Singaporean mothers' perception of their three-year-old child's weight status: A cross-sectional study

Tuck Seng Cheng, See Ling Loy, Yin Bun Cheung, Jerry Kok Yen Chan, Mya Thway Tint, Keith M. Godfrey, Peter D. Gluckman, Kenneth Kwek, Seang Mei Saw, Yap Seng Chong*, Yung Seng Lee, Fabian Yap, Ngee Lek, Allan Sheppard, Amutha Chinnadurai, Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Arijit Biswas, Bee Wah LeeBirit F.P. Broekman, Boon Long Quah, Borys Shuter, Chai Kiat Chng, Cheryl Ngo, Stephen Chin Ying Hsu, Choon Looi Bong, Christiani Jeyakumar Henry, Cornelia Yin Ing Chee, Doris Fok, George Seow Heong Yeo, Hazel Inskip, Helen Chen, Hugo P.S. Van Bever, Iliana Magiati, Inez Bik Yun Wong, Ivy Yee Man Lau, Jeevesh Kapur, Jenny L. Richmond, Joanna D. Holbrook, Joshua J. Gooley, Kok Hian Tan, Krishnamoorthy Niduvaje, Leher Singh, Lin Lin Su, Lourdes Mary Daniel, Lynette Pei Chi Shek, Marielle V. Fortier, Mark Hanson, Mary Foong Fong Chong, Growing Up in Singapore Towards Healthy Outcomes (GUSTO) study group221

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective Inaccurate parental perception of their child's weight status is commonly reported in Western countries. It is unclear whether similar misperception exists in Asian populations. This study aimed to evaluate the ability of Singaporean mothers to accurately describe their three-year-old child's weight status verbally and visually. Methods At three years post-delivery, weight and height of the children were measured. Body mass index (BMI) was calculated and converted into actual weight status using International Obesity Task Force criteria. The mothers were blinded to their child's measurements and asked to verbally and visually describe what they perceived was their child's actual weight status. Agreement between actual and described weight status was assessed using Cohen's Kappa statistic (κ). Results Of 1237 recruited participants, 66.4% (n = 821) with complete data on mothers' verbal and visual perceptions and children's anthropometric measurements were analysed. Nearly thirty percent of the mothers were unable to describe their child's weight status accurately. In verbal description, 17.9% under-estimated and 11.8% over-estimated their child's weight status. In visual description, 10.4% under-estimated and 19.6% over-estimated their child's weight status. Many mothers of underweight children over-estimated (verbal 51.6%; visual 88.8%), and many mothers of overweight and obese children under-estimated (verbal 82.6%; visual 73.9%), their child's weight status. In contrast, significantly fewer mothers of normal-weight children were inaccurate (verbal 16.8%; visual 8.8%). Birth order (p<0.001), maternal (p = 0.004) and child's weight status (p<0.001) were associated with consistently inaccurate verbal and visual descriptions. Conclusions Singaporean mothers, especially those of underweight and overweight children, may not be able to perceive their young child's weight status accurately. To facilitate prevention of childhood obesity, educating parents and caregivers about their child's weight status is needed.

Original languageEnglish
Article numbere0147563
JournalPLoS ONE
Issue number1
Publication statusPublished - 1 Jan 2016
Externally publishedYes

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