Estilos de alimentación y su asociación con apreciación corporal, internalización del sesgo del peso y autocompasión / Eating styles and their association with body appreciation, weight bias internalization and self-compassion

Resumen Antecedentes: La valoración de la delgadez y sesgo hacia las personas con sobrepeso, pueden promover menor valoración del cuerpo y estilos de alimentación desadaptativos; la autocompasión podría actuar mitigando estas relaciones. Objetivo: comprender la asociación entre apreciación corporal, internalización del sesgo del peso y estilos de alimentación (EA), así como el rol que cumple una actitud autocompasiva en la apreciación corporal. Método: Estudio correlacional, transversal, en el que participaron 837 adultos residentes en Chile. En el análisis de datos se empleó regresión múltiple y análisis de mediación. Resultados: La apreciación corporal y la internalización del sesgo del peso predijeron EA emocional (β = -,126; p <,001 y β = ,146 p <,001, respectivamente), EA externo (β = -,095; p <,001 y β = ,064 p <,001, respectivamente) y EA restrictivo (β = ,134; p <,001 y β = ,258; p <,001, respectivamente). La autocompasión medió la relación entre internalización del sesgo del peso y apreciación corporal (β = -,133; IC:[-,157; −0,11]). Conclusiones: La valoración del cuerpo y la internalización del sesgo del peso influyen en los EA, y una actitud compasiva hacia sí mismo media en el efecto del sesgo del peso sobre la devaluación hacia el propio cuerpo.

Abstract Background: The assessment of thinness and bias towards overweight people can promote body appreciation and maladaptive eating styles; self-compassion could act mitigating these relationships. Objective: to understand the association between body appreciation, weight bias internalization and eating styles (ES), as well as the role of a self-compassionate attitude in body appreciation. Method: Correlational, cross-sectional study, with 837 adults living in Chile. In the data analysis, multiple regression and mediation analysis were used. Results: Body appreciation and internalization of weight bias predicted emotional ES (β = -.126; p < .001 and β = .146; p < .001, respectively), external ES (β = -.095; p < .001 and β = .064; p < .001, respectively) and restrictive ES (β = -.134; p < 001 and β = .258; p < .001, respectively). Self-compassion mediated the relationship between internalization of weight bias and body appreciation (β = -.133, CI: [- .157, -.11]). Conclusions: The assessment of the body and the weight bias internalization influence eating styles, and a compassionate attitude towards oneself intervenes in the effect of the weight bias on the devaluation towards the own body.

Actitudes y prácticas parentales de alimentación infantil: Una revisión de la literatura / Parental attitudes and feeding practices: A scoping review

RESUMEN Introducción: si bien la conducta alimentaria depende de múltiples factores, existe acuerdo en la importancia de aspectos socio-ambientales en los que la familia tiene un rol central, especialmente en edades tempranas. Objetivo: sistematizar evidencia científica actualizada sobre la asociación entre actitudes y prácticas de alimentación infantil, conducta alimentaria y estado nutricional del niño. Método: revisión narrativa de 40 artículos empíricos publicados entre los años 2011 y 2019. Resultados: se identificó tendencia en los padres a subestimar el peso corporal en niños con sobrepeso, y asociación entre preocupación por el peso, presión para comer y estado nutricional del niño. La alimentación restrictiva y el uso de la alimentación para fines instrumentales y controlar emociones, no serían prácticas efectivas, posiblemente porque interfieren en la capacidad de autorregulación del niño. Prácticas positivas incluyeron monitoreo, modelado de patrones alimentarios saludables y creación de ambientes no obesogénicos. Conclusión: existen hallazgos consistentes respecto a que prácticas coercitivas pueden ejercer efectos negativos en la conducta alimentaria infantil y prácticas que promueven la estructuración en la alimentación y un entorno positivo, serían más funcionales. La evidencia internacional es consistente en la relevancia de padres y cuidadores en la promoción de una conducta alimentaria saludable y la condición nutricional de niños.

ABSTRACT Introduction: In the last years, there has been an exponential increase in childhood obesity rates worldwide. Although eating behavior depends on multiple factors, there is agreement on the impact of socio-environmental aspects in which the family has a central role. Identifying the influence of parents and caregivers on child eating behavior can help to generate effective strategies for controlling obesity, especially at early stages. Aim: To review recent scientific evidence on the association between parental feeding attitudes and practices, eating behavior and nutritional status of the child. Method: Narrative review of 40 empirical articles published between 2011 and 2019. Results: Parents tend to underestimate body weight in overweight children. Weight concern and pressure to eat are associated with the nutritional status of the child. Restrictive feeding and the use of food for instrumental purposes and as a mean of controlling emotions, would not be effective practices, possibly because they interfere with the child's ability to self-regulate intake. Positive practices included monitoring, modelling healthy eating patterns and creating non-obese environments. Conclusion: Consistent findings support the notion that coercive practices could have negative effects on child eating behavior. Moreover, practices that promote structured and a positive environment could be more functional. However, international evidence is consistent in the relevance of parents and caregivers in promoting healthy eating behavior and the nutritional status of children.

