School physical activity and mental health in school-aged Brazilian adolescents: a systematic review

ABSTRACT The aim of this study was to identify evidence regarding associations between School Physical Activity (PA) and Mental Health (MH) in Brazilian school-aged adolescents. This is a systematic review study. Studies were selected in Portuguese and English and identified by a systematic search in six electronic databases: PubMed, Web of Science, SPORTDiscus / Ebsco, ScIELO, ERIC, and LILACS, which comprised publications until 2019. Inclusion criteria were: studies with cohort, descriptive, cross-sectional or qualitative design; performed with children and adolescents; studies that analyzed the relationship between PA and MH; studies that investigated adolescents who practiced PA in schools; studies carried out in Brazil; and studies that reached minimum of 60% of methodological quality criteria according to STROBE. Physical education, as curricular activity in basic education, has protective effect on MH in the school setting. In addition, more than 300 min/week of PA was positively associated with MH; while associations between PA and excessive TV time; social isolation; and body weight dissatisfaction were negatively associated. School PA is positively associated with MH as it promotes physical and psychological well-being, impacting on the reduction of insomnia rates, attenuating loneliness and improving physical appearance.

Diet quality in middle-aged and older women with and without body weight dissatisfaction: results from a population-based national nutrition survey in Switzerland

Body weight dissatisfaction is associated with unhealthy dietary behaviours in young adults, but data are scarce regarding how this relationship evolves with age. The objectives of the present study were to assess the prevalence of body weight dissatisfaction and the association between body weight dissatisfaction, nutrient intake and diet quality in middle-aged and older women. We used data of a population-based sample of 468 middle-aged (50–64 y/o) and older (65–75 y/o) women, extracted from the cross-sectional 2014–15 Swiss National Nutrition Survey. Body weight dissatisfaction was assessed by questionnaire. Dietitians assessed dietary intakes using two non-consecutive computer-assisted multi-pass 24-h dietary recalls and performed anthropometric measurements. Nutrient intakes were calculated and compared with national dietary guidelines, and diet quality scored with the 2010 Alternate Healthy Eating Index (2010-AHEI). 41⋅1 % of women reported body weight dissatisfaction, and 49⋅8 % wanted to lose weight. Body weight dissatisfaction was associated with weight loss desire and a higher body mass index (BMI; P < 0⋅001). Women with body weight dissatisfaction consumed significantly less carbohydrates and dietary fibres, even when BMI was controlled for (P < 0⋅05). They also fell short of national dietary guidelines for magnesium and iron. Body weight dissatisfied women obtained lower 2010-AHEI scores than satisfied women (β −4⋅36, 95 % CI −6⋅78, −1⋅93). However, this association disappeared when the BMI was introduced in the equation. This highlights the importance of targeting both body dissatisfaction and unhealthy eating in obesity prevention and treatment at all ages.

Body Weight Dissatisfaction Is Associated with Cardiovascular Health-Risk Behaviors among Brazilian Adolescents: Findings from a National Survey

Body weight dissatisfaction (BWD) among adolescents may be a predictor of adoption of health-risk behaviors. The study aimed to assess the gendered association between two forms of BWD (feeling underweight/overweight) and cardiovascular health-risk behaviors among Brazilian adolescents. This cross-sectional study used data from the National Study of Cardiovascular Risks in Adolescents (ERICA) in Brazil, including 71,740 adolescents aged 12–17 years. BWD was defined as satisfied, dissatisfied feeling underweight and dissatisfied feeling overweight. We considered four health-risk behaviors: tobacco use, alcohol use, physical inactivity and skipping breakfast. Assessment of the associations between BWD and these behaviors were undertaken using logistic regression models. All analyses were stratified by gender. Analyses revealed that 14.9% of male adolescents and 14.5% of female adolescents were dissatisfied feeling underweight and 21.5% of males and 39.9% of females were dissatisfied feeling overweight. Among male adolescents, dissatisfied feeling overweight was associated with greater odds of physical inactivity and skipping breakfast. Among female adolescents, dissatisfied feeling underweight and overweight were associated with higher odds of alcohol use and skipping breakfast. These results highlight the importance of BWD and the association with a range of adolescent health behaviors increasing cardiovascular risk over the life course, depending on gender.

