Association of Perceived Weight Status versus Body Mass Index on Adherence to Weight-modifying plan Among Iranian Children and Adolescents: The CASPIAN-IV Study

Sociodemographic factors associated with weight perception of adolescents: A systematic review and meta-analysis

PURPOSE

To systematically assess the main sociodemographic factors associated with weight perception of adolescents.

METHODOLOGY

All studies related to adolescents' weight perception were retrieved from seven databases from January 2001 to July 2022. A total of 13 Medical Subject Headings (MeSH) and keywords were used to identify qualified studies, and reference lists included in the retrieved studies were manually searched to identify potentially relevant publications. Two evaluators independently assessed the eligibility and extracted data of each study. Agency for Healthcare Research and Quality (AHRQ) risk of bias evaluation tool was used to evaluate the quality and bias risk of included studies. RevMan (version: 5.3) software was used to conduct heterogeneity test and meta-analysis.

RESULTS

A total of 12 studies, published between 2003 and 2020, were selected and included in the systematic review and meta-analysis, consisting of 325,367 adolescents from five countries. The risk of bias evaluation indicated that risk of bias was low in five studies and moderate in seven studies. The results of meta-analysis showed that there were no differences in the weight perception accuracy among adolescents under different gender (odds ratio [OR] = 1.00, 95% confidence interval [CI]: 0.88-1.15, p = 0.940), place of residence (OR = 0.98, 95% CI: 0.83-1.16, p = 0.800), grade (OR = 1.73, 95% CI: 0.68-4.42, p = 0.250), and family economic level (OR = 0.94, 95% CI: 0.86-1.02, p = 0.140). Egger's linear regression showed that there was no significant publication bias in the primary analysis.

CONCLUSIONS

The current analysis indicates that gender, place of residence, grade, and family economic level were not identified as influencing factors for adolescents' weight perception accuracy. Due to the limitations of the review and included studies, more robust trials are warranted in different social and economic environments to confirm our findings.

Determining the effective factors in predicting diet adherence using an intelligent model

Adhering to a healthy diet plays an essential role in preventing many nutrition-related diseases, such as obesity, diabetes, high blood pressure, and other cardiovascular diseases. This study aimed to predict adherence to the prescribed diets using a hybrid model of artificial neural networks (ANNs) and the genetic algorithm (GA). In this study, 26 factors affecting diet adherence were modeled using ANN and GA(ANGA). A dataset of 1528 patients, including 1116 females and 412 males, referred to a private clinic was applied. SPSS Ver.25 and MATLAB toolbox 2017 were employed to make the model and analyze the data. The results showed that the accuracy of the proposed ANN and ANGA models for predicting diet adherence was 93.22% and 93.51%, respectively. Also, the Pearson coefficient showed a significant relationship among the factors. The developed model showed the proper performance for predicting adherence to the diet. Moreover, the most effective factors were selected using GA. Some important factors that affect diet adherence include the duration of the marriage, the reason for referring to the clinic, weight, body mass index (BMI), weight satisfaction, lunch and dinner times, and sleep time. Therefore, applying the proposed model can help dietitians identify people who need more support to adhere to the diet.

Classification of psychiatric symptoms using deep interaction networks: the CASPIAN-IV study

Identifying the possible factors of psychiatric symptoms among children can reduce the risk of adverse psychosocial outcomes in adulthood. We designed a classification tool to examine the association between modifiable risk factors and psychiatric symptoms, defined based on the Persian version of the WHO-GSHS questionnaire in a developing country. Ten thousand three hundred fifty students, aged 6–18 years from all Iran provinces, participated in this study. We used feature discretization and encoding, stability selection, and regularized group method of data handling (GMDH) to classify the a priori specific factors (e.g., demographic, sleeping-time, life satisfaction, and birth-weight) to psychiatric symptoms. Self-rated health was the most critical feature. The selected modifiable factors were eating breakfast, screentime, salty snack for depression symptom, physical activity, salty snack for worriedness symptom, (abdominal) obesity, sweetened beverage, and sleep-hour for mild-to-moderate emotional symptoms. The area under the ROC curve of the GMDH was 0.75 (CI 95% 0.73–0.76) for the analyzed psychiatric symptoms using threefold cross-validation. It significantly outperformed the state-of-the-art (adjusted p < 0.05; McNemar's test). In this study, the association of psychiatric risk factors and the importance of modifiable nutrition and lifestyle factors were emphasized. However, as a cross-sectional study, no causality can be inferred.

