Trends in the perceived body size of adolescent males and females in Scotland, 1990-2014: changing associations with mental well-being

Perceived Barriers to Physical Activity Among Youth Living in Rural and Urban Canadian Communities: A Nationally Representative Cross-Sectional Study

BACKGROUND

We used nationally representative data to explore associations among location of residence (rural/urban) and perceived barriers to physical activity (PA) in Canadian youth.

METHODS

We analyzed the 2017 Canadian Community Health Survey, Barriers to Physical Activity Rapid Response data for 12- to 17-year-old youth. Nine items from the survey assessing perceived barriers to PA were combined into 3 barrier domains: resources, motivational, and socioenvironmental. The likelihood of reporting barriers to PA based on rural-urban location was examined using survey-weighted binary logistic regression following a model fitting approach. Sociodemographic factors were modeled as covariates and tested in interaction with location. For each barrier domain, we derived the best-fitting model with fewest terms.

RESULTS

There were no location-specific effects related to reporting any barrier or motivation-related PA barriers. We found a sex by location interaction predicting the likelihood of reporting resource-related barriers. Rural boys were less likely to report resource-related barriers compared with urban boys (odds ratio [OR] = 0.42 [0.20, 0.88]). Rural girls were more likely to report resource-related barriers compared with boys (OR = 3.72 [1.66, 8.30]). Regarding socioenvironmental barriers, we observed a significant body mass index by location interaction demonstrating that rural youth with body mass index outside the "normal range" showed a higher likelihood of reporting socioenvironmental barriers compared with urban youth (OR = 2.38 [1.32, 4.30]). For urban youth, body mass index was unrelated to reporting socioenvironmental barriers (OR = 1.07 [0.67, 1.71]).

CONCLUSION

PA barriers are not universal among Canadian youth. Our analyses highlight the importance of testing interactions in similar studies as well as considering key sociodemographic characteristics when designing interventions.

Association between weight, weight perception, weight teasing and mental health among adolescents

BACKGROUND

Adolescent mental health problems are becoming increasingly prevalent, and there are correlations between weight-related concerns and adolescent mental health. The aim of this study is to explore the association between three weight-related factors (actual weight, weight perception, and weight teasing) and mental health problems (depressive symptoms, anxiety symptoms, and loneliness) in Chinese adolescents.

METHODS

10,070 adolescents between the ages of 11-18 from schools in Shanghai, China were selected using a stratified random cluster sampling method. Self-reported questionnaires were collected to investigate weight-related factors and mental health problems. Logistic regression analysis was used to examine the relationship.

RESULTS

The prevalence of depressive symptoms, loneliness, mild anxiety symptoms, and moderate to severe anxiety symptoms among adolescents were 18.0%, 53.8%, 26.5%, and 12.3%, respectively, with a higher prevalence found in females. After adjusting for weight perception and weight teasing, actual weight had no harmful impact on adolescents' mental health. Adolescents' perception of being overweight increased the risk of depressive symptoms, loneliness, mild anxiety symptoms, and moderate to severe anxiety symptoms, while the perception of being underweight had a similar but more profound impact (depressive symptoms OR = 1.590, 95% CI: 1.342-1.883; loneliness OR = 1.537, 95% CI: 1.353-1.746; mild anxiety symptoms OR = 1.368, 95% CI: 1.178-1.589; moderate to severe anxiety symptoms OR = 1.780, 95% CI: 1.449-2.186). Experiencing weight teasing more than once a year had a greater effect on adolescents' mental health, especially among adolescents with overweight/obesity (depressive symptoms OR = 2.970, 95% CI: 2.325-3.793; loneliness OR = 3.839, 95% CI: 3.119-4.727; mild anxiety symptoms OR = 2.822, 95% CI: 2.236-3.562; moderate to severe anxiety symptoms OR = 5.212, 95% CI: 3.846-7.065).

CONCLUSIONS

The prevalence of mental health problems among adolescents was high, especially loneliness. Weight perception and weight teasing, but not the actual weight, independently influenced adolescent mental health.

Assessment of Factors Associated With Mental Well-Being Among Chinese Youths at Individual, School, and Province Levels

Importance

Although rapid urbanization in China provided improved economic prosperity and educational opportunities, it was associated with increased internalizing and externalizing problems among youths, with negative outcomes for mental well-being. Previous studies suggested that factors in individual, school, and regional levels were associated with mental well-being, and comprehensively examining these factors may provide evidence for policies for improving youth mental health.

