Weight management goals and practices among U.S. high school students: associations with physical activity, diet, and smoking

Association between body weight perception and actual body mass index among adult women in Erbil city, Iraq

BACKGROUND

The misperception of body weight can significantly affect individuals' health behaviors, such as physical activity, diet, and weight management. This study aimed to examine the association between body weight perception and actual body mass index (BMI) among adult women and explore the factors influencing this relationship.

METHODS

Five hundred forty female individuals aged 18-65 participated in this cross-sectional study. The validated Global Physical Activity Questionnaire was used for data collection. The BMI of the participants was calculated from measured body weight and height. Body weight perception was assessed using a single questionnaire item. The association of BMI and body weight perception was assessed, and the result was categorized as underestimation, consistency, and overestimation. The Chi-square test was used to assess the association between the consistency of BMI and body weight perception by different sociodemographic factors. The kappa test was used to analyze the consistency of BMI and body weight perception.

RESULTS

Of the 540 participants, 13.3% underestimated their body weight status, 79.1% accurately perceived their body weight status, and 7.6% overestimated their body weight status. Unmarried women (11.7%) were more likely than ever married (4.3%) to overestimate their body weight (p = 0.005). On multiple logistic regression, being unmarried (OR = 1.68 (95%CI 1.01-2.80)) was significantly associated with body weight misperception. Body weight perception and BMI categories showed a significantly good consistency (kappa = 0.612, p < 0.001). Correct perception of body weight was highest among the overweight, followed by normal weight and underweight individuals (82.1%, 75.8%, and 72.2%, respectively).

CONCLUSION

Body weight perception was well associated with actual body weight status. Unmarried women are more likely to misperceive body weight, particularly overestimating it. Underestimation of body weight was relatively high and much higher than the overestimation, which might keep obese individuals from weight loss activities. Preventing obesity should include awareness about body weight misperceptions.

Socioeconomic position, perceived weight, lifestyle risk, and multimorbidity in young adults aged 18 to 35 years: a Multi-country Study

BACKGROUND

Multimorbidity-risk is established early in life, therefore reducing modifiable risk factors such as overweight or obesity may, in part, tackle the burden of multimorbidity in later life.

METHODS

We made use of a cross-sectional online survey that included young adults (18-35yrs old) from three countries - Kenya, South Africa, and the United Kingdom (n = 3000). Information pertaining to socio-demographic, health, lifestyle, and perceived weight was collected. Additionally, the sum of affirmed morbidities was used to determine a morbidity score. Likewise, a lifestyle risk score was calculated based on information obtained from questions surrounding four unhealthy lifestyle behaviours, namely current smoking, alcohol consumption, physical inactivity, and overweight/obese weight status as a confirmed clinic condition. We further explored differences in socioeconomic position, and the prevalence of perceived weight, multimorbidity, and lifestyle risk factors between the three countries. We also determined the odds ratio of multimorbidity with perceived weight as a main predictor variable. We furthermore performed a generalised structural equation model to determine whether the association between socioeconomic position and multimorbidity was mediated via perceived weight and/or lifestyle risk.

RESULTS

Socioeconomic position, weight perceptions, lifestyle risk, and multimorbidity varied significantly across the different economic countries. Higher morbidity (by > 11.9%) and lifestyle risk (by > 20.7%) scores were observed in those who reported an overweight weight perception when compared to those with an underweight or normal weight perception. In pooled analyses, the odds ratio in developing 2 or more morbidities increased multiple times in those who perceived themselves as overweight (all models: OR ≥ 2.241 [95% CI ≥ 1.693; ≥ 2.966] p < 0.001), showing a larger odds ratio with high significance in those who reported 3 or more morbidities (all models: OR ≥ 3.656 [95% CI ≥ 2.528; ≥ 5.286] p < 0.001). Furthermore, this study showed that an overweight weight perception partially mediated (p ≤ 0.001) the association between socioeconomic position and multimorbidity.

CONCLUSIONS

This study confirmed poorer health outcomes in those who perceived themselves as overweight. The findings from this study further emphasise the importance of targeted intervention strategies directed at raising weight-related awareness and potentiating risk factors, specifically in those who reside in lower economic developed countries.

Screen time, social media use, and weight-change behaviors: Results from an international sample of adolescents

This study aimed to investigate whether screen time and social media use are associated with weight-change behaviors among an international sample of adolescents. Cross-sectional data from the 2020 International Food Policy Study Youth Survey (ages 10-17; Australia, Canada, Chile, Mexico, United Kingdom, United States; N = 12,031) were analyzed. Self-reported hours of use of five forms of screen time (e.g., social media use), and total screen time per weekday were assessed. Use of six contemporary social media platforms (e.g., Facebook, Instagram) were also assessed. Weight-change behaviors included current attempts to gain weight, lose weight, stay the same weight, and not do anything to change weight, as well as dieting to lose weight in the past 12 months. Greater total screen time per weekday was associated with attempts to gain weight and lose weight, and dieting to lose weight. Specific social media platform use was associated with weight-change behaviors. For example, use of Twitter was most strongly associated with attempts to gain weight, lose weight, and dieting to lose weight. Findings underscore the international pervasiveness of screen time and social media use correlating with weight-change behaviors among adolescents. Global efforts are needed to ensure the appropriate use of screens and social media among adolescents.

Nutritional intake and metabolic parameters of Japanese university students with and without obesity: Sex-specific differences

OBJECTIVE

To establish effective methods of obesity prevention among young adults, we analyzed the relationship between obesity-related food intake and metabolic factors in Japanese university students.

METHODS

We performed a cross-sectional analysis of nutrient intake information and metabolic parameters among 1,206 Gifu University students categorized by body mass index.

RESULTS

The overweight/obesity rate was significantly higher in males. Additionally, among males, the intake of protein, potassium, magnesium, phosphorus, iron, zinc, all lipids/fats, and all metabolic parameters including blood sugar, hemoglobin A1c, uric acid, alanine aminotransferase, aspartate aminotransferase, low-density lipoprotein, high-density lipoprotein, triglycerides, and blood pressure significantly differed between the obese and non-obese groups. However, the same comparison among females revealed no significant differences in nutrient intake and significant differences in only half of the parameters. Among males, energy intake from protein and fat was significantly higher in the obese group, while the percentage of total energy intake from carbohydrates and fat was lower and higher, respectively, among females in the obese group.

CONCLUSIONS

Overeating of protein and fat in males and unbalanced nutrition in females are sex-specific characteristics of Japanese university students with obesity, and metabolic abnormalities in students with obesity are more remarkable in males than in females.

Relationship Between Weight Status and Self-Image Mediated by Pubertal Timing and Athletic Competence: A Cohort Study With Taiwanese Adolescents

Background

Self-image reflects overall self-acceptance in developing adolescents. Using a representative cohort of Taiwanese youth, this study aims to explore the relationship between weight status, pubertal timing, athletic competence, and adolescent self-image.

Methods

Data come from the Taiwan Youth Project that comprised a longitudinal cohort of adolescents (N = 2690, 51% males, Mage = 13.3 ± 0.5 years) surveyed annually from seventh grade. Self-image was measured by perceived satisfaction with appearance and physique. Weight status was proxied by self-reported body mass index (BMI; kg/m2). Pubertal timing was defined using the Pubertal Developmental Scale, which mainly measured physical changes in puberty. Athletic competence was assessed by experiences with participation in competitive sports and self-perceived talent for sports. Linear regression analysis was applied to test for an association between BMI and self-image. In order to test for mediating roles of pubertal timing and athletic competence, Hayes' PROCESS macro on SPSS was conducted applying 5,000 bootstrap resamples with 95% confidence intervals of the indirect effect.

