Body image in middle school children

Healthier Minds in Fitter Bodies: A Systematic Review and Meta-Analysis of the Association between Physical Fitness and Mental Health in Youth

BACKGROUND

Physical fitness is an important marker of current and future health status, yet the association between physical fitness and indicators of mental health in youth has not been systematically reviewed and meta-analyzed.

OBJECTIVE

The aim of this work was to systematically review and meta-analyze the association between physical fitness components (i.e. cardiorespiratory fitness, muscular fitness, speed-agility, flexibility and fitness composite) and mental health indicators (i.e. psychological well-being and psychological ill-being) in preschoolers, children and adolescents.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Systematic searches were conducted in PubMed, Web of Science and Scopus from database inception to May 2020.

ELIGIBILITY CRITERIA

Studies (cross-sectional, longitudinal and intervention designs) were included if they measured at least one physical fitness component and one mental health indicator in healthy youth (2-18 years).

RESULTS

A total of 58 unique studies (52 cross-sectional, 4 longitudinal and 4 intervention studies) met all eligibility criteria and were included. There was a significant positive overall association between physical fitness and mental health in children and adolescents (pooled r = 0.206, p < 0.001). We found suggestive evidence of moderation by age group, fitness components and socioeconomic status (all p < 0.08). No relevant studies focusing on preschoolers were identified. Evidence based on longitudinal and intervention studies was limited.

CONCLUSION

We observed a small to medium sized positive association between physical fitness and overall mental health in youth. However, as the majority of studies were cross-sectional, additional longitudinal and intervention studies are needed to provide evidence of causation.

TRIAL REGISTRATION

PROSPERO registration number CRD42017080005.

Body Image and its Role in Physical Activity: A Systematic Review

Despite the benefits of youth sports, most children drop out by the age of 13 years. A better understanding of the etiology of sports dropout in children will serve to improve interventions to keep children active. The objective of this review was to investigate the associations between body image and perceived physical competence and sports attrition in children. A systematic literature review was conducted using PubMed and MEDLINE database searches in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Included studies were full-text English articles that addressed body image or perceived competence and attrition or dropout with subjects 21 years and younger. The results were organized by age to demonstrate the changing relationship body image has on physical activity. Evidence revealed that children younger than 7 years have an inflated self-perception and are eager to participate in activities regardless of competence. Between 7 to 10 years of age, children begin to more accurately perceive their skills and draw comparisons with their peers. Elevated body mass index (BMI) becomes a deterrent between 6 to 11 years. After 12 years, teasing and gender identification issues become causes of attrition. In adolescence, body image becomes a significant determinant of continuation of physical activity, more than actual skill. Perceived physical competency and body image do not appear to affect sports attrition in children younger than 7 years. As children get older, BMI/body image and physical competency become greater factors in sports attrition, with body image playing a significant role in adolescents.

[Association between dissatisfaction with body image and health-related physical fitness among adolescents]

The scope of this study was to estimate the prevalence of dissatisfaction with body image and verify the association between dissatisfaction with thinness or with overweight and health-related physical fitness components among adolescents. Participants included 1058 adolescents (570 girls and 488 boys), with mean age of 16.3 (±1.0) years. The investigated variables were dissatisfaction with body image (Figure Rating Scale), and health-related physical fitness: body fat (skin folds), muscle strength (handgrip strength) and cardiorespiratory fitness (mCAFT test). The association of body image and the health-related physical fitness variables was tested by Multinomial Regression analysis. The prevalence of body dissatisfaction was 75.2% (girls = 79.5%; boys = 70.3%). Girls and boys with high body fat were less likely to be dissatisfied with thinness and more likely to be dissatisfied with overweight. Those who needed to improve muscle strength and cardiorespiratory fitness were more likely to be dissatisfied with thinness and with overweight, respectively. In conclusion, physical fitness was associated with body image, with the adolescents with less healthy conditions of the components being more dissatisfied.

