How do I look? Body image perceptions among university students from England and Denmark

What Motivates Men to Improve Their Health? Understanding the Roles of Self-Esteem and Influential Others in Behaviour Change

The aim of this study was to examine men's body image confidence, social reflectivity, body image perceptions and external information sources influence regarding body assessments. Data were collected via a cross-sectional survey and found that men have a low motivation toward physical health behaviour changes such as food, alcohol and exercise evaluation, and have generally positive views of their bodies overall. Relationship status, rather than age, defined behavioural and attitudinal differences within the men studied here. Men in this study were largely uninfluenced by celebrities or fashion in developing their own body image perceptions; single males were more likely to turn to friends, the female population generally and societal norms when evaluating themselves. Males in relationships however, weighted their partner's opinion as the greatest influence, followed by their involvement in sport. This study offers an insight into the role of body confidence in male perspectives of the self, which is important for its intrinsic connection to motivations for health behaviours such as body weight management. This has implications for increasing the effectiveness of health-related product and service messaging, and public health messages regarding body weight management for men.

Depression, anxiety, and stress in medical students in Peru: a cross-sectional study

Objective

To determine the prevalence and factors associated with depressive, anxious, and stress symptoms in medical students in Peru, during the second pandemic wave of COVID-19.

Methods

We conducted an analytical cross-sectional study in 405 medical students from a university in northern Peru. The DASS-21 instrument was used to evaluate mental health outcomes (depression, anxiety, and stress), and to investigate their association with socio-educational characteristics.

Results

We found a prevalence of depressive, anxious, and stress symptoms of 71.6% (95% CI: 66.94-75.95), 71.9% (95% CI: 67.2-76.2), and 62.7% (95% CI: 57.8-67.4); respectively. Students with eating behavior disorders had a higher prevalence of depressive symptoms (PR: 1.35), anxious symptoms (PR: 1.27), and stress symptoms (PR: 1.31). The prevalence of depressive symptoms (PR: 1.57), anxious symptoms (PR: 1.27), and stress symptoms (PR: 1.24) increased in students who did not report regular physical activity. In addition, having almost always academic exhaustion increased the prevalence of depressive symptoms (PR: 1.46), stress symptoms (PR: 1.72). On the contrary, the prevalence of depressive symptoms (PR: 0.79), anxious symptoms (PR: 0.73) and stress symptoms (PR: 0.82) decreased in male students. Students who reported sleeping 8 or more hours daily had a lower prevalence of stress symptoms (PR: 0.82).

Conclusion

Symptoms of depression and anxiety occurred in 7 out of 10 students, and stress in 6 out of 10. Among the factors associated with the presence of anxiety, depression, and stress were eating behavior disorder and not regularly exercising. Periodic evaluations of mental symptomatology are required and counseling should be promoted in medical schools.

Body image dissatisfaction, nutritional status and weight control strategies among university undergraduates in Lagos: a descriptive cross-sectional study

Introduction

body image dissatisfaction has been associated with poor nutritional status and unhealthy weight management strategies. This study determined the prevalence and relationships between body image dissatisfaction, nutritional status, and weight management strategies among university undergraduate students in Lagos, Nigeria.

Methods

a descriptive cross-sectional study employed a multi-stage sampling technique to select 865 undergraduates in Lagos. A pretested self-administered questionnaire was used to assess the variables. Stunkard figure rating scale was used to determine body image dissatisfaction. Body mass index (BMI) was calculated to determine nutritional status. A standard weight control strategy scale was adopted to determine weight management strategies. SPSS (version 23) was used for analysis and the association between variables was determined using Chi-square. The level of significance was set at P= <0.05.

Results

the prevalence of body image dissatisfaction was high (63.5%) but not associated with gender. The majority (65.1%) had normal BMI, 10.6% were overweight and 7.2% were obese. Majority of the respondents (93.3%) engaged in weight management practices with dietary control being the most employed strategy. The most commonly employed unhealthy practice is strict dieting (37.7%). Body image dissatisfaction was significantly associated with overweight/obesity (P=0.001) but not with weight management practices. Age and overweight/obesity were predictors of BID.

Conclusion

prevalence of body image dissatisfaction, overweight and obesity, and unhealthy weight management strategies were high. Body image dissatisfaction was associated with obesity but not associated with weight management strategies. All undergraduates need health education on body image and appropriate weight management strategies.

Physical Activity and Body Image Perceived by University Students during the COVID-19 Pandemic: A Systematic Review

Our objective was to assess the perception of body image and physical activity in university students during the COVID-19 pandemic. Of 74,270 papers found on 13 search engines between 12 August 2020, and 2 November 2021, we identified six studies (n = 1392 and 1097 were women). We found several results on the perception of both variables during the pandemic. First, physical activity tended to decrease or have negative changes, either because they dedicated less time to it, decreased the type of intensity or because they dedicated more time to sedentary activities. In addition, women were more physically active than men, since men perceived a decrease in their levels of physical activity. Secondly, there were also slight changes in the perception of body image; several students perceived that they gained weight and others had an increase in their BMI. It is even noted that those who were physically active or who were older in the population studied had a better perception of their actual physical condition. Similarly, we found that a concern for body image and even negative changes in the perception of appearance during confinement were reported. In conclusion, we found changes in the perception of physical activity and body image in college students during the COVID-19 pandemic.

Micronutrient intake and associated factors among school adolescent girls in Meshenti Town, Bahir Dar City Administration, Northwest Ethiopia, 2020

BACKGROUND

Adolescent girls have a greater nutrient demand and their poor dietary intake is associated with micronutrient deficiencies and poor maternal outcomes. Having information on micronutrient intake inadequacy in adolescent girls is critical for promoting healthy behavior and breaking the cycle of intergenerational malnutrition. Thus, this study assessed overall micronutrient intake inadequacy and associated factors among school adolescent girls in Meshenti town of Bahir Dar City Administration, North West Ethiopia.

METHODS

A school-based cross-sectional study was conducted among 401 adolescent girls from February 7 to 23, 2020. A Simple random sampling technique was used to select study participants. A multiple-pass 24-hour dietary recall with portion size estimation method and recommended dietary allowance cut-off point were used to assess micronutrient intake inadequacy. Overall micronutrient intake inadequacy was measured using the mean adequacy ratio. Nutrient databases were developed by ESHA FOOD PROCESSOR version 8.1 software. Data were entered into Epi-data version 3.1 and exported to SPSS version 23 for analysis. Multivariable logistic regression was performed to identify determinants of overall micronutrient intake inadequacy and an adjusted odds ratio at a p-value of less than 0.05 was used to see the strength of statistical association.

RESULTS

The prevalence of overall micronutrient intake inadequacy was 44.4% (95% CI: 39.7%-49.6%). Early adolescent age (AOR: 2.75, 95% CI: 1.71-4.42), food-insecure household (1.74, 95%CI: 1.087-2.784), low dietary diversity score (AOR = 2.83, 95% CI: 1.35-5.92), and high peer pressure on eating and body concern (AOR = 1.853, 95% CI: 1.201-2.857) were significantly associated factors with overall micronutrient intake inadequacy.

CONCLUSION

Findings of this study revealed that micronutrient intake inadequacy among adolescent girls was a high public health problem in the study area. Therefore, attention should be given to adolescent girls of the study area, especially the ones in the early adolescent age. Interventions should also focus on nutrition-sensitive activities to address food insecurity, a less diversified diet, and the negative impact of peer influence.

