Body dissatisfaction, engagement in body change behaviors and sociocultural influences on body image among Chinese adolescents

Mindfulness-based interventions for body image dissatisfaction among clinical population: A systematic review and meta-analysis

PURPOSE

Mindfulness-based interventions (MBIs) are well-validated interventions to enhance the favourable body image of individuals. Despite their wide application, the efficacy of MBIs in reducing body image dissatisfaction (BID) among various clinical populations remains unclear. This study aims to expand the literature on MBIs for BID and identify effective types of MBIs for reducing BID in diverse clinical populations for future research and practice.

METHODS

A systematic search for studies published in English on the effectiveness of MBIs for BID among the clinical population was done on APA PsycNet, PubMed, Science Direct, Web of Science and Google Scholar databases in August 2023. Of the 1962 articles initially identified, 17 were found eligible and evaluated based on the JBI checklist.

RESULTS

Random effects meta-analyses on six MBIs revealed their effectiveness in reducing BID among the clinical population (SMD = -.59 and 95% CI = -1.03 to -.15, p = .009), with Acceptance and Commitment Therapy (ACT) (SMD = -1.29, 95% CI = -2.06 to -.52, p = .001) and My Changed Body (MyCB) (SMD = -.24, 95% CI = -.46 to -.01, p = .04) reporting significant effect sizes. Among the patients with breast cancer, MyCB (SMD = -.24, 95% CI = -.46 to -.01, p = .04) showed a significant effect size.

CONCLUSIONS

MBIs appear to be promising interventions in reducing BID among the clinical population. However, findings should be considered cautiously due to the possible publication bias, high heterogeneity and fewer available studies.

Development of food literacy in children and adolescents: implications for the design of strategies to promote healthier and more sustainable diets

Food literacy has emerged as a key individual trait to promote the transformation of food systems toward healthy and sustainable diets. Childhood and adolescence are key periods for establishing the foundations of eating habits. Different food literacy competencies are acquired as children develop different cognitive abilities, skills, and experiences, contributing to the development of critical tools that allow them to navigate a complex food system. Thus, the design and implementation of programs to support the development of food literacy from early childhood can contribute to healthier and more sustainable eating habits. In this context, the aim of the present narrative review is to provide an in-depth description of how different food literacy competencies are developed in childhood and adolescence, integrating the extensive body of evidence on cognitive, social, and food-related development. Implications for the development of multisectoral strategies to target the multidimensional nature of food literacy and promote the development of the 3 types of competencies (relational, functional, and critical) are discussed.

Translation and validation of a Chinese version of the Appearance Schemas Inventory-Revised in Chinese adults

The current study translated the Appearance Schemas Inventory-Revised (ASI-R) into Chinese (Mandarin) and examined its psychometric properties in Chinese adult women and men. Sample 1 included 400 women and 400 men to examine the factor structure of the ASI-R with exploratory factor analysis (EFA). Sample 2 involved 300 women and 300 men, and the EFA-derived factor structures in Sample 1 of the ASI-R were examined with exploratory structural equation modeling (ESEM), bifactor ESEM (B-ESEM), and bifactor ESEM with correlated uniqueness for negatively worded items (B-ESEM-CU) for both women and men. Results of the EFA identified a 4-factor model in women and a 2-factor model in men. The B-ESEM-CU consistently showed the best model fit. In the B-ESEM-CU, the general factor was well-defined, but the specific factors were not, supporting the use of the global factor to conceptualize the ASI-R for Chinese women and men. Evidence of adequate internal consistency, test-retest reliability, and construct validity of the global factor of the ASI-R was suggested in both women and men. Findings suggest the ASI-R is a useful instrument to measure body image investment in Chinese women and men, specifically using the B-ESEM-CU to understand the dimensionality of the ASI-R.

Peer effects and health impacts of different body cognitive biases in children: micro evidence from China

Background

In China, children commonly display body cognitive biases, which constitute a significant yet hidden public health issue. These biases potentially jeopardize children's well-being, hinder the cultivation of human capital, and impede societal progress. However, limited research employs theoretical analysis and econometric testing to investigate the formation of different body cognitive biases among Chinese children and their health impacts.

Methods

Based on a local average network model for theoretical analysis, this study utilizes a sample of 4,289 children from four phases of the China Health and Nutrition Survey (CHNS) conducted from 2004 to 2011. Utilizing Logit and IV Probit models, systematically evaluate the peer effect, heterogeneity of effects, and health impacts of children's different body cognitive biases.

Results

(1) The peer effect contributes to the development of light- and heavy-body cognitive biases in Chinese children. (2) The heterogeneity analysis shows that the peer effect of body cognitive biases is more significant in rural and female children. (3) The influence of heavy-body cognitive bias is more pronounced in adolescent children. (4) The "eating-activity balance" is disrupted by the two body cognitive biases in children, leading to deviations from normal body type. (5) Specifically, the light-body cognitive bias leads children to intake more and burn fewer calories, increasing their risk of obesity. (6) Conversely, the heavy-body cognitive bias prompts children to intake less and expend more calories, resulting in a higher prevalence of thinness.

Discussion

This study innovates by exploring peer effects on body cognitive biases in Chinese children, elucidating their direction and health implications. While overweight and obesity are recognized as overt health issues, the spread and impact of implicit issues like body cognitive biases should not be overlooked. Nevertheless, the issue is largely neglected in developing countries, such as China, where existing children's health policies are inadequate in addressing it. Promoting accurate body image perception and understanding of health prevention strategies among children requires adequate attention to peer effects.

Exploring the tripartite influence model of body image and disordered eating among adolescent girls living in Australia, China, India, and Iran

The aim of this study was to evaluate the tripartite influence model of body image and disordered eating among 12-18-year-old girls (N = 900) living in Australia (n = 184), China (n = 293), India (n = 223), and Iran (n = 200). Participants completed measures about appearance pressures from family, peers, and media, thin-ideal internalization, appearance comparisons, appearance satisfaction, and disordered eating. Results indicated that media- pressures were most salient in Australia, whereas Iranians perceived family pressures to be the strongest. Indians felt the most pressure to look attractive from their family and peers, whereas Chinese felt similar levels of pressure from family, peers, and media. Path analyses suggested direct associations from one or more sociocultural factors to appearance satisfaction or disordered eating, with indirect paths via thin-ideal internalization and appearance comparisons emerging in all countries. Certain sociocultural factors contributed more strongly to the internalization of ideals and appearance comparisons within some countries. Multigroup path analyses demonstrated some cross-cultural variations in the strength of the pathways. Findings extend cross-cultural support for a modified tripartite influence model emphasizing culture-based specificities that can further guide preventative efforts to improve body image and eating attitudes among young girls in these four countries.

