Trends in body image of adolescent females in metropolitan and non-metropolitan regions: a longitudinal study

The Influence of a Girls' Health and Well-Being Program on Body Image, Self-Esteem, and Physical Activity Enjoyment

Adolescent girls report low physical activity levels and poor body image and self-esteem. This study evaluated the impact of a girls' health intervention on body image, self-esteem, and physical activity enjoyment. The intervention was grounded in self-determination theory, resulting in lessons designed to promote autonomy, competence, and relatedness. The two primary components of the intervention included opportunities for girls to learn about resistance training as well as ways to improve their psychosocial health (i.e., body image, self-esteem, and physical activity enjoyment). Girls (n = 590), in the intervention (Mage = 12.79, SD = 0.69) and control group (Mage = 12.92, SD = 0.73), completed pre and post measures. A repeated measures MANOVA was conducted to assess changes in body image, self-esteem, and physical activity enjoyment. The intervention resulted in a significant increase in body esteem-appearance, F = 9.23, p = 0.003, and body esteem-weight, F = 4.77, p = 0.029, and a greater, non-significant, increase in self-esteem (3.22%), and physical activity enjoyment (4.01%) compared to the control group. This highlighted the use of the intervention for significant improvements in appearance and weight-related body image. The results support implementing psychosocial lessons, as well as physical activity, in health programming for girls.

Analysis of Determinants of Food Preferences in a Polish Population-Based Sample of Primary School Adolescents: Diet and Activity of Youth during COVID-19 (DAY-19) Study

For the choices of food products, food preferences are crucial, as they influence the intake of nutrients and the resultant quality of diet, but in Poland, no studies of food preferences were conducted during the COVID-19 pandemic on a population of young adolescents. The aim of this study was to analyze the determinants of food preferences in a Polish population-based sample of primary school adolescents as part of the Diet and Activity of Youth during COVID-19 (DAY-19) Study. The DAY-19 Study focused on a national sample of a population of primary school adolescents who were recruited based on cluster sampling of participants from counties and schools, yielding a sample of 5039 individuals. Their food preferences were assessed using the Food Preference Questionnaire (FPQ), and they were compared in subgroups stratified by (1) gender: male and female; (2) age: younger (10-13 years) and older (14-16 years); (3) place of residence: urban and rural; (4) Body Mass Index (BMI): underweight, normal body weight, and overweight/obese (assessed based on Polish growth reference values); and (5) physical activity level: low and moderate (assessed using the International Physical Activity Questionnaire for children aged 10-13 (IPAQ-C) and adolescents aged 14-16 (IPAQ-A)). In the population of adolescents, no statistically significant differences in food preferences between subgroups stratified by gender were observed (p > 0.05). For boys, none of the studied factors (age, place of residence, BMI, physical activity level) was statistically significant determinant of food preferences (p < 0.05), while for girls, all of them were statistically significant determinants (p > 0.05). All the assessed factors (age, place of residence, BMI, physical activity level) in girls were associated with preferences for snacks, and older girls, those from a rural environment, those who were underweight and overweight/obese, as well as those having a low physical activity level declared a higher preference for snacks than younger ones (p = 0.0429), those from an urban environment (p = 0.0484), those of a normal body weight (p = 0.0091), and those having a moderate physical activity level (p = 0.0083). Similarly, girls from rural environments declared a higher preference for starches than those from urban environments (p = 0.0103), and girls having a low physical activity level declared a higher preference for fruit than those having a moderate physical activity level (p = 0.0376). Taking this into account, the population of girls, in particular, needs dedicated educational actions to support proper nutritional habits. Additionally, older age, living in a rural environment, being underweight and overweight/obese, and having a low physical activity level may be indicated as factors predisposing one to food preferences potentially promoting unhealthy dietary habits.

Eating disorders in 11–17 year old schoolgirls: Prevalence, features of clinical manifestations, psychosomatic comorbidity

Background. Eating disorders are an urgent public health problem due to their high prevalence and mortality. The disease prognosis depends on timely diagnosis; however, these conditions are sure to be underestimated.

The aim. To study the prevalence, features of clinical manifestations and psychosomatic comorbidity of eating disorder (ED) and subthreshold eating disorder (SED) in schoolgirls aged 11–17 years.

