Cai Li, Zhang Ting, Ma Jun, Ma Lu, Jing Jin, Chen Yajun
Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
J Epidemiol. 2017 Jul;27(7):338-345. doi: 10.1016/j.je.2016.08.011. Epub 2017 Feb 20.
How weight perception influences weight-related knowledge, attitudes, and behaviors in Chinese children is unknown. We investigated self-perception of body weight and its correlates, and analyzed the relationship between weight perception and weight-related knowledge, attitudes, and behaviors in children in Guangzhou, China.
We assessed self-reported weight perception, weight-related knowledge, attitudes, and behaviors in 3752 children aged 7-12 years. Underweight or overweight was defined using the Chinese criteria based on body mass index (BMI). Binary logistic regression analyses were performed to assess correlates of weight underestimation.
In total, 27.3% of children underestimated and 6.7% overestimated their weight status. Weight underestimation was common among normal-weight (34.1%) and overweight children (25.3%). Older age, female sex, and child BMI z-score were negatively associated with normal-weight children's underestimation, whereas older age, paternal obesity, maternal obesity, and child BMI z-score were negatively associated with overweight children's underestimation. Correct answers on weight-related knowledge questions ranged from 81.5% to 98.6% and did not differ by weight perception within BMI categories. Although negative perceivers (i.e., those who perceived themselves as underweight or overweight) had a higher intention to change weight, they behaved more unhealthily on fruit intake, breakfast, screen time, and daily moderate-to-vigorous physical activities time than counterparts.
Weight underestimation was prevalent in normal-weight and overweight children in Guangzhou. Negative perceivers had stronger willingness to change weight but tended to behave more unhealthily on certain behaviors than positive perceivers. Childhood obesity interventions should incorporate health education and practical support to promote healthy eating and physical activity.
体重认知如何影响中国儿童与体重相关的知识、态度和行为尚不清楚。我们调查了中国广州儿童对体重的自我认知及其相关因素，并分析了体重认知与体重相关知识、态度和行为之间的关系。
我们评估了3752名7至12岁儿童自我报告的体重认知、体重相关知识、态度和行为。根据中国基于体重指数（BMI）的标准定义体重过轻或超重。进行二元逻辑回归分析以评估体重低估的相关因素。
总体而言，27.3%的儿童低估了自己的体重状况，6.7%的儿童高估了自己的体重状况。体重低估在正常体重儿童（34.1%）和超重儿童（25.3%）中很常见。年龄较大、女性以及儿童BMI z评分与正常体重儿童的体重低估呈负相关，而年龄较大、父亲肥胖、母亲肥胖和儿童BMI z评分与超重儿童的体重低估呈负相关。体重相关知识问题的正确答案率在81.5%至98.6%之间，且在BMI类别中，不同体重认知的儿童之间没有差异。尽管负面认知者（即那些认为自己体重过轻或超重的人）有更高的改变体重的意愿，但他们在水果摄入量、早餐、屏幕时间和每日中度至剧烈体育活动时间方面的行为比正面认知者更不健康。
体重低估在广州的正常体重和超重儿童中普遍存在。负面认知者改变体重的意愿更强，但在某些行为上往往比正面认知者更不健康。儿童肥胖干预应纳入健康教育和实际支持，以促进健康饮食和体育活动。
