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Social inequality and age-specific gender differences in overweight and perception of overweight among Swedish children and adolescents: a cross-sectional study
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Karolinska University Hospital, Sweden.
2015 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, no 628Article in journal (Refereed) Published
Abstract [en]

Background: Overweight among children and adolescents related to social inequality, as well as age and gender differences, may contribute to poor self-image, thereby raising important public health concerns. This study explores social inequality in relation to overweight and perception of overweight among 263 boys and girls, age 7 to 17, in Vaxjo, Sweden. Methods: Data were obtained through a questionnaire and from physical measurements of height, weight and waist circumference [WC]. To assess social, age and gender differences in relation to overweight, the independent sample t- and chi-square tests were used, while logistic regression modeling was used to study determinants for perception of overweight. Results: Social inequality and gender differences as they relate to high ISO-BMI [Body Mass Index for children] and WC were associated with low maternal socioeconomic status [SES] among boys less than 13 years [mean age = 10.4; n = 65] and with low paternal education level among boys = 13 years [mean age = 15.0; n = 39] [p less than 0.05]. One suggested explanation for this finding is maternal impact on boys during childhood and the influence of the father as a role model for adolescent boys. The only association found among girls was between high ISO-BMI in girls = 13 years [mean age = 15.0; n = 74] and low paternal occupational status. Concerning perception of overweight, age and gender differences were found, but social inequality was not the case. Among boys and girls less than 13 years, perception of overweight increased only when overweight was actually present according to BMI or WC [p less than 0.01]. Girls = 13 years [mean age = 15.0] were more likely to unrealistically perceive themselves as overweight or "too fat," despite factual measurements to the contrary, than boys [p less than 0.05] and girls less than 13 years [mean age = 10.4; n = 83] [p less than 0.001]. Conclusions: The association between social inequality and overweight in adolescence in this study is age-and gender-specific. Gender differences, especially in perception of overweight, tend to increase with age, indicating that adolescence is a crucial period. When planning interventions to prevent overweight and obesity among children and adolescents, parental SES as well as age and gender-specific differences in social norms and perception of body weight status should be taken into account.

Place, publisher, year, edition, pages
BioMed Central , 2015. Vol. 15, no 628
Keyword [en]
Social inequality; Overweight; Obesity; Perception of overweight; Childhood; Adolescence
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-120339DOI: 10.1186/s12889-015-1985-xISI: 000357559600001PubMedID: 26156095OAI: oai:DiVA.org:liu-120339DiVA: diva2:843903
Note

Funding Agencies|Erik Johan Ljungberg Educational Fund; County Council of Ostergotland; Medical Research Council of Southeast Sweden [FORSS-233111]

Available from: 2015-07-31 Created: 2015-07-31 Last updated: 2017-12-04
In thesis
1. Balancing body perception during growth and development
Open this publication in new window or tab >>Balancing body perception during growth and development
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Among children and adolescents, the drive to be slender and the fear of being fat is a growing public health concern. This trend stands in contrast to the increasing prevalence of overweight reported worldwide. Both feeling too fat and being overweight are associated with physical, psychological and social health-related issues from a shortand long-term perspective. The aim of this thesis is to study body perception in relation to actual body size and the bodily changes that occur naturally during puberty. Another objective is to identify risk factors for overweight, overweight perception and unhealthy eating habits in childhood and adolescence.

This thesis describes the prevalence of 1) perception of overweight, 2) overweight/obesity and 3) unhealthy eating habits in Finland and Sweden. We compare our results with the World Health Organization (WHO) Health Behaviour in Schoolchildren (HBSC) survey in 2001/2002 and 2009/2010. Our cross-sectional studies were performed on a female cohort of 11-18 year old girls in Finland and a cohort of boys and girls 7-17 years in Sweden.

In both Finland and Sweden, the prevalence of overweight increased over time, especially among boys. Also perception of overweight increased over time – not just among girls, but also among boys. We found social inequality in overweight, particularly in boys in relation to maternal socioeconomic status. No social inequality, but age and gender differences were found in relation to perception of overweight, where girls older than 13 years showed the highest prevalence. Body perception among girls agreed better with international reference values for waist circumference (WC) than for body mass index (BMI). Breast development and acne increased the risk for overweight perception, particularly among non-overweight girls. Perception of overweight was the strongest risk factor for dieting and skipping breakfast in both boys and girls. These behaviours were more common among adolescents than among younger boys and girls. Skipping breakfast was related to unbalanced food consumption patterns in both sexes, but in a gender-specific way.

We have shown that body perception during growth and development relates to a complex age- and gender-specific balance between body size, stage and timing of pubertal maturation, eating habits as well as parental and peer influences. From a broader perspective, improving adequate body perception entails optimising this balance by influencing one or more of the individual, societal and environmental factors that determine health outcomes among children and adolescents, tracking into adulthood.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 73 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1482
National Category
Pediatrics Nutrition and Dietetics Public Health, Global Health, Social Medicine and Epidemiology Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-123861 (URN)10.3384/diss.diva-123861 (DOI)978-91-7685-947-6 (ISBN)
Public defence
2015-12-10, Berzeliussalen, Campus US, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2016-01-12 Created: 2016-01-12 Last updated: 2016-01-13Bibliographically approved

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Gustafsson, PerDuchén, KarelNelson Follin, Nina

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