Materials and methods. We examined 917 schoolgirls aged 11–17 years. The screening questionnaire including 11questions combined into three pools named “Thoughts about one’s own body” was used. The first pool (A) – assessed body dissatisfaction, the second one (B) – eating disorders, the third one (C) – food intake disorders. The answers were encoded as “1”, “2”, “3” (“false”, “rather true”, “true”). Schoolgirls who scored the maximum number of points (12) in the pool A were regarded as dissatisfied with their body and were further divided into two groups: the first group (ED) included girls who scored more than 10 points in the pool B; girls who scored less than 10 points were in the second group (SED), respectively. Body mass index (BMI) was determined by the weight-height coefficient correlated with centile tables. Psychosomatic comorbidity was assessed by the presence of recurrent headache and abdominal pain in the last six months.

Results. The overall prevalence of eating disorders was 11.7 %, where ED made 2.1 %, SED – 9.6 %. All schoolgirls had abnormal eating behavior; however, those with SED used less aggressive weight-loss methods. BMI ˂ 5th percentile was observed in 10 % of girls with ED and 4.5 % – with SED. 60 % of girls with ED and 40.9 % with SED complained about frequent headaches; 30 % of girls with ED and 20.4 % with SED were suffering from frequent abdominal pain.

Conclusion. In schoolgirls, subthreshold eating disorder is 4.6 times more common than threshold eating disorder. Characteristics of clinical manifestations are the absence of underweight for most schoolgirls and comorbidity with pain syndrome. 

Body image perception and body composition in early adolescents: a longitudinal study of an Italian cohort

BACKGROUND

Adolescence is a sensitive period of life in which everyone faces physical and psychological changes. No longitudinal studies considering changes in body image perception and body composition in Italian adolescents have been carried out. The aims of this study were to evaluate the longitudinal change in body composition and weight status in a sample of Italian students of both sexes over the 3 years of middle school and to analyse the influence of these parameters on the perception and satisfaction of one's own body image.

METHODS

Sixty-four males and seventy females were followed longitudinally from 11 to 14. Age at first measurement was 11.8 ± 0.3 yrs. in males and 11.9 ± 0.3 yrs. in females, then the students were measured again after 1 year and 2 years. Anthropometric measurements were collected and body composition was assessed by skinfolds. Maturity status was detected by age at menarche in females and by estimated age at peak height velocity in males; sports practice was assessed by a questionnaire. Body Silhouette Charts were used to assess body image perception. The degree of body image dissatisfaction and improper perception of weight status were evaluated. Univariate and multivariate analyses were applied.

RESULTS

Height, sitting height, leg length, and weight increments were higher in males than in females, and in both sexes the sitting height increment was higher than that of leg length. Skinfold thicknesses and percentage of body fat, showed a decrease in males and an increase in females over the 3 years. About 90% of the sample practiced sport during the 3 years. No significant variations in body image perception were observed among repeated measures but significantly differences were observed between sexes. Although the girls showed a lower incidence of overweight and obesity than boys, girls had a higher dissatisfaction than males. Males were less accurate in one's perception of one's own weight status.

CONCLUSIONS

The changes in body composition observed in the sample of the present study were in accordance with their maturity stage. An increase in parameters connected with adiposity is observed in females and a decrease in males. Body image perception did not seem to change with growth, but associations were found between body image perception and BMI and sex. Monitoring body image perception in young adolescents, especially in females and in overweight/obese subjects, is a priority to prevent nutritional disorders.

Body image is associated with leisure-time physical activity and sedentary behavior in adolescents: data from the Brazilian National School-based Health Survey (PeNSE 2015)

Objective:

To evaluate the association of leisure-time physical activity and sedentary behavior with body image concern and satisfaction in Brazilian adolescents.

Methods:

Data were extracted from the 2015 Brazilian National Adolescent School-based Health Survey (Pesquisa Nacional de Saúde do Escolar [PeNSE]). Information regarding body image concern and satisfaction, as well as exposures (physical activity and sedentary behavior) and covariates (maternal education, age, smoking, and alcohol intake), were assessed through a questionnaire.

