Date of Award:


Document Type:


Degree Name:

Master of Science (MS)


Nutrition, Dietetics, and Food Sciences


Siew Sun Wong


Obesity results from a complex interaction between diet, physical activity, and the environment. The purposes of this study were to identify behaviors associated with resilience to childhood obesity, and to compare the sensitivity of the Figure Rating Scales (FRS) in reflecting Body Mass Index (BMI).

Fifty health professionals in nutrition and 35 low-income, parent-and-child pairs completed the study. Children aged 6-11, perceived as “normal-weight” by their parents, were recruited. Five children had a measured BMI above the 85th percentile. Using a picture-sort method, each participant responded to a series of questions about 13 childhood obesity-related messages. Results included comparison between health professionals, parents, and children about 1) familiarity toward each message, 2) frequency in following the recommendation, 3) perception of ease for others to follow, and 4) perception of effectiveness to help prevent childhood obesity. Health professionals and parents had similar familiarity regarding all 13 messages. However, in terms of practicality, health professionals and parents differed significantly in eight messages that they reported “always taught/followed,” seven messages that they “sometimes taught/followed,” and two messages that they “seldom or never taught/followed.”

In most messages, children’s observation about what the family followed differed from what parents reported following. In terms of ease for others to follow “Watch portion sizes” and “Tell children to eat all of the meal before getting dessert,” health professionals and parental perception differed significantly. In terms of effectiveness in childhood obesity prevention, health professionals and parents agreed on 12 of 13 messages. Health professionals did not find message “Tell children to eat all of the meal before getting dessert” to be effective in preventing childhood obesity, whereas parents did.

FRS and measured BMI were significantly correlated among health professionals (r=0.75), parents (r=0.72), and children (r=0.53 for children ages 8-11, r=0.64 when a mother selected a silhouette for her child). For different subgroups, parent-and-child silhouette selection was closely correlated (r= 0.84). However, correlation between child’s BMI percentile and silhouette was nonsignificant in most subgroups (r= 0.47). In conclusion, FRS was effective among adults and older children (aged ≥8) in reflecting BMI but not among younger children (aged 6-7).




This work made publicly available electronically on November 21, 2011.

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