Associations between Body Image and Self-Perceived Physical Fitness in Future Spanish Teachers

Body image is a complex construct related to how each person perceives their own body and how they value it. Physical fitness and physical activity are factors that can influence the perception of a better or worse body image. This study aimed to identify the potential associations between body image and physical fitness self-perception in future Spanish teachers, analysing possible sex-related differences. A total of 278 Spanish university students answered the Multidimensional Body Self Relations Questionnaire and the International Fitness Scale, having an average age of 22 years, of which 40% were men and 60% were women. Nonparametric techniques (Spearman's Rho test) were used as the data did not fit normality. The findings showed associations between body image and perceived physical fitness, confirming differences between the sexes. Correlations were found between the first three dimensions of the Multidimensional Body Self Relations and the International Fitness Scale, with sex-related differences being more significant in women than in men, and between the physical abilities self-assessed by the International Fitness Scale (except flexibility) and the dimensions of the Multidimensional Body Self Relations (except Dimension 4). Since body image influences well-being and conditions the time spent exercising, public health organisations and universities should design supports to improve master students' body image through physical activity programmes, education and sex-specific individualised attention.

Gender Difference in Food Choice and Eating Practice and Their Association with Health among Students of Kathmandu, Nepal

BACKGROUND

Our eating practice is generally based on the food we choose to eat. The selection of unhealthy food, high cost of healthy food items, and easy availability of fast food may have negative impact on our health and eating behaviour. This study aims to access the gender difference in food choice and eating practice and their association with health among students in Kathmandu, Nepal.

METHODS

A cross-sectional descriptive study was conducted among 385 randomly selected undergraduate BBA (Bachelor in Business Administration) students of Tribhuvan University in Kathmandu by using semistructured self-administered questionnaire. The questionnaire included sociodemographic characters, health status, behaviour factors, eating practice, and food choice which were measured using Food Choice Questionnaire (FCQ). The data was analysed in SPSS. Frequency, percentage, mean, and standard deviation were calculated, and chi-square test and logistic regression were used to measure the association between two variables.

RESULTS

The study is comprised of 50.4% female and 49.6% male with mean ages of 20.04 and 20.75, respectively. A gender difference was observed in food choice but no gender difference was observed in eating practice. There was no significant association of food choice and eating practice with health. However, food choice and eating practice showed an association with the current living status of the respondents. Sensory appeal and health were the most important food choice motives among males and females, respectively.

CONCLUSION

The study concluded that no gender difference was observed in food choice. However, gender difference was observed in eating practice. There was no association of food choice and eating practice with health.

[Factors associated with the risk of developing eating disorders among medical students in Casablanca, Morocco]

Introduction

les troubles du comportement alimentaire (TCA) sont particulièrement fréquents chez les jeunes adultes, y compris les étudiants. Les objectifs de cette étude sont de déterminer la prévalence d'éventuels troubles du comportement alimentaire chez les étudiants en médecine de Casablanca et d´évaluer le risque de TCA selon les facteurs associés, notamment les facteurs socioéconomiques, cliniques, l´anxiété et la dépression.

Méthodes

nous avons mené une étude transversale descriptive et analytique au niveau du Centre Hospiatlier Universiatire Ibn Rochd de Casablanca et à la faculté de médecine et de pharmacie de Casablanca Maroc, durant l´année universitaire 2016-2017. L´enquête a porté sur un échantillon de 506 étudiants. Nous avons utilisé le questionnaire SCOFF-F (Sick, Control, One stone, Fat, Food; version française), un outil validé pour le dépistage des troubles du comportement alimentaire et l´échelle HAD (Hospital anxiety and depression) pour dépister les troubles anxieux et dépressifs.

Résultats

le questionnaire SCOFF a détecté 127 personnes (soit 25,09%) sur 506 susceptibles de souffrir de troubles du comportement alimentaire. L´âge, le niveau d´études, l´utilisation des moyens de contrôle du poids, l´anxiété et la dépression sont des facteurs associés de façon significative au risque de présenter un trouble du comportement alimentaire chez les étudiants.

Conclusion

nos résultats sont en accord avec les données de la littérature concernant la fréquence des troubles du comportement alimentaire en population étudiante et plus spécifiquement les étudiants en médecine. Mener d´autres études sur une population plus variée pourraient également être envisagées afin d´avoir une vision plus globale de la situation au Maroc.

Beauty Is Skin Deep; The Self-Perception of Adolescents and Young Women in Construction of Body Image within the Ankole Society

Introduction: Adolescents and young women become increasingly aware of their bodies through images presented to them through social structures during their developmental stage. These images may drive them toward unhealthy behaviors including overeating, starving, and skin bleaching. This paper is part of a study that examined the Older Adolescent Banyankole Girl’s Response to the socio-cultural constructions of body image in The Ankole Region, Uganda. It aimed to understand the self-perceptions of adolescent girls of their body image within Ankole society. Methods: The study collected narrative interviews of 30 adolescent and young adult females (16–24) recruited from various institutions of learning as well as the Ankole community of southwestern Uganda. Results: Adolescent girls’ perceptions of beauty were influenced by pull and push factors that included beauty expectations, beauty comparisons, relationships, and dietary habits that keep them oscillating between traditional and contemporary beauty ideals. Findings suggest that young women could benefit from social shifting of focus from physical appearance to other valuable developmental assets. Conclusion: Government-sponsored programs that provide education and positive media messages may be beneficial to building the self-esteem of young women.

Gender Differences in Healthy Lifestyle, Body Consciousness, and the Use of Social Networks among Medical Students

Background and Objectives: The goal of this survey was to identify the relationship between the level of satisfaction with body image, perceived health, and the usage of social media among freshmen medical university students. The influence of social media and peers was also related to body image. Materials and Methods: An online survey was distributed among freshmen healthcare students. The questionnaire collected sociodemographic, anthropometric data, and information about students’ perception about healthy lifestyle using open-ended questions, as well as their opinion about the importance of perfect body image and the level of satisfaction with their physical appearance. Questions focusing on the use of social media and the relationship with body image collected data on the use of social networks and how they affect students’ opinion about their own body image. Psychometric data were also gathered using the Body Consciousness Scale. For the statistical analysis, QSR NUD*IST (Non-numerical Unstructured Data Indexing Searching and Theorizing) Vivo 12 was used for qualitative data and IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, version 23 (SPSS Inc., Chicago, IL, USA) was used for descriptive and comparative results. Results: In total, 77 students aged 20.09 ± 2.47 years, of which the majority were women (75.30%), were included in the survey. The use of social network was about 4.81 ± 3.60 h/day. Facebook was the most used social networking site (94.80%), followed by Instagram (92.20%), Snapchat (16.90%), WhatsApp (15.60%), and TikTok (10.40%). The most common reason for using these sites was socialization. We found that 64.90% of healthcare students were normal weight. The main barriers for having a healthy lifestyle, as they were perceived by students, were the busy schedule and the lack of time needed to prepare healthy meals, lack of motivation, and lack of money. Women scored higher for the Private Body Consciousness and Public Body Consciousness scales. The main aspects related to a healthy lifestyle referred to physical activity, consumption of fruit and vegetables, water consumption, and a good quality of sleep. Gender differences were discussed as well. Conclusions: The results illustrated the complexity of the relationship between social media and body image and the need to prevent body image concerns, especially in young women.

Exploring a core psychopathology in disordered eating: the feelings of fat scale

BACKGROUND

Feelings of fat are common for people with eating disorders, but ways of measuring its intensity are needed. Therefore, our goal was to develop a self-report feelings of fat scale that asked participants to indicate how intensely they currently felt statements such as "I feel fat". With such a scale we can determine how strongly feelings of fat relate to evidence of disordered eating.