Association of Weight Misperception with Unhealthy Diet-related Behaviors among University of the Philippines Manila Undergraduate Students

Objectives@#The study aims to determine whether there is an association of perceived weight status with unhealthy diet practices. @*Method@#An analytic cross-sectional study was conducted among 625 adult undergraduate students from U.P. Manila. The survey included questions regarding sociodemographic status, habits related to diet and weight management, and perceived body mass index (BMI). Actual BMI were obtained and calculated from actual anthropomorphic measurements. @*Results@#In the population surveyed, it was seen that 53.28% of the students accurately perceived their BMI status, 26.08% overestimated their BMI status, while 17.28% underestimated their BMI status. It was also seen that over-estimating of BMI status is more associated with unhealthy diet practices. Those who over estimated their BMI were 1.95 times more likely to skip meals (p=0.001) and 1.56 times more likely to engage in cutting of food (p=0.034). Physical activity was also seen to be associated with these practices. @* Conclusion@#Over-estimation of BMI may be linked to unrealistic goals in weight loss resulting in unhealthier diet-related habits.

Body Weight Misperception and Psychological Distress Among Children and Adolescents: The CASPIAN-V Study

OBJECTIVES: Misperception of weight status is a risk factor that affects psychological health. The aim of this study was to evaluate the association between weight misperception patterns and psychological distress among Iranian children and adolescents. METHODS: This was a cross-sectional nationwide study where data was collected from 14,440 students, aged 7–18 years who participated in the national school-based surveillance program (CASPIAN-V). The students’ weight perception and psychological distress were assessed by validated questionnaires. Weight misperception was classified as misperception of being either underweight or overweight with respect to actual weight. RESULTS: The rate of weight misperception in all study participants was 59.1%. In groups with a perception of being underweight or overweight, the risks of worthlessness, being worried, experiencing aggression, insomnia, or depression, were significantly higher than groups with an accurate weight perception (p < 0.05). The risk of anxiety in girls of normal weight who perceived themselves as underweight, decreased by 57% compared to girls with an accurate weight perception (OR: 0.43; 95% CI, 0.28–0.66). CONCLUSION: Weight misperception is highly prevalent among Iranian children and adolescents and is associated with their psychological health status. Appropriate education intervention needs to be developed to improve the children and adolescents’ perception of their body weight status.

Percepción materna del estado nutricional de sus hijos que acuden a un consultorio pediátrico, Asunción, 2018

Introducción: La percepción de la madre acerca del estado nutricional de su hijo es clave para el éxito o fracaso de las medidas preventivas o terapéuticas a implementar en relación a la obesidad. El objetivo de este trabajo fue evaluar la concordancia entre la percepción de las madres acerca del estado nutricional de sus hijos y su estado nutricional real. Materiales y Métodos: Estudio observacional, descriptivo con componente analítico, trasversal. La percepción materna del estado nutricional del hijo fue comparada con el índice de masa corporal real. Los datos fueron expresados en porcentajes. La concordancia se determinó a través del coeficiente Kappa de Cohen (p(0,05). Para evaluar los factores asociados con la falla de la madre en percibir correctamente el estado nutricional de su hijo se realizó el análisis de regresión logística bivariada y mutivariado con los factores significativos. Resultados: Fueron evaluados 636 pacientes, 54% masculinos, con edad media de 10 años. Se encontraban con peso adecuado 57%, bajo peso 9%, sobrepeso 22% y obesidad 11%. El 59,9% de las madres clasificaron correctamente el estado nutricional de su hijo, kappa 0,09 (p=0,0003). Los factores asociados significativamente con la falla de la madre en percibir correctamente el estado nutricional de su hijo fueron: el sexo masculino (OR 1,54), edad entre 4 a 9 años (OR 1,92), edad entre 9 a 14 años (OR 1,23) e Indice de Masa Corporal - Z score para edad y sexo (OR 2,04). El análisis multivariado mostró valores similares (p(0,001). Conclusión: Aproximadamente el 60% de las madres clasifican el estado nutricional de sus hijos de manera correcta. Sin embargo, los niños con sobrepeso y obesidad son reconocidos por sus madres como tales sólo en un 31% de los casos. Se considera estos hallazgos como de gran importancia para el éxito de los programas de intervención en obesidad.

Introduction: The mother's perception regarding the nutritional status of her child is a key to the success or failure to implement preventive or therapeutic measures to manage obesity. The objective of this study was to evaluate the concordance between mothers' perception of the nutritional status of their children and their actual nutritional status. Materials and Methods: This was an observational, descriptive and cross-sectional study with an analytical component. The maternal perception of the child's nutritional status was compared with the actual body mass index. The data were expressed in percentages. Concordance was determined through Cohen's Kappa coefficient (p≤0.05). To assess the factors associated with the failure of the mother to correctly perceive the nutritional status of her child, the bivariate and multivariate logistic regression analysis was performed with the significant factors. Results: A total of 636 patients were evaluated, 54% were male, the average age was 10 years. 57% had an adequate weight, 9% were underweight, 22% were overweight and 11% had obesity. 59.9% of the mothers correctly classified the nutritional status of their child, kappa 0.09 (p = 0.0003). Factors that were significantly associated with the failure of the mother to correctly perceive the nutritional status of her son were: male sex (OR 1.54), age between 4 to 9 years old (OR 1.92), age between 9 to 14 years old (OR 1.23) and Body Mass Index - Z score for age and sex (OR 2.04). The multivariate analysis showed similar values ​​(p≤0.001). Conclusion: Approximately 60% of mothers correctly classified the nutritional status of their children. However, overweight and obese children were recognized by their mothers as such in only 31% of cases. These findings are considered to be of great importance for the success of obesity intervention programs.

