BMI percentiles and body image discrepancy in black and white adolescents

Comprehensive Scoping Review on Body Image Perceptions and Influences in Children and Adolescents

Conducting a scoping review helps identify research gaps and opportunities, avoid duplication, guide the selection of appropriate methodologies, and base studies on existing evidence. The aim of this study was to map the literature on body image in children and adolescents (0 to 19 years). The present study follows the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA). The search was conducted in the following databases: PubMed, Web of Science, Scopus, SPORTDiscus, LILACS, SciELO, PsycINFO, CINAHL, and the Cochrane Library. A total of 3257 articles were found, of which 2147 were duplicates, resulting in 1110 articles. Of these, 41 met the inclusion criteria. The results were divided into analytical dimensions, including measurement instruments, programs and interventions, social media, sociodemographic aspects, physical activity, personality and cognitive thinking, and studies with specific populations. The results highlight that peer influence, physical activity, media, and the school environment play crucial roles in shaping young people's body image; factors such as sex, age, and socioeconomic context emerge as important variables in understanding body perceptions, and educational interventions and health promotion programs have been shown to be effective in preventing and reducing body dissatisfaction, underscoring the need for multifactorial and collaborative approaches.

Prevalence of malnutrition based on global leadership initiative in malnutrition criteria for completeness of diagnosis and future risk of malnutrition based on current malnutrition diagnosis: systematic review and meta-analysis

Background

The proposal of the global leadership initiative in malnutrition (GLIM) criteria has received great attention from clinicians. The criteria are mainly used in the research environment and have the potential to be widely used in the clinic in the future. However, the prevalence of malnutrition and risk of future malnutrition based on a current diagnosis of malnutrition are worth exploring.

Methods

A systematic search of PubMed, Embase, and the Cochrane Library was performed from the earliest available date to 1 February 2023. According to the diagnostic criteria of the GLIM, we analysed the prevalence of malnutrition by directly adopting the GLIM criteria for diagnosis without a previous nutritional risk screening (one-step approach) and by adopting the GLIM criteria for diagnosis after a nutritional risk screening (two-step approach). The main outcome was the prevalence of malnutrition based on the one-and two-step approaches. Secondary outcomes were the future risk of malnutrition based on the GLIM diagnosis, including mortality within and beyond 1 year. primary outcomes were pooled using random-effects models, and secondary outcomes are presented as hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

A total of 64 articles were included in the study, including a total of 47,654 adult hospitalized patients and 15,089 malnourished patients based on the GLIM criteria. Malnutrition was diagnosed by the one-step approach in 18 studies and by the two-step approach in 46 studies. The prevalence of malnutrition diagnosed by the one-and two-step approaches was 53% (95% CI, 42%-64%) and 39% (95% CI, 0.35%-0.43%), respectively. The prevalence of malnutrition diagnosed by the GLIM criteria after a nutritional risk screening was quite different; the prevalence of malnutrition diagnosed by the Nutritional Risk Screening 2002 (NRS2002) GLIM tool was 35% (95% CI, 29%-40%); however, the prevalence of malnutrition diagnosed by the Mini Nutrition Assessment (MNA) GLIM tool was 48% (95% CI, 35%-62%). Among the disease types, the prevalence of malnutrition in cancer patients was 44% (95% CI, 36%-52%), while that in acute and critically ill patients was 44% (95% CI, 33%-56%). The prevalence in patients in internal medicine wards was 40% (95% CI, 34%-45%), while that in patients in surgical wards was 47% (95% CI, 30%-64%). In addition, the mortality risk within 1 year (HR, 2.62; 95% CI, 1.95-3.52; I² = 77.1%) and beyond 1 year (HR, 2.04; 95% CI, 1.70-2.45; I² = 59.9%) of patients diagnosed with malnutrition by the GLIM criteria was double that of patients with normal nutrition.

Conclusion

The prevalence of malnutrition diagnosed by the GLIM criteria after a nutritional risk screening was significantly lower than the prevalence of malnutrition diagnosed directly by the GLIM criteria. In addition, the mortality risk was significantly greater among malnourished patients assessed by the GLIM criteria.Systematic review registration: identifier CRD42023398454.

