BACKGROUND AND OBJECTIVE: Parental perceptions of their children' s weight play an important role in obesity prevention and treatment. The objective of this study was to determine the proportion of parents worldwide who underestimate their children' s weight and moderators of such misperceptions. METHODS:Original studies published to January 2013 were chosen through literature searches in PUBMED, PSYCHINFO, and CINAHL databases. References of retrieved articles were also searched for relevant studies. Studies were published in English and assessed parental perceptions of children' s weight and then compared perceptions to recognized standards for defining overweight based on anthropometric measures. Data were extracted on study-level constructs, child-and parent-characteristics, procedural characteristics, and parental underestimates separately for normal-weight and overweight/obese samples. Pooled effect sizes were calculated using random-effects models and adjusted for publication bias. Moderators were explored using mixed-effect models.RESULTS: A total of 69 articles (representing 78 samples; n = 15 791) were included in the overweight/obese meta-analysis. Adjusted effect sizes revealed that 50.7% (95% confidence interval 31.1%-70.2%) of parents underestimate their overweight/obese children' s weight. Significant moderators of this effect included child' s age and BMI. A total of 52 articles (representing 59 samples; n = 64 895) were included in the normal-weight meta-analysis. Pooled effect sizes indicated that 14.3% (95% confidence interval 11.7%-17.4%) of parents underestimate their children' s normal-weight status. Significant moderators of this effect included child gender, parent weight, and the method (visual versus nonvisual) in which perception was assessed. CONCLUSIONS:Half of parents underestimated their children' s overweight/obese status and a significant minority underestimated children' s normal weight. Pediatricians are well positioned to make efforts to remedy parental underestimates and promote adoption of healthy habits. Ms Lundahl conceptualized the study, coded the original studies, conducted the meta-analyses, and drafted the initial manuscript; Ms Kidwell coded a portion of the original studies, reviewed and revised the manuscript, and approved the final manuscript as submitted; and Dr Nelson contributed to the conceptualization of the study, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.www.pediatrics.org/cgi

CONTEXT: Mixed findings exist on whether stimulant medications alter youth sleep. OBJECTIVE:To determine the effect of stimulant medications on sleep.DATA STUDIES: Studies published through March 2015 were collected via CINAHL, PsycINFO, and PubMed. References of retrieved articles were reviewed.STUDY SELECTION: Eligibility criteria included studies with children/adolescents who had attention-deficit/hyperactivity disorder (ADHD), random assignment to stimulants, and objective sleep measurement. Studies that did not include information about key variables were excluded. DATA EXTRACTION: Study-level, child-level, and sleep data were extracted by 2 independent coders. Effect sizes were calculated by using random effects models. Potential moderators were examined by using mixed effect models.RESULTS: A total of 9 articles (N = 246) were included. For sleep latency, the adjusted effect size (0.54) was significant, indicating that stimulants produce longer sleep latencies. Frequency of dose per day was a significant moderator. For sleep efficiency, the adjusted effect size (20.32) was significant. Significant moderators included length of time on medication, number of nights of sleep assessed, polysomnography/actigraphy, and gender. Specifically, the effect of medication was less evident when youth were taking medication longer. For total sleep time, the effect size (20.59) was significant, such that stimulants led to shorter sleep duration. LIMITATIONS:Limitations include few studies, limited methodologic variability, and lack of unpublished studies.CONCLUSIONS: Stimulant medication led to longer sleep latency, worse sleep efficiency, and shorter sleep duration. Overall, youth had worse sleep on stimulant medications. It is recommended that pediatricians carefully monitor sleep problems and adjust treatment to promote optimal sleep.Department of Psychology, University of Nebraska-Lincoln, Lincoln, NebraskaMs Kidwell contributed to the conceptualization of the study, organized literature searches, coded the original studies, and drafted the introduction and discussion sections; Ms Van Dyk contributed to the conceptualization of the study, coded the original studies for reliability analyses, and reviewed and revised the manuscript; Ms Lundahl contributed to the conceptualization of the study, conducted the meta-analyses, and drafted the methods and results sections; Dr Nelson contributed to the conceptualization of the study and provided critical editing of the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

The foods we eat have substantial impact on our health, and excessive food intake is associated with numerous long-term health conditions. It is therefore essential to understand the factors influencing this crucial health behavior. Research has identified sleep problems as one such factor; however, little research has examined how sleep problems impact food intake. Using a multisystemic perspective, this article proposes a variety of ways in which sleep problems likely increase food intake and illustrates the need for research to empirically examine these underlying mechanisms. Such research would have important treatment implications for health conditions often treated with dietary interventions.

This meta-analysis examined the effect experimental sleep restriction has on youth's attention and hyperactivity outcomes. Thirteen published studies containing 17 independent samples were included (N = 496). Random- and fixed-effects models were used to estimate pooled effect sizes and moderator effects, respectively. Results indicate that sleep-restricted youth had significantly worse attention outcomes than youth with extended sleep, but no differences were evident regarding hyperactivity. Significant moderators of this effect included age and sex. These results have important implications for both the prevention and treatment of attention problems, highlighting the need for health professionals to screen for and treat underlying sleep issues.

Simple adjustment factors can enhance the correspondence and utility of parent reports of child sleep duration for clinical and research purposes.

An emerging literature suggests that poor executive control may be associated with clinical weight problems (e.g., BMI-for-age percentile ≥ 85 in children). However, our understanding of the impact of executive control on overweight and obesity in childhood is limited by the lack of longitudinal studies spanning critical developmental periods and assessing executive control using comprehensive performance-based batteries. The current study addresses these limitations in a longitudinal examination of 212 children who completed an extensive laboratory-based executive control task battery in preschool (age 4 years, 6 months) and were followed through elementary school (grades 1 through 4) with objective measures of weight status. Logistic regression results indicate that poorer executive control in preschool was associated with significantly greater risk for clinical weight problems (either overweight or obese status, as defined by BMI-for-age percentile ≥ 85) in elementary school, controlling for maternal education. Executive control in preschool was not significantly associated with risk for obese status, specifically (defined by BMI-for-age percentile ≥ 95), but the trend was in the expected direction. Results suggest that early executive abilities are relevant for children’s subsequent health status, with deficits in executive control in the critical period of preschool conferring risk for later problems with weight. Based on these findings, early interventions to promote stronger executive control may be a promising, yet currently overlooked, component in pediatric obesity prevention efforts.

This study provides a novel investigation of child temperament and eating behaviors, allowing for a better understanding of how negative affectivity is associated with instrumental feeding, emotional feeding, and selective eating. These results inform interventions to improve child health.

This study elucidates the role of impulsivity in disordered eating behaviors among non-clinical college students. For both women and men, attentional and motor impulsivity were related to disordered eating attitudes and behaviors. Overall, these findings suggest that different facets of impulsivity are related to disordered eating attitudes and behaviors in a non-clinical college population.