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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 5  |  Issue : 2  |  Page : 85-90

Parental perception and knowledge about ideal weight among preschool-aged children in Abha city, southwestern Saudi Arabia


1 Department of Child Health, College of Medicine, King Khalid University, Kingdom of Saudi Arabia
2 Medical Student, College of Medicine, King Khalid University, Kingdom of Saudi Arabia
3 Abha Maternity and Children Hospital, Abha, Kingdom of Saudi Arabia
4 South Dahran General Hospital, Kingdom of Saudi Arabia
5 Tanuma General Hospital, Aseer Region, Kingdom of Saudi Arabia
6 King Fahad Armed Forced Hospital, Khamis Mushait, Kingdom of Saudi Arabia
7 Department of Community Medicine, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia

Date of Web Publication29-Dec-2017

Correspondence Address:
Abdullah S Alqahtani
Department of Child Health, College of Medicine, King Khalid University, P.O. Box: 960, Abha 61421
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjo.sjo_18_17

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  Abstract 


Background: Obesity among children is becoming a major health problem in the Kingdom of Saudi Arabia. Little is known regarding parents’ perception about ideal weight among preschool children in Abha city, Saudi Arabia.
Objectives: To assess parents’ perception regarding ideal weight for their preschool children and to evaluate their awareness about childhood obesity.
Materials and Methods: This cross-sectional study targeted the parents of healthy children attending primary healthcare centers (PHCCs) in Abha city, Kingdom of Saudi Arabia. The study was conducted in five PHCCs. All parents who had a child aged 12–72 months were included. The parents were interviewed through a structured questionnaire. The questionnaire included 32 questions about demographic data, perception and knowledge about ideal weight, preferred weight for children, and child’s nutrition and lifestyle. Saudi body mass index chart was used to classify the children as ideal, overweight, or failure to thrive.
Results: The study included 385 parents and their healthy children aged 12–70 months. The overall percentage of overweight children amounted to 8.6%. It was found that 57.6% of the parents of overweight children perceived the weight of their children to be ideal. On the other hand, 42.2% (141) of the parents of ideal weight children thought that the weight of their children was low, when it was ideal. However, 90.9% of the parents among the children with obesity and 85.5% of the parents among the children with ideal weight preferred their children to have ideal weight. The difference was not statically significant (P = 0.535). Among overweight children, 6.1% of their parents preferred their children to have an increase in their weight. Similarly, among ideal weight children, about 15.1% of the parents preferred an increase in their child’s weight.
Conclusion: The majority of parents preferred their children to have ideal weight. There is a need to start a major campaign to educate parents regarding the ideal weight for children and obesity.

Keywords: Awareness, children, obesity, overweight, parents, perception


How to cite this article:
Al-Qahtani SM, Alsultan BS, Awdah NA, Alshehri MA, Alqahtani AS, Al Assiri KM, Bosily MJ, Jalfan AM, Mahfouz AA. Parental perception and knowledge about ideal weight among preschool-aged children in Abha city, southwestern Saudi Arabia . Saudi J Obesity 2017;5:85-90

How to cite this URL:
Al-Qahtani SM, Alsultan BS, Awdah NA, Alshehri MA, Alqahtani AS, Al Assiri KM, Bosily MJ, Jalfan AM, Mahfouz AA. Parental perception and knowledge about ideal weight among preschool-aged children in Abha city, southwestern Saudi Arabia . Saudi J Obesity [serial online] 2017 [cited 2018 Dec 13];5:85-90. Available from: http://www.saudijobesity.com/text.asp?2017/5/2/85/221989




  Introduction Top


The epidemic of obesity in children has become one of the main concerns in developed and developing countries.[1] Most parents consider overweight as a sign of health. Moreover, parents might not be satisfied with their child’s weight and try to increase her/his weight by overfeeding. Excessive weight during childhood results from several interacting factors including poor diet and exercise habits. Dietary preferences and physical activity patterns are probably shaped early in childhood influenced by parental practices and familial environment.[2],[3] The prevalence of overweight [body mass index (BMI) of 85th to 95th percentile] and obesity (BMI > 95th percentile) among preschool children in Saudi Arabia were about 15 and 6%, respectively.[4] Childhood obesity is related to some chronic diseases in adulthood such as hypertension, diabetes mellitus, and cardiovascular disease.[1],[5] Worldwide, complex interactions among genetics, sedentary lifestyle, poor nutrition, and psychosocial and environmental factors are essential for inducing excess body weight among children.[4],[6],[7]