Examination of the Interaction between Parental Military-Status and Race among Non-Hispanic Black and Non-Hispanic White Adolescents with Overweight/Obesity

OBJECTIVES

Adolescent military-dependents experience distinct risk and protective factors, which may necessitate additional clinical considerations. In civilian youth, overweight/obesity is associated with eating, internalizing, and externalizing difficulties, with some studies reporting more difficulties among non-Hispanic White (vs. non-Hispanic Black) youth. It is unknown if these disparities exist among adolescent military-dependents, or between civilian and military-dependent youth.

METHODS

Non-Hispanic Black (187 civilian, 38 military-dependent) and non-Hispanic White (205 civilian, 84 military-dependent) adolescents with overweight/obesity (14.7 ± 1.6 years; 73.9% girls; body mass index adjusted for age and sex 1.9 ± 0.5) completed a disordered-eating interview; parents completed a measure assessing their child's internalizing and externalizing difficulties. Multiple linear regressions examined parental military-status as a moderator of the relationship of participant race with eating, internalizing, and externalizing difficulties.

RESULTS

White civilian youth with overweight/obesity reported significantly greater disordered-eating than their Black peers (p < .001); there were no other significant racial differences. In all regressions, parental military-status significantly moderated the association between race and each dependent variable (ps < .047). Black military-dependents (vs. civilians) reported more disordered-eating and internalizing difficulties (ps = .01). White military-dependents (vs. civilians) reported fewer externalizing difficulties (p = .01).

CONCLUSIONS

Black adolescent military-dependents with overweight/obesity may experience more eating and internalizing difficulties (vs. civilians), a pattern not observed among White participants. Future work should examine if being a military-dependent and a historically marginalized racial group member accounts for these findings. Such data may inform providers of youth with intersecting minority identities.

Body image and dissatisfaction among rural Deep South African American women in a weight loss intervention

Body image perception may impact health-promoting behaviors as well as knowledge regarding health risks associated with obesity. Our cross-sectional analysis evaluated body image and its association with body mass index among overweight and obese treatment-seeking African American women (N = 409). Differences between current and desired body image were captured using the Pulvers scale. Results indicated the presence of body image dissatisfaction among participants (median = 2.00, interquartile range: 2.00-3.00), with greater dissatisfaction observed at higher categories of body mass index. Additionally, receiver operating curves demonstrated the ability of the Pulvers scale to correctly identify participants classified by body mass index. Further research is needed to identify factors that influence body image perception.

Physical self-concept and body dissatisfaction among Special Olympics athletes: A comparison between sex, weight status, and culture

BACKGROUND

Little research has looked at the associations between sex, weight status and culture, and the physical self-perceptions and body dissatisfaction of individuals with intellectual disabilities (ID) involved in Special Olympics (SO) sports.

AIMS

To examine sex- (male vs female), weight status- (non-overweight/obese vs. overweight/obese), and culture-based (North American vs. Asian) differences in physical self-concept and body dissatisfaction among SO athletes.

METHODS AND PROCEDURES

A total of 139 SO athletes (aged 12-30 years) with ID participated in this study and completed measures of physical self-perceptions and body dissatisfaction. Differences according to sex, weight status, culture, and their interactions were examined.

OUTCOMES AND RESULTS

Males SO athletes presented higher levels of self-perceived physical strength and ideal body shape than females. Additionally, non-overweight/obese SO athletes presented higher levels of self-perceived physical appearance and physical condition than their overweight/obese counterparts, as well as lower actual body shape perceptions and body dissatisfaction. Moreover, North-American SO athletes presented higher levels of self-perceived physical appearance and sport competence than their Asians counterparts, as well as lower actual body shapes perceptions and body dissatisfaction.

CONCLUSION AND IMPLICATIONS

This study reveals substantial sex-, weight status-, and culture-based differences in the physical self-concept and body dissatisfaction of SO athletes.

Reported Motivations for and Locations of Healthy Eating Among Georgia High School Students

BACKGROUND

Understanding how youth perceive eating healthy foods can inform programs and policies that aim to improve healthy eating. We assessed the reasons for and the most common locations of eating healthy foods among Georgia's (GA) high school (HS) students.

METHODS

Using the 2013 GA HS Youth Risk Behavior Survey, we examined motivations for and locations of eating healthy foods by sociodemographic characteristics and daily fruit and vegetable intake. Weighted chi-square tests were used to examine differences in responses for each perception.

RESULTS

Nineteen percent of GA HS students consumed fruit ≥3 times/day and 11% consumed vegetables ≥3 times/day. The most frequently chosen response to motivations for eating healthy foods was the desire to be healthy (42%), followed by enjoying their taste (18%). The most likely location to eat healthy foods was at home (80%), followed by at school (13%).

