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Zhang Y, Wang X, Zhu W. Peer effects and health impacts of different body cognitive biases in children: micro evidence from China. Front Public Health 2024; 11:1305795. [PMID: 38259771 PMCID: PMC10800558 DOI: 10.3389/fpubh.2023.1305795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Background In China, children commonly display body cognitive biases, which constitute a significant yet hidden public health issue. These biases potentially jeopardize children's well-being, hinder the cultivation of human capital, and impede societal progress. However, limited research employs theoretical analysis and econometric testing to investigate the formation of different body cognitive biases among Chinese children and their health impacts. Methods Based on a local average network model for theoretical analysis, this study utilizes a sample of 4,289 children from four phases of the China Health and Nutrition Survey (CHNS) conducted from 2004 to 2011. Utilizing Logit and IV Probit models, systematically evaluate the peer effect, heterogeneity of effects, and health impacts of children's different body cognitive biases. Results (1) The peer effect contributes to the development of light- and heavy-body cognitive biases in Chinese children. (2) The heterogeneity analysis shows that the peer effect of body cognitive biases is more significant in rural and female children. (3) The influence of heavy-body cognitive bias is more pronounced in adolescent children. (4) The "eating-activity balance" is disrupted by the two body cognitive biases in children, leading to deviations from normal body type. (5) Specifically, the light-body cognitive bias leads children to intake more and burn fewer calories, increasing their risk of obesity. (6) Conversely, the heavy-body cognitive bias prompts children to intake less and expend more calories, resulting in a higher prevalence of thinness. Discussion This study innovates by exploring peer effects on body cognitive biases in Chinese children, elucidating their direction and health implications. While overweight and obesity are recognized as overt health issues, the spread and impact of implicit issues like body cognitive biases should not be overlooked. Nevertheless, the issue is largely neglected in developing countries, such as China, where existing children's health policies are inadequate in addressing it. Promoting accurate body image perception and understanding of health prevention strategies among children requires adequate attention to peer effects.
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Affiliation(s)
- Yun Zhang
- College of Economics and Management, Nanjing Agricultural University, Nanjing, China
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Liu J, Ma Q, Wang X, Chen M, Ma T, Cui M, Jiang J, Li Y, Gao D, Ma Y, Yuan W, Chen L, Zhang Y, Guo T, Ma J, Dong Y. Weight self-misperception and obesity-related knowledge, attitudes, lifestyle behaviours and cardio-metabolic markers among Chinese school-aged children and adolescents. Public Health Nutr 2023; 26:1549-1561. [PMID: 37092759 PMCID: PMC10410384 DOI: 10.1017/s1368980023000630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/09/2023] [Accepted: 03/22/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVE The relationships between childhood weight self-misperception and obesity-related factors particularly health markers have not been extensively discussed. This study aims to examine the associations between weight self-misperception and obesity-related knowledge, attitudes, lifestyles and cardio-metabolic markers among Chinese paediatric population. DESIGN Cross-sectional study. SETTING Data sourced from a national survey in Chinese seven provinces in 2013. PARTICIPANTS Children and adolescents aged 5-19 years. RESULTS Of the total 14 079 participants, there were 14·5 % and 2·2 % participants over-estimated and under-perceived their weight, respectively. Multi-variable logistic regression was applied to calculate OR and 95 % CI (95 % Cl) of obesity-related behaviours and cardio-metabolic markers by actual and perceived weight status. Individuals who perceived themselves as overweight/obese were more likely to have prolonged screen time, insufficient dairy intake and over sugar-sweetened beverages consumption (all P < 0·05), regardless of their weight. Furthermore, actual overweight/obese individuals had higher odds of abnormal cardio-metabolic markers, but a smaller magnitude of association was found among weight under-estimators. Among non-overweight/obese individuals, weight over-estimation was positively associated with abdominal obesity (OR: 10·49, 95 % CI: 7·45, 14·76), elevated blood pressure (OR: 1·30, 95 % CI: 1·12, 1·51) and dyslipidemia (OR: 1·43, 95 % CI: 1·29, 1·58). CONCLUSIONS Weight over-perception was more prevalent than under-estimation, particularly in girls. Weight over-estimators tended to master better knowledge but behave more unhealthily; both weight over-perception and actual overweight/obesity status were associated with poorer cardio-metabolic markers. Future obesity intervention programmes should additionally pay attention to the population with inaccurate estimation of weight who were easily overlooked.
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Affiliation(s)
- Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Qi Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Xinxin Wang
- School of Public Health and Management, Ningxia Medical University, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Mengjie Cui
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Jun Jiang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Yanhui Li
- School of Nursing, Peking University, Beijing, China
| | - Di Gao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Ying Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Wen Yuan
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Tongjun Guo
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China
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Abstract
OBJECTIVE To evaluate weight misperception among adolescents and determine associations between self-perceived weight and socio-demographic characteristics, BMI, screen time, self-rated food quantity and diet quality, weekly frequency of breakfast and the consumption of healthy and unhealthy foods. DESIGN A cross-sectional, two-stage, probabilistic population-based study was conducted in Campinas, Brazil. Multinomial logistic regressions were run to estimate weight self-perception. SETTING Data from the Campinas Health Survey (ISACamp) and Campinas Food Consumption Survey (ISACamp-Nutri). PARTICIPANTS A total of 911 adolescents aged 10-19 years. RESULTS Nearly half (47·7 %) of the adolescents with overweight/obesity did not evaluate their weight properly. Weight self-perception as thin and excess weight was associated with the female gender, overweight/obesity, self-rated diet quality as poor/very poor and eating snacks ≥3 times/week. Adolescents who did not consume breakfast daily were less likely to perceive themselves as thin. Adolescents who ate excessively were more likely and those who consumed cookies/crackers ≥3 times/week were less likely to perceive themselves as having excess weight. CONCLUSIONS Greater weight misperception was found in overweight/obese adolescents. Gender, BMI, self-rated food quantity/diet quality, weekly frequency of breakfast and some unhealthy foods were associated with self-perceived weight. The present findings could contribute to health promotion strategies targeting adolescents.