Objective

To investigate factors associated with mental well-being at individual, school, and province levels among Chinese youths.

Design, Setting, and Participants

This cross-sectional study analyzed nationally representative data collected December 1, 2021, to January 1, 2022, from schools in China. Among 435 schools, 144 institutions had primary school students, 107 institutions had middle school students, 95 institutions had primary and middle school students, and 89 institutions had high school students. A total of 398 520 students were included.

Exposures

Characteristics at individual, school, and province levels.

Main outcomes and measures

The main outcome was mental well-being, assessed by the Short Warwick-Edinburgh Mental Well-being Scale. Linear mixed-effects models were used to investigate individual, school, and regional disparities in mental well-being among youths.

Results

There were 398 520 participants (194 460 females [48.80%]; mean [SD; range] age, 13.78 [2.40; 9-20] years). At the school level, 352 443 students (88.44%) were in public school and 291 354 students (73.11%) were in urban schools. Drinking (coefficient = -1.08; 95% CI, -1.12 to -1.05; P < .001), smoking (coefficient = -0.89; 95% CI, -0.96 to -0.83; P < .001), and increased age (coefficient per 1-year increase in age = -0.02; 95% CI, -0.03 to -0.01; P < .001) were associated with worse mental well-being. Male sex (coefficient = 1.01; 95% CI, 0.98 to 1.04; P < .001), being in a 1-child family (coefficient = 0.17; 95% CI, 0.13 to 0.20; P < .001), being in the Han group (coefficient vs other ethnic groups = 0.20; 95% CI, 0.14 to 0.26; P < .001), a higher frequency and coverage of psychological courses (eg, ≥2/wk for all students vs none: coefficient = 1.02; 95% CI, 0.36 to 1.69; P = .003), and a higher level of self-rated popularity in school (coefficient per 1-unit increase in score = 0.89; 95% CI, 0.88 to 0.89; P < .001) were associated with improved mental well-being. However, age (eg, age and 1 courses/2 wk for all students: coefficient per 1-year increase in age = -0.047; 95% CI, -0.089 to -0.005; P = .03) and sex (eg, female sex and ≥2 courses/wk for some students: coefficient = -0.184; 95% CI, -0.323 to -0.046; P = .009) had interactions with the association between psychological courses and mental well-being.

Conclusions and relevance

This study found that social disparities in mental well-being existed and that various factors at different levels were associated with mental well-being among Chinese youths. These findings suggest that public mental health programs may be recommended for associated improvements in regional disparities in mental health resources.

Relationship between eating disorders perception and psychosocial profile in school-dropout adolescents

BACKGROUND

In body-mind relationship field, eating disorders (ED) are considered disabling disorders that can alter physical health status, inducing profound alterations in psychosocial, cognitive and emotional dimensions. These disorders, characterized by a strong comorbidity with other diseases, usually begin during childhood or adolescence, and include anorexia nervosa, bulimia nervosa and binge eating. Aim of this study was to investigate the associations between eating disorders perception and dimensions of health-related quality of life (HRQoL) and well-being perception (WBP) in school-dropout adolescents.

METHODS

Data were collected in 450 adolescents (19 ± 2 years, male 308), and HRQoL, WBP, and ED were assessed by means a battery of standardized questionnaire.

RESULTS

EDs are more pronounced in females than in males (p < 0.05) and are associated with lower HRQoL (p < 0.001) and lower well-being perception (p < 0.001). EDs are associated with an impairment of physical (p < 0.05) and psychological well-being perception (p < 0.001), emotional responses (p < 0.001), self-perception (p < 0.001), and a reduction of general well-being (p < 0.05).

CONCLUSIONS

Although it is complicated to distinguish between causes and consequences, these findings suggest a complex and multifaceted, association between ED and HRQoL domains. Thus, multiple factors need taking into account in the policy of EDs prevention, identifying all the components of well-being to focus and personalize healthy programs in adolescences.