METHODS

We conducted three studies of eating disorders with undergraduate women taking introductory psychology classes. The combined sample was 472 participants. A previous eating disorder diagnosis was self-reported by 33 participants and a current diagnosis by 11. All participants completed the EDE-Q and the seven (Study 1) or nine item (Studies 2 and 3) "State Feelings of Fat" (SFF) scales we developed. Each item asked them to rate the intensity with which they felt statements such "I feel fat" on a seven-point scale from "not at all" to "the most I have ever felt".

RESULTS

Both the seven and nine item SFF scales were highly coherent (Cronbach's α were .94, .95 and .94), but factor analysis supported the seven-item version. We found high correlations between SFF and EDE-Q scores (Study 1: .816; Study 2: .808; Study 3: .841). SFF scores distinguished participants self-reporting no eating disorder diagnosis from those with a former diagnosis, t (361) = 2.33, p = .021, who in turn were distinguished from those with a current diagnosis, t (42) = 2.09, p = .043. Due to the high coherence of the scale, the single item "I feel fat" captured most of the variance in EDE-Q scores (r [472] = .793).

CONCLUSIONS

We have constructed an eating disorders relevant feelings of fat scale. Given that the EDE-Q is considered a valid questionnaire for measuring severity of eating disorders, our findings suggests that feelings of fat are core to the psychopathology of eating disorders. To the extent that EDE-Q scores are stable it also suggests that feelings of fat are surprisingly stable. Furthermore, the single item "I feel fat" alone may capture most of what the EDE-Q measures.

Are lifestyle factors significantly associated with self-rated health among Japanese female healthcare students?

Background

Self-rated health (SRH), a subjective perception of an individual’s overall health, is widely used in public health assessment. The transition from adolescence to young adulthood is a critical period involving substantial changes in lifestyle and dietary habits. Therefore, it is important to understand SRH among young Japanese females. The present study aimed to investigate the relationships between SRH among female healthcare students and their lifestyle factors, such as living status (living with others or living alone), smoking habit, alcohol consumption, frequency of breakfast consumption (FBC), physical activity, insomnia, and physique recognition.

Methods

A cross-sectional survey was conducted on 1101 female healthcare students in Japan. The body mass index was calculated from the body height and weight using data from periodic health examinations. Self-reported sociodemographic, lifestyle or dietary habits, physical activity, and SRH were used through a self-administered questionnaire. Participants were classified as having either good SRH (excellent, very good, or good) or impaired SRH (fair or poor). Multivariate logistic regression analysis was performed to investigate the independent relationships between SRH and lifestyle factors.

Results

A total of 11.4% participants demonstrated impaired SRH. Multivariate logistic regression analysis showed that the University of California Los Angeles activity score, Athens Insomnia Scale, and physique recognition were associated with SRH.

Conclusions

It was suggested that public health activities that consider physical activity, sleep, and physique recognition may help maintain and improve SRH in female university students in Japan.

Correlates of over- or under-estimation of body size among resource-poor urban dwellers in a sub-Saharan African city

BACKGROUND

Individual perception of body size has implications for lifestyle behaviours including dietary habits and weight management practices.

AIM

To examine factors related to respondents' estimation of their body sizes compared to their body mass index (BMI).

SUBJECTS AND METHODS

This cross-sectional survey comprised a sample of 917 adults in urban poor Accra, Ghana. Silhouette figure ratings were used to assess perceived body size and ideal body size at a community level. Logistic regression analysis was used to determine correlates of respondents overestimating or underestimating their body sizes.

RESULTS

Approximately, 69% of respondents either underestimated or overestimated their body sizes. About a quarter of respondents perceived being overweight as the preferred ideal body size in their communities. The mean BMI of females and males who underestimated their body sizes were within the overweight category and normal weight category, respectively. Gender, educational level, employment status, the community of residence, and ethnicity were associated with how respondents correctly estimated, over- or under-estimated their body sizes. There was evidence of ethnicity mediating the association between the community of residence and body size estimation.

CONCLUSION

Weight management interventions must be mindful of the socio-demographic and cultural proclivities of the targeted populace for optimum impact.

Self-perception of physical health conditions and its association with depression and anxiety among Bangladeshi university students

BACKGROUND

Self-perception of physical health conditions is associated with depression and anxiety. Although some recent studies revealed a high prevalence of depression and anxiety among Bangladeshi university students, no study has yet investigated the link between self-perception of physical health and these common psychological disorders. Therefore, this study aimed to explore the association of self-perception of physical health conditions with depression and anxiety among university students in Dhaka, Bangladesh.

METHODS

A cross-sectional study was conducted between August and November 2017 among 897 undergraduate students of Jahangirnagar University, Dhaka through face-to-face interviews using a semi-structured questionnaire. Chi-square test and binary logistic regression analysis were used to examine the association between the variables.

RESULTS

13.9% of the respondents had poor self-rated health (SRH) and 49.9% had self-rated body image (SRBI) dissatisfaction. 25.6% of the students reported to be overweight/obese whereas 18.7% to be underweight. Poor and moderate SRH was found to be significantly associated with students' depression (adjusted odds ratio [AOR]: 6.700; 95% CI: 3.821-11.749 and AOR: 2.155; 95% CI: 1.582-2.934) and anxiety (AOR: 4.365; 95% CI: 2.599-7.332 and AOR: 1.776; 95% CI: 1.270-2.484). Furthermore, SRBI dissatisfaction, underweight SRBI, overweight/obese SRBI, low blood pressure and hypertension were also significantly linked with students' depression and anxiety.

CONCLUSION

Students dissatisfied with their physical health status had higher chances to suffer from depression and anxiety. The findings of this study would create room for further research and could be used to design a comprehensive health program for young students.

Dieting, body weight concerns and health: trends and associations in Swedish schoolchildren

Background

Dieting is a risk factor of both eating disorders and obesity. The aim was to examine time trends of dieting in Swedish adolescents, and explore how dieting and body weight dissatisfaction are related to self-reported health, wellbeing and health behaviours.

Methods

Analyses of cross-sectional Swedish data from HBSC (Health Behaviour in School-aged Children) surveys 1994–2014. In total, about 30,000 girls and boys in the age of 11, 13 and 15 years participated. Data was collected by using classroom administered questionnaires in 5th, 7th and 9th grade. Logistic regressions was used to analyse secular trends of dieting, and how dieting and body dissatisfaction were associated with self-reported overall health, health behaviours, BMI and various physical, psychological and social aspects of health in 2014.

Results

Dieting increased from 1994 to 2014 in both girls and boys in all age groups, and in 2014, the prevalence was 14% in girls and 8% in boys. The prevalence of body satisfaction was 65% respectively 69%. Body weight dissatisfaction and dieting were present in all body weight classes and were associated with self-reported poor health and many other negative health aspects. In comparison with the participants that were satisfied with their body weight the odds ratio (95% CI) for self-reported poor health was 3.4 (2.6–4.4) in dieters, 4.9 (3.8–6.4) in participants who perceived a need to lose weight and 2.1 (1.5–2.8) in those who perceived a need to gain weight, when adjusting for age, sex and body weight class.

Conclusions

When promoting health among school age children body weight dissatisfaction and dieting ought to be considered. Furthermore, it is important to support girls and boys in all weight classes to reach and maintain a healthy body image and weight.

Eating disorders risk among medical students: a global systematic review and meta-analysis

PURPOSE

Medical students appear to be a high-risk group to develop psychological problems including eating disorders (ED). The prevalence estimates of ED risk vary greatly between studies. This systematic review and meta-analysis was done to estimate the prevalence of ED risk among medical students.

METHODS

An electronic search of EMBASE, MEDLINE, ProQuest and Google Scholar was conducted. Studies that reported the prevalence of ED risk among medical students and were published in English peer-reviewed journals between 1982 and 2017 were included. Information about study characteristics and the prevalence of ED risk were extracted by four investigators. Each article was reviewed independently by at least two investigators. Estimates were pooled using random-effects meta-analysis using the DerSimonian-Laird method. The main outcome of interest was the prevalence of ED risk in medical students.

