Physical, Behavioral, and Body Image Characteristics in a Tri-Racial Group of Adolescent Girls

Use of race, ethnicity, and ancestry data in health research

Race, ethnicity, and ancestry are common classification variables used in health research. However, there has been no formal agreement on the definitions of these terms, resulting in misuse, confusion, and a lack of clarity surrounding these concepts for researchers and their readers. This article examines past and current understandings of race, ethnicity, and ancestry in research, identifies the distinctions between these terms, examines the reliability of these terms, and provides researchers with guidance on how to use these terms. Although race, ethnicity, and ancestry are often treated synonymously, they should be considered as distinct terms in the context of health research. Researchers should carefully consider which term is most appropriate for their study, define and use the terms consistently, and consider how their classification may be used in future research by others. The classification should be self-reported rather than assigned by an observer wherever possible.

Gestational Weight Gain and Interpregnancy Weight Change in Adolescent Mothers

STUDY OBJECTIVE

To examine the association between gestational weight gain (GWG) and interpregnancy weight change (IPWC) in adolescent mothers (younger than 20 years), and to determine if this association differs from adult women (aged 20-35 years).

DESIGN

Retrospective cohort study.

SETTING AND PARTICIPANTS

We included 3055 adolescents and 17,090 adult women with singleton pregnancies recorded in the Nova Scotia Atlee Perinatal Database with a subsequent pregnancy occurring between 2003 and 2014.

INTERVENTIONS AND MAIN OUTCOME MEASURES

GWG in the first pregnancy was categorized as below, within, or above the current Institute of Medicine recommendations. IPWC was defined as the difference between the prepregnancy weights of the 2 pregnancies. Analyses were adjusted for parity, body mass index in the first pregnancy, and time between pregnancies.

RESULTS

Relative to adolescents with GWG within the recommendations, those who gained below had a 2.7 kg (95% confidence interval [CI], 1.4-3.9) lower mean IPWC whereas those who gained above had a 4.2 kg (95% CI, 3.3-5.1) higher mean IPWC. Smaller differences in IPWC between GWG categories were observed in adult women; relative to those with GWG within the recommendations, adults who gained below had a 1.3 kg (95% CI, 0.9-1.7) lower mean IPWC and those who gained above had a 2.9 kg (95% CI, 2.6-3.2) higher mean IPWC.

CONCLUSION

Mean IPWC differed across GWG categories and the differences were greater in adolescents than in adult women. This difference should be considered when assessing whether specific GWG recommendations are needed for adolescents.

Gender and racial/ethnic differences in binge eating symptoms in a nationally representative sample of adolescents in the United States

OBJECTIVE

Binge eating disorder (BED) is the most prevalent eating disorder in the U.S. adolescent population. Both BED and subthreshold binge eating disorder (SBED) are associated with physical and mental health problems. Gender and racial/ethnic differences in prevalence of binge eating in a nationally representative sample of adolescents have been reported but have not yet been assessed in relation to individual symptoms of binge eating. We examined gender and racial/ethnic differences in endorsement of eight binge eating symptoms in a nationally representative sample of U.S. adolescents.

METHODS

We used data from the National Comorbidity Survey-Adolescent Supplement (NCS-A; 2001-2004), a nationally representative cross-sectional study of adolescents aged 13 to 18years (n=9336). We compared binge eating symptoms across gender and racial/ethnic groups using multivariable regression models.

RESULTS

Females endorsed more binge eating symptoms than males associated with loss of control ('eat when not hungry') (adjusted prevalence ratio [aPR]=1.18, 95% confidence interval [CI]=1.02, 1.37, p=0.024) and distress (e.g., 'afraid of weight gain while binge eating' [aPR]=3.29, CI=2.43, 4.47, p<0.001). Racial/ethnic minorities displayed different patterns of binge eating symptoms than non-Hispanic Whites. Hispanics reported being more 'afraid of weight gain while binge eating' (aPR=2.05, CI=1.25, 3.37, p=0.006) than non-Hispanic Blacks.

DISCUSSION

Our findings suggest significant gender and racial/ethnic differences in binge eating symptom presentation. Future work should explore reasons for these gender and racial/ethnic differences and consider these differences when determining how best to prevent and treat binge eating in adolescents.

Sports Participation and Positive Correlates in African American, Latino, and White Girls

PURPOSE

The purpose of the study was to examine relations among sports participation and positive correlates across African American, Latino, and white girls. Positive correlate variables were self-perceptions (self-worth, body attractiveness, athletic competence), less depression, and participation in extracurricular activities.

METHODS

The sample comprised 372 girls (mean age = 12.03 years). Data were analyzed using multiple-sample structural equation models, controlling for age and income.

RESULTS

Across all ethnic groups, greater sports participation was significantly related to higher self-worth, body attractiveness, and athletic competence, and to more extracurricular activity. Among Latino and white girls only, greater sports participation also was related to less depression. There were significant age and income influences on the positive correlates.