CONCLUSIONS

GA HS students are most motivated to eat healthy foods by the desire to be healthy and their enjoyment of the taste of healthy foods. Incorporating messages that align with students' motivations to eat healthy foods could be considered when developing promotional programs/policies targeting healthy eating.

Factors related to obesity and overweight among Black adolescent girls in the United States

In the United States, Black adolescents have the highest prevalence of pediatric obesity and overweight among girls. While Black girls are disproportionately affected, the reasons for this health disparity remain unclear. The authors conducted a systematic review to investigate the factors related to obesity and overweight among Black adolescent girls. The authors searched four databases for relevant English-language publications using all publication years through 2015. Fifty-one studies met the inclusion criteria and were used for this review. Using a configuration approach to synthesis, three categories were identified, paralleling the bioecological theory of human development: (1) individual, (2) interpersonal, and (3) community and societal factors. A description of each factor's association with obesity among Black adolescent girls is presented. From this review, the authors identified a diverse and vast set of individual, interpersonal, and community and societal factors explored for their relationship with obesity and overweight. Given the insufficient repetition and limited significant findings among most factors, the authors believe that multiple gaps in knowledge exist across all categories regarding the factors related to obesity and overweight among Black adolescent girls. To improve the quality of research in this area, suggested research directions and methodological recommendations are provided.

Overweight in young adult students: the vulnerability of a distorted self-perception of body image

RESUMO Objetivo: analisar o excesso ponderal em adultos jovens escolares a partir da dimensão individual da vulnerabilidade, especificamente de seus marcadores interpessoais e subjetivos. Método: delineou-se um estudo analítico, quantitativo, realizado com 560 adultos jovens de 26 escolas de uma capital do nordeste brasileiro. Após obtenção dos dados pela aplicação de questionários específicos, utilizou-se a regressão logística para identificação dos marcadores de vulnerabilidade individual. Resultados: na análise bivariada, o excesso ponderal apresentou associação estatística significativa com autopercepção de saúde, satisfação corporal e autopercepção de excesso ponderal, esta permanecendo no modelo final da regressão. Conclusão: conclui-se, sobremaneira, que a autopercepção de excesso ponderal sofre distorções em relação à real situação corporal e por isso torna o adulto jovem vulnerável a estados disfuncionais de saúde. No entanto, ratifica-se que o agravo deve ser compreendido numa perspectiva individual e contextual.

Relationship Between Body Image Discrepancy and Intuitive Eating

Dieting is widespread among college women despite being ineffective and harmful long term. Intuitive eating is a dieting alternative that teaches eating in response to hunger and satiety cues. It has been associated with improved physical and psychological health and studied in association with various body image dimensions. A sample of college first years completed baseline measurements during an intuitive eating intervention to test the association between intuitive eating and body image discrepancy (BID). BID represents whether a respondent believes her current body is larger or smaller than ideal. Greater BID was negatively associated with intuitive eating ( p ≤ .05); participants who believed that their current bodies were larger than ideal were less likely to attend to hunger and satiety cues than participants who expressed little or no BID. These women should be targeted in future weight management interventions in order to avoid negative health outcomes of dieting.

Assessing the Feasibility of a Web-Based Weight Loss Intervention for Low-Income Women of Reproductive Age: A Pilot Study

Background

Low-income women of reproductive age are at increased risk for obesity and resulting increases in the risk of maternal/fetal complications and mortality and morbidity. Very few weight-loss interventions, however, have been targeted to this high-risk group. Based on the high prevalence of social media use among young and low-income individuals and previous successes using group formats for weight-loss interventions, the use of social media as a platform for weight-loss intervention delivery may benefit low-income women of reproductive age.

Objective

Examine the feasibility of delivering group-based weight-loss interventions to low-income women of reproductive age using face-to-face meetings and Web-based modalities including social media.

Methods

Participants attended a family planning clinic in eastern North Carolina and received a 5-month, group- and Web-based, face-to-face weight-loss intervention. Measures were assessed at baseline and 20 weeks.

Results

Forty participants enrolled, including 29 (73%) African American women. The mean body mass index of enrollees was 39 kg/m². Among the 12 women who completed follow-up, mean weight change was -1.3 kg. Participation in the intervention was modest and retention at 5 months was 30%. Returnees suggested sending reminders to improve participation and adding activities to increase familiarity among participants.

