Food Insecurity Associated With Underestimation of Weight Status in Children With a Healthy Weight.

OBJECTIVE: Accurate parental weight perception of one's child is an important step in addressing healthy behaviors, but its associations with socioeconomic status (SES) and household food insecurity (HFI) are unclear. We aimed to assess the association of parental weight perception with HFI. METHODS: This was a secondary data analysis of a cross-sectional study of 284 children ages 2 to 8 years whose parents completed surveys about weight perception, SES, and HFI. Height and weight were measured to determine the children's body mass index scores and were self-reported by parents. We performed chi-square tests to compare HFI and accuracy of parental weight perception and used logistic regression to assess accuracy, adjusting for significant covariates and stratifying by child weight category. RESULTS: Approximately two thirds of children had healthy weight, 18% had overweight, and 15% had obesity. About one third of parents inaccurately identified their child's weight category, almost always underestimating weight status. Twenty-eight percent of the families were food insecure. HFI was not associated with parental weight perception in bivariate analysis. When stratified by weight status, food insecure families with children at healthy weight had 0.16 times the odds of accurately perceiving their children's weight status. There was no association between HFI and accuracy of weight perception in children with overweight or obesity. CONCLUSIONS: Food insecurity was associated with a decrease in the accuracy of parental weight perceptions in children with healthy weight. Pediatricians should clearly communicate about weight status, as families with HFI may adopt unhealthy eating behaviors under the incorrect assumption that their child is underweight.

Duke Scholars

Author Eliana Miller Perrin Pediatrics, General Pediatrics and Adolescent Health