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Zhang Y, Wang R, Liu B, Sun L. Weight in the mind: Weight perception and depressive symptoms in Chinese adolescents. J Affect Disord 2021; 278:506-514. [PMID: 33017678 DOI: 10.1016/j.jad.2020.09.112] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/25/2020] [Accepted: 09/26/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND Increasing evidence demonstrates the significant role of weight perception in shaping the mental health of adolescents. This study sought to extend previous literature by examining the associations of weight perception categories with depressive symptoms for both boys and girls in China, and further explored whether the associations varied between urban and rural areas. METHODS Data were from a large-scale, national survey of Chinese middle school students. The analytical sample had 8568 respondents with a mean age of 13.9 years (SD=0.7). Bivariate and multiple regression analyses were adopted to examine the links between weight perception and depressive symptoms. RESULTS Overweight perceptions were more prevalent in girls than in boys (47.0% vs. 29.3%), whereas underweight perceptions were less common in girls than in boys (15.7% vs. 29.3%). After adjusting for sociodemographic characteristics and health conditions, self-perceiving as "slightly overweight" and "very overweight" were significantly related to more depressive symptoms for both boys (p<0.05) and girls (p<0.05). A "very underweight" perception, however, was found to be only linked to greater depressive symptoms in boys (p<0.05). Notably, these patterns showed no significant rural-urban difference, as evidenced by the lack of significant interactive effects of all weight perceptions categories and region (urban/rural) on depressive symptoms. LIMITATIONS This study was based on a cross-sectional design, which essentially precludes the possibility to determine the causality of the observed associations. CONCLUSION Findings in this study indicated that the impacts of subjective physical attractiveness have been gendered and regionally pervasive in affecting emotional well-being of Chinese adolescents.
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Affiliation(s)
- Yueyun Zhang
- School of Philosophy and Social Development, Shandong University, China
| | - Ruochen Wang
- School of Sociology and Population Studies, Renmin University of China, China
| | - Baozhong Liu
- Institute of Sociology, Chinese Academy of Social Sciences, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, China; NHC Key Lab of Health Economics and Policy Research (Shandong University), China.
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Justino MIC, Enes CC, Nucci LB. Self-perceived body image and body satisfaction of adolescents. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2020. [DOI: 10.1590/1806-93042020000300004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to evaluate self-perceived body image and body satisfaction of adolescents and their associated factors. Methods: across-sectional study carried out with 200 adolescents from a non-govern-mental organization of Campinas-SP. Self-perceived body image was assessed using a scale of silhouettes and body satisfaction by body areas. Association between sociodemographic and anthropometric data and body image and satisfaction were assessed by logistic regres-sion. Results: seventy percent of normal weight boys and 88% of girls wrongly perceived their nutritional status according to the objective standards. The prevalence of body dissatisfac-tion was 76.5%. Twenty-two percent of adolescents reported dissatisfaction with their body shape. Self-perceived body image was associated with nutritional status (OR= 0.25; CI95%=0.09-0.73), abdominal obesity (Waist/Height ratio- WHR) (OR=26.57; CI95%=3.98-177.18), and gender (OR=2.65; CI95%=1.16-6.05). Conclusions: we identified an important distortion and dissatisfaction with body shape. Girls, overweight/obese adolescents and those with abdominal obesity have more chance to this condition. These findings can subsidize actions that deal with the issue of acceptance of self-image, preventing more serious disorders that may directly affect the health of young-sters.
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Yao L, Niu G, Sun X. Body Image Comparisons on Social Networking Sites and Chinese Female College Students’ Restrained Eating: The Roles of Body Shame, Body Appreciation, and Body Mass Index. SEX ROLES 2020. [DOI: 10.1007/s11199-020-01179-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Self‐perceived body image, dissatisfaction with body weight and nutritional status of Brazilian adolescents: a nationwide study. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2018.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Moehlecke M, Blume CA, Cureau FV, Kieling C, Schaan BD. Self-perceived body image, dissatisfaction with body weight and nutritional status of Brazilian adolescents: a nationwide study. J Pediatr (Rio J) 2020; 96:76-83. [PMID: 30098939 PMCID: PMC9432337 DOI: 10.1016/j.jped.2018.07.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the agreement and risk factors for underestimation and overestimation between nutritional status and self-perceived body image and to assess the prevalence and associated factors for dissatisfaction with body weight among Brazilian adolescents. METHODS Students aged 12-17 years participating in the Study of Cardiovascular Risk in Adolescents ("ERICA"), a multicenter, cross-sectional, school-based country-wide study, were included (n=71,740). Variables assessed as covariates were sex, age, skin color, socioeconomic status, and common mental disorders (screened by the General Health Questionnaire, GHQ-12). Multinomial logistic regression was used to explore the association between covariates and combinations between self-perceived body image and body mass index (agreement, underestimation and overestimation). The associations between dissatisfaction with body weight and exposure variables were investigated using multivariable Poisson regression models. RESULTS Approximately 66% students rightly matched their body mass index with self-perceived weight (kappa coefficient was 0.38 for boys and 0.35 for girls). Agreement was higher among younger students and adolescents from low income households. Male sex, older age, and GHQ-12 score ≥3 were associated with weight overestimation. Prevalence of dissatisfaction with body weight was 45.0% (95% CI: 44.0-46.0), and higher among girls, older adolescents, those with underweight or overweight/obesity, as well as those who were physically inactive and with GHQ-12 ≥3. CONCLUSIONS Most of the sample rightly self-perceived their body image according to body mass index. Students with body image misperception and those dissatisfied with their weight were more likely to present a positive screening for common mental disorders.