O estágio de manutenção para o exercício está associado à uma melhor percepção de diferentes indicadores de saúde na adolescência / Maintenance to exercise is associated to adolescents' perceived health

O objetivo deste estudo foi investigar a associação entre diferentes estágios de mudança do comportamento para o exercício e a percepção de indicadores de saúde em estudantes adolescentes. Participaram 662 adolescentes de 14 a 19 anos, distribuídos proporcionalmente nos 12 distritos de Florianópolis/SC. Foram utilizados: questionários de caracterização socioeconômica, condições de saúde e avaliação dos estágios de mudança de comportamento para o exercício. Observou-se que o estágio de manutenção para o exercício esteve associado às percepções de saúde. Rapazes em manutenção, apresentaram maiores chances de avaliarem positivamente sua saúde (OR=3,65; IC95%: 1,62-8,25). Entre as moças, o estágio de manutenção para a prática de exercícios foi associado à satisfação com o peso corporal (OR=1,68; IC95%: 1,01-2,80) e ao melhor autocontrole do estresse (OR=1,88; IC95%: 1,03-3,42). Rapazes e moças no estágio de manutenção para a prática de exercícios apresentaram chances reduzidas de perceberem-se frequentemente doentes (rapazes: OR=0,32; IC95%: 0,16-0,63; moças: OR=0,57; IC95%: 0,33-0,97). Adolescentes em manutenção para o exercício físico apresentaram melhores percepções de saúde comparados aqueles que não praticaram atividades físicas. A percepção positiva esteve associada ao tempo de exposição ao exercício, pois não foram observadas associações em adolescentes no estágio de ação.

This study aimed to analyze the association between the stages of exercise behavior and perceived health of adolescent students. The sample was composed by 662 adolescents aged between 14 to 19 years old, proportionally distributed among 12 districts of Florianopolis/SC/Brazil. Health conditions (1) and (2) Stages of exercise behavior change questionnaires were used. We observed that maintenance stage of physical exercise was associated with perceived health. Boys in maintenance were more likely to positively assess their health (OR: 3.65; CI95%: 1.62­8.25). Among girls, the maintenance for exercise was associated with body weight satisfaction(OR: 1.68; CI95%: 1.01­2.80) and better stress management(OR: 1.88; CI95%: 1.03­3.42).Boys and girls in the maintenance stage for exercise are less likely to perceive themselves sick (boys: OR: 0.32; CI95%: 0.16­0.63; girls: OR: 0.57; IC95%: 0.33­0.97).We conclude that adolescents in maintenance for exercise showed a better perception of their health conditions compared to those who did not engage in physical activities regularly. Adaptive benefits of exercise seem to appear as adolescent maintain physical activities over time.

Factors associated with parental underestimation of child's weight status / Fatores associados à subestimação do status do peso da criança pelos pais

Abstract Objective The aim of this study was to examine the prevalence of parental misperception of child weight status, and identify socioeconomic, anthropometric, behavioral and dietary factors associated with underestimation. Method Cross-sectional study. Data was collected in 14 Brazilian private schools. Parents of children aged 2-8 years (n = 976) completed a self-reported questionnaire assessing their perception of their child's weight status, and sociodemographic, anthropometric, behavioral and dietary information. To measure the agreement between parental perception about child weight status and actual child weight status, the Kappa coefficient was estimated, and to investigate associations between parental underestimation and independent variables, chi-squared tests were performed, followed by multiple logistic regression, considering p ≤ 0.05 for statistical significance. Results Overall, 48.05% of the parents incorrectly classified their child's weight. Specifically, 45.08% underestimated their child's weight status, with just 3% of parents overestimating. Children with higher body mass index (OR = 2.03; p < 0.001) and boys (OR = 1.70; p < 0.001) were more likely to have their weight status underestimated by parents. Conclusion Since awareness of weight problems is essential for prevention and treatment, clinical practitioners should help parents at high risk of misperception to correctly evaluate their child's weight status.

Resumo Objetivo Analisar a prevalência de percepção errônea dos pais sobre o status do peso infantil e identificar fatores socioeconômicos, antropométricos, comportamentais e dietéticos associados à subestimação. Método Trata-se de um estudo transversal. Os dados foram coletados em 14 escolas particulares brasileiras. Pais de crianças de dois a oito anos de idade (n = 976) preencheram um questionário autoaplicável sobre sua percepção do estado nutricional do seu filho e informações sociodemográficas, antropométricas, comportamentais e dietéticas. Para medir o grau de concordância entre a percepção dos pais do peso do filho e o peso real do filho, estimamos o coeficiente Kappa e investigamos as associações entre subestimação do pai e variáveis independentes, calculamos o qui-quadrado seguido do modelo de regressão logística múltipla considerando p≤0,05 para significância estatística. Resultados Em geral, 48,05% dos pais classificaram incorretamente o peso de seus filhos; particularmente, 45,08% subestimaram o peso do seu filho e apenas 3% subestimaram o peso infantil. A regressão logística demonstrou que as crianças com maior índice de massa corporal (OR = 2,03; p < 0,001) e os meninos (OR = 1,70; p < 0,001) tinham maior probabilidade de ter seu peso subestimado pelos pais. Conclusão Médicos clínicos devem concentrar suas intervenções nessas crianças para ajudar os pais a avaliar corretamente o seu peso. A consciência dos pais sobre um problema de peso em crianças é essencial para a prevenção e tratamento da obesidade infantil e estilos de vida saudáveis.