RESULTS

The prevalence of ED risk among medical students was extracted from nineteen cross-sectional studies across nine countries (total participants n = 5722). The overall pooled prevalence rate of ED risk was 10.4% (497/5722 students, 95% CI 7.8-13.0%), with statistically significant evidence between-study heterogeneity (Q = 295, τ2 = 0.003, I2 = 94.0%, P < 0.001). Prevalence estimates between studies ranged from 2.2 to 29.1%.

CONCLUSION

In this systematic review and meta-analysis, the summary prevalence of ED risk among medical students was 10.4%. Further research is needed to identify and prevent ED in this population. Studies are also needed to investigate concurrent pathologies associated with ED risk.

LEVEL OF EVIDENCE

Level I, systematic review and meta-analysis.

A qualitative study of drivers of psychoactive substance use among Mekelle University students, Northern Ethiopia

Background

Psychoactive substance (PS) use is a public health concern among University students. Understanding the factors underlay the use helps to underpin effective preventive interventions. However, there is dearth of exploratory studies on the drivers of psychoactive substance use in Ethiopian universities. Here, we aimed to explore the drivers for psychoactive substance use among Mekelle University undergraduate students.

Methods

Exploratory qualitative study was conducted from April 1 to May 30, 2017. We conducted five focus group discussions (FGDs) and eleven in-depth interviews (IDIs) with students, proctors and bar owners. We also conducted three round interviews within two weeks interval with each of four key-informant researchers (KIR). Participants were selected purposively and the investigators conducted the discussions and the interviews using semi-structured guides. Data were audio-recorded, transcribed verbatim and imported into qualitative data analysis software for coding and analysis. An inductive approach was applied to crystalize non-repetitive emerging themes overarching the drivers for psychoactive substance use among university students.

Results

The following themes emerged as drivers for psychoactive substance use among University students; (1)feeling helpless following detachment from family, (2) prior experience with substances, (3) socialization reasons, (4) low academic performance, (5) physical environment (explained by easy access to substance and limited recreational alternatives), and (6) sub-optimal organizational support.

Conclusions

Multiple drivers that range from individual to structural levels are involved in university student’s use of psychoactive substances, with socialization process at the center of the factors. Thus, the study appeals for a range of multifaceted interventions directed to the individual, interpersonal and organizational level factors.

Electronic supplementary material

The online version of this article (10.1186/s13011-018-0190-1) contains supplementary material, which is available to authorized users.

Weight perceptions, weight management practices, and nutritional status of emerging adults living in the Accra Metropolis

Background

Many young people have a tendency to be concerned about their physical appearance and undertake practices in order to achieve certain body ideals. There is however limited information from developing countries on the weight perceptions of emerging adults (i.e. individuals leaving the adolescence life stage and preparing to take on adulthood) and whether these opinions influence their nutritional status and weight management practices. This study sought to assess emerging adults' nutritional status, their weight perceptions and the methods they use to manage their weight.

Methods

This study was cross-sectional, involving emerging adults (N = 192) recruited at shopping areas in the Accra Metropolis of Ghana. A pretested questionnaire was used to collect information on demographic characteristics, weight perceptions, and weight management strategies. Anthropometric measurements were taken using standard procedures. Descriptive analysis was performed on the demographic data, methods used to manage weight, and weight perceptions. Logistic regression was used to assess possible relationships between weight perceptions and nutritional status as well as weight perceptions and weight management practices.

Results

The mean age of participants was 21.8(2.2) years with 51.0% of participants being female. Majority of the participants perceived normal weight status as the ideal body for themselves and half of them thought that they were slimmer than they actually were in reality. Three major weight management strategies were identified: engaging in physical activity, dieting and making lifestyle modifications (i.e. changes in normal eating habits coupled with regular physical activity and behavioral changes). Emerging adults who had an inaccurate body image perception were less likely (OR = 0.30, 95% CI: 0.15-0.61) to have a healthy nutritional status than emerging adults who had an accurate body image perception.

Conclusion

Weight perception was associated with nutritional status. Discussions with nutrition professionals regarding realistic weight ideals would be beneficial for this age-group since half of the study's participants had inaccurate perceptions about their current weight statuses even though their statuses were normal.

Identifying the Incidence of Exercise Dependence Attitudes, Levels of Body Perception, and Preferences for Use of Fitness Technology Monitoring

Background: The study was focused on identifying the relationship between the incidence of exercise dependence attitudes, the level of body perception, and preferences for use of fitness technology monitoring. Methods: We investigated 241 students from physical education and sports specializations. We used a questionnaire structured in 5 parts: personal information (age, gender, weight, height, and institutional membership), Exercise Dependence Scale-R (EDS-21), the Compulsive Exercise Test (CET), Body perception questionnaire, and Fitness Monitoring Technology. Results: Application of EDS-21 revealed 8.3% with dependence and CET with 13.4%. Body mass index (BMI) in combination with self-image body: 18 (7.4%) of subjects over-estimated themselves, 18 (7.4%) of subjects underestimated themselves, 38.6% of the subjects were satisfied with their appearance, 17% were very satisfied and none were dissatisfied. A total of 36.1% thought they had the correct weight and 8.7% thought of losing weight. The most preferred monitoring technologies were the treadmill and the smartphone's fitness applications. A total of 11.6% of the subjects always used technologies, and 17% of subjects never did so. Conclusions: In order to identify the level of incidence of exercise dependence, body perception, and preference and frequency of use of monitoring technology, it is necessary to expand the level of knowledge about health and physical activities. The approach would diminish medical incidences of addiction, improve proactive behaviors, and correct prohealth.

Behavioral Health Risk Profiles of Undergraduate University Students in England, Wales, and Northern Ireland: A Cluster Analysis

Background

Limited research has explored clustering of lifestyle behavioral risk factors (BRFs) among university students. This study aimed to explore clustering of BRFs, composition of clusters, and the association of the clusters with self-rated health and perceived academic performance.

Method

We assessed (BRFs), namely tobacco smoking, physical inactivity, alcohol consumption, illicit drug use, unhealthy nutrition, and inadequate sleep, using a self-administered general Student Health Survey among 3,706 undergraduates at seven UK universities.

Results

A two-step cluster analysis generated: Cluster 1 (the high physically active and health conscious) with very high health awareness/consciousness, good nutrition, and physical activity (PA), and relatively low alcohol, tobacco, and other drug (ATOD) use. Cluster 2 (the abstinent) had very low ATOD use, high health awareness, good nutrition, and medium high PA. Cluster 3 (the moderately health conscious) included the highest regard for healthy eating, second highest fruit/vegetable consumption, and moderately high ATOD use. Cluster 4 (the risk taking) showed the highest ATOD use, were the least health conscious, least fruit consuming, and attached the least importance on eating healthy. Compared to the healthy cluster (Cluster 1), students in other clusters had lower self-rated health, and particularly, students in the risk taking cluster (Cluster 4) reported lower academic performance. These associations were stronger for men than for women. Of the four clusters, Cluster 4 had the youngest students.

Conclusion

Our results suggested that prevention among university students should address multiple BRFs simultaneously, with particular focus on the younger students.