Association between Nutritional Behaviours and Acne-Related Quality of Life in a Population of Polish Male Adolescents

Acne vulgaris is diagnosed in the majority of adolescents, decreasing their quality of life, while the diet may influence its aetiology in a gender-dependent manner. The aim of the study was to analyse associations between nutritional behaviours and acne-related quality of life in a population of Polish male adolescents. The study was conducted on a population of Polish secondary school adolescents (a studied sample of 925 adolescents), while the random quota sampling procedure of secondary schools was applied. To assess acne-related quality of life, the Acne Quality of Life (AQoL) Scale and Acne Disability Questionnaire (ADQ) were applied, while the Social Quality of Life (SOCQOL) Score and Cardiff Acne Disability Index (CADI) were calculated. To assess the diet, an Acne-specific Food Frequency Questionnaire (Acne-FFQ) was applied. Neither for the ADQ results, nor for the CADI calculated on the basis of ADQ, was there an association with dietary intake (p > 0.05). The results of the SOCQOL Score (calculated on the basis of AQoL) were positively correlated with the intake of fish (p = 0.0085; R = 0.1144), salty snacks (p = 0.0495; R = 0.0854), and non-chocolate confectionary (p = 0.0078; R = 0.1156). In a group of respondents declaring any acne-related quality of life problems in AQoL, while compared with those declaring no such problems, higher intakes of dairy beverages other than milk (p = 0.0063), white bread (p < 0.0001), other white cereal products (p < 0.0001), fast foods (p = 0.0006), salty snacks (p < 0.0001), chocolate confectionary (p < 0.0001), and other confectionary (p < 0.0001), but lower intake of wholegrain bread (p = 0.0084) were observed. It may be concluded that acne-related quality of life is associated with dietary intake in a population of Polish male adolescents. In the studied population, the most prominent influencing factors were salty snacks and non-chocolate confectionary, with both of them having a proacnegenic effect.

Psychosocial Predictors of Body Weight Congruence in Adolescents Aged 15 and 17 Years in Poland: Findings from the Health Behaviour in School-Aged Children (HBSC) Study

Background: Body weight congruence (BWC) has implications for adolescent health. The main goal of this study was to examine the distribution of BWC and its relationship with six psychosocial factors. Methods: A representative sample of N = 3508 adolescents aged 15 and 17 years (52.4% girls) derived from the Health Behaviour in School-aged Children study, conducted in 2017/2018 in Poland, was used. BWC groups were defined based on self-reported BMI and subjective assessment of weight: (1) correct perception; (2) overestimation, and (3). underestimation. Principal component analysis (PCA) extracted the following two factors: a socio-relational factor (SR) related to perceived social support and social self-efficacy, and a body attitudes and social media exposure factor (BAME). Using the total sample, multinomial logistic regression was applied to estimate their impact on the BWC, and gender-specific models were compared. Results: Half (48.6%) of the adolescents correctly estimated their body weight, 31.0% overestimated it (girls 43.9%, boys 17.1%), and 20.0% underestimated it (boys 37.2%, girls 9.0%). Overestimation of body weight concerns 48.0% of normal weight girls, 50.0% of underweight girls, and 21.3% and 32.1% of normal weight and underweight boys, respectively. The percentage of normal weight (34.4%), and overweight and obese (30.8%) boys who underestimated their body weight was three times higher than the respective percentages of girls that underestimated their weight (9.0% and 11.9%). The SR factor protected adolescents from both underestimation (only in girls) and overestimation in the total sample (OR 0.74, 95%CI 0.68–0.81) and both genders. BAME increased this risk of overestimation in both genders (OR = 1.83, 95%CI 1.67–2.0), and the risk of underestimation among boys. Conclusions: Prevention programmes should include a wide range of psychosocial factors to improve BWC among adolescents.

Measuring Happiness in Adolescent Samples: A Systematic Review

Background: Happiness is a phenomenon that relates to better mental and physical health and even longevity. There has been an increase in surveys assessing subjective well-being as well as happiness, one of the well-being components that reflect one’s feelings or moods. Happiness is mostly measured in adult samples. There is a lack of an overview of the tools used to evaluate adolescent happiness, so this paper aimed to review them. Methods: A literature search was performed in the PubMed and PsycArticles databases (2010–2019). In total, 133 papers met the eligibility criteria for this systematic review. Results: The results are grouped according to the type of measure, single or multiple items, that was used in a study. Almost half of the studies (64 of 133) evaluated subjective happiness using single-item measures. The most commonly used scales were the 4-item Subjective Happiness Scale and the Oxford Happiness Questionnaire. Among the 133 articles analyzed, 18 reported some validation procedures related to happiness. However, in the majority of cases (14 studies), happiness was not the central phenomenon of validation, which suggests a lack of happiness validation studies. Conclusions: Finally, recommendations for future research and for the choice of happiness assessment tools are presented.