Role of peer support on the cycle of weight teasing, psychological distress and disordered eating in Taiwanese adolescents: A moderated mediation analysis

BACKGROUND

Several studies have reported the beneficial role of social support on adolescent health. However, few studies have explored the role of peer support on the cycle of weight teasing, psychological distress, and disordered eating.

METHODS

A total of 689 adolescents aged between 13 and 16 years recruited from 37 classes in three middle schools in New Taipei City from March to June 2019 were included for analysis. Path analysis was performed using Hayes' PROCESS module.

RESULTS

The study found that weight teasing is directly and indirectly associated with disordered eating through psychological distress. Peer support plays a role in moderating the relationship between weight teasing and psychological distress; however, it is not significantly associated with decreased risk of disordered eating among adolescents experiencing weight teasing.

CONCLUSION

While peer support can be used against the adverse effects of weight teasing, it is not the absolute solution, and additional interventions are warranted.

The Relationship between Anxious-Ambivalent Attachment and Social Appearance Anxiety in Adolescents: The Serial Mediation of Positive Youth Development and Instagram Addiction

The prevalence of social appearance anxiety among adolescents has increased in recent years. It can be said that one of the reasons for this situation is appearance-oriented social media applications. Attachment styles in adolescents may play a role in social appearance anxiety, as in many types of anxiety. However, adolescents' positive youth development levels may have a protective role against social appearance anxiety. Therefore, this study investigated the serial mediator roles of Instagram addiction and positive youth development in the relationship between anxious-avoidant attachment style and social appearance anxiety in adolescents. The research was carried out with 508 high school students. As a result of the research, it was determined that anxious-avoidant attachment and Instagram addiction predicted social appearance anxiety positively. It was determined that positive youth development predicted social appearance anxiety negatively. In addition, mediating roles in the relationship between positive youth development and Instagram addiction, anxious-avoidant attachment and social appearance anxiety were found significant in the study.

Validation of a Farsi version of the Eating Disorder Examination Questionnaire (F-EDE-Q) in adolescents and university students from Iran

BACKGROUND

Although the Farsi version of the Eating Disorder Examination-Questionnaire (F-EDE-Q) is frequently utilized to assess disordered eating in Iran, its factor structure, reliability, and validity have not been investigated in Iranian samples, which is the aim of the current investigation.

METHOD

Using convenience sampling, this study recruited 1112 adolescents and 637 university students to complete disordered eating and mental health-focused questionnaires, including the F-EDE-Q.

RESULTS

Confirmatory factor analyses of the 22 attitudinal items in the F-EDE-Q indicated that a brief seven-item, three-factor model (i.e., Dietary Restraint, Shape/Weight Overvaluation, Body Dissatisfaction with Shape and Weight) was the only factor structure that fit the data well for either sample. This brief version of the F-EDE-Q was invariant across gender, body weight, and age. Adolescent and university participants with higher weight reported higher average scores on each of the three subscales. Subscale scores showed good internal consistency reliability in the two samples. Further, supporting convergent validity, subscales were significantly associated with measures of body image-related preoccupation and bulimia symptoms, as well as measures of other theoretically related constructs including depressive symptoms and self-esteem.

CONCLUSION

Findings suggest that this brief, validated measure will enable researchers and clinical providers to appropriately assess disordered eating symptoms in adolescent and young adult Farsi-speaking populations.

Is There an Association between Food Consumption According to the Degree of Processing and Body Image (Dis)satisfaction in Adolescents?

(1) Background: Adolescence is characterized by changes in eating habits, with increased consumption of ultra-processed foods and reduced intake of unprocessed or minimally processed foods, which can affect body image satisfaction. Thus, this study aims to verify the association of food consumption according to the degree of processing with body image (dis)satisfaction in adolescents from the 1997/1998 birth cohort of São Luís, Maranhão. (2) Methods: A cross-sectional study was conducted with 2515 adolescents aged between 18 and 19. Food consumption was stratified based on the NOVA classification in culinary preparations, processed foods, and ultra-processed foods, categorized into tertiles. Body image (dis)satisfaction was evaluated based on the Stunkard Body Scale and was classified as satisfaction, dissatisfaction with thinness, and dissatisfaction with excess weight. Multinomial logistic regression was used for associations. (3) Results: Among the adolescents, 77% considered themselves dissatisfied with their body image, with 42.8% dissatisfied with being thin and 34.2% dissatisfied with excess weight. However, food consumption, according to the degree of processing, was not associated with body image (dis)satisfaction. (4) Conclusion: This work highlighted the prevalence of body image dissatisfaction among adolescents but found no association between body (dis)satisfaction and food consumption according to the degree of processing.

Socio-cultural attitudes toward the body as a predictor of motivation for physical activity in young people brought up in Asian and European culture-Chinese-Polish comparison

The influence of sociocultural attitudes toward the body on young people's physical activity has received increasing attention. However, there is a lack of cross-cultural research in this area. The main aim of this research was to identify the similarities and differences in the sociocultural attitudes toward the body of Polish and Chinese young people who grew up in European and Asian cultures and to analyze their effect on the motivation for physical activity. A cross-sectional research study was conducted among 18- to 30-year-old Polish (n = 259) and Chinese (n = 208) young people. The variables were measured using the Sociocultural Attitudes towards Appearance Questionnaire 3 (SATAQ 3) and the Inventory of Physical Activity Objectives (IPAO). Descriptive and comparative statistics, Spearman's rho, and the stepwise multiple regression analysis were used. The main analysis showed There are both similarities and significant differences in the performance of young Polish and Chinese men and women on the variables studied; Internalization-Athlete, Pressures, and Internalization-General are universal sociocultural predictors of motivation for physical activity among young people in Poland and China; Information is a specific sociocultural predictor of motivation for physical activity in Polish young people. The cultural nuances need to be considered in understanding young people's Motivation for undertaking physical activity.

Differential pathways to disordered eating for immigrant and native adolescents in Taiwan

BACKGROUND

Few studies have investigated disparities in disordered eating between new immigrant and native adolescents in Taiwan. This study examines the differential pathways to disordered eating in these two populations.

METHODS

This cross-sectional study analyzed data collected from March to June 2019. In total, 729 adolescents aged between 13 and 16 years recruited from 37 classes in 3 middle schools in New Taipei City were included in the final analysis. Standardized assessment tools measured disordered eating (EAT-26) and psychological distress (BSRS-5). Generalized structural equation modeling was used to conduct the path analysis.

RESULTS

The prevalence of disordered eating was significantly higher in immigrant adolescents than in their native counterparts. Multipath models indicated that weight-teasing driven by overweight and obese status and weight overestimation could lead to disordered eating through psychological distress; however, the pathways differed for the two groups studied. Family weigh-teasing indirectly leads to disordered eating through psychological distress for native adolescents; by contrast, for immigrant adolescents, friend weigh-teasing indirectly leads to disordered eating through psychological distress. Additionally, weight overestimation directly leads to disordered eating and indirectly through psychological distress to disordered eating for immigrant adolescents.