Agreement between the nutritional status of schoolchildren and the perception of their guardians / Concordância entre o estado nutricional de escolares e a percepção de seus responsáveis

ABSTRACT Objective Assess the correlation between classification of nutritional status of schoolchildren and the perception of their guardians. Methods A cross-sectional study with children aged 6-10 years from a public school in the South of Brazil. Weight and height of the schoolchildren were collected, and the guardians answered a questionnaire containing the range of silhouettes of Brazilian children. The perception through the scale of silhouettes was compared with the actual nutritional status. Kappa coefficient was used to check the consistency of actual and perceived perception. The prevalence ratio was calculated between perceived overweight and well-nourished children. Results A total of 236 guardians of schoolchildren were interviewed. The level of agreement between the nutritional status assessment of actual and perceived perception was weak (Kappa=0.32, p<0.001). As for the perception of nutritional status, 50.8% of the guardians scored the nutritional rating their children correctly, of which 42.0% of these children were overweight and 60.2% were well-nourished, p<0.05. The prevalence of guardians who underestimated the classification of the nutritional status was 21.6%, and underestimation of overweight children was 1.8 times greater than of well-nourished children. The overestimation of the nutritional status was 27.5%. The most prevalent nutritional status was well-nourished, followed by overweight. Conclusion The study showed that guardians do not have the correct perception of the nutritional status of the schoolchildren. Public interventions for health education must be conducted to reduce erroneous perceptions.

RESUMO Objetivo Este artigo tem por objetivo avaliar a concordância entre a classificação do estado nutricional de escolares e a percepção dos seus responsáveis. Métodos Foi realizado um estudo transversal com uma amostra de crianças de seis a dez anos de idade, matriculadas em uma escola pública do Sul do Brasil. Foram coletados peso e estatura dos escolares e aplicado aos responsáveis um questionário contendo a escala de silhuetas brasileira para crianças. A percepção por meio da escala de silhuetas foi comparada com o real estado nutricional. Utilizou-se o coeficiente Kappa para verificar a concordância da percepção real e percebida. Foi calculada a razão de prevalência entre a percepção de excesso de peso e a eutrofia. Resultados Foram entrevistados 236 responsáveis pelos escolares. O nível de concordância entre a avaliação do estado nutricional real e percebido foi fraco (Kappa= 0,32, p<0,001). Quanto à percepção do estado nutricional, 50,8% dos responsáveis acertaram a classificação nutricional de suas crianças, sendo que 42% delas apresentavam excesso de peso e 60,2% eram eutróficas, p<0,05. A prevalência de responsáveis que subestimaram a classificação do estado nutricional foi de 21,6%, sendo que naquelas com excesso de peso a subestimação foi de 1,8 vez maior em relação aos eutróficos. A superestimação do estado nutricional foi de 27,5%. O estado nutricional mais prevalente foi eutrofia, seguido de sobrepeso. Conclusão O estudo demonstrou que os responsáveis pelas crianças não tem a percepção correta do estado nutricional dos escolares. É importante realizar ações públicas de educação em saúde a fim de reduzir as percepções errôneas.

Differences in Breast Cancer Screening Rates according to Obesity and Weight Perception among Korean Women

PURPOSE: This study was performed to elucidate whether the obesity or body image is a barrier to breast screening compliance in Korean women. METHODS: We included 54,017 women aged between 35 to 70 years from the Korea Community Health Survey (KCHS) 2014 dataset. To identify whether a mutual relationship exists between weight perceptions and breast cancer screening rates, the participants were divided into three groups according to the level of concordance between Body Mass Index (BMI) and a subjective body image. Descriptive analyses, a chi-square test, and multivariate logistic regression analyses were performed. RESULTS: After covariate adjustment, the screening rate of the overweight group was 1.09 times higher than the normal weight group (odds ratio [OR], 1.09; confidence interval [CI], 0.00–0.16; p=.038) and the severe obesity group was 1.20 times lower (OR, 0.83; CI, −0.36–0.00; p=.047). Weight misperception also had a significant influence on breast cancer screening. Especially, The overweight distortion group was less likely to undergo breast cancer screening (OR, 0.93; CI, −0.15–0.00; p=.037). CONCLUSION: Obesity and weight misperceptions are associated with lower compliance with breast cancer screening guidelines.

Estado nutricional, imagem corporal e associação com comportamentos extremos para controle de peso em adolescentes brasileiros, Pesquisa Nacional de Saúde do Escolar de 2015 / Nutritional status, body image, and their association with extreme weight control behaviors among Brazilian adolescents, National Adolescent Student Health Survey 2015