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Affiliation(s)
- Milene Moehlecke
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil.
| | - Carina Andriatta Blume
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil
| | - Felipe Vogt Cureau
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Instituto de Avaliação de Tecnologia em Saúde (IATS), Porto Alegre, RS, Brazil
| | - Christian Kieling
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Departamento de Psiquiatria, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Divisão de Psiquiatria da Infância e Adolescência, Porto Alegre, RS, Brazil
| | - Beatriz D Schaan
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Médicas: Endocrinologia, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Divisão de Endocrinologia, Porto Alegre, RS, Brazil
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Riahi R, Motlagh ME, Heshmat R, Qorbani M, Daniali SS, Kelishadi R. Body Weight Misperception and Psychological Distress Among Children and Adolescents: The CASPIAN-V Study. Osong Public Health Res Perspect 2019; 10:315-324. [PMID: 31673493 PMCID: PMC6816359 DOI: 10.24171/j.phrp.2019.10.5.08] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objectives Misperception of weight status is a risk factor that affects psychological health. The aim of this study was to evaluate the association between weight misperception patterns and psychological distress among Iranian children and adolescents. Methods This was a cross-sectional nationwide study where data was collected from 14,440 students, aged 7–18 years who participated in the national school-based surveillance program (CASPIAN-V). The students’ weight perception and psychological distress were assessed by validated questionnaires. Weight misperception was classified as misperception of being either underweight or overweight with respect to actual weight. Results The rate of weight misperception in all study participants was 59.1%. In groups with a perception of being underweight or overweight, the risks of worthlessness, being worried, experiencing aggression, insomnia, or depression, were significantly higher than groups with an accurate weight perception (p < 0.05). The risk of anxiety in girls of normal weight who perceived themselves as underweight, decreased by 57% compared to girls with an accurate weight perception (OR: 0.43; 95% CI, 0.28–0.66). Conclusion Weight misperception is highly prevalent among Iranian children and adolescents and is associated with their psychological health status. Appropriate education intervention needs to be developed to improve the children and adolescents’ perception of their body weight status.
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Affiliation(s)
- Roya Riahi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Seyede Shahrbanoo Daniali
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Body Weight Misperception and Weight Disorders among Chinese Children and Adolescents: A Latent Class Analysis. Curr Med Sci 2019; 39:852-862. [PMID: 31612407 DOI: 10.1007/s11596-019-2116-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 04/08/2019] [Indexed: 10/25/2022]
Abstract
Body misperception plays an important role in the development of weight and dietary disorders among children and adolescents. A school-based health promotion program (2014-2015) was conducted to promote the school health education and improve the teenagers' physical health among Chinese children and adolescents. Based on this program, we intended to examine weight status and weight misperception among Chinese children and adolescents and to explore the relationship between weight misperception and lifestyle behaviors. A total of 10 708 Chinese children and adolescents in 3rd and 7th grade from Shandong and Qinghai province participated in the program. The participants' dietary and activity patterns were clustered by latent class analysis (LCA). Logistic regression analysis was undertaken to explore the relationship between weight perception and demographic factors or dietary and activity patterns. Given the gender-specific difference of children and adolescents, analyses were separately conducted among boys and girls. The total prevalence of weight misperception was 44.50%. Boys, especially those in higher grade and living in wealthier district, were more likely to misperceive body weight. Girls were more likely to overestimate their weight (26.10%) while boys tended to underestimate the weight (28.32%). Three latent dietary and activity patterns including obesogenic pattern, malnourished pattern and healthy pattern were derived. The participants who had weight misperception were more likely to choose unhealthy dietary and exercise activities. The high prevalence of weight misperception was closely related to the unhealthy weight pattern and unhealthy dietary or exercise patterns. Our research found that most children and adolescents failed to perceive their weight correctly and boys tended to underestimate their weight while girls were subjected to overestimation. So, comprehensive intervention programs should focus on improving self-weight awareness, and appropriate guidance should be made to lead the adolescents to more healthy weight pattern.
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Does perceived overweight increase risk of depressive symptoms and suicidality beyond objective weight status? A systematic review and meta-analysis. Clin Psychol Rev 2019; 73:101753. [PMID: 31715442 DOI: 10.1016/j.cpr.2019.101753] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/22/2019] [Accepted: 07/05/2019] [Indexed: 01/24/2023]
Abstract
Obesity is associated with a significant disease burden, but whether recognising as opposed to failing to recognise personal overweight is beneficial or detrimental to mental health is unclear. Here we examine the associations between perceived overweight and depressive symptoms and suicidality. A systematic search of three electronic databases yielded 10,398 unique records, from which 32 studies (110 observations) were eligible for inclusion. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for each outcome using random effects meta-analyses and potential publication bias was examined. Perceived overweight was associated with an increased risk of depressive symptoms (OR: 1.42, CI: 1.31, 1.54 p <.0001, N >128,585) and suicidality (OR: 1.41, CI: 1.28, 1.56, p <.0001, N = 133,576) in both cross-sectional and longitudinal studies. The association between perceived overweight and poorer mental health was observed irrespective of study origin, participant age (children vs. adults), gender, and whether or not a person was objectively overweight. The pooled statistical relationship between objective weight status and poorer mental health was attenuated to non-significance when perceived overweight was accounted for, suggesting that the detrimental effect of overweight on mental health is largely dependent on whether or not a person identifies as overweight.
