Perceived and desired weight, weight related eating and exercising behaviours, and advice received from parents among thin, overweight, obese or normal weight Australian children and adolescents

O'Dea, Amy

Description

Thin children are less muscular, weaker, less active, and have lower performance in measures of physical fitness than their normal weight peers. Thin children are also more frequently subjected to teasing and stigmatization. Little is known about thin children's weight perceptions, desired weight and attitudes and behaviours towards food and exercise. The study aimed to compare perceived weight status, desired weight, eating and exercise behaviours and advice received from parents among thin, overweight, obese or normal weight Australian children and adolescents. Methods The sample included 8550 school children aged 6 to 18 years selected from every state and territory of Australia. The children were weighed, measured and classified as thin, normal, overweight or obese using international standards. The main outcome measures were perceived and desired weight, weight related eating and exercising behaviours, and advice received from parents. Results The distribution of weight status was - thin 4.4%; normal weight 70.7%; overweight 18.3%; and obese 6.6%. Thin children were significantly shorter than normal weight, overweight or obese children and they were also more likely to report regularly consuming meals and snacks. 57.4% of thin children, 83.1% of normal weight children, 63.7% of overweight and 38.3% of obese children perceived their weight as "about right". Of the thin children, 53.9% wanted to be heavier, 36.2% wanted to stay the same weight, and 9.8% wanted to weigh less. Thin children were significantly less likely than obese children to respond positively to statements such as "I am trying to get fitter" or "I need to get more exercise." Parents were significantly less likely to recommend exercise for thin children compared with other weight groups. Conclusions Thin children, as well as those who are overweight or obese, are less likely than normal weight children to consider their weight "about right'. Thin children differ from children of other weights in that thin children are less likely to desire to get fitter or be encouraged to exercise. Both extremes of the spectrum of weight, from underweight to obese, may have serious health consequences for the individuals, as well as for public health policy. Health and wellness programs that promote positive social experiences and encourage exercise should include children of all sizes.

Informations

• Publié par: biomed
• Publié le: 01 janvier 2011
• Nombre de lectures: 6
• Langue: English

Extrait

O
’
DeaandAmy
InternationalJournalofBehavioralNutritionandPhysicalActivity
2011,
8
:68
http://www.ijbnpa.org/content/8/1/68

RESEARCH

OpenAccess

Perceivedanddesiredweight,weightrelated
eatingandexercisingbehaviours,andadvice
receivedfromparentsamongthin,overweight,
obeseornormalweightAustralianchildrenand
adolescents
JenniferAO
’
Dea
1
†
andNancyKAmy
1,2*

†Abstract
Background:
Thinchildrenarelessmuscular,weaker,lessactive,andhavelowerperformanceinmeasuresof
physicalfitnessthantheirnormalweightpeers.Thinchildrenarealsomorefrequentlysubjectedtoteasingand
stigmatization.Littleisknownaboutthinchildren
’
sweightperceptions,desiredweightandattitudesand
behaviourstowardsfoodandexercise.Thestudyaimedtocompareperceivedweightstatus,desiredweight,
eatingandexercisebehavioursandadvicereceivedfromparentsamongthin,overweight,obeseornormalweight
Australianchildrenandadolescents.
Methods:
Thesampleincluded8550schoolchildrenaged6to18yearsselectedfromeverystateandterritoryof
Australia.Thechildrenwereweighed,measuredandclassifiedasthin,normal,overweightorobeseusing
internationalstandards.Themainoutcomemeasureswereperceivedanddesiredweight,weightrelatedeating
andexercisingbehaviours,andadvicereceivedfromparents.
Results:
Thedistributionofweightstatuswas-thin4.4%;normalweight70.7%;overweight18.3%;andobese
6.6%.Thinchildrenweresignificantlyshorterthannormalweight,overweightorobesechildrenandtheywerealso
morelikelytoreportregularlyconsumingmealsandsnacks.57.4%ofthinchildren,83.1%ofnormalweight
children,63.7%ofoverweightand38.3%ofobesechildrenperceivedtheirweightas
“
aboutright
”
.Ofthethin
children,53.9%wantedtobeheavier,36.2%wantedtostaythesameweight,and9.8%wantedtoweighless.Thin
childrenweresignificantlylesslikelythanobesechildrentorespondpositivelytostatementssuchas
“
Iamtrying
togetfitter
”
or
“
Ineedtogetmoreexercise.
”
Parentsweresignificantlylesslikelytorecommendexerciseforthin
childrencomparedwithotherweightgroups.
Conclusions:
Thinchildren,aswellasthosewhoareoverweightorobese,arelesslikelythannormalweight
childrentoconsidertheirweight
“
aboutright
’
.Thinchildrendifferfromchildrenofotherweightsinthatthin
childrenarelesslikelytodesiretogetfitterorbeencouragedtoexercise.Bothextremesofthespectrumof
weight,fromunderweighttoobese,mayhaveserioushealthconsequencesfortheindividuals,aswellasfor
publichealthpolicy.Healthandwellnessprogramsthatpromotepositivesocialexperiencesandencourage
exerciseshouldincludechildrenofallsizes.