CONCLUSION

This study offers a plausible explanation of the differences in the paths to disordered eating between immigrant and native adolescents in Taiwan, which was not reported previously. The study urges the need for school-based prevention programs to improve immigrant students' mental health.

Body Self-Perception, Dietary Self-Efficacy, and Body Mass Index in Young Adults: A Cross-Sectional Survey

Background

Body self-perception and dietary self-efficacy may represent an important factor in the prevention of excess body weight.

Purpose

This study evaluated body self-perception, dietary self-efficacy, and body mass index (BMI) in the Peruvian population.

Methods

A cross-sectional online survey was administered to 190 men and 210 women. Each participant was shown 9 Stunkard anatomical silhouettes corresponding to BMI values. The results obtained were classified as underweight, normal weight, overweight, and obese. The Dieting Self-Efficacy Scale (DIET-SE) was also applied. Chi-square statistic, Kruskal-Wallis, Student t-test, and ANOVA were used to explore differences in means and proportions.

Results

Age was significantly higher in those who underestimated their weight and who were dissatisfied with their body (p = 0.000). BMI was higher in men, most were dissatisfied with their body (p<0.05), and were more likely to underestimate their weight compared to women (p = 0.000). Those participants who were dissatisfied with their body and who underestimated their weight were more likely to have an elevated BMI compared to those who were satisfied and who did not underestimate their weight. All participants had low dietary self-efficacy (LDSE), with a little higher proportion in men compared to women (62.6% vs 61.4%). The majority (45.9%) reported little confidence to resist high-calorie food temptations. More than half of the participants reported body dissatisfaction and LDSE, this was more frequent in men compared to women.

Conclusion

It is necessary to develop and implement preventive measures to improve self-perception of the body, taking into account factors such as gender, age, and eating habits.

Peer Appearance Teasing and Restrained Eating Among Chinese Adolescent Girls: A Mediation Model of Fear of Negative Appearance Evaluation and Body Surveillance

Restrained eating is becoming widespread recently. The present study aimed to examine whether peer appearance teasing was positively associated with restrained eating among Chinese adolescent girls and whether this association was mediated by fear of negative appearance evaluation (FNAE) and body surveillance. A sample of 720 Chinese adolescent girls completed questionnaires on peer appearance teasing, FNAE, body surveillance, and restrained eating. Peer appearance teasing was significantly and positively related to girls' restrained eating. FNAE mediated the relationship between peer appearance teasing and restrained eating. Furthermore, the association between peer appearance teasing and restrained eating was sequentially mediated by FNAE and body surveillance. The findings of this study provide new insights into the development of restrained eating among adolescent girls, and highlight peer appearance teasing and body surveillance as potential targets for intervention programs regarding body image concerns and eating disorders.

Optimal BMI cutoff points in obesity screening for Chinese college students

Objective

An accurate BMI classification system specific to the population is of great value in health promotion. Existing studies have shown that the BMI recommended cut-off value for adults is not suitable for college students. Thus, the current study aims to identify optimal BMI cutoff points in obesity screening for Chinese college students.

Methods

Anthropometric assessments were performed on 6,798 college students (Male = 3,408, Female = 3,390) from three universities in Jiangsu, China. Exploratory factor analysis (EFA) was conducted to establish the standardized models to estimate anthropometry for male and female students. Further indices were derived from the assessments, including body mass index (BMI), relative fat mass (RFM), obesity degree percentage (OBD%), waist-to-hip ratio (WHR), waist circumference (WC), and body fat percentage (BF%). The anthropometric index with the highest correlation to the models for male and female students were selected as the gold standard for obesity screening. Receiver operating characteristic (ROC) curve was applied to evaluate diagnostic value of each anthropometric index according to the area under curve (AUC). Youden index maximum points determined the optimal cutoff points with the highest accuracy in obesity screening.

Results

The anthropometric models for both male and female students consisted of three factors. Vervaeck index was selected as the gold standard for obesity screening. By comparing AUC of the anthropometric indices, we found BMI provided the highest value in obesity screening. Further analysis based on Youden index identified the optimal BMI of 23.53 kg/m² for male and 23.41 kg/m² for female. Compared with the universal standard recommended by World Health Organization (WHO), the adjusted BMI criteria were characterized by high sensitivity as well as specificity.

Conclusion

BMI is the most appropriate anthropometric index of obesity screening for Chinese college students. The optimal cutoff points were lower than the WHO reference. Evidence substantiated the adjusted BMI criteria as an effective approach to improve accuracy of obesity screening for this population.

Relationship between body dissatisfaction, insufficient physical activity, and disordered eating behaviors among university students in southern China

Background

With an increasing incidence of obesity, the relationship between obesity and body image has become a hot research topic worldwide. From high school to university, young people experience changes in their social environment. University students have a high incidence of eating disorders and insufficient physical activity. The purpose of this study was to explore the relationship between body dissatisfaction, insufficient physical activity, and disordered eating behaviors among university students in southern China.

Methods

In total, 1296 university students aged 18–23 years were recruited for this study. The participants completed anthropometric measurements, the Physical Activity Rating scale-3 (PARS-3), and the Chinese-Dutch Eating Behavior Questionnaire (C-DEBQ). The ideal weight and silhouette were reported by university students using a questionnaire.

Results

Compared with men, young women had a higher level of body dissatisfaction. For men, body mass index (BMI; β = 0.76, P <  0.01), physical activity score (β = − 0.11, P <  0.01), and restrained eating score (β = 0.10, P <  0.01) were the significant factors predictive of body dissatisfaction. For women, BMI (β = 0.57, P <  0.01), muscle mass (β = 0.12, P <  0.01), physical activity score (β = − 0.11, P <  0.01), and restrained eating score (β = 0.09, P <  0.01) were the significant factors predictive of body dissatisfaction.

Conclusions

University students with high body dissatisfaction had lower physical activity scores and higher restrained eating scores. The data presented here highlight the impact of university students’ body dissatisfaction on physical activity deficiency and disordered eating behaviors in China.

The association between body image, emotional health, relationships, and unhealthy dietary behaviors among medical sciences students: A structural equation modeling analysis

AIM

Although it showed that poor body image may drive an individual to unhealthy dietary behaviors, but less is known about the role of emotional health and interpersonal relationships in this regard in different age group of population. This study aimed to investigate the association between body image, emotional health, relationships, and unhealthy dietary behaviors among medical sciences students.

