Association between body mass index and health outcomes among adolescents: the mediating role of traditional and cyber bullying victimization

Association between Body Mass Index and Externalizing and Internalizing Symptoms among Chinese Adolescents: Mediating Role of Traditional Bullying and Cyberbullying Victimization

BACKGROUND

Externalizing problems, internalizing problems, and obesity are among the greatest challenges to adolescent health. However, the moderating and mediating mechanisms that underlie this association remain predominantly unexplored.

OBJECTIVES

In this study, we examined the association between body mass index (BMI) and externalizing and internalizing scores in adolescents, tested whether traditional bullying and cyberbullying mediated the association, and explored the moderated role of sex.

METHODS

The data came from 1486 adolescents from grade 7, 8, and 10 living in Shantou, China. Information on BMI, traditional bullying, and cyberbullying victimization was obtained through a self-administered questionnaire. The students' externalizing and internalizing scores were evaluated using the Strengths and Difficulties Questionnaire (SDQ). Furthermore, we built two parallel mediation models with sex as a moderating variable.

RESULTS

Compared to their peers with normal weight, adolescents with increased BMI reported higher externalizing and internalizing scores. Traditional bullying and cyberbullying were both significant mediators in the two relationships. Sex moderated the pathway from BMI to cyberbullying. But sex did not moderate the relationship between BMI and traditional bullying.

CONCLUSIONS

The results highlight that it is imperative for educators to identify students who are subjected to weight-based bullying and provide them with recommendations for effective coping strategies. Meanwhile, both victims of traditional bullying and those affected by cyberbullying should be the focus of prevention and intervention efforts when developing a strategy to improve levels of internalizing and externalizing symptoms among adolescents with increased BMI.

Impact of motor self-efficacy on cyberbullying in adolescents and pre-adolescents in physical education

Introduction

In recent years, cyberbullying rates have increased, especially among adolescents in the school environment. According to the literature, the factors that influence this type of behavior are access to technologies, physical activity and BMI, among others.

Aim

The aim is to find correlations between motor self-efficacy and cyberbullying.

Methods

The ECIP-Q and E-AEM questionnaire was applied to 1,232 students from Spanish schools and institutes (8-18 years old) in a cross-sectional study.

Results

Significant inverse correlations were found between the ECIP-Q and the E-AEM on the variables of gender, educational stage, daily physical activity, BMI, telephone ownership and hours spent on the Internet.

Conclusion

In conclusion, it can be understood that the higher the level of self-efficacy, the lower the level of abuse and victimization. Therefore, physical activity could be considered to act as a regulator of cyberbullying. And it would be interesting for public administrations to increase the number of hours of physical education, to expand out-of-school physical activities and to promote an active lifestyle in order to eradicate this type of abusive school behavior.

The Impact of a Healthy Lifestyle on Psychological Well-Being Among Saudi Adolescent Girls Attending Secondary Schools in Taif City, Saudi Arabia

Background and objective A healthy lifestyle encompasses healthy eating, regular exercise, getting enough sleep, and avoiding smoking, drug abuse, and alcohol, which will help improve mental health and manage the symptoms of anxiety, stress, and depression. In this study, we aimed to evaluate the relationship between a healthy lifestyle and psychological well-being among Saudi adolescent girls. Materials and methods A cross-sectional study was conducted among adolescent girls in secondary schools in Taif City, Saudi Arabia. The main outcome measures were the Simple Lifestyle Indicator Questionnaire (SLIQ), Patient Health Questionnaire-2 (PHQ-2) and PHQ-9 (if PHQ-2-positive), Generalized Anxiety Disorder 7-item (GAD-7) questionnaire, and Perceived Stress Scale (PSS) scores. Results The age of the respondents ranged between 15 and 19 years with an arithmetic mean of 16.72 and a standard deviation (SD) of 0.96 years. Most of the students (58.3%) followed a healthy lifestyle whereas only 6.7% followed an unhealthy one. The prevalence of depression was 52.5%; moderately severe depression was observed in 14.8% and severe depression was seen in 6.9% of the schoolgirls. Moderate or severe anxiety was observed in 24.3% and 17.8% of schoolgirls, respectively. High perceived stress was observed in 18% of the students. There was a statistically significant association between students' lifestyle and the severity of depression, anxiety, and perceived stress (p<0.001). Conclusion While unhealthy lifestyles are not common among secondary schoolgirls in Taif City, we found a significant association between such lifestyles among students and the deterioration of their psychological well-being.