Results:

Logistic regression analysis revealed that engagement in recommended levels of physical activity (≥ 300 min/week) was associated with a decreased concern with body image and a high satisfaction in boys. Four or more hours spent in sedentary activities were associated with increased concern with body image and dissatisfaction among boys and girls.

Conclusion:

These findings support the relevance of programs aiming to promote physical activity and reduce sedentary behavior in the adolescent population. Such programs play a protective role against body dissatisfaction and are important for the development of a healthy body image in adolescence.

Does level of motor competence affect the associations between identity health and self-perceptions in adolescents?

BACKGROUND

Adolescence is a particularly important time for the development of self-perceptions and identity as many environmental and personal factors are influential. One relatively unexplored factor is level of motor competence.

AIM

To examine the relationship between identity health and self-perceptions in male and female adolescents with low motor competence (LMC) compared to typically developing (TD) adolescents.

METHOD

Adolescents (N = 160, 64.4% males, M_age = 14.45 yrs., SD = 0.75) completed the Adolescent Motor Competence Questionnaire (AMCQ), Assessment of Identity Development in Adolescence (AIDA), and Harter's Self-Perception Profile for Adolescents (SPPA). Based on the AMCQ score, the sample was grouped into LMC and TD. Pearson's product moment correlations between the AIDA and SPPA subscales were derived for gender, competence groups, and gender x competence sub-groups.

RESULTS

Overall, males had lower AIDA scores (healthier identity) than the females and significant associations with all self-perception domains. For females, only scholastic and social competence, physical appearance, behavioural conduct, close friendship and Global Self-worth (GSW) domains were significantly related to their AIDA score. The adolescents in the LMC group had higher AIDA scores (less-healthier identity) and fewer self-perception domains [scholastic competence, physical appearance, behavioural conduct, close friendships and GSW] were associated to their AIDA scores. For the TD group, all self-perception domains were significantly correlated with their AIDA scores. When grouped by gender and motor competence, the TD males had the healthiest identity scores which were strongly associated with all self-perception subdomains. For males with LMC, only scholastic competence, behavioural conduct and GSW domains were significantly related with their identity score. Females from both competence groups reported significant associations between physical appearance, close friendships, behavioural conduct, and social competence domains with their identity scores. Scholastic competence was also significantly associated with identity only for females with LMC.

CONCLUSION

Positive self-perceptions across a range of domains are associated with a healthier identity, but differ according to level of motor competence and gender. For those with LMC, the self-perception subdomains unrelated to physical activity and sport, such as school-based aspects were associated with a healthier identity. These findings should guide school based interventions to provide support in these domains in order to strengthen self-worth and identity health.

Early adolescent food routines: A photo-elicitation study

Early adolescence (ages 10-14) encompasses a critical transition period in which food and nutrition decisions are shifting in important ways. Food routines are food-based activities that repeat across days, weeks, seasons, or lives. Examining routines can provide insight into how individuals are influenced in food choices. The objective of this study was to describe current influences on and experiences with food routines during early adolescence. In-depth interviews, using a photo-elicitation approach, were conducted with 30 participants (16 females; 14 males) in the United States. Participants took photos that were then used during the interview to describe food-related decisions and influences. Interviews were audio recorded and transcribed verbatim. Analysis was guided by a grounded theory approach to identify emergent themes related to routines and resulted in the development of a conceptual model for early adolescent food routines. Participants identified a wide range of routines and three main themes emerged: family, settings, and meals/foods consumed. Some had highly established routines throughout the week, while others described routines only for certain meals or days. Several participants described increased control or the ability to modify routines around some eating episodes such as snacks, lunches, and weekend breakfasts. Findings revealed how participants viewed eating routines and provided information about food-and nutrition-related behaviors that can inform future research and practice. Early adolescents appear to have complex food routines influenced by structures and different amounts of control.

Comparison of Body-Image Dissatisfaction Among Chinese Children and Adolescents at Different Pubertal Development Stages

Background

Body-image dissatisfaction among children and adolescent has become increasingly serious, and may be the result of staged differences in the puberty-development process. The aim of this study was to compare differences in body-image dissatisfaction among children and adolescents at different pubertal stages.

