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Caregivers’ inability to identify childhood adiposity: A cross-sectional survey of rural children and their caregivers’ attitudes


John Fraser, Hunter New England Area Health Service, Rural Training Unit, Locked Bag 9783, Tamworth, New South Wales 2348, Australia. Email:


Objectives: To determine the prevalence of overweight and obese children in north-western New South Wales and to assess caregivers’ ability to detect adiposity in their children.

Design: A cross-sectional survey using a standardised caregiver questionnaire and anthropometric measurements of school children attending 10 primary schools selected by stratified random sampling.

Subjects: A total of 598 eligible school children aged between five and eight years.

Measurements: Body mass index for children; caregivers’ assessment of their children's dietary intake, physical activity and adiposity by questionnaire.

Results: A total of 348 caregivers responded to the survey, yielding a response rate of 58.2%. Significantly more caregivers of boys (200) than girls (144) chose to participate (χ2 = 8.3, d.f. = 1, P < 0.01). The vast majority of caregivers (87%) consented to their children being measured. Body mass index measurements revealed the following: more than three quarters of boys (82%) and girls (77%) were of normal weight. Of boys and girls 13% were overweight. Twice as many girls (6%) than boys (3%) were obese. In total, 31% of caregivers underestimated the weight of their children. This proportion of caregivers underestimating the correct weight category of their children almost doubled to 56% of caregivers of overweight children. Proportionately more caregivers of overweight boys underestimated their children's weight than caregivers of girls (67% compared with 44%).

Conclusion: Health promotional activities need to address, as a matter of priority, caregivers’ ability to accurately assess the correct weight category of their children.