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Yan H, Wu Y, Oniffrey T, Brinkley J, Zhang R, Zhang X, Wang Y, Chen G, Li R, Moore JB. Body Weight Misperception and Its Association with Unhealthy Eating Behaviors among Adolescents in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050936. [PMID: 29738429 PMCID: PMC5981975 DOI: 10.3390/ijerph15050936] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 04/28/2018] [Accepted: 05/04/2018] [Indexed: 02/07/2023]
Abstract
This study aims to examine associations between body weight misperception and eating behaviors among Chinese adolescents. Students (N = 2641) from a middle school and a high school in Wuhan, China participated in a cross-sectional study in May 2016. A questionnaire based on the World Health Organization’s Global School-Based Student Health Survey was employed to assess responses. Self-reported data, including weight, height, body weight perception, and eating habits, were collected. Body Mass Index (BMI) for age z-score was calculated from self-reported height and weight using WHO AnthroPlus. We used descriptive, logistic regression analysis and a Kappa test to analyze the data using SPSS. Overall, 56.6% of participants did not correctly categorize their weight status; these were much more likely to be girls. Compared with the correctly-perceived group, those who underestimated their weight tended to report eating late at night, having dinners with family, and checking nutrition labels. In contrast, weight overestimating students were less likely to report eating late at night, having breakfasts with family, having dinners with family, and discussing nutrition topics over meals. Body weight misperception was associated with unhealthy eating behaviors among Chinese adolescents.
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Affiliation(s)
- Hanyi Yan
- School of Health Sciences, Wuhan University, Wuhan 430071, China.
| | - Yingru Wu
- School of Health Sciences, Wuhan University, Wuhan 430071, China.
| | | | | | - Rui Zhang
- College of Life Sciences, South-Central University for Nationalities, Wuhan 430074, China.
| | - Xinge Zhang
- School of Health Sciences, Wuhan University, Wuhan 430071, China.
| | - Yueqiao Wang
- School of Health Sciences, Wuhan University, Wuhan 430071, China.
| | - Guoxun Chen
- Department of Nutrition, The University of Tennessee, Knoxville, TN 37996, USA.
| | - Rui Li
- School of Health Sciences, Wuhan University, Wuhan 430071, China.
| | - Justin B Moore
- Department of Family & Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
- Department of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
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Awosan KJ, Adeniyi SA, Bello H, Bello-Ibrahim Z. Nutritional status, weight perception and weight control practices among office employees in Sokoto, Nigeria. Pan Afr Med J 2017; 27:279. [PMID: 29187948 PMCID: PMC5660898 DOI: 10.11604/pamj.2017.27.279.12222] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/07/2017] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Overweight and obesity have become the fifth leading risk for global deaths. Office employees have been identified as a high risk group due to the sedentary nature of their work, and accurate weight perception is believed to be critical to acceptance of weight control interventions. This study was conducted to assess the nutritional status, weight perception and weight control practices of office employees in Sokoto, Nigeria. METHODS A cross sectional study was conducted among 285 randomly selected office employees in private establishments in Sokoto, Nigeria, in February and March 2013. Anthropometry was done for the participants in addition to questionnaire administration. RESULTS The mean age of the participants was 33.08 ± 7.23 years, they were predominantly males (56.5%) and married (57.5%). None was underweight, 111 (38.9%) had normal weight, 105 (36.8%) were overweight and 69 (24.2%) were obese. Among the participants with normal weight, overweight and obesity, 71.2%, 35.2% and 58.0% respectively accurately perceived their weight; while 28.8%, 50.5% and 30.4% respectively underestimated their weight. There was poor agreement between actual and perceived weight (k statistics = 0.341, p < 0.001). Only 67 (23.5%) of the 285 participants were engaged in weight control practices. CONCLUSION This study showed high prevalence of overweight and obesity, weight misperceptions, and poor uptake of weight control practices among office employees in Sokoto, Nigeria. These findings underscore the need for a holistic approach to obesity control interventions that encompasses both body image perception and nutritional assessment.
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Cai L, Zhang T, Ma J, Ma L, Jing J, Chen Y. Self-perception of weight status and its association with weight-related knowledge, attitudes, and behaviors among Chinese children in Guangzhou. J Epidemiol 2017; 27:338-345. [PMID: 28223085 PMCID: PMC5498423 DOI: 10.1016/j.je.2016.08.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 08/11/2016] [Indexed: 02/01/2023] Open
Abstract
Background How weight perception influences weight-related knowledge, attitudes, and behaviors in Chinese children is unknown. We investigated self-perception of body weight and its correlates, and analyzed the relationship between weight perception and weight-related knowledge, attitudes, and behaviors in children in Guangzhou, China. Methods We assessed self-reported weight perception, weight-related knowledge, attitudes, and behaviors in 3752 children aged 7–12 years. Underweight or overweight was defined using the Chinese criteria based on body mass index (BMI). Binary logistic regression analyses were performed to assess correlates of weight underestimation. Results In total, 27.3% of children underestimated and 6.7% overestimated their weight status. Weight underestimation was common among normal-weight (34.1%) and overweight children (25.3%). Older age, female sex, and child BMI z-score were negatively associated with normal-weight children's underestimation, whereas older age, paternal obesity, maternal obesity, and child BMI z-score were negatively associated with overweight children's underestimation. Correct answers on weight-related knowledge questions ranged from 81.5% to 98.6% and did not differ by weight perception within BMI categories. Although negative perceivers (i.e., those who perceived themselves as underweight or overweight) had a higher intention to change weight, they behaved more unhealthily on fruit intake, breakfast, screen time, and daily moderate-to-vigorous physical activities time than counterparts. Conclusion Weight underestimation was prevalent in normal-weight and overweight children in Guangzhou. Negative perceivers had stronger willingness to change weight but tended to behave more unhealthily on certain behaviors than positive perceivers. Childhood obesity interventions should incorporate health education and practical support to promote healthy eating and physical activity. Over one third of children misperceived their weight status in Guangzhou, China. Underestimation of body weight was much more prevalent than overestimation. Underestimation was common in younger children, girls, and those with obese parents. Children perceived as underweight/overweight had a higher intention to change weight. Children perceived as normal weight behaved more healthily on certain behaviors.