Changing Trends in Nutritional Behavior among University Students in Greece, between 2006 and 2016

The objective of the present survey was to study the dietary behavior of university students residing away from the family home. In this context, we (a) compared their dietary habits in two time periods, namely 2006 and 2016; and (b) explored the possible impact of gender on the behavioral changes in nutritional choices. A total of four hundred and five university students (2006, n = 242; 2016, n = 163) participated in the study. Dietary assessment was carried out using a qualitative Food Frequency Questionnaire, while data about demographic and lifestyle factors were also collected. Students' dietary habits have been modified in a generally desirable direction, as reflected, e.g., in the elevated consumption of several plant-based foods. Gender was also significantly associated with Body Mass Index (BMI) and changes in dietary attitudes. Possible reasons for the transition towards healthier and more balanced dietary habits could involve the budgetary constraints facing Greece in the last decade, as well as increasing nutritional awareness and other socio-cultural factors characterizing this target group. A deeper understanding of these relations would be crucial to foster nutritional education and further enhance the effectiveness of health promotion campaigns.

Relationship Among Body Image, Anthropometric Parameters and Mental Health in Physical Education Students

Background

The prevalence of body image dissatisfaction (BID) is currently high. Given that psychological well-being is associated with the body measurements imposed by esthetic standards, BID is an important risk factor for mental disorders.

Objective

Identify the prevalence of BID, and compare anthropometric and mental health parameters between individuals satisfied and dissatisfied with their body image.

Method

A total of 140 university students completed the silhouette scale to screen for BID. Anthropometric measures, body mass index (BMI), waist circumference (WC) and body fat percentage (BFP) were used. To investigate mental health, The State-Trait Anxiety Inventories (STAI-S and STAI-T), Profile of Mood States (POMS) scale and Quality of Life (QOL-36) questionnaire were used to investigate mental health. The Student’s t-test was applied to compare anthropometric and mental health parameters.

Results

67.1% of university students exhibited BID. There was a significant difference (p = 0.041) in BF and WC (p = 0.048) between dissatisfied and satisfied individuals. With respect to mood states, significant differences were observed for anger (p = 0.014), depression (p = 0.011), hostility (p = 0.006), fatigue (p = 0.013), mental confusion (p = 0.021) and total mood disturbance (TMD) (p = 0.001). The mental aspect of QOL was significantly higher (p = 0.001) in satisfied university students compared to their dissatisfied counterparts.

Conclusion

BID was high and it seems to be influenced by anthropometric measures related to the amount and distribution of body fat. This dissatisfaction may have a negative effect on the quality of life and mood state of young adults.

Longitudinal multigroup invariance analysis of the satisfaction with food-related life scale in university students

This study examined longitudinal measurement invariance in the Satisfaction with Food-related Life (SWFL) scale using follow-up data from university students. We examined this measure of the SWFL in different groups of students, separated by various characteristics. Through non-probabilistic longitudinal sampling, 114 university students (65.8% female, mean age: 22.5) completed the SWFL questionnaire three times, over intervals of approximately one year. Confirmatory factor analysis was used to examine longitudinal measurement invariance. Two types of analysis were conducted: first, a longitudinal invariance by time, and second, a multigroup longitudinal invariance by sex, age, socio-economic status and place of residence during the study period. Results showed that the 3-item version of the SWFL exhibited strong longitudinal invariance (equal factor loadings and equal indicator intercepts). Longitudinal multigroup invariance analysis also showed that the 3-item version of the SWFL displays strong invariance by socio-economic status and place of residence during the study period over time. Nevertheless, it was only possible to demonstrate equivalence of the longitudinal factor structure among students of both sexes, and among those older and younger than 22 years. Generally, these findings suggest that the SWFL scale has satisfactory psychometric properties for longitudinal measurement invariance in university students with similar characteristics as the students that participated in this research. It is also possible to suggest that satisfaction with food-related life is associated with sex and age.

Influence of personality traits in self-evaluative salience, motivational salience and self-consciousness of appearance

Aim

The aim of this study was to understand the possible influence of personality traits on the importance and significance of perception of body image and self-awareness of appearance in individuals.

Method

214 online recruited subjects between the ages of 17 and 64 years answered to a socio-demographic questionnaire, the Portuguese version of the instruments NEO-FFI (NEO-Five Factor Inventory), ASI-R (The Appearance Schemas Inventory – Revised) and DAS-24 (Derriford Appearance Scale – short).

Results

It was found that age, Neuroticism and Agreeableness dimensions significantly influence an individual's investment in body image and self-awareness of appearance. Sexual orientations differed with regard to Self-Evaluative Salience and Self-Consciousness of Appearance.

Conclusion

The performed analysis showed that neuroticism and agreeableness are related to Self-Evaluative Salience and Self-Consciousness of Appearance.

Análise fatorial da versão portuguesa da Escala de Avaliação da Aparência de Derriford (DAS-24)

Objetivo

As preocupações com a aparência têm vindo a ter um crescente interesse ao nível da investigação. Pretende-se avaliar a validade fatorial e a fiabilidade da Escala de Avaliação da Aparência de Derriford (DAS-24) na população portuguesa.

Método

Quinhentos e oito sujeitos, participaram neste estudo, utilizando uma amostra por conveniência. Os participantes responderam a questões sociodemográficas, questões relacionadas com o investimento esquemático da aparência e a autoconsciência da aparência.

Resultados

A DAS-24 apresentou um bom índice de consistência interna (α = 0,91). Através dos resultados obtidos na análise fatorial confirmatória (AFC), apresenta um ajustamento aceitável (χ²/df = 2,5; GFI = 0,912; CFI = 0,925; TLI = 0,909; RMSEA = 0,054; p [rmsea ≤ 0,05] = 0,130).

Conclusão

A DAS-24, na população portuguesa, apresenta-se psicometricamente robusta na avaliação da autoconsciência da aparência, tornando-se uma escala aplicável e aceitável da versão original.

Is Healthier Nutrition Behaviour Associated with Better Self-Reported Health and Less Health Complaints? Evidence from Turku, Finland

We examined nutrition behaviour, self-reported health and 20 health complaints of undergraduates in Finland. Students at the University of Turku in Finland participated in a cross-sectional online survey (N = 1189). For nutrition behaviour, we computed two composite food intake pattern scores (sweets, cakes and snacks; and fruits and vegetables), a dietary guideline adherence index and the subjective importance of healthy eating. Multinomial logistic regression assessed the association of students' nutrition behaviour with three levels of self-reported health, controlling for many potential confounders (age, sex, living with partner, economic situation, moderate physical activity, Faculty and BMI). Factor analysis of the 20 health complaints revealed three components (psychological, pains/aches and circulatory/breathing symptoms). Multiple linear regression tested the association of students' eating habits with the three components of health complaints, controlling for the same confounders. Fruits and raw and cooked vegetable consumption, dietary guideline adherence index and subjective importance of healthy eating were highest among students with excellent/very good self-reported health, exhibiting a decreasing trend for those individuals with poor/fair self-reported health. High levels of psychological symptoms were associated with decreased consumption of fruits and vegetables, less dietary guideline adherence and less subjective importance of healthy eating. Pain/aches symptoms were associated with a higher consumption of sweets, cookies and snacks and a lower adherence to dietary guidelines. More healthy nutrition behaviour was consistently associated with better self-reported health and less health complaints. Of the four nutrition behaviour indicators we employed, the dietary guideline adherence index was the best indicator and exhibited the most consistent associations with self-reported health and health complaints.

Body image dissatisfaction: clinical features, and psychosocial disability in inflammatory bowel disease

BACKGROUND

Body image refers to a person's sense of their physical appearance and body function. A negative body image self-evaluation may result in psychosocial dysfunction. Crohn's disease and ulcerative colitis are associated with disabling features, and body image dissatisfaction is a concern for many patients with inflammatory bowel disease (IBD). However, no study has assessed body image and its comorbidities in patients with IBD using validated instruments. Our aim was to explore body image dissatisfaction in patients with IBD and assess its relationship with biological and psychosocial variables.

