Study On Body Image Self-perception, Eating Behavior And Physical Activity Among Students In Grade4～6in Changsha

Objective:To understand the pupils’self-perception of body image and eating behavior, as well as physical activity status in Changsha, and to provide a scientific basis for the development of intervention program to prevent obesity in children as well as improve their nutrition status.Methods:A multi-stage stratified cluster sampling method was applied on2224primary school students and their parents in grades4to6in6districts and2counties in Changsha. Physical measurements and questionnaires were applied to collect student height and weight, general household demographic characteristics, body image perception and satisfaction of students and parents, as well as their eating behavior and physical activity status.According to overweight and obesity screening criteria by WGOC, the students were classified by their body image calculated by height and weight. Not only the perceptive body image of students and their parents, but also the ideal body image of students and actual ones were compared. The correlation between body image, body image perception, body image satisfaction and eating behavior, physical activity were evaluated. EpiData3.1was applied to establishment the database. SPSS18.0was applied for statistical analysis.Results:1. The status of students overweight and obesityThe detective rate of overweight and obesity of pupils in Grade4-6in Changsha were11.7%and6.8%, respectively. The detective rate of overweight and obesity of boy were16.2%and9.4%, girls were6.5%and3.9%. The results of Chi-square analysis showed that the only-child had a higher detective rate of overweight and obesity than who had siblings. Students from single-parent families had a higher detective rate of overweight and obesity than two-parent families. Urban students had a higher detective rate of overweight and obesity than rural students. 2. The status of body image perceptionThe perception bias of body image was prevalent among pupils in Grade4-6in Changsha, mostly of which was underestimation. In the total sample, the percentage of body image perception as thin appropriate, overweight and obesity were27.5%,58.5%,11.1%and2.9%, respectively. There were2.3%and57.0%overweight boys considered themselves as thin and appropriate, while this rate in girls were1.7%and49.2%. In the total sample population,4.8%of not overweight students overestimate their body image, and there was significantly more girls overestimated their body image than boys(6.3%vs.3.2%, x2=8.842, P=0.003); Difference of the accuracy of body image perception existed between genders, urban and rural students, only-child and ones had siblings. In addition, the accuracy of body image perception among different BMI groups followed the pattern:the obese group<Super restructuring<not-overweight. In the not-overweight group,31.7%girls wanted to be thinner, while34.7%boys wanted to achieve a bigger body image.Parents generally underestimated the student’s body image. Their perception of the student’s body image had discrepancy with the actual ones. There was3.5%and40.6%parents of overweight boys considered their sons as thin and appropriate, while among the parents of overweight girls,38.6%of them contemplated their daughters’body image appropriate.3. The status of body image satisfactionThere were16.0%,37.1%and69.5%of not-overweight, overweight and obese boys dissatisfied with their body image, respectively. While in girls were25.1%,62.5%and86.1%, respectively. Multinomial logistic regression analysis showed that students of high-grade (OR=1.320), overweight and obesity(OR=13.944), overestimated their body image(OR=8.416) and female (OR=1.654) were prone to dissatisfactory with their body image.4. The status of eating behavior and physical activityA certain proportion of pupils in Grade4-6in Changsha had unhealthy dietary behaviors. More than20%of the students did not have breakfast every day. More than half of the student had meals irregularly. The unhealthy dietary behaviors, such as eating too fast, having instant noodles instead of dinner, watching TV while having meals, picky eaters prevailed among students. The primary school students were short for physical activity. There were49.4%of the students failed to reach the one-hour-per-day recommended standard physical activity, while64.1%of the students showed a favor to physical activity.5. The influence of body image perception on weight management behaviorAfter other factors were adjusted, logistic regression analysis showed that the weight management behavior of non-overweight students such as skip breakfast (OR=4.045), skip dinner (OR=4.051), do not eat meat(OR=2.699)were correlate with body image overestimation. The weight management behavior of Overweight and obese groups students such as take supplements (OR=8.167) and increase food intake (OR=5.016) were correlate with body image underestimation.Conclusions:1. In this survey, the detective overweight rate of pupils in Grade4-6in Changsha was11.7%, the detective obesity rate was6.8%. The students’self-perception and parents perception of students’body image is biased, mainly of which exhibited underestimation.2. The survey showed that pupils in Grade4～6in Changsha possess dissatisfaction on their body image. The influence factors were grade, body image, bias on self-perception of body image and gender.3. Bias of pupils’self-perception of body image was the risk factor of unhealthy eating behavior and neglecting physical activity on their weight management behavior. The promotion of correct perception of body image is crucial in the prevention of children obesity by nutrition interventions.