Middle school transition and body weight outcomes: Evidence from Arkansas Public Schoolchildren

There is evidence that middle school transition adversely affects educational and psychological outcomes of pre-teen children, but little is known about the impacts of middle school transition on other aspects of health. In this article, we estimate the impact of middle school transition on the body mass index (BMI) of public schoolchildren in Arkansas, United States. Using an instrumental variable approach, we find that middle school transition in grade 6 led to a moderate decrease of 0.04 standard deviations in BMI z-scores for all students. Analysis by subsample indicated that this result was driven by boys (0.06-0.07 standard deviations) and especially by non-minority boys (0.09 standard deviations). We speculate that the changing levels of physical activities associated with middle school transition provide the most reasonable explanation for this result.

Depression is more common in girls with nonatopic asthma

BACKGROUND

Asthma may increase the risk of comorbid depressive disorders in children. Children suffering from asthma or depression are more often overweight. We examined whether depression was more likely in children with atopic and nonatopic asthma, independent of abdominal adiposity.

METHODS

A cross-sectional analysis was performed on data collected in the Study of Asthma, Genes, and Environment in Canada. Children aged 11 to 14 years were assessed by a pediatric allergist to confirm asthma, allergic rhinitis, and atopic dermatitis diagnosis. Atopic asthma was defined based on skin prick testing and allergic asthma based on the presence of allergic rhinitis or atopic dermatitis in addition to asthma. Depressive symptoms were assessed using the Children's Depression Inventory-Short Form. Data were analyzed using logistic regression modeling to determine likelihood of depression in children with asthma, stratified by gender and adjusting for ethnicity, waist circumference (WC), and atopy.

RESULTS

Four hundred thirty-one children aged 11 to 14 years (136 with asthma and 295 without asthma) were studied. After adjusting for the covariates, girls who had nonatopic or nonallergic asthma were three times more likely to have comorbid depressive symptoms compared with healthy girls (OR, 2.84; 95% CI, 1.00-8.10; OR, 3.47; 95% CI, 1.30-9.25, respectively). For each 10-cm increase in WC of girls, our model showed a 39% to 56% increase in the chance of depression. In boys, neither asthma nor WC showed an association with depression.

CONCLUSIONS

We recommend all health practitioners who see girls with asthma or girls who are overweight watch for depressive symptoms and treat comorbid depression seriously.

Measured body mass index, body weight perception, dissatisfaction and control practices in urban, low-income African American adolescents

BACKGROUND

Current understanding of the associations between actual body weight status, weight perception, body dissatisfaction, and weight control practices among low-income urban African American adolescents is limited. The knowledge can help direct future intervention efforts.

METHODS

Cross-sectional data including measured weight and height and self-reported weight status collected from 448 adolescents in four Chicago Public Schools were used.

RESULTS

The prevalence of overweight and obesity (BMI > or = 85th percentile) was 39.8%, but only 27.2% considered themselves as obese, although 43.4% reported trying to lose weight. Girls were more likely to express weight dissatisfaction than boys, especially those with BMI > or = 95th percentile (62.9% vs. 25.9%). BMI > or = 85th percentile girls were more likely to try to lose weight than boys (84.6% vs. 66.7%). Among all adolescents, 27.2% underestimated and 67.2% correctly judged their own weight status. Multinomial logistic models show that those with BMI > or = 85th percentile, self-perceived as obese, or expressed body dissatisfaction were more likely to try to lose weight; adjusted odds ratios and 95% confidence intervals were 4.52 (2.53-8.08), 18.04 (7.19-45.30), 4.12 (1.64-10.37), respectively. No significant differences were found in diet and physical activity between those trying to lose weight and those not trying, but boys who reported trying to lose weight still spent more television time (P < 0.05).

CONCLUSION

Gender differences in weight perception, body dissatisfaction, and weight control practices exist among African American adolescents. One-third did not appropriately classify their weight status. Weight perception and body dissatisfaction are correlates of weight control practices. Adolescents attempting to lose weight need be empowered to make adequate desirable behavioral changes.

