Body composition parameters can better predict body size dissatisfaction than body mass index in children and adolescents

PURPOSE

Recent studies suggest that body mass index is not a reliable enough measurement for body composition in individuals, particularly in older and younger people. However, most research on body image has used the body mass index (BMI) as a physiological predictor of body satisfaction, particularly in children. The aim of this study was to investigate whether body composition is a better predictor of body size dissatisfaction in children than BMI.

METHODS

This is a cross-sectional study. Healthy children and adolescents aged 5-19 years, sex male and female, were recruited using a convenience sample in Brazil. BMI was measured according to the international standardization method and body composition was measured by bioelectrical impedance analysis (BIA) with a portable device model (BIA InBodyS10 multi-frequency, USA). Body size dissatisfaction was assessed using the Kakeshita's Figure Rating Scale for Brazilian Children. Data were analyzed with logistic regression analysis.

RESULTS

A total of 547 participants were evaluated, including 54% females and 67% Caucasian, with a mean age of 11.4 ± 3.8 years. The mean BMI was 20.5 ± 4.6 kg/m², and the mean percentages of fat and lean mass were 23.01 ± 10.59% and 72.84 ± 10.03%, respectively. In the multivariable model, only body composition was significantly associated with body size dissatisfaction (odds ratio: 1.849 (1.085-3.149, p = 0.024) and 1.828 (1.043-3.202, p = 0.035), respectively).

CONCLUSIONS

Body composition measures can better predict body size dissatisfaction in children and adolescents than BMI. This result may be relevant for the design of future studies on physiological indicators and body satisfaction.

LEVEL OF EVIDENCE

Level V, cross-sectional study.

Body size dissatisfaction associated with dietary pattern, overweight, and physical activity in adolescents - a cross-sectional study

This study analyzed the association of body size dissatisfaction with body mass index, dietary pattern, and physical activity in adolescents. A sample of 1,074 participants between 10-17years was recruited. Body size dissatisfaction was assessed by silhouettes scale. Dietary pattern, physical activity, and socioeconomic status were assessed by questionnaires. Body mass index was objectively measured. Body size dissatisfaction prevalence was 77.0%, where 29.8% desired to increase body size and 47.2% desired to decrease body size. Adolescents who desired to increase body size were more likely to consume vegetables and sweets, and less likely to be in highest quartile of physical activity than satisfied adolescents. Those adolescents who desired to reduce body size were more likely to have low fruit consumption and low vegetables consumption than satisfied adolescents. Health actions aiming to reduce body dissatisfaction in adolescents should address the improvement of dietary pattern and physical activity engagement, considering the desire to increase or to decrease body size, once were differently associated in this study. This article is protected by copyright. All rights reserved.

Perceived overweight/obesity, low resilience, and body size dissatisfaction among adolescents

OBJECTIVE

The obesity epidemic has been compounded by the stress of weight stigmatization. Resilience helps adolescents achieve positive outcomes during times of stress. This study aimed to determine relationships between overweight/obesity, perceived overweight/obesity, body size dissatisfaction (BSD), and/or resilience using a novel assessment tool among adolescents, and to determine if a modifiable factor such as resilience holds potential for treatments for BSD.

METHODS

Adolescents, ages 13-21, were recruited from clinics at an academic medical center. Weight, height, demographic characteristics, BSD, and resilience were assessed via questionnaires and health records. A model of predictive variables for BSD was tested, and an adjusted analysis was performed using logistic regression.

RESULTS

Eighty-five adolescents participated: 48% overweight/obese, 32% BSD, and 53% low resilience (LR). There was no association between actual and perceived overweight/obesity and LR (P=0.386 and P=0.123, respectively). Perceived overweight/obesity was five times (AOR 5.3; 95% CI=1.6-14.5; P=0.004) and LR was six times (AOR 6.4; 95% CI=1.9-22.4; P=0.003) more likely to be associated with BSD. The strongest sub-component of LR associated with BSD, was low confidence (OR 4.7; 95% CI=1.4-15.2; P=0.008).

CONCLUSIONS

LR and perceived overweight/obesity are independently associated with BSD. This finding is important because resilience can be improved, thus highlighting a need for future studies involving resilience building interventions to decrease BSD.

Changes in body image and onset of disordered eating behaviors in youth with type 1 diabetes over a five-year longitudinal follow-up

OBJECTIVE

To examine changes over a five-year period in body image accuracy and dissatisfaction, as well as relationships with disordered eating behaviors (DEBs), in young patients with type 1 diabetes.

METHODS

Of 81 children (42 male, 39 female) with type 1 diabetes first assessed at ages 5.1-10.06 years, 67 (83%) were re-enrolled and interviewed as adolescents (aged 10.07-15.08 years) at follow-up. DEBs were assessed using a parent-report standardized measure. Height and weight were determined, and BMI was calculated. Glycemic control was assessed by glycated hemoglobin.

RESULTS

BMI increased from childhood to adolescence. The general tendency towards body size underestimation (i.e., perceiving the body to be smaller than it is) and dissatisfaction, already described at baseline, was found unchanged at follow-up, revealing continuing attitude towards body image problems. Body-size perception accuracy, degree of body-size dissatisfaction, and HbA1c did not increase significantly over five years, but the presence of DEBs was observed. Degree of body dissatisfaction was found to be a significant predictor for DEBs (standardized beta = 0.272, p < 0.05).

CONCLUSION

Body image problems persisted over the five-year study period and were found associated with higher levels of DEBs. Identification of such body image characteristics may be useful in developing strategies for intervention early in the course of illness.

Body size dissatisfaction among young Chinese children in Hong Kong: a cross-sectional study

OBJECTIVE

To determine the potential predictors of body size dissatisfaction in Chinese children.

DESIGN

The Child's Body Image Scale was used to assess body size perception and dissatisfaction. BMI was calculated from objectively measured height and weight. Predictors of body size dissatisfaction were examined by logistic regression analysis.

SETTING

Hong Kong, China.

SUBJECTS

Six hundred and twenty children (53 % boys, aged 6·1-12·9 years) from a state-run primary school.

RESULTS

Female sex (adjusted OR (AOR)=1·91; 95 % CI 1·32, 2·76), age (AOR=2·62; 95 % CI 1·65, 4·16 for 8-10 years; AOR=2·16; 95 % CI 1·38, 3·38 for >10 years), overweight (AOR=6·23; 95 % CI 3·66, 10·60) and obesity (AOR=19·04; 95 % CI 5·64, 64·32) were positively associated with desire to be thinner. Size misperception was a strong predictor of body size dissatisfaction, irrespective of actual weight status (AOR=1·90; 95 % CI 1·02, 3·54 for overestimation; AOR=0·43; 95 % CI 0·27, 0·67 for underestimation).

CONCLUSIONS

Body size dissatisfaction is prevalent among Chinese children as young as 6 years. Female sex, age, overweight, obesity and overestimation of size were associated with increased desire to be thinner. These findings emphasise the importance of preventing body image issues from an early age.