Obesity, Pocrescophobia and Oral Health.

Oral health plays a crucial role in obesity management. Scientific evidence suggests an association between obesity and oral diseases, including periodontal disease, dental caries, tooth erosion, xerostomia, and dentinal hypersensitivity. Maintaining optimal oral health is essential for obese patients, as compromised dentition or oral discomfort can influence dietary habits. However, managing oral health in obese individuals can be challenging due to anatomical limitations and lifestyle choices. Profound knowledge of obesity and its manifestations, the oral health professionals need to raise awareness and provide patients with comprehensive care. Pocrescophobia also known as obesophobia, is an intense fear of gaining weight. It affects both adoloscent women and men, manifesting as an irrational dread associated with weight gain. Like other phobias, obesophobia falls under the umbrella of anxiety disrders, leading to exaggerated anxiety when discussing or thinking about weight gain. Individuals with this fear may go to extreme lengths to avoid weight gain, which can increase the risk of developing eating disorders. Stress can lead to bruxism, wears away the occlusal surfaces and incisal edges, resulting in flat, shorter teeth. Smooth V-shaped cavities arise when lateral stresses surpass physiological limitations, resulting in gum recession and tooth discomfort. Canker sores, xerostomia, and lichen planus have all been linked to stress. By addressing both obesophobia and obesity as well as oral health, patients' overall well-being and quality of life can be improved.

Stress system dysfunction revealed by integrating reactivity of stress pathways to psychological stress in lean and overweight/obese men.

Although the patterns of response within the sympathoadrenal medullary (SAM) system and hypothalamo-pituitary adrenal (HPA) axis are interesting and important in their own accord, the overall response to acute psychological stress involves reactivity of both pathways. We tested the hypothesis that consideration of the integrated response of these pathways may reveal dysregulation of the stress systems, which is not evident when considering either system alone. Age-matched lean and overweight/obese men were subjected to a Trier Social Stress Test and reactivity of the SAM system (salivary α-amylase, systolic blood pressure, diastolic blood pressure, and heart rate) and the HPA axis (salivary cortisol) were measured. Relative reactivity of SAM system and HPA axis was calculated as the ratio between the measures from each pathway. Although analysis of reactivity of individual stress pathways showed no evidence of dysfunction in overweight/obese compared with lean men, analysis of HPA/SAM reactivity revealed significantly lower cortisol over systolic blood pressure (CoSBP) and cortisol over diastolic blood pressure (CoDBP) reactivity in overweight/obese compared with lean men. Other measures of HPA/SAM reactivity and all measures of SAM/HPA reactivity were unaltered in overweight/obese compared with lean men. These findings suggest that the cortisol response per unit of blood pressure response is blunted in men with elevated adiposity. Furthermore, these findings support a notion of a coordinated overall approach to activation of the stress pathways with the degree of activation in one pathway being related to the degree of activation in the other.

Stress and eating responses in adolescent females predisposed to obesity: A pilot and feasibility study.

OBJECTIVE: To explore how chronic stress, reactivity to acute stress, and obesogenic eating are linked in adolescent females predisposed to obesity. METHODS: Participants included 21 adolescent females (mage = 14.57 years) and their biological mothers with obesity (body mass index [BMI] ≥ 30 kg/m2). The pilot and feasibility study involved adolescent self-report of chronic stress, an acute stress-induction paradigm (Trier Social Stress Task, TSST), salivary cortisol collection to assess stress reactivity, and both subjective (self-report) and objective (snack buffet) measures of obesogenic eating. RESULTS: Adolescent females reporting high chronic stress were significantly more likely to engage in self-reported emotional and external eating and to have higher food cravings (p's < .05) compared to adolescents with low chronic stress. Effect size estimates suggested a blunting effect of cortisol in the high chronic stress group. Blunted cortisol reactivity significantly predicted higher self-reported food cravings for the high chronic stress group (p = .04). Associations among chronic stress, cortisol, and self-reported and objective obesogenic eating reflected medium to large effect sizes. CONCLUSIONS: This study built on limited extant research on stress and eating to demonstrate that chronic stress was associated with self-reported obesogenic eating patterns in adolescent females predisposed to obesity. Different patterns of cortisol reactivity and eating emerged depending on chronic stress group (low versus high). Understanding these eating patterns in the context of chronic stress can inform interventions to reduce obesity risks in adolescence.

