title: Large proportions of overweight and obese children, as well as their parents, underestimate children's weight status across Europe. The ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project.
abstract: OBJECTIVE
  To investigate the magnitude and country-specific differences in underestimation of children's weight status by children and their parents in Europe and to further explore its associations with family characteristics and sociodemographic factors.
  
  
  METHODS
  Children's weight and height were objectively measured. Parental anthropometric and sociodemographic data were self-reported. Children and their parents were asked to comment on children's weight status based on five-point Likert-type scales, ranging from 'I am much too thin' to 'I am much too fat' (children) and 'My child's weight is way too little' to 'My child's weight is way too much' (parents). These data were combined with children's actual weight status, in order to assess underestimation of children's weight status by children themselves and by their parents, respectively. Chi-square tests and multilevel logistic regression analyses were conducted to examine the aims of the current study.
  
  
  METHODS
  Eight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project.
  
  
  METHODS
  A school-based survey among 6113 children aged 10-12 years and their parents.
  
  
  RESULTS
  In the total sample, 42·9 % of overweight/obese children and 27·6 % of parents of overweight/obese children underestimated their and their children's weight status, respectively. A higher likelihood for this underestimation of weight status by children and their parents was observed in Eastern and Southern compared with Central/Northern countries. Overweight or obese parents (OR=1·81; 95 % CI 1·39, 2·35 and OR=1·78, 95 % CI 1·22, 2·60), parents of boys (OR=1·32; 95 % CI 1·05, 1·67) and children from overweight/obese (OR=1·60; 95 % CI 1·29, 1·98 and OR=1·76; 95 % CI 1·29, 2·41) or unemployed parents (OR=1·53; 95 % CI 1·22, 1·92) were more likely to underestimate children's weight status.
  
  
  CONCLUSIONS
  Children of overweight or obese parents, those from Eastern and Southern Europe, boys, younger children and children with unemployed parents were more likely to underestimate their actual weight status. Overweight or obese parents and parents of boys were more likely to underestimate the actual weight status of their children. In obesity prevention such underestimation may be a barrier for behavioural change.
authors: 1Department of Nutrition and Dietetics,Harokopio University,70 El Venizelou Avenue,17671 Kallithea,Athens,Greece.
authors: Yannis
authors: Y
authors: Manios
authors: 1Department of Nutrition and Dietetics,Harokopio University,70 El Venizelou Avenue,17671 Kallithea,Athens,Greece.
authors: George
authors: G
authors: Moschonis
authors: 1Department of Nutrition and Dietetics,Harokopio University,70 El Venizelou Avenue,17671 Kallithea,Athens,Greece.
authors: Kalliopi
authors: K
authors: Karatzi
authors: 1Department of Nutrition and Dietetics,Harokopio University,70 El Venizelou Avenue,17671 Kallithea,Athens,Greece.
authors: Odysseas
authors: O
authors: Androutsos
authors: 2Department of Public and Occupational Health and EMGO Institute for Health and Care Research,VU University Medical Center,Amsterdam,The Netherlands.
authors: Mai
authors: M
authors: Chinapaw
authors: 3GENUD (Growth,Exercise,Nutrition and Development) Research Group,EU Ciencias de la Salud,Universidad de Zaragoza,Zaragoza,Spain.
authors: Luis A
authors: LA
authors: Moreno
authors: 4Department of Public Health,Sport and Nutrition,University of Agder,Kristiansand,Norway.
authors: Elling
authors: E
authors: Bere
authors: 5Department of Paediatrics,University of Pecs,Pecs,Hungary.
authors: Denes
authors: D
authors: Molnar
authors: 6Slovenian Heart Foundation,Ljubljana,Slovenia.
authors: Natasha
authors: N
authors: Jan
authors: 7Swiss Federal Institute of Sport,Magglingen,Switzerland.
authors: Alain
authors: A
authors: Dössegger
authors: 8Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences,Ghent University,Ghent,Belgium.
authors: Ilse
authors: I
authors: De Bourdeaudhuij
authors: 9Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research,VU University Medical Center,Amsterdam,The Netherlands.
authors: Amika
authors: A
authors: Singh
authors: 9Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research,VU University Medical Center,Amsterdam,The Netherlands.
authors: Johannes
authors: J
authors: Brug
mesh_terms: D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D002149:Energy Intake; D004734:Energy Metabolism; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control; D050177:Overweight / Q000453:epidemiology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D015430:Weight Gain
keywords: Childhood obesity; Perceptions of weight status; Weight status underestimation
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