CONCLUSIONS

Findings confirm the existence of significant relationships between organized sports participation and positive correlates among early adolescent African American, Latino, and white girls. Despite a few ethnic differences in relationships, the current study revealed more similarities than differences.

Relations Among Teasing, Body Satisfaction, Self-Esteem, and Depression in Treatment-Seeking Obese African American Adolescents

The objective of this study was to examine correlates of weight-based teasing, self-esteem, and depression among 119 treatment-seeking obese African American adolescents aged 11 to 18 years. Body satisfaction was examined as a potential mediator of the association between teasing and self-esteem and teasing and depression. Study participants (mean age = 13.9 years; 72% female) completed measures evaluating teasing, self-esteem, depression, and body satisfaction. Body satisfaction was measured using a multiethnic figure rating scale and a measure of overall satisfaction with appearance. The results indicated an association between teasing and decreased self-esteem and increased depression. Males exhibited higher body satisfaction than females. Body satisfaction partially mediated the association between teasing and self-esteem and teasing and depression. These data suggest that body satisfaction is relevant to well-being among obese African American adolescents seeking weight loss treatment.

Ethnic differences in perceptions of body satisfaction and body appearance among U.S. schoolchildren: a cross-sectional study

BACKGROUND

Perceived body appearance and body satisfaction are potentially related to weight problems and poor health. The purpose of this study was to examine how gender, and ethnic differences in body satisfaction, perceived body appearance and weight status change by age in a representative sample of U.S. adolescents 11-17 years old.

METHODS

We used the US Health Behavior in School-Aged Children (HBSC) 2001 survey which assessed perceived body appearance, body satisfaction, self-reported body mass index (BMI) and socio-demographic indicators. The associations between age and perceived appearance, age and body satisfaction, and between z-transformed BMI and body satisfaction were analyzed using separate non-parametric regression models for both genders and the three ethnic groups.

RESULTS

Body satisfaction did not vary significantly by age except for an increase with age in the proportion of Non-Hispanic White girls who perceived themselves as too fat. Although boys did not report being too fat unless their BMI was above the age- and gender-specific median, one third of Non-Hispanic White girls felt too fat at or below the age- and gender-specific median. Compared to other ethnicities, African-American students' perceived appearance was significantly more positive and they were less likely to perceive themselves overweight at higher BMI scores. However, during adolescence, the positive self-reported perceived appearance of African-American boys dropped substantially while it remained relatively stable in African-American girls.

CONCLUSIONS

There were substantial differences in body satisfaction and perceived appearance across the three largest ethnic groups of school-age children in the U.S. Stability across age indicates that these perceptions are most likely established before the age of 10 and underline the importance of primary schools and parents in prevention. Special attention should be directed to the dramatic loss of positive perceived appearance among African-American boys.

Shared norms and their explanation for the social clustering of obesity

OBJECTIVES

We aimed to test the hypothesized role of shared body size norms in the social contagion of body size and obesity.

METHODS

Using data collected in 2009 from 101 women and 812 of their social ties in Phoenix, Arizona, we assessed the indirect effect of social norms on shared body mass index (BMI) measured in 3 different ways.

RESULTS

We confirmed Christakis and Fowler's basic finding that BMI and obesity do indeed cluster socially, but we found that body size norms accounted for only a small portion of this effect (at most 20%) and only via 1 of the 3 pathways.

CONCLUSIONS

If shared social norms play only a minor role in the social contagion of obesity, interventions targeted at changing ideas about appropriate BMIs or body sizes may be less useful than those working more directly with behaviors, for example, by changing eating habits or transforming opportunities for and constraints on dietary intake.

Gender and ethnic disparities contributing to overweight in California adolescents

Purpose

To explore differences in health behaviors and factors contributing to overweight among 12 to 17 year olds in California.

Methods

Data from the 2005 California Health Interview Survey for 3,315 adolescents self-identified as Latino, Asian, or white were reviewed. Adolescents reported their weight, height, gender, ethnicity, parents’ educational level, household income, physical activity, sedentary activity, breakfast consumption, and family meals.

Results

Overall 34% of boys and 22% of girls in this study were overweight (>85th percentile for age and gender). Approximately 38% of Latinos, 25% of whites, and 16% of Asians were overweight. Latinos were more than twice as likely to be overweight as whites (2.07) and Asians (2.53). Younger adolescents (12–13 years old) and adolescents whose family income is less than 200% of the federal poverty level were more likely to be overweight. Low level of parental education is a risk factor for Latino and Asian girls and white and Latino boys. White girls with a lower socioeconomic status and white boys with more than 2 h daily of television, video, and computer time were more likely to be overweight.

