Body image dissatisfaction and dietary patterns according to nutritional status in adolescents

The Association of Body Image Perceptions with Behavioral and Health Outcomes among Young Adults

This study was conducted on 5 March 2024, by the Universidad Europea de Madrid. This study aims to explore how body image perceptions influence health behaviors and mental and physical health outcomes among a specific group of 605 young adults aged 20 to 35 engaged in strength training regimes. To measure these perceptions, the Multidimensional Body-Self Relations Questionnaire (MBSRQ) was employed, an advanced tool that assesses multiple dimensions of body image through its subscales, including feelings of physical attractiveness, investment in one's appearance, and satisfaction with different body areas. Participants were segmented into two groups based on a median split of their self-reported body image. The survey assessed a diverse array of variables, including demographic details, physiological data, resistance training routines, and psychological attributes. In this revision, we consistently use the term 'dietary habits' to ensure clear and uniform language when discussing eating patterns. Notable differences were observed in dietary habits and exercise engagement, influenced significantly by body image perceptions. Negative body image was linked to less healthy dietary habits, diminished physical activity, and worse psychological outcomes, such as increased anxiety and depression. Conversely, a positive body image was associated with healthier dietary habits, more frequent physical activity, and better psychological health. The findings suggest that interventions aimed at improving body image could be crucial for enhancing overall health within this specific demographic. Due to the non-representative nature of the study group, conclusions are cautiously presented as applicable only to similar populations engaged in strength training. This study underscores the need for holistic strategies that encourage positive body image to improve both physical and psychological health outcomes in young adults.

[Body image dissatisfaction and low adherence to the Western dietary standard among schoolchildren: a cross-sectional study]

This study aimed to identify dietary patterns and to evaluate the association between body image perception and these patterns among schoolchildren. A cross-sectional study was conducted on 385 schoolchildren (both sexes, 10-17 years old) from four public schools in Salvador, Brazil. Two non-consecutive 24-hour dietary recalls were applied, and the dietary pattern was determined by Exploratory Factor Analysis after adjustment of dietary data using the Multiple Source Method. To evaluate body image perception, the Brazilian body shape silhouette was used. The associations between body image perception and dietary patterns using the polytomous logistic regression model adjusted for covariables was assessed. Three dietary patterns were obtained: "Western standard," unhealthy, "healthy pattern" and "typical dishes/ junk food." After adjustment, adolescents who wished for a slimmer silhouette (2.48 [95%CI: 1.04-6.11], 3.49 [95%CI: 1.35-9.05] and 2.87 [95%CI: 1.13-7.26]) were more likely to adhere to the quintiles with the lowest consumption of the Western standard, compared to those satisfied with their body image. No associations were identified in the other two dietary patterns. Adolescents dissatisfied with their bodies tend to adhere less to unhealthy dietary patterns.

Body image and dietary habits in adolescents: a systematic review

CONTEXT

Adolescence is a critical developmental stage in which increasing concerns about body image (BI) coincide with the consolidation of dietary habits (DHs). Multiple studies have sought robust associations between BI and DHs to prevent unhealthy behaviors.

OBJECTIVE

The aim of this systematic review was to examine the available literature on the association between BI perception (BIP) and/or satisfaction (BIS) and DHs in adolescents.

DATA SOURCES

A search was carried out of 5 electronic databases (PubMed, SciELO, Cochrane, Embase, and PsycInfo) using a combination of keywords (and synonyms) related to adolescence, BI, and diet.

DATA EXTRACTION

Data screening, extraction, and quality assessment were performed independently by 2 investigators using the PRISMA and AXIS guidelines.

DATA ANALYSIS

Of 2496 articles screened, 30 articles, published in English or Spanish, that evaluated the relationship between BI and DHs in adolescents aged between 10 years and 18 years, were included. A relationship between accurate BI perception in adolescents and healthy DHs was reported in 5 articles (16.2%). A relationship between overestimation of body weight in adolescents and healthy DHs was reported in 4 articles (13.3%). A relationship between underestimation of body weight and unhealthy DHs was reported in 8 articles (26.7%). In addition, 4 articles (13.3%) reported a relationship between BIS and healthy DHs. The desire to gain weight was associated with unhealthy DHs in 3 (10%) of the articles, while the desire to lose weight was related to healthy DHs in 3 (10%) of the articles and to unhealthy DHs in 3 (10%) other articles. There were also gender differences in the relationship between BIP or BIS and DHs.

CONCLUSION

Adolescents who underestimate their body weight tend to report less healthy DHs than body weight overestimators. Adolescents unsatisfied with their BI and with a drive for thinness frequently engage in DHs linked to losing weight.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020184625.

Diet-Related Attitudes, Beliefs, and Well-Being in Adolescents with a Vegetarian Lifestyle

Vegetarianism can meet healthy, ethical, or ecological values (such as equality and protection of animals or the environment). At the same time, it can represent a response to the need for self-determination in adolescence. Furthermore, some studies show vegetarians have greater depressive risk and a lower sense of body satisfaction. Considering the spread of non-meat diets in the Western world, researchers have investigated the benefits and risks to physical and psychological health. Despite this, few studies have been conducted on factors influencing adolescent's vegetarian diet-related attitudes. Through self-administered loosely structured interviews, this research investigated factors potentially associated with vegetarian choices in adolescence. It checked (a) gender differences in vegetarian choices; (b) religious, familial, ethical, or health factors implied in vegetarian choices; and (c) indicators of well-being among young vegetarians. The findings suggest that for our sample, non-vegetarians have lower scores on health-related questions than others, while for vegetarian adolescents, the benefits of vegetarianism mainly depend on their ethical stances, beliefs, and values. Conversely, it is unrelated to factors such as the desire to lose weight, dissatisfaction about one's body shape, or depressive feelings.

Is There an Association between Food Consumption According to the Degree of Processing and Body Image (Dis)satisfaction in Adolescents?