METHODS

In this cross-sectional study, using a three-stage stratified sampling method, 248 Iranian medical sciences students were recruited. The participants completed self-administered questionnaires, including Youth Risk Behavior Survey Questionnaire, Adolescent Health Concerns Inventory, and Body Image Concern Inventory. The data were analyzed using SPSS-20 and structural equation modeling in the Amos software version 24.

RESULTS

The results indicate the acceptability of the goodness of fit model index. Direct association of body image with emotional health (β = 0.91, p = 0.005) and relationships (β = 0.88, p = 0.009) was significant, but any direct and indirect association between body and unhealthy dietary behaviors was not found.

CONCLUSION

This study underlines the importance of being aware of the association between body image, emotional health, and relationships Further studies are recommended to explore the relationship between these factors and unhealthy dietary behaviors in medical sciences students.

Effects of short-video use on undergraduates’ weight- loss intention: a regulatory mediation model

This research intends to explore the effects of short video use on college students’ weight loss intentions, and its intrinsic mechanism of action, based on the responses of 1268 students from three universities in southwest China to questionnaires with the instruments of a sports participation scale, body image scale, self-esteem scale and weight loss intention scale. The findings are listed as follows: 1) Short video use can significantly and positively predict weight loss intention; 2) Body image mediates the relationship between short video usage and weight loss intentions; 3) Self-esteem plays a regulatory effect as the direct path between short video use and weight loss intention as well as partial mediation effect of body image. The direct effect of short video use on weight loss intentions and the mediating effect of body image gradually increased with the decrease of self-esteem. The results of the study suggest that short video use can affect the weight loss intentions of college students through either a direct or indirect path created by the mediating role of body image. Meanwhile, the influence of self-esteem on weight loss intention can’t be ignored, which is another key factor that affects college students’ weight loss intentions beyond short video use and body image.

Analysis of Adolescent Physical Activity Levels and Their Relationship with Body Image and Nutritional Habits

The main objective of this research article was to make a cluster analysis in Compulsory Secondary Education students with regard to their physical activity levels, their relationship with nutritional habits and body perception. In this study, a total of 1089 students participated, to whom a battery of tests was given in order to assess three aspects: levels of physical activity, food consumption habits and perception of body image. The main results indicated that the adolescent sample presented high levels of physical activity in comparison with other studies. In addition, a profile analysis was carried out, showing that there were no differences in physical activity, in nutritional habits or in body-image index. Taking into account gender, women who practice light physical activity had better nutritional habits. On the other hand, boys dominated in the group of moderate-to-high physical activity, while the girls were mainly included in the profile of low physical activity. Finally, body-image index was greater in men than women. It was concluded that is necessary to promote the importance of adequate nutritional habits in addition to physical activity, and it is necessary to promote body image, particularly among adolescent girls, given their low values of physical activity and worse body-image perception in relation to boys.

A preliminary study of body image and depression among adults during COVID-19: A moderation model

BACKGROUND

Since many aspects of functioning can affect body image, the aim of our study was to assess whether the relationship between body image-related negative emotions or depression and body dissatisfaction was moderated by body image-related quality of life and to compare these analyses among participants with various body mass index during COVID-19.

SUBJECTS AND METHODS

One hundred and thirty-one adults participated in the study. Measurement tools included the Body Image Quality of Life Inventory, the short form of the Situational Inventory of Body-Image Dysphoria, the Beck Depression Inventory-II and the Contour Drawing Scale.

RESULTS

The effects of body image-related negative emotions or depression on body dissatisfaction is moderated by body image-related quality of life, but only among obese participants.

CONCLUSION

Treatment of obese patients should focus on improving quality of life related to body image, while managing negative emotions and body dissatisfaction.

A Novel, Scalable Social Media-Based Intervention ("Warna-Warni Waktu") to Reduce Body Dissatisfaction Among Young Indonesian Women: Protocol for a Parallel Randomized Controlled Trial

Background

Despite the prevalence of body dissatisfaction among young Indonesian women and its consequential negative impacts, there are currently no evidence-based, culturally appropriate interventions to tackle this issue. Therefore, there is a need to develop scalable, cost-effective, and accessible interventions to improve body image among this population.

Objective

This paper describes the study protocol of a parallel randomized controlled trial to evaluate the effectiveness of Warna-Warni Waktu, a social media–based intervention that aims to reduce state and trait body dissatisfaction and improve mood among young Indonesian women aged 15-19 years.

Methods

The trial will take place online. Approximately 1800 young women from 10 cities in Indonesia, evenly split across the ages of 15-19 years, will be recruited via a local research agency’s established research panel. Participants will be randomly allocated to the intervention condition or a waitlist control condition. The intervention consists of six 5-minute videos, with each video supplemented with up to five brief interactive activities. The videos (and associated activities) will be delivered at a rate of one per day across 6 days. All participants will complete three self-report assessments: at baseline (Day 1), 1 day following the intervention (Day 9), and 1 month following the intervention (Day 36). The primary outcome will be change in trait body dissatisfaction. Secondary outcomes include change in internalization of appearance ideals, trait mood, and skin shade satisfaction. Intervention effectiveness on these outcomes will be analyzed using linear mixed models by a statistician blinded to the randomized condition. Intervention participants will also complete state measures of body satisfaction and mood before and after watching each video to assess the immediate impact of each video. This secondary analysis of state measures will be conducted at the within-group level.

Results

Recruitment began in October 2021, with baseline assessments underway shortly thereafter. The results of the study will be submitted for publication in 2022.

Conclusions

This is the first study to evaluate an eHealth intervention aimed at reducing body dissatisfaction among young Indonesian women. If effective, the intervention will be disseminated to over half a million young women in Indonesia via Facebook, Instagram, and YouTube.

Trial Registration

ClinicalTrials.gov NCT05023213; https://clinicaltrials.gov/ct2/show/NCT05023213

International Registered Report Identifier (IRRID)

PRR1-10.2196/33596

Psychometric properties of Chinese Translated body compassion scale (BCS) among Hong Kong adolescents

Background

Adolescence is at a transition stage of developmental psychology, and they must go through their psychosocial and identity crisis, which affect their self-concept. According to the structure of self-concept, physical is considered as one of the elements affecting a person's evolvement of self, which can be called as physical self-esteem. In regards to the equilibrium mental benefits of self-compassion, the concept of body compassion was focused. Together with the lack of body-part related research being further investigated among non-western countries, this research aimed at translating the Body Compassion Scale (BCS) to Chinese and examining the reliability and validity of the Chinese translated BCS among Hong Kong adolescents.

Methods

The reliability of the translated BCS was examined by the test-retest reliability test as well as the Cronbach's alpha value for the internal consistency. The confirmatory factor analysis (CFA) was adopted to investigate the construct validity, and Pearson's correlation was used to examine the convergent validity with other related scales.