Sociocultural influences on body dissatisfaction and body change behaviors among Malaysian adolescents

Little research on body dissatisfaction and body change behaviors, and the sociocultural influences on them, has been undertaken in non-Western contexts. The current study investigated these variables and the relationships between them among a sample of 529 Malaysian high school students (103 Malays, 344 Chinese and 82 Indians), who completed a set of measures in classroom settings. Chinese girls were more dissatisfied with their bodies than Chinese boys, but no gender difference was found for Malay and Indian participants. Girls were more likely to engage in behaviors to lose weight, and boys were more likely to engage in behaviors to increase muscle. The influence of sociocultural factors on body dissatisfaction and body change behaviors was limited and varied across both sex and ethnicity. Findings are discussed in relation to Western research, and it is concluded that cultural nuances need to be considered when investigating these phenomena.

Eating disorder attitude and abnormal eating behaviours in a sample of 11-13-year-old school children: the role of pubertal body transformation

OBJECTIVE

A cross sectional study was performed to evaluate the presence, in a sample of subjects in the age of pubertal transition, of those psychological characteristics and abnormal eating behaviours, which are generally considered the predictors of eating disorders (EDs) in adolescence. The primary aim of our study was to evaluate the presence of EDs-related psychological traits and of abnormal eating behaviours, in a wide sample of natural 11-13-year-old population, and to determine if, in this period of transition, there are the same differences between males and females, which are related to the ED psychological characteristics that are often observed and assessed in samples of adolescents or young adults; our secondary aim was to evaluate, in the female sample, if and how the episode of menarche, and the related pubertal body transformation, play a role in the development of ED symptomatology.

METHOD

We screened 2925 school children by means of an ad-hoc socio-demographic schedule, the EDI 2 and the EDI-Symptom Checklist questionnaires. We compared each EDI 2 scales score (Mann-Whitney U) and the abnormal eating behaviours (chi(2) analyses) between pre- and post-menarche female subjects, for each age subgroup.

RESULTS

Fourteen percent of the entire sample scored higher than the cut-off value at the EDI 2 drive for thinness scale and have to be considered at risk for an ED onset. The EDI 2 scores and the adoption of abnormal eating behaviour increase, in the female population, depending on whether they have had menarche. In the male sample the mean values at EDI 2 scales decrease with increasing age.

DISCUSSION

The abnormal eating behaviours and the psychological ED attitude are widespread even among a "cross-pubertal" population. Our data confirm the differences between male and female subjects at the EDs attitude, suggesting a strong relation in the female children between the pubertal body transformation and the risk of ED onset.

Determinants of eating attitudes among overweight and non-overweight adolescents

PURPOSE

Limited research has examined the determinants of eating attitudes among both adolescent boys and girls. The aims of this study were to examine the extent to which depressive symptoms, body satisfaction, and physical activity (PA) predict eating attitudes in adolescent boys and girls, and to determine the moderating influences of sex and body mass index (BMI).

METHODS

The participants (N = 646 adolescent boys and girls; mean age 14.28 years; 49% boys) completed self-reported measures of their depressive symptoms, body satisfaction, leisure-time PA, and eating attitudes during their high school health and physical education classes.

RESULTS

Hierarchical regression analyses revealed that: (1) BMI, depressive symptoms, body satisfaction, PA, and their interaction terms explained 14% and 17% of the variance in eating attitudes for boys and girls, respectively; (2) BMI moderated the contributions of body satisfaction and PA for predicting eating attitudes such that overweight boys scored lower on body satisfaction and higher on PA than normal-weight boys; and (3) BMI did not moderate the contributions of any of the psychobehavioral constructs for predicting eating attitudes among girls.

CONCLUSIONS

Our findings illustrate that eating attitudes are determined differently for boys and girls, and the findings demonstrate the need for sex-specific interventions to promote healthy eating attitudes and behaviors during adolescence.

Prevalence of overweight and obesity in Sardinian adolescents

BACKGROUND

To estimate the prevalence of overweight and obesity among adolescents in Sardinia and to examine the association with several biological and geographic factors.