(1) Background: Adolescence is characterized by changes in eating habits, with increased consumption of ultra-processed foods and reduced intake of unprocessed or minimally processed foods, which can affect body image satisfaction. Thus, this study aims to verify the association of food consumption according to the degree of processing with body image (dis)satisfaction in adolescents from the 1997/1998 birth cohort of São Luís, Maranhão. (2) Methods: A cross-sectional study was conducted with 2515 adolescents aged between 18 and 19. Food consumption was stratified based on the NOVA classification in culinary preparations, processed foods, and ultra-processed foods, categorized into tertiles. Body image (dis)satisfaction was evaluated based on the Stunkard Body Scale and was classified as satisfaction, dissatisfaction with thinness, and dissatisfaction with excess weight. Multinomial logistic regression was used for associations. (3) Results: Among the adolescents, 77% considered themselves dissatisfied with their body image, with 42.8% dissatisfied with being thin and 34.2% dissatisfied with excess weight. However, food consumption, according to the degree of processing, was not associated with body image (dis)satisfaction. (4) Conclusion: This work highlighted the prevalence of body image dissatisfaction among adolescents but found no association between body (dis)satisfaction and food consumption according to the degree of processing.

Effects of social media on body dissatisfaction in junior high school girls in Japan

AIMS

Body dissatisfaction (BD) is a serious problem related to the incidence of eating disorders. Social media (SM) use is known to be associated with BD. With a view to preventing the incidence of eating disorders, this study aimed to investigate the association between SM and BD, particularly, the role of SM in the encouragement of thinness and its relationship with adolescent girls' BD.

METHODS

Junior high school girls aged 12-15 in Japan completed the Body Shape Questionnaire (BSQ), Eating Attitudes Test-26, Bulimic Investigatory Test Edinburgh, Depression Self-Rating Scale for Children, and SM usage. Participants were classified into two groups based on their BSQ cut-off score.

RESULTS

Overall, 161 students were recruited (44 participants with BD; 117 without BD). The BD group used SM more than the non-BD group (χ² (1) = 4.61, p = .032). The frequency of following SM accounts related to thinness was significantly higher in the BD group than in the non-BD group (χ² (1) = 7.76, p = .005). The association between BD and following SM accounts focused on thinness was the most important (adjusted OR = 3.82; 95 % CI: 1.05-13.89).

CONCLUSIONS

The risks of SM use increasing BD in adolescent girls should be considered to prevent mental disorders, including eating disorders.

Self-perception of physical appearance of adolescents and associated factors in Addis Ababa, Ethiopia

INTRODUCTION

Establishing a positive body image is a critical factor for adolescents' physical and mental health, as it determines self-confidence, and sustainable individual growth and development throughout their lives. This reality needs to be supported by evidences generated locally. However, there is a lack of information in this regard in the study setting. Thus, the aim of this study was to assess the self-perception of one's physical appearance and its associated factors among adolescents in Addis Ababa, Ethiopia.

METHODS AND MATERIALS

A community-based, cross-sectional study design was used to conduct the study. At the end of the multistage sampling procedure, a systematic random sampling technique was employed to select 308 study participants from selected districts. The questionnaire was adapted from previous studies as it was appropriate for local context. The data collectors were trained before the data collection and supervised during the data collection period, and the questionnaire was pretested. Bivariate logistic regression was used to identify candidate variables, and then variables with p<0.2 were taken to multiple logistic regressions to identify independent associated factors. Statistical significance was considered at P <0.05 with adjusted odds ratios calculated at 95% CIs.

RESULT

A total of 283 adolescents were participated in the study, with a response rate of 91.9%. The overall good self-perception of one's physical appearance was 48.4% [95% CI = 43.8, 54.1]. Having a BMI between 18.5 kg/m2-24.9 kg/m2 (AOR = 2.56; 95% CI: 1.45, 4.54), presence of enough sport fields in the school (AOR = 1.89; 95% CI: 1.09, 3.29), having daily access to internet services (AOR = 1.69; 95% CI: 1.07, 2.94), following Ethiopian movies/cinemas (AOR = 2.46; 95% CI: 1.46, 4.15), and regularly following western movies/cinemas (AOR = 2.0; 95% CI: 1.11, 3.59) were significantly associated with a good self-perception of one's physical appearance.

CONCLUSION

According to this study, only 48.4% of respondents reported a good self-perception of their physical appearance. Adolescents and their family need to work to bring normal body mass index, which in turn will increase good self-perceptions of their physical appearance. Schools and the local administrations need to increase availability and access to enough sport fields for students to strengthen their physical fitness, which increases their good self-perception of their physical appearance.

Restrained eating behaviour, anorexia nervosa and food consumption between children and adolescents: a scoping review

Anorexia nervosa (AN) and restrained eating behaviour (REB) are characterised by reduced food intake to achieve body weight loss. This scope review aimed to describe the existing evidence on the association between AN, restrictive eating behaviour and food consumption. Studies with children and adolescents of both sexes of all races and ethnicities were included. Experimental and observational studies, systematic reviews, meta-analysis, case reports or series, conference abstracts, dissertations and theses were also included. The search was conducted in ten electronic databases and grey literature without language restriction on 14 November 2020. Twenty-four studies met the inclusion criteria. Most studies included girls and identified lower intake of energy content, fat and certain micronutrients. There was also a higher intake of caffeine, fibre, vegetables, legumes and fruits and a lower intake of low-quality snack, fast food, sweets and foods with high carbohydrate and fat contents. The need to improve the quality of the diet among study participants was also identified. Thus, it is recommended that the evaluation of food consumption be careful to develop effective prevention strategies for the development of AN/REB and minimise nutritional deficiencies in these individuals.

Implementation of food education in school environments improves pupils' eating patterns and social participation in school dining

OBJECTIVE

Schools can be an effective arena for food education. The Tasty School is a tailored teacher-driven food education model that provides tools for implementing food education in primary schools. This study aimed to investigate the effects of the Tasty School model on pupils' eating patterns and experiences. We also aimed to assess the implementation strength of the Tasty School.