*Correspondence:[e-mail]
†
Contributedequally
1
FacultyofEducation&SocialWork,BuildingA35,TheUniversityofSydney
NSW,2006,Australia
Fulllistofauthorinformationisavailableattheendofthearticle
©2011O
’
DeaandAmy;licenseeBioMedCentralLtd.ThisisanOpenAccessarticledistributedunderthetermsoftheCreative
CommonsAttributionLicense(http://creativecommons.org/licenses/by/2.0),whichpermitsunrestricteduse,distribution,and
reproductioninanymedium,providedtheoriginalworkisproperlycited.

O
’
DeaandAmy
InternationalJournalofBehavioralNutritionandPhysicalActivity
2011,
8
:68
http://www.ijbnpa.org/content/8/1/68

Background
Ifgoodhealthinchildrenwereassociatedwiththemost
desirablebodytypeportrayedinpopularmedia,one
mightexpectthinchildrentobedemonstrablyhealthier
thantheirobese,overweightandperhapsevennormal
weightpeers.Problemsrelatedtomalnutritionandeat-
ingdisordersinthinchildrenhavebeenstudied,but
persistentthinnessthatisnotduetothesecauseshas
receivedlittlescrutiny.
Comparedtonormalweightchildren,thinchildren
mayhavearangeofsignificanthealthproblemsnot
directlyrelatedtomalnutritionandeatingdisorders
including:lowerbodyfatstores;delayedgrowth;
increasedriskofosteoporosis;lowermuscleandskeletal
massassociatedwithlowbonemineralcontent;and
increasedriskofbonefracture[1-7].
Instudiesofphysicalfitness,thinadolescentsspent
lesstimedoingphysicalactivity[8]andhavelowerper-
formanceinmeasurescomparedtonormalweightado-
lescents[1,9].Theremaybean
inutero
explanationfor
thinnessinchildrenthatisassociatedwithmaternal
undernutritioninthatwomenwithlowpre-pregnancy
weightareatincreasedriskofpre-termdelivery,small-
for-gestationalageinfants,andfetalandneonataldeaths
[7,10,11].Further,strongevidenceexistsforthegenetic
basisofthinnessinhumansandanimals.Sinceunder-
weight(aswellasobese)adultssufferincreasedmortal-
ityrelativetonormalweightoroverweightadults[12],
thinchildrenwhobecomethinadultsmaybeatriskof
havingshortenedlifespans.Recentreportsindicatethat
underweightinadulthoodisclearlyassociatedwithan
increasedmortalityduetodiabetes,kidneydisease,
respiratorydisease,infectiousdisease,andothercauses
intheUSA[13]andthatthesediscrepanciesareinde-
pendentofsmokingstatus.
Weightissuesinchildrenareimportantnotonly
becauseofhealthrisks,butalsobecauseofpotential
emotionalconsequencesofpracticessuchasstigmatiza-
tion.Thinchildrenaresubjectedtofrequentteasingata
muchhigherratethannormaloroverweightchildren
andarealsoatagreaterriskofunhealthyweightcontrol
behaviours[14].Thinboysaremorelikelytodislike
schoolandconsiderthemselvestobepoorstudents[15].
Studiesthatexplorebodyimageinchildrengenerally
comparetheattitudesofoverweightandobesechildren
withnon-obesechildren,andtheattitudesofthinchil-
drenarenotreportedseparatelyfromotherchildren.
Littleisknownaboutthinchildren
’
sbodyimage,atti-
tudes,andbehaviourstowardsfoodandexercise.
ThinnessisdefinedaslowBodyMassIndex(BMI)for
ageandgenderinchildren.However,theprevalenceof
thinnessacrosscountriesandyearshasbeendifficultto
comparebecauseunderweighthasbeendefineddiffer-
entlyinthesestudies.Toaddressthisproblem,Cole

