{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:06:53Z","timestamp":1788930413932,"version":"build-2803163510"},"reference-count":76,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CIHR MOP-246983-ABH-CCAA-11829-FRN-115096"],"award-info":[{"award-number":["CIHR MOP-246983-ABH-CCAA-11829-FRN-115096"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"award":["CIHR MOP-246983-ABH-CCAA-11829-FRN-115096"],"award-info":[{"award-number":["CIHR MOP-246983-ABH-CCAA-11829-FRN-115096"]}],"id":[{"id":"https:\/\/ror.org\/01gavpb45","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background\/Objectives: Indigenous children in Canada face higher rates of overweight and obesity compared to non-Indigenous children. Parents\u2019 perceptions of their child\u2019s body weight are shaped by broader systemic influences, including historical trauma and limited access to healthy food. This study aimed to evaluate the association between children\u2019s actual body weight (measured by BMI) and parental perceptions among First Nations children. Methods: Participants were children from two Saskatchewan First Nations communities involved in the First Nations Lung Health Project (2013 and 2017). Self-administered questionnaires were distributed through schools to parents of children in Grades 1\u201312. The questionnaire collected data on health, environment, physical activity, and diet. Parents assessed their child\u2019s weight as underweight, about the right weight, or overweight. BMI was calculated using clinically measured height and weight. Logistic regression was used to identify predictors of BMI misclassification. Results: Among 472 children with both survey and clinical data, 42.6% were boys. Clinically measured overweight prevalence was 52.3%, compared to 15.9% based on parental perception. Overall, 58% of parents accurately perceived their child\u2019s weight status. Misclassification was more likely among children who engaged in at least 60 min of daily physical activity on more days per week. Conclusions: Parents underestimated their children\u2019s overweight status compared to clinical measures. Questionnaire-based assessments significantly underestimated true weight status among school-aged First Nations children. These findings highlight the need to consider systemic and environmental factors when addressing childhood obesity in First Nations communities.<\/jats:p>","DOI":"10.3390\/children13091197","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:07:32Z","timestamp":1788538052000},"page":"1197","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Actual Body Weight and the Parent\u2019s Perspective of Child\u2019s Body Weight Among Canadian First Nations Children"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6960-5583","authenticated-orcid":false,"given":"Chandima P.","family":"Karunanayake","sequence":"first","affiliation":[{"name":"Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Dosman","sequence":"additional","affiliation":[{"name":"Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada"},{"name":"Department of Medicine, College of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Seeseequasis","sequence":"additional","affiliation":[{"name":"Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Naytowhow","sequence":"additional","affiliation":[{"name":"Community A, P.O. Box 250, Montreal Lake, SK S0J 1Y0, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reynaldo","family":"Lindain","sequence":"additional","affiliation":[{"name":"Community A, P.O. Box 250, Montreal Lake, SK S0J 1Y0, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warren","family":"Seesequasis","sequence":"additional","affiliation":[{"name":"Community B, P.O. Box 96, Duck Lake, SK S0K 1J0, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5776-5328","authenticated-orcid":false,"given":"Kathleen","family":"McMullin","sequence":"additional","affiliation":[{"name":"Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6100-2307","authenticated-orcid":false,"given":"Meera J.","family":"Kachroo","sequence":"additional","affiliation":[{"name":"Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Kirychuk","sequence":"additional","affiliation":[{"name":"Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada"},{"name":"Department of Medicine, College of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punam","family":"Pahwa","sequence":"additional","affiliation":[{"name":"Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada"},{"name":"Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"ref_1","unstructured":"Public Health Agency of Canada (2026, March 19). Obesity Statistics in Canada, Available online: https:\/\/www.canada.ca\/content\/dam\/phac-aspc\/documents\/services\/publications\/healthy-living\/obesity-statistics-canada\/obesity-statistics-canada.pdf."},{"key":"ref_2","unstructured":"National Aboriginal Health Organization (NAHO) (2026, March 19). Fact Sheet. Aboriginal Children and Obesity. Available online: https:\/\/ruor.uottawa.ca\/server\/api\/core\/bitstreams\/53c52b0a-0f2c-46a8-b345-5d6ecbb262be\/content."