Conclusions

Engagement with the intervention was limited and attrition was high. Additional formative work on the barriers and facilitators to participation may improve the intervention’s feasibility with low-income women of reproductive age.

Body image perception and its association with body mass index and nutrient intakes among female college students aged 18-35 years from Tabriz, Iran

PURPOSE

Recent studies have shown that body image perception is an important factor in weight management and can be influenced by several social or cultural factors in Western or non-Western societies; however, body image perception and its nutritional and demographic determinants in Iran have not been extensively studied. In the current study, we aimed to evaluate body image perception and its socio-demographic and nutritional determinants among female university students in Tabriz City of Iran.

METHODS

In the current cross-sectional survey, 184 female students aged 18-35 years from Tabriz, Iran, were enrolled. Anthropometric variables including weight, height, waist and hip circumference were measured and body mass index (BMI) and waist to hip ratio (WHR) were calculated. Body image perception and distortion were assessed by Figure Rating Scale (FRS) developed by Stunkard consisting of nine silhouettes. Nutrition intake was assessed by a 3-day 24-h dietary recall method and analyzed by Nutritionist IV software.

RESULTS

Most of the participants in the underweight (41.66%), normal weight (67.71%) and overweight (57.14%) categories of BMI selected the thinnest figure as their desirable or ideal body image perception. The total prevalences of body image dissatisfaction and distortion were 51.63% and 64.13%, respectively. Subjects who had undistorted body image perception consumed more time for physical activity and had more night sleeping hours compared with others (P < 0.05). Subjects who perceived themselves as being of normal weight had significantly lower intake of total fat and saturated fatty acids and higher intakes of monounsaturated fatty acids (MUFAs) compared with other groups (P < 0.05).

CONCLUSIONS

According to our findings, female participants had a higher tendency to consider thinness as the preferred body image style. Persons with undistorted body image perception had healthy nutritional status compared with others. Due to high prevalence of body image dissatisfaction, the need for appropriate interventional programs to prevent the associated co-morbidities is emphasized.

Nobody's perfect: a qualitative examination of African American maternal caregivers' and their adolescent girls' perceptions of body image

Using semi-structured interviews, we explored African American maternal caregivers' and their adolescent girls' (N=25 dyads) perceptions about the adolescent's body using Grounded Theory. Caregivers and adolescent girls (Mage=13.42) were asked what the adolescent girls liked most/least about their bodies and how peers and media may affect adolescent girls' perceptions. While some adolescent girls reported overall body satisfaction, others described features they would like to change. Belief in God, body acceptance, and appreciation for average/moderate features helped the adolescent girls maintain their positive body image. The body-related messages that adolescent girls received from caregivers and peers included compliments, pressure to lose weight, teasing, and advice. Adolescent girls also reported being either influenced by or skeptical of the images presented in the media. Programs that promote caregiver-adolescent communication about body perceptions and that build on the adolescent girls' media skepticism may prove useful for their health-related attitudes and behaviors.

Estudo de validação e fidedignidade de escalas de silhuetas brasileiras em adolescentes

Objetivou-se avaliar a validade de construto e a fidedignidade das escalas de silhuetas de Kakeshita (2008) em adolescentes brasileiros. Após a condução do teste-reteste em 112 participantes com intervalo de um mês, os resultados demonstraram que as escalas foram capazes de discriminar os diferentes grupos de estado nutricional em ambos os sexos; apresentaram coeficientes de correlação entre IMC real, IMC atual e insatisfação e coeficientes de correlação intraclasse elevados, comprovando que o instrumento é apropriado para avaliar a imagem corporal nessa faixa etária.

Establishing the optimal body mass index - body esteem relationship in young adolescents

Background

This study sought to compare the utility of either inverted body mass index or body mass index to optimise the relationship with body esteem in young adolescents Design: The study was cross sectional in design and assessed body esteem and weight status in756 young adolescents (394 boys, 362 girls, mean age ± S.D. 11.4 ± 1.6 years).

Methods

Body esteem was determined using the body esteem scale for children. Height and body mass were measured directly. Body mass index was determined as kg/m² and iBMI as cm²/kg.

Results

Results indicated that the association between iBMI and body esteem was curvilinear in nature and iBMI was the better predictor of body esteem (P = .001) predicting 21.3% of the variance in body esteem scores compared to 20.5% using BMI (P = .001). When split by gender, the curvilinear relationship was still evident but significantly different between boys and girls although iBMI remained a better predictor of body esteem compared to BMI in both boys and girls. The peak differed between gender groups with the association between iBMI and body esteem peaking at 642 cm²/kg for boys and 800.64 cm²/kg for girls.