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Affiliation(s)
- Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ting Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Lu Ma
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Lee J, Lee Y. The association of body image distortion with weight control behaviors, diet behaviors, physical activity, sadness, and suicidal ideation among Korean high school students: a cross-sectional study. BMC Public Health 2016; 16:39. [PMID: 26772963 PMCID: PMC4714421 DOI: 10.1186/s12889-016-2703-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 01/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The identification of predictors for body image distortion would be an especially important first step in targeting a vulnerable population and developing a nutrition intervention program. We aimed to investigate the prevalence of body image distortion and the factors associated with body image distortion among Korean high school students. METHODS We selected 20,264 normal weight high school students from the 10(th) Korea Youth Risk Behavior Web-based Survey using nationally representative data in 2014. With multivariate logistic regression, we assessed the association of body image distortion with individual demographic and socio-economic factors, weight control behaviors, and mental health characteristics. RESULTS The over-estimation group of body weight status, compared with the correct estimation group, was significantly more likely to be a 3(rd) year high school student [adjusted odds ratio (AOR): 1.27, 95% confidence interval (CI): 1.16-1.39], to be female [AOR: 3.52, 95% CI: 3.25-3.81], to employ unhealthy weight control behaviors [AOR: 1.54, 95% CI: 1.37-1.72], and to have a sadness [AOR: 1.25, 95% CI: 1.16-1.35] and suicidal ideation [AOR: 1.20, 95% CI: 1.08-1.33]. The under-estimation group, compared with the correct estimation group, was significantly less likely to be female [AOR: 0.23, 95% CI: 0.21-0.25] and to employ unhealthy weight control behaviors [AOR: 0.50, 95% CI: 0.43-0.59] but were more likely to have a sadness [AOR: 1.12, 95% CI: 1.03-1.21] and suicidal ideation [AOR: 1.12, 95% CI: 1.00-1.25]. CONCLUSIONS Not only the over-estimation but also the under-estimation of body weight is prevalent among high school students in South Korea. Body image distortion was significantly associated with sadness and suicidal ideation.
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Affiliation(s)
- Jounghee Lee
- Department of Nutrition Education, Graduate School of Education, Kyonggi University, Gyeonggido, 443-760, South Korea.
| | - Youngmin Lee
- Department of Food and Nutrition, Seoul Women's University, 621 Hwarangro, Nowongu, Seoul, 139-774, South Korea.
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Shin A, Nam CM. Weight perception and its association with socio-demographic and health-related factors among Korean adolescents. BMC Public Health 2015; 15:1292. [PMID: 26703247 PMCID: PMC4690271 DOI: 10.1186/s12889-015-2624-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 12/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is a time of rapid growth with dramatic changes in physical appearance. The body image established at this time could affect their physical and mental health throughout their entire life. However, adolescents sometimes perceive themselves as underweight or overweight irrespective of actual weight status. The purpose of the present study was to examine the extent of weight misperception for Korean adolescents, to explore socio-demographic factors associated with weight misperception, and to examine gender-specific differences in the relationships between weight misperception and health-related factors. METHODS We selected data on 3321 adolescents aged 12-18 years from the five-year Korea Health and Nutrition Examination Survey (KNHANES) datasets (2007-2011). Self-perceived weight status was compared with measured weight status by cross-tabulation. The generalized logit model was used to explore the socio-demographic factors associated with weight misperception, and separate logistic regression models were fitted to examine gender-specific differences in the relationships between weight misperception and health-related factors. RESULTS Overall, 25.8 % of boys (overestimation 17.1 %; underestimation 8.6 %) and 29.3 % of girls (overestimation 24.0 %; underestimation 5.3 %) misclassified their weight status according to the objective standards. Weight overestimation was particularly prominent among underweight girls. Weight misperception was associated with socio-demographic factors such as gender, age, BMI, place of residence, and maternal education level. Weight overestimation and underestimation in boys and weight overestimation in girls were significantly related to inappropriate weight control practice. However, weight underestimation in girls seems to be negatively linked to inappropriate weight control practice. CONCLUSIONS Based on the results of the present study, comprehensive intervention programs for adolescents and their parents could be devised to raise self-awareness of their weight status, to overcome weight misperception, and to prevent obesity and its related health risks.
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Affiliation(s)
- Anna Shin
- Department of Public Health, College of Medicine, Yonsei University, Seoul, South Korea.
| | - Chung Mo Nam
- Department of Preventive Medicine/Department of Biostatistics, College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-Gu, Seoul, 120-752, South Korea.
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Ho LM, Wang MP, Ho SY, Lam TH. Changes in individual weight status based on body mass index and waist circumference in Hong Kong Chinese. PLoS One 2015; 10:e0119827. [PMID: 25775476 PMCID: PMC4361652 DOI: 10.1371/journal.pone.0119827] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 01/17/2015] [Indexed: 01/16/2023] Open
Abstract
Background Weight change predicted diseases and mortality. We investigate 3-year changes in individual body mass index (BMI) and waist circumference in Hong Kong Chinese adults. Methods In the Population Health Survey, 7084 adults in 2003 (baseline) were followed up in 2006. Longitudinal anthropometric data were available in 2941 (41.5%) for BMI and 2956 for waist circumference. Weight status and central obesity were based on objectively measured BMI and waist circumference using Asian standards. Results Mean BMI (SD) increased from 22.8 (3.62) to 23.1 (3.95) (p<0.001) with 1.3 percentage point increase in prevalence of overweight and obesity (from 44.3% to 45.6%). One in 5 (22.0%) normal or underweight baseline respondents became overweight or obese and a similar proportion (24.8%) of overweight and obese respondents became normal or underweight. Prevalence of central obesity increased from 28.3% to 32.4% (p<0.001) with a non-significantly greater increase in women (30.0% to 38.1%) than men (23.0% to 26.1%) (p=0.63). A higher proportion of centrally obese respondents returned to normal (29.4%) than normal respondents developing central obesity (17.4%). Conclusions This is one of the few studies in Chinese, which found dynamic longitudinal changes (increase/stable/decrease) in individual weight status and waist circumference. Future studies with better follow-up and investigating the causes of such changes are warranted.