},{"key":"ref_3","unstructured":"First Nations Regional Longitudinal Health Survey (RHS) (2005). 2002\/03, Results for Adults, Youth and Children Living in First Nations Communities, First Nations Centre. Available online: https:\/\/fnigc.ca\/wp-content\/uploads\/2020\/09\/6d630af33e986fb89b6f89895e540513_rhs2002-03-technical_report.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Banerji, A., Pelletier, V.A., Haring, R., Irvine, J., Bresnahan, A., and Lavallee, B. (2023). Food insecurity and its consequences in indigenous children and youth in Canada. PLoS Glob. Public Health, 3, Erratum in: PLoS Glob. Public Health 2024, 4, e0003552.\t\t  https:\/\/doi.org\/10.1371\/journal.pgph.0003552.","DOI":"10.1371\/journal.pgph.0003552"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1017\/S1368980021003487","article-title":"Diet quality and food security amongst Indigenous children in Canada: Facing the legacy of decades of dispossession and governmental neglect","volume":"25","author":"Batal","year":"2022","journal-title":"Public Health Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Malli, A., Monteith, H., Hiscock, E.C., Smith, E.V., Fairman, K., Galloway, T., and Mashford-Pringle, A. (2023). Impacts of colonization on Indigenous food systems in Canada and the United States: A scoping review. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-16997-7"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1139\/h11-128","article-title":"A socioecological framework to understand weight-related issues in Aboriginal children in Canada","volume":"37","author":"Willows","year":"2012","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1038\/oby.2007.108","article-title":"Parental recognition of overweight in school-age children","volume":"16","author":"West","year":"2008","journal-title":"Obesity"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"306703","DOI":"10.1155\/2010\/306703","article-title":"Parental Misperception of their child\u2019s body weight status impedes the assessment of the child\u2019s lifestyle behaviors","volume":"2010","author":"Mathieu","year":"2010","journal-title":"Int. J. Pediatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1177\/1941406409341479","article-title":"Parent Perceptions of Children\u2019s Weight Status, Nutrition, and Activity Level","volume":"1","author":"Chiang","year":"2009","journal-title":"Infant Child Adolesc. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1111\/j.1525-1446.2007.00666.x","article-title":"Maternal perception of their overweight children","volume":"24","author":"Hackie","year":"2007","journal-title":"Public Health Nurs."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e1495","DOI":"10.1542\/peds.2007-2642","article-title":"Accurate parental classification of overweight adolescents\u2019 weight status: Does it matter?","volume":"121","author":"Wall","year":"2008","journal-title":"Pediatrics"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e234","DOI":"10.3399\/bjgp15X684385","article-title":"Child obesity cut-offs as derived from parental perceptions: Cross-sectional questionnaire","volume":"65","author":"Black","year":"2015","journal-title":"Br. J. Gen. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1097\/MPG.0b013e31815a34","article-title":"Body perception: Do parents, their children, and their children\u2019s physicians perceive body image differently?","volume":"47","author":"Chaimovitz","year":"2008","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1038\/oby.2004.217","article-title":"Mothers\u2019 perceptions of their adolescents\u2019 weight status: Are they accurate?","volume":"12","author":"Boutelle","year":"2004","journal-title":"Obes. Res."},{"key":"ref_16","first-page":"1493","article-title":"Are parents aware that their children are overweight or obese?","volume":"53","author":"He","year":"2007","journal-title":"Can. Fam. Phys."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1159\/000517586","article-title":"Parental Perceptions of Children\u2019s Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015\/2017","volume":"14","author":"Buoncristiano","year":"2021","journal-title":"Obes. Facts."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"103097","DOI":"10.1016\/j.pmedr.2025.103097","article-title":"Parental perceptions of child weight status and the interplay of socio-demographic factors and children\u2019s BMI in South-Western Sydney: The growing healthy kids Survey, Australia","volume":"54","author":"Kovai","year":"2025","journal-title":"Prev. Med. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s40292-019-00352-2","article-title":"Parental Perception of Children\u2019s Weight Status: Love Overpasses Scientific Evidence! A Cross-Sectional Observational Study","volume":"27","author":"Sirico","year":"2020","journal-title":"High Blood Press. Cardiovasc. Prev."},{"key":"ref_20","unstructured":"Henderson, R.I., Boyling, E., McInnes, A., Green, M., Jacklin, K., Walker, L., Calam, B., Toth, E., and Crowshoe, L. (2020). Canadian Adult Obesity Clinical Practice Guidelines: Obesity Management and Indigenous Peoples, Obesity Canada. Available online: https:\/\/obesitycanada.ca\/guidelines\/indigenouspeoples."