Results

The Chinese translated BCS (Pilot Study: n = 220; Main Study: n = 1047) showed adequate psychometric properties results. It had a satisfying internal consistency and test-retest reliability. It showed an adequate goodness of fit results in CFA, with X²(465.64)/227 = 2.05,p < 0.001, CFI = 0.916, TLI = 0.906,SRMR = 0.071,RMSEA = 0.069 [90% CI = 0.06 to 0.078]. Additionally, the measurement invariance model suggested that the factor loadings and mean differences of the translated BCS were invariant across early and older adolescents.

Conclusion

The Chinese translated BCS is considered as valid and reliable in examining Hong Kong adolescents’ body compassion.

Association between body weight misperception and dietary patterns in Brazilian adolescents: Cross-sectional study using ERICA data

The association between body image and eating behaviors or weight control strategies has been demonstrated in the scientific literature, but there is a lack of evidence on the association between weight misperception and food consumption indicators in adolescents. This study aimed to evaluate the association between weight misperception and dietary patterns (DPs) in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA). It was a national school-based cross-sectional study conducted among students aged 12–17 years. Data were collected in the form of anthropometric measurements, responses in self-answered questionnaires, and 24-h dietary recall. The following variables were assessed: weight underestimation and overestimation (independent variables), which were defined as the presence of a disagreement between nutritional status and self-perceived weight; dietary patterns (dependent variables), defined by a posteriori method using principal component factor analysis; and individual and demographic variables (covariates). Data analysis was performed using the Poisson regression models method, stratified by sex. A total of 52,038 adolescents with normal weights were evaluated. The weight misperception prevalence was 34.0% (95% confidence interval [CI]: 33.0, 35.0). Three DPs were identified: “Traditional Brazilian,” “Processed meat sandwiches and coffee,” and “Ultra-processed and sweet foods.” In girls, weight underestimation was directly associated with the “Traditional Brazilian” (1.24; 95% CI: 1.08, 1.43) and “Ultra-processed and sweet foods” DPs (1.29; 95% CI: 1.09, 1.54), and overestimation was inversely associated with all the DPs. In boys, a direct association between underestimation and the “Ultra-processed and sweet foods” DP (1.29; 95% CI: 1.10, 1.51) was found. Overestimation was inversely associated with the “Traditional Brazilian” DP (0.79; 95% CI: 0.63, 0.99). The inverse association between overestimation and the “Traditional Brazilian” DP, and the direct association between underestimation and the “Ultra-processed and sweet foods” DP indicated that weight misperception was related to unhealthy eating habits in Brazilian adolescents.

Investigating the Linkages between BMI, Body Image, and SATAQ among Young Asian Females

Sociocultural attitudes toward appearance and its linkage to body mass index (BMI) and body image is a relationship worth studying, especially in Asia, where the idealization of thinness can be prominent. The Sociocultural Attitudes Toward Appearance Questionnaire (SATAQ) developed by Heinberg et al. in 1995 was used in this study to examine whether these beliefs have been internalized. Furthermore, the Body Esteem Scale (BES) was used to quantify body image. The formal in-person survey was administered in Taipei, Taiwan. There were 301 valid samples out of 330 surveyed respondents. To enhance the representativeness of the samples, a stratified sampling technique was applied to generate survey data with valid samples following gender and age distributions of the population between the ages of 14 and 28. The internalization dimension represented how strongly the respondents considered the importance of the socially accepted concept of appearance based on personal perceived social norms. The other dimension, awareness, represented the sociocultural pressures from the outside world, such as from the image of slimness illustrated in the media or group, in comparison to personal beliefs. Our results demonstrated that respondents with above-normal BMIs internalized the socially preferred standards of thinness more than respondents with normal or under-normal BMIs. Furthermore, results also revealed, overall, a negative relationship between SATAQ and body image and between body image and BMI. The study highlights the need to emphasize “fitness over thinness” to help improve negative body image among young Asian females.

Effects of Long-Duration Home Isolation Linked to the COVID-19 Pandemic on Mental Health of Adolescent Athletes

PURPOSE

To assess whether adolescent athletes were affected or not in terms of mental health by the long duration at home linked to isolation enforced during the COVID-19 pandemic.

METHOD

The study included 940 team athletes, 274 individual athletes, and 131 nonathlete controls aged 12-17 years. Demographic data were obtained with a form including questions about age, sex, sports type, and physical activity status (type, duration, and frequency) during the isolation period. Participants completed the Children's Revised Impact of Event Scale-13, Center for Epidemiological Studies Depression Scale for Children, and State-Trait Anxiety Inventory for Children.

RESULTS

Among participants, 88% did not meet the physical activity recommendations for children and adolescents, while 42.8% felt depressed. Depressive symptoms were present in 38.1% of boys and 59.7% of girls, with girls (6.4%) having higher posttraumatic stress symptoms than boys (3.5%). Among athletes, depressive and anxiety symptoms were lower compared with nonathlete controls (P < .01). Posttraumatic stress symptoms were lower among athletes than nonathlete controls for girls (team vs control, P = .006; individual vs control, P = .002) but similar for boys (P > .05). The depression (P = .518), state (P = .866), and trait anxiety (P = .507) symptoms were similar between team athletes and individual athletes.

CONCLUSION

Though adolescent athletes' depression, anxiety, and posttraumatic stress symptoms were significantly lower than nonathlete controls, athletes also had high depression levels. These findings show the need to take precautions to protect the psychological health of not only nonathletes, but also athletes in the pandemic period.

The clash of culture and cuisine: A qualitative exploration of cultural tensions and attitudes toward food and body in Chinese young adult women

OBJECTIVE

Accumulating evidence suggests that the prevalence of eating disorders among Chinese women is a public health concern. Prior studies have drawn linkages between conflicting cultural values, identity confusion, and eating disorder symptomatology, which may be relevant for understanding the rise of eating disorders amidst China's rapid economic and sociocultural transformation. Here, we explore how women's experiences with traditional eating norms and modernizing norms of femininity may shape their food and body attitudes.

METHOD

Chinese young adult women (N = 34; aged 18-22 years) participated in semi-structured interviews focusing on experiences with norms surrounding eating and ideal feminine appearance, perceived conflict between these norms, and their responses to perceived conflict. Interviews were conducted via email (n = 27) or via Skype (n = 7). Participants were not asked about past or present diagnoses of eating disorders. Analysis of responses was guided by the principles of thematic analysis.

RESULTS

Women reported encounters with cultural eating norms and feminine appearance norms, and described factors that motivated continued or discontinued adherence to these norms. Women reported strategies of conflict resolution, which resulted in different emotional and behavioral outcomes including eating disorder symptoms.

DISCUSSION

Women's experiences with norms surrounding eating and appearance indicate the centrality of these encounters in the formation of individual and interpersonal values. Our findings suggest the importance for clinicians to assist clients in exploring the meanings behind internalized attitudes toward food and body, and to help clients balance interpersonal and individual needs.