RESUMO: Introdução: Este estudo objetivou analisar a associação entre estado nutricional, percepção da imagem corporal e comportamentos extremos para controle de peso nos adolescentes. Metodologia: Estudo transversal analítico, realizado no Brasil a partir da Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015, com adolescentes de 13 a 17 anos. Estado nutricional e percepção da imagem corporal foram as variáveis independentes. As dependentes foram vômito ou uso de laxantes e uso de remédios e outras fórmulas para controle de peso nos últimos 30 dias. Modelos de regressão de Poisson foram empregados para associação, com uso de variáveis demográficas para controle. Resultados: 7,4% dos adolescentes (IC95% 6,7 - 8,2) relataram vômito ou uso de laxantes, sem diferença entre os sexos. A prevalência de uso de remédio e fórmulas foi maior entre meninos (7,8%; IC95% 6,6 - 8,9). A associação entre estado nutricional e comportamentos extremos não foi significativa; entretanto, a prevalência de vômito ou uso de laxantes foi 2,3 (IC95% 1,1 - 4,7) vezes maior em meninos e 5,3 (IC95% 3,3 - 8,6) vezes maior em meninas que se sentiam muito gordos(as), ao passo que uso de remédios e fórmulas foi 4,0 vezes (IC95% 2,3 - 7,1) maior em meninas que sentiam muito gordas. Conclusão: A percepção da imagem corporal parece ter maior influência na prática dos comportamentos extremos do que o estado nutricional. Estratégias envolvendo serviços de saúde e escolas têm grande potencialidade para ações que impactem positivamente na autoestima e na saúde dos estudantes.

ABSTRACT: Introduction: This study aimed to analyze the association between nutritional status, body image perception, and extreme weight control behaviors among adolescents. Methods: This is an analytical cross-sectional study conducted in Brazil based on the National Adolescent Student Health Survey (Pesquisa Nacional de Saúde do Escolar - PeNSE) of 2015, with adolescents aged 13 to 17 years. Nutritional status and body image perception were the independent variables. The two dependent variables were vomiting or laxative use and use of medicines and other formulas for weight control in the 30 days prior to data collection. We used Poisson regression models for association, with demographic variables for control. Results: 7.4% of adolescents (95%CI 6.7 - 8.2) reported vomiting or using laxatives, with no difference between genders. The prevalence of use of medicines and formulas was higher among boys (7.8%; 95%CI 6.6 - 8.9). The association between nutritional status and extreme behaviors was not significant. However, the prevalence of vomiting or laxative use for adolescents who considered themselves very fat was 2.3 (95%CI 1.1 - 4.7) times higher for boys and 5.3 (95%CI 3.3 - 8.6) times higher for girls, while the use of medicines and formulas was 4.0 (95%CI 2.3 - 7.1) times higher for girls who considered themselves very fat. Conclusion: Body image perception seems to have a greater influence on extreme behaviors than nutritional status. Strategies involving health services and schools have great potential to impact the self-esteem and health of students positively.

Multilevel Analysis of Factors associated with Subjective Weight Perception among Normal Body Weight Adolescents based on the 2017 Korean Youth's Risk Behavior Survey (KYRBS)

PURPOSE: The present study is focused on understanding weight perception related with individual- and school-level multifactorial origins, underestimated and overestimated respectively, in normal body weight adolescents. METHODS: Using the 2017 Korea Youth Risk Behavior Web-based Survey data of 45,902 students from 799 secondary schools, a multilevel multinomial logistic regression analysis was performed where adolescents (level1) were nested within schools (level 2). RESULTS: At the school level, the average school body mass index (BMI, kg/m²) and physical education were associated with weight perception among both boys and girls. In boys, geographic areas were associated with weight underestimation. At the individual level, perceived economic status, weekly allowance, BMI (kg/m²), smartphone usage time (hrs/day) and perceived stress were associated with weight perception among both boys and girls. Age, paternal education, academic achievement and alcohol use were associated with weight perception among girls, while part-time job and physical activity were associated with weight perception among boys. CONCLUSION: Our findings underscore the importance of individual- and school-level environments in developing correct weight perception and have implications for school health education to establish healthy lifestyle behaviors for all adolescents.

Gender Differences in the Prevalence of Overweight and Obesity, Associated Behaviors, and Weight-related Perceptions in a National Survey of Primary School Children in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To in vestigate potential gender differences in the odds of overweight/obese, weight-related perceptions, and behaviors among Chinese school children.</p><p><b>METHODS</b>Height, weight, and a survey of weight-related perceptions and behaviors were measured in a nationally representative survey of 12,811 children in primary schools in China. Logistic regression analyses were used to assess gender differences, adjusting for confounders.</p><p><b>RESULTS</b>Boys had higher odds of being overweight/obese compared to girls within both urban [adjusted odds ratio (OR) 2.30, 95% CI 2.00 to 2.65] and rural areas (OR = 1.85, 95% CI 1.55 to 2.20). Girls reported healthier diets (e.g., daily vegetables OR = 0.79, 95% CI 0.73 to 0.85) whereas boys consumed fried food (OR = 1.21, 95% CI 1.06 to 1.38) and sugar-sweetened drinks more often (OR = 1.49, 95% CI 1.34 to 1.65). Gender differences included higher odds of boys perceiving themselves as overweight if they had more highly educated mothers (OR = 1.35, 95% CI 1.09 to 1.68), less educated fathers (OR = 0.79, 95% CI 0.63 to 0.99), and if they frequently consumed carbonated drinks (OR = 1.48, 95% CI 1.07 to 2.05).</p><p><b>CONCLUSION</b>Childhood obesity prevention in China should be gender-focused, particularly for boys who reported an unhealthier diet but were less likely to see they were fat, even though more boys were overweight or obese than girls.</p>

Associação entre estresse percebido na adolescência, peso corporal e relacionamentos amorosos / Association between perceived stress in adolescence, body weight and romantic relationships