Results

BMI was inversely associated with self-image in both males (β = -0.074, [-0.095, -0.053]) and females (β = -0.095, [-0.122, -0.069]). The boot-strapped 95% confidence intervals indicated statistically significant mediating effects of pubertal timing (β = -0.008, [-0.015, -0.001]) and athletic competence (β = -0.006, [-0.011, -0.002]) in the link between BMI and self-image in females, whilst only athletic competence mediated this association (β = -0.006, [-0.009, -0.002]) in males. Moreover, BMI at baseline were also associated with long-term self-image in males (β = -0.037, [-0.057, -0.017]) and females (β = 0.132, [0.073, 0.190]).

Conclusions

Understanding the mediating factors may help enhance adolescents' self-image by providing guidance on healthy weight and physical activity behaviors according to different stages of pubertal progression.

The Contribution of Walking to School in Students' Physical Activity and Its Effect on Being Overweight

Results

The findings of this research showed that being overweight is a concerning issue even in a small-sized and lightly populated city such as Bandar-Turkmen, Iran. Most students (90%) did not perform the required minimum daily activity when commuting to school. Further, overweight could be found even among those students who walked more than one hour to commute to school. The contribution of walking to school to the MVPA of overweight students was found to be low on school days and throughout the year. Counterintuitively, the situation is even worse for nonoverweight students.

Conclusion

The population of overweight students was more active compared to nonoverweight students in general, although they still suffered from excess weight since walking distances were short and not all days were school days. Thus, encouraging students to walk to school is necessary, while it is not sufficient alone as a single measure. Moreover, we recommend that all students should perform extra PA at home, school, or other places, on both school days and all other days of the year.

Orthorexia nervosa and substance use for the purposes of weight control, conformity, and emotional coping

PURPOSE

Orthorexia nervosa (ON), characterized by extreme behaviors driven by the goal of eating only healthy and pure foods, could plausibly be associated with avoidance of nicotine, alcohol, and illicit drugs. However, findings from the limited research on these relationships are mixed, and other eating disorders are associated with greater substance abuse.

METHOD

An online survey was completed by 471 participants (86% women, mean age = 20) recruited from undergraduate courses and through an Instagram advertisement. The questionnaires assessed ON symptomatology; frequency of smoking, alcohol consumption, and illicit drug use; abuse of these substances; and motivations for using these substances.

RESULTS

ON scores were not significantly related to the level of use or abuse of nicotine, alcohol, or most illicit drugs. Yet, ON scores were positively correlated with frequency of using illicit depressant drugs. Further, among substance users, ON scores were positively associated with smoking or vaping for the purpose of weight control, and with consuming alcohol and using illicit drugs for the purposes of conformity and coping with such negative emotions as anxiety and depression.

CONCLUSION

Although people who are high in ON symptomatology may be at least partly driven by a strong desire to be as healthy as possible, they are not less likely to use potentially harmful drugs. Instead, many of them may even turn to certain drugs for the same weight control and emotional-coping motives that guide the behaviors of individuals with other eating disorders.

LEVEL OF EVIDENCE

Level V, descriptive cross-sectional study.

Weighing the Risk: Developmental Pathways and Processes Underlying Obesity to Substance Use in Adolescence

Research on co-occurring obesity and substance use in adolescence has grown substantially in the past decade, but questions on the pathways and processes underlying co-occurrence remain. This review first synthesizes empirical findings on the relationship between obesity and substance use (e.g., alcohol, cannabis, tobacco use). Multidisciplinary theoretical frameworks referencing behavioral medicine, neuroscience, psychology, and public health are then used to inform an interdisciplinary, conceptual model focused on pathways and processes by which obesity increases risk of substance use. Recommendations for future research underscore the importance of prospective studies that encompass multiple domains of development. Recommendations for practice include family-based interventions that promote adaptive self-regulation, targeted antibullying or victimization interventions, and increased attention by health professionals on risky behavior associated with adolescent obesity.

Adolescents' Weight Management Goals: Healthy and Unhealthy Associations with Eating Habits and Physical Activity

BACKGROUND

This study aims to quantify associations between one's weight management goal and eating behaviors and physical activity among teenagers.

METHODS

Weighted logistic regressions were performed predicting healthy behaviors from weight goal separately for boys and girls while controlling for age, body mass index, socioeconomic indicators, school type, and region using data from the 2010 to 2011 Enquête québécoise sur la santé des jeunes du secondaire, a survey of a representative sample of Quebec adolescents (N = 32,040).

RESULTS

About 18%, 31%, 19%, and 34% of boys and 32%, 34%, 5%, and 25% of girls were respectively trying to lose weight, maintain their weight, gain weight, and not trying to do anything about their weight. Trying to lose weight was associated with lower likelihood of eating breakfast daily (boys: odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.61, 0.84 girls: OR = 0.61; 95% CI = 0.54, 0.70). Among girls, trying to lose weight was also associated with higher likelihood of consuming at least 5 portions of fruits and vegetables (OR = 1.20; 95% CI = 1.04, 1.37), lower likelihood of drinking sugar-sweetened beverages daily (OR = 0.77; 95% CI = 0.66, 0.90). Each weight-related goal was associated with unhealthy behaviors but most of them were also associated with adoption of healthier ones.

CONCLUSION

Having a weight related goal cannot inherently be thought of as health promoting goal.

Smoking beliefs across genders, a comparative analysis of seven European countries

BACKGROUND

Most European countries have seen a decrease in the prevalence of adolescent smoking. This decrease has, however, been patterned by gender. Girls' smoking rates have now overtaken boys' in many European countries. The two genders may not, however, share the same smoking beliefs and this could explain differences between the genders in smoking prevalence. We describe gender differences in smoking beliefs and investigate variations between countries, along with their gender context.

METHODS

In 2016, we conducted the SILNE R study (Smoking Inequalities Learning from Natural Experiments - Renew) in 55 schools located in seven European countries: Belgium, Italy, The Netherlands, Portugal, Finland, Ireland, and Germany. We surveyed 12,979 students aged 14-16 years (50% were girls). We classified smoking beliefs into four categories: positive individual, positive social, negative individual, and negative social beliefs. We expected girls to score higher on the last three of those categories and we hypothesized that countries with a more gender-equal culture would have less gender difference in beliefs about smoking.

RESULTS

One out of two smoking beliefs differed significantly between genders. Negative social beliefs were more common in girls, while beliefs about the dating-related aspects of smoking were more common in boys. We identified Germany and Belgium as the only countries with no gender differences in any of the belief scales. No correlation was found, however, between these scales and the Gender Inequality Index.

CONCLUSIONS

In some countries, gender-specific interventions might be implemented; however, two opposing strategies might be used, depending on whether such programs are aimed at boys or girls.

Do sex differences in reported weight loss intentions and behaviours persist across demographic characteristics and weight status in youth? A systematic review

Background

Evidence suggests that young females are more likely to try to lose weight than young males, however whether this sex difference persists across demographic characteristics and weight status is unclear. Further, whether females are more likely than males to try to lose weight using unhealthy weight loss strategies has never been systematically assessed. The objective of this systematic review was to examine the literature on sex differences in weight loss intentions and strategies in children and adolescent observational studies to determine whether sex differences persisted across demographic characteristics (race/ethnicity, grade level) and weight status.

Methods

Relevant articles published after 1990 were identified using PubMED, Web of Science, and PsycInfo. Searches were conducted in May of 2015 and again in May of 2017. Studies conducted in the US and Canada with participants 18-years old or younger who measured weight loss strategies in the context of weight loss intention were selected. Descriptive statistics were extracted from 19 studies.