Time trends in adolescent mental wellbeing in the Czech Republic between 2002 and 2018: gender, age and socioeconomic differences

OBJECTIVES

Recent literature indicates a decline over time in adolescent mental wellbeing but results are inconsistent and rely mainly on data from Western societies. This study investigates time trends in adolescent mental wellbeing (psychological and somatic complaints, life satisfaction) among Czech adolescents and explores the moderating role of gender, age and socioeconomic status.

METHODS

Nationally representative data from 29,376 Czech adolescents (50.8% girls, mean age = 13.43; SD = 1.65) across five Health Behaviour in School-aged Children (HBSC) surveys (2002, 2006, 2010, 2014, 2018) were used. Hierarchical regression models estimated national trends in adolescent mental wellbeing and established the moderating role of gender, age and socioeconomic status.

RESULTS

From 2002 to 2018, an increase in the psychological complaints was observed. Life satisfaction decreased over time up to 2014 only, whereas somatic symptoms increased until 2010, followed by a decline in 2014 and 2018. Girls, older adolescents and those from low family affluence reported poorer mental wellbeing. Gender gap increased over time for psychological complaints and life satisfaction. Socioeconomic inequalities gap remained stable over the investigated timeframe.

CONCLUSIONS

Our findings do not provide evidence for substantial temporal changes in mental wellbeing among adolescents in the Czech Republic. Yet, the increase in psychological complaints has been consistent which is an indicator of a small decline over time in adolescent mental wellbeing. Furthermore, the gender gap in mental wellbeing increased over time, whereas the age and socioeconomic differences remained relatively stable. This calls for the attention of public health professionals and policy makers from the Czech Republic.

Body Appreciation in Light of Psychological, Health- and Weight-Related Variables Among Female Adolescents

Recent research has begun to focus on positive body image and how this can be supported in adolescence. Body appreciation is a key element of positive body image, and has been associated with self-reported health status, weight-related concern, family factors and psychological variables such as self-esteem. In this study we explored these associations among Hungarian adolescent females. Female high school students from two major towns in Csongrád county, Hungary (N = 454; age range from 14 to 20; M = 16.3 years, SD = 1.2) completed questionnaires assessing body appreciation, self-esteem, optimism, life satisfaction and health- and weight-related variables. Analyses revealed that body appreciation was most strongly related to self-esteem, as well as being positively associated with life satisfaction, self-perceived health, being in control of diet, and engagement in sport. Conversely, binge drinking, engaging in slimming behaviors and having eating disorders in the family were negatively associated with body appreciation. These findings provide some indications of factors that might be targetted in health education programs aiming to promote positive body image and to develop resilience against body dissatisfaction in this demographic group. Such programs should also include information of nutrition and media literacy.

Weight in the mind: Weight perception and depressive symptoms in Chinese adolescents

BACKGROUND

Increasing evidence demonstrates the significant role of weight perception in shaping the mental health of adolescents. This study sought to extend previous literature by examining the associations of weight perception categories with depressive symptoms for both boys and girls in China, and further explored whether the associations varied between urban and rural areas.

METHODS

Data were from a large-scale, national survey of Chinese middle school students. The analytical sample had 8568 respondents with a mean age of 13.9 years (SD=0.7). Bivariate and multiple regression analyses were adopted to examine the links between weight perception and depressive symptoms.

RESULTS

Overweight perceptions were more prevalent in girls than in boys (47.0% vs. 29.3%), whereas underweight perceptions were less common in girls than in boys (15.7% vs. 29.3%). After adjusting for sociodemographic characteristics and health conditions, self-perceiving as "slightly overweight" and "very overweight" were significantly related to more depressive symptoms for both boys (p<0.05) and girls (p<0.05). A "very underweight" perception, however, was found to be only linked to greater depressive symptoms in boys (p<0.05). Notably, these patterns showed no significant rural-urban difference, as evidenced by the lack of significant interactive effects of all weight perceptions categories and region (urban/rural) on depressive symptoms.

LIMITATIONS

This study was based on a cross-sectional design, which essentially precludes the possibility to determine the causality of the observed associations.

CONCLUSION

Findings in this study indicated that the impacts of subjective physical attractiveness have been gendered and regionally pervasive in affecting emotional well-being of Chinese adolescents.