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Affiliation(s)
- Lai Ming Ho
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, University of Hong Kong, Hong Kong, China
- * E-mail:
| | - Sai Yin Ho
- School of Public Health, University of Hong Kong, Hong Kong, China
| | - Tai Hing Lam
- School of Public Health, University of Hong Kong, Hong Kong, China
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Jiang Y, Kempner M, Loucks EB. Weight misperception and health risk behaviors in youth: the 2011 US YRBS. Am J Health Behav 2014; 38:765-80. [PMID: 24933146 DOI: 10.5993/ajhb.38.5.14] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To evaluate dose-response associations between misperceived weight and 32 health risk behaviors in a nationally representative sample of US adolescents. METHODS Participants included 13,864 US high school students in the 2011 Youth Risk Behavior Survey. Comparing the degree of agreement between perceived and reported actual weight, weight misperception was determined as 5 categories. Multivariable-adjusted logistic regression analyses evaluated associations of weight misperception with 32 health risk behaviors. RESULTS Both underestimated and overestimated weight were statistically significantly associated with all 32 health risk behaviors in a dose-response manner after adjustment for age, sex and race/ethnicity, where greater weight misperception was associated with higher engagement in health risk behaviors. CONCLUSIONS Understanding potential impacts of weight misperception on health risk behaviors could improve interventions that encourage healthy weight perception and attainment for adolescents.
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Affiliation(s)
- Yongwen Jiang
- Center for Health Data and Analysis, Rhode Island Department of Health, Providence, RI, USA.
| | - Marga Kempner
- Brown University School of Public Health, Department of Epidemiology, Providence, RI, USA
| | - Eric B Loucks
- Brown University School of Public Health, Department of Epidemiology, Providence, RI, USA
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Body size dissatisfaction among young Chinese children in Hong Kong: a cross-sectional study. Public Health Nutr 2014; 18:1067-74. [PMID: 24844379 DOI: 10.1017/s1368980014000810] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine the potential predictors of body size dissatisfaction in Chinese children. DESIGN The Child's Body Image Scale was used to assess body size perception and dissatisfaction. BMI was calculated from objectively measured height and weight. Predictors of body size dissatisfaction were examined by logistic regression analysis. SETTING Hong Kong, China. SUBJECTS Six hundred and twenty children (53 % boys, aged 6·1-12·9 years) from a state-run primary school. RESULTS Female sex (adjusted OR (AOR)=1·91; 95 % CI 1·32, 2·76), age (AOR=2·62; 95 % CI 1·65, 4·16 for 8-10 years; AOR=2·16; 95 % CI 1·38, 3·38 for >10 years), overweight (AOR=6·23; 95 % CI 3·66, 10·60) and obesity (AOR=19·04; 95 % CI 5·64, 64·32) were positively associated with desire to be thinner. Size misperception was a strong predictor of body size dissatisfaction, irrespective of actual weight status (AOR=1·90; 95 % CI 1·02, 3·54 for overestimation; AOR=0·43; 95 % CI 0·27, 0·67 for underestimation). CONCLUSIONS Body size dissatisfaction is prevalent among Chinese children as young as 6 years. Female sex, age, overweight, obesity and overestimation of size were associated with increased desire to be thinner. These findings emphasise the importance of preventing body image issues from an early age.
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Blashill AJ, Wilhelm S. Body Image Distortions, Weight, and Depression in Adolescent Boys: Longitudinal Trajectories into Adulthood. PSYCHOLOGY OF MEN & MASCULINITY 2014; 15:445-451. [PMID: 25383047 PMCID: PMC4219600 DOI: 10.1037/a0034618] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Depressive symptoms are common among the U.S. population, yet research into prospective risk factors of depression among men is limited. Distorted body image is also prevalent among adolescent boys, and may be linked with elevated depression; however, longitudinal associations have rarely been measured. Thus, the aim of the current study was to assess the prospective relationship between forms of body image distortion and depressive symptoms among adolescent boys, into adulthood. Data were extracted from the National Longitudinal Study of Adolescent Health. Participants were 2,139 U.S. adolescent boys (M age = 16) who were followed prospectively over 13-years (1996 to 2009), into adulthood. Longitudinal mixed-level modeling was employed to assess the temporal prediction of body image distortion on symptoms of depression. Results revealed that boys who were average weight and viewed themselves as either very underweight (very underweight distorted; Cohen's d = .47) or overweight (overweight distorted; Cohen's d = .29) reported significantly higher levels of depressive symptoms compared to boys who accurately viewed their weight as average; this effect remained constant over the 13-year study period. These findings indicated that distortions in body image, particularly extreme distortions, are risk factors for elevated depressive symptoms among adolescent boys, and persist into early adulthood.