},{"key":"ref_21","first-page":"175","article-title":"The Effectiveness of Indigenous Knowledge-Based Lifestyle Interventions in Preventing Obesity and Type 2 Diabetes Mellitus in Indigenous Children in Canada: A Systematic Review","volume":"14","author":"Kshatriya","year":"2023","journal-title":"Adolesc. Health Med. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"77","DOI":"10.24095\/hpcdp.37.3.03","article-title":"The association of household food security, household characteristics and school environment with obesity status among off-reserve First Nations and M\u00e9tis children and youth in Canada: Results from the 2012 Aboriginal Peoples Survey","volume":"37","author":"Bhawra","year":"2017","journal-title":"Health Promot. Chronic Dis. Prev. Can."},{"key":"ref_23","first-page":"497","article-title":"The prevalence of overweight and obesity in Indigenous kindergarten children--a cross sectional population-based study","volume":"42","author":"Hickie","year":"2013","journal-title":"Aust. Fam. Physician"},{"key":"ref_24","unstructured":"(2026, June 30). Government of Canada Publications Words First 2022. Available online: https:\/\/publications.gc.ca\/collections\/Collection\/R2-236-2002E.pdf."},{"key":"ref_25","unstructured":"University of British Columbia (2026, June 30). First Nations Studies Program. Terminology. Available online: http:\/\/indigenousfoundations.arts.ubc.ca\/terminology\/."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Pahwa, P., Abonyi, S., Karunanayake, C., Rennie, D., Janzen, B., Kirychuk, S., Lawson, J., Katapally, T., McMullin, K., and Seeseequasis, J. (2015). A community-based participatory research methodology to address, redress and reassess disparities in respiratory health among First Nations. BMC Res. Notes, 8.","DOI":"10.1186\/s13104-015-1137-5"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1523897","DOI":"10.1155\/2016\/1523897","article-title":"Ear infection and Its Associated Risk Factors in First Nations and Rural School-Aged Canadian Children","volume":"2016","author":"Karunanayake","year":"2016","journal-title":"Int. J. Pediatr."},{"key":"ref_28","unstructured":"Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada (2014). Research Involving the First Nations, Inuit and M\u00e9tis Peoples of Canada, Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans, TCPS2 2014."},{"key":"ref_29","first-page":"1","article-title":"2000 CDC growth charts for the United States: Methods and development","volume":"11","author":"Kuczmarski","year":"2002","journal-title":"Vital. Health Stat."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1542\/peds.111.S1.1226","article-title":"Maternal perceptions of weight status of children","volume":"111","author":"Maynard","year":"2003","journal-title":"Pediatrics"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1136\/bmj.39238.399444.55","article-title":"Body mass index cutoffs to define thinness in children and adolescents: International survey","volume":"335","author":"Cole","year":"2007","journal-title":"BMJ"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1136\/bmj.320.7244.1240","article-title":"Establishing a standard definition for child overweight and obesity worldwide: An international survey","volume":"320","author":"Cole","year":"2000","journal-title":"BMJ"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Hosmer, D.W., Lemeshow, S., and Sturdivant, R.X. (2013). Assessing the Fit of the Model. Applied Logistic Regression, JohnWiley & Sons Inc.. [3rd ed.].","DOI":"10.1002\/9781118548387"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1093\/eurpub\/ckl253","article-title":"Reported versus measured body weight and height of 4-year-old children and the prevalence of overweight","volume":"17","author":"Scholtens","year":"2006","journal-title":"Eur. J. Public Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.apnr.2010.06.001","article-title":"The validity of self-report weight and height as a surrogate method for direct measurement","volume":"25","year":"2012","journal-title":"Appl. Nurs. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2109","DOI":"10.1542\/peds.2006-0961","article-title":"Validity of parentally reported weight and height for preschool-aged children in Belgium and its impact on classification into body mass index categories","volume":"118","author":"Huybrechts","year":"2006","journal-title":"Pediatrics"},{"key":"ref_37","first-page":"47","article-title":"Obesity estimates for children based on parent-reported versus direct measures","volume":"22","author":"Shields","year":"2011","journal-title":"Health Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e12532","DOI":"10.2196\/12532","article-title":"Accuracy of parent-reported child height and weight and calculated body mass index compared with objectively measured anthropometrics","volume":"21","author":"Chai","year":"2019","journal-title":"J. Med. Internet Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.pedhc.2007.12.014","article-title":"Do parents accurately perceive their child\u2019s weight status?","volume":"23","author":"Jordan","year":"2009","journal-title":"J. Pediatr. Health Care"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Vivian, E.M., Becker, T.L., and Carrel, A.L. (2012). Weight perceptions of parents with children at risk for diabetes. BMC Res. Notes, 5.","DOI":"10.1186\/1756-0500-5-47"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1038\/ijo.2011.106","article-title":"Parental perceptions of weight status in children: The Gateshead Millennium Study","volume":"35","author":"Jones","year":"2011","journal-title":"Int. J. Obes."