DESIGN

A quasi-experimental study was conducted during one school year 2019-2020 in fifteen intervention and ten control schools. The intervention schools implemented the Tasty School food education model. The pupils completed web-based baseline and follow-up questionnaires in class during a school day. The principals were interviewed after the intervention. The data were analysed using a mixed-effects model for repeated measures, accounting for the implementation strength and selected standardisation effects.

SETTING

A total of twenty-five general Finnish primary schools.

PARTICIPANTS

1480 pupils from grades 3-6 (age 8-12 years) from five municipalities in Finland.

RESULTS

Percentages of pupils eating a balanced school meal increased in schools where food education was actively implemented (P = 0·027). In addition, pupils' experience of social participation in school dining strengthened in schools where the Tasty School model was implemented (5-point scale mean from 2·41 to 2·61; P = 0·017).

CONCLUSIONS

Healthy eating patterns can be promoted by the active implementation of food education in primary schools. The Tasty School model offers a promising tool for developing healthy eating patterns and increasing social participation among pupils not only in Finland, but also potentially in other countries as well.

The relationship between self-esteem, body dissatisfaction, and eating attitudes in bariatric surgery candidates

Objectives

Considering the effects of self-esteem, eating attitudes and body satisfaction on obesity and bariatric surgery outcomes, psychiatric evaluation is important for the identification and treatment of psychopathology, improvement of self-esteem, eating attitudes and body satisfaction. In this study, it was aimed to determine the relation between eating behaviors, body dissatisfaction, self-esteem and psychological symptoms in patients seeking bariatric surgery. Our second aim was to determine whether depressive symptoms and anxiety had a mediating role in the relationship between body satisfaction and self-esteem and eating attitudes.

Material and Methods

The study included 200 patients. Patients' data were retrospectively evaluated. Psychometric evaluation performed during the preoperative period included psychiatric examination and administration of the Beck Depression Inventory, Beck Anxiety Inventory, Rosenberg SelfEsteem Scale, Body-Cathexis Scale, and Dutch Eating Behaviors Questionnaire.

Results

There was a positive correlation between self-esteem and body satisfaction and a negative correlation between self-esteem and emotional eating (r= 0.160, p= 0.024; r= -0.261, p <0.001 respectively). Body satisfaction had an effect on emotional eating mediated by depression and an effect on external and restrictive eating mediated by anxiety. Furthermore, anxiety mediated the relations between self-esteem and external and restrictive eating behaviors.

Conclusion

Our finding indicating that depression and anxiety have mediator effects on the relation between self-esteem, body dissatisfaction, and eating attitudes is significant since screening for these entities and their treatment is relatively more practical in clinical settings.

Association of Weight Perception, Body Satisfaction, and Weight Loss Intention With Patterns of Health Risk Behaviors in Adolescents With Overweight and Obesity

Obesity is a public health issue and childhood is a critical window in which to establish healthy eating patterns and modify risk factors for overweight. This study aims to verify the association of weight perception, body satisfaction, and weight loss intention with patterns of health risk behaviors in adolescents with overweight and obesity. We analyzed health risk behavior from a school-based national survey conducted in 2015 in Brazil (n = 2,703 students with overweight or obesity, aged 13-17 years). We performed latent class analysis of alcohol consumption, tobacco use, physical activity, screen time, and eating habits for adolescents with overweight and identified four distinct health behavior patterns. The association of these patterns with weight perception, body satisfaction, and weight loss intention was analyzed through multinomial logistic regression. Adolescents who perceived themselves as "fat" or "very fat" were more likely to have a sedentary lifestyle and low consumption of fruit and vegetables. Body satisfaction was a protective factor against sedentary lifestyle. Students who reported weight loss intention were less likely to be in high-health-risk behavior groups (low consumption of fruit and vegetables; sedentary lifestyle; tobacco and alcohol use). Self-perception as overweight had detrimental associations, while body satisfaction was a protective factor for a healthy lifestyle. Weight loss intention still requires rigorous analysis due to inconsistencies in the literature. The complexity of the relationship between body image and obesity needs to be highlighted. Multicomponent strategies are required to control the global obesity pandemic.

Agreement of adolescents’ self-perception of their body image with the analysis on the three-dimensional body image

Abstract Objectives: to verify the agreement among adolescents’ perception of their own body image and the health professionals’ analysis based on three-dimensional body image and the inter-rater agreement. Methods: a cross-sectional study was carried out with 1,662 adolescents, aged 18 to 19 years old, from the 1997/98 birth cohort in São Luís, Maranhão. Self-perception of body image was assessed using the Stunkard’s body image scale. Three nutritionists evaluated the three-dimensional body image obtained by the Photonic Scanner (3D Body Scanner) and classified according to the Stunkard’s scale. The agreement between raters was verified by using weighted Kappa. Results: the analysis of agreement between raters in the general group and when stratified by sexwas considered moderate to good by Kappa. Regarding the intraclass correlation (ICC), good and excellent correlation values were observed both in the general group, males and females. There was a greater perception of overweight by all raters, when compared with the adolescents’ self-assessments. When stratified by sex, examiner 1 had the same perception as male self-assessments, as for females the perception of overweight was more frequent, as well as raters 2 and 3, for both sexes. Conclusion: agreement between raters and self-assessments was considered weak/moderate in Kappa and good/excellent in ICC.

Novel anthropometric predictors of subjective weight among women

The main aim of the current study was to examine novel anthropometric predictors of subjective weight among women. In this cross-sectional study, 229 women were selected through simple random sampling method. The participants completed the Multidimensional Body Self-Relation Questionnaire. Pearson correlation coefficient and linear regression were used to analyze the data. The mean subjective weight score was 4.05 ± 1.01. There was a significant relationship between anthropometric indices and subjective weight (Pearson r correlation range: 0.62-0.81, p < .01). Beta coefficients for predictor variables indicated that weight (ß = -2.774, t (229) = -2.868, p = .005), hip circumference (ß = 3.454, t (229) = 5.999, p < .001), waist to hip ratio (ß = 4.218, t (229) = 4.953, p < .001), waist to height ratio (ß = -3.284, t (229) = -2.067, p = .04), and conicity index (ß = -0.708, t (229) = -2.518, p = .013) significantly predicted the subjective weight. The waist to hip ratio was the most important predictor of the subjective weight. This study suggests using the waist to hip ratio as an anthropometric index in subjective weight studies in women. Considering the negative impact of subjective weight on women's health, these results indicate the need for interventions designed to control body weight and unsuitable anthropometric indices in women.