Impact of a health marketing campaign on sugars intake by children aged 5-11 years and parental views on reducing children's consumption.

BACKGROUND: The association between Free Sugars intake and non-communicable diseases such as obesity and dental caries is well documented and several countries are taking measures to reduce sugars intakes. Public Health England (PHE) instigated a range of approaches to reduce sugars, including a national health marketing campaign (Sugar Smart). The campaign aimed to raise awareness of the amount of sugars in foods and drinks and to encourage parents to reduce their children's intake. The aim of this study was to determine whether the campaign was effective in altering dietary behaviour, by assessing any impact of the campaign on sugars intake among children aged 5-11 years. Parental perceptions of the campaign and barriers to reducing sugars intake were also explored. METHODS: Parents of 873 children aged 5-11 years, identified from an existing PHE database, were invited to take part. Dietary information was collected online using Intake24 before, during, and at 1, 10 and 12 months following the campaign. Change in sugars intake was assessed using mixed effects linear regression models. One-to-one telephone interviews were conducted with a purposive sample of parents to explore perceptions of the campaign and identify barriers and facilitators to reducing children's sugars intake. RESULTS: Completion rates for dietary assessment ranged from 61 to 72% across the follow up time points. Qualitative telephone interviews were conducted with 20 parents. Total sugars intake decreased on average by ~ 6.2 g/day (SD 43.8) at peak campaign and the percentage of energy from total sugars significantly decreased immediately and 1 year post campaign. The percentage of energy from Free Sugars significantly decreased across all time points with the exception of the long term follow up at 12-months post campaign. The percentage of energy intake from total fat increased. Parents expressed a willingness to reduce sugars intakes, however, identified barriers including time constraints, the normalisation of sugary treats, and confusing information. CONCLUSIONS: A health marketing campaign had a positive impact in reducing sugars intake but reductions in sugars were not sustained. Parents want to reduce their child's sugars intake but societal barriers and confusion over which sources of sugars to avoid hamper efforts to change.

Pythagorean self-awareness intervention: A novel cognitive stress management technique for body weight control.

BACKGROUND: Over the past decades, the prevalence of obesity has markedly increased worldwide. Stress is recognized as a substantial contributor to increased body weight; therefore, stress management interventions, especially cognitive behavioural, are becoming increasingly popular. The impact of stress management on stress- and obesity-related biomarkers (eg blood lipid profile, HBA1c, inflammatory biomarkers, such as CRP) has been scarcely studied. The aim of this study was to assess the effect of a novel cognitive behavioural stress management intervention, called 'Pythagorean Self-Awareness Intervention' (PSAI), in overweight/obese adults. MATERIALS AND METHODS: This was a two-armed 1:1 randomized, nonblind controlled study including overweight/obese individuals. The control group followed a personalized Mediterranean low-calorie diet, and the intervention group followed the same diet in addition to the PSAI intervention for 8 weeks. Measurements included demographic, anthropometric (ie BMI, waist-to-hip ratio), stress (ie perceived stress, salivary cortisol), dietary behaviour (ie emotional eating) and metabolic parameters (ie blood lipid profile, HBA1c, CRP, body composition in fat and water). Outcome per-protocol analysis was performed using mixed linear models adjusted for age and gender. RESULTS: A total of 49 of 62 eligible adults were analysed in the study (there were three dropouts in the intervention group and 10 dropouts in the control group); 28 were assigned to the intervention group (mean age 54.7 ± 11.9 years) and 21 to the control group (mean age 51.8 ± 11.9 years). The intervention group showed a statistically significant decrease in perceived stress, cortisol concentrations 30 minutes after awakening, cortisol's area under the curve, BMI, waist-to-hip ratio, restrained, emotional and external eating behaviour, fasting glucose, LDL, triglycerides, HbA1c and body and trunk fat, compared with the control group. Based on the observed effect sizes, clinically meaningful changes may be more evident in stress perception, restrained and external eating behaviour, Hb1ac and trunk fat. The compliance to the PSAI intervention reached 100%, and there were no adverse effects. CONCLUSIONS: The PSAI technique may be an effective stress management method for overweight/obese adults. Future and larger randomized controlled studies are needed to allow generalization of these findings.