RESUMO Objetivo: Analisar a associação entre estresse percebido na adolescência, peso corporal e relacionamentos amorosos. Métodos: Participaram do estudo 2.517 adolescentes (56,1% moças), com média de idade de 16,6±1,2 anos, estudantes de escolas públicas estaduais do Amazonas. Os adolescentes responderam a um questionário composto por questões sociodemográficas (sexo, faixa etária, ano escolar, turno de estudo, escolaridade da mãe e renda familiar) e relacionadas à insatisfação com o peso corporal; ao envolvimento em relacionamentos amorosos (identificado pelo status de relacionamento - com ou sem parceiro); e à percepção de estresse (variável dependente). A associação entre estresse percebido, insatisfação com o peso corporal e relacionamentos amorosos foi testada por meio da Regressão Logística Binária, ajustando-se as análises por sexo e faixa etária. Resultados: A prevalência de estresse percebido foi de 19,0% (intervalo de confiança de 95% - IC95% 17,5-20,3), sendo maior entre as moças (23,2%; IC95% 21,5-24,5) do que entre os rapazes (13,6%; IC95% 12,2-14,7). Os adolescentes com companheiro (Odds Ratio - OR 1,76; IC95% 1,14-2,71) e que desejavam diminuir seu peso corporal (OR 1,53; IC95% 1,18-1,98) tiveram maior chance de se perceberem estressados. Conclusões: Houve associação entre o estresse percebido, o status de relacionamento e a insatisfação com o peso corporal. Independentemente do sexo e da idade, os adolescentes com companheiro e os que desejavam diminuir o peso apresentaram mais chances de se perceberem estressados. Uma particular atenção em relação ao estresse percebido deve ser dada às moças, aos adolescentes com companheiros e àqueles que desejam reduzir seu peso corporal.

ABSTRACT Objective: To analyze the association between perceived stress in adolescence, body weight and romantic relationships. Methods: Participants were 2,571 adolescents (56.1% female), with mean age of 16.6±1.2 years, who were students of public schools in Amazonas. The adolescents answered a questionnaire with sociodemographic questions (sex, age group, school year, study shift, maternal schooling and family income) and related to body weight dissatisfaction, romantic relationships (identified by the relationship status - with or without a partner) and perceived stress (dependent variable). Binary Logistic Regression was used to test the association between perceived stress, body weight dissatisfaction and romantic relationships. The analysis was adjusted by sex and age group. Results: The prevalence of perceived stress was 19.0% (95% confidence interval - 95%CI 17.5-20.3), and was higher among girls (23.2%; 95%CI 21.5-24.5) than boys (13.6%; 95%CI 12.2-14.7). Adolescents with partners (OR 1.76; 95%CI 1.14-2.71) and those who wanted to lose body weight (OR 1.53; 95%IC 1.18-1.98) were more likely to perceive themselves as stressed. Conclusions: There was an association between perceived stress, relationship status and body weight dissatisfaction. Regardless of sex and age group, the adolescents with a partner and those who wanted to lose weight were more likely to perceive themselves as stressed. Girls should receive special attention, as well as adolescents with partners and those who want to lose body weight.

Diferencias por sexo en el índice de masa corporal, percepción del peso corporal, satisfacción con el peso, desórdenes de la alimentación y estrategias para el control de peso en estudiantes de medicina y enfermería de la India / Diferenças por sexo no índice de massa corporal, percepção do peso corporal, satisfação com o peso, desordens da alimentação e estratégias para o controle de peso em estudantes de medicina e enfermagem da Índia / Gender Differences in Body Mass Index, Body Weight Perception, weight satisfaction, disordered eating and Weight control strategies among Indian Medical and Nursing Undergraduates

Objective. To assess gender disparity in body weight perception, Body Mass Index (BMI), weight satisfaction and role of depression among undergraduate Medical and Nursing students. Methods. A descriptive cross sectional descriptive study was conducted in conveniently selected medical (n=241) and nursing (n=213) students of Bangalore, South India. Data was collected using self-administered SCOFF questionnaires. Results. Our findings revealed that men had a significantly higher BMI than women (t=5.403, p<0.001). More number of women compared to men, perceived themselves as over weight (74.8%) and not satisfied with their weight status (81.6%). More men than women scored positively for disordered eating behaviors on SCOFF (45.4% vs. 31.1%) and EAT scale (16.5% vs. 8.7%). While, 48.2% of the women practice binge eating, 41.2% of the men practice it (p<0.004); more men (47.4%) than women (25.4%) exercised for more than sixty minutes (p<0.001) to control their weight. Conclusion. Findings indicate small differences between the genders that have to be taken in consideration in planning interventional programs to prevent eating disorders in this population. (AU)

Objetivo. Evaluar la disparidad por sexo en el índice de masa corporal, la percepción del peso corporal, la satisfacción con el peso, los desórdenes de la alimentación y estrategias para el control de peso en estudiantes de medicina y enfermería de la India. Métodos. Se realizó un estudio descriptivo de corte transversal con una muestra tomada a conveniencia de estudiantes de Medicina (n=241) y de Enfermería (n=213) de Bangalore, en el sur de India. Los datos se recolectaron usando los instrumentos auto-administrados SCOFF y EAT-26. Resultados. Los hombres tenían un IMC significativamente mayor que las mujeres (t=5.403, p<0.001); un mayor porcentaje de mujeres, en comparación con los hombres, percibía que pesaba más (74.8%), sin embargo, no estaban satisfechas con su peso (81.6%). Los hombres y las mujeres tuvieron puntajes que mostraban riesgo de tener trastornos de conductas alimentarias en el SCOFF (45.4% vs. 31.1%) y en el EAT (16.5% vs. 8.7%). Mientras que el 48.2% de las mujeres practicaba el atracón, el 41.2% de los hombres lo tenía (p <0.004); más hombres (47.4%) que mujeres (25.4%) se ejercitaban por más de sesenta minutos (p<0.001) para controlar su peso. Conclusión. Los hallazgos indican pequeñas diferencias por sexo que deben ser tenidas en cuenta en la planeación de programas de intervención para prevenir los trastornos en la alimentación en esta población. (AU)

