Association between body image dissatisfaction and depressive symptoms in adolescents

Body image dissatisfaction is associated with perceived body weight among secondary school adolescents in Harar Town, eastern Ethiopia

Purpose

Body image dissatisfaction has emerged as an important determinant of dietary and physical activity, which in turn determine adolescents' nutritional status. Hence, it is important to understand predictors of body image dissatisfaction. Therefore, this study aimed to assess body image dissatisfaction and its associated factors among secondary school adolescents in the study area.

Methods

Data collected for other purposes were used to assess body image dissatisfaction among adolescents in Harar town. Body image dissatisfaction was assessed using the Body Part Satisfaction Scale. Data processing and analysis were performed using STATA version 14, and binary logistic regression was used to identify factors associated with body image dissatisfaction. Factors associated with body image dissatisfaction were determined by estimating AOR along with 95% CI and the statistical significance was declared at a p-value less than or equal to 0.05.

Result

The prevalence of body image dissatisfaction was 22.06% [95% CI (19.63, 24.70)]. This study also revealed that males were more dissatisfied with their upper torso and face, and females were more dissatisfied with their middle torso, lower torso, height, and weight than males. In this study, body image dissatisfaction was associated with perception of being fat [AOR = 1.89, 95% CI (1.23, 2.91)], anxiety [AOR = 1.59, 95% CI (1.02, 2.48)], and cigarette smoking [AOR = 1.63, 95% CI (1.03, 2.58)].

Conclusion

Almost one in five secondary school adolescents in Harar had body image dissatisfaction, which was significantly associated with perceptions of being fat, anxiety, and smoking. In this study, a significant number of the adolescents experienced body image dissatisfaction. Hence, all concerned bodies have to take action to reduce the burden.

Body image dissatisfaction and its relation to body mass index among female medical students in Sudan: across-sectional study 2020-2021

BACKGROUND

Body image is mainly determined by biological, social, psychological and cultural factors thus it is a multifaceted vigorous construct. Body image is an essential aspect of girls' self-definition and individual identity. Excessive concern about body image and body image misconceptions leads to dissatisfaction, disturbed eating patterns, affecting the nutritional status and also leading to depression and anxiety disorder.

METHODS

This is a descriptive cross-sectional university-based study aiming to investigate body image dissatisfaction and its relation to BMI among female medical students at the University of Khartoum, faculty of medicine. The study was carried out between December 2020 and January 2021. Simple random sampling was applied and a two-sectioned questionnaire was used. The first part consisted of socio-demographic data and the second part contained questions to assess body image the data was. A total of 277 participants were enrolled in the study. Data was analyzed using SPSS version 20.

RESULTS

We enrolled 277 female medical students the majority of participants (53%) were considered of normal weight according to BMI, 7% considered obese, and 18% underweight. Large number of participants thought that they are not in the ideal weight according to their height (62%). (21% to 17%) of participants always feel pressure from people or society to get to a certain weight. With respect to attitude towards weight, (29%) of participants always wear clothes that don't reveal their body shape, (35%) of them always tend to wear clothes that hide their excess weight.

CONCLUSIONS

The study concluded that participants who were overweight, obese or underweight have significant increase risk for poor body image perception with odd ratio of 39, 11, and 59 respectively. Thus early and proper interventions are necessary to circumvent the impact and future repercussion of body image distortion.

Perceived Discrimination as a Critical Factor Affecting Self-Esteem, Satisfaction with Physical Appearance and Depression of Racial/Ethnic Minority Adolescents in Korea

The effect of perceived discrimination on adolescents' developmental outcome has long been a topic of research, however, little is known about how it affects their depression especially among the racial/ethnic minority adolescents in Asian countries. In Korea, a country with a relatively short history of immigrant influx, discrimination has become an important social issue affecting a rapidly growing population. This study examines the impact of perceived discrimination on racial/ethnic minority adolescents in Korea, specifically focusing on its impact on depression through self-esteem and satisfaction with physical appearance. The Multicultural Adolescents Panel Study data were used for analyses, and the SPSS Process Macro program was used to test the parallel mediating effects of self-esteem and satisfaction with physical appearance. The findings show that perceived discrimination was a strong predictor of their depression. Self-esteem and satisfaction with physical appearance also had significant mediating effect. There were no distinct gender differences among paths though the male adolescents were found to have more discriminatory experiences than the female adolescents. The findings call for the development of healthy coping strategies for these adolescents to prevent the effect of perceived discrimination, not only for their mental health, but also with their self-perception including physical appearance.