Parents do not typically consult growth charts to determine whether a child is overweight. Instead, they compare the child to others in the same age or notice when a child becomes inactive or suffers from teasing by other children. Parents may tend to define obesity as a condition accompanied by severe physical impairment especially compromised mobility. They may also believe that a child’s size is inherited and that the child will eventually shed excess weight with age.[8]

Data regarding parental perception of their child’s ideal weight in Abha city are scarce and even lacking. The purpose of this study was to evaluate parents’ perception regarding the weight status of their children and correlate it with the actual weight.


  Materials and methods Top


This study used a cross-sectional survey to evaluate parental perception on child weight and the prevailing parental perceptions regarding child weight. Seven primary healthcare centers (PHCCs) in Abha city were selected as the study setting, and data were collected. Participants who met the following criterion were invited to participate in the study: the parents of a preschool child aged 12–72 months. These parents constituted the target population for the study. An Arabic language questionnaire with 32 questions was utilized for data collection. The questionnaire included an informed consent containing the objective of the study and the confidentiality relevant information from each parent. Using World Health Organization manual for sample size determination in health studies[9] with a conservative anticipated population proportion of 50% and with an absolute precision of 1% at 95% confidence interval, the minimal sample size required for the study was calculated to be 385 cases.

The anthropometric data of children including height and weight were measured by the nurse designated for children attending the well-baby clinic. Child’s BMI according to BMI-for-age growth chart with percentile rankings were plotted. Underweight children were those with ranking less than 5th percentile; ideal weight children were those with a ranking of 5th percentile to less than the 85th percentile; overweight children were those with ranking from 85th to less than the 95th percentile; and obese children were those with ranking equal to or greater than the 95th percentile.[10]

This study was approved by the King Khalid University ethical committee. Data were collected during August–September 2016. The data were collected and verified by hand, and coded before entry. Statistical Package for the Social Sciences version 22 software (SPSS Inc., Chicago, IL, United States) was used for data entry and analysis.


  Results Top


The study included 385 parents, with 128 (32.2%) fathers and 257 (66.8%) mothers. Giving a response rate of 98%. The age of the children ranged between 12 and 70 months with a mean of 35.8 months and a standard deviation of ±17.3 months. Most of the children (72.5%) were over 2 years. More than half of the children (55.1%) were males. Approximately half of the parents (43.7%) were at least university graduated, whereas 5.7% of the parents were illiterates. Income ranged between 5001 and 10,000 SR/month among 35.1% of the parents, and it was 5000 SR/month or less among 33.5% of the parents [Table 1].
Table 1: Baseline characteristics of the participants and their children (n = 385)

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More than half of the parents (54.5%) thought that they are overweight, and only 21.6% of them knew their BMI. More than sixty percent (61%) of the parents reported trials to lose weight mainly through dieting (52.7%) followed by exercise (39.6%) [Table 2].
Table 2: Parental perception about obesity (n = 385)

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Regarding parental perception of their own child’s weight, 54.3% perceived their children as having ideal weight, whereas 41% perceived their children as underweight; and only 4.7% of the parents considered their children as overweight. The parents depended mainly on body shape for determining their child’s ideal weight (58.2%). About 29% of the parents claimed that they knew the ideal weight for their children. Their main sources of information regarding the ideal weight were physicians (40.8%) and the Internet (21.6%) [Table 2].

The majority of the parents preferred their children to have ideal weight (86.2%); however, 12.8% of the parents preferred overweight children. About one-quarter of the parents (24.7%) reported that their children had ideal weight, but they preferred to increase their body weight. Less than one third (32%) of the parents considered childhood obesity as a risk factor for adult obesity [Table 2].