How should sugar-sweetened beverage health warnings be designed? A randomized experiment.

Health warnings are a promising strategy for reducing consumption of sugar-sweetened beverages (SSBs), but uncertainty remains about how to design warnings to maximize their impact. Warnings already implemented in Latin America use nutrient disclosures, while proposed U.S. warnings would describe the health effects of consuming SSBs. We sought to determine whether warning characteristics influence consumers' reactions to SSB health warnings. A national convenience sample of U.S. adults (n = 1360) completed an online survey in 2018. In a factorial design, we randomly assigned participants to view SSB health warnings that differed in: 1) inclusion of health effects ("Drinking beverages with added sugar contributes to obesity, diabetes, and tooth decay"); 2) inclusion of a nutrient disclosure ("High in added sugar"); 3) inclusion of the marker word "WARNING;" and 4) shape (octagon vs. rectangle). The primary outcome was perceived message effectiveness (PME, range 1-5). PME was higher for warnings that included health effects (average differential effect [ADE] = 0.63, p < 0.001) or nutrient disclosures (ADE = 0.32, p < 0.001) compared to warnings without this information. However, adding a nutrient disclosure to a warning that already included health effects did not lead to higher PME compared to warnings with health effects alone. The marker "WARNING" (ADE = 0.21) and the octagon shape (ADE = 0.08) also led to higher PME compared to warnings without these characteristics (ps < 0.001). The same pattern of results held for the secondary outcomes, fear and thinking about harms. SSB health warnings may have more impact if they describe health effects, use the marker "WARNING," and are octagon-shaped.

Association between oral health-related quality of life and nutritional status among older adults in district of Kuala Pilah, Malaysia.

BACKGROUND: Poor oral health has an impact on food choices and intake of important nutrients among older population. The use of oral health-related quality of life instruments along with the clinical dental indicators can help to assess the oral problems that lead to nutritional problems in this group. This study aims to determine the association between oral health-related quality of life (OHRQoL) and nutritional status among a group of older adults in Kuala Pilah district, Malaysia. METHODS: A cross-sectional study was carried out on 446 older adults aged 50 years and above from 20 randomly selected villages. Respondents were interviewed to collect information on their demographic characteristics and oral health perception, followed by physical examination to measure height, weight and body mass index (BMI) of respondents. The validated Malay version of General Oral Health Assessment Index (GOHAI) was used to measure OHRQoL. RESULTS: About one-third (35.8%) of the respondents had normal BMI. Majority of the respondents were overweight (40.4%) and obese (19.9%), while only a small proportion was underweight (3.9%). Mean GOHAI score was 53.3 (SD = 4.7), indicating low perception of oral health. About 81.6% respondents had moderate to low perception of oral health. Logistic regression analysis showed a statistically significant association between the GOHAI and BMI scores (OR = 2.3; p < 0.01). CONCLUSIONS: Oral health-related quality of life was significantly associated with nutritional condition of respondents. Older adults with poor perception of their oral health were more likely to have unsatisfactory BMI compared to those who perceived their oral health to be good.

Dried fruit and public health - what does the evidence tell us?