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e112","DOI":"10.1542\/peds.2006-2143","article-title":"Parental ability to discriminate the weight status of children: Results of a survey","volume":"120","author":"Huang","year":"2007","journal-title":"Pediatrics"},{"key":"ref_43","first-page":"575184","article-title":"Barriers to lose weight from the perspective of children with overweight\/obesity and their parents: A sociocultural approach","volume":"2014","year":"2014","journal-title":"J. Obes."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Remmers, T., van Grieken, A., Renders, C.M., Hirasing, R.A., Broeren, S.M.L., and Raat, H. (2014). Correlates of parental misperception of their child\u2019s weight status: The \u2018Be Active, Eat Right\u2019 study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0088931"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1740-8709.2012.00462.x","article-title":"Difference between parental perception and actual weight status of children: A systematic review","volume":"9","author":"Paulis","year":"2013","journal-title":"Matern. Child Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1007\/s10826-014-9945-0","article-title":"Parental perception of child\u2019s body weight: A systematic Review","volume":"24","author":"Tompkins","year":"2015","journal-title":"J. Child Fam. Stud."},{"key":"ref_47","first-page":"23","article-title":"Parental perceptions of the preschool obese child","volume":"26","author":"Myers","year":"2000","journal-title":"Pediatr. Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1177\/0009922810368288","article-title":"Parents\u2019 healthy weight perceptions and preferences regarding obesity counselling in preschoolers: Pediatricians matter","volume":"49","author":"Hernandez","year":"2010","journal-title":"Clin. Pediatr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/j.1745-7599.2008.00382.x","article-title":"Parental disconnect between perceived and actual weight status of children: A metasynthesis of the current research","volume":"21","author":"Doolen","year":"2009","journal-title":"J. Am. Acad. Nurs. Pract."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Almoosawi, S., Jones, A.R., Parkinson, K.N., Pearce, M.S., Collins, H., and Adamson, A.J. (2016). Parental Perception of Weight Status: Influence on Children\u2019s Diet in the Gateshead Millennium Study. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0144931"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.jped.2014.01.009","article-title":"Mothers\u2019 perceptions about the nutritional status of their overweight children: A systematic review","volume":"90","author":"Francescatto","year":"2014","journal-title":"J. Pediatr."},{"key":"ref_52","unstructured":"Wahi, G. (2021). Health Promotion and Childhood Obesity Among Indigenous Children: Understanding Community Priorities, Prevention Programs and Protective Factors [Dissertation], McMaster University. Available online: https:\/\/prod-ms-be.lib.mcmaster.ca\/server\/api\/core\/bitstreams\/c159a1a1-1620-48a6-bece-4ea0335d1cee\/content."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"38","DOI":"10.3892\/wasj.2023.215","article-title":"Childhood obesity: Facts and parental perceptions","volume":"5","author":"Abbas","year":"2023","journal-title":"World Acad. Sci. J."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1007\/s12519-022-00540-6","article-title":"Parental perception of child\u2019s weight, their attitudes towards child\u2019s dietary habits and the risk of obesity","volume":"18","author":"Berasaluce","year":"2022","journal-title":"World J. Pediatr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1177\/1049732308325537","article-title":"Parental perceptions of overweight during early childhood","volume":"18","author":"Goodell","year":"2008","journal-title":"Qual. Health Res."},{"key":"ref_56","unstructured":"World Obesity Federation (2025). Report Card\u2013Children: Canada, World Obesity Observatory. Available online: https:\/\/data.worldobesity.org\/country\/canada-36\/report-card-children.pdf."},{"key":"ref_57","unstructured":"Arriagada, P. (2026, June 10). Food Insecurity Among Inuit Living in Inuit Nunangat, Available online: https:\/\/www150.statcan.gc.ca\/n1\/pub\/75-006-x\/2017001\/article\/14774-eng.htm."},{"key":"ref_58","unstructured":"Inuit Tapiriit Kanatami (2021). Inuit Nunangat Food Security Strategy, Inuit Tapiriit Kanatami. Available online: https:\/\/itk.ca\/projects\/inuit-nunangat-food-security-strategy\/."