Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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4th-grade elementary-school children's body image and dietary habits according to body mass index

초등학교 4학년 어린이에서 비만도에 따른 신체상과 식습관

  • Shim, Eugene (Department of Food and Nutrition, Soongeui Women's College) ;
  • Yang, Yoon Kyoung (Department of Food and Nutrition, Soongeui Women's College)
  • 심유진 (숭의여자대학교 식품영양과) ;
  • 양윤경 (숭의여자대학교 식품영양과)
  • Received : 2014.04.15
  • Accepted : 2014.07.22
  • Published : 2014.08.31
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Abstract

Purpose: The goal of this study was to examine body image satisfaction and perception according to weight status, and to investigate those associations with dietary habits and nutritional status among preadolescent children. Methods: Body image and dietary habits and intake were assessed in 134 elementary school students in grade 4. Children were categorized according to normal and overweight or obese groups. Figure rating scales were used to assess body image perception (identification of perceived current body size) and dissatisfaction (difference between perceived current body size and ideal body image). Results: There were sex differences in body image perceptions. Normal-weight girls, overweight or obese girls and boys were more likely to desire a leaner body size than their perceived body size compared with normal-weight boys. Body image satisfaction and perception showed an association with weight status. More overweight or obese children indicated dissatisfaction or underestimation of body image than normal-weight children. Children with body image dissatisfaction due to heavier perceived body size than ideal body image showed lower frequencies of consumption of meals and vegetables, compared to those who were satisfied with their body image. Children who underestimated their body image were more likely to have a lower frequency of breakfast and meal regularity and a higher frequency of eating out of home or food deliveries than those with accurate body image perception. In addition, body image underestimation showed an association with lower intakes of protein, dietary fiber and calcium, and the higher percentage of calories derived from fat. Conclusion: Body image dissatisfaction as well as underestimation in children before puberty showed an association with overweight or obesity, and was also related to unhealthy dietary habits. These findings highlight the importance of accurate perception and satisfaction with body image in preadolescent children in order to prevent development of obesity in adolescents and adults.

초등학교 4학년 아동 134명을 대상으로 신체상 및 신체상의 인지도와 만족도를 조사하고 식습관과 영양상태와의 관련성을 분석하였다. 희망하는 신체상에는 성별에 의한 차이가 존재하였는데 남학생에 비하여 여학생의 희망 신체상이 더 날씬한 모습이었으며, 정상체중의 남학생과 달리 과체중 및 비만 남학생, 정상체중 여학생, 과체중 및 비만 여학생은 자신의 현재 신체상에 비해 희망하는 신체상이 더 날씬한 모습인 것으로 나타났다. 정상체중군과 달리 과체중 및 비만군의 거의 대부분은 희망 신체상보다 자신의 신체상이 큰 신체상 불만족의 상태였다. 희망 신체상보다 자신의 신체상이 큰 신체상 불만족은 상대적으로 낮은 식습관 점수와 관련되어 있었는데 특히 규칙적인 식생활과 낮은 일일 식사 빈도 및 낮은 채소의 섭취 빈도와 관련되어 있는 것으로 나타났다. 정상체중군에 비하여 많은 수의 과체중 및 비만군은 현재 자신의 신체크기를 실제 비만도보다 낮게 인지하는 신체상 과소평가의 상태였다. 신체상 과소평가군은 정확한 인지군에 비해 아침식사의 빈도와 식사시간의 규칙성이 낮았고 외식이나 배달음식의 이용 빈도가 높은 등 상대적으로 좋지 않은 식습관을 가지고 있었으며, 낮은 단백질 섭취 수준과 높은 지질 섭취 수준 및 낮은 식이섬유와 칼슘 섭취와 관련되어 있었다. 결론적으로 초등학교 4학년 아동에서 신체상은 성별과 비만도에 따른 차이가 있었으며 식습관 및 영양섭취와도 관련되어 있었다. 청소년기 이후의 바람직한 식생활과 비만의 예방 및 정신적, 육체적으로 건강한 삶을 위해서는 신체상이 형성되는 아동기에 자신의 신체에 대한 만족도를 높이고 신체상을 정확하게 인지하려는 시도가 이루어져야 할 것이다.

