WHAT'S KNOWN ON THIS SUBJECT:There is a generational shift in social norms related to body weight among adult population; little is known about the secular change of paternal perceptions of their child' s weight. WHAT THIS STUDY ADDS:A shift in body norms toward heavier weight statuses exists among parents of children, presenting a vast challenge to family-based childhood obesity prevention. Primary care providers can play a more active role in identifying the children with increased weight. abstract BACKGROUND: Parental perceptions of child' s weight status may influence family readiness to foster healthy behaviors. This study investigated the generational shifting of parental perceptions about children' s weight.METHODS: Data were collected in the NHANES 1988-1994 (n = 2871) and 2005-2010 (n = 3202). Parents, mainly mothers, were asked whether they considered their child, ages 6 to 11 years, to be overweight, underweight, or just about the right weight. The Centers for Disease Control and Prevention 2000 growth chart was used for reference. We ran Poisson regression to estimate the probability ratio between the 2 surveys for parents perceiving their child as overweight after controlling for actual weight. RESULTS:The 10th percentile of BMI z scores for children who were parentally perceived as overweight shifted with statistical significance from 84th percentile of reference population in the early survey to 91st percentile of reference population in the recent survey (P , .05). The mean z score of children parentally perceived as overweight also increased between surveys with the largest increase among children from poor families (from 1.60 [SE: 0.20] to 1.98 [0.08], P , .05), followed by African Americans (from 1.65 [0.09] to 2.02 [0.05], P , .05). The probability of overweight/obese children being correctly perceived as overweight by the parents declined by 24% between surveys (probability ratio = 0.76 [95% confidence interval: 0.67-0.87]).CONCLUSIONS: Overweight/obese children were less likely to be perceived as overweight in the recent survey compared with peers of similar weight but surveyed 10+ years earlier. The declining tendency among parents to perceive overweight children appropriately may indicate a generational shift in social norms related to body weight.

Socially acceptable body weight is increasing. 1 If more individuals who are overweight or obese are satisfied with their weight, fewer might be motivated to lose unhealthy weight. This study assessed the trend in the percentage of adults who were overweight or obese and trying to lose weight during 3 periods from 1988 through 2014.

Owning a cat rather than a dog was significantly associated with a reduced hazard of dying from CVD events, in particular, stroke. The protection pets confer may not be from physical activities, but possibly due to personality of the pet owners or stress-relieving effects of animal companionship.

There was a declining tendency among parents to perceive overweight children appropriately. Strategies are needed to explore how to encourage clinician discussions with parents about appropriate weight for their child and strengthen capacity for childhood obesity prevention.

Excessive TV watching among children and adolescents, and inactivity and high activity levels (≥7 times per week) among children are independently associated with severe school absenteeism.

Objectives: We examined trends in prevalence rates of smoking and smoking cessation during pregnancy among women in the United States to assess achievement of Healthy People 2020 prevention targets. Methods: We assessed the smoking habits of 30 667 mothers whose children were born between 1985 and 2014 and who were sampled by the National Health and Nutrition Examination Survey, 1999-2014. Sampled participants were children aged 0-15 at the time of interview; however, an adult proxy-usually the biological mother-responded on the child's behalf and reported information about maternal tobacco use during pregnancy. We calculated prevalence rates, adjusted odds ratios (aORs), and predicted annual increase or decrease of smoking and quitting smoking during pregnancy, adjusting for mother's age at delivery and income level and child's race/ethnicity and sex. Results: The average annual prevalence of smoking at any time during pregnancy decreased from 25.7% (95% confidence interval [CI], 15.3%-36.0%) in 1985 to 10.1% (95% CI, 7.1%-13.0%) in 2014 (P < .001), and quitting smoking at any time during the index pregnancy increased from 36.6% (95% CI, 20.3%-52.9%) in 1985 to 54.9% (95% CI, 44.4%-65.4%) in 2008 (P ¼ .002). The adjusted annual risk of smoking during pregnancy decreased significantly by 3% (aOR ¼ 0.97; 95% CI, 0.95-0.98; P < .001). The prevalence rate of smoking in the year 2020 extrapolated from the current trend would be 6.1%. Conclusions:Smoking during pregnancy in the United States is declining. However, renewed public health measures are needed to achieve the Healthy People 2020 objectives of preventing smoking among pregnant women in the United States.

Given the pivotal role of African American caregiver's perceptions of childhood obesity in rural areas, the inclusion of caregiver's perceptions could potentially reduce childhood obesity rates. The objective of the current study was to explore childhood obesity perceptions among African Americans in a rural Georgia community. This concurrent mixed methods study utilized two theoretical frameworks: Social Cognitive Theory and Social Ecological Model. Using a convenience sample, caregivers ages 22-65 years completed a paper-based survey (n = 135) and a face-to-face interview (n = 12) to explore perceptions of obesity risk factors, health complications, weight status, built environment features, and obesity prevention approaches. Descriptive statistics were generated and a six-step process was used for qualitative analysis. Participants commonly cited behavioral risk factors; yet, social aspects and appearance of the community were not considered contributing factors. Chronic diseases were reported as obesity health complications. Caregivers had a distorted view of their child's weight status. In addition, analysis revealed that caregivers assessed child's weight and height measurements by the child's appearance or a recent doctor visit. Environmental barriers reported by caregivers included safety concerns and insufficient physical activity venues and programs. Also, caregivers conveyed parents are an imperative component of preventing obesity. Although this study found caregivers were aware of obesity risk factors, health complications, built environment features, and prevention approaches their obesity perceptions were not incorporated into school or community prevention efforts. Findings suggest that children residing in rural areas are in need of tailored efforts that address caregiver perceptions of obesity.

Notification of child's unhealthy weight by HCPs increased significantly between 1999 and 2014, but the opportunity of clinical intervention remained substantially under-utilized.