@article{8717878,
  abstract     = {{Objective:
To examine the effect of the intervention implemented in the ToyBox-study on changes observed in age- and sex-specific BMI percentile and investigate the role of perinatal factors, parental perceptions and characteristics on this change.

Design:
A multicomponent, kindergarten-based, family-involved intervention with a cluster-randomised design. A standardised protocol was used to measure children’s body weight and height. Information was also collected from parents/caregivers via the use of validated questionnaires. Linear mixed effect models with random intercept for country, 
socio-economic status and school were used.

Setting:
Selected preschools within the provinces of Oost-Flanders and West-Flanders (Belgium), Varna (Bulgaria), Bavaria (Germany), Attica (Greece), Mazowieckie (Poland) and Zaragoza (Spain).

Participants: A sample of 6268 preschoolers aged 3·5–5·5 years (51·9 % boys).

Results:
There was no intervention effect on the change in children’s BMI percentile. However, parents’ underestimation of their children’s actual weight status, parental overweight and mothers’ pre-pregnancy overweight/obesity were found to be significantly and independently associated with increases in children’s BMI percentile in multivariate modelling.

Conclusions: 
As part of a wide public health initiative or as part of a counseling intervention programme, it is important to assist parents/caregivers to correctly perceive their own and their children’s weight status. Recognition of excessive weight by parents/caregivers can increase their readiness to change and as such facilitate higher adherence to favourable behavioural changes within the family.}},
  articleno    = {{PII S1368980021001518}},
  author       = {{Manios, Yannis and Lambert, Katrina A and Karaglani, Eva and Mavrogianni, Christina and Moreno Aznar, Luis A and Iotova, Violeta and Świąder-Leśniak, Anna and Koletzko, Berthold and Cardon, Greet and Androutsos, Odysseas and Moschonis, George}},
  issn         = {{1368-9800}},
  journal      = {{PUBLIC HEALTH NUTRITION}},
  keywords     = {{Public Health,Environmental and Occupational Health,Nutrition and Dietetics,Medicine (miscellaneous),Preschool,Lifestyle,Perinatal,FAMILY-INVOLVED INTERVENTION,EARLY-CHILDHOOD,ENERGY-BALANCE,RISK-FACTORS,MATERNAL PERCEPTIONS,PREVENT OBESITY,OVERWEIGHT,PREGNANCY,GROWTH,FETAL}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{PII S1368980021001518:1552--PII S1368980021001518:1562}},
  title        = {{Prospective BMI changes in preschool children are associated with parental characteristics and body weight perceptions : the ToyBox-study}},
  url          = {{http://dx.doi.org/10.1017/s1368980021001518}},
  volume       = {{25}},
  year         = {{2022}},
}

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