Children who carry extra weight can sometimes have bones that look older than their actual age on an X-ray. Doctors call this "advanced bone age". This study asked whether a parent's health literacy is linked to that happening. Health literacy means being able to find, understand and use health information to make everyday decisions.
The researchers studied school-aged children with overweight or obesity and split them into two groups: those whose bone age was advanced and those whose was not. The article summary we had does not give the country, the children's exact ages or the number of children, so we cannot say how widely the findings apply. It is a cross-sectional study, meaning it took a snapshot at one point in time.
Higher parental health literacy, lower risk of advanced bone age
After the researchers accounted for factors such as the child's age, sex and BMI SDS (a measure of how a child's weight compares with other children of the same age and sex), higher parental health literacy was still linked to a lower risk of advanced bone age.
Because this is a snapshot, it shows a pattern, not a cause. The study cannot tell us that improving a parent's health literacy would slow a child's bone ageing.
Mothers' scores looked steadier, but fathers were not ruled out
Mothers' health literacy showed a more consistent link across the different statistical models. Fathers' results shifted more once other factors were taken into account.
However, when the researchers formally compared the two, the difference between mothers and fathers was not statistically significant (χ2 = 0.444, p = 0.505). In plain terms, the study cannot say that one parent matters more than the other.
The researchers also ran an exploratory test of how well each measure helped tell the two groups of children apart. Scores run up to 1, and higher is better. Adding maternal health literacy to a model of basic characteristics gave 0.734. Adding paternal health literacy gave 0.717, and combining both parents gave 0.733. These scores are close together, and the authors describe the analysis as exploratory.
The link was stronger for mothers with more education
The negative link between maternal health literacy and advanced bone age, meaning higher literacy went with lower risk, was more pronounced among mothers with higher educational levels. The summary does not explain why. It also does not say whether this applies to families in Singapore or elsewhere in Asia, so we should not assume it does.
What parents might take from this
The authors conclude that health education, such as that offered in paediatric nursing care, could help build parents' health literacy and support healthy bone growth in children with overweight or obesity. The study did not test this directly, so the actions below are modest.
- If a doctor has said your child is above a healthy weight, ask the nurse or doctor for health education. The authors suggest it can build parental health literacy.
- Include both parents in those conversations. The difference between mothers' and fathers' results was not statistically significant (p = 0.505).