Keywords

References

  1. Edwards NM, Pettingell S, Borowsky IW. Where perception meets reality: self-perception of weight in overweight adolescents. Pediatrics 2010; 125(3): e452-e458. https://doi.org/10.1542/peds.2009-0185
  2. Brener ND, Eaton DK, Lowry R, McManus T. The association between weight perception and BMI among high school students. Obes Res 2004; 12(11): 1866-1874. https://doi.org/10.1038/oby.2004.232
  3. Standley R, Sullivan V, Wardle J. Self-perceived weight in adolescents: over-estimation or under-estimation? Body Image 2009; 6(1): 56-59. https://doi.org/10.1016/j.bodyim.2008.08.004
  4. Gray WN, Crawford MJ, Follansbee-Junger K, Dumont-Driscoll MC, Janicke DM. Associations between actual and perceived weight and psychosocial functioning in children: the importance of child perceptions. Child Obes 2012; 8(2): 147-154. https://doi.org/10.1089/chi.2011.0033
  5. Eisenberg ME, Neumark-Sztainer D, Paxton SJ. Five-year change in body satisfaction among adolescents. J Psychosom Res 2006; 61(4): 521-527. https://doi.org/10.1016/j.jpsychores.2006.05.007
  6. McCabe MP, Ricciardelli LA. Body image dissatisfaction among males across the lifespan: a review of past literature. J Psychosom Res 2004; 56(6): 675-685. https://doi.org/10.1016/S0022-3999(03)00129-6
  7. Calzo JP, Sonneville KR, Haines J, Blood EA, Field AE, Austin SB. The development of associations among body mass index, body dissatisfaction, and weight and shape concern in adolescent boys and girls. J Adolesc Health 2012; 51(5): 517-523. https://doi.org/10.1016/j.jadohealth.2012.02.021
  8. Santana ML, Silva Rde C, Assis AM, Raich RM, Machado ME, de JPE, de Moraes LT, Ribeiro Júnior Hda C. Factors associated with body image dissatisfaction among adolescents in public schools students in Salvador, Brazil. Nutr Hosp 2013; 28(3): 747-755.
  9. Austin SB, Haines J, Veugelers PJ. Body satisfaction and body weight: gender differences and sociodemographic determinants. BMC Public Health 2009; 9: 313. https://doi.org/10.1186/1471-2458-9-313
  10. Kostanski M, Fisher A, Gullone E. Current conceptualisation of body image dissatisfaction: have we got it wrong? J Child Psychol Psychiatry 2004; 45(7): 1317-1325. https://doi.org/10.1111/j.1469-7610.2004.00315.x
  11. Parkinson KN, Tovree MJ, Cohen-Tovée EM. Body shape perceptions of preadolescent and young adolescent children. Eur Eat Disord Rev 1998; 6(2): 126-135. https://doi.org/10.1002/(SICI)1099-0968(199806)6:2<126::AID-ERV221>3.0.CO;2-L
  12. Tremblay L, Limbos M. Body image disturbance and psychopathology in children: research evidence and implications for prevention and treatment. Curr Psychiatry Rev 2009; 5(1): 62-72. https://doi.org/10.2174/157340009787315307
  13. Saxton J, Hill C, Chadwick P, Wardle J. Weight status and perceived body size in children. Arch Dis Child 2009; 94(12): 944-949. https://doi.org/10.1136/adc.2009.162578
  14. Park E. Overestimation and underestimation: adolescents' weight perception in comparison to BMI-based weight status and how it varies across socio-demographic factors. J Sch Health 2011; 81(2): 57-64. https://doi.org/10.1111/j.1746-1561.2010.00561.x
  15. Magarey AM, Perry RA, Baur LA, Steinbeck KS, Sawyer M, Hills AP, Wilson G, Lee A, Daniels LA. A parent-led family-focused treatment program for overweight children aged 5 to 9 years: the PEACH RCT. Pediatrics 2011; 127(2): 214-222. https://doi.org/10.1542/peds.2009-1432
  16. Kim JA. A study on the obese child's body image, food habit and food attitude. J Korean Soc Matern Child Health 1999; 3(1): 89-104.