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Huang R, Ho SY, Lo WS, Lam TH. Assessment of weight-related factors of adolescents by private practitioners. BMC FAMILY PRACTICE 2013; 14:141. [PMID: 24070145 PMCID: PMC3852667 DOI: 10.1186/1471-2296-14-141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 09/20/2013] [Indexed: 12/15/2022]
Abstract
Background Few studies have examined how common physicians assess various weight-related variables and patient characteristics that predict such assessments based on adolescents’ reports. We aimed to examine how common adolescents received weight-related physical measurements and lifestyle enquiries (dietary habits and physical activity) from private practitioners and to identify factors associated with these assessments. Methods In the Hong Kong Student Obesity Surveillance (HKSOS) project, 33692 students (44.9% boys; mean age 14.8, SD 1.9 years, age range 11–18) from 42 randomly selected schools completed an anonymous questionnaire. The students were asked “In the past 12 months, has any private practitioners (or their nurses) measured or asked about these items?” Response options included height, weight, waist circumference (WC), blood pressure (BP), BMI, diet, and physical activity. Weight status was based on self-reported weight and height. Logistic regression was used to identify student characteristics associated with each assessment. Analyses were conducted using STATA 10.0. Results Among 13283 students who had doctor consultations in the past 12 months, 37.9% received physical measurements or lifestyle enquiries, with weight (20.8%), height (16.8%) and blood pressure (11.5%) being the most common, followed by diet (8.1%), BMI (6.3%), WC and physical activity (both 4.6%). In general, adolescents who were female, older, underweight or overweight/obese, had parents with higher education level, and had actively asked private practitioners for advice about weight were more likely to receive assessments of weight-related factors. Conclusions Weight-related factors in adolescents were infrequently assessed by private practitioners in Hong Kong. Generally, unhealthy weight, higher parental education and advice-seeking by adolescents predicted these assessments.
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Affiliation(s)
- Rong Huang
- School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong.
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Saleem MD, Ahmed G, Mulla J, Haider SS, Abbas M. Weight misperception amongst youth of a developing country: Pakistan -a cross-sectional study. BMC Public Health 2013; 13:707. [PMID: 23915180 PMCID: PMC3734050 DOI: 10.1186/1471-2458-13-707] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 07/31/2013] [Indexed: 11/23/2022] Open
Abstract
Background Weight misperception is the discordance between an individual’s actual weight status and the perception of his/her weight. It is a common problem in the youth population as enumerated by many international studies. However data from Pakistan in this area is deficient. Methods A multi-center cross-sectional survey was carried out in undergraduate university students of Karachi between the ages of 15–24. Participants were questioned regarding their perception of being thin, normal or fat and it was compared with their Body Mass Index (BMI). Measurements of height and weight were taken for this purpose and BMI was categorized using Asian cut offs. Weight misperception was identified when the self-perceived weight (average, fat, thin) did not match the calculated BMI distribution. Chi square tests and logistic regression tests were applied to show associations of misperception and types of misperception (overestimation, underestimation) with independent variables like age, gender, type of university and faculties. P-value of <0.05 was taken as statistically significant. Results 42.4% of the total participants i.e. 43.3% males and 41% females misperceived their weight. Amongst those who misperceived 38.2% had overestimated and 61.8% had underestimated their weight. Greatest misperception of was observed in the overweight category (91%), specifically amongst overweight males (95%). Females of the underweight category overestimated their weight and males of the overweight category underestimated their weight. Amongst the total participants, females overestimated 8 times more than males (OR 8.054, 95% CI 5.34-12.13). Misperception increased with the age of the participants (OR 1.114, 95% CI 1.041-1.191). Odds of misperception were greater in students of private sector universities as compared to public (OR 1.861, 95% CI: 1.29-2.67). Odds of misperception were less in students of medical sciences (OR 0.693, 95% CI 0.491-0.977), engineering (OR 0.586, 95% CI 0.364-0.941) and business administration (OR 0.439, 95% CI 0.290-0.662) as compared to general faculty universities. Conclusion There was marked discrepancy between the calculated BMI and the self-perceived weight in the youth of Karachi. Better awareness campaigns need to be implemented to reverse these trends.
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Affiliation(s)
- Muhammad Danish Saleem
- Medical Student, Dow Medical College, Dow University of Health Sciences, Baba-E-Urdu Road, Karachi, Pakistan.
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Wang MP, Ho SY, Lam TH. Underage alcohol drinking and medical services use in Hong Kong: a cross-sectional study. BMJ Open 2013; 3:bmjopen-2013-002740. [PMID: 23793697 PMCID: PMC3664344 DOI: 10.1136/bmjopen-2013-002740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To investigate the association of underage alcohol drinking with medical consultation and hospitalisation in Hong Kong. DESIGN Cross-sectional study. SETTING Secondary schools in Hong Kong. PARTICIPANTS A total of 33 300 secondary 1 (US grade 7) to secondary 5 students (47.6% boys; mean age 14.6 years, SD 1.6) in 85 randomly selected schools. OUTCOME MEASURES An anonymous questionnaire was used to obtain information about medical consultation in the past 14 days, hospitalisation in the past 12 months, drinking alcohol, smoking, illicit drug use, physical activity, secondhand smoke exposure, feeling depressed, feeling anxious and sociodemographic characteristics. Drinking alcohol was categorised as non-drinking (reference), <1, 1-2 and 3-7 days/week. Logistic regression yielded adjusted ORs (AORs) of medical consultation and hospitalisation for drinking, adjusting for different potential confounders. Subgroup analysis was conducted among adolescents who did not report feeling anxious or depressed. RESULTS More than one-fourth (27.6%) of adolescents drank alcohol, 15.9% had medical consultation and 5.1% had been hospitalised. In the fully adjusted model, the AORs (95% CI) for medical consultation were 1.14 (1.06 to 1.23) for <1 day/week, 1.30 (1.13 to 1.50) for 1-2 days/week and 1.70 (1.41 to 2.06) for 3-7 days/week of drinking compared with non-drinking (p for trend <0.001). The corresponding AORs (95% CI) for hospitalisation were 1.14 (1.02 to 1.28), 1.68 (1.32 to 2.14) and 2.38 (1.90 to 2.98) (p for trend <0.001). Similar associations were observed among students who did not feel anxious or depressed. CONCLUSIONS Alcohol consumption was associated with medical services use in Chinese adolescents. More rigorous alcohol control policies and health promotion programmes are needed to reduce alcohol drinking and related harms in adolescents.
