Gender inequalities in maternal perception of healthy child body shape and their association with child body mass and blood pressure.

OBJECTIVE: To investigate whether maternal perception of child body shape is different for boys and girls and whether this subjective parameter is associated with objective indices of cardiovascular health. DESIGN: Cross-sectional survey (the ARCA Project). SETTING: Southern Italy. SUBJECTS: Body mass index, waist circumference and blood pressure were measured according to standardised procedures in 3551 children (Boys = 1778; Girls = 1773) aged 6-11 years. Maternal perception of child body shape was investigated by inviting mothers to choose, within two sets of seven, 9-year-old child silhouettes (one set for boys and one set for girls), the body shape they perceived as that of a healthy child. RESULTS: Although the majority of mothers indicated the median silhouette as 'healthy', mothers of girls chose a fatter silhouette as 'healthy' more often than the mothers of boys (P = 0.001). By regression analysis, mothers' perception of a child's body shape was a significant determinant (P < 0.01) of blood pressure in both genders, and of anthropometric indices in girls only, independently of parental overweight, education, birth weight and physical activity. CONCLUSIONS: Our study suggests that maternal perception of a healthy body shape in children is associated with her child's blood pressure and degree of adiposity; with regard to the latter, differences between genders are apparent.