The Association of Body Image Perception With Dietary and Physical Activity Behaviors Among Adolescents in Indonesia

BACKGROUND

Growing evidence highlights the linkage between body image, eating, and exercise behaviors among adolescents.

OBJECTIVE

This study aims to determine the association between body image perception, nutritional status, and dietary and physical activity behaviors among adolescents in Indonesia.

METHODS

A cross-sectional household survey was conducted among a representative sample (n = 2160) of adolescent girls and boys aged 12 to 18 years in Klaten and Lombok Barat districts. The association between adolescents' body image, their diets, and physical activity patterns was determined using complex samples Cox's regression analysis. Separate multivariate models were developed for adolescent girls and boys.

RESULTS

Physical appearance was considered important to nearly all adolescents. Approximately 11% of girls and 14% of boys were overweight or obese, the majority of whom (∼70%) correctly perceived themselves as overweight or obese. More of overweight or obese adolescents felt unhappy about their perceived weight than their thin counterparts. With respect to the overweight/obese girls, the adolescents' perceptions of being overweight or obese was associated with a 63% reduction in the prevalence of overweight/obese girls consuming fatty snacks, such as deep-fried crackers (adjusted prevalence ratio (PR): 0.37, 95% confidence interval (CI): 0.19-0.71) and a 40% reduction in the prevalence of overweight/obese girls engaging in moderate-intensity physical activity (adjusted PR: 0.60, 95% CI: 0.38-0.94), after adjusting for potential confounders. No association between body image and eating and physical activity behaviors was observed among adolescent boys.

CONCLUSIONS

Body image may be one of the most important determinants of dietary and physical activity behaviors, and thus future efforts to foster healthy eating and physical activity behaviors among Indonesian adolescents need to address body image concerns.

Is fast-food consumption a problem among adolescents in Malaysia? An analysis of the National School-Based Nutrition Survey, 2012

BACKGROUND

Fast-food consumption is an unhealthy dietary behaviour because it increases the risk of diet-related chronic diseases. We aimed to investigate factors associated with fast-food consumption, namely sociodemographic characteristics, body mass index-for-age, meal away from home habit, and intake of various food groups among adolescents in Malaysia.

METHODS

We analysed data from the National School-Based Nutrition Survey (NSNS). The NSNS was a nationwide, cross-sectional survey. Multiple-stage stratified cluster random sampling method was applied to obtain a representative sample of adolescents' population. This study recruited adolescents aged 10-18 years who were attending schools. Pre-tested self-administered questionnaires in Malay language were used to obtain relevant information. Frequency of fast-food consumption per week was classified into three groups: "consumed fast-food four to seven days", "consumed fast-food one to three days", and "did not consume fast-food". Intake of food groups was assessed by self-administered food frequency questionnaire. Descriptive and complex sample multinomial logistic regression analyses were performed in data analysis.

RESULTS

A total of 26,383 from 40,012 selected adolescents completed all the relevant questions for this study. Of those surveyed, 13.5% of the respondents consumed fast-food 4 to 7 days, 69.3% of the respondents consumed fast food 1 to 3 days, and 17.2% of them did not consume fast-food in a typical week. Frequency of fast-food consumptions (4 to 7 days and 1 to 3 days per week) was significantly associated with age; sex; ethnicity; locality of schools; frequency of eating out; and not consuming recommended intake of cereals or grains, vegetables, and meat or poultry or eggs.

CONCLUSION

In conclusion, age; sex; ethnicity; locality of schools; frequency of eating out per week; imbalanced intake of cereals or grains, meat, or poultry or eggs; and inadequate vegetable intake were significantly associated with fast-food consumption among adolescents in Malaysia. The findings of this study will be useful for policy makers in promoting healthy food choices among adolescents in Malaysia.

Effects of Nutrition, and Physical Activity Habits and Perceptions on Body Mass Index (BMI) in Children Aged 12-15 Years: A Cross-Sectional Study Comparing Boys and Girls

Background: The aim of the present study was to examine the effects of socioeconomic status, nutrition and physical activity lifestyle habits and perceptions on Body Mass Index (BMI) in children aged 12-15 years in Greece. Furthermore, to compare the difference between the two sexes. Methods: This is a cross-sectional study conducted on a representative secondary school cohort that included 5144 subjects, aged 12 to 15 years. Students and their parents filled in validated questionnaires evaluating socioeconomic status, nutrition and physical activity. International Obesity Task Force cut offs were used to classify the children. Factor analysis of mixed data and partial proportional ordered logistic models were used to analyze ΒMΙ distributions. All analyses were stratified by gender. Results: Boys were 2.9 (95%CI: 2.592-3.328) times more likely to be overweight/obese than girls. Partial proportional ordinal models indicate significant associations between nutritional and physical habits and perceptions variables but also significant gender differences in socio-demographic, nutritional risk factors as well as physical activity habits and perceptions. Conclusions: A clear understanding of the factors that contribute to the sex differences in nutrition and physical activity habits and perceptions may guide intervention efforts.

Alternative diets among adolescents: facts or fads?

PURPOSE OF REVIEW

With rising rates of chronic noninfectious diseases across the United States thought to be associated with the average American diet, many have adopted alternative diets. Most of these diets promise weight reduction via adherence to strict dietary guidelines, often removing certain types of food. With access to a plethora of information online, it is easy for adolescents to become confused when making dietary decisions. Although these diets promise benefits, it is important to understand common shortcomings and how to overcome them for safe implementation among adolescents.