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Affiliation(s)
- Man Ping Wang
- School of Public Health, The University of Hong Kong, Hong Kong, Hong Kong
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Zhao M, Zhang M, Zhou X, Yang H, Yang Y, Yang N. Weight misperception and its barriers to keep health weight in Chinese children. Acta Paediatr 2012; 101:e550-6. [PMID: 23025796 DOI: 10.1111/apa.12011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To examine the prevalence rate of misperception, assess the relationship between weight perception and weight-related behaviors in Chinese children. METHODS A total of 2708 children aged 7-12 years from five public primary schools and their parents completed questionnaires assessing social demographic background, dietary and activity related factors. Weight and height were measured by trained investigators. The prevalence of misperception was defined by comparing calculated BMI and their perceived weight status. Log-binomial model yielded adjusted prevalence ratios (PRs) for each behavior by weight misperception in boys and girls separately. RESULTS Misperception was more prevalent in normal weight children 33.3% for girls and 40.5% for boys and boys were more likely to underestimate their weight status than girls. Associations were observed between misperceived thinness and eating before bed, want to eat seeing others eating, eating sugar and snacks frequently, monophagia and choosy in food both in girls and boys. And associations between misperceived fatness and depression and want to eat seeing others eating were found only in girls. CONCLUSIONS Our findings underscore the importance of weight perception in shaping realistic body image among normal weight children. Education must be introduced to help children accurately look on their body shape.
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Affiliation(s)
- Min Zhao
- Department of Nutrition and Food Hygiene and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Lo WS, Ho SY, Mak KK, Lam TH. The use of Stunkard's figure rating scale to identify underweight and overweight in Chinese adolescents. PLoS One 2012; 7:e50017. [PMID: 23189177 PMCID: PMC3506537 DOI: 10.1371/journal.pone.0050017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 10/16/2012] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND To compare the performance of Stunkard's current body size (CBS) with self-reported body mass index (BMI), waist circumference (WC) and waist to stature ratio (WSR) in predicting weight status in Chinese adolescents, and to determine the CBS cutoffs for overweight/obesity and underweight. METHODOLOGY This cross-sectional study was conducted in a sample of 5,418 secondary school students (45.2% boys; mean age 14.7 years). Height and weight were measured by trained teachers or researchers. Subjects were classified as underweight, normal weight, or overweight/obese according to the International Obesity Task Force cutoffs. Subjects were asked to select the figure that best resembled their CBS on the Stunkard's figure rating scale. Self-reported height, weight, WC and WSR were also obtained. The performance of CBS, self-reported BMI, WC and WSR as a weight status indicator was analysed by sex-specific receiver operating characteristic curves. The optimal CBS cutoffs for underweight and overweight/obesity were determined based on the Youden Index. PRINCIPAL FINDINGS Apart from self-reported BMI, CBS had the greatest area under curve (AUC) for underweight in boys (0.82) and girls (0.81). For overweight/obesity, CBS also had a greater AUC (0.85) than self-reported WC and WSR in boys, and an AUC (0.81) comparable to self-reported WC and WSR in girls. In general, CBS values of 3 and 5 appeared to be the optimal cutoffs for underweight and overweight/obesity, respectively, in different sex-age subgroups. CONCLUSIONS/SIGNIFICANCE CBS is a potentially useful indicator to assess weight status of adolescents when measured and self-reported BMI are not available.
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Affiliation(s)
- Wing-Sze Lo
- School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
| | - Sai-Yin Ho
- School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
| | - Kwok-Kei Mak
- School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
| | - Tai-Hing Lam
- School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
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Almeida S, Severo M, Araújo J, Lopes C, Ramos E. Body image and depressive symptoms in 13-year-old adolescents. J Paediatr Child Health 2012; 48:E165-71. [PMID: 22998142 DOI: 10.1111/j.1440-1754.2012.02576.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To evaluate the prevalence of body dissatisfaction and the association with depressive symptoms in 13-year-old adolescents, according to gender, and also to analyse the possible modifying effect of body mass index on this association. METHODS We evaluated 1868 adolescents as part of a population-based study in an urban community in Porto, Portugal. Using the Figure Rating Scale, participants choose their perceived and their desired figures; body dissatisfaction was measured by the difference between these values. The Beck Disorder Inventory II was used to measure depressive symptoms. Weight and height were measured by trained interviewers. To quantify the association between depressive symptoms and body dissatisfaction, regression parameters and 95% confidence intervals (CIs) were obtained by linear regression and bootstrapping. RESULTS Among females, 15.8% desired a bigger figure and 41.4% desired a thinner figure. Among males, this occurred for 34.1% and 33.5%, respectively. After adjustment, we found that body dissatisfaction was associated with increased depressive symptoms, in both genders, especially in those participants who wish to be thinner and in those presenting higher discrepancy between figures (B = 6.5, 95% CI 4.1;9.3 for females, B = 3.3, 95% CI 1.3;6.8 for males). The association between body dissatisfaction and depressive symptoms was stronger among non-overweight (for participants who wish to be thinner: B = 5.18 95% CI 3.56; 6.95 vs. B = 3.49, 95% CI 1.70; 5.29 among females and B = 2.47, 95% CI 0.73; 4.76 vs. B = 1.60, 95% CI 0.34; 2.88 among males). CONCLUSIONS The direct association between the wish to be thinner and depressive symptoms was stronger among the non-overweight youth.
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Affiliation(s)
- Sandra Almeida
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, University of Porto, Porto, Portugal
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