Methods

A total of 574 students aged 8–15 years were recruited from two nine-year schools via stratified cluster sampling, their secondary sex characteristics and external genital development examined, and body-image cognition surveyed using the teenage body-image annoyance questionnaire. This questionnaire covers body-shape, gender, sexual organ, and appearance dissatisfaction. Lower scores indicate a more negative body image.

Results

Total, gender, and appearance-dissatisfaction scores in girls were significantly lower than in boys (P<0.05); however, sexual organ–dissatisfaction scores in girls were significantly higher than in boys (P<0.05). Girls’ gender-dissatisfaction scores before breast development Tanner II were higher than those after menarche (P<0.05); however, girls’ sexual organ–dissatisfaction scores before breast development Tanner II were significantly higher than those after menarche (P<0.05).

Conclusion

The girls were more dissatisfied with their gender and appearance than the boys, and the boys were more dissatisfied with their sexual organs than the girls. The girls were more dissatisfied with their sexual organs before breast development Tanner II and more dissatisfied with their gender after menarche.

Attitudes towards body weight dissatisfaction associated with adolescents’ perceived health and sleep (PeNSE 2015)

Abstract This study aimed to investigate whether attitudes towards body weight dissatisfaction is associated with perceived health and impairments in sleep among a national population-based sample of Brazilian adolescents. This is a cross-sectional data from the 2015 National School-Based Health Survey (PeNSE). A total of 100.182 students (70.8% were between 14 to 15) in ninth-grade, enrolled in public and private schools were eligible for data analysis. Variables were measured using a questionnaire and binary logistic regression was used. There was association between attitudes towards body weight dissatisfaction and perceived health (not controlling weight = OR: 2.19, 95%CI: 2.00-2.40; trying to lose = OR: 1.90, 95%CI: 1.75-2.05; gain = OR: 2.22, 95%CI: 2.01-2.46; maintain = OR: 1.81, 95%CI: 1.54-2.14). Adolescents were also more likely to present impairments in sleep (not controlling weight = OR: 1.21, 95%CI: 1.11-1.32; trying to lose = OR: 1.16, 95%CI: 1.08-1.25; gain = OR: 1.43, 95%CI: 1.28-1.61; maintain = OR: 1.43, 95%CI: 1.22-2.68). Dissatisfaction is an additional concern in the daily life of adolescents, which is associated to depreciation of the quality of sleep and decrement of psychological well-being.

Update on Syphilis for Women's Health Nurses

After declining for many years, rates of syphilis in the United States are increasing. This article discusses possible reasons why women, and specifically pregnant women, are not getting tested properly. Lack of prenatal care, poor access to prenatal care, and improper prenatal care all have contributed to cases of congenital syphilis. Clinicians working in women's health care can address this issue by taking accurate sexual histories, remaining open to sexual fluidity among their patients, ensuring they are up to date on appropriate syphilis testing guidelines, and routinely offering screening to any woman at risk. Syphilis is a treatable and preventable sexually transmitted infection, and nurses, advanced practice nurses, and midwives can significantly contribute to reversing the current trend.

What are the correlates of body image distortion and dissatisfaction among school-adolescents?

BACKGROUND

Body image is considered as central to many aspects of human functioning including emotions, thoughts, behaviors and relationships. Our study aimed to investigate the prevalence of body image distortion and dissatisfaction among adolescents and to assess their main determinants.

METHODS

This was a cross-sectional school-based study conducted among school-adolescents in the south of Tunisia, between October 2017 and February 2018.

RESULTS

Among 1210 school-adolescents, body image distortion and dissatisfaction prevalence were 44.8% and 42.4%, respectively. Multivariate analysis showed that being in the 16-18 years age group [adjusted odds ratio (AOR) = 1.28, p = 0.046], low family financial situation (AOR = 1.88, p = 0.014), as well as high frequency of eating pasta (AOR = 1.3, p = 0.04) and fast-food consumption (AOR = 1.7, p = 0.042) were independently associated with under-estimated body image. Skipping breakfast (AOR = 1.9, p = 0.017) and having one obese parent (AOR = 1.9, p = 0.01) were independently associated with higher frequency of over-estimated body image. Regarding body image dissatisfaction, independent factors associated with desire to lose weight were: female gender (AOR = 1.53, p = 0.007), high income family financial situation (AOR = 2.1, p = 0.008) and having one parent who is obese (AOR = 2.21, p < 0.001). However, frequent fast-food consumption (AOR = 1.9, p = 0.038) and eating between meals (AOR = 1.57, p = 0.01) were independently associated with a higher desire to gain weight.