RECENT FINDINGS

This review discusses the theory, implementation, and risks associated with intermittent fasting as well as vegetarian, vegan, ketogenic, Atkins, Paleolithic, and Mediterranean diets. These considerations are further modified for pediatric populations with a focus on the social influences on dieting.

SUMMARY

Although these diets may be promising, successful adherence to them requires addressing possible shortcomings associated with a certain diet. Pediatricians should be aware of how these dietary strategies may be properly implemented in order to prevent any harm to the patient. Empowering the patient and their families through informational resources is recommended. Pediatricians should also discuss motivations underlying their patient's dietary changes in order to determine whether these motivations are healthy.

Disentangling the Drivers of Obesity: An Analytical Framework Based on Socioeconomic and Intrapersonal Factors

Obesity is increasing at exponential rates in developed economies despite the numerous policy interventions being implemented. The causes of obesity are multifactorial demanding a holistic review for targeted intervention. This study, therefore, provides a holistic overview of multiple factors affecting body weights i.e., socioeconomic and intrapersonal factors. We used data from a household and experimental survey carried out in Spain (Barcelona) in 2014. A non-linear path analysis was used considering the non-linear relationships that might exist between these factors and body weight. Results confirm non-linear relationships between some socioeconomic, intrapersonal factors and body weight. Among the intrapersonal factors, obesity is directly influenced by volitional control of obesity, attitude toward obese persons, holding a correct body image and body image dissatisfaction. Socioeconomic factors that have significant influence on obesity were age, education and gender. Risk attitudes do not correlate with obesity.

Patterns of Dietary Iron Intake, Iron Status, and Predictors of Haemoglobin Levels among Early Adolescents in a Rural Ghanaian District

Introduction

Early adolescents are vulnerable to anaemia due to lean body mass and menarche. The study assessed patterns of dietary iron intake, iron status, and predictors of anaemia among early adolescents.

Method

One hundred and thirty-seven early adolescents were randomly selected in a rural district in Ghana. Multiple-pass 24-hour recall, iron food frequency questionnaire consisting of 27 food items, and semistructured questionnaire were administered. Variables include sociodemographics, dietary factors, and laboratory investigation including haemoglobin, ferritin, and C-reactive protein examination. Statistical Package for the Social Sciences (SPSS) software was used to calculate odds ratio and perform Mann–Whitney U test, chi-square (X²) test, exploratory factor analysis, and partial correlation (r) tests.

Results

Participants had mean age of 11.5 years. Three iron dietary patterns explaining 28.7% of the total variance were identified: iron dietary pattern 1 (11%) composed of iron-rich, iron-enhancing, and iron-inhibiting foods; iron dietary pattern 2 (9.9%) comprised of iron-rich, iron-enhancing, and non-iron-inhibiting foods; and iron dietary pattern 3 (7.1%) consisting of stinging nettle, iron-inhibiting foods, non-iron-enhancing foods, non-cocoyam leaves, and non-turkey berries. Meal skipping (X² = 5.7, p < 0.05), times of eating a day (X² = 12.6, p < 0.05), and guardian educational status (X² = 6.7, p < 0.05) significantly affected dietary iron intake. Anaemia was associated with meal skipping (β = 0.367, p > 0.05), snacking (β = 0.484, p > 0.05), and junior high school (JHS) education (β = 0.544, p > 0.05). Partial correlation showed statistically significant relationship between iron dietary pattern 1 and dietary iron (r = −0.234, p < 0.01), iron dietary pattern 2 and dietary iron (r = -0.198, p < 0.05), iron dietary pattern 2 and vitamin C (r = -0.201, p < 0.05), and haemoglobin and ferritin (r = −0.178, p < 0.05).

Conclusion

Meal skipping, guardian educational status, and number of times of eating a day were significantly associated with dietary iron intake. Meal skipping, snacking, and adolescents with JHS education were positively associated with anaemia.

Relationship of sociodemographic conditions with the formation of body image in Brazilian adolescents

ABSTRACT Objective To investigate the associations between sociodemographic population conditions and adolescents’ body image Methods This is a cross-sectional study using data from the Pesquisa Nacional de Saúde do Escolar (PeNSE, National School Health Survey), conducted in 2015. The objective was to analyze the relationship between students’ sociodemographic conditions and body image attending public and private schools in Brazil capitals and the Federal District. For the statistical analysis, we conducted the Poisson regression models, generating adjusted prevalence ratios and their respective 95% CI. In the multiple models, sociodemographic variables were included, which were significantly associated with body image variables (p<0.05) or which altered the prevalence ratios by at least 10%. Results The research involved 10,926 adolescentes The analyses showed that the older the adolescents, the greater their dissatisfaction with their body. As for the school administrative status, students from private schools were more unhappy with their image (Girls: 33% and Boys: 17.6%) and, they tend to have more attitudes to lose weight (Girls: 42.8% and Boys: 28%). The mother’s level of education causes daughters to be more dissatisfied with their bodies (33.3%) and sons showing more attitudes of wanting to lose weight (26.6%). Conclusion Sociodemographic conditions are directly and indirectly associated with the adolescents’ body image. Negative deviations in body image can result in binge eating and social disorders hindering the development of these pubescent children. The consequences of these actions become a risk to health and psychological well-being, strongly supporting the initiative of programs aimed at issues related to body image in the school setting.

ASSOCIATION BETWEEN BODY WEIGHT PERCEPTION AND QUALITY OF DIET IN BRAZILIAN ADOLESCENTS

Objective:

To evaluate the association between body weight perception and quality of diet among Brazilian adolescents.

Methods:

The sample was composed of 71,740 adolescents aged from 12 to 17 years-old enrolled in the Study of Cardiovascular Risks in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA), carried out during 2013-2014. Body weight perception was self-reported. Food consumption was assessed by food record and quality of diet index for Brazilian adolescents (DQIA-BR) was calculated, considering the balance, diversity, and diet composition. The quality of diet was compared according to weight perception for the entire sample and after stratification by nutritional status. Linear regression models were used to assess the association between body weight perception and quality of diet.