The role of sexual orientation in the relationships between body perception, body weight dissatisfaction, physical comparison, and eating psychopathology in the cisgender population

Purpose Body weight dissatisfaction (BWD) and visual body perception are specific aspects that can influence the own body image, and that can concur with the development or the maintenance of specific psychopathological dimensions of different psychiatric disorders. The sexual orientation is a fundamental but understudied aspect in this field, and, for this reason, the purpose of this study is to improve knowledge about the relationships among BWD, visual body size-perception, and sexual orientation. Methods A total of 1033 individuals participated in an online survey. Physical comparison, depression, and self-esteem was evaluated, as well as sexual orientation and the presence of an eating disorder. A Figure Rating Scale was used to assess different valences of body weight, and mediation analyses were performed to investigated specific relationships between psychological aspects. Results Bisexual women and gay men reported significantly higher BWD than other groups (p < 0.001); instead, higher body misperception was present in gay men (p = 0.001). Physical appearance comparison mediated the effect of sexual orientation in both BWD and perceptual distortion. No difference emerged between women with a history of eating disorders and without, as regards the value of body weight attributed to attractiveness, health, and presence on social media. Conclusion This study contributes to understanding the relationship between sexual orientations and body image representation and evaluation. Physical appearance comparisons should be considered as critical psychological factors that can improve and affect well-being. The impact on subjects with high levels of eating concerns is also discussed. Level of evidence Level III: case–control analytic study.

Attitudes towards body weight dissatisfaction associated with adolescents’ perceived health and sleep (PeNSE 2015)

This study aimed to investigate whether attitudes towards body weight dissatisfaction is associated with perceived health and impairments in sleep among a national population-based sample of Brazilian adolescents. This is a cross-sectional data from the 2015 National School-Based Health Survey (PeNSE). A total of 100.182 students (70.8% were between 14 to 15) in ninth-grade, enrolled in public and private schools were eligible for data analysis. Variables were measured using a questionnaire and binary logistic regression was used. There was association between attitudes towards body weight dissatisfaction and perceived health (not controlling weight = OR: 2.19, 95%CI: 2.00-2.40; trying to lose = OR: 1.90, 95%CI: 1.75-2.05; gain = OR: 2.22, 95%CI: 2.01-2.46; maintain = OR: 1.81, 95%CI: 1.54-2.14). Adolescents were also more likely to present impairments in sleep (not controlling weight = OR: 1.21, 95%CI: 1.11-1.32; trying to lose = OR: 1.16, 95%CI: 1.08-1.25; gain = OR: 1.43, 95%CI: 1.28-1.61; maintain = OR: 1.43, 95%CI: 1.22-2.68). Dissatisfaction is an additional concern in the daily life of adolescents, which is associated to depreciation of the quality of sleep and decrement of psychological well-being.

The association between body weight dissatisfaction with unhealthy eating behaviors and lack of physical activity in adolescents: A systematic review

A systematic review examined the association between body weight dissatisfaction with unhealthy eating behaviors and lack of physical activity in adolescents, since it represents an alert to adolescent’s health and well-being. Six electronic databases and gray literature were systematically searched from January 1980 to December 2018. A total of 11 articles met the inclusion criteria. Included studies assessed body weight dissatisfaction using different dimensions/components: satisfaction component of the attitudinal dimension was assessed in five studies, behavior component of the attitudinal dimension was assessed in two studies, perceptual dimension was assessed in two studies, and two studies were unclear about dimension. Behaviors: two assessed only unhealthy eating behaviors, six assessed lack of physical activity, and three assessed both behaviors. Only three studies found an association between body weight dissatisfaction with unhealthy eating behaviors, three with lack of physical activity, and one did not perform a statistical test for an association between body weight dissatisfaction with unhealthy eating behaviors and lack of physical activity. Few studies have reported an association between body weight dissatisfaction with one of these unhealthy behaviors. There was substantial heterogeneity related to unit of measures, both for body weight dissatisfaction and for behaviors studied.