Body shape perception in men and women without obesity during caloric restriction: a secondary analysis from the CALERIE study

OBJECTIVE

To examine body shape perception in 218 adults without obesity or history of eating disorders during caloric restriction (CR).

METHODS

Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) is a 2-year, randomized clinical trial using a 2:1 assignment (CR, 25% reduction in calories; Control, typical diet). For this secondary analysis, we examined perceived body shape using the Body Shape Questionnaire (BSQ). Analyses of BSQ scores are reported by group, over time, by sex, and by BMI. Data for body fat percentage, symptoms of depression, food cravings, maximal oxygen consumption, and stress were analyzed for their association with BSQ scores.

RESULTS

Compared to control, CR reduced BSQ scores. Women tended to have greater concern with body shape than men across all measurement times. There was no difference in change in BSQ scores at 12 or 24 months between those with a BMI < 25 kg/m² or ≥ 25 kg/m². Change in body fat percentage was most correlated with change in BSQ score from 0 to 12 (r = 0.39) and 0-24 months (r = 0.38). For change in BSQ score, Akaike/ Bayesian information criterion (AIC/BIC) found that the model of best fit included the following three change predictors: change in body fat percentage, depression symptoms, and food cravings. For 0-12 months, AIC/BIC = 1482.0/1505.6 and for 0-24 months AIC/BIC = 1364.8/1386.5.

CONCLUSIONS

CR is associated with reduced concern for body shape in men and women without obesity and with no history of eating disorders. Body shape perception among this sample was complex and influenced by multiple factors.

LEVEL OF EVIDENCE

Level I, randomized controlled trial.

A Qualitative Exploration of Body Image from the Perspective of Adolescents with a Focus on Psychological Aspects: Findings from Iran

The current study employs a qualitative approach to uncover the perceptions of Iranian adolescents regarding their bodies, with a focus on the psychological components that contribute to their body image perceptions. Data collection conducted using 13 semi-structured focus group discussions with 42 girls and 42 boys (15-18 years). All focus group discussions were audio recorded and transcribed verbatim. Data analysis was done manually using constant comparative analysis according to the Strauss and Corbin analysis method. Based on the participants' statements, four main themes and related categories emerged from data: (1) Beliefs including uncontrollable body, biased opinion of those around, priority of health, spiritual/religious beliefs and affecting future success, (2) Body-evaluation including direct body evaluation and indirect body evaluation, (3) Feelings and emotions including disgust and hatred, frustration, sadness, shame, envy, fear, approval and satisfaction and (4) Behaviors including lifestyle modifications, beautifying and using make up, extreme dieting, physical inactivity, avoidance behaviors, passive behaviors, aggressive behaviors and social isolation. Findings of the current study provide further information regarding cognitive, emotional and behavioral aspects of body image from the perspectives of adolescents in a West-Asian region.

Relationships between physical activity, body image, BMI, depression and anxiety in Chinese college students during the COVID-19 pandemic

BACKGROUND

Both depression and anxiety are worldwide burden that is not being abated with our current knowledge and treatment of the condition. Numerous clinical trials have supported that physical activity (PA) can reduce the depression and anxiety in adolescents, but little is known about its mechanism of action. Therefore, the study objectives were to explore the potential relationship between physical activity and depression and anxiety from the perspective of body image and body mass index (BMI), and to provide an important reference for future self-esteem education and health promotion intervention.

METHODS

The participants in this study were 251 Chinese college students between 17 and 22 years old. Participants completed the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Body Image Questionnaire (BIQ), the Self-rating Depression Scale (SDS) and the Self-rating Anxiety Scale (SAS). A descriptive and correlational approach was used, using the PROCESS macro for Statistical Package for the Social Sciences (SPSS).

RESULTS

(1) Physical activity was significantly negatively correlated with both depression and anxiety (t = -0.216, p < 0.001; t = -0.184, p < 0.01). (2) Body image had a significant moderating effect on the relationship between physical activity and anxiety among college students, but there was no moderating effect between depression and physical activity. BMI has no moderating effect on the two interrelationships.

CONCLUSION

There is only body image that moderates the relationship between anxiety and physical activity.

