Nutritional surveillance in Tuscany: maternal perception of nutritional status of 8-9 y-old school-children

Overweight and obesity in the developmental age has become a public health problem. For this reason, prevention projects must be developed in advance with the aim to involve not only children, but their parents as well. Our objective is to evaluate the accuracy of the mothers' perceptions of adolescent nutritional status.

Cross-sectional study. We selected a statistical sample of 3,076 subjects (1,583 males, 1,493 females), 8-9 y-old school-children of 164 3rd-grade elementary school classes from throughout Tuscany, as well as their mothers. The mothers' information was gathered via self-administered questionnaires, while the children were given an eating behaviour survey under the supervision of qualified personnel. Mothers' education level (self-reported) height and weight were collected; children's height and weight were measured. The former were asked how they perceived their children's body image.

A correlation exists between the mothers' perceptions of the nutritional state of their children via the silhouettes and the BMI classes of the children, which is equal to 80% with a kappa-Cohen for agreement equal to 0.58 (SE = 0.02; P < 0.0001). However, no correlation exists between the mothers' responses to the question "In your opinion, is your child ...?" and the child's actual BMI class (the exact percentage correlation is equal to 75%, with a kappa-Cohen for agreement equal to 0.43 SE = 0.014; P < 0.0001).

Mothers have an accurate perception of the nutritional status of their children, correctly choosing the silhouette that corresponds to the child's BMI profile without variation by gender. We can assume that mothers in our sample have a good concept about healthy nutritional status.