Page2of8

developedacommonsetofreferencesforinternational
comparisons[16].Thinnessinchildrenandadolescents
isdefinedbasedonageandgenderspecificcurvesthat
arelinkedtotheWorldHealthOrganization(WHO)
recommendedadultcut-offpointsofBMI16,17,and
18.5atage18.Thesethinnessstandardsallowdistinc-
tionsbetweendifferentgradesofundernutritionand
differentlevelsofriskinchildren.Themethodscur-
rentlyusedworldwidetodevelopthethinnesscut-offs
aresimilartothoseusedbytheInternationalObesity
TaskForce(IOTF)foroverweightandobesitycut-offs
[17]andthereforeallowforthecomparisonofpreva-
lenceofthinness,overweightandobesity.
Theobjectiveofthisstudywastoexaminetherela-
tionshipsbetweenperceivedanddesiredweight,weight
relatedeatingandexercisingbehaviours,andadvice
receivedfromparentsamongthin,overweight,obeseor
normalweightAustralianchildrenandadolescents.
Thestudymeasured:1)theprevalenceofthinness,
normalweight,overweightandobesityinalarge,repre-
sentativepopulationsampleofAustralianschoolchil-
dren;2)thedifferencesinperceivedanddesiredweight,
dietaryhabits,exercisebehavioursandconcernsabout
weightbetweenthinchildrenandtheirpeersofother
sizes;and3)therelationshipbetweentheparental
advicegiventochildrenofdifferentweightstatusand
thechildren
’
s
’
behavioursandattitudesconcerningbody
sizeandexercise.
Methods
DatainthisstudywerecollectedaspartoftheYouth
CulturesofEatingStudy,a3-yearAustralianResearch
Councilfundedstudyofhealth,weight,cultureandeat-
ingamong8550schoolchildrenfromeverystateand
territoryofAustraliain2006.Thedescriptionsofstudy
recruitmentandsamplingaregiveninpreviouslypub-
lishedarticles[18-20].Childreningrades2to12(aged
6to18years)participated,fromrandomlyselectedclass
groupswithinschoolsthathadbeenrandomlyselected
fromlistsofallstateandterritory
’
sschoolsinAustralia.
Thesampleincludedstudentsfrompublic,private,and
Catholicschoolsinbothruralandurbanareas,with
low,middleandhighsocio-economicstatus(SES)levels.
Theethnicdistributionofthesamplewasrepresentative
ofthegeneralpopulationandhasbeendescribedpre-
viously[19].Theparticipationratewashighat82%.
Childrenwereweighedandmeasuredusingdigital
scalesandportablestadiometersinlightschooluni-
forms,afterremovingjackets,shoesandemptyingtheir
pockets,inprivateareasoftheschools,underthesuper-
visionofthefirstauthorandtrainedresearchassistants.
Theprevalenceofnormalweight,overweightandobe-
sitywasmeasuredusingtheInternationalObesityTask
Force(IOTF)BMIcut-offs,withageinyearstakento

O
’
DeaandAmy
InternationalJournalofBehavioralNutritionandPhysicalActivity
2011,
8
:68
http://www.ijbnpa.org/content/8/1/68

the0.5yearscutoff[17].Heightwasmeasuredtothe
nearest0.5cmusingaportablestadiometer.Weightwas
measuredtothenearest0.1kgusingportabledigital
scales.Participants
’
heightandweightwereusedtocal-
culatetheageandsex-adjustedBMIpercentile.Thin-
ness,ingrades1,2,and3childrenandadolescentswas
basedonadultBMIof16,17and18.5at18years,and
curvesprovidedageandsex-specificcut-offpoints[16].
Studentsweregroupedbyageintotwocategories:pri-
maryschoolstudents,aged6to12years;andsecondary
schoolstudents,aged13to18years.
Detailsofthequestionnaireandthestudyvariables
havebeendescribedpreviously[18-20].Thequestion-