Results

Almost two-thirds of youth reported trying to lose weight. High-school and middle-school aged females reported consistently higher prevalence of weight loss intentions compared to male counterparts, as did Caucasian, African-American, and Hispanic females. The proportion of youth using unhealthy or extreme strategies reached 44 and 13%, respectively, with a similar proportion of males and females endorsing the use of each category of weight loss strategies across studies. Native-American youth reported the highest prevalence (27%) of using extreme strategies.

Conclusions

Researchers should consider demographic characteristics when reporting prevalence information for weight loss intentions and behaviours, as certain groups might require more targeted public health initiatives. Across characteristics, prevalence ranges were broad for weight loss intentions and use of particular strategies, suggesting the need to standardize and refine data collection and reporting practices in this literature.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6179-x) contains supplementary material, which is available to authorized users.

Meeting fruit and vegetable consumption and physical activity recommendations among adolescents intending to lose weight

Two-thirds of adolescents who are overweight or have obesity report weight loss intentions. Most report using weight loss strategies consistent with expert recommendations for obesity prevention; however whether they meet recommended fruit and vegetable (F&V) intake and physical activity (PA) recommendations is unknown. We investigated whether weight loss attempts, and weight loss strategies were associated with meeting F&V and PA recommendations. Data were from the 2010 National Youth Physical Activity and Nutrition Study, which surveyed a cross-sectional, nationally representative sample of U.S. high school students. Analyses were restricted to overweight/obese students (n = 2841). Adjusted logistic regression models assessed the odds of meeting daily F&V and weekly PA recommendations after adjusting for grade, sex, race/ethnicity and perceived weight status. Compared to students who were overweight and were not currently intending to lose weight, students who were overweight and intending to lose weight were not more likely to meet F&V or PA. Among students with obesity, those who intended to lose weight were more likely than students who were not currently intending to lose weight to meet F&V recommendations (OR: 3.62, 95% CI: 1.70–7.73). Students who were overweight/obese and used F&V or PA for weight loss were significantly more likely to meet the corresponding recommendation than students intending to lose weight without specific strategies. Weight loss attempts alone do not affect the likelihood of meeting most expert recommendations. Public health efforts emphasizing recommended strategies for healthy eating and active living still need to be encouraged for overweight/obese youth.

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Among weight loss attempters, odds of meeting F&V/PA recommendations were analyzed.

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Weight loss attempts were associated with meeting F&V only among those with obesity.

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F&V/PA weight loss strategies were more consistent with meeting recommendations.

Youth WAVE Screener

Purpose

This study evaluated the feasibility of using the youth Weight, Activity, Variety, and Excess (WAVE) screener in a classroom setting for assessing student weight control intentions and the extent to which they used the WAVE strategies to control their weight.

Methods

The Youth WAVE Screener was administered to fifth-grade students in an inner-city school located in the Bronx, New York. The study was conducted in part to increase student awareness of snack foods and sugary beverages in relation to weight.

Results

Of the 169 students who completed the survey, 45.5% (n = 77) were trying to lose weight. Students who were trying to lose weight were more likely to have low-fat dairy products, less likely to have sugary beverages, and less likely to eat junk foods than those who were not trying to lose weight. Students who reported exercising 3 times weekly were more likely to report healthier dietary patterns and less sedentary behaviors than were students who exercise less often. Feedback and dialogue with fifth graders addressed the relationship between TV viewing and eating behavior, advertisement, availability, and preferences of fruits and vegetables.

Conclusions

The Youth WAVE Screener can be used to quickly identify children who are concerned about their weight as well as those with dietary and physical activity patterns that may increase the risk of obesity. Diabetes educators can use this screener to start a dialogue with children about their weight-related behaviors.

Factors Associated With Current Smoking Among Off-Reserve First Nations and Métis Youth: Results From the 2012 Aboriginal Peoples Survey

First Nations and Métis, two of Canada's constitutionally recognized Indigenous groups, suffer from poorer overall health than non-Indigenous Canadians. Current smoking, a known predictor of chronic health conditions, is close to twice as prevalent among Indigenous youth as it is among non-Indigenous Canadian youth. However, little population-level research has examined the correlates of current smoking among this population. Guided by a health framework centered on Indigenous-specific determinants, we used data from the 2012 Aboriginal Peoples Survey to examine the correlates of current smoking among First Nations and Métis youth aged 15-17 years living outside of First Nations reserves. Using binary logistic regression, we investigated how culturally specific factors, namely knowledge of an Indigenous language, participation in traditional activities, and family members' attendance at residential schools, were correlated with current smoking. We also considered demographic, geographic, socioeconomic and health-related correlates. Overall, an estimated 20.6% of First Nations and Métis youth reported current smoking. We found no significant associations between culturally specific activities and current smoking in the multivariate analyses, although those who spoke an Indigenous language were more likely to smoke. Those who participated in sports more often were less likely to smoke, and respondents who reported heavy drinking and who were from families with lower income were more likely to smoke. Gender, body mass index, urban/rural geography and regional geography, and mother's highest level of education were not significantly correlated with smoking. The results of our study support prior research that has found a disturbingly high prevalence of current smoking among Indigenous youth, compared to their non-Indigenous counterparts. Our results highlight the importance of considering sports participation, co-occurring health-risk behaviours and socioeconomic factors when developing interventions aimed at reducing the prevalence of smoking among First Nations and Métis youth.

Self-Perception of Body Weight among Secondary Students in Chiang Mai, Thailand

Self-perception of body weight and other weight-related factors were assessed among 2,519 Chiang Mai Province, Thailand high school students. A high percentage of the girls (57.6%) and boys (29.0%) reported that they were too fat and these percentages were higher than those reported by U.S. students in a recent Youth Risk Behavior Survey. Yet, in comparison to U.S. students, the Thai students were less likely than their U.S. counterparts to engage in weight management practices (e.g., dieting, eating less food, using diet pills). Thai students with a self-perception of being too fat were more likely than those with perceptions of being just right or too thin to engage in weight management practices, to be dissatisfied with their weight, feel that they were unattractive, estimate that their same-sex peers were trying to lose weight, and have a higher body mass index. The findings showed a relationship between self-perception of body size and engaging in weight control behaviors consistent with other research. It suggested that self-perception of body weight, more so than objective weight status, was predictive of weight loss behavior and also negative psychological outcomes associated with poor body weight image. As a result, self-perception of weight may be an important point of focus for the design and implementation of clinical and public health initiatives and health education interventions targeted at this adolescent population.

Relationships between Body Image, Body Mass Index, and Smoking in Korean Adolescents: Results of a Nationwide Korea Youth Risk Behavior Web-based Survey

OBJECTIVE

This study assessed the association between subjective body image or objective body mass index (BMI) and the risk of daily smoking in Korean adolescents, with a purpose of identifying the most suitable models.

MATERIALS AND METHODS

Using the 2013 9th Korea Youth Risk Behavior Web-based Survey data for 72,435 students, odds ratios were calculated for daily smoking in the past month, according to the subjective body image and calculated BMI using a respective multiple logistic regression model. The combined effect of these two factors was also analyzed by pairing a BMI category with a subjective body image category, using odds ratios for the same event within each sex group.