A scientific workshop held in the UK explored the potential contribution of traditional dried fruits to public health, identified gaps in the evidence and addressed priorities for research. Presentations considered the categorisation and composition of dried fruits; dried fruit and gastrointestinal health; the polyphenol content of dried fruits and their potential contribution to health; dried fruit and appetite in relation to the psychology of snacking and obesity; dried fruit and dental health including its role as a snack; and conflicts in public health advice for dried fruits. A round table discussion explored the contribution of dried fruit to "five a day" fruit and vegetable intake and fibre intake, whether dried fruits have equivalence with fresh in terms of dietary advice, advice on snacking in relation to dental health and appetite control, informing the public about different types of dried fruits and avoiding consumer confusion, and future research requirements.

Increased BMI in children-an indicator for less compliance during orthodontic treatment with removable appliances.

Aim: To assess whether or not childhood overweight is associated with lower levels of compliance during orthodontic therapy with removable appliances. Materials and methods: Starting in 2011, all upper expansion plates and Sander II appliances were equipped with a Theramon® microsensor chip to assess appliance wear time objectively. According to their pre-treatment, BMI normal weight patients were matched to consecutively treated overweight or obese patients by gender, age, and appliance type. Cooperation was assessed with microelectronic wear time documentation over a period of at least 6 months. Results: A total of 50 patients (25 overweight, 25 normal weight) with upper expansion plates and 64 patients (32 overweight, 32 normal weight) with Sander II appliances were analysed. Spearman Rho coefficients showed an indirect association between BMI and appliance wear time, indicating that the higher the BMI, the less the patients wore their appliances (P < 0.05). Furthermore, both normal- and overweight children wore upper expansion plates significantly more than Sander II appliances (P < 0.05). Although no gender-specific difference was found (P = 0.723), an age-related correlation could be verified, indicating a decrease in wear time with increasing age (P < 0.05). Conclusions: An increased BMI appears to be a risk factor for less appliance wear during orthodontic treatment with removable appliances. Additional factors which influenced cooperation during treatment with removable appliances were patient age and appliance type.

Reward Systems in the Brain and Nutrition.

The taste cortex in the anterior insula provides separate and combined representations of the taste, temperature, and texture of food in the mouth independently of hunger and thus of reward value and pleasantness. One synapse on, in the orbitofrontal cortex, these sensory inputs are combined by associative learning with olfactory and visual inputs for some neurons, and these neurons encode food reward value in that they respond to food only when hunger is present and in that activations correlate linearly with subjective pleasantness. Cognitive factors, including word-level descriptions and selective attention to affective value, modulate the representation of the reward value of taste, olfactory, and flavor stimuli in the orbitofrontal cortex and a region to which it projects, the anterior cingulate cortex. These food reward representations are important in the control of appetite and food intake. Individual differences in reward representations may contribute to obesity, and there are age-related differences in these reward representations. Implications of how reward systems in the brain operate for understanding, preventing, and treating obesity are described.

Impact of non-surgical periodontal therapy on OHRQoL in an obese population, a randomised control trial.

BACKGROUND: Oral Health Related Quality of Life (OHRQoL) is an important measure of disease and intervention outcomes. Chronic periodontitis (CP) is an inflammatory condition that is associated with obesity and adversely affects OHRQoL. Obese patients with CP incur a double burden of disease. In this article we aimed to explore the effect of Non-Surgical Periodontal Therapy (NSPT) on OHRQoL among obese participants with chronic periodontitis. MATERIALS AND METHODS: This was a randomised control clinical trial at the Faculty of Dentistry, University of Malaya. A total of 66 obese patients with chronic periodontitis were randomly allocated into the treatment group (n=33) who received NSPT, while the control group (n=33) received no treatment. Four participants (2 from each group) were non-contactable 12 weeks post intervention. Therefore, their data were removed from the final analysis. The protocol involved questionnaires (characteristics and OHRQoL (Oral Health Impact Profile-14; OHIP-14)) and a clinical examination. RESULTS: The OHIP prevalence of impact (PI), overall mean OHIP severity score (SS) and mean OHIP Extent of Impact (EI) at baseline and at the 12-week follow up were almost similar between the two groups and statistically not significant at (p=0.618), (p=0.573), and (p=0.915), respectively. However, in a within-group comparison, OHIP PI, OHIP SS, and OHIP EI showed a significant improvement for both treatment and control groups and the p values were ((0.002), (0.008) for PI), ((0.006) and (0.004) for SS) and ((0.006) and (0.002) for EI) in-treatment and control groups, respectively. CONCLUSION: NSPT did not significantly affect the OHRQoL among those obese with CP. Regardless, NSPT, functional limitation and psychological discomfort domains had significantly improved. TRIAL REGISTRATION: ( NCT02508415 ). Retrospectively registered on 2nd of April 2015.