[Relationship between body dissatisfaction and mental health of Brazilian adolescents: a nationally representative study]

Dissatisfaction with body image is considered a relevant variable in understanding the mental health of adolescents. In this respect, the scope of this study was to evaluate the impact of this dissatisfaction on variables associated with the mental health of Brazilian students enrolled in the 9th year. To achieve this, the data from the 2015 National School Health Survey was used and the methodology applied was based on Propensity Score Matching (PSM). The results showed that dissatisfaction with one's own body has an impact on the mental health of adolescents, with a positive influence on the probability of the student reporting a frequent feeling of loneliness, reporting insomnia for reasons of anxiety and having difficulty socializing. This impact increased with the degree of dissatisfaction with body image, with girls being more affected than boys. Thus, it is important to develop strategies for a more positive perception of body image among adolescents, contributing to the increase in the well-being of this group in line with existing body differences.

Suicide risk in high school students: who are the most vulnerable groups?

OBJECTIVE

To investigate the prevalence and factors associated with suicide risk among high school students from a federal educational institution in Rio Grande do Sul (IFRS).

METHODS

This is a cross-sectional study based on a census of students (n=510) enrolled in IFRS, campus Rio Grande, in the second half of 2019. Data were collected through a self-administered questionnaire. Suicide risk was measured with the instrument Mini-International Neuropsychiatric Interview, and data were analyzed using Poisson regression with robust variance adjustment.

RESULTS

The prevalence of high suicide risk was 17.3% (95% confidence interval - 95%CI 14.0-20.0), with the following independent associated factors: female gender, higher socioeconomic status, alcohol consumption, less social support, attempt to lose weight, self-harm behavior, and increased risk of depression, anxiety, and stress.

CONCLUSIONS

One in six students showed a high suicide risk. The identification of factors associated with the outcome is useful for detecting the most severe cases and referring them to specialized care.

Cognitive behavioral therapy adapted for patients with acromegaly

In acromegaly, excess secretion of growth hormone and insulin-like growth factor 1 may result in coarse features and enlargement of the extremities. Its negative repercussion on self-esteem can impair quality of life. Ten patients with acromegaly participated in this study. The treatment covered nine weekly group sessions. Unhealthy behaviors, thoughts, and emotions were identified, and healthy behaviors and thoughts were constructed, along with positive reflections on their associated emotions. In Session 7, the “Think healthy and feel the difference” technique was adapted to help patients better deal with their physical appearance and improve their quality of life. Qualitative data was obtained from an analysis of the content of a collaborative exercise developed in Session 7. Factors, especially thoughts, emotions, and advantages and disadvantages associated with both healthy and unhealthy behaviors, were identified. The technique improved quality of life for patients with acromegaly in relation to their acceptance of their physical appearance. UTN U 1111–1220-9846 (September 24th, 2018).

Emotional and Behavioral Problems in Children With a Cleft Lip With or Without Palate or an Infantile Hemangioma

OBJECTIVE

Life can be challenging for children with a visible difference due to a medical condition, and they might be at risk for emotional and behavioral problems. This study examines emotional and behavioral problems in children with a cleft lip with or without palate (CL ± P) or an infantile hemangioma (IH) in relation to the visibility of the condition, the presence of additional condition-related problems, and parental affect.

SETTING

This cross-sectional study took place in an academic medical hospital in the Erasmus MC Sophia Children's Hospital, the Netherlands.

PARTICIPANTS

A total of 309 parents (mean age = 40.34, 44.00% male) of 182 children with CL ± P and 48 parents (mean age = 39.21, 37.50% male) of 33 children with an IH completed questionnaires. Children were 1.5 to 12 years old.

RESULTS

Parents reported fewer child emotional and behavioral problems compared to normative data. Problems reported were mainly related to learning difficulties and parent gender, while visibility of the condition had no significant influence. Parental negative affect was related to child internalizing problems. Parental positive affect was not related to any of the outcome measures.

CONCLUSIONS

Parents reported fewer problems for their children compared to normative data. This is inconsistent with previous research, showing similar or worse scores for these children compared to peers. Our findings may be explained by a protective parenting style, a response shift in parents, or problems developing at a later point in life.