Relationship between Physical Fitness and Cyberbullying Patterns (Cybervictimization and Cyberperpetration) in Spanish Adolescents

(1) Background: Cyberbullying is a growing problem among adolescents, and deeper knowledge of this phenomenon could facilitate the implementation of adequate prevention and intervention strategies. Therefore, the aim of this study was to analyze the relationships between victimization and aggression patterns in cyberbullying and physical fitness levels in Spanish adolescents. (2) Methods: A total of 741 adolescents aged 12 to 19 years from two high schools in Andalusia, Spain (mean = 14.52 ± 1.96 years; 50.9% girls, 49.1% boys) participated in the study. The participants underwent the EUROFIT battery test and completed the Spanish version of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) scale. T-test, bivariate correlations and a linear regression analysis were used for statistical analysis. (3) Results: The study results indicated positive relationships between cyberbullying patterns, especially cybervictimization, and age, as well as several physical fitness measures, including BMI, sit-ups, sit-and-reach, and handgrip tests. On the other hand, cyberperpetration was positively related only to age and the specific grip strength test. Further statistical analysis revealed that cybervictimization was primarily influenced by age, while cyberperpetration was mainly influenced by age and performance in a functional test (sit-and-reach). (4) Conclusions: Cyberbullying roles, both as victims and aggressors, may not be strongly influenced by isolated physical fitness factors. Thus, in order to reach a more comprehensive understanding and better explanations of individual involvement in cyberbullying behavior, future studies should analyze psychological and social factors along with the variables considered in this study.

The role of dieting, happiness with appearance, self-esteem, and bullying in the relationship between mental health and body-mass index among UK adolescents: a longitudinal analysis of the Millennium Cohort Study

Background

Mental illness and obesity are among the biggest challenges to population health, they are linked, and may be modifiable during adolescence. We aimed to determine intervening pathways between mental health and BMI z-score symptoms across adolescence.

Methods

In this longitudinal cohort study, we used path models to examine self-reported dieting, happiness with appearance, self-esteem and bullying at 14 years as potential mediators of the cross-lagged relationship between mental health (via the Strengths and Difficulties Questionnaire) and Body Mass Index (BMI) z-score at 11 and 17 years by sex in the UK Millennium Cohort Study, a prospective cohort study of 18,818 children born in the UK between September 1st, 2000, and January 31st, 2002. Full, incomplete data on all singleton children still participating in the study by age 11 years were analysed in GSEM via maximum likelihood estimation (N = 12,450).

Findings

We found happiness with appearance and self-esteem, but not dieting or bullying, mediated the relationship between BMI age 11 and mental health age 17. Each increase in BMI z-score at 11 years was associated with 0.12 increase for boys and a 0.19 increase for girls in scores of unhappiness with appearance (boys: b 0.12, 95% C.I.; girls b 0.19, C.I. 0.14 to 0.23) and a 16% increase for boys and a 22% increase for girls in odds of low self-esteem (boys OR 1.16, 95% C.I. 1.07 to 1.26; girls: OR 1.22, 95% C.I. 1.15 to 1.30) at 14 years. In turn, for both boys and girls, being unhappy with appearance and low self-esteem at 14 years were associated with a greater likelihood of emotional and externalizing symptoms at 17 years.

Interpretation

Early prevention strategies to encourage healthy physical and mental development of children need to focus on the promotion of positive body-mage and self-esteem.

Funding

The National Institute for Health and Care Research (NIHR) School for Public Health Research (SPHR).

Time spent on social media use and BMI z-score: A cross-sectional explanatory pathway analysis of 10798 14-year-old boys and girls

BACKGROUND

The association between adolescent time spent on social media use and body mass index z-score (BMI z-score) is unclear. Pathways of association and sex differences are also unclear. This study examined the association between time spent on social media use and BMI z-score (primary objective) and potential explanatory pathways (secondary objective) for boys and girls.

METHODS

Data are from 5332 girls and 5466 boys aged 14 years in the UK Millennium Cohort Study. BMI z-score was regressed on self-reported time spent on social media use (h/day). Potential explanatory pathways explored included dietary intake, sleep duration, depressive symptoms, cyberbullying, body-weight satisfaction, self-esteem, and well-being. Sex-stratified multivariable linear regression and structural equation modelling were used to examine potential associations and explanatory pathways.

RESULTS

Using social media for ≥5 h/day (vs. <1 h/day) was positively associated with BMI z-score for girls (β [95% CI]) (0.15 [0.06, 0.25]) (primary objective, multivariable linear regression). For girls, the direct association was attenuated when sleep duration (0.12 [0.02, 0.22]), depressive symptoms (0.12 [0.02, 0.22]), body-weight satisfaction (0.07 [-0.02, 0.16]), and well-being (0.11 [0.01, 0.20]) were included (secondary objective, structural equation modelling). No associations were observed for boys and potential explanatory pathway variables were not examined.