Results:

Among the studied adolescents, 14.7 and 30.3% reported to be underweight or overweight in relation to their desired weight, respectively. Those who perceived themselves as overweight had lower quality of diet (DQIA-BR=16.0 vs. 17.4 points; p<0.001). After stratification by BMI, adolescents with normal weight (DQIA-BR=15.3 points) or overweight (DQIA-BR=16.1 points), but who perceived themselves as overweight showed lower quality of diet when compared to their peers. In adjusted analysis, overweight perception (β= -0.51; 95%CI -0.77; -0.24) was associated to lower quality of diet. However, this association was no longer significant after stratification by BMI status.

Conclusions:

Body weight perception can influence the consumption of healthy foods and the quality of diet, especially for those who consider themselves overweight. However, this association is influenced by nutritional status.

Understanding the Influence of Eating Patterns on Binge Drinking: A Mediation Model

BACKGROUND

Binge drinking is an important health problem, and it has been related to binge eating and fat intake in animal models, but this relationship has not been tested in humans. The first objective of this study was to analyze whether binge eating and fat intake are related to binge drinking in a youth sample. The second objective was to analyze whether binge eating and fat intake mediate the relationship between individual factors associated with binge eating and fat intake (sex, body mass index (BMI), drive for thinness, body dissatisfaction, eating styles, impulsivity, and food addiction) and binge drinking.

METHODS

A sample of 428 undergraduate students filled out several questionnaires on binge drinking, binge eating, fat intake, drive for thinness, body dissatisfaction, eating styles, food addiction, and impulsivity.

RESULTS

Results showed an excellent model fit: χ2(25) = 30.342 (p = 0.212), comparative fit index (CFI) = 0.992, root mean squared error of approximation (RMSEA) = 0.022 [90% CI = 0.000, 0.047]. Binge eating and fat intake were positively related to binge drinking. Furthermore, emotional eating, external eating, and food addiction showed positive and statistically significant indirect relationships with binge drinking, whereas the relationship with restrained eating was negative.

CONCLUSIONS

These findings point to the need to use a broader approach in understanding and preventing binge drinking in the youth population by showing the influence of the eating pattern on this problem. This information could be helpful in preventing future behaviors and improving interventions that address health risk behaviors.

The Homeostatic Theory of Obesity: An Empirical Verification of the Circle of Discontent with an Assessment of Its Relationship to Restrained and Uncontrolled Eating among Children and Adolescents

The purpose of the present study was to provide an empirical verification of the Circle of Discontent with an assessment of its relationship to restrained and uncontrolled eating among children and adolescents. This study examined whether our results confirm a new hypothesized model. The total sample comprised 282 children and adolescents (148 girls and 134 boys; 141 participants with normal body weight and 141 with obesity). The mean age was 12.23 years (SD = 2.80), and the average BMI (body mass index) was 23.29 kg/m² (SD = 6.27). The following were used: Positive and Negative Affect Scale for Children, Children’s Body Image Scale, Figure Rating Scale, Three-Factor Eating Questionnaire and Eating Disorders in Youth. The obtained values of the model fit indices proved the goodness of fit. Our findings show that obesity accompanies body dissatisfaction and uncontrolled and restrictive eating. Moreover, the higher the level of restrictive eating, the lower the level of uncontrolled eating. The relationships between body dissatisfaction, negative affect and restrictive eating, as well as that between uncontrolled eating and high-energy consumption, are significant and positive. Other relationships are non-significant. The above-mentioned relationships established in the Circle of Discontent, as well as relationships of restrained and uncontrolled eating with variables described in the circle, were confirmed. Based on our results, preventive strategies and psychological interventions can be created and may include changes in body image, eating behaviors and emotional functioning.

Insatisfação com a imagem corporal e fatores associados em estudantes universitários

RESUMO Objetivo Avaliar a prevalência de insatisfação com a imagem corporal e os fatores associados entre universitários da área da saúde. Métodos Trata-se de um estudo descritivo, de caráter transversal e abordagem quantitativa, com 364 acadêmicos matriculados em cinco cursos da área da saúde. Para a obtenção dos dados, foram utilizados seis instrumentos autoaplicáveis: questionário socioeconômico, demográfico e de hábitos de vida adaptado do Vigitel, o Body Shape Questionnaire (BSQ), o Eating Attitudes Test (EAT-26), o Questionário Internacional de Atividade Física (IPAQ), o Inventário de Ansiedade de Beck (BAI) e o Inventário de Depressão de Beck (BDI). Foram coletadas, ainda, as medidas antropométricas. A associação entre as variáveis estudadas e a insatisfação com a imagem corporal foi verificada por análise bivariada seguida de regressão logística, com variância robusta. Resultados Houve prevalência de insatisfação com a imagem corporal de 9,1% entre os universitários. As variáveis que, após análise múltipla, se mostraram associadas a maior prevalência de insatisfação com a imagem corporal foram: cor da pele não branca, realização de tratamento para perder peso, presença de atitudes para transtorno alimentar, estado de saúde regular/ruim, ansiedade moderada/grave e circunferência abdominal. Conclusão A prevalência com a insatisfação com a imagem corporal nos universitários foi baixa, entretanto fatores sociodemográficos, estilo de vida, estado de saúde e condições clínicas e antropométricas mostraram-se associados com a prevalência da insatisfação com a imagem corporal.