Factors Associated with Tendency for Weight Loss in a Representative Sample of Children and Adolescents: The CASPIAN-V Study

Background:

This study aims to determine the factors affecting the tendency to lose weight (TLW) and its methods in Iranian children and adolescents.

Methods:

In this cross-sectional nationwide study 14800 students, aged 7–18 years, living in 30 provinces of Iran were selected via multistage cluster random sampling method. The dietary and physical activity habits and TLW as well as psychosocial health status, anxiety, self-satisfaction, and change in dietary behaviors were assessed by the global school-based student health survey (WHO-GSHS) questionnaire. Multivariate logistic regression model was used to identify factors influencing TLW.

Results:

Overall, 14274 students (participation rate of 99%), consisting of 51% boys and 71.4% urban residents, completed the study. Of them, 37.7% (51.4% Girls and 48.6% boys) tended to lose weight. In multivariate model, the odds for TLW was 12% higher in students aged 13–18 years than those aged 6–12 years (OR = 1.12, 95% CI: 1.02 to 1.23; P < 0.001). Students with high anxiety level were 43% more likely to have TLW (OR = 1.43, 95% CI: 1.28–1.59; P < 0.001). The odds of increasing physical activity for weight loss was 22% lower in obese than in normal weight students (OR = 0.78, 95% CI: 0.66 to 0.93; P < 0.001).

Conclusions:

TLW was significantly higher in girls, as well as in those with higher anxiety level. In addition to dietary change, increasing physical activity should be encouraged among children and adolescents with excess weight. Public education regarding proper lifestyle change for reaching healthy weight should be underscored.

The Relationship Between Body Image Concerns and Weight-Related Behaviours of Adolescents and Emerging Adults: A Systematic Review

This systematic review investigates evidence on the association between body image concerns and weight-related behaviours of adolescents and emerging adults. It includes peer-reviewed journal articles reporting research involving body image concerns and weight-related behaviours of adolescents and emerging adults, published between 2005–2017, and located through systematic searches from four databases. This review includes studies from 11 countries or regions: United States (n = 13), Asia (n = 9), Europe (n = 8), Middle East (n = 3), South America (Brazil; n = 3), Canada (n = 3), Australia (n = 1), New Zealand (n = 1), Trinidad (n = 1), Turkey (n = 1) and Seychelles (n = 1); 24 different countries (n = 1); three Asian countries and the United States (n = 1). Out of 46 studies included in this review, 45 studies reported a positive association between body image concerns and weight-related behaviours. Adolescents and emerging adults who misperceived their weight engaged in weight-related behaviours. Higher body dissatisfaction had a significant association in the development of eating disorders and extreme weight-loss behaviours. Body image concerns play a significant role in adolescents and emerging adults engaging in weight-related behaviours. Experimental research designs are required to determine the causality of this association. Evidence strongly suggests policy makers and public health practitioners contemplate strategies to promote positive body image and healthy weight-related behaviours among adolescents and emerging adults.

Obesity, body image, and its impact on children's eating and exercise behaviors in China: A nationwide longitudinal study

Body image seems to mediate the association between obesity and health behaviors as well as weight control attempts. We examined the distribution of children's body image by demographic characteristics and their subsequent associations with eating, exercise, and weight change. Child body image and health behaviors from the China Health National Survey 2000-2011 were assessed at baseline and in follow-up for 6- to 17-year-old children during 2000-2011 using mixed models. There was a large discrepancy between children's actual weight status (overweight: 16.9%) vs. self-rated body image (fat: 2.4% in 2011). Less than 1% of children desired a fat body; girls were more likely to want to be thin (52.5% vs. 40.9%) than boys. About 11% of children needed to lose weight in order to be at their desired baseline. During follow-up, those needing weight loss to be as desired were more likely to attempt dieting to change their weight (OR, 95% CI=1.9, 1.1-3.5 in boys; 1.7, 1.1-2.5 in girls) and less likely to feel they had enough physical activity (OR, 95% CI=0.5, 0.4-0.7 in boys; 0.6, 0.5-0.9 in girls), although their weight gain had been significantly higher than those having consistent self and desired body images (β [SE]=0.4 [0.1] in boys; 0.2 [0.1] in girls, all p<0.05). However, no significant difference was shown in subsequent health behaviors among overweight children by body image discrepancy. The discrepancy in self vs. desired body image motivated children to change their obesity-related health behaviors among non-overweight children in China.