[Figure 1] presents the actual weight of children in comparison to the parent’s perception of their child’s weight. It is obvious that majority of the children (87%) were normal, whereas 8.6% were overweight or obese and 4.4% were underweight. There was a significant difference between parental perception of their children’s weight and their actual weight (P < 0.001). For example, 57.6% of the overweight/obese children were perceived as ideal, and 42.1% of the normal children were perceived as underweight by their parents [Figure 2]. The accurate perception of ideal weight was 88.5% (185/209); for underweight, it was 6.3% (10/158); and for overweight, it was 38.9% (7/18) [Table 3].
Figure 1: Distribution of the children according to their body mass index

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Figure 2: Parental perception regarding their child’s weight versus their child’s actual weight

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Table 3: Association between parents’ perception to their child’s weight and the child’s actual weight

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The majority of overweight/obese children (90.9%) belonged to parents who preferred ideal weight for their children. In addition, 82.4% of underweight children belonged to parents who preferred ideal weight for their children. Among overweight children, 6.1% (2/33) of their parents preferred to increase the weight of their children; on the other hand, among ideal weight children, more parents (15.1%; 44/335) preferred to increase their children’s weight [Table 4].
Table 4: Association between parents’ preference weight for their child and the child’s actual weight

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  Discussion Top


This study showed that most parents did not know the ideal weight for their children. The majority of the parents of overweight or obese children were unaware that their children were overweight, while 42.2% (141) of the parents of ideal weight children thought that their children were under weight. This study showed that most of the parents preferred ideal weight for their children. Three similar studies were identified for comparison. Jackson et al. reported that 6% of mothers with an overweight preschool-aged child believed that her child was overweight.[11] Baughcum et al. reported that only 20% of mothers correctly identified their overweight children as overweight.[12] Carnell et al. found that only 6% of parents described their overweight children as “overweight.”[13]

In this study, almost half of the parents perceived their children as having ideal weight. In one study conducted in the United States, most parents perceived their infants as having healthy weight, regardless of their child’s actual weight. However, they focused their study on children during the first year of life compared to children aged 2–5 years in our study.[14]

The difference between the parent’s perception of their child’s weight and the child’s actual weight is apparent in this study, 57.6% of the overweight/obese children were perceived as having ideal weight by their parents, while 42.1% of the normal children were perceived as underweight. The accurate perceptions of ideal weight, underweight, and overweight were 88.5, 6.3, and 38.9%, respectively. This finding concurs with what has been reported by Brown et al.,[14] who concluded that the parents of healthy weight children were more likely to have an accurate perception of their child’s weight (accuracy 89%) rather than the parents of a child who was overweight (accuracy only 26%).

The parental perception of a child’s overweight status is essential for adhering to dietary and physical activity recommendations early in life.[15],[16],[17] This study has shown that most parents of overweight children do not have an accurate perception of their child’s weight status and that many parents of ideal weight children believe their child to be underweight.

Parents in this study depended mainly on body shape for their perception of their child’s weight. Therefore, it is necessary to develop new culturally sensitive models for referring to the child’s weight status in our community. Additionally, we need to start a major campaign to educate parents about ideal weight and the risks of obesity and its prevention among children.

This study has some limitations that should be mentioned. It is cross-sectional design makes difficulty drawing causation. Child’s weight was categorized into three categories corresponding to the three categories that were used to ascertain the parental perceptions regarding their child’s weight. This categorization could be difficult to parents, because there might be children at the upper end of healthy weight (e.g., 83rd percentile) who were described by their parents as overweight. Such a description would be considered a misperception in this study. Generalization the results of this study should be addressed cautiously as it targeted parents attending urban PHCCs in Abha City, KSA. Despite these limitations, this study discusses important health topic in Saudi community.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Jackson J, Strauss CC, Lee AA, Hunter K. Parents’ accuracy in estimating child weight status. Addict Behav 1990;15:65-8.  Back to cited text no. 11
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Baughcum AE, Chamberlin LA, Deeks CM, Powers SW, Robert C, Whitaker RC. Maternal perceptions of overweight preschool children. Pediatrics 2000;106:1380-6.  Back to cited text no. 12
    
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Carnell S, Edwards C, Croker H, Boniface D, Wardle J. Parental perceptions of overweight in 3–5 y olds. Int J Obes 2005;29:353-5.  Back to cited text no. 13
    
14.
Brown CL, Skinner AC, Yin HS, Rothman RL, Sanders LM, Delamater AM et al. Parental perceptions of weight during the first year of life. Acad Pediatr 2016;16:558-64.  Back to cited text no. 14
    
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Rhee KE, Lumeng JC, Appugliese DP, Kaciroti N, Bradley RH. Parenting styles and overweight status in first grade. Pediatrics 2006;117:2047-54.  Back to cited text no. 17
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