Conclusion

This study suggests that iBMI is a better predictor of body esteem in young adolescents, and that the association between body esteem and iBMI is curvilinear in nature. However, the peak of body esteem scores occured at a lower degree of leanness for boys compared to girls and indicated that the point at which body esteem scores are highest for girls is at a point of extreme leanness whereas the peak for boys was within the values considered as ‘normal’ on the leanness to obesity continuum. iBMI may therefore be a useful measure of leanness for future studies examining the association between overweight/obesity and body esteem in young adolescents.

[Silhouette scales and body satisfaction in adolescents: a systematic literature review]

The purpose of this study was to summarize studies on adolescents' body satisfaction, focusing on the use of silhouette scales. A systematic review was carried out on MEDLINE, LILACS, SciELO, and in unpublished papers. The final analysis included 36 studies. The majority adopted the scale proposed by Stunkard et al., self-administered, presented in ascending order and on a single sheet of paper. Most studies compared characteristics on satisfaction and dissatisfaction, used the chi-square test, and did not test for confounding. Among 18 studies included in the meta-analysis, prevalence of body dissatisfaction ranged from 32.2% to 83%. The review showed wide heterogeneity between studies (p-value = 0.000; I(2) = 87.39) even after sub-group analysis and the absence of relevant information for proper comparison of studies. The article concludes by recommending greater rigor in application of the scales and presentation of study methods on body satisfaction assessed by silhouette scales, in addition to new methodological studies and those that elucidate factors related to body satisfaction.

The influence of ethnicity and gender on the association between measured obesity and cardiorespiratory fitness with self-rated overweight, physical activity and health

BACKGROUND

Little is known about how ethnicity may influence how self-rated physical activity (PA) and obesity relates to measured obesity, cardiorespiratory fitness and self-rated health.

AIMS

To examine the influence of ethnicity on the association between: (1) self-rated and measured obesity; (2) self-reported PA and cardiorespiratory fitness; and (3) obesity and PA with self-rated health.

METHODS

Data from NHANES 1999-2004 (2,981 adults) was used.

RESULTS

Compared to white and overweight black men, Hispanic men were less likely to consider themselves overweight (OR = 0.36-0.56). Compared to white men, black active men were more likely to report being more active than their peers (OR = 1.44) but were less likely to be fit (OR = 0.74). Black active women and non-white overweight women were less likely to self-rate as having very good or excellent health as compared to white women with similar self-reported and measured health factors.

CONCLUSIONS

Ethnicity and gender influence how self-rated and measured health factors interrelate.

Physical activity and self-concept: the SEARCH for diabetes in youth case control study

In this study, the relationship between physical activity (PA) and 3 self-concept constructs (physical abilities, physical appearance, and general self-concept) was examined. Youth with type 1 diabetes (n = 304), type 2 diabetes (n = 49), and nondiabetic controls (n = 127) aged 10-20 years wore pedometers over 7 days. Youth completed the Self-Description Questionnaire and correlation coefficients were calculated. Mean steps/day were 7413 ± 3415, 4959 ± 3474 and 6870 ± 3521 for type 1, type 2 and control youth, respectively. Significant correlations were found between steps/day and perception of physical abilities (r = .29; r = .31; r = .31) for type 1, type 2, and control youth, respectively. The other correlations were not significant. Among youth with type 2 diabetes, steps/day were significantly correlated with physical appearance (r = .46). The positive correlation between PA and physical abilities suggests a reciprocal relationship between behavior and perception.

Adolescent health, stress and life satisfaction: the paradox of indulgent parenting

A survey of adolescents aged 15 to 16 years was used to examine the relationship between their perceptions of indulgent parenting and adolescent weight status to overall satisfaction with life, as associated with adolescent perceptions of body image, health and stress. In addition, perceptions of parental indulgence were examined in terms of their association with adolescent eating behaviours and health. The results revealed a paradox related to indulgent parenting, with both positive and negative outcomes for adolescents. Structural equation analyses showed that parental indulgence was not only related to lower stress and higher life satisfaction, but also to unhealthy eating behaviours. Path analysis indicated that both positive and negative eating outcomes for adolescents were related to parental indulgence. This research has many implications for both parent and adolescent health education, focusing on parenting styles, stress and healthy lifestyles.