Individual Differences in Reward and Somatosensory-Motor Brain Regions Correlate with Adiposity in Adolescents.

The prevalence of adolescent obesity has increased dramatically over the past three decades, and research has documented that the number of television shows viewed during childhood is associated with greater risk for obesity. In particular, considerable evidence suggests that exposure to food marketing promotes eating habits that contribute to obesity. The present study examines neural responses to dynamic food commercials in overweight and healthy-weight adolescents using functional magnetic resonance imaging (fMRI). Compared with non-food commercials, food commercials more strongly engaged regions involved in attention and saliency detection (occipital lobe, precuneus, superior temporal gyri, and right insula) and in processing rewards [left and right nucleus accumbens (NAcc) and left orbitofrontal cortex (OFC)]. Activity in the left OFC and right insula further correlated with subjects' percent body fat at the time of the scan. Interestingly, this reward-related activity to food commercials was accompanied by the additional recruitment of mouth-specific somatosensory-motor cortices-a finding that suggests the intriguing possibility that higher-adiposity adolescents mentally simulate eating behaviors and offers a potential neural mechanism for the formation and reinforcement of unhealthy eating habits that may hamper an individual's ability lose weight later in life.

Nutritional issues and body weight in long-term survivors of allogeneic blood and marrow transplant (BMT) in NSW Australia.

PURPOSE: The aims of this study were to describe the long-term nutrition, body weight and body image issues facing survivors of Allogeneic Blood and Marrow Transplant (BMT) and their impact on quality of life. It also describes survivors' perception of enteral feeding during BMT. METHODS: Four hundred and forty-one survivors who had undergone a BMT in NSW, Australia between 2000 and 2012 (n = 441/583) completed the Sydney Post BMT Study Survey (SPBS). RESULTS: Forty-five percent of survivors less than 2-year post-transplant reported a dry mouth, 36 % reported mouth ulcers and 19 % had diarrhoea. This was consistent across all survivor groups, regardless of time since transplant. Patients with one or more gastrointestinal (GI) symptoms had significantly lower quality of life scores. There was a significant difference in quality of life scores when comparing those with no GI symptoms to those with one or more symptoms (P = <0.0001). Quality of life was significantly higher in those who once again enjoyed mealtimes (P < 0.0001). Males were more likely to be satisfied with their body weight compared to females (P = 0.009). The median body mass index (BMI) for all patients reporting body weight satisfaction was significantly lower (BMI 23.5) than those reporting dissatisfaction (BMI 27.5) (P = <0.0001). Survivors who had a normal BMI had significantly higher rates of body weight satisfaction compared to underweight, overweight and obese survivors (P = <0.0001). Those survivors who were overweight or obese were significantly more likely to be diabetic (P = 0.008). CONCLUSION: This study revealed an important relationship between gastrointestinal symptoms, body weight and body image and survivor's quality of life. It provides further support for the importance of nutrition therapy post-BMT.

Eating moderates the link between body mass index and perceived social connection.

Some studies have demonstrated that heavier people perceive themselves as lacking social connections, whereas others have not. The current study investigated whether eating alters the link between body mass index (BMI) and perceived social connection, providing one explanation for inconsistencies across previous studies. Participants were instructed to refrain from eating or drinking anything except water after 9 p.m. the prior night. Upon arrival at the lab, participants were assigned to the food (n = 63) or no food (n = 110) condition. They also provided a saliva sample that was assayed for ghrelin (an appetite-relevant hormone), and completed a series of questionnaires about their relationships. Participants with a higher BMI felt more socially disconnected than people with a lower BMI, but only among those who had not recently eaten. BMI and perceived social disconnection were unrelated among people who had recently eaten. These results were consistent across multiple measures of perceived social disconnection, and also across the experimental manipulation and continuously measured ghrelin.