RESULTS

Among the surveyed students, 7.2% of boys and 1.8% of girls were classified as daily smokers. Students who perceived themselves as being very obese tended to be at lower risk of daily smoking (OR=0.61 in boys with 95% CI=0.47 to 0.79; OR=0.66 in women with 95% CI=0.47 to 0.93). In addition, boys within the obese or overweight BMI category showed a lower risk of daily smoking (OR=0.86, 95% CI: 0.77-0.96). Lean BMI was significantly associated with higher odds ratios for daily smoking only in female students (OR=1.24, 95% CI: 1.02-1.52). When pairing these two objective and subjective factors, results suggested that subjective body image has a greater effect on daily smoking than BMI in both boys and girls.

CONCLUSIONS

In both male and female students, subjective body image had a greater effect on daily smoking than body mass index. A model using the combination of BMI and subjective body image was the best fit in girls, in contrast to the model using subjective body image only best suitable in boys, for the prediction of daily smoking. These results including several factors associated with daily smoking in Korean students, provide useful data for the development and implementation of smoking intervention and cessation programs for adolescents.

Smoking, Adolescents and Health: Isfahan Healthy Heart Programme-Heart Health Promotion from Childhood

To evaluate the effect of some environmental factors on smoking, and to assess some health hazards of smoking in adolescents, this cross-sectional study was performed among 1950 students, ages11-18, selected by multi-stage random sampling from three cities in Iran. According to self-administered questionnaires, 12.9% of boys and 4% of girls reported to be smoker (OR=3.34, 95%CI: 2.33, 4.77, p<0.001). The mean values of total-and LDL-cholesterol were higher in smokers and their HDL-C was lower than non-smokers (163.33± 33.83, 90.73± 31 and 46.7± 12.24 vs.156± 29.53, 85±26.5 and 49.4±13.7 mg/dl, respectively, p<0.05). The mean systolic and diastolic blood pressures were higher in smokers than non-smokers (110.7± 14.5, 67.6± 11.55 vs. 104.9± 14.3, 63.2± 10.8 mmHg, respectively, p<0.05). The smokers had higher BMI than non-smokers (20.34 ±3.84 vs.19.55 ± 3.66, p<0.05). The mean food consumption frequency was lower for fruits and vegetables and higher for fat/salty snacks and fast foods in smokers than non-smokers. Logistic regression analysis showed significant association between sex, age, the number of family members and number of smokers in the family and smoking in students. The findings of this study have implications for future tobacco prevention strategies through community-based interventions. Asia Pac JPublic Health 2004; 16(1): 15-22.

Obesity-Related Dietary Patterns and Health Status of Diabetes among At-Risk Latino College Students

This study examined within-group differences in obesity-related dietary behaviors and the health status of 156 Latino students at-risk for diabetes due to family history. Approximately 58% of students were overweight/obese, with female students reporting a greater risk for diabetes. Consumption of meats, fried potatoes, breads, and tortillas was associated with higher BMI and diabetes risk indices. Differences in dietary behaviors were found based on students' college profile and sociodemographic characteristics. Implications for university-related intervention health initiatives are discussed.

Weight perception in overweight adolescents: Associations with body change intentions, diet and physical activity

This study examined the association of weight perception and weight satisfaction with body change intentions and weight-related behaviours in 928 overweight adolescents (aged 11-18 years, 44% female). Accurate perception of weight was associated with trying to lose weight and inaccurate perception was associated with trying to gain muscle. Weight dissatisfaction was associated with trying to lose weight and gain muscle. Accurate weight perception and weight dissatisfaction were not associated with healthy weight-related behaviours. Awareness of overweight and body dissatisfaction may be detrimental to the adoption of healthy weight-control behaviours. Interventions with overweight adolescents should encourage body satisfaction, rather than promoting awareness of overweight.

Body image emotions, perceptions, and cognitions distinguish physically active and inactive smokers

Objectives

To determine if body image emotions (body-related shame and guilt, weight-related stress), perceptions (self-perceived overweight), or cognitions (trying to change weight) differ between adolescents characterized by smoking and physical activity (PA) behavior.

Methods

Data for this cross-sectional analysis were collected in 2010–11 and were available for 1017 participants (mean (SD) age = 16.8 (0.5) years). Participants were categorized according to smoking and PA status into four groups: inactive smokers, inactive non-smokers, active smokers and active non-smokers. Associations between body image emotions, perceptions and cognitions, and group membership were estimated in multinomial logistic regression.

Results

Participants who reported body-related shame were less likely (OR (95% CI) = 0.52 (0.29–0.94)) to be in the active smoker group than the inactive smoker group; those who reported body-related guilt and those trying to gain weight were more likely (2.14 (1.32–3.48) and 2.49 (1.22–5.08), respectively) to be in the active smoker group than the inactive smoker group; those who were stressed about weight and those perceiving themselves as overweight were less likely to be in the active non-smoker group than the inactive smoker group (0.79 (0.64–0.97) and 0.41 (0.19–0.89), respectively).

Conclusion

Body image emotions and cognitions differentiated the active smoker group from the other three groups.

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We examined body image in physically active adolescent smokers.

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Body-related shame and guilt were related to being a physically active smoker.

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Trying to gain weight was also associated with being a physically active smoker.

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Body image emotions and cognitions differentiate physically active smokers.

Adolescent obesity and future substance use: Incorporating the psychosocial context

A growing body of work has shown that obese adolescents are at risk of engaging in problematic substance use, but mixed findings highlight the complexity of the relationship. Incorporating the psychosocial context into this research may inform past discrepancies. The current study assessed whether obese adolescents had a higher likelihood of experiencing a psychosocial context that predicted problematic substance use in young adulthood. Latent class analysis on 10,637 adolescents from The National Longitudinal Study of Adolescent to Adult Health (Add Health) identified four psychosocial classes in adolescence: Adjusted, Deviant Peer/Victimization, Moderate Depression, and Maladjusted. Obese adolescents were more likely to belong to the Maladjusted class, characterized by higher levels of depression and deviant peer affiliation. Those in the Maladjusted class had the second highest levels of cigarette smoking and marijuana use in young adulthood. Obese adolescents' psychosocial context should be considered in future research linking obesity and substance use.

Associations of Physical Activity and Sedentary Behaviors with Dietary Behaviors among US High School Students

BACKGROUND

Physical activity (PA), sedentary behaviors, and dietary behaviors are each associated with overweight and obesity among youth. However, the associations of PA and sedentary behaviors with dietary behaviors are complex and not well understood.

PURPOSE

To describe the associations of PA and sedentary behaviors with dietary behaviors among a representative sample of US high school students.

METHODS

We analyzed data from the 2010 National Youth Physical Activity and Nutrition Study (NYPANS). Using logistic regression models which controlled for sex, race/ethnicity, grade, body weight status, and weight management goals, we compared dietary behaviors among students who did and did not meet national recommendations for PA and sedentary behaviors.

RESULTS

Students who participated in recommended levels of daily PA (DPA) and muscle strengthening PA (MSPA) were more likely than those who did not to eat fruits and vegetables. Students who exceeded recommended limits for television (TV) and computer/video game (C/VG) screen time were less likely than those who did not to consume fruits and vegetables and were more likely to consume fast food and sugar-sweetened beverages.

CONCLUSIONS

Researchers may want to address PA, sedentary behaviors, and dietary behaviors jointly when developing health promotion and obesity prevention programs for youth.

Body-weight perception and related preoccupations in a large national sample of adolescents

OBJECTIVES

This study aimed to investigate the association between body-weight (BW) perception, weight preoccupation and behaviour, including weight control practices and compulsive over-eating episodes, across gender and actual BW classes.

DESIGN

This study used a cross-sectional observational study.

PARTICIPANTS

A large, nationally representative sample of 6404 ninth-grade French adolescents was randomly selected from schools throughout France.

METHODS

Weight and height were measured, and BW preoccupation, BW control practices and compulsive over-eating were self-reported using standardized questionnaires.