Measuring positive and negative body talk in men and women: The development and validation of the Body Talk Scale

Research suggests that positive and negative body talk are important factors in people's body image, however, the instruments designed to measure body talk are generally designed for use with a specific gender and primarily measure negative body talk. To address the shortcomings in the existing measures, the Body Talk Scale (BTS) was designed to measure both positive and negative body talk in men and women. The current study examines the development and psychometric properties of this new scale in two samples of adults, both including men and women. Study 1 focused on the development and examined the factor structure of the original scale items. Study 2 confirmed the factor structure and examined the concurrent validity, incremental validity, test-retest reliability of the scale, and also gender differences. The results indicated that the BTS is a 14-item scale that contains three subscales (Negative Fat Talk, Negative Muscle Talk, and Positive Body Talk) and demonstrates good concurrent validity, incremental validity, and test-retest reliability. Gender comparisons on all three subscales indicated that men engage in more positive body talk than women. The findings demonstrate that the BTS is a useful measure of positive and negative body talk in both men and women.

Body image dissatisfaction and symptoms of depression disorder in adolescents

The objective of this study was to evaluate the effect of body image dissatisfaction on symptoms of depressive disorder in adolescents. This is a cross-sectional study that included 2,162 adolescents ages 18-19 born in São Luís, Maranhão, Brazil, which was part of the joint RPS cohort (Brazilian birth cohorts of Ribeirão Preto-SP, Pelotas-RS, and São Luís-MA). Socioeconomic characteristics, nutritional status, mental health, and body image characteristics were evaluated. Body image was assessed by Stunkard’s silhouettes scale. The presence of symptoms indicative of depressive disorder was investigated through a diagnostic interview MINI (Mini International Neuropsychiatric Interview). A theoretical model was built in a Directed Acyclic Graph (DAG) in order to investigate the relationship between the variables of the study. The relationship was estimated weighting the inverse probability of selection for the variables of adjustment: sex and nutritional status. Among the dissatisfied adolescents due to overweight, 66.54% were girls, 32.85% were overweight, and 11.99% were obese (P<0.01). There was a significant association between dissatisfaction due to overweight and symptoms of depressive disorder (P=0.01), and there was no evidence of the same association with dissatisfaction due to thinness. Therefore, only dissatisfaction due to overweight was associated with the symptoms of depressive disorder in the evaluated adolescents.

Is the Effect of Body Dissatisfaction on Depressive Symptoms Dependent on Weight Status? A Study with Early-to-Middle Adolescents

Depression is a recognized mental health problem in adolescence and body dissatisfaction is an important risk factor. The main goal of this study is to examine the relationship between body dissatisfaction and depressive symptoms, and whether it depends on adolescents' weight status, an issue that remains understudied. Two hundred and fourteen adolescents (12-16 years) completed self-report measures of depressive symptoms, body dissatisfaction and weight status (i.e., current body weight and height, to compute body mass index z-scores, BMIz). Hierarchical multiple regression and moderation analyses were conducted, accounting for gender and age effects on depressive symptoms. Body dissatisfaction was found to be a predictor of depressive symptoms for the low and median BMIz adolescents, but not for those with high BMIz. In addition, this interaction of body dissatisfaction and BMIz improved the ability of the regression model to explain depressive symptoms´ variance beyond the effect of gender and age. The high-BMIz adolescents presented higher body dissatisfaction but similar levels of depressive symptoms, compared to the lower BMIz adolescents. These findings suggest the influence of body dissatisfaction in the emergence of depressive symptoms in the first half of adolescence, and the importance of weight status throughout this path.

Depression is associated with lower levels of physical activity, body image dissatisfaction, and obesity in Chilean preadolescents

Mental health during the preadolescent years may be determinant for later periods of life; therefore, the factors that influence it need to be studied deeply. The aim of this study was to determine the association between depressive symptoms with physical activity (PA), body image dissatisfaction and weight status in preadolescents. A total of 269 girls and 329 boys (age 12.02 ± 0.98 years) were included in this study. Body mass index (BMI), waist circumference, body image dissatisfaction, PA and depressive symptoms were assessed. The PA reported an inverse association with depression in girls (β:-2.12, P < 0.0001) and boys (β:-1.13, P = 0.001). Instead, BMI in girls (β: 1.00, P < 0.0001) and boys (β: 0.70, P < 0.0001), and body image dissatisfaction in girls (β: 0.05, P = 0.017) and boys (β: 0.04, P = 0.003) reported positive association with depression. In the same way, depression was associated with obesity (odds ratio [OR] = 2.05, P = 0.020), but, the boys had higher risk (OR = 18.4, P < 0.001) than girls. In conclusion, depression in Chilean preadolescents presented association with low levels of PA, obesity and body image dissatisfaction. Therefore, schools should target and promote PA to improve psychological and physical health in preadolescents, which may reduce the future burden of mental illness.

