One reason kids may not be eating more healthfully is that their parents vastly overestimate the quality of their child’s diet.
Perceptions of Childhood Obesity and Diet Quality
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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
In response to the rising rates of childhood obesity, English children started getting screened at school, and their parents informed of their kid’s weight status and the risk of excess body fat. It did not go well. Telling parents that a lifetime of excess body fat can increase cancer risk, for example, caused “controversy and anger.” Parents attributed weight to genetics or puppy fat, claiming their kids had healthy diets.
One reason kids may not be eating more healthfully is that their parents overestimate the quality of their child’s diet. If it ain’t broke, don’t fix it. I mean, if they think their kids are already eating well, then there’s no reason to change. The mothers of 2,000 preschoolers were interviewed. What percentage of moms believed that their child’s diet was good? The vast majority. What percentage of their kids’ diets were actually good, even just according to the U.S. Department of Agriculture’s Healthy Eating guidelines, which aren’t exactly strict? Only 0.2 percent—one in every 500 kids! The vast majority of mothers overestimated the quality of their child’s diet.
Here’s an updated study. Another 2,000 households, just seeing if kids meet the fruit, vegetable, and sugar recommendations from the U.S. dietary guidelines and the American Heart Association. Researchers looked at kids from ages three through 18, and relied on reporting from their own parents as to what they were eating. Overall, the majority of parents strongly agreed that their children ate healthfully. So, how many of 2,229 households met the guidelines to eat even the minimum recommended amounts of fruits and veggies, and not eat more than six spoonsful of sugar a day? Zero. Not a single kid, in a single household. On average, the kids were eating more than 15 spoonfuls of added sugar every day.
Parental denial over the healthfulness of their children’s diet mirrors the parental denial that their overweight and obese kids are even overweight at all. Based on surveys in more than 20 countries, 94 percent of parents with obese children believe that their children are normal weight or only “a little overweight.” 94 percent! And the greater the obesity prevalence, the more likely parents think their kids look normal, because they kind of do, more and more. But this underestimation of their child’s weight status is a barrier to slowing the childhood obesity epidemic. And just as parents of overweight kids fail to recognize that their kids are overweight, overweight parents are also in denial about their own weight. This is not surprising. Who wants to admit they are part of a widely stigmatized group? Of course, researchers aren’t helping matters when they title their papers about parental misperception about overweight kids: “Every cockroach is beautiful to his mother’s eyes.”
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- Nnyanzi LA, Summerbell CD, Ells L, Shucksmith J. Parental response to a letter reporting child overweight measured as part of a routine national programme in England: results from interviews with parents. BMC Public Health. 2016;16:846.
- Syrad H, Falconer C, Cooke L, et al. 'Health and happiness is more important than weight’: a qualitative investigation of the views of parents receiving written feedback on their child’s weight as part of the National Child Measurement Programme. J Hum Nutr Diet. 2015;28(1):47-55.
- Kourlaba G, Kondaki K, Grammatikaki E, Roma-Giannikou E, Manios Y. Diet quality of preschool children and maternal perceptions/misperceptions: the GENESIS study. Public Health. 2009;123(11):738-742.
- Eliason J, Acciai F, DeWeese RS, Vega-López S, Ohri-Vachaspati P. Children’s consumption patterns and their parent’s perception of a healthy diet. Nutrients. 2020;12(8):2322.
- Ramos Salas X, Buoncristiano M, Williams J, et al. Parental perceptions of children’s weight status in 22 countries: the WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017. Obes Facts. 2021;14(6):658-674.
- Binkin N, Spinelli A, Baglio G, Lamberti A. What is common becomes normal: the effect of obesity prevalence on maternal perception. Nutr Metab Cardiovasc Dis. 2013;23(5):410-416.
- Ruiter ELM, Saat JJEH, Molleman GRM, et al. Parents’ underestimation of their child’s weight status. Moderating factors and change over time: A cross-sectional study. PLoS One. 2020;15(1):e0227761.
- Robinson E. Overweight but unseen: a review of the underestimation of weight status and a visual normalization theory. Obes Rev. 2017;18(10):1200-1209.
- Salini C, Messina G, Messina D, Nante N. "Every cockroach is beautiful to his mother’s eyes"? A multicentric study on the perception of child’s health status according to the parent. J Prev Med Hyg. 2023;64(3):E311-E315.