Validation of the Chinese Version of the Body Image Concern Inventory

The Body Image Concern Inventory (BICI) was developed to assess dysmorphic appearance concern and has been found to be a reliable and valid instrument in Western societies. To examine the psychometric properties of a new Chinese BICI, the BICI was administered to 1,231 Chinese young adults (Study 1) and 47 female patients with eating disorders and 56 matched controls (ED; Study 2). In study 1, Cronbach's alpha of .92 and test-retest reliability of .73 over a 6-month interval was observed for the total scale. Confirmatory factor analysis supported a 3-factor model for the BICI: avoidant behaviors (AB), safety behaviors against perceived flaws (SB), and negative appearance evaluation (NE). In study 2, ED patients scored significantly higher on the BICI total and three subscale scores than controls. In addition, AB best differentiated ED patients and matched controls (Cohen's d = 1.52); SB best differentiated between the non-clinical female and male groups (Cohen's d = 0.75); NE was most closely associated with level of negative affect and subjective well-being (inverse relationship) in both clinical and non-clinical groups. In conclusion, the Chinese BICI is a reliable and valid tool for evaluating dysmorphic appearance concern among Chinese speakers.

Psychometric properties of measures of sociocultural influence and internalization of appearance ideals across eight countries

The aim of the current study was to examine the psychometric properties of two well-established measures of sociocultural influence and internalization of the thin/low body fat ideal and muscular ideal. Data from 6272 emerging adults (68.9 % female), aged 18-30 years from Australia, Belgium, Canada, China, Italy, Japan, Spain, and the U.S. were included in this study. Participants completed measures of pressure from mother, fathers, peers, and media, to both increase muscles and lose weight, as well as internalization of the thin/low body fat ideal and muscular ideal. Overall, support for partial invariance was found across the scales. In addition, group level differences were found between countries as well as along demographic factors including gender, age, body mass index, and socioeconomic status. These findings make an important contribution by identifying these scales as useful tools that will support future cross-country and cross-cultural examinations of explanatory models of the development of body image and eating concerns grounded within sociocultural theories.

Sociocultural Influences, Drive for Thinness, Drive for Muscularity, and Body Dissatisfaction among Korean Undergraduates

For many years, body dissatisfaction was considered a western phenomenon, and was studied mostly in Caucasian women. Recent studies, however, suggest that these issues are also present in men and in other ethnic groups. This research investigated the differential effects of various sociocultural pressures transmitted from the media, one’s parents, and one’s peers on the drives for thinness and muscularity, and body dissatisfaction among 1125 Korean college students (56% male) using structural equation modeling. The results indicate that, after controlling for body mass index and exercise, media pressures exerted the largest effects on participants’ body ideals and, in turn, body dissatisfaction across both genders (β = 0.44, and 0.30, p < 0.05, for females and males, respectively). This study’s results also indicate that there are considerable gender differences in this relationship. Specifically, the results show that parental and media pressure had significant indirect relationships with body dissatisfaction via the drive for thinness among females, while peer and media pressures had significant indirect relationships with body dissatisfaction via the drive for muscularity among males. As body dissatisfaction is known to significantly affect an individual’s mental and physical health, future research needs to identify relevant influential factors in this area, as well as the paths they have leading to increased body dissatisfaction.

Strategies for eating and body change among Brazilian women and men

OBJECTIVES

Our study was conducted to adapt the Body Image and Body Change Inventory (BIBCI) for Portuguese; to evaluate the BIBCI's psychometric properties in samples of university students; to calculate the prevalence of strategies for eating and body change among students; and to evaluate the impact of demographic, social, and anthropometric characteristics on the BIBCI subscales.

METHODS

798 students (women = 63%) answered the Portuguese translation of the BIBCI and answered a demographic questionnaire. All analyses were performed separately for women and men. The BIBCI's psychometric properties were estimated using confirmatory factor analysis. Mean scores were calculated for each BIBCI subscale. A multivariate regression model was tested to evaluate the impact of demographic, social, and anthropometric characteristics on mean BIBCI subscale scores.

RESULTS

The psychometric properties of the BIBCI were adequate in the samples analyzed. The BIBCI subscales scores did not differ according to sex. According to the cut-off points adopted, most of the students were classified in the very low category of the BIBCI subscales. For women, characteristics such as self-reported eating assessment, economic class, physical activity level, and work were significant. For men, only physical activity level was significant.

CONCLUSION

The Portuguese translation of the BIBCI was presented and its psychometric properties were found to be adequate in the samples analyzed. The models identified significant characteristics that can be used in intervention protocols for preventing inappropriate behaviors in relation to body image and eating.

Muscles and the Media: A Natural Experiment Across Cultures in Men's Body Image

An increasing number of studies are evidencing relationships between the drive for muscularity and potentially harmful behavioral strategies, such as unhealthy dieting and steroid use amongst men in WEIRD (Western, Educated, Industrialized, Rich, Democratic) populations. As such Western appearance standards proliferate around the world via the media, men who live in other cultural contexts are also at risk of potentially negative effects from aspiring to the “muscular ideal.” However, few studies have explored these relationships in non-WEIRD populations. We investigated men’s body ideals and body image in two non-WEIRD, non-White populations, Uganda (Africa) and Nicaragua (Central America), and compared them with an ethnically diverse sample of men in the United Kingdom. We also examined whether socio-cultural factors including media and ethnicity, predicted the drive for muscularity and body change behaviors among our participants. Results showed that Ugandan men had the least desire for muscularity relative to men in the United Kingdom. Supporting the Tripartite model we found that media and peer influences significantly predicted the drive for muscularity, particularly among men from White British and Nicaraguan Miskitu ethnic groups. By contrast, Creole / Garifuna and Mestizo men from Nicaragua were more likely to want to increase muscularity relative to Black African men from Uganda. Overall, our findings support previous research in demonstrating that there are cultural differences in the kind of body men desire, and that men from WEIRD and non-WEIRD populations may experience similar pressures to aspire to and attain a muscular body type.

Body-related comments experienced by Chinese young women: A cross-sectional study

Within Chinese culture, one way that family and friends demonstrate that they care about one-another is by making body-related comments. How such comments are experienced by young women, in particular, including how they relate to their psychological disposition and/or use of unhealthy weight control behaviors, is unknown. The purposes of this study were to understand the frequency and type of body-related comments Chinese college women received, from whom, and their associations with body mass index (BMI), body satisfaction, body change motivations, and unhealthy weight control behaviors. Women from a comprehensive university in Southwest China (N = 236) participated in this cross-sectional study. Results showed that female Chinese college students received body-related comments most frequently from their friends, followed by parents, and romantic partners. While the frequency of receiving body-related comments was not associated with BMI, higher frequencies were associated with stronger motivation to lose weight/fat and to practice unhealthy weight control behaviors. Additionally, positive body-related comments from romantic partners were associated with higher motivation to gain weight/muscle and/or to maintain weight. Furthermore, positive body-related comments from friends were associated with higher body satisfaction. Educational programs are needed to help female Chinese college students and members of their social networks recognize and understand the potential impact associated with giving body-related comments. Screening protocols for unhealthy weight control behaviors and appropriate counseling services should also be developed and made available.