RESULTS

Nearly one-third of adolescents misperceived their BW. Misperception was more frequent among girls than boys (42.2% vs. 27.3%, P < 0.01). Underestimation of BW among overweight adolescents, like BW overestimation among underweight adolescents, was associated with less preoccupation with weight and fewer weight control practices than accurate perception of BW. Normal weight adolescents who overestimated their BW were more likely to declare weight preoccupations (ORa = 8.66 [6.67-11.25]), dieting (ORa = 4.81 [3.68-6.27]) and recurrent compulsive over-eating episodes (ORa = 2.36 [1.72-3.23]) compared with their counterparts who correctly estimated their BW.

CONCLUSION

Our study underlines the role of these associations in each category of actual BW (underweight, normal weight and overweight) in a large national sample.

Does adolescent weight status predict problematic substance use patterns?

OBJECTIVES

To identify underlying patterns of cigarette smoking, alcohol use, and marijuana use in young adulthood, and ascertain whether adolescent overweight or obesity status predicts problematic substance use patterns.

METHODS

The study included 15,119 participants from the National Longitudinal Study of Adolescent Health (Add Health) at Wave 1 (11-19 years) and Wave 3 (18-26 years). Latent class analysis was conducted.

RESULTS

Participants were classified into a Low Substance Use (35%), Regular Smokers (12%), High-risk Alcohol use (33%), or High Substance Use (20%) class. Overweight/obese adolescents had a greater likelihood of belonging to the Regular Smokers class.

CONCLUSIONS

Overweight/obese adolescents are at higher risk of engaging in regular cigarette smoking without problematic alcohol or marijuana use.

Association between adolescent substance use and obesity in young adulthood: a group-based dual trajectory analysis

PURPOSE

This study investigated whether and how trajectories of substance use in adolescence were associated with obesity trajectories in young adulthood. We hypothesized that: (1) exposure to persistent substance use throughout adolescence may heighten obesity risk in young adulthood; and (2) such associations may differ once gender, ethnicity, socioeconomic status, and obesity status in adolescence, are considered.

METHODS

The study included 5141 adolescents from the child sample of the 1979 National Longitudinal Survey of Youth and utilized biennial data across the 12 assessments (1986-2008) to examine trajectories of substance use behaviors (i.e., cigarette smoking, alcohol use, and marijuana use) from ages 12 to 18 and obesity trajectories from ages 20 to 24. Group-based dual trajectory modeling was applied to examine sequential associations of trajectories of each type of substance use behavior with obesity trajectories.

RESULTS

Three distinctive trajectory patterns were respectively identified for cigarette smoking, alcohol use, and marijuana use from ages 12 to 18, as well as for obesity status (BMI ≥ 30) from ages 20 to 24. Taking into account gender, ethnicity, socioeconomic status, and obesity status in adolescence, adolescents with the most problematic smoking trajectory (High-decreasing) were more likely to exhibit a High-obesity trajectory from ages 20 to 24. Also, adolescents with an Increasing marijuana use trajectory were more likely to exhibit an Increased obesity trajectory in young adulthood.

CONCLUSIONS

The current study demonstrates that adolescent substance use is associated with subsequent obesity in young adulthood. The associations appear to differ based on the type of substance use and patterns of use.

Body Weight Perception and Weight Control Practices among Teenagers

Background. Weight-loss behaviours are highly prevalent among adolescents, and body weight perception motivates weight control practices. However, little is known about the association of body weight perception, and weight control practices among teenagers in Mauritius. The aim of this study is to investigate the relationships between actual body weight, body weight perception, and weight control practices among teenagers. Methods. A questionnaire-based survey was used to collect data on anthropometric measurements, weight perception and weight control practices from a sample of 180 male and female students (90 boys and 90 girls) aged between 13 and 18 years old. Results. Based on BMI, 11.7% of students were overweight. Overall, 43.3% of respondents reported trying to lose weight (61.1% girls and 25.6% boys). Weight-loss behaviours were more prevalent among girls. Among the weight-loss teens, 88.5% students perceived themselves as overweight even though only 19.2% were overweight. Reducing fat intake (84.6%), exercising (80.8%), and increasing intake of fruits and vegetables (73.1%) and decreasing intake of sugar (66.7%) were the most commonly reported methods to lose weight. Conclusion. Body weight perception was poorly associated with actual weight status. Gender difference was observed in body weight perception.

A longitudinal analysis of adolescent smoking: using smoking status to differentiate the influence of body weight measures

BACKGROUND

Previous research has reported mixed results on the association between body weight measures (ie, perception of weight and weight loss goal) and cigarette smoking prevalence-and how these associations vary by sex and race. This longitudinal study assessed the relationship between these 2 body weight measures and smoking prevalence by smoking status (ie, nonsmoker, former smoker, smoker).

METHODS

Panel data of adolescents (N = 1592) from Louisiana schools completed survey interviews in the 9th grade and again in the 12th grade. Three separate ordinary least squares (OLS) regression analyses were conducted based on respondents' smoking status in the 9th grade: nonsmoker, former smoker, and smoker. The dependent variable, smoking prevalence was assessed in the 12th grade.

RESULTS

Among nonsmokers, weight loss goal was associated with smoking in the 12th grade. Among former smokers, the association between weight loss goal and smoking varied by sex. Girls who reported the goal to lose weight smoked more than their male counterparts. In contrast, among those who did not have the goal of losing weight, boys smoked more than girls. Among adolescents who were already smokers in the 9th grade, weight loss goal was not significantly associated with smoking prevalence.

CONCLUSION

Differences in the association between weight-related variables and smoking prevalence may be attributed, in part, to smoking status. School-based smoking interventions should target nonsmokers and female former smokers who desire weight loss.

Associations between different forms of body dissatisfaction and the use of weight-related behaviors among a representative population-based sample of adolescents

Weight management strategies have two components: weight goals and behaviors to reach weight goals. In the literature, weight goals and weight-related behaviors have both been linked with body dissatisfaction separately, but have rarely been examined simultaneously. This paper examines the associations between different forms of body dissatisfaction and various weight-related behaviors and investigates the moderating role of weight goals in these associations. Measures included weight goals (matching or mismatching current weight status), self-reported frequencies of use of weight-related behaviors, and a body dissatisfaction measure (strength of aspiring for weight gain or weight loss) from a representative population-based sample of adolescents (n = 2,346, 51 % female). Sex-specific multilevel logistic and ordinal regression analyses indicated that aspiring for a thinner body among girls was associated with more frequent use of healthy and unhealthy behaviors, whereas body dissatisfaction of any type among boys was linked to more frequent use of unhealthy behaviors. Girls aspiring for substantial weight loss and boys aspiring for substantial weight gain were more likely to use disordered health behaviors. Aiming for a goal that is mismatched with current weight status increases the use of unhealthy behaviors among body dissatisfied adolescents. We conclude that in order to elaborate interventions aimed at promoting health, research should focus on processes leading to specific forms of body dissatisfaction which in turn produce varying frequencies of use of weight-related behaviors.