Geographic location, sex and nutritional status play an important role in body image concerns among Brazilian adolescents

This study compared body image concerns among adolescents from different geographic locations in Brazil, and the influence of sex and nutritional status. Seven hundred eighty-eight adolescents completed the Body Shape Questionnaire (BSQ) and had their weight and height measured. There were significant cross-regional differences in BSQ scores. Also, body image concerns were more prevalent among girls and among overweight adolescents. It is suggested that sex and nutritional status may play an important role in body image concerns, which is more common between adolescents from urban areas. Furthermore, our findings contribute to the literature by examining patterns of body image concerns within subgroups of adolescents who have received little research attention on these issues.

Body esteem in Chinese adolescents: Effect of gender, age, and weight

This study examined the associations of body esteem with gender, age, and Body Mass Index (BMI) among 905 Hong Kong adolescents using the Body-Esteem Scale (BES). Older age, male gender and lower BMI were associated with better body esteem. Multiple regression analyses indicated significant main effects of gender, age and weight on BES-Total. Significant interaction effects of gender × BMI and gender × age × BMI were also found on BES-Weight (beta = −0.149, p = .028) and BES-Total (beta = −0.139, p = .044). Improvement of body esteem with age may be associated with age-related BMI differences.

The impact of weight, sex, and race/ethnicity on body dissatisfaction among urban children

The purpose of the current study was to examine the relative contributions of weight status, race/ethnicity, sex, and age on body dissatisfaction in a large group of diverse children. Participants were 4th-6th graders (N=1212) in ten inner-city schools who participated in an obesity prevention study previously published. Children completed the body dissatisfaction subscale of the Eating Disorder Inventory-2 (EDI-2), and weight status was assessed by measured weights and heights. Multiple regression analyses were conducted. Relative weight status was the strongest predictor of body dissatisfaction, followed by race/ethnicity, and sex. Body dissatisfaction was greatest in obese, Asian, and female children. Overall, results indicated that children's body dissatisfaction varies based on relative weight status, as well as race/ethnicity and sex among urban children. Results highlight the strong need for additional research so that more definitive conclusions may be drawn regarding the development of body image among diverse groups of children.

Intra-familial and ethnic effects on attitudinal and perceptual body image: a cohort of South African mother-daughter dyads

BACKGROUND

International studies suggest ethnic differences in obesity prevalence may be due, in part, to differences in body image and body size dissatisfaction between groups. Further, there is evidence to suggest that there is a familial resemblance in body image between mothers and their younger (preadolescent) daughters. This research was therefore conducted to specifically identify the extent to which family status (presented as mother-daughter resemblance) and ethnicity impact on body image attitudes and perceptions of South African mothers and their pre-adolescent daughters.

METHODS

Mother-daughter dyads (n = 201, 31% black, 37% mixed ancestry and 32% white) answered questions regarding their body image perception (the way they saw their body size status), their body image ideals, and body image attitudes (body size dissatisfaction in particular, presented as the Feel-Ideal Difference [FID] index score). Mothers' and daughters' body image results were compared within dyads and across ethnic groups using repeated measures of ANOVA.

RESULTS

Overall, body image resemblances exist between South African mothers and their pre-adolescent daughters. Mothers and daughters chose similarly weighted silhouettes to represent their body size ideals (p = 0.308), regardless of their ethnicity or body mass index (BMI). The FID index scores were similar between mothers and their daughters only after the confounding effects of maternal BMI were removed (p = 0.685). The silhouettes chosen to represent thinness were also similar between mothers and their daughters (p = 0.960) regardless of ethnicity and maternal BMI. On the other hand, the silhouettes chosen to represent fatness were similar (p = 0.342) between mothers and their daughters, only after the confounding effects of maternal BMI were removed. Lastly, mothers and their daughters chose similarly weighted silhouettes as engendering feelings of beauty, respect and happiness (p = 0.813; p = 0.615 and p = 0.693, respectively). In this instance, black mother-daughter dyads chose significantly heavier silhouettes than the other ethnic groups. This implies that black mothers and daughters associate beauty, respect and happiness with a bigger body size.

CONCLUSION

Resemblances exist between pre-adolescent girls and their mothers on issues related to ideal and attitudinal body image. In this regard, South African researchers should consider the effects ethnicity and family status on body image of women when developing targeted interventions to prevent or manage obesity.