Associations of body dissatisfaction with anxiety and depression in the pregnancy and postpartum periods: A longitudinal study

BACKGROUND

Pregnancy is a time of increasing vulnerability to the development of body dissatisfaction, anxiety, and depression. The present study aims to examine associations of body dissatisfaction with anxiety and depression at the following points: 6 months before pregnancy (retrospective report); in the first, second, and third trimesters of pregnancy; and up to 6 weeks postpartum.

METHODS

A prospective longitudinal design with a quantitative approach was adopted. A consecutive sample of 1,371 Chinese pregnant women in Hong Kong was assessed using standardized instruments at four time points.

RESULTS

A mixed-effects model with repeated measures revealed that body dissatisfaction and depression symptoms changed across different stages of pregnancy. Hierarchical multiple regressions showed that, after adjusting for the identified risk factors, body dissatisfaction before and during pregnancy were positively associated with antenatal anxiety and depression symptoms. Concurrent body dissatisfaction was positively associated with postpartum depression symptoms.

LIMITATIONS

There was a high attrition rate in the follow-up assessments. Antenatal anxiety symptoms were assessed using the scale for general anxiety, which may not adequately capture the experience of anxiety among pregnant women.

CONCLUSIONS

Primary healthcare practitioners should be made aware of body dissatisfaction among pregnant women in order to facilitate early intervention for anxiety and depression, because untreated psychological disturbance during pregnancy may persist into the postpartum period.

Unhealthy weight control behaviors, disordered eating, and body image dissatisfaction in adolescents from São Paulo, Brazil

OBJECTIVE

To identify the frequency of disordered eating (DE) and unhealthy weight control behaviors (UWCB) among adolescents and associations with age, sex, actual weight status, perceived weight status, and body image dissatisfaction.

METHODS

Cross-sectional study of 1,156 adolescents. DE was assessed using a specific self-report questionnaire, UWCB by specific behaviors that were not typically recommended for weight management, and body dissatisfaction by Stunkard's silhouettes.

RESULTS

The frequency of DE was 17.3%, and that of UWCB, 31.9%; 80.1% of participants were dissatisfied with body image. Perception of oneself as overweight was associated with 1.795-fold odds of DE. Those with UWCB had 7.389-fold odds of DE, while DE increased the odds of UWCB 7.280-fold. Girls, participants who perceived themselves as overweight, and those who reported body dissatisfaction were 2.266, 2.381, and 1.752 times more likely to have UWCB, respectively.

CONCLUSION

A high prevalence of UWCB and a moderate prevalence of DE behaviors was found in adolescents from the city of São Paulo, Brazil. Those who perceived themselves as overweight had more DE and UWCB, and both behaviors were related. UWCB was more common in girls and among those dissatisfied with their bodies.

The Relative Associations of Body Image Dissatisfaction among Psychiatric Out-Patients in Singapore

Background: Adults with body image dissatisfaction (BID) are more likely to be depressed, anxious, and suicidal when compared to those without intense dissatisfaction over their appearance. The current study aimed to estimate the prevalence and factors associated with BID among out-patients with mental illness in Singapore. Methods: Data was collected from 310 psychiatric out-patients using a self-administered questionnaire. Measurements used were socio-demographic characteristics, Body Mass Index scores, Body Shape Questionnaire, Binge Eating Scale, Eating Attitudes Test, Beck’s Depression Inventory, Beck’s Anxiety Inventory and Alcohol Use Disorders Identification Test. Results: A prevalence of 30.9% of BID was established among psychiatric out-patients in Singapore. Being female, having higher BMI scores, binge eating behavior, eating disorders, and those diagnosed with depression were positively associated with BID. Conclusion: BID is prevalent among those with psychiatric illnesses which could lead to a higher degree of psychological distress and the emergence of eating disorders.

The Relationship between the Use of Social Networking Sites and Sexually Explicit Material, the Internalization of Appearance Ideals and Body Self-Surveillance: Results from a Longitudinal Study of Male Adolescents

Although there is now a substantial body of research suggesting a positive association between the exposure to sexualized content in the media and self-objectification/body surveillance, most of the studies have been cross-sectional, conducted in exclusively female samples, focused on the use of traditional media (e.g., printed magazines and TV), and have not assessed the role of the internalization of appearance ideals, which is potentially an important intervening variable in the relationship between media exposure and outcomes related to body concerns. Addressing the need for further assessments of self-objectification in more diverse samples, this study used five-wave longitudinal data to investigate the parallel changes in the use of social networking sites and sexually explicit material and the internalization of appearance ideals and body surveillance in Croatian adolescent men (M_{age at baseline} = 15.9, SD = 0.54; n= 743). Over a period of 22 months during the transition from middle to late adolescence, both the internalization of appearance ideals and body surveillance decreased. Furthermore, although the internalization of appearance ideals and body surveillance were associated both at baseline and over time, this study's results did not indicate a longitudinal relationship between respectively the use of online social networking sites and sexually explicit material and either the internalization of appearance ideals or body surveillance among adolescent males. Overall, this study's findings highlight the potential for a more specific assessment of the role of the use of social networking sites and sexually explicit material in self-objectification and body surveillance among young men. Future research may benefit from exploring the relationship between young men's modes of engagement with and motives for the use of social networking sites and body surveillance, as well as the possible association between the use of sexually explicit material and competency-based self-objectification, in particular sexual body functionality.

The risk of eating disorders and bone health in young adults: the mediating role of body composition and fitness

PURPOSE

To analyze the independent relationship between the risk of eating disorders and bone health and to examine whether this relationship is mediated by body composition and cardiorespiratory fitness (CRF).

METHODS

In this cross-sectional study, bone-related variables, lean mass, fat mass (by DXA), risk of eating disorders (SCOFF questionnaire), height, weight, waist circumference and CRF were measured in 487 university students aged 18-30 years from the University of Castilla-La Mancha, Spain. ANCOVA models were estimated to test mean differences in bone mass categorized by body composition, CRF or risk of eating disorders. Subsequently, linear regression models were fitted according to Baron and Kenny's procedures for mediation analysis.