Body Image and its Relation with Body Mass Index among Indian Adolescents

OBJECTIVE

To evaluate association of body mass index with perception and attitude towards bodyweight, shape and body image among adolescents.

Methods

This cross-sectional study was done on 1811 adolescents. Attitude towards body image was assessed by using a self-administered Multidimensional Body-Self Relations Questionnaire. Perceived body shape was measured using the Stunkard scale.

RESULTS

Adolescents showed significant difference (P<0.005) in perceptions and behaviors related to appearance, fitness, health, body areas and weight across various body mass index and socioeconomic categories. Girls articulated significantly higher (P<0.005) body dissatisfaction than boys.

CONCLUSION

Attitudes and perceptions towards body image differ with sex, body mass index and socioeconomic class.

Body image dissatisfaction and its determinants among young primary-school adolescents

Objectives

Awareness of body image perception among children and adolescents has been rising during recent years. The objectives of this study were to identify body image dissatisfaction and its associated factors among primary-school students.

Methods

A cross-sectional study was conducted in seven randomly selected primary schools, involving students aged 11 to 12. A guided self-administered questionnaire, which included sociodemographic data, body mass index (BMI) parameters, and body image perception (Childress Contour Drawing Rating Scale), was used.

Results

This study involved 776 primary-school students. Approximately 60.1% of students had body image dissatisfaction, which was significantly (p < 0.001) associated with sex and Body Mass Index (BMI). Females had 2.07 times higher rates of body image dissatisfaction (b = 0.73, OR = 2.07, 95% CI 1.53, 2.81, p < 0.001) compared to their male counterparts when adjusted for other variables. Overweight/obese students had 4.06 times greater body image dissatisfaction (b = 1.40, OR = 4.06, 95% CI 2.70, 6.10, p < 0.001) compared to students with normal BMI when adjusted for other variables.

Conclusion

This study highlights a high prevalence of body image dissatisfaction that is correlated with sex and BMI among primary-school students.

Association of some psychosocial factors with anthropometric measures in nationally representative sample of Iranian adolescents: the CASPIAN-III study

Background

During the last two decades, adolescent obesity has increased in western countries. In Iran-as a developing country- the prevalence of obesity is raised among youngsters as well. This study conducted to identify an association of adolescents’ loneliness, self-confidence and relationship with others in home and school environment with their weight status.

Methods

In this cross-sectional national survey, 5682 students aged 10–18 years from urban and rural districts of 27 provinces of Iran were selected via stratified multi-stage sampling method. Data on psychological problems of students was gathered through a questionnaire. Height, weight, and waist circumferences were measured according to standard protocols. Body mass index (BMI) and waist- to-height ratio was calculated.

Results

Boys which did not have best friends, spend time with their friends after school or get acceptance from them, had higher BMI than others. Only girls who did not spend time with their friends had higher BMI (19.48 ± 4.28) vs. (19.09 ± 3.92) and WC (71.04 ± 21.29) vs. (69.15 ± 17.43) than others, P < 0.05. In both sexes, adolescents who had sense of pressure about doing homework or had difficulties in relationship with their parents had higher BMI and WC values. Girls who reported being victim of violent behaviors (being bullied), had lower BMI compared to others. Risk of being overweight and obese, but not abdominal obese was statistically higher in adolescents not having close friends (OR = 1.81, CI: 1.11–2.95). Lack of self-confidence increased only the risk of obesity in teens (OR = 1033, CI: 1.09–1.64).

Conclusions

Our findings suggest that strategies for prevention of overweight and obesity in adolescent should be taking into account a deeper knowledge of psychosocial issues due to be able to design more effective programs for treating overweight teens.