Objetivo. Avaliar a disparidade por sexo no índice de massa corporal, percepção do peso corporal, satisfação com o peso, desordens da alimentação e estratégias para o controle de peso em estudantes de medicina e enfermagem da Índia. Métodos. Se realizou um estudo descritivo de corte transversal com uma amostra tomada a conveniência de estudantes de Medicina (n=241) e de Enfermagem (n=213) de Bangalore, no sul da Índia. Os dados foram coletados usando os instrumentos auto-administrados SCOFF e EAT-26. Resultados. Os homens tinham um IMC significativamente maior que as mulheres (t=5.403, p<0.001), mas um maior número de mulheres em comparação com os homens, percebiam que pesavam mais (74.8%) e não estavam satisfeitas com seu peso (81.6%). Os homens e as mulheres tiveram pontuações que mostravam risco de ter transtornos de condutas alimentar no SCOFF (45.4% vs. 31.1%) e no EAT (16.5% vs. 8.7%). Enquanto que 48.2% das mulheres praticavam o excesso, já os homens 41.2% (p <0.004); mais homens (47.4%) do que mulheres (25.4%) se exercitavam por mais de sessenta minutos (p<0.001) para controlar seu peso. Conclusão. As descobertas indicam pequenas diferenças por sexo que devem ser tidas em conta no planejamento de programas de intervenção para prevenir os transtornos na alimentação nesta população. (AU)

Association of weight control behaviors with body mass index and weight-based self-evaluation

Objective: To determine the frequency of weight control behaviors (WCBs) and their correlation with body mass index (BMI) and weight-based self-evaluation. Methods: Data were collected by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP) from 27,501 volunteers (30.4% men, mean age 28.9±8.7 years). Results: The most prevalent WCBs for men and women were exhaustive physical exercise and prolonged fasting, respectively. Frequent exhaustive physical exercise was the only behavior more often adopted by men. BMI was positively associated with WCBs, which were very frequent in obese subjects. About 15% of normal-weight women reported using diuretics and laxatives, and 12.2% reported vomiting as a WCB at least occasionally. Among subjects who regarded body weight highly in their self-evaluation, there was a strong positive association with all WCBs, at similar degrees, in both genders. Compared to those who never base their intrinsic personal value on body weight, those who frequently base intrinsic value on body weight were at 25-30 times higher risk of inducing vomiting. Conclusion: The prevalence of participants adopting WCBs was high, especially in women and obese subjects. Weight-based self-evaluation was more strongly associated with WCBs than BMI.

Concordância entre o estado nutricional aferido e o percebido pelas mães em crianças pré-escolares / Agreement between measured and perceived nutritional status reported by preschool children's mothers

RESUMO Objetivo: Verificar a concordância entre o estado nutricional percebido pelas mães e o diagnosticado em crianças pré-escolares, distinguindo diferenças segundo o sexo e a idade da criança. Métodos: Estudo com dados provenientes de uma coorte de 269 crianças pré-escolares assistidas em creches públicas de Campina Grande, Paraíba. Coletaram-se informações sobre a data de nascimento, sexo e estado nutricional das crianças (escores-Z de peso/estatura). Além disso, as mães foram questionadas em relação à percepção sobre o peso da criança. A concordância diagnóstica entre o estado nutricional aferido e o percebido pelas mães foi avaliada pelo teste Kappa ponderado, com significância de 5%. Resultados: O percentual de desacertos entre o estado nutricional percebido pelas mães e o diagnosticado foi de 32,7%, com Kappa de 0,122, considerado desprezível. Destacou-se, principalmente, o excesso de peso subestimado (69,6%). A percepção materna do sobrepeso e o diagnosticado apresentou maior concordância nas crianças de maior faixa etária (36-59 meses versus 24-35 meses) e nas meninas. Conclusões: O estudo da percepção materna do estado nutricional de crianças pré-escolares mostrou a dificuldade que as mães apresentam em reconhecer o real estado nutricional de seus filhos, principalmente a subestimação do sobrepeso. A percepção materna do sobrepeso das crianças é mais distorcida em meninos e nas crianças mais novas.

ABSTRACT Objective: To verify the agreement between nutritional status perceived by mothers and that diagnosed in preschool children, by providing the differences according to children's sex and age. Methods: Study with data from a cohort of 269 preschool children assisted in public daycare centers of Campina Grande, Paraíba (Northeast Brazil). Children's information about their date of birth, sex and nutritional status (weight/stature Z scores) was collected. Furthermore, the mothers were asked about their perception of children's weight. The diagnostic agreement between the measured nutritional status and that perceived by mothers was assessed through the weighted Kappa test, with a 5% significance level. Results: The percentage of disagreement between the measured nutritional status and that perceived by mothers was 32.7%, with Kappa of 0.122, which is considered insignificant. There was a remarkable overweight underestimation (69.6%). Agreement between maternal perception of overweight and the diagnosed nutritional status was higher for older children (36-59 months versus 24-35 months) and for girls. Conclusions: The study regarding maternal perception of preschool children's nutritional status showed the difficulty that mothers face in recognizing the real nutritional status of their children, especially the underestimation of overweight. Maternal perception of overweight in children is misrepresented in boys and in younger children with more importance.