METHODS

We studied 330 patients (median age, 36 yr; range, 18-83; 169 men) using quantitative and qualitative methods. Patients completed a self-administered questionnaire that included a modified Hopwood Body Image Scale, the Cash Body Image Disturbance Questionnaire, and other validated instruments. Clinical and disease activity data were also collected.

RESULTS

Body image dissatisfaction was associated with disease activity (P < 0.001) and steroid treatment (P = 0.03) but not with immunotherapy (P = 0.57) or biological (P = 0.55) therapy. Body image dissatisfaction was also associated with low levels of general (P < 0.001) and IBD-specific (P < 0.001) quality of life, self-esteem (P < 0.001), and sexual satisfaction (P < 0.001), and with high levels of anxiety (P < 0.001) and depression (P < 0.001). Qualitative analysis indicated that patients were concerned about both physical and psychosocial consequences of body image dissatisfaction, including steroid side effects and impaired work and social activities.

CONCLUSIONS

Body image dissatisfaction is common in patients with IBD, relates to specific clinical variables and is associated with significant psychological dysfunction. Its measurement is warranted as part of a comprehensive patient-centered IBD assessment.

Food and mental health: relationship between food and perceived stress and depressive symptoms among university students in the United Kingdom

AIMS

The current study assessed, by university and sex, the association between nutritional behaviour (twelve independent variables), and stress and depressive symptoms (dependent variables) in a sample from three UK countries.

METHODS

A cross-sectional survey was undertaken among undergraduates enrolled across seven universities in England, Wales and Northern Ireland (N = 3,706). Self-administered questionnaires included a 12-item food frequency questionnaire, Cohen's Perceived Stress Scale and modified Beck Depression Inventory. Sex and university comparisons were undertaken. Univariable and multivariable regression analyses were computed for each of the two outcomes--perceived stress and depressive symptoms.

RESULTS

The frequencies of consuming of the various food groups differed by university and sex, as did depressive symptoms and perceived stress. Multivariable regression analyses indicated that consuming 'unhealthy' foods (e.g. sweets, cookies, snacks, fast food) was significantly positively associated with perceived stress (females only) and depressive symptoms (both males and females). Conversely, consuming 'healthy' foods (e.g. fresh fruits, salads, cooked vegetables) was significantly negatively associated with perceived stress and depressive symptoms scores for both sexes. There was significant negative association between consuming fish/sea food and depressive symptoms among males only. For males and for females, consuming lemonade/soft drinks, meat/sausage products, dairy/dairy products, and cereal/cereal products were not associated with either perceived stress or depressive symptoms.

CONCLUSIONS

The associations between consuming 'unhealthy' foods and higher depressive symptoms and perceived stress among male and female students as well as the associations between consuming 'healthy' foods and lower depressive symptoms and perceived stress among male and female students in three UK countries suggest that interventions to reduce depressive symptoms and stress among students could also result in the consumption of healthier foods and/or vice versa.

Body image concerns: levels, correlates and gender differences among students in the United Kingdom

AIMS

This cross-sectional study aimed to determine the socio-demographic, lifestyle and well-being variables that are associated with body image concerns (BIC) and whether these associations differed between female and male students.

METHODS

A cross-sectional survey; 3,706 undergraduate students (2,699 females, 765 males) from seven universities in the UK completed a self-administered questionnaire that assessed socio-demographic, lifestyle, well-being and BIC based on the Body Shape Questionnaire developed by Cooper et al. Multifactorial logistic regression analysis examined the odds ratios for the association between four increasing levels of BIC as the dependent variables (no BIC, mild BIC, moderate BIC and marked BIC) on the one hand, and the socio-demographic (gender, age, year at university), lifestyle (physical activity, nutrition) and mental well-being variables (quality of life, perceived stress, perceived health, depressive symptoms) on the other.

RESULTS

More females (35%) than males (8%) reported being moderately or markedly concerned with their body image. For both genders, BIC was associated with a higher level of depressive symptoms and to variable extents, with nutrition and year at university. Females' BICs were exclusively associated with low perceived health, higher perceived stress, studies in general as a stressor, and low physical activity. In contrast, males' BIC were found to be exclusively associated with low quality of life and with older age.

CONCLUSIONS

Health promoting strategies and activities should address the co-occurrence of depressive symptoms and BIC and should moreover pay attention to the gender-specific correlates of BIC for tailoring evidence based interventions for females and for males.

Agreement and association between different indicators of body image and body mass index in adolescents

The aim of the study was to examine the correlation among different indicators of body image; between each one of these and nutritional status; and the association of these indicators with the Body Mass Index (BMI) of adolescents. A random sample of 152 students from public and private schools in the city of Rio de Janeiro, Brazil, was studied. On four occasions, two silhouette scales and two questions regarding the opinion of the student about his/her body and weight were applied and weight and height were measured. The BMI was examined both as a continuous and as a categorical variable. The agreement between the variables was analyzed using the quadratic weighted Kappa statistics. The association between body image variables and BMI was examined by the comparison among median, mean, standard deviation and 95% confidence interval of BMI for each category of the body image variables. In general, the correlation among the body image variables ranged from reasonable to good; between these and the variable nutritional status, correlation ranged from regular to reasonable. Best results were observed among boys and students from private schools. All body image variables showed good discriminatory power for BMI, when it was analyzed as a continuous variable, even when controlling for potential confounders. The question about body seems to be better than that about weight to compose the questionnaire of a surveillance system for risk and protective factors for adolescent health.

Are students' symptoms and health complaints associated with perceived stress at university? Perspectives from the United Kingdom and Egypt

This cross-sectional survey assessed and compared by country, the levels and correlates of 21 self-reported symptoms/health complaints. We examined the associations between self-reported symptoms and perceived stress. Data was collected from universities in the United Kingdom and Egypt (N = 3706 and 3271 undergraduates, respectively). A self-administered questionnaire assessed a range of self-reported symptoms, perceived stress, sociodemographic (gender, age, marital status, year of study, living arrangements during semester, income sufficiency), lifestyle (tobacco smoking, illicit drug/s use, alcohol consumption frequency), and health variables (subjective health status, health awareness, BMI), along with religiosity, and quality of life. Factor analysis categorized the 21 self-reported symptoms into four components. Correlation analysis and linear regression tested the associations between the self-reported symptoms and stress. Factor analysis of the health symptoms generated four symptom groups for each of the UK and Egypt (psychological; circulatory/breathing; gastrointestinal; and, pains/aches), and factor loadings were quite similar for both countries. Whilst the two samples showed similarities as to the kind of symptoms most frequently reported by students, the Egyptian sample had significantly higher frequency than the UK for every symptom. Frequent complaints (both countries) included difficulties to concentrate, fatigue, headaches, nervousness/anxiety, and back pain (UK) and mood swings (Egypt). Significantly more Egyptian students reported ≥4 symptoms over the past year than the UK. For each of the UK and Egypt, across each of the four symptom groups, there was a stepladder appearance whereby the frequency of symptoms increased with increasing quartiles of perceived stress. Not controlling for other variables, for both countries, there were significant positive correlations between each of the four symptom groups and stress; the highest correlation was for psychological symptoms. After controlling for sex, age country, and other symptom groups, stress was highly and significantly associated with psychological symptoms and also with pain & aches symptoms in both countries. UK students were generally less stressed than their counterparts in Egypt. Age and female gender were also associated with stress; the younger the student was the more likely to suffer from stress. Interactions were not significant. Across both countries, the levels of stress among students and the associations between perceived stress and health complaints suggest the need for a multiple approaches in order to understand the sources of stress; how college students experience stress; and, the coping mechanisms that different students employ to mitigate stress. Interventions aimed at both preventing, treating and caring for students’ distress, and also preventive strategies to help minimize the impact of stressful situations are required. Strategies that address both physical and psychological complaints may be beneficial for this population.