Body size estimation in early adolescence: factors associated with perceptual accuracy in a nonclinical sample

This study investigated body size estimation in Norwegian adolescents (aged 12-15; N=406) using a distorting photograph technique. The percentage of over- or underestimation was calculated for pictures of the subject, other persons and a neutral object. The Eating Disorders Inventory for Children (EDI-C) was also completed. Among adolescents at risk of eating problems, girls tended to overestimate their own body size while boys showed a pattern of underestimation, compared to a relatively accurate body perception for low-risk subjects. The groups did not differ in the perception of the neutral object. Important predictors of perceived body size included the size estimation of other children, preoccupation with weight and shape, self-esteem, and emotional instability. The results support the predictive value of body size estimation. Gender differences in judgement bias can be interpreted within present aesthetic ideals and their relation to self perception, body image, and eating problems in adolescence.

Predictors of erroneous perception of being overweight among adolescents

OBJECTIVE

Adolescents' perception of overweight often disagrees with objective measurements; if factors explaining this discrepancy are potentially modifiable is unclear.

METHODS

We analyzed cross-sectional data from a cohort of 2,001 Swedish adolescents (1,026 females, 975 males) at the age of 15 years in 2003. Erroneous perception of overweight was defined as the perception of being overweight in relation to normal or lower than normal BMI (kg/m(2)). BMI measured by the school nurse at 11 years, school-based education on nutrition/physical activity, smoking, alcohol consumption, physical activity, and healthy/unhealthy eating were examined as potential predictors/correlates of overweight misperception in multivariate logistic regression models.

RESULTS

At the age of 15 years, 32% of girls and 10% of boys misclassified themselves as overweight. Overweight at 11 years predicted misperception of overweight 4 years later (adjusted odds ratio (OR) = 2.3, 95% confidence interval (95% CI) = 1.4-3.6 in boys; OR = 1.9, 95% CI = 1.3-2.8 in girls). Among girls, smoking was associated with a higher probability of misperception (adjusted OR = 1.6, 95% CI = 1.2-2.2). Among boys, physical activity (>6 h/ week) was associated with a lower probability of misperception (OR = 0.4, 95% CI = 0.2-0.7). No association was observed with school-based education on nutrition and physical activity.

CONCLUSION

Preventing overweight in pre-adolescence may be a way to avoid later unjustified weight concerns in adolescence.

The relationship between body mass index and body size dissatisfaction in young adolescents: spline function analysis

This study assessed how body size dissatisfaction (BSD) varies in relationship to specific body mass index (BMI) values in a sample of preadolescents. A novel statistical approach based on spline function, suitable to assess in detail how two variables are related, was used. The study was conducted between December 2004 and March 2005. Students (aged 11 to 14 years) from seven selected secondary schools in Verona, Italy, were invited to participate. The final study group included 678 subjects. BSD was assessed using the Body Image Assessment Procedure. BMI values were expressed as z scores. It was found that, in the total sample, slightly underweight subjects (BMI z scores=-0.5) had no BSD. BSD progressively increased (current body size > ideal body size) for BMI z scores >-0.5 and became negative (ideal body size > current body size) for BMI z scores <-0.5. In boys, average weight subjects had no BSD. BSD progressively increased for BMI z scores >0 and became negative for BMI z scores <0. In girls, moderately underweight subjects (BMI z scores=-1) had no BSD. BSD progressively increased for BMI z scores >-1 and became negative for BMI z scores <-1. Although sex significantly moderated the relationship between BMI and BSD (P<0.001), socioeconomic status did not (P=0.459). Because average weight and slightly underweight young girls desired a thinner body, our study suggests that these subgroups should receive particular attention in public health programs as well as in dietetics clinical practice.

Self-perceived weight in adolescents: over-estimation or under-estimation?

Prevalence of obesity has increased worldwide in the past 20 years, but it is not known whether this has resulted in increased numbers of young adults feeling overweight. This study evaluated weight self-perception in a large, multi-ethnic sample of 14-15 years old (n=4167) in London, UK as part of a longitudinal, school-based study of health behaviours. Weight perceptions were recorded on a simple scale from 'too thin' to 'too fat'. Results indicated that under-estimation was more common than over-estimation, with more than a quarter of overweight or obese adolescents unaware of their excess weight. Under-estimation was greatest among boys and ethnic minorities. It may be timely to reassess weight control advice given to adolescents.