Dieting, body weight concerns and health: trends and associations in Swedish schoolchildren

Background Dieting is a risk factor of both eating disorders and obesity. The aim was to examine time trends of dieting in Swedish adolescents, and explore how dieting and body weight dissatisfaction are related to self-reported health, wellbeing and health behaviours. Methods Analyses of cross-sectional Swedish data from HBSC (Health Behaviour in School-aged Children) surveys 1994–2014. In total, about 30,000 girls and boys in the age of 11, 13 and 15 years participated. Data was collected by using classroom administered questionnaires in 5th, 7th and 9th grade. Logistic regressions was used to analyse secular trends of dieting, and how dieting and body dissatisfaction were associated with self-reported overall health, health behaviours, BMI and various physical, psychological and social aspects of health in 2014. Results Dieting increased from 1994 to 2014 in both girls and boys in all age groups, and in 2014, the prevalence was 14% in girls and 8% in boys. The prevalence of body satisfaction was 65% respectively 69%. Body weight dissatisfaction and dieting were present in all body weight classes and were associated with self-reported poor health and many other negative health aspects. In comparison with the participants that were satisfied with their body weight the odds ratio (95% CI) for self-reported poor health was 3.4 (2.6–4.4) in dieters, 4.9 (3.8–6.4) in participants who perceived a need to lose weight and 2.1 (1.5–2.8) in those who perceived a need to gain weight, when adjusting for age, sex and body weight class. Conclusions When promoting health among school age children body weight dissatisfaction and dieting ought to be considered. Furthermore, it is important to support girls and boys in all weight classes to reach and maintain a healthy body image and weight.

Eating Disorders among Psychic Patients: A Clinical Study

Background: Eating disorders (ED) are common conditions that have gained increasing attention over the last two decades. This study was conducted to correlate the eating disorder with body weight dissatisfaction (BWD) and body shape dissatisfaction (BSD) in study population. Materials & Methods: This study was conducted in department of Psychiatry in year 2012. It was cross sectional type of study conducted on 2360 patients visited the department with any psychiac disorders. Patient information regarding name, age, gender etc was recorded. Body mass index (BMI) was also recorded. Patients were asked to reply the Eating aptitude test (EAT) and BSQ questionnaire. EAT is 26 items evaluated attitudes, feelings and preoccupations in relation to food and weight. The BSQ is a self-report, 34 items questionnaire that evaluates feelings of low self-esteem, the desire to lose weight and body dissatisfaction. For detecting body shape dissatisfaction (BSD), Cooper and Taylor classification was used. The BSD value, <81-slight BSD value, 81- 110- moderate BSD and BSD value 111-140- extreme BSD. For detecting BWD, discrepancy between students current and desired weight was considered. Results: Out of 520 patients, 250 (48%) were males and 270 (51%) were females. 40% (208) had BSD, 60% (312) had BWD, 20% (104) had positive EAT, 60% (338) had normal weight, 10 % (52) had underweight and 25% (130) had overweight. The magnitudes of BSD in patients with positive EAT. 94 patients (90%) with a positive EAT expressed BSD. Out of 104 slightly dissatisfied BSD patients, 26 had positive EAT. Of 56 moderately dissatisfied BSD patients, 54 had positive EAT. Of 48 severely dissatisfied BSD patients, 14 had positive EAT. The difference was significant (P<0.05). Patients with overweight had significantly higher BSD, BWD and positive EAT Conclusion: Eating disorders are increasing day by day. This is an alarming signal for most of the people and westernization is playing important role in this. There is need to educate the people psychologically also.