Underestimation of overweight weight status in children and adolescents aged 0‐19 years: A systematic review and meta‐analysis

Abbott et al.16

Australia

Q1 “how would you describe your child’s current body weight?”

A1 “too thin,” “About right,” “Too fat”

OWOB 24%

Parents-verbal 60%

Children-verbal 36%

4–8 years

Native American

366 participants

Mothers, grandmothers, fathers, and other guardians

OW 26%

Parents-verbal 85%

Child's BMI,

Grandmother as caregiver

6–14 years, Caucasians, Hispanics, African americans

1205 participants,

Mothers, fathers, and other legal guardians

AROW 17%

OW 25%

Parents-verbal 61%

6–19 years

NA

1440 participants

Mothers

Q1 “do you think that your child’s weight is”

A1“Underweight,” “normal,” or “overweight?”

OW 14.7%

OB 18.9%

Parents-verbal 27%

6–10 years

NA

601 participants

NA

Al-Qaoud et al.21

Kuwait

3–6 years

NA

2329 participants

Mothers

4–7–9 years

American Indian

124 participants

Mothers, grandmothers, fathers/step fathers, and other

Q1 “how would you describe your kindergarten child’s weight?”

A1 “very underweight,” “slightly underweight,” “about the right weight,” “slightly overweight,” and “very overweight”

29% OWOB

Parents-verbal 33%

2–5 years

Hispanic-white, non-hispanic black, hispanic-black, Asian or Pacific Islander and other

622 participants

Mothers

Q1 “I feel my child is”

A1 “very under-weight,” “a little underweight,” “about the right weight,” “a little overweight,” or “very overweight”

OW 16%

Parents-verbal 79%

Bossink-Tuna et al.24

Netherlands

2–4 years

Urban and rural

682 participants

Mothers and fathers

Q1 “I am worried my child is overweight right now”

Q2 “In comparison with other children his/her age’ with regard to weight”

A1 “dis-agree a lot,” “disagree a little,” “no strong feelings either way,” “agree a little,” and agree a lot”

A2 “much thinner” to “much more overweight”

OW 7.2%

Parents-verbal 62%

14 years

White, black, Asian, Hispanic, and other mixed

755 participants

Mothers

Q1 how they would describe their adolescent’s current weight?

A1 “very underweight,” “somewhat underweight,” “about right,” “somewhat overweight,” or “very overweight”

OW 16.5%

AROW 19.9%

Parents-verbal 70%

8–10 years

Caucasian

49 participants

Mothers and fathers

Q1 adolescent were instructed to choose a picture from the figure drawings, resembling their present size and the size that they desire to be

A1 Collins’ Figure Drawings (CFD)99

Q2 parents were asked to rate their child’s ‘present’ body size, using Collins’ Figure Drawings (CFD)99

Q1 5-point liker scale was used when extracting information from parents about their child’s size

A1 “too skinny,” “thin,” “just right,” “somewhat overweight,” and “overweight.”

OWOB 30.3%

Parents-verbal 20%

Campbell et al.28

Australia

4 years

945 participants

Mother and fathers

Q1 “I am worried my child is overweight right now”

Q2 “In comparison with other children his/her age’ with regard to weight”

A1 “dis-agree a lot,” “disagree a little,” “no strong feelings either way,” “agree a little,” and “agree a lot.”

A2 “much thinner” to “much more overweight”

OW 17%

OB 3%

Parents-verbal 90%

Carnell et al.29

England

5–3 years

NA

564 participants

Mothers

Q1 “how would you describe your child’s weight at the moment?”

A1 “very underweight,” “underweight,” “normal,” “overweight” or “very overweight”

OW 26.9%

OB 8%

Parents-verbal 81%

Chaimovitz et al.9

Canada

Q1 selecting a picture or using words.

Physicians also followed the same procedure for categorising the body size of each patient

A1 “underweight,” “slightly underweight,” “average,” “slightly overweight,” and “overweight”

2–5 years

NA

1702 participants

Mothers

PHFE (public health Foundation Enterprises), then the special supplemental nutrition program for women, children (PHFE to WIC) and infants; taken via a computer aided telephone interviewing procedure

Q1 mothers were asked “do you consider your child to be”

A1 “overweight,” “underweight” or “about right weight for (his) (her) height?”

OW 15.0%

OB 17.0%

Parents-verbal 90%

Q1 mothers were asked “do you consider your child to be

A1 “overweight, underweight or about right weight for (his) (her) height?”

17.4% OW 19.8% OB

Parents-verbal 25%

Children -verbal 27%

Crawford et al.32

Australia

Q1 centred around five choices, parents were instructed to categorize their child’s weight during the investigation

A1 “markedly underweight”; “underweight”; “average,” “overweight”; “markedly overweight.”

de Hoog et al.33

Netherlands

Q1 “I feel my child’s weight is”

A1 “much too low, too low, normal, too high or much too high.”

Maternal educational,

Immigrant generation

5–12 years

10–12 years

Non-hispanic and white

576 participants

Mothers or fathers

Q1 parents were asked to report their child’s weight

A1 “extremely overweight,” “somewhat overweight,” “about right,” “somewhat underweight,” or “extremely underweight”

OWOB 16%

Parents-verbal 75%

12–36 months

NA

135 participants

Mothers and fathers

AROW 23.7%

OW 9.7%

Parents-visual 61%

Q1 “I feel my child is”

Q2 “did your child’s doctor ever tell you that your child is gaining weight too fast or is overweight?”

Q3 We also sked the participants to mark the drawing that looked the most like their child

A1 “underweight,” “a little underweight,” “about the right weight,” “a little overweight,” or “overweight”

A2 “yes,” “no,” or “I don’t know”

A3 Collins’ Figure Drawings (CFD)99

5–3 years

Caucasian

56 participants

NA

Q1 “what do you think about your child’s (or grandchild’s weight)?”

Q2 In comparison to the child’s siblings, cousins and other children

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