Body image concern and its correlates among male and female undergraduate students at Assuit University in Egypt

Introduction:

This cross-sectional study examined variables associated with body image concern (BIC) and whether these associations differed between female and male students in Egypt. During the period 2009-2010, 3271 undergraduate students (1663 females, 1504 males) at Assuit University in Egypt completed a self-administered questionnaire that assessed BIC and other socio-demographic and health related variables.

Methods:

Based on Cooper et al.’s Body Shape Questionnaire the authors categorized BIC into ‘no BIC’; ‘mild BIC’; and ‘moderate/marked BIC’. Multifactorial linear regression analysis examined the association between BIC and BMI, body image perception, lifestyle (physical activity, nutrition, smoking) and mental well-being variables (quality of life, finances-related stress, perceived stress, perceived health, depressive symptoms).

Results:

About 40% of the female students and 25.6% of male students reported having mild to marked BIC. The correlates of BIC did not exhibit striking differences between male and female students. For both genders, BIC was positively associated with BMI, body image perception as being too fat and with depressive symptoms. Self-rated health was inversely associated with BIC.

Conclusion:

These findings suggest that health promoting strategies should address the co-occurrence of depressive symptoms and BIC, and should furthermore pay due attention to higher prevalence of BIC among female students.

The body image scale: a simple and valid tool for assessing body image dissatisfaction in inflammatory bowel disease

BACKGROUND

Body image refers to a persons' sense of their own physical appearance. This can be negatively influenced by a number of factors including disease states and treatments. Inflammatory bowel disease (IBD) carries a distinct psychosocial and a physical burden, but body image has not been formally assessed in patients with IBD, nor is there a validated body image questionnaire. Our aim was to assess and validate a body image questionnaire for patients with IBD.

METHODS

Three hundred thirty-eight ambulatory patients (median age, 36; 174 male) completed a questionnaire that included the Hopwood body image scale adapted from the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Study Group. Data from another scale, the Cash Body Image Disturbance Questionnaire, were also collected in addition to demographic and clinical data.

RESULTS

Factor analysis resulted in a single factor solution explaining 65% of the variance. Internal consistency of the body image scale was demonstrated with a Cronbach alpha of 0.93. Convergent validity was established with a correlation coefficient of 0.64 (P < 0.001) with the Cash Body Image Disturbance Questionnaire. Females (P < 0.001) and those who had undergone either stoma or nonstoma forming surgery experienced more body image dissatisfaction (P = 0.002), indicating predictive validity. Reliability was confirmed with a test-retest correlation of 0.82 (P < 0.001).

CONCLUSIONS

The modified body image scale is a valid tool for assessing body image in patients with IBD.

Do importance of religious faith and healthy lifestyle modify the relationships between depressive symptoms and four indicators of alcohol consumption? A survey of students across seven universities in England, Wales, and Northern Ireland

We examined the associations between depressive symptoms and four indicators of alcohol consumption (high frequency of drinking, frequency of heavy episodic drinking, problem drinking, and possible alcohol dependence). We also explored whether personal importance of religious faith as well as healthy lifestyle had any modifying roles in these relationships. During 2007-2008, 3,220 students at seven UK universities completed a questionnaire containing questions on CAGE, frequency alcohol use, heavy episodic drinking, modified Beck-Depression Inventory, physical activity and sleep, and importance of religious faith. Multivariate logistic regressions were performed separately for four alcohol consumption indicators, stratified by gender. Controlling for demographic variables, depressive symptoms were positively associated with problem drinking and possible alcohol dependence for both genders. Religiosity was negatively associated with frequency of drinking and heavy episodic drinking among both genders, while healthy lifestyle was not associated with any of the four measures of alcohol consumption among both genders. No evidence suggested that either religiosity or healthy lifestyle modified the relationships between depressive symptoms and any of the four measures of alcohol consumption. This study shows a link between hazardous drinking and mental ill health and suggests religiosity as a protective factor for high alcohol consumption. Promotion of students' mental and spiritual health could have a preventive role in hazardous drinking at universities.

Socio-demographic correlates of six indicators of alcohol consumption: survey findings of students across seven universities in England, Wales and Northern Ireland

Background

This study assessed the prevalence of six alcohol consumption indicators in a sample of university students. We also examined whether students’ sociodemographic and educational characteristics were associated with any of the six alcohol consumption indicators; and whether associations between students’ sociodemographic and educational characteristics and the six alcohol consumption indicators differed by gender.

Methods

A cross-sectional study of 3706 students enrolled at 7 universities in England, Wales and Northern Ireland. A self-administered questionnaire assessed six alcohol consumption measures: length of time of last (most recent) drinking occasion; amount consumed during last drinking occasion; frequency of alcohol consumption; heavy episodic drinking (≥ 5 drinks in a row); problem drinking; and possible alcohol dependence as measured by CAGE. The questionnaire also collected information on seven relevant student sociodemographic characteristics (age, gender, academic year of study, current living circumstances - accommodation with parents, whether student was in intimate relationship, socioeconomic status of parents - parental education, income sufficiency) and two academic achievement variables (importance of achieving good grades at university, and one’s academic performance in comparison with one’s peers).

Results

The majority of students (65% of females, 76% of males) reported heavy episodic drinking at least once within the last 2 weeks, and problem drinking was prevalent in 20% of females and 29% of males. Factors consistently positively associated with all six indicators of alcohol consumption were male gender and perceived insufficient income. Other factors such as living away from home, being in 1^st or 2^nd year of studies, having no intimate partner, and lower academic achievement were associated with some, but not all indicators of alcohol consumption.

Conclusions

The high level of alcohol consumption calls for regular/periodic monitoring of student use of alcohol, and for urgent preventive actions and intervention programmes at the universities in the UK.

Self-reporting and measurement of body mass index in adolescents: refusals and validity, and the possible role of socioeconomic and health-related factors

Background

Body mass index assessment using self-reported height and weight (BMIsr) can encounter refusals and under/over-reporting while for assessment with measured data (BMIm) refusals can be more frequent. This could relate to socioeconomic and health-related factors. We explored these issues by investigating numerous potential factors: gender, age, family structure, father’s occupation, income, physical/sports activity, subjective weight perception, school performance, unhealthy behaviours, physical/psychological health, social relationships, living environment, having sustained violence, sexual abuse, and involvement in violence.

Methods

The sample included 1559 adolescents from middle schools in north-eastern France. They completed a questionnaire including socioeconomic and health-related data, self-reported height/weight, measured height/weight, and weight perception (participation rate 94%). Data were analysed using logistic regression models.

Results

BMIsr encountered under-reporting (with change in BMI category, 11.8%), over-reporting (6.0%), and reporting refusals (3.6%). BMIm encountered more numerous refusals (7.9%). Reporting refusal was related to living with a single parent, low school performance, lack of physical/sports activity, sustained violence, poor psychological health, and poor social relationships (gender/age-adjusted odds ratios 1.95 to 2.91). Further to these factors, measurement refusal was related to older age, having divorced/separated parents, a father being a manual worker/inactive, insufficient family income, tobacco/cannabis use, involvement in violence, poor physical health, and poor living environment (1.30 to 3.68). Under-reporting was related to male gender, involvement in violence, poor psychological health, and overweight/obesity (as assessed with BMIm) (1.52 to 11). Over-reporting was related to male gender, younger age, alcohol consumption, and underweight (1.30 to 5.35). Weight perception was linked to reporting refusals and under/over-reporting, but slightly linked to measurement refusal. The contributions of socioeconomic and health-related factors to the associations of weight perception with reporting refusal and under/over-reporting ranged from −82% to 44%. There were substantial discrepancies in the associations between socioeconomic/health-related factors and overweight/obesity assessed with BMIsr and BMIm.