Authenticity in Obesity Public Service Announcements: Influence of Spokesperson Type, Viewer Weight, and Source Credibility on Diet, Exercise, Information Seeking, and Electronic Word-of-Mouth Intentions.

This study examined the joint influence of spokesperson type in obesity public service announcements (PSAs) and viewer weight on diet intention, exercise intention, information seeking, and electronic word-of-mouth (eWoM) intention. Results of a 2 (spokesperson type: real person vs. actor) × 2 (viewer weight: overweight vs. non-overweight) between-subjects experiment indicated that overweight viewers who saw the PSA featuring the real person had the highest diet intention, exercise intention, information seeking, and eWoM intention. Parasocial interaction was also found to mediate the relationships between spokesperson type/viewer weight and two of the dependent variables: diet intention and exercise intention. In addition, viewers who saw the PSA featuring the real person rated the spokesperson as significantly higher on source credibility (trustworthiness, competence, and goodwill) than those who saw the PSA featuring the actor.

Impact of body mass index on oral health during orthodontic treatment: an explorative pilot study.

AIM: To answer the question: is there a correlation between body mass index (BMI), oral health, and patient cooperation during multibracket (MB) appliance therapy? MATERIALS AND METHODS: All adolescent MB patients started and finished between 2007 and 2012 were analysed. According to their pre-treatment BMI, patients were divided into one of the following groups: normal weight, overweight, or obese. Using the patients' records, the cooperation during treatment was classified as good, bad, or poor and the treatment duration was calculated. Using pre- and post-treatment photographs, white spot lesion (WSL) formation and gingivitis before and after MB therapy were assessed. RESULTS: Of the 175 subjects, 138 had a normal BMI (79 per cent), 22 were overweight (12.5 per cent), and 15 obese (8.5 per cent). Whereas 42.8 per cent of the normal weight patients showed a good cooperation, only 22.7 per cent of the overweight and 20.9 per cent of the obese patients cooperated sufficiently. On average, normal weight patients were treated for 22.2 months, overweight patients for 23.0 months, and obese patients for 27.7 months. Normal weight patients developed less WSL (41.3 per cent) during MB treatment than overweight (50 per cent) or obese (66.7 per cent) patients. Furthermore, patients with a normal weight or overweight had less gingival inflammation (79.5 per cent) after treatment than obese individuals (93.3 per cent). CONCLUSION: An increased BMI appears to be a risk factor for less cooperation, a longer treatment duration, and more oral health-related problems during MB treatment, indicating that these patients require special attention during orthodontic therapy.

Stress inhibits PYY secretion in obese and normal weight women.

The impact of stress on circulating levels of appetite-regulating hormones remains largely unknown. The aim of this study was to analyze the effect of acute psychosocial stress on the gut hormone peptide YY (PYY) secretion in obese and normal weight women. Therefore, we compared pre- and post-prandial plasma PYY secretion of 42 obese and 43 normal weight women in a repeated measure randomized controlled laboratory experiment. PYY and cortisol concentrations were measured and ratings of stress and satiety were also recorded in response to a psychological stressor (Trier Social Stress Test, TSST). PYY samples were collected in the fasting state both before participating in the TSST and before a control session. Participants had a standardized meal after the TSST and control session, respectively. PYY was measured both 30 and 60 min after the TSST and control session, respectively. Stress inhibited PYY secretion as well as food intake in all women, but did not influence subjective satiety perception. The present data indicate that despite of lower PYY levels the subjects' requirement to overeat was not increased. From an evolutionary perspective this finding is adaptive. After stress the organism is prepared for fight or flight reaction, whereas not primarily necessary functions are inhibited. Therefore, increased food intake during stress would be dysfunctional.

