Children's Nutrition Research Centre, School of Medicine, The University of Queensland, Herston, Brisbane, Queensland 4029, Australia.
Public Health Nutr. 2013 Feb;16(2):274-80. doi: 10.1017/S1368980012002972. Epub 2012 Jul 2.
To investigate which anthropometric measure of overweight status, BMI or waist-to-height ratio (WHtR), is most closely associated with parents' perception of their child's overweight status.
The sensitivity and specificity of parental perception against child-specific BMI and WHtR definitions of overweight were tested.
Primary schools in Queensland, Australia.
Boys and girls aged 9·00-11·99 years (n 1431).
Of the 138 boys and 202 girls who were classified as overweight according to BMI, only 27·5 % (boys) and 22·7 % (girls) were also perceived as overweight by their parents. Using WHtR, 206 boys and 333 girls were classified as overweight, of whom only 21·9 % and 13·8 %, respectively, were perceived as overweight. Perception of overweight was underestimated in approximately 15 % of boys and 21 % of girls when compared with BMI. Underestimation was higher when compared with WHtR: 25 % (boys) and 39 % (girls). Overweight prevalence was significantly lower according to perception than according to BMI or WHtR. Mother's education level was significantly associated with accurate perception of overweight status (P < 0·001).
The sensitivity of parental perception of child overweight was higher when BMI was used. However, emphasis needs to be placed on using WHtR as an actual measure of overweight because high central adiposity is associated with increased risk of CVD. The combined use of WHtR, body-shape images rather than word responses regarding perception and public health messages that educate parents and children about body shape and associated health risks may be the best combination in improving parents' perception of their child's overweight status.
研究超重状态的人体测量指标，即 BMI 或腰高比（WHtR），与父母对子女超重状况的认知最为密切相关。
测试了父母对儿童 BMI 和 WHtR 超重定义的感知的敏感性和特异性。
澳大利亚昆士兰州的小学。
年龄在 9.00-11.99 岁的男孩和女孩（n=1431）。
根据 BMI 分类为超重的 138 名男孩和 202 名女孩中，只有 27.5%（男孩）和 22.7%（女孩）被父母认为超重。使用 WHtR，206 名男孩和 333 名女孩被归类为超重，其中只有 21.9%和 13.8%的人被父母认为超重。与 BMI 相比，大约有 15%的男孩和 21%的女孩对超重的认知被低估了。与 WHtR 相比，低估程度更高：男孩为 25%，女孩为 39%。根据认知判断，超重的流行率明显低于 BMI 或 WHtR。母亲的教育水平与准确认知超重状况显著相关（P<0.001）。
当使用 BMI 时，父母对子女超重的认知敏感性更高。然而，需要强调的是，应该将 WHtR 作为超重的实际衡量标准，因为中心性肥胖与 CVD 风险增加有关。综合使用 WHtR、身体形状图像而不是关于感知的文字反应，以及向父母和儿童宣传有关身体形状和相关健康风险的公共卫生信息，可能是改善父母对子女超重状况认知的最佳组合。