CONCLUSIONS

In girls, high time spent on social media use (≥5 h/day) was positively associated with BMI z-score, and this association was partially explained by sleep duration, depressive symptoms, body-weight satisfaction, and well-being. Associations and attenuations between a self-reported summary variable of time spent on social media use and BMI z-score were small. Further research should examine whether time spent on social media use is related to other adolescent health metrics.

Bullying and coping with bullying among obese\overweight and normal weight children

This study aimed to determine the obese\overweight and normal weight children's status of encountering and coping with bullying and the correlational factors. This case-control study was conducted with 1.680 students in the second level (5th, 6th, 7th, 8th grades) from September 24, 2018 to May 31, 2019 in the Mediterranean Region in Turkey. The data were collected using a personal information form, the Traditional Peer Victimization Scale and the Coping with Bullying Scale. Data were analyzed using the Shapiro-Wilk test, Mann-Whitney U test, Binary Logistic Regression, Backward Wald Elimination, and Simple Linear and Backward Stepwise Multiple Linear Regression analyses. This study indicated that the risk of becoming victims, bullies or bully-victims increases among boys and 8th grade students. It also found that the risk of being victims and bully-victims increases among children whose father is illiterate. There was no significant difference between obese\overweight and normal weight children in terms of being victims, bullies and bully-victims. Grade level, academic performance, father's education level and awareness of reporting bullying were effective in coping with bullying among the children, while weight was not. Further studies are needed to determine different factors that affect children's coping strategies against bullying.

Associations Between Weight-Based Bullying, Developmental Internal Assets, and Perceived Social Support Among Youth

BACKGROUND

Youth with obesity are likely to experience weight-based bullying victimization, and adolescents have the highest obesity rates among children. Factors that protect youth from traditional bullying victimization may protect youth from weight-based bullying victimization: internal assets such as positive identity and social competence, and external assets such as perceived support from parents and friends.

METHODS

To examine this proposition, data from 8th, 9th, and 11th graders were obtained from the 2016 Minnesota Student Survey (N = 126,495). Logistic regressions were conducted to identify the relationship between assets and weight-based bullying and to determine possible moderation by weight status.

RESULTS

Results demonstrate that positive identity, parent support, and friend support were associated with lower odds of experiencing weight-based bullying victimization. Moderation analyses revealed that perceived parent support was most protective against experiencing weight-based bullying victimization among youth with obesity compared to youth with overweight, normal weight, or underweight.

CONCLUSION

School administrators, counselors, and teachers should be aware of the increased risk of weight-based bullying for youth with obesity and underweight. Results underscore the need to foster youth's internal assets like positive identity to promote a strength-based approach for prevention. Parent involvement is warranted in weight-based bullying prevention efforts.

Bullying Victimization Profiles of School-Aged Adolescents and Associations With Weight Statuses: A Latent Class Analysis

Bullying and childhood obesity are public health concerns in the United States. While obesity has been found to be associated with bullying victimization, it is less clear how it is differentially associated with biological sex and grade level across varying patterns of bullying victimization. Based on the subset of U.S. students in the Health Behavior in School-Aged Children study, patterns of co-occurring bullying victimization and sex and grade level differences in the association between the patterns of bullying victimization and weight status were examined among 9,124 students in Grades 5 to 10. The latent class analysis revealed three patterns of bullying victimization: verbal-relational victimization (Class 1), all-type victimization (Class 2), and noninvolved pattern (Class 3). The results found that females had a higher likelihood of being in Class 1 than males. Moreover, fifth to sixth and seventh to eighth-graders were more likely than ninth to tenth graders to be in both Class 1 and Class 2. Obese males and overweight females were more likely to be in Class 1 and Class 2 than in Class 3. In addition, obesity and overweight status were positively associated with bullying victimization among fifth to sixth and seven to eighth-graders. However, no significant association was found between obesity and overweight status and bullying victimization among ninth to tenth graders. Findings from the study suggest that school-based strategies, especially sex- and age-specific programs, need to take into consideration the bullying involvement of students who are overweight or obese.

Evidence from a meta-analysis for association of MC4R rs17782313 and FTO rs9939609 polymorphisms with susceptibility to obesity in children

BACKGROUND AND AIM

The aim of this study was to evaluate the association of MC4R rs17782313 and FTO rs9939609 polymorphisms with childhood obesity.

METHODS

A universal search was performed up to May 2021.

RESULTS

A total of 31 studies including 13 studies with 9565 cases and 11956 controls on MC4R rs17782313 and 18 studies with 4789 cases and 15918 controls on FTO rs9939609 were selected.

