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

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.

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

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Publication Type : Randomized Controlled Trial

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