},{"key":"ref_59","unstructured":"Polar Knowledge Canada (2026, June 10). Understanding the Effects of Climate Change on Food Security in Northern Indigenous Communities, Available online: https:\/\/www.canada.ca\/en\/polar-knowledge\/publications\/aqhaliat\/volume-4\/climate-change.html."},{"key":"ref_60","unstructured":"Abrahamson-Richards, T. (2014). The Effects of Perceived Body Weight on Dieting Behaviors and Physical Activity in Overweight and Obese American Indian and Alaska Native Adolescents. [Master\u2019s Thesis, University of Washington]. Available online: https:\/\/digital.lib.washington.edu\/researchworks\/items\/fe9377dc-c7fb-4344-83ef-07951e9ee92b\/full."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1542\/peds.2008-3586C","article-title":"Introduction to issues and implications of screening, surveillance, and reporting of children\u2019s BMI","volume":"70","author":"Dietz","year":"2009","journal-title":"Pediatrics"},{"key":"ref_62","unstructured":"World Health Organization (2020). BMI Classification and Use."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/NT.0000000000000092","article-title":"Body mass index: Obesity, BMI, and health: A critical review","volume":"50","author":"Nuttall","year":"2015","journal-title":"Nutr. Today"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1542\/peds.108.3.712","article-title":"Relationship of childhood obesity to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study","volume":"108","author":"Freedman","year":"2001","journal-title":"Pediatrics"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"S161","DOI":"10.2337\/dc11-s212","article-title":"Type 2 diabetes in youth: Epidemiology and pathophysiology","volume":"34","author":"Caprio","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s40273-014-0243-x","article-title":"The epidemiology of obesity: A big picture","volume":"33","author":"Hruby","year":"2015","journal-title":"Pharmacoeconomics"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1111\/j.2047-6310.2012.00064.x","article-title":"Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity","volume":"7","author":"Cole","year":"2012","journal-title":"Pediatr. Obes."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Benedet, J., da Silva Lopes, A., Adami, F., de Fragas Hinnig, P., and de Assis Guedes de Vasconcelos, F. (2014). Association of sexual maturation with excess body weight and height in children and adolescents. BMC Pediatr., 14.","DOI":"10.1186\/1471-2431-14-72"},{"key":"ref_69","first-page":"3","article-title":"A comparison of self-reported leisure time physical activity and measured moderate-to-vigorous physical activity in adolescents and adults. Statistics Canada, Catalogue No. 82-003-X","volume":"25","author":"Garriguet","year":"2014","journal-title":"Health Rep."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1111\/j.1746-1561.1991.tb06017.x","article-title":"Self-reported measures of children\u2019s physical activity","volume":"61","author":"Sallis","year":"1991","journal-title":"J. Sch. Health"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1136\/thoraxjnl-2012-202285","article-title":"Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three","volume":"68","author":"Ellwood","year":"2013","journal-title":"Thorax"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1111\/j.1365-2214.2011.01349.x","article-title":"Fast-food consumption and educational test scores in the USA","volume":"39","author":"Tobin","year":"2013","journal-title":"Child Care Health Dev."},{"key":"ref_73","unstructured":"Reading, C.L., and Wien, F. (2009). Health Inequalities and Social Determinants of Aboriginal Peoples\u2019 Health, National Collaborating Centre for Aboriginal Health."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1001\/archpediatrics.2009.18","article-title":"Prevalence of obesity among US preschool children in different racial and ethnic groups","volume":"163","author":"Anderson","year":"2009","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_75","first-page":"2665","article-title":"Body weight perceptions and eating-related weight control behaviors of on-reserve First Nations youth from Ontario, Canada","volume":"14","author":"Gates","year":"2014","journal-title":"Rural Remote Health"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1177\/1049732312443737","article-title":"Using First Nations children\u2019s perceptions of food and activity to inform an obesity prevention strategy","volume":"22","author":"Pigford","year":"2012","journal-title":"Qual. Health Res."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1197\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:15:31Z","timestamp":1788927331000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/9\/1197"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":76,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["children13091197"],"URL":"https:\/\/doi.org\/10.3390\/children13091197","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]}}}