CONCLUSIONS

Our study highlighted that the prevalence of body image distortion and dissatisfaction were substantially high among adolescents. Their determinants included socio-demographic factors and lifestyle behaviors. Increased awareness among parents, educators and public health planners may help adolescents improve accuracy of body image attitudes.

Are Adolescent Body Image Concerns Associated with Health-Compromising Physical Activity Behaviours?

The present study aimed to assess the-prevalence of health-compromising eating and physical activity behaviours, and to test their associations with physical activity, internalisation of sociocultural attitudes towards appearance, and body image in a sample of adolescents of both genders. A total sample of 736 adolescents (437 or 59.4% were girls) participated in the study. The participants ranged in age from 16 to 19 years (x = 17.2, SD = 0.6). The sample completed a questionnaire measuring body mass index, the risk of eating disorders, body image, internalisation of sociocultural ideals of appearance, health-compromising eating behaviours (HCEB), and health-compromising weight control related to physical activity behaviours (HCPAB). Logistic regressions were used to assess the associations between the study variables and predictors of HCEB and HCPAB. The results of the study showed a relatively high prevalence of HCEB with a significantly higher prevalence in girls and participants with a higher BMI. The study also demonstrated that the prevalence of adolescent HCPAB was higher than HCEB. The internalisation of sociocultural attitudes towards appearance and body image concerns were higher in the HCEB and HCPAB groups. Female gender (OR = 1.88; 95% PI = 1.10–3.18), HCPAB (OR = 1.19; 95% PI = 1.10–1.28), a preoccupation with being overweight (OR = 3.43; 95% PI = 2.52–4.66), and body weight evaluation as too high (OR = 2.40; 95% PI = 1.57–3.68) were significant predictors of HCEB. More frequent physical activity (OR = 3.02; 95% PI = 1.76–5.17), HCEB (OR = 1.22; 95% PI = 1.11–1.32), and perceived pressures to conform to popular beauty ideals (OR = 1.51; 95% PI = 1.12–2.03) predicted higher HCPAB. HCPAB is an important variable associated with adolescents’ body image, physical activity, and weight control. The results of the present study are important for health promotion and education programs addressing adolescents’ healthy lifestyle, weight control, and body image concerns.

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.

Body dissatisfaction and disordered eating symptoms in Finnish preadolescents

To evaluate whether body dissatisfaction is associated with disordered eating symptoms in Finnish preadolescents, and to assess the moderator effects of gender and body mass index on this association. We included 10,526 9- to 12-year-old preadolescents at baseline from the Finnish Health in Teens cohort. We used the Children's Eating Attitudes Test for assessing disordered eating symptoms and a pictoral instrument for evaluating body dissatisfaction, comparing self-assessment of wanted and current body shape. Odds ratio (OR) for disordered eating symptoms were estimated using unconditional logistic regression. A high percentage of preadolescents reported body dissatisfaction: 30.0% wanted a smaller body and 9.3% wanted a larger body. Only 2.2% of the participants had disordered eating symptoms. Preadolescents who wanted a larger (OR = 2.83; 95% confidence intervals (CI): 1.68-4.78) or smaller body (OR = 4.48; 95% CI: 3.20-6.26) had a higher risk of having disordered eating symptoms, compared to preadolescents satisfied with their body. Among preadolescents who wanted a smaller body, the effect of body dissatisfaction was more pronounced among girls (OR = 5.00; 95% CI: 3.25-7.70) than boys, and among normal-weight (OR = 6.82; 95% CI: 4.53-10.25) and underweight (OR = 23.23; 95% CI: 5.31-101.61) than overweight preadolescents. Body dissatisfaction is associated with disordered eating symptoms especially among girls, and those who are underweight and normal-weight. Our study suggests that, in the prevention of eating disorders, special attention should be given to preadolescents with body dissatisfaction.