Body-related Perspectives and Weight Control Methods of Korean-Chinese Nursing School Students in Yanbian, China: A Pilot Study

OBJECTIVES: This study aimed at identifying the current nutrition knowledge, body-related perspectives, and weight control behaviors of Korean-Chinese college students. METHODS: We conducted a pilot study by employing a healthy weight education program targeting Korean-Chinese nursing school students at the Yanbian University of Science and Technology in Yanbian, China. RESULTS: This pilot study included 40 participants (38 women and 2 men; mean age, 20.5 years). The current weight status of the participants was as follows: 7.9% underweight, 78.9% normal weight, 7.9% overweight, and 5.3% obese. However, nearly two-thirds of the participants were dissatisfied with their current body size (43.6% a little dissatisfied; 20.5% very dissatisfied). Fifty percent of the participants perceived their current body size as being either slightly fat (35.0%) or very fat (15.0%). The following unhealthy weight control methods were commonly used among the 24 participants who practiced weight control: (1) laxatives or diuretics (91.7%), (2) saunas or spas (87.5%), and (3) a one-food diet (79.2%). In addition, the nutrition knowledge of the participants increased by 24 points from 117 points (pretest) to 141 points (posttest) through the healthy weight education program. CONCLUSION: The findings of this study indicate an urgent need to educate Korean-Chinese college students on healthy weight control methods and body-related perspectives.

Body Weight Perception, Mental Health, and Weight Control Behavior in Normal Weight Adolescents: Based on the Korea National Health and Nutrition Examination Survey 2013-2015

PURPOSE: The aim of this study was to assess the body weight perception of adolescents and to investigate the difference between mental health and weight control behavior according to body weight perception. METHODS: Study data on 12–18 years old adolescents with normal BMI was obtained from the 6th Korea National Health and Nutrition Examination Survey (2013–2015). Rao-Scott Chi-square test and ANOVA were used for the analysis. RESULTS: The percentage of adolescents with a misperception of body weight was 43.3%, and their subjective health status (p=.013), stress perception (p=.001), and depression (p=.001) were worse than for adolescents who had the correct perception of their body weight. The percentage of adolescents who were trying to lose weight while perceiving their body weight as normal was 36.9%. Body weight control behavior had significant differences according to dietary intake (frequency of eating dinner (p=.015)), energy intake (p=.004), and carbohydrate intake (p<.001), but there was no significant difference according to exercise. CONCLUSION: Parents, school teachers, and nurses should make efforts to ensure that Korean adolescents perceive their body weight correctly, and prevent unhealthy weight control behaviors.

Gender Differences in the Effects of Weight, Weight Perception, and Weight Satisfaction on Depression in Adolescents

PURPOSE: This study aims to investigate gender differences in the association between depressive symptoms and weight, weight perception, and body satisfaction among Korean adolescents. METHODS: A secondary data analysis was performed on data from 33,374 adolescents who participated in the 2015 Adolescent Health Behavior Online Survey. They were classified as underweight, normal weight, or overweight/obese; weight perception was classified into perception of being underweight, normal weight, or overweight/obese; and weight satisfaction into desire to gain weight, satisfied, and desire to lose weight. RESULTS: Among boys, perception of being underweight (adjusted odds ratio [AOR]: 1.20, 95% confidence interval [CI]: 1.07~1.35) and desire to gain weight (AOR: 1.45, 95% CI: 1.30~1.62) were associated with depression. Among girls, perception of being overweight or obese (AOR: 1.18, 95% CI: 1.07~1.29) and a desire to lose weight (AOR: 1.30, 95% CI: 1.18~1.42) were associated with depression. CONCLUSION: Gender differences were observed in the association between weight perception and depression in adolescents. The perception of being underweight among boys and the perception of being overweight/overweight among girls were associated with depression. Thus, gender-specific intervention programs to correct weight perception and weight satisfaction are needed in order to relieve depressive symptoms in adolescents.

Body Mass Index, Body Weight Perception, and Depressed Mood in Korean Adolescents

OBJECTIVES: We examined the relationships between the body mass index, body weight perception, and depressed mood in a nationally representative sample of Korean adolescents. METHODS: We analyzed the data from the 2013 Korean Youth Risk Behavior Web-based Survey and evaluated the relationships between the body mass index, body weight perception, and depressed mood by gender (36655 boys and 35780 girls). RESULTS: For boys, a low body mass index and perceiving oneself as underweight were related to depressed mood. For girls, both low and high body mass indices were negatively related to depressed mood. In addition, self-perceptions of being underweight or overweight were positively related to depressed mood. Body weight perception was not a significant mediator in the relationship between body mass index and depressed mood. CONCLUSION: These results suggest that both body mass index and body weight perception significantly contribute to Korean adolescents' depressed mood. Thus, research and clinical attention needs to be given to underweight as well as overweight adolescents, because those who perceive their weight as not normal are at risk for depression.