Racial/Ethnic Disparities in US Adolescents' Dietary Quality and Its Modification by Weight-Related Factors and Physical Activity

There are well-known disparities in the prevalence of obesity across racial-ethnic groups, although the behavioral and psychological factors driving these disparities are less well understood. Therefore, the objectives of this study were: (1) to examine differences in dietary quality by race/ethnicity and weight-related variables [body mass index (BMI), weight loss attempt, and weight dissatisfaction] and physical activity (PA) using the Health Eating Index-2015 (HEI-2015); and (2) to investigate the interactions and independent associations of race/ethnicity, weight-related variables and PA on dietary quality. Data for adolescents aged 12–19 years (n = 3373) were abstracted from the 2007–2014 National Health and Nutrition and Examination Survey and analyzed using multiple PROC SURVEYREG, adjusting for demographics and accounting for complex sampling. Analyses determined that Hispanic males had better overall HEI-2015 scores than non-Hispanic whites (48.4 ± 0.5 vs. 45.7 ± 0.6, p = 0.003) or blacks (48.4 ± 0.5 vs. 45.5 ± 0.5, p < 0.001). Hispanic females also had better dietary quality than non-Hispanic whites (50.2 ± 0.4 vs. 47.5 ± 0.5, p < 0.001) and blacks (50.2 ± 0.4 vs. 47.1 ± 0.5, p < 0.001). Meeting the PA recommendation modified racial/ethnic differences in dietary quality for females (p = 0.011) and this was primarily driven by the associations among non-Hispanic white females (ΔR² = 2.6%, p = 0.0004). The study identified racial/ethnic and gender differences among adolescents in factors that may promote obesity. Results may be useful for obesity prevention efforts designed to reduce health disparities in adolescents.

Association of Health Status and Health Behaviors with Weight Satisfaction vs. Body Image Concern: Analysis of 5888 Undergraduates in Egypt, Palestine, and Finland

Little is known about the relationships between weight satisfaction, body image concern, healthy nutrition, health awareness, and physical activity among college students across culturally different countries. We assessed country and sex-specific associations between health status (self-rated health, depression, BMI), healthy behavior (healthy nutrition, physical activity, health awareness), weight satisfaction, and body image concern via a cross-sectional survey (5888 undergraduates) in Egypt, Palestine, and Finland. This health and wellbeing survey employed identical self-administered paper questionnaires administered at several Universities in two Eastern Mediterranean countries (Egypt, Palestine—Gaza Strip), and an online-survey comprising the same questions in Finland. Regression analyses were employed. Health status variables exhibited the strongest associations; high BMI and more depressive symptoms were more often among students satisfied with their weight (except in Palestine), but they were positively associated with body image concern irrespective of country or gender. Self-rated health was not associated with body image concern or weight satisfaction. Healthy behaviors were not associated with body image concern or weight satisfaction. Depressive symptoms and BMI were the most prominent predictors for body image concern. There were country-specific consistent results when using the body image concern score. Further research is necessary to compare body image across different cultures and countries.

Association of body image (dis)satisfaction and perception with food consumption according to the NOVA classification: Pró-Saúde Study

The literature on body image and food consumption has generally focused on isolated food items, while overlooking the growing role of ultra-processed foods in the overall diet. The objective of this study was to assess the association of body image (dis)satisfaction and perception with food consumption, according to the NOVA classification, which takes into account the extent and purpose of industrial food processing. A silhouette scale developed considering the Brazilian adults' Body Mass Index was used to assess body image (dis)satisfaction and perception. Food consumption was evaluated using a Food Frequency Questionnaire, and its items were categorized into three groups: unprocessed or minimally-processed foods and culinary preparations; processed foods; ultra-processed foods. The association was assessed using linear regression models. A total of 514 of Brazilian university employees were evaluated. Women dissatisfied due to excess weight consumed less unprocessed or minimally-processed foods and culinary preparations (-6.6, 95% CI: -10.7; -2.5) and more ultra-processed foods (3.7, 95% CI: 0.1; 7.2) compared to satisfied. Women that overestimated their body size consumed less unprocessed or minimally-processed food and culinary preparations (-4.2, 95% CI: -7.3; -1.1), compared to those who had not distorted body image. Food consumption appears to be more strongly associated with body image (dis)satisfaction than with perception. An association was established between body image dissatisfaction and unhealthy eating habits. This relation deserves public health attention since it may contribute to the development of chronic diseases and reduce the quality of life and body image assessment could be adopted by nutritionists and other health professionals in their practice.

Influence of the Mass Media and Body Dissatisfaction on the Risk in Adolescents of Developing Eating Disorders

Media influence may lead adolescents to internalize patterns of physical beauty, resulting in dissatisfaction with their own bodies when they are unable to match up to these patterns. In the constant search for an ‘ideal body’, adolescents may begin to develop risk behaviors for the development of eating disorders (ED). The object of this study was to analyze the influence of the mass media on body dissatisfaction (BD) and on ED in adolescents, comparing genders. We also analyzed the influence of BD on the risk of developing unsuitable eating behaviors, with risk of ED, comparing genders. A cross-sectional study was carried out with 1011 adolescents: 527 girls and 484 boys. The BMI of each adolescent was determined, and the instruments EAT-26, Sociocultural Attitudes towards Appearance Questionnaire-3 (SATAQ-3), and body shape questionnaire (BSQ), were applied. For statistical analysis, we used Student’s t-test, the chi-square test, Pearson’s correlation test, the odds ratio, and hierarchical multiple linear regression. The influence of the mass media is associated with a greater probability of adolescents presenting BD. An increase in BD is associated with an increased risk of developing ED in adolescents of both genders but is greater in girls than in boys. Furthermore, the influence of the MM and BMI are predictors of BD in both genders; and BD is a predictor of ED risk in both girls and boys.

Body Image Concerns and Body Weight Overestimation Do Not Promote Healthy Behaviour: Evidence from Adolescents in Lithuania