Conclusion

Results suggest gender and ethnic variations in factors that contribute to overweight in California adolescents. To influence the current overweight epidemic, clinicians must develop culturally sensitive and gender-specific interventions that address the unique needs of an ethnically diverse adolescent population.

The obesity epidemic: are minority individuals equally affected?

There is a greater prevalence of obesity in ethnic and racial minorities than in non-Hispanic whites. This disparity is multifactorial, with culture, environment, and genetics playing a role. There are limited data on successful interventions to prevent and treat obesity in minority populations.

Body image perceptions in Western and post-communist countries: a cross-cultural pilot study of children and parents

The development of an unrealistic ideal body image and body size dissatisfaction among children is common in Western countries, including the USA and many European nations. However, little is known about children's body image perceptions in post-communist countries. This pilot study evaluated body image perceptions in a sample of Czech school-aged children and their parents and compared them with the perceptions of American children and parents. Ninety-seven Czech and 45 American 4th-6th graders and their parents from eight urban schools participated in this study. A previously developed silhouette body image instrument was utilized in a parent questionnaire and during child interviews to measure perceived and ideal body image perceptions of children and parents. Descriptive statistics, independent t-tests and paired t-tests were used to compare differences between children's and parents' perceived and ideal body image perceptions. Associations between body image perceptions and other variables were explored using bivariate correlations. American children had a thinner ideal body image compared with Czech children (P < 0.05). However, a larger proportion of Czech boys desired to be thinner compared with American boys (34.2% vs. 20%). Parent's ideal body image for their children did not differ by nationality (P = 0.858). While the pressure on children to look thinner was apparent among both American and Czech children, Czech children considered a larger body size as more ideal. A future study should evaluate body image perceptions and factors influencing these perceptions in a representative sample of Czech children and parents.

Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on population and prevention science)

Obesity is a major influence on the development and course of cardiovascular diseases and affects physical and social functioning and quality of life. The importance of effective interventions to reduce obesity and related health risks has increased in recent decades because the number of adults and children who are obese has reached epidemic proportions. To prevent the development of overweight and obesity throughout the life course, population-based strategies that improve social and physical environmental contexts for healthful eating and physical activity are essential. Population-based approaches to obesity prevention are complementary to clinical preventive strategies and also to treatment programs for those who are already obese. This American Heart Association scientific statement aims: 1) to raise awareness of the importance of undertaking population-based initiatives specifically geared to the prevention of excess weight gain in adults and children; 2) to describe considerations for undertaking obesity prevention overall and in key risk subgroups; 3) to differentiate environmental and policy approaches to obesity prevention from those used in clinical prevention and obesity treatment; 4) to identify potential targets of environmental and policy change using an ecological model that includes multiple layers of influences on eating and physical activity across multiple societal sectors; and 5) to highlight the spectrum of potentially relevant interventions and the nature of evidence needed to inform population-based approaches. The evidence-based experience for population-wide approaches to obesity prevention is highlighted.

Gender and ethnic differences in body image and opposite sex figure preferences of rural adolescents

This study examined whether rural adolescents would report gender and ethnic differences in body image similar to those that have been observed in urban samples. Data were analyzed for 384 rural adolescents (57% African American, 43% Caucasian, mean age 13 years) to determine gender and ethnic differences in body dissatisfaction, body size discrepancy, and current and ideal figure ratings. Females wanted to be smaller and reported more body dissatisfaction than did males. Caucasian females reported the most body dissatisfaction. African Americans reported larger current and ideal figure ratings than did Caucasians. African Americans preferred larger opposite sex figures than did Caucasians. Both African American and Caucasian males selected a larger female figure as ideal than was selected by females. Results demonstrated that gender and ethnic differences exist in body image for rural adolescents. This frequently overlooked population may benefit from further study. Implications of findings and limitations of the study are also discussed.

Agreement with Satisfaction in Adolescent Body Size between Female Caregivers and Teens from a Low-income African-American Community

OBJECTIVE

To describe body size satisfaction and agreement among low-income, urban, African-American adolescents, and female caregivers.

METHODS

Two hundred and fifteen adolescent-caregiver pairs completed measures of demographics, anthropometrics, and body size satisfaction.

RESULTS

Adolescent-caregiver agreement on body size satisfaction varied by body mass index (BMI) category. Among normal weight adolescents, 61% of adolescent-caregivers agreed that current body size was ideal. Among adolescents at risk for overweight, 38% of adolescent-caregivers agreed that current body size was ideal, and 38% were discordant with adolescents wanting to be thinner and caregivers satisfied with current body size. Among overweight adolescents, adolescent-caregiver agreement was 67%; 52% agreed the adolescent should be thinner and 15% agreed current body size was ideal.

CONCLUSIONS

Body size satisfaction is related to BMI category for adolescents and caregivers, but adolescents have a lower threshold. Encouraging caregivers to elicit their adolescents' views on body size satisfaction may enable caregivers to support their adolescents in addressing weight-related issues.