  17. Johnstone AM, Stewart AD, Benson PJ, Kalafati M, Rectenwald L, Horgan G. Assessment of body image in obesity using a digital morphing technique. J Hum Nutr Diet 2008; 21(3): 256-267. https://doi.org/10.1111/j.1365-277X.2008.00862.x
  18. Schwartz MB, Brownell KD. Obesity and body image. Body Image 2004; 1(1): 43-56. https://doi.org/10.1016/S1740-1445(03)00007-X
  19. Must A, Strauss RS. Risks and consequences of childhood and adolescent obesity. Int J Obes Relat Metab Disord 1999; 23 Suppl 2: S2-S11.
  20. Erickson SJ, Robinson TN, Haydel KF, Killen JD. Are overweight children unhappy?: body mass index, depressive symptoms, and overweight concerns in elementary school children. Arch Pediatr Adolesc Med 2000; 154(9): 931-935. https://doi.org/10.1001/archpedi.154.9.931
  21. Pallan MJ, Hiam LC, Duda JL, Adab P. Body image, body dissatisfaction and weight status in South Asian children: a cross-sectional study. BMC Public Health 2011; 11: 21. https://doi.org/10.1186/1471-2458-11-21
  22. Neumark-Sztainer D, Paxton SJ, Hannan PJ, Haines J, Story M. Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. J Adolesc Health 2006; 39(2): 244-251. https://doi.org/10.1016/j.jadohealth.2005.12.001
  23. Blaesing S, Brockhaus J. The development of body image in the child. Nurs Clin North Am 1972; 7(4): 597-607.
  24. Moon JS, Lee SY, Nam CM, Choi JM, Choe BK, Seo JW, Oh K, Jang MJ, Hwang SS, Yoo MH, Kim YT, Lee CG. 2007 Korean National Growth Charts: review of developmental process and an outlook. Korean J Pediatr 2008; 51(1): 1-25. https://doi.org/10.3345/kjp.2008.51.1.1
  25. Collins ME. Body figure perceptions and preferences among preadolescent children. Int J Eat Disord 1991; 10(2): 199-208. https://doi.org/10.1002/1098-108X(199103)10:2<199::AID-EAT2260100209>3.0.CO;2-D
  26. Truby H, Paxton SJ. Development of the children's body image scale. Br J Clin Psychol 2002; 41(Pt 2): 185-203. https://doi.org/10.1348/014466502163967
  27. Jang YA, Lee HS, Kim BH, Lee Y, Lee HJ, Moon JJ, Kim CI. Revised dietary guidelines for Koreans. Asia Pac J Clin Nutr 2008;17 Suppl 1: 55-58.
  28. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2008: Korea National Health and Nutrition Examination Survey (KNHANES IV-2). Cheongwon: Korea Centers for Disease Control and Prevention;2009.
  29. Oh K, Jang MJ, Lee NY, Moon JS, Lee CG, Yoo MH, Kim YT. Prevalence and trends in obesity among Korean children and adolescents in 1997 and 2005. Korean J Pediatr 2008; 51(9): 950-955. https://doi.org/10.3345/kjp.2008.51.9.950
  30. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2012: Korea National Health and Nutrition Examination Survey (KNHANES V-3). Cheongwon: Korea Centers for Disease Control and Prevention;2013.
  31. Davison KK, Markey CN, Birch LL. Etiology of body dissatisfaction and weight concerns among 5-year-old girls. Appetite 2000; 35(2): 143-151. https://doi.org/10.1006/appe.2000.0349
  32. Tiggemann M, Lynch JE. Body image across the life span in adult women: the role of self-objectification. Dev Psychol 2001; 37(2): 243-253. https://doi.org/10.1037/0012-1649.37.2.243
  33. Presnell K, Bearman SK, Stice E. Risk factors for body dissatisfaction in adolescent boys and girls: a prospective study. Int J Eat Disord 2004; 36(4): 389-401. https://doi.org/10.1002/eat.20045
  34. Shunk JA, Birch LL. Girls at risk for overweight at age 5 are at risk for dietary restraint, disinhibited overeating, weight concerns, and greater weight gain from 5 to 9 years. J Am Diet Assoc 2004; 104(7): 1120-1126. https://doi.org/10.1016/j.jada.2004.04.031