The present study aimed to explore the associations between body image concerns, body weight evaluation, disordered eating, nutrition habits, self-esteem, and physical activity (PA) in a mixed sample of adolescents of both genders. Methods. A total sample of 579 adolescents (299, 51.6% were girls) participated in this study. The participants ranged in age from 14–16 years old (M = 15.0, SD = 0.4). Respondents provided their answers filling in the questionnaires consisting of a battery of self-report questionnaires. An analysis of covariance was employed to test the hypothesis about the differences in body image concerns in the groups of BMI and body weight estimation controlling for gender. Results. Adolescents with a higher body mass index (BMI) and those overestimating body weight reported a higher body dissatisfaction (BD), a drive for thinness (DT), social physique anxiety (SPA), disordered eating, and lower self-esteem, but there were no differences in PA. Body weight overestimation was more prevalent in girls, yet body weight underestimation was more prevalent in boys. In girls, a higher BMI and body weight overestimation were associated with having less sweets, a lower frequency of having breakfast and for just a lower BMI alone—with consuming less fats, spreads, and oils. In boys, the BMI was associated with consuming less fruits and berries. The boys’ body weight overestimation was related to a lower reported number of meals, a lower frequency of breakfast, and a lower consumption of milk, cheese, yogurt, fats, spreads, and oils. Body dissatisfaction in boys and girls was negatively related to the number of meals, DT is related to a lower breakfast consumption (in girls), SPA was related to a lower nutrition score (in boys), the number of meals (boys and girls), and a lower use of meat and vegetables (boys). Conclusions. Adolescents with a higher BMI and body weight overestimation demonstrated higher body image concerns, lower self-esteem and a poorer eating-related behavioural profile. Body image concerns and body weight overestimation did not promote healthy behaviour in adolescents. It is critical to promote a positive body image, adequate body weight evaluation, self-esteem, and a healthy lifestyle in health promotion and health education programs for adolescents of both genders and different BMIs.

Orthorexic Tendency in Polish Students: Exploring Association with Dietary Patterns, Body Satisfaction and Weight

Body dissatisfaction is central to clinically diagnosed eating disorders (ED) and seems to be important in causing other non-clinical disorders, including orthorexia nervosa (ON). It can also affect eating behaviors. The aim of this study was to assess the associations of ON tendency with dietary patterns (DPs) and body satisfaction. The data were collected in 2017 through questionnaire survey among 1120 students of health-oriented and other academic programs from seven universities in Poland. Principal components analysis (PCA) was conducted to derive DPs and body satisfaction factors. Six DPs, such as, ‘High-sugar products & snacks’, ‘Fresh products & nuts’, ‘Fatty products & dressings’, ‘Oils & potatoes’, ‘Dairy products & whole-meal bread’, ‘Meat’, and two body satisfaction factors, such as, ‘Bottom body & weight’, and ‘Upper body’ were identified. ON tendency was measured using ORTO-15 questionnaire with both cut-offs, i.e., 35 and 40. Logistic regression analysis was used to verify associations between ON tendency, body satisfaction factors, and DPs. More students of health related majors were characterized by ON tendency in comparison to students of other majors (35.9 vs. 37.2; p < 0.001). More women were dissatisfied with ‘Bottom body & weight compared to men (<0.001). The higher the body mass index (BMI), the more people were dissatisfied with ‘Bottom body & weight’ (p < 0.001). More students with ON tendency were satisfied with their ‘Upper body’ than those without ON tendency, but there were no differences in ON tendency in regard to ‘Bottom body & weight’ satisfaction. ON tendency was associated with more frequent consumption of vegetables, fruits, nuts and seeds, and less frequent consumption of products high in sugar, snacks, fatty products and dressings. Using cut-off at 35 in ORTO-15 seems to be more appropriate than cut-off at 40 to identify external variables describing ON. Future research on orthorexia nervosa should use other research tools than ORTO-15 to better identify individuals with ON and to confirm our findings.

Padrões alimentares de adolescentes brasileiros por regiões geográficas: análise do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA)

O estudo teve como objetivo identificar os padrões alimentares de adolescentes brasileiros para cada uma das cinco regiões do país, e verificar se há diferença na adesão dos padrões alimentares de acordo com idade, sexo e tipo de escola. Foram analisados dados de 71.298 adolescentes de 12 a 17 anos que participaram do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA), pesquisa transversal, nacional, multicêntrica e de base escolar. Os dados de consumo alimentar foram obtidos por meio de recordatório alimentar de 24hs, e para a identificação dos padrões alimentares foi aplicada análise fatorial. A associação entre as características dos adolescentes e os padrões alimentares foi verificada por meio de análises de regressão linear, estratificadas por idade e ajustadas por estado nutricional, ingestão energética total e atividade física. Nas cinco regiões foram identificados três padrões alimentares com características similares: padrão tradicional, padrão pão e café e padrão não saudável. A Região Norte apresentou um quarto padrão alimentar caracterizado por alimentos típicos da região: padrão tradicional Norte. Em todas as regiões, os adolescentes do sexo masculino registraram maior adesão ao padrão tradicional e menor adesão ao padrão não saudável. entre os estudantes de escolas privadas foi observada maior adesão ao padrão não saudável e menor adesão ao padrão tradicional. Os resultados sugerem que, entre os adolescentes avaliados, ser do sexo masculino foi associado ao maior consumo de alimentos tradicionalmente brasileiros como o arroz e feijão, já o maior nível socioeconômico esteve associado ao consumo de alimentos não saudáveis como bebidas açucaradas e lanches.

Dietary patterns, sociodemographic and behavioral characteristics among Brazilian adolescents

INTRODUCTION

Inadequate dietary patterns in childhood and adolescence are a major risk factor for the early onset of obesity and other chronic diseases.

OBJECTIVES

To identify and to analyze dietary patterns among Brazilian adolescents.

METHODS

Data from the Brazilian National School Health Survey (PeNSE) of 2015 were used (n = 10,926 adolescents). The identification and analyses of dietary patterns were calculated using principal component analysis and linear regression, respectively.

RESULTS

Two dietary patterns were identified. The first one was characterized by the presence of markers of unhealthy eating, and the second one by markers of healthy eating. The adherence to the unhealthy pattern was positively associated with female adolescents, which mothers had completed, at least, the elementary school, residents in developed regions and urban areas, as well as those students who usually chose to skip breakfast, to not have meals with their parents/guardians, and who usually had meals while watching TV/studying, and at fast food restaurants.

DISCUSSION

Analyses of the consumption of isolated food groups, which do not consider the diet in all its complexity, have been insufficient in explaining the main outcomes of the public health nutrition area.

CONCLUSION

Our findings contributed to the identification of the most vulnerable population groups to unhealthy dietary patterns and to the understanding of the coexistence of different food habit determinants among adolescents.