Anxiety and depression in adolescents with a visible difference: A systematic review and meta-analysis

Living with a visible difference can entail challenging social situations, associated with psychosocial symptoms. However, it is not clear whether adolescents with a visible difference experience more anxiety and depression than unaffected peers. We aim to determine whether adolescents with a visible difference experience more symptoms of anxiety and depression than unaffected peers. A literature search was conducted in Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, PsycINFO Ovid, and Google Scholar. Meta-analyses were done using random-effects models to calculate a standardised mean difference. Analyses for subgroups were used to study causes of visible difference. Eleven studies were identified (n = 1075, weighted mean age = 15.80). Compared to unaffected peers, adolescents with a visible difference experience more symptoms of anxiety (SMD = 0.253, 95 % CI [0.024, 0.482], p = .030), but not depression (SMD = 0.236, 95 % CI [-0.126, 0.599], p = .202). Adolescents with a skin condition did not experience more symptoms of anxiety (SMD = 0.149, 95 % CI [-0.070, 0.369], p = .182) or depression (SMD = 0.090, 95 % CI [-0.082, 0.262], p = .305) when compared to unaffected peers. Overall, more symptoms of anxiety are found in adolescents with a visible difference compared to peers. No differences in anxiety or depression were found for skin differences. Screening for anxiety is recommended.

Longitudinal bidirectional relations between body dissatisfaction and depressive symptoms among Black adolescents: A cross-lagged panel analysis

Objective

To assess the variation in body dissatisfaction and depressive symptoms by weight status and the bi-directional relations between body dissatisfaction and depressive symptoms by weight status among Black adolescents.

Methods

A sample of 153 Black adolescents aged 12–13 years, either overweight/obese (n = 57, 37%) or healthy weight (n = 96, 63%), were recruited and evaluated three times over two years (T1, T2 and T3). Measured weight and height were converted to age and sex-specific BMI z-score; body dissatisfaction was measured with silhouettes, and depressive symptoms were measured with the Beck Depression Inventory (BDI-I). Bidirectional relations were assessed with cross-lagged panel analyses, accounting for stability over time and contemporary correlations.

Results

Body dissatisfaction was higher among the overweight/obese group than the healthy weight group. No significant differences were found for depressive symptoms by weight status. Among the overweight/obese group, there were bidirectional relations: antecedent body dissatisfaction predicted subsequent depressive symptoms (T1-T2: β = 0.42, SE = 0.11, p<0.001; T2-T3: β = 0.36, SE = 0.09, p<0.001) and antecedent depressive symptoms predicted subsequent body dissatisfaction (T1-T2: β = 0.25, SE = 0.10, p = 0.012; T2-T3: β = 0.17, SE = 0.08, p = 0.045). Among the healthy weight group, there was no relation in either direction.

Conclusions

Elevated body dissatisfaction among the overweight/obese group supports weight-based stigma as a stressor among Black adolescents. The bidirectional relations between body dissatisfaction and depressive symptoms among the overweight/obese group support the internalization of thinness idea and negative self-appraisal associated with depressive symptoms. Prevention of both body dissatisfaction and depressive symptoms may be mutually beneficial among Black adolescents with overweight/obesity.

Association of depression and obesity is mediated by weight perception

This study investigates whether the association between obesity and depression is mediated by the perception of body weight and verifies the combined effect of being obese and having a self-perception of being fat on depression in a population-based sample of 1238 individuals. Weight perception mediated the association between depression and obesity in 39.3 percent of participants. In stratified analysis, mediation occurred in the following groups: non-single, those with more schooling, non-alcohol abusers, non-smokers, and those who did not engage in physical activity. Being obese and having a self-perception of being fat produced a potentiating effect, significantly increasing the likelihood of depression.

