Parents may be in denial when it comes to their kids’ weight.

Parents may be in denial when it comes to their kids’ weight.

About half of parents with overweight or obese children don’t think their kids are too heavy, a new study shows.

This is true in the U.S. and around the world, the researchers found.

“Parents who underestimate their kids’ weight may not take action to encourage healthy behaviors that would improve their child’s weight and reduce their risk of future health conditions,” says lead author Alyssa Lundahl, a graduate student in the clinical psychology program at the University of Nebraska, Lincoln.

These findings come after a study out last week showed that kids who are overweight in kindergarten are four times more likely to be obese by eighth grade compared with their normal-weight peers.

About a third of the nation’s young people are overweight or obese, says the Centers for Disease Control and Prevention. Extra pounds put kids at a higher risk for type 2 diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea, musculoskeletal problems and other health problems.

Lundahl and colleagues reviewed 69 studies involving almost 16,000 children, ages 2 to 18. Among findings in the March issue ofPediatrics, online today:

• 51% of parents with overweight or obese children thought their kids were a normal weight.

• About 14% of parents with normal-weight kids considered their child underweight.

• Parents of kids ages 2 to 5 were more likely to underestimate the weight of heavy children than parents of heavy kids in elementary school or older. “As kids get older, parents realize it’s not just baby fat any more, and the kids are not going to grow out of it,” Lundahl says.

• Parents were less accurate in judging the size of their sons, thinking that normal weight boys were actually underweight. “There is a belief that boys are supposed to be big, strong and muscular, so normal-weight sons are sometimes perceived as too small,” she says.

Children are classified as overweight or obese based on where they fall on body mass index (BMI) growth charts: Those at the 85th to 95th percentile are considered overweight; those at or above the 95th percentile are considered obese.

Exercise physiologist Melinda Sothern, co-author ofTrim Kidsand a professor at Louisiana State University Health Sciences Center in New Orleans, offers these suggestions for parents who want to improve the eating and exercise habits of their children:

• When kids are thirsty, give them water, not high-sugar beverages such as sodas. Serve fat-free or low-fat milk at meals.

• For treat foods, provide healthy fruits and snacks such as grapes, raisins and string cheese. When your child selects an unhealthy snack, redirect and give choices: Do you want strawberries, carrots or melon for your snack?

• Consume food and drinks only at the kitchen or dining room table or other designated areas.

• Have children eat a healthy breakfast.

• Reduce eating fast food to less than once a week.

• At the grocery store, have children select one fruit and vegetable to try each week and skip the candy, cookie and soda aisles.

• Provide opportunities for young children to safely climb, run and jump to encourage the development of muscular strength and endurance.

• Let your children try a variety of activities such as sports, dance, martial arts or swimming in a safe and encouraging program.

• Limit screen time to less than two hours a day.