  35. Toselli S, Brasili P, Spiga F. Body image, body dissatisfaction and weight status in children from Emilia-Romagna (Italy): comparison between immigrant and native-born. Ann Hum Biol 2014; 41(1): 23-28. https://doi.org/10.3109/03014460.2013.822557
  36. Stice E, Ng J, Shaw H. Risk factors and prodromal eating pathology. J Child Psychol Psychiatry 2010; 51(4): 518-525. https://doi.org/10.1111/j.1469-7610.2010.02212.x
  37. Haines J, Neumark-Sztainer D, Wall M, Story M. Personal, behavioral, and environmental risk and protective factors for adolescent overweight. Obesity (Silver Spring) 2007; 15(11): 2748-2760. https://doi.org/10.1038/oby.2007.327
  38. van den Berg P, Neumark-Sztainer D. Fat'n happy 5 years later: is it bad for overweight girls to like their bodies? J Adolesc Health 2007; 41(4): 415-417. https://doi.org/10.1016/j.jadohealth.2007.06.001
  39. Choi TI, Rhee HJ, Ko KM, Yoo SM, Kim KN, Lee SY, Kang JH. The prevalence of obesity and obesity-related metabolic complications in Korean adolescents. J Korean Acad Fam Med 2006; 27(3): 175-181.
  40. Cho JH, Han SN, Kim JH, Lee HM. Body image distortion in fifth and sixth grade students may lead to stress, depression, and undesirable dieting behavior. Nutr Res Pract 2012; 6(2): 175-181. https://doi.org/10.4162/nrp.2012.6.2.175
  41. Lim H, Wang Y. Body weight misperception patterns and their association with health-related factors among adolescents in South Korea. Obesity (Silver Spring) 2013; 21(12): 2596-2603. https://doi.org/10.1002/oby.20361
  42. Viner RM, Haines MM, Taylor SJ, Head J, Booy R, Stansfeld S. Body mass, weight control behaviours, weight perception and emotional well being in a multiethnic sample of early adolescents. Int J Obes (Lond) 2006; 30(10): 1514-1521. https://doi.org/10.1038/sj.ijo.0803352
  43. Yao NL, Hillemeier MM. Weight status in Chinese children: maternal perceptions and child self-assessments. World J Pediatr 2012; 8(2): 129-135. https://doi.org/10.1007/s12519-012-0346-4
  44. Rietmeijer-Mentink M, Paulis WD, van Middelkoop M, Bindels PJ, van der Wouden JC. Difference between parental perception and actual weight status of children: a systematic review. Matern Child Nutr 2013; 9(1): 3-22. https://doi.org/10.1111/j.1740-8709.2012.00462.x
  45. West DS, Raczynski JM, Phillips MM, Bursac Z, Heath Gauss C, Montgomery BE. Parental recognition of overweight in schoolage children. Obesity (Silver Spring) 2008; 16(3): 630-636. https://doi.org/10.1038/oby.2007.108
  46. Pimenta AM, Sanchez-Villegas A, Bes-Rastrollo M, Lopez CN, Martinez-Gonzalez MA. Relationship between body image disturbance and incidence of depression: the SUN prospective cohort. BMC Public Health 2009; 9: 1. https://doi.org/10.1186/1471-2458-9-1
  47. Toschke AM, Kuchenhoff H, Koletzko B, von Kries R. Meal frequency and childhood obesity. Obes Res 2005; 13(11): 1932-1938. https://doi.org/10.1038/oby.2005.238
  48. Cho KJ. The research study on the food habits according to obesity index of primary school children in Busan. Korean J Food Cult 2004; 19(1): 106-117.
  49. Lee MS, Sung CJ, Sung MK, Choi MK, Lee YS, Cho KO. A comparative study on food habits and nutrient intakes among high school students with different obesity indexes residing in Seoul and Kyunggi-do. Korean J Community Nutr 2000; 5(2): 141-151.

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