Associated Factors of Unhealthy Eating Patterns among Spanish University Students by Gender

This study has examined bio-socio-demographic and psychopathological factors probably associated with unhealthy eating patterns among university students and to estimate a multifactorial model following the associated factors by gender. Adjusted odds ratios were calculated to describe associations on basis of Eating Disorder Inventory (EDI) stratified by gender in a representative sample of Spanish university students (n = 2551). The high EDI scorers for both sexes presented higher prevalence of dieting, body dissatisfaction, levels of psychopathology and lower self-esteem than the low EDI scorers. The results suggest that older students and higher self-esteem scores present lower scores in the EDI. In the female population, depression, paranoid dimension, dieting and body dissatisfaction were associated with population with unhealthy eating patterns. In the male sample, dieting, body dissatisfaction and interpersonal sensibility were also associated with unhealthy eating patterns. The results corroborate that abnormal eating patterns tend to affect specific vulnerable groups. We do not know the precise mechanisms through which these risk behaviors and attitudes, such as dieting or body dissatisfaction, may facilitate the later development of an eating disorder.

Gender Differences in the Relationship Between Physical Activity and Smoking Among Psychiatrically Hospitalized Adolescents

Physical activity has been identified as a protective factor with regard to tobacco use, such that physically active adolescents are less likely to initiate smoking, and smokers are less physically active than non-smokers. These findings, along with the well-documented benefits of exercise on mood and well-being in adults, have stimulated interest in exercise-based smoking cessation interventions. However, little research has explored the relationship between physical activity and smoking characteristics within adolescent smokers. Also, gender differences in adolescents' motives for smoking and exercise may have implications for intervention development, especially in clinical populations. The current study explored the relationship between physical activity and smoking in a sample of adolescent smokers (N = 191) and non-smokers (N = 48) receiving inpatient psychiatric treatment (61% female, mean age 15.3 years). Results indicated that smokers were less likely to be physically active than non-smokers. Additionally, there was a consistent pattern of gender differences in the relationship between smoking and physical activity within smokers. Specifically, physically active male smokers were less nicotine dependent and less prone to withdrawal, and had a trend toward greater motivation to quit, than their non-active counterparts. In contrast, physically active female smokers did not differ in dependence or withdrawal and were less motivated to quit than non-active female smokers. Taken together, these results suggest that within clinical populations of adolescent females, smoking and exercise may be used jointly as weight control strategies. Exercise-based interventions for smoking cessation for adolescent females, especially clinical populations, should address weight and body image concerns.

Developmental trajectories of childhood obesity and risk behaviors in adolescence

Using group-based trajectory modeling, this study examined 5156 adolescents from the child sample of the 1979 National Longitudinal Survey of Youth to identify developmental trajectories of obesity from ages 6-18 and evaluate associations of such trajectories with risk behaviors and psychosocial health in adolescence. Four distinctive obesity trajectories were identified: "Chronically Obese," "Decreasing," "Increasing," and "Non-obese." Males were overrepresented in the Chronically Obese and Increasing groups; females were overrepresented in the Decreasing group. African-Americans were overrepresented in the Chronically Obese, Increasing, and Decreasing groups; in contrast, Whites were overrepresented in the Non-obese group. Obesity trajectories were not associated with greater trends in alcohol use, marijuana use, or delinquency, but Chronically Obese adolescents showed a greater increase in cigarette smoking over time compared to other trajectories. The Increasing trajectory, representing a transition into obesity status from childhood to adolescence, was associated with poorer psychosocial health compared to other trajectories.

Factors associated with tobacco smoking and the belief about weight control effect of smoking among Hungarian adolescents

INTRODUCTION

The relationship between body weight and smoking has been well-documented among adult populations, but the data among youth are inconsistent. This study explores the relationship among social, behavioural, body weight-related factors and adolescent smoking while identifying factors associated with the belief that smoking controls weight.

MATERIALS AND METHODS

Baseline data from a three-year, prospective cohort study started in 2009 in Hungary's six metropolitan cities. Randomly selected 6th and 9th grade students completed a self-administered questionnaire during the 2009-2010 school year (n = 1445; 45% boys, mean age of 6th graders: 12.06 years, SD = 0.63; mean age of 9th graders: 15.06 years, SD = 0.63). Calculations of Body Mass Index (BMI) were based on objectively measured weight and height data of participants. Appetite-Weight Control Scale of the Short Form of Smoking Consequences Questionnaire was used to measure the belief that smoking supports weight control. Bivariate and multivariate logistic regression analyses were performed to examine the association between the perception of weight control and smoking, while controlling for potential confounding variables (e.g., gender).

RESULTS

24.8% of participants smoked cigarettes within the past 30 days. The odds of smoking were increased among students who were older, had smoking friends, were exposed to parental smoking, and had poorer academic performance. BMI showed positive association with smoking (increases in BMI were associated with higher odds of smoking), and the belief that smoking controls weight mediated this association. There was no difference in smoking prevalence among those motivated either to lose or gain weight (approximately 30%), but was considerably lower among adolescents satisfied with their body weight (19%). The belief that smoking supports weight control was more common for girls, older students, and those who perceived themselves as overweight.

CONCLUSIONS

Dissatisfaction with body weight and the belief that smoking has weight controlling effects are associated with an increased likelihood of adolescent smoking, therefore they must be considered in smoking prevention programmes among youth.

Risk factors for smoking among adolescent survivors of childhood cancer: a report from the Childhood Cancer Survivor Study

BACKGROUND

Few studies have examined risk factors for smoking among adolescent survivors of childhood cancer. The present study reports on the rate of smoking and identifies factors associated with smoking in a sample of adolescent survivors from the Childhood Cancer Survivor Study (CCSS).

PROCEDURE

Participants included 307 adolescent survivors and 97 healthy siblings (ages 14-20) who completed a self-report survey of health, quality of life, and health behaviors.

RESULTS

Smoking rates did not differ significantly between survivor and sibling groups (ever smokers: 28% vs. 33%, recent smokers: 10% vs. 9%, respectively). Ever smoking was significantly associated with peer smoking, smokers in the household, binging, suicidal behavior, and no history of CRT. There were significant interactions of peer smoking with gender and CRT for ever smoking and with binging for recent smoking. Recent smoking was more likely for survivors with other household smokers (RR=2.24, CI=1.21-4.16), past suicidality (RR=1.89, CI=1.00-3.56), and no CRT (RR=2.40, CI=1.12-5.17). Among survivors with few smoking friends, ever smoking was more likely for survivors with no CRT (RR=4.47, CI=1.43-13.9), and recent smoking was more likely among survivors who binged (RR=3.37, CI=1.17-9.71).

CONCLUSIONS

Despite the health risks associated with survivorship, nearly one in three adolescent survivors of childhood cancer has smoked. Exposure to other smokers, in particular, appears to increase the likelihood of smoking for some survivors. Providing smoking cessation programs targeted to family members, helping survivors choose non-smoking friends, and teaching ways to resist smoking influences from peers may be important pathways for smoking prevention with adolescent survivors.

Association of Sleep Duration with Obesity among US High School Students

Increasing attention is being focused on sleep duration as a potential modifiable risk factor associated with obesity in children and adolescents. We analyzed data from the national Youth Risk Behavior Survey to describe the association of obesity (self-report BMI ≥95th percentile) with self-reported sleep duration on an average school night, among a representative sample of US high school students. Using logistic regression to control for demographic and behavioral confounders, among female students, compared to 7 hours of sleep, both shortened (≤4 hours of sleep; adjusted odds ratio (95% confidence interval), AOR = 1.50 (1.05-2.15)) and prolonged (≥9 hours of sleep; AOR = 1.54 (1.13-2.10)) sleep durations were associated with increased likelihood of obesity. Among male students, there was no significant association between obesity and sleep duration. Better understanding of factors underlying the association between sleep duration and obesity is needed before recommending alteration of sleep time as a means of addressing the obesity epidemic among adolescents.

Driven exercise among treatment-seeking youth with eating disorders

PURPOSE

This study evaluated the prevalence and clinical significance of driven exercise (DE) in treatment-seeking youth.

