9 % boys).

RESULTS

There was no intervention effect on the change in children's BMI percentile. However, parents' underestimation of their children's actual weight status, parental overweight and mothers' pre-pregnancy overweight/obesity were found to be significantly and independently associated with increases in children's BMI percentile in multivariate modelling.

CONCLUSIONS

As part of a wide public health initiative or as part of a counseling intervention programme, it is important to assist parents/caregivers to correctly perceive their own and their children's weight status. Recognition of excessive weight by parents/caregivers can increase their readiness to change and as such facilitate higher adherence to favourable behavioural changes within the family.

Address: Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Avenue, Kallithea 17671, Athens, Greece.; Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.; GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, C/Corona de Aragon, Zaragoza, Spain.; School of Health Science (EUCS), University of Zaragoza, C/Domingo Miral s/n, Zaragoza, Spain.; Department of Pediatrics, Medical University Varna, Varna, Bulgaria.; The Children's Memorial Health Institute, Warsaw, Poland.; Ludwig-Maximilians-Universität Munich, Dr von Hauner Children's Hospital, University of Munich Medical Centre, Munich, Germany.; Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, Ghent, Belgium.; Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Volos, Greece.; Department of Dietetics, Nutrition and Sport, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.

DOI: 10.1017/S1368980021001518

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MeSH Terms: Body Mass Index, Body Weight, Child, Preschool, Female, Humans, Male, Overweight, Parents, Pediatric Obesity, Pregnancy, Prospective Studies, Weight Perception