Conclusions

BMIsr and BMIm were affected by numerous biases related to vulnerability which were also obesity risk factors. BMIsr encountered under/over-reporting which were related to some socioeconomic and health-related factors, weight perception, and BMIm. BMIm was more affected by refusals than BMIsr due to socioeconomic and health-related factors. Further research is needed.

Physical and Psychological Well-being of University Students: Survey of Eleven Faculties in Egypt

BACKGROUND

We examined perceived health status and physical and psychological well-being of 3,271 undergraduate students attending eleven faculties in a university in Egypt.

METHODS

During 2009-2010, participants completed a self-administered questionnaire that gathered socio-demographic, physical and psychological health data. Body mass index (BMI) was calculated from students' measured height and weight. Differences across these variables were computed by gender and participating faculties.

RESULTS

Whilst more females watched and rated their health favorably, they were more likely to feel psychosomatic/physical health problems, to have seen a medical practitioner or been ill that they had to stay in bed. Females were consistently more likely to feel burdened overall, and across several aspects apart from financial problems. Less females had 'normal' BMI, were satisfied with current weight, perceived their body image as 'just right', or were not worried about their shape. More males rated their quality of life favorably. About 25% of males and 32% of females were either overweight/obese. Exams, presentations, and the lack of time for studies were the frequently-reported burdens. Comparisons of health/well-being indicators across the participating faculties suggested some evidence of 'clustering': Favorable indicators would cluster at some faculties; and conversely, less favorable variables would cluster at other faculties.

CONCLUSIONS

Generally, the levels of some health complaints and psychological problems/burdens are higher than in other countries. Increased vigilance of university administrators and leaders to monitoring the health and well-being of their students, as well as their health needs is required if policy makers are to operate from a valid evidence base platform. Given cultural factors prevalent in the Eastern Mediterranean region generally, female students might require particular attention. The clustering effects suggest the need for local (faculty-specific) health and well-being profiles as basis and guidance for relevant health promotion programs in faculty/university settings.

Effect of gender on the association between weight status and health-related quality of life in adolescents

Background

Some studies have investigated the association between body mass index (BMI) and health-related quality of life (HRQoL) among adolescents, but their results have been discrepant and few paid attention to the role of gender. The present investigation aimed to assess the relationship between weight status and HRQoL in adolescents and to verify whether it was similar in boys and girls.

Methods

Five thousand two hundred and twenty six adolescents aged 14 to 18 years were included in the PRomotion de l’ALIMentation et de l’Activité Physique (PRALIMAP) trial, a 2x2x2 factorial cluster randomized trial performed in 24 high schools in France. Sociodemographic, anthropometric and HRQoL data were collected. BMI was categorized in four classes (thin, normal-weight, overweight, obese). Linear regression models were used to estimate the association between weight status and HRQoL, adjusting for confounders.

Results

The mean age of adolescents was 15.7±0.6 years and their mean BMI was 21.6 ±3.5 kg/m²; 55% were girls. Boys were more often overweight and obese than were girls (overweight: 15.6% vs 14.2%, obese: 4.8% vs 3.3%), and girls were more likely to be thin (5.5% vs 4.5%, p=0.0042). All HRQoL scores were higher for boys (p=<0.0001). Weight status was not associated with physical and social scores neither in boys nor in girls. Conversely, it was associated with mental score, but differently in girls than boys. As compared with normal-weight girls, thin girls had better mental HRQoL (β=+6.17, p=0.0010), and overweight and obese girls had lower mental HRQoL (β=−3.89 and β=−5.90, respectively, p<0.001). Mental HRQoL was lower for thin, overweight and obese boys than for normal-weight boys (β= −4.97, β= −1.68 and β= −3.17, respectively, p<0.0001).

Conclusions

Gender can modify the association between weight status and HRQoL in adolescents. Body image could be an important target of public health programs to improve subjective health during adolescence.

Fatores associados à imagem corporal em estudantes de Educação Física

Objetivou-se investigar alguns fatores associados à percepção da imagem corporal em acadêmicos de educação física. 230 estudantes responderam a um questionário com questões relacionadas à imagem corporal e práticas de atividade física. Avaliações antropométricas foram realizadas. Análises ajustadas da insatisfação pelo excesso de peso e pela magreza foram apresentadas. As prevalências de insatisfação com a imagem corporal foram de 62,8% para o sexo masculino e de 67% para o feminino. A insatisfação pela magreza foi 2,71 (IC95%: 1,47-4,99) vezes maior no grupo masculino e a insatisfação pelo excesso de peso foi 2,22 (IC95%: 1,40-3,54) vezes maior no grupo feminino. Devido às altas prevalências de insatisfação com a imagem corporal identificadas, sugere-se que os cursos de formação dêem maior destaque a temas como imagem corporal e padrões de beleza nas atividades curriculares, possibilitando uma melhor atuação junto a grupos com distorções de imagem corporal, comuns em escolas e academias.

Feeling healthy? A survey of physical and psychological wellbeing of students from seven universities in the UK

University students’ physical and psychological health and wellbeing are important and comprise many variables. This study assessed perceived health status in addition to a range of physical and psychological wellbeing indicators of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these variables across males and females, and across the participating universities. The data was collected in 2007–2008. A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), self-reported physical and psychological health data, as well as questions on health awareness, health service use, social support, burdens and stressors and university study related questions. While females generally reported more health problems and psychological burdens, male students felt that they received/had fewer persons to depend on for social support. The comparisons of health and wellbeing variables across the different universities suggested some evidence of ‘clustering’ of the variables under study, whereby favourable situations would be exhibited by a cluster of the variables that is encountered at some universities; and conversely, the clustering of less favourable variables as exhibited at other universities. We conclude that the level of health complaints and psychological problems/burdens is relatively high and calls for increased awareness of university administrators, leaders and policy makers to the health and well-being needs of their students. The observed clustering effects also indicated the need for local (university-specific) health and wellbeing profiles as basis and guidance for relevant health promotion programmes at universities.

Does the association between depressive symptomatology and physical activity depend on body image perception? A survey of students from seven universities in the UK

This cross-sectional study assessed the association between depression and PA in university students of both genders and the role of body image perception as a potential effect modifier. Undergraduate students (N = 3706) from seven universities in the UK completed a self-administered questionnaire that assessed sociodemographic information; a range of health, health behaviour and health awareness related factors; the modified version of Beck’s Depression Inventory (M-BDI); educational achievement, and different levels of physical activity (PA), such as moderate PA (at least 5 days per week moderate exercise of at least 30 minutes), and vigorous PA (at least 3 days per week vigorous exercise of at least 20 minutes). Only 12.4% of the sample achieved the international recommended level for moderate PA, and 33.1% achieved the recommendations for vigorous PA. Both moderate and vigorous PA were inversely related to the M-BDI score. Physically active students, regardless of the type of PA, were significantly more likely to perceive their health as good, to have higher health awareness, to perform strengthening exercises, and to be males. The stratified analyses indicated that the association between depression and PA differed by body image. In students perceiving their body image as ‘just right’, moderate (>4th percentile) and high (>5th percentile) M-BDI scores were inversely related to vigorous PA. However, in students who perceived their body image as ‘overweight’, the inverse association was only significant in those with high M-BDI scores. We conclude that the positive effect of PA on depression could be down modulated by the negative impact of a ‘distorted’ body image on depression. The practical implications of these findings are that PA programmes targeting persons with depressive symptoms should include effective components to enhance body image perception.