METHODOLOGY

A cross-sectional study was performed in 3,946 unselected adolescents (2,011 boys, 1,935 girls; aged 11-15 years) attending the public secondary schools in 33 Sardinian municipalities: 28 semi-rural, 5 urban, sub-grouped according to their geographic location (mountain, hillside and plain). Oversized children were measured and their BMI defined as being above normal values according to parameters provided by the International Obesity Task Force (IOFT) by Cole et al. (BMI for age > or = 95th percentile). Relative risk for overweight and obesity was calculated using Poisson regression analysis: risks associated to each covariate were reciprocally adjusted. The 95% confidence interval (CI) of the estimated risk was calculated using Wald's formula (RR, RR = log(n) beta +/- 1.96 se(beta)).

MAIN FINDINGS

The overall prevalence rate found for overweight and obesity was 14.9% (95% C.I.: 13.7-16.1%) and 3.7% (95% C.I. 3.1-4.3%), respectively. Overweight rate showed no association with gender, whereas belonging to the female sex constituted a significant protection against obesity. Increasing age in the range 12-14 years was protective against both overweight and obesity in the whole sample. A similar finding however was not observed for obesity in girls or overweight in boys, when considered separately. Boys, but not girls, living in urban areas displayed a modest though significant 20% increase in overweight and a 40% decrease in obesity risk. Living in a mountainous area conveyed a 30% decrease in risk of overweight and a 50% decrease in risk of obesity, when compared to living on the plains and hillside combined. However, the small sample size of study subjects living in mountainous areas generated extremely wide 95% confidence intervals, thereby preventing the drawing of any significant conclusions.

CONCLUSION

In comparison with other surveys performed by the IOFT, Sardinian adolescents show a low prevalence rate for oversize, emphasizing a marked discrepancy with the general north-south rising trend of oversize observed throughout Europe. Geographic location, aesthetic or other age related factors seem to exert a different gender-specific influence on overweight and obesity.

SIGNIFICANCE

The present report is cross sectional and the consequences of overweight and obesity on individuals over time are not traceable. However, the outcome of the study suggests the need to implement suitable policies and public health programs leading to increased awareness.

Body Image and Children’s Mental Health Related Behaviors: Results from the Healthy Passages Study

OBJECTIVE

This study examined the relationship between body image discrepancy (BID) scores for actual versus ideal body image for children and indicators of child mental health.

METHODS

Data were collected from 650 5th graders and their parents who participated in the Healthy Passages Phase I study. Participants were recruited through schools in Alabama, California, and Texas. Measures included the Collins Body Image to produce child- and parent-reported child BID scores, respectively, body mass index (BMI) for child and parent, the Strengths and Difficulties Questionnaire (SDQ), and the Positive and Negative Affect Scale for Children (PANAS-C).

RESULTS

After controlling for potential confounders, children's internalizing problems as rated by parents and negative affect as rated by children were significantly associated with discrepancies based on child- and parent-reported child BID scores, respectively.

CONCLUSIONS

Overall, higher child- and parent-reported child BID scores were significantly associated with more internalizing problems and negative affect among children. There were some inconsistencies in the associations between other mental health behaviors and child BID scores contingent on parent or child ratings. Early intervention may be indicated to prevent possible adverse consequences, especially for internalizing problems, from the effects of child- and parent-reported child BID scores on adolescent and adult mental health and well-being.

Predictors of body dissatisfaction in boys and girls with asthma

BACKGROUND

Body satisfaction is an important issue for youth. Youth with more severe asthma may have experiences and emotions associated with less body satisfaction; however, this has not been studied.

OBJECTIVE

To identify correlates of body dissatisfaction in youth with asthma.

METHODS

Sixty-three females and 60 males, ages 8-18 years with asthma, completed measures of body dissatisfaction, anxiety, depression, asthma symptoms, and behaviors. Parents completed measures of asthma limitations; clinicians rated asthma severity.

RESULTS

Anxiety, depression, and body mass index (BMI) accounted for 21 and 15% of the variance in body dissatisfaction for females and males, respectively. Physical activity added 13% variance to the above model for females. Asthma symptoms added 14% for males. Of note, neither parent ratings of asthma limitations nor clinician ratings of asthma severity contributed additional variance.

CONCLUSION

This study increases our understanding of youth with asthma and provides future research directions.