METHODS

Participants were 380 consecutive referrals to a pediatric eating disorder program (90.8% female; M age=14.9±2.2). Spearman's rho correlations examined the relation between DE frequency, and Beck Depression Inventory (BDI) and Eating Disorders Examination (EDE) Global Severity scores. ANOVA compared those reporting only DE, only vomiting, or both DE and vomiting on the aforementioned measures.

RESULTS

51.3% of participants (n=193) reported DE in the past 3 months, with an average of 21.8 (SD=32.6) episodes. Frequency of DE was related to EDE global severity score (Spearman's rho=.46; p<.001) and BDI Total Score (Spearman's rho=.33; p<.001). Participants reporting both vomiting and DE had the highest EDE global severity and BDI total scores.

CONCLUSIONS

DE is associated with greater eating disorder and depressive symptomatology, especially when paired with vomiting. The findings highlight the importance of assessing for DE in youth presenting for eating disorder treatment.

Association of web-based weight loss information use with weight reduction behaviors in adolescent women

PURPOSE

To examine the association between seeking weight loss information from the Internet and weight loss behaviors.

METHODS

A self-administered survey was conducted on 3,181 women, aged 16-24 years, between August 2008 and August 2010. Questions were asked on use of the Internet to obtain weight loss information and various weight loss practices. Multivariate logistic regression analyses were performed to examine the association between seeking weight loss information online and practicing these weight loss behaviors.

RESULTS

In all, 39% used the Internet to seek weight loss information. Women who obtained weight loss information from the Internet were more likely to exercise (odds ratio [OR]: 1.31, 95% confidence interval [CI]: 1.07-1.60), use diet pills (OR: 4.14, 95% CI: 2.93-5.84), laxatives (OR: 2.02, 95% CI: 1.15-3.54), diuretics (OR: 7.89, 95% CI: 2.88-21.61), vomit after eating (OR: 2.56, 95% CI: 1.24-5.30), skip meals (OR: 2.77, 95% CI: 2.26-3.39), smoke more cigarettes (OR: 1.56, 95% CI: 1.14-2.14), and stop eating carbohydrates (OR: 3.09, 95% CI: 1.81-5.26) after adjusting for age, race/ethnicity, body mass index, and education.

CONCLUSIONS

Many young women engage in unhealthy weight loss behaviors which they may learn online. Interventions are needed to instruct young women on safe practices to lose weight.

Correlates of dietary intake in youth with diabetes: results from the SEARCH for diabetes in youth study

OBJECTIVE

To explore demographic, socioeconomic, diabetes-related, and behavioral correlates of dietary intake of dairy, fruit, vegetables, sweetened soda, fiber, calcium, and saturated fat in youth with diabetes.

METHODS

Cross-sectional study of youth 10-22 years old with type 1 (T1DM, n = 2,176) and type 2 diabetes (T2DM, n = 365). Association of dietary intake, demographics, socioeconomic status, behavioral, and diabetes-related measures was explored with quantile regression.

RESULTS

T1DM males had lower consumption of vegetables, fruit, and fiber, and higher consumption of soda and saturated fat than females (P < .01). African Americans had lower dairy and higher soda intake than non-Hispanic T1DM whites (P < .01). Soda consumption was higher in older T2DM youth than in younger participants (P < .01). Lifestyle and physical activity patterns were also significantly associated with dietary intake.

CONCLUSIONS AND IMPLICATIONS

Identified demographic and behavioral correlates may help dietitians to focus on groups of youth with diabetes who have lower adherence to a healthful diet. Diet counseling groups may be tailored according to these major determinants.

Predictors of erroneous perception of being overweight among adolescents

OBJECTIVE

Adolescents' perception of overweight often disagrees with objective measurements; if factors explaining this discrepancy are potentially modifiable is unclear.

METHODS

We analyzed cross-sectional data from a cohort of 2,001 Swedish adolescents (1,026 females, 975 males) at the age of 15 years in 2003. Erroneous perception of overweight was defined as the perception of being overweight in relation to normal or lower than normal BMI (kg/m(2)). BMI measured by the school nurse at 11 years, school-based education on nutrition/physical activity, smoking, alcohol consumption, physical activity, and healthy/unhealthy eating were examined as potential predictors/correlates of overweight misperception in multivariate logistic regression models.

RESULTS

At the age of 15 years, 32% of girls and 10% of boys misclassified themselves as overweight. Overweight at 11 years predicted misperception of overweight 4 years later (adjusted odds ratio (OR) = 2.3, 95% confidence interval (95% CI) = 1.4-3.6 in boys; OR = 1.9, 95% CI = 1.3-2.8 in girls). Among girls, smoking was associated with a higher probability of misperception (adjusted OR = 1.6, 95% CI = 1.2-2.2). Among boys, physical activity (>6 h/ week) was associated with a lower probability of misperception (OR = 0.4, 95% CI = 0.2-0.7). No association was observed with school-based education on nutrition and physical activity.

CONCLUSION

Preventing overweight in pre-adolescence may be a way to avoid later unjustified weight concerns in adolescence.

Overestimation of own body weights in female university students: associations with lifestyles, weight control behaviors and depression

The study aimed to analyze the lifestyles, weight control behavior, dietary habits, and depression of female university students. The subjects were 532 students from 8 universities located in 4 provinces in Korea. According to percent ideal body weight, 33 (6.4%), 181 (34.0%), 283 (53.2%), 22 (4.1%) and 13 (2.5%) were severely underweight, underweight, normal, overweight and obese, respectively, based on self-reported height and weight. As much as 64.1% and only 2.4%, respectively, overestimated and underestimated their body weight status. Six overweight subjects were excluded from overestimation group for the purpose of this study, resulting in overestimation group consisting of only underweight and normal weight subjects. Compared to those from the normal perception group, significantly more subjects from the overestimation group were currently smoking (P = 0.017) and drank more often than once a week (P = 0.015), without any significant differences in dietary habits. Despite similar BMIs, subjects who overestimated their own weight statuses had significantly higher weight dissatisfaction (P = 0.000), obesity stress (P = 0.000), obsession to lose weight (P = 0.007) and depression (P = 0.018). Also, more of them wanted to lose weight (P = 0.000), checked their body weights more often than once a week (P = 0.025) and had dieting experiences using 'reducing meal size' (P = 0.012), 'reducing snacks' (P = 0.042) and 'taking prescribed pills' (P = 0.032), and presented 'for a wider range of clothes selection' as the reason for weight loss (P = 0.039), although none was actually overweight or obese. Unlike the case with overestimating one's own weight, being overweight was associated with less drinking (P = 0.035) and exercising more often (P = 0.001) and for longer (P = 0.001) and healthier reasons for weight control (P = 0.002), despite no differences in frequency of weighing and depression. The results showed that weight overestimation, independent of weight status, is associated with risky lifestyles, weight control behaviors, and mental conditions. Preventive interventions should focus not only on obesity, but also on body weight overestimation.

Having a personal weight goal that mismatches healthy weight recommendations increases the likelihood of using unhealthy behaviors among a representative population-based sample of adolescents

Free living populations adopt practices designed to maintain or influence their weight. These practices include at least two components: a personal weight goal and use of a variety of behaviors to reach this personal weight goal. Personal weight goals can either concur (match) or not concur (mismatch) with recommendations that a health professional might stipulate for achieving a healthy weight status. The variety of behaviors used to achieve a personal weight goal can be thought of as inherently healthy, unhealthy, or disordered. We examined associations between matched vs. mismatched personal weight goals and the frequency of use of different types of weight-related behaviors among adolescents. Measures included whether or not personal weight goals matched or mismatched aims that should be pursued given current weight status and self-reported frequency of use of behaviors from a representative population-based sample of adolescents (n=2, 346, 51% female; 93.3% complete data). Sex-specific multilevel logistic and ordinal regression analyses showed that pursuing a mismatched personal weight goal increases the likelihood of using unhealthy behaviors across sexes. This association is however not significant for healthy and disordered behaviors. We conclude that there is an association between pursuing a mismatched personal weight goal and the use of unhealthy behaviors but not with healthy or disordered behaviors.