The Body Shape Questionnaire Is Not Invariant Across Sex: Evidence From Portuguese-Speaking University Students

The Body Shape Questionnaire (BSQ) is a widely used measure of body shape concerns that was originally designed for use with women but has more recently been used with boys and men. The latter use may be problematic, given that no previous study has demonstrated sex invariance for BSQ scores. To determine the extent to which BSQ scores are sex invariant, we asked Portuguese-speaking women ( n = 1,613) and men ( n = 871) to complete the full BSQ (34 items). Confirmatory factor analysis indicated that a hypothesized 32-item model of BSQ scores and shorter versions had acceptable fit indices in women and men, separately. However, multigroup confirmatory factor analysis showed that these BSQ model scores had configural but not metric, scalar, or strict sex invariance. Differential item analysis indicated significant item-functioning differences on 19 of the 32 retained BSQ items. Thus, BSQ scores are not sex invariant, making problematic the results of previous studies that have compared latent BSQ scores across sex.

Prevalência de pensamentos e comportamentos suicidas e associação com a insatisfação corporal em adolescentes

RESUMO Objetivo Estimar a prevalência de pensamentos e comportamentos suicidas e a associação com a insatisfação corporal em adolescentes. Métodos Participaram 1.090 adolescentes (501 do sexo masculino e 589 do sexo feminino), com média de 16,2 (1,1) anos de idade, estudantes do ensino médio em São José-SC. Por meio de questionário autoadministrado, os adolescentes responderam a questões sociodemográficas (sexo, idade) e sobre maturação sexual, insatisfação corporal (escala de silhuetas) e pensamentos e comportamentos suicidas (ideação, planejamento e tentativa de suicídio), e tiveram as medidas de peso corporal e altura aferidas para cálculo do índice de massa corporal (IMC = peso corporal dividido pela altura ao quadrado). Empregou-se a regressão logística binária para análise dos dados. Resultados O sexo feminino apresentou maiores prevalências de pensamento, planejamento e tentativa de suicídio comparado ao masculino. Os adolescentes insatisfeitos pelo excesso de peso e pela magreza apresentaram maior chance de terem pensado e planejado suicídio. Não foram encontradas associações entre tentativa de suicídio e insatisfação corporal. Conclusões O sexo feminino apresentou maiores prevalências de pensamentos e comportamentos suicidas do que o masculino. Independentemente do sexo, idade, IMC e maturação sexual, os adolescentes insatisfeitos com o corpo (pelo excesso de peso e pela magreza) estiveram mais suscetíveis à ideação suicida e ao planejamento de suicídio, comparados aos satisfeitos. Por serem adolescentes em idade escolar, a escola pode ser um agente de discussão sobre a temática, auxiliando na prevenção da insatisfação corporal e desfechos suicidas. Outros profissionais envolvidos com essa população e os familiares precisam estar atentos a essas questões.

High prevalence of cardiovascular risk factors in Peruvian adolescents living in a peri-urban shantytown: a cross-sectional study

BACKGROUND

Adults of the peri-urban Peruvian shantytown of Lomas de Zapallal have a high prevalence of risk factors for developing cardiovascular disease (CVD)-likely due to behavioral choices established during childhood and adolescence. To guide the development of community-based risk reduction programs, we assessed the prevalence of risk factors for developing CVD among adolescents.

METHODS

We collected cross sectional data from adolescents of Peruvian peri-urban shantytown to evaluate four domains of CVD risk factors: (1) clinical (blood pressure, fasting blood glucose, and blood lipids), (2) anthropometric (height, weight, and waist circumference), (3) behavioral (physical activity, diet, and substance abuse), and (4) psychosocial (mental health and violence).

RESULTS

We enrolled 275 adolescents (56.4% female, mean age 14 years). Prevalence of overweight or obese status was 27.8%. High blood pressure was more common in males (37.4%) than females (20.5%) (p = 0.002). Total cholesterol was elevated (>170 mg/dL) in nearly half (45.5%) of the adolescents, and 71% had impaired fasting blood glucose (>100 mg/dL). Females were less likely to exercise daily (95.4%) than males (84.2%) (p = 0.002) but reported higher rates of depression (66.4%), anhedonia (67.6%), and self-harm behavior (37.9%) (all p < 0.01).

CONCLUSIONS

Adolescents living in the peri-urban population of Puente Piedra had high prevalence of risk factors for future development of CVD; preventative efforts focused on improving nutrition, increasing physical inactivity, and addressing mental health conditions could reduce such risk factors.