Prevalence and Factors Associated with Thinness in Rural Polish Children

A lot of attention has been focused on obesity, however, the other extreme—thinness—may lead to inhibition of physical and intellectual development. The aim was to assess the prevalence of thinness and determine the associated factors in children from rural populations. We used data from the cross-sectional sample of 3048 children, examined in schools from a district in southern Poland. The sample included 89% of the district departments, and included a proportion of rural and small town populations—a representative one for the region. Thinness was determined based on the criteria proposed by Cole and Lobstein. Biological, sociodemographic and lifestyle factors were analysed. The odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression analysis. The prevalence of thinness was 11.5% in boys and 13.5% in girls. In the younger group, it was similar in boys and girls at 11.8%; whereas in the older group, it was 11.1% and 14.5%, respectively. The prevalence of thinness Grade 3 in girls was two times higher than in boys. The increased index of leisure time physical activity was connected with thinness in prepubertal boys. The mechanism determining the development of thinness is very complex and further exploration of this trend is recommended.

The association of weight status and weight perception with number of confidants in adolescents

Weight status and self-weight perception are related to social relationship issues. Studies have suggested links between non-normal weight status or weight perception and youths having fewer confidants, but these relationships are unclear and remain to be studied. This preliminary cross-sectional study examined the effects of weight status and weight perception on the number of confidants in adolescents. Self-report data from 15,279 grade 7–12 students (54.2% boys) were analyzed. The number of confidants (0–3 or ≥ 4) was examined, according to five weight status categories (underweight, low-normal weight, mid-normal weight (reference), high-normal weight, overweight, with Body Mass Index corresponding to ≤ 18.5, ≤ 20.0, ≤ 22.5, ≤ 25.0 and > 25.0 in adults, respectively), and five weight perception categories (too thin, a bit thin, good (reference), a bit fat, too fat). Boys and girls who were overweight and those who perceived themselves to be too fat were significantly more likely to have few confidants. High-normal weight in girls and self-perception of being a bit fat in boys were also associated with having few confidants. In boys, underweight and self-perception of being too thin were additionally associated with having few confidants. Adolescents with non-normal weight status or weight perception may have fewer confidants and require more social support.

The relationship between body shape perception and health behaviors among Korean normal-weight adolescents using Korea Youth Risk Behavior Web-Based Survey

Inappropriate adolescent health behavior can be influenced by the negative impact of physical and mental health promotion. Obesity influences subjective improper weight perception. This study aimed to verify Korean normal-weight adolescents' subjective experience of weight control, mental health, physical activity, and subjective status based on their body mass index (BMI). As a result, efforts to control weight appeared less in normal-weight boys. Thin girls were less likely to carry out 60 min of physical activity 7 or 5 days per a week. Obese boys were less likely to carry out vigorous physical activity 3 days per a week. Normal-weight girls were less likely to practice muscular strength training 3 days per a week. Thin boys and thing girls were less likely to practice regular physical activity, and less likely to practice at the rate stipulated in the sedentary behavior guideline. In conclusion, boys and girls with inappropriate weight perception reported feeling stressed and depressed, and reported subjective sleep fulfillment, perceived subjective happiness, and perceived subjective health.

Reliability and validity of body weight and body image perception in children and adolescents from the South American Youth/Child Cardiovascular and Environmental (SAYCARE) Study

OBJECTIVE

To assess the reliability and validity of body weight (BW) and body image (BI) perception reported by parents (in children) and by adolescents in a South American population.

DESIGN

Cross-sectional study. BW perception was evaluated by the question, 'Do you think you/your child are/is: severely wasted, wasted, normal weight, overweight, obese?' BI perception was evaluated using the Gardner scale. To evaluate reliability, BW and BI perceptions were reported twice, two weeks apart. To evaluate validity, the BW and BI perceptions were compared with WHO BMI Z-scores. Kappa and Kendall's tau-c coefficients were obtained.

SETTING

Public and private schools and high schools from six countries of South America (Argentina, Peru, Colombia, Uruguay, Chile, Brazil).ParticipantsChildren aged 3-10 years (n 635) and adolescents aged 11-17 years (n 400).

RESULTS

Reliability of BW perception was fair in children's parents (κ=0·337) and substantial in adolescents (κ=0·709). Validity of BW perception was slight in children's parents (κ=0·176) and fair in adolescents (κ=0·268). When evaluating BI, most children were perceived by parents as having lower weight. Reliability of BI perception was slight in children's parents (κ=0·124) and moderate in adolescents (κ=0·599). Validity of BI perception was poor in children's parents (κ=-0·018) and slight in adolescents (κ=0·023).

CONCLUSIONS

Reliability of BW and BI perceptions was higher in adolescents than in children's parents. Validity of BW perception was good among the parents of the children and adolescents with underweight and normal weight.