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
In response to the rising rates of childhood obesity, English children started getting screened at school, and their parents informed of their kid’s weight status and the risk of excess body fat. It did not go well. Telling parents that a lifetime of excess body fat can increase cancer risk, for example, caused “controversy and anger.” Parents attributed weight to genetics or puppy fat, claiming their kids had healthy diets.
One reason kids may not be eating more healthfully is that their parents overestimate the quality of their child’s diet. If it ain’t broke, don’t fix it. I mean, if they think their kids are already eating well, then there’s no reason to change. The mothers of 2,000 preschoolers were interviewed. What percentage of moms believed that their child’s diet was good? The vast majority. What percentage of their kids’ diets were actually good, even just according to the U.S. Department of Agriculture’s Healthy Eating guidelines, which aren’t exactly strict? Only 0.2 percent—one in every 500 kids! The vast majority of mothers overestimated the quality of their child’s diet.
Here’s an updated study. Another 2,000 households, just seeing if kids meet the fruit, vegetable, and sugar recommendations from the U.S. dietary guidelines and the American Heart Association. Researchers looked at kids from ages three through 18, and relied on reporting from their own parents as to what they were eating. Overall, the majority of parents strongly agreed that their children ate healthfully. So, how many of 2,229 households met the guidelines to eat even the minimum recommended amounts of fruits and veggies, and not eat more than six spoonsful of sugar a day? Zero. Not a single kid, in a single household. On average, the kids were eating more than 15 spoonfuls of added sugar every day.
Parental denial over the healthfulness of their children’s diet mirrors the parental denial that their overweight and obese kids are even overweight at all. Based on surveys in more than 20 countries, 94 percent of parents with obese children believe that their children are normal weight or only “a little overweight.” 94 percent! And the greater the obesity prevalence, the more likely parents think their kids look normal, because they kind of do, more and more. But this underestimation of their child’s weight status is a barrier to slowing the childhood obesity epidemic. And just as parents of overweight kids fail to recognize that their kids are overweight, overweight parents are also in denial about their own weight. This is not surprising. Who wants to admit they are part of a widely stigmatized group? Of course, researchers aren’t helping matters when they title their papers about parental misperception about overweight kids: “Every cockroach is beautiful to his mother’s eyes.”
Please consider volunteering to help out on the site.
- Nnyanzi LA, Summerbell CD, Ells L, Shucksmith J. Parental response to a letter reporting child overweight measured as part of a routine national programme in England: results from interviews with parents. BMC Public Health. 2016;16:846.
- Syrad H, Falconer C, Cooke L, et al. 'Health and happiness is more important than weight’: a qualitative investigation of the views of parents receiving written feedback on their child’s weight as part of the National Child Measurement Programme. J Hum Nutr Diet. 2015;28(1):47-55.
- Kourlaba G, Kondaki K, Grammatikaki E, Roma-Giannikou E, Manios Y. Diet quality of preschool children and maternal perceptions/misperceptions: the GENESIS study. Public Health. 2009;123(11):738-742.
- Eliason J, Acciai F, DeWeese RS, Vega-López S, Ohri-Vachaspati P. Children’s consumption patterns and their parent’s perception of a healthy diet. Nutrients. 2020;12(8):2322.
- Ramos Salas X, Buoncristiano M, Williams J, et al. Parental perceptions of children’s weight status in 22 countries: the WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017. Obes Facts. 2021;14(6):658-674.
- Binkin N, Spinelli A, Baglio G, Lamberti A. What is common becomes normal: the effect of obesity prevalence on maternal perception. Nutr Metab Cardiovasc Dis. 2013;23(5):410-416.
- Ruiter ELM, Saat JJEH, Molleman GRM, et al. Parents’ underestimation of their child’s weight status. Moderating factors and change over time: A cross-sectional study. PLoS One. 2020;15(1):e0227761.
- Robinson E. Overweight but unseen: a review of the underestimation of weight status and a visual normalization theory. Obes Rev. 2017;18(10):1200-1209.
- Salini C, Messina G, Messina D, Nante N. "Every cockroach is beautiful to his mother’s eyes"? A multicentric study on the perception of child’s health status according to the parent. J Prev Med Hyg. 2023;64(3):E311-E315.
Motion graphics by Avo Media
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Perceptions of Childhood Obesity and Diet Quality
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
For even more on weight control, go to your local public library and check out my book, How Not to Diet, available in print, e-book, and audio. (All proceeds I receive from the book are donated directly to charity.)
For more on childhood obesity, see:
- Infectobesity: Adenovirus 36 and Childhood Obesity
- Formula for Childhood Obesity
- Animal Protein, Pregnancy, and Childhood Obesity
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