Differences in psychological correlates of excess weight between adolescents and young adults in Canada

There is a noticeable rise in the prevalence of excess weight in Canadian youth. Research has shown that certain psychological variables are implicated in the etiology of obesity. Hence, this study had the purpose of examining some of these variables among Canadian youth, and detecting differences between adolescents and young adults. Data from the Canadian Community Health Survey collected in 2003 was used to depict associations between selected psychological variables and excess weight among Canadians aged between 15 and 29 years. Results have shown that satisfaction with the way the body looks and satisfaction with life were inversely associated with excess weight in females. However, in males, satisfaction with life seemed to increase with age. For both genders, significant associations were observed between having a strong fear of being too fat, the respondent opinion of own weight and excess weight. Regarding weight control and eating habits, excess weight was associated with smoking less frequently in males aged between 25 and 29 years. The opposite was observed for females. For both genders, a positive association was observed between avoiding food because of calorie content and excess weight. Present findings highlight gender differences in body image perception, life satisfaction, and weight control practices. Moreover, changes or persistence in these variables between adolescents and young adults have also been detected in both males and females suggesting that early interventions might prevent the persistence of these psychological issues and habits in a older age.

Assessing weight perception accuracy to promote weight loss among U.S. female adolescents: a secondary analysis

BACKGROUND

Overweight and obesity have become a global epidemic. The prevalence of overweight and obesity among U.S. adolescents has almost tripled in the last 30 years. Results from recent systematic reviews demonstrate that no single, particular intervention or strategy successfully assists overweight or obese adolescents in losing weight. An understanding of factors that influence healthy weight-loss behaviors among overweight and obese female adolescents promotes effective, multi-component weight-loss interventions. There is limited evidence demonstrating associations between demographic variables, body-mass index, and weight perception among female adolescents trying to lose weight. There is also a lack of previous studies examining the association of the accuracy of female adolescents' weight perception with their efforts to lose weight. This study, therefore, examined the associations of body-mass index, weight perception, and weight-perception accuracy with trying to lose weight and engaging in exercise as a weight-loss method among a representative sample of U.S. female adolescents.

METHODS

A nonexperimental, descriptive, comparative secondary analysis design was conducted using data from Wave II (1996) of the National Longitudinal Study of Adolescent Health (Add Health). Data representative of U.S. female adolescents (N = 2216) were analyzed using STATA statistical software. Descriptive statistics and survey weight logistic regression were performed to determine if demographic and independent (body-mass index, weight perception, and weight perception accuracy) variables were associated with trying to lose weight and engaging in exercise as a weight-loss method.

RESULTS

Age, Black or African American race, body-mass index, weight perception, and weight perceptions accuracy were consistently associated with the likeliness of trying to lose weight among U.S. female adolescents. Age, body-mass index, weight perception, and weight-perception accuracy were positively associated (p < 0.05) with trying to lose weight. Black/African American subjects were significantly less likely than their White counterparts to be trying to lose weight. There was no association between demographic or independent variables and engaging in exercise as a weight-loss method.

CONCLUSIONS

Findings suggest that factors influencing weight-loss efforts, including age, race, body-mass index, weight perception, and weight-perception accuracy, should be incorporated into existing or new multi-component weight-loss interventions for U.S. adolescent females in order to help reduce the national epidemic of overweight and obesity among U.S. female adolescents.

Is participation in after-school physical activity associated with increased total physical activity? A study of high school pupils in the Czech Republic

This study assessed the physical activity (PA) levels and its variability across days, months and seasons of two groups of high school pupils: those who did and those who did not participate in regular organized after-school physical activity (ASPA). Thirteen pupils wore pedometers continuously for one school-year, logged their step counts into record sheets and were then interviewed for information as regards their participation in any ASPA. Repeated measures analysis of variance showed that regardless of the day, month and season, ASPA pupils achieved significantly more mean step counts/day than the non-ASPA pupils. There were no significant fluctuations across months and seasons in PA levels of ASPA pupils when compared to non-ASPA pupils. We conclude that regular organised ASPA might increase the pupils’ total PA levels; and could help to maintain a relatively constant PA level for adolescents across the whole school-year regardless of the influences of a range of weather and meteorological indicators that are related to months/seasons.

Gender differences in smoking: A longitudinal study of beliefs predicting smoking in 11-15 year olds

This longitudinal study investigated differences in beliefs and perceived behavioural control between smokers and non-smokers in a large sample of adolescents. Positive and negative instrumental beliefs, normative beliefs, perceived behavioural control (PBC) and smoking status were assessed in the same participants at 11, 13 and 15 years of age. Prospective analyses among non-smokers revealed that for boys, negative instrumental beliefs in non-smokers at age 11 predicted smoking at age 15 years. For girls, normative beliefs and PBC in non-smokers at age 11 predicted smoking status at age 13; normative beliefs at age 11 predicted smoking at age 15; and positive instrumental beliefs and normative beliefs at age 13 predicted smoking status at age 15. Cross-sectional data revealed that smokers were significantly more likely than non-smokers to endorse positive instrumental beliefs, less likely to agree with negative instrumental belief items, more likely than non-smokers to perceive social pressure to smoke, and less likely to report control over smoking, and that female smokers reported less control over smoking and fewer negative instrumental beliefs than all other groups including male smokers at age 13. The need for belief-based preventative interventions that are age- and gender-relevant is discussed.

Associations between physical activity and health parameters in adolescent pupils in Egypt

Physical activity (PA) could be protective against hypertension, atherosclerosis, coronary heart disease and cardiovascular disease. This quantitative study assessed the association between a PA intervention and three anthropometric parameters (weight, body mass index, body fat) and four physiological parameters (cholesterol level, systolic blood pressure, diastolic blood pressure, heart rate) among secondary school pupils (N = 160) in Egypt through the school term. The pupils were randomised to an intervention group (80 pupils) and controls (80 pupils). Measurements were obtained for all pupils twice: at baseline; and then again after three months. The PA intervention programme comprised an ‘afterschool’ one hour of moderate exercise three times a week for three months. Both the controls and the intervention pupils attended the ‘normal’ exercise schedule provided by the school; in addition, the intervention group attended afterschool PA programme from about 2–3 o’clock in the afternoon. At baseline, employing pupil’s BMI, 27.5% and 28.8% of the intervention and control pupils respectively were classified as overweight. After three months, the percentage of overweight decreased to 12.5% in the intervention pupils, while it increased to 37.3% in the controls. At the end of the three months period, there were significant improvements across most anthropometric and physiological parameters of the intervention pupils when compared with the control children. The correlation coefficient of the improvements for the boys and the girls was 0.97, indicating clearly that the intervention was having nearly the same beneficial effect for boys and girls. A moderate PA programme for a modest period of 3 months could be effective in maintaining or enhancing pupil’s anthropometric and physiological parameters in comparison to the controls where there was deterioration in both parameters. Policy makers and secondary schools in Egypt might need to pay more attention to PA programmes conducted on school days, in order to motivate pupils to attend such programmes. There is also an urgent need to look at current PA systems within schools in Egypt in order to assess PA outside school times.