RESULTS

The marginal estimated mean ± SE values of total body bone mineral density for the categories "no risk of eating disorders" and "risk of eating disorders" were 1.239 ± 0.126 < 1.305 ± 0.089, P = 0.021. However, this relationship disappeared after adjustment for any of the parameters of body composition or CRF. Therefore, all body composition parameters (except for lean mass) and CRF turned out to be full mediators in the association between the risk of eating disorders and bone health in young adults.

CONCLUSIONS

Body composition and CRF mediate the association between the risk of eating disorders and bone health. These findings highlight the importance of maintaining a healthy weight and good CRF for the prevention of the development of eating disorders and for the maintenance of good bone health in young adults.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Knowledge, Attitude and Behaviours Related to Weight Control and Body-Image Perceptions among Chinese High School Students

Background

Body-image perception is one of the determinants in weight management, especially among adolescents. This study aimed to assess weight-control knowledge, attitude and behaviours along with body-image perceptions among Chinese high school students in order to compare the weight-control behaviours with those perceptions.

Methods

A cross-sectional study was conducted among 277 Chinese students in Form 1 and Form 2 in Pulau Pinang, Malaysia using convenience sampling. The following outcomes were evaluated: weight-control knowledge, attitude and behaviours (weight-related knowledge and attitude questionnaire; weight control strategies scale) and body-image perceptions (figure rating scale).

Results

Both genders were found to have high weight-control knowledge, with female adolescents scoring significantly higher than male adolescents (P = 0.010). However, only half of the adolescents (50.9%) perceived that obesity is bad for health. Although only 44.4% of adolescents were dissatisfied with their current weight status, 62.8% intended to change their present weight status. Male adolescents significantly engaged more in physical activity (PA) (P = 0.035) and self-monitoring (SM) (P = 0.014) compared to their female counterparts. Furthermore, male adolescents chose their current body size as their ideal body image, but female adolescents preferred a slimmer ideal figure. The percentage of male and female adolescents who desired a smaller body figure was 39.6% and 54.5%, respectively. Lastly, there was no significant difference between weight-control behaviours and adolescents’ body-image perceptions.

Conclusion

Female Chinese adolescents had higher weight-control knowledge and preferred a slimmer body size, yet males were more likely to engage in PA and SM behaviours. Essentially, imprecise attitude towards obesity among half of the Chinese high school students is of particular concern.

[Tripartite Influence Scale (TIS) applied to university students: validation study and application]

The Tripartite Influence Scale (TIS) is used to assess the influence of social and family factors on individuals' body image. However, little evidence has been presented on the validity of the TIS construct. The study aimed to estimate the psychometric indicators in TIS and identify the degree of influence of the media, parents, and peers on body image in university students, considering different characteristics. University students of both sexes participated. The psychometric indicators in TIS were assessed for each sex using confirmatory factor analysis. Mean scores were calculated for each TIS factor. Prevalence rates for degree of influence were presented. A multivariate regression model was built to verify the relationship between target characteristics and TIS factor scores. The sample included 791 university students (63.2% women) 18 to 40 years of age. TIS did not initially display a good fit to the samples and was therefore refined. After refinement, the scale showed adequate validity and reliability for women and men. Significant differences were observed in the mean scores between women and men, and in the prevalence rates the majority of the students were in the low category. Work, consumption of food supplements for body changes, age, body mass index, self-rated diet, and level of physical activity were significantly related to TIS factors. Women were generally more influenced than men by the media and peers. Characteristics identified as related to TIS can be relevant for inclusion in clinical and research protocols.

Social Media and Body Dissatisfaction: Investigating the Attenuating Role of Positive Parent-Adolescent Relationships

Previous research has shown that adolescents´ social media use predicts increased body dissatisfaction. However, little is known about social environmental factors that may attenuate this relationship. This study examines one such potential moderating social environmental factor: positive parent–adolescent relationships. A school-based survey was conducted among 440 adolescents aged 12 to 19 (M= 14.9, SD= 1.8, 47% female). On average, social media use was positively associated with body dissatisfaction, but this relationship was weaker among adolescents who reported a more positive mother–adolescent relationship. Positive father–adolescent relationship did not moderate the association between social media use and body dissatisfaction. These findings may indicate that adolescents’ social environment, notably the relationship they have with their mothers, can protect them against the detrimental effects of social media use on body dissatisfaction. However, longitudinal and experimental studies are needed to examine the direction of effects and test the validity of this interpretation.

Analysis of dietary trends in Chinese adolescents from 1991 to 2011

BACKGROUND AND OBJECTIVES

To examine temporal trends in dietary energy, fat, carbohydrate, protein, sodium and potassium intake of Chinese adolescents aged 12 - 17 years by sex and urbanicity, using data from the China Health and Nutrition Survey.

METHODS AND STUDY DESIGN

Individual level, consecutive 3 - day 24-hour recalls were analyzed from survey years 1991 (n=504), 2000 (n=665), and 2011 (n=267) from nine provinces representing a range of geography, economic development, and health indicators in China. Linear multivariable regression models were conducted to predict mean intakes of energy, macronutrients, sodium, and potassium. Models were adjusted for age, per capita income, parental education, region, and family size.

RESULTS

From 1991 to 2011, total energy consumption decreased among both sexes and all urbanicity groups (p<0.05). Sodium intake decreased in all sex and urbanicity groups except the high urbanicity group, which was the only group to show significant change in potassium intake (p<0.05). Sodium-potassium ratios decreased overall and across both sexes (p<0.05). However, the major observed shift was a structural change from carbohydrates to fat and protein. Both sexes showed decrease in carbohydrate-derived energy (p<0.05). Proportion of fat-derived energy increased in female adolescents. Proportion of protein-derived energy increased in male adolescents, as well as in the low and high urbanicity groups (p<0.01).

CONCLUSIONS

This suggests Chinese adolescents are transitioning to a low carbohydrate diet. Urbanicity appears to play a role in sodium, potassium and protein intake. Improvements of sodiumpotassium ratios are primarily due to decreased sodium intake and require further reduction efforts.

Why do women want to be beautiful? A qualitative study proposing a new "human beauty values" concept

This study investigated the underlying reasons women desire to be beautiful in South Korean, Chinese, and Japanese cultures by proposing a new concept called human beauty value (HBV). This exploratory qualitative study includes a literature review in related disciplines and the results from ten focus group interviews. Based on the interviews, this study proposes four dimensions of HBV (i.e., superiority, self-development, individuality, and authenticity) and a hierarchical process among the antecedents (i.e., social comparison, social competition, and social norms), the pursuit of HBV, and the consequences (i.e., emotional, attitudinal, and behavioral aspects). Participants from each culture revealed a unique hierarchical process of HBV that reflects both cultural universality and specificity. The results of this study lead to new knowledge about East Asian women's identities and perceptions of beauty. In addition, the proposed concept, HBV, can broaden the academic lens for beauty-related disciplines.