Stress-related cortisol response and laboratory eating behavior in obese women.

Stress-related cortisol secretion has been linked to increased appetite and subsequent food intake in overweight individuals. The present study addresses this relationship in a repeated-measures randomized controlled laboratory experiment. Nineteen obese women were compared to 36 normal weight controls with respect to stress-induced salivary cortisol and laboratory eating behavior, measured by a universal eating monitor. The trier social stress test served as stressor. Stress-induced cortisol levels were significantly higher in the obese compared to the normal weight controls. Unexpectedly, a corresponding increase in laboratory food intake was not detected. The results are interpreted and discussed with regard to restrained eating, which was found to be present to a significant degree in the obese women.

[Hygienic habits and health behaviors in patients with obesity].

Introduction: Smoking is the most common addiction in the world. Coexistence of smoking and obesity lead to a significant increase in the risk of cardiovascular diseases. It is also known that both the tobacco and excessive weight have a negative impact on oral health. Aim: Assessment of the frequency of smoking, hygienic habits and healthy behaviors in people with obesity. Material and Methods: The study included 125 people, of both sexes, aged from 20 to 65 years. The study group consisted of patients Clinic of Internal Medicine, Metabolic and Nutrition, Poznan University of Medical Sciences with a BMI> 25 kg/m2, control group - patients Clinic of Conservative Dentistry and Periodontology, Poznan University of Medical Sciences of normal weight (BMI <25 kg/m2). All participants were asked to complete a short survey on smoking, frequency of dental checkups and hygiene habits associated with the oral cavity. Results: In both groups of patients, obese and normal weight, we found similar percentages of smokers: 25 and 24.24%. Both groups showed a similar time of brushing, however, we found statistically significant differences in the frequency of tooth brushing. Conclusion: Despite the similar results obtained during the survey in both groups of patients, it seems necessary to take patients with obesity particularly dental care, enhancement of preventive measures as well as incitement to refrain from smoking.

Size misperception among overweight and obese families.

BACKGROUND: Perception of body size is a key factor driving health behavior. Mothers directly influence children's nutritional and exercise behaviors. Mothers of ethnic minority groups and lower socioeconomic status are less likely to correctly identify young children as overweight or obese. Little evaluation has been done of the inverse--the child's perception of the mother's weight. OBJECTIVE: To determine awareness of weight status among mother-child dyads (n = 506). DESIGN: Cross-sectional study conducted in an outpatient pediatric dental clinic of Columbia University Medical Center, New York, NY. PARTICIPANTS: Primarily Hispanic (82.2 %) mothers (n = 253), 38.8 ± 7.5 years of age, and children (n = 253), 10.5 ± 1.4 years of age, responding to a questionnaire adapted from the validated Behavioral Risk Factor Surveillance System. MAIN MEASURES: Anthropometric measures-including height, weight, and waist circumference-and awareness of self-size and size of other generation were obtained. KEY RESULTS: 71.4 % of obese adults and 35.1 % of overweight adults underestimated size, vs. 8.6 % of normal-weight (NW) adults (both p < 0.001). Among overweight and obese children, 86.3 % and 62.3 % underestimated their size, vs. 14.9 % NW children (both p < 0.001). Among mothers with overweight children, 80.0 % underestimated their child's weight, vs. 7.1 % of mothers with NW children (p < 0.001); 23.1 % of mothers with obese children also underestimated their child's weight (p < 0.01). Among children with obese mothers, only 13.0 % correctly classified the adult's size, vs. 76.5 % with NW mothers (p < 0.001). Among obese mothers, 20.8 % classified overweight body size as ideal, vs. 1.2 % among NW mothers (p < 0.001). CONCLUSION: Overweight/obese adults and children frequently underestimate their size. Adults misjudge overweight/obese children as being of normal weight, and children of obese mothers often underestimate the adult's size. Failure to recognize overweight/obesity status among adults and children can lead to prolonged exposure to obesity-related comorbidities.