CONCLUSIONS

Pooled data showed that FTO rs9930506 and MC4R rs17782313 polymorphisms were significantly associated with obesity in children. Stratified analyses revealed that these genetic variants were associated with childhood obesity in Caucasian and Asian children.

Bullying experiences, body esteem, body dissatisfaction, and the moderating role of weight status among adolescents

INTRODUCTION

The present study examined the relationships between bullying victimization experiences, body esteem (BE), and body dissatisfaction (BD) by obesity status.

METHODS

Using a cross-sectional design, adolescents (10-16y) from the U.S. completed surveys. Weight and height were objectively assessed. Bullying was assessed using the Personal Experiences Checklist, with a total score that included three subscales (cyber, verbal-relational, and physical). BE was assessed using total score on the BE Scale, and BD was assessed using the Body Image Assessment for Pre-Adolescents, operationalized as the discrepancy between current and ideal body figure. Linear regression models, controlling for sociodemographics, were used to examine obesity status (with vs. without obesity) and sex as moderators of the relationships between bullying, BE, and BD.

RESULTS

On average, adolescents (n = 328) were 12.6 ± 1.9 y, 45.4% male, 58.2% White, 35.7% Black, and 36.0% had obesity. Obesity status moderated the relationship between bullying experiences and BE, such that these relationships were only significant (B = -0.38, p<.05) among adolescents with obesity compared to adolescents without obesity. In both groups, greater verbal-relational bullying experiences were associated with lower BE, while greater physical bullying experiences were related to higher BE only among adolescents with obesity. In adolescent girls without obesity, greater cyberbullying experiences were associated with lower BD.

CONCLUSIONS

The findings suggest different associations between sub-types of bullying victimization experiences and BE and BD, highlighting the importance of examining these associations separately by obesity status.

Weight Status and School Bullying Experiences in Urban China: The Difference Between Boys and Girls

This article examined the associations between weight status (body mass index [BMI] and perceived weight measures) and school bullying experiences (being bullied and bullying others) of children and adolescents in urban China. A national representative sample (n = 3,675) of all types of pre-college schools from seven Chinese cities was employed for the analysis. Students from all grades in high school, vocational school, middle school, and primary grades 4 to 6 were surveyed. Height, weight, perceived weight status, and experiences of being bullied and bullying others were obtained. The results demonstrated that the objective weight status (BMI) was neither associated with being bullied overall by others nor associated with bullying others, but the subjective/perceived weight status was significantly related to being bullied. Regarding the specific forms of being bullied, underweight (measured by BMI) students were less likely to be cyberbullied, whereas obese (measured by BMI) students were more likely to be cyberbullied. Students who perceived themselves as slightly fat and too fat were more likely to be verbally bullied. Overweight and obese students were more likely to bully others physically and relationally, and the students who perceived themselves as too thin were positively associated with physically bullying others. Moreover, BMI had a role in the involvement in school bullying for boys, whereas perceived weight status had a role in school bullying involvement in girls. These results indicate that school bullying prevention and intervention should consider weight status, as well as gender differences.

Housing affordability effects on physical and mental health: household survey in a population with the world's greatest housing affordability stress

BACKGROUND

We examined the association of housing affordability with physical and mental health in Hong Kong, where there is a lack of related research despite having the worst housing affordability problem in the world, considering potential mediating effect of deprivation.

METHODS

A stratified random sample of 1978 Hong Kong adults were surveyed. Housing affordability was defined using the residual-income (after housing costs) approach. Health-related quality of life was assessed by the Short-Form Health Survey version 2 (SF-12v2), from which the physical component summary (PCS) and mental component summary (MCS) measures were derived. Multivariable linear regressions were performed to assess associations of housing affordability with PCS and MCS scores, adjusting for sociodemographic, socioeconomic and lifestyle factors. Mediation analyses were also conducted to assess the mediating role of deprivation on the effect of housing affordability on PCS or MCS.

RESULTS

Dose-response relationships were observed between housing affordability and mean PCS score (β (95% CI) compared with the highest affordable fourth quartile: -2.53 (-4.05 to -1.01), -2.23 (-3.54 to -0.92), -0.64 (-1.80 to 0.51) for the first, second and third quartiles, respectively) and mean MCS score (β (95% CI): -3.87 (-5.30 to -2.45), -2.35 (-3.59 to -1.11), -1.28 (-2.40 to -0.17) for the first, second and third quartiles, respectively). Deprivation mediated 34.3% of the impact of housing unaffordability on PCS and 15.8% of that on MCS.

CONCLUSIONS

Housing affordability affects physical and mental health, partially through deprivation, suggesting that housing policies targeting deprived individuals may help reduce health inequality in addition to targeting the housing affordability problem.