Self-perception of weight status and its association with weight-related knowledge,attitudes, and behaviors among Chinese children in Guangzhou

Background

How weight perception influences weight-related knowledge, attitudes, and behaviors in Chinese children is unknown. We investigated self-perception of body weight and its correlates, and analyzed the relationship between weight perception and weight-related knowledge, attitudes, and behaviors in children in Guangzhou, China.

Current Assessment of Weight,Dietary and Physical Activity Behaviors among Middle and High School Students in Shanghai,China—A 2019 Cross-Sectional Study

Poor nutrition or insufficient physical activity (PA) are risk factors for obesity and chronic diseases. This 2019 cross-sectional study from the school health survey examined the dietary and PA behaviors of Chinese adolescents. A total of 12,860 adolescents aged 11–18 participated through multistage and stratified cluster random sampling. A questionnaire collected data on weight, PA, sedentary lifestyle, and eating habits. Unhealthy behaviors were identified and summed up for each behavior. Participants were then classified into high and low amounts of risk behaviors. Weight status was defined using Body Mass Index (BMI) cutoff points for Chinese individuals aged 6–18. Multinomial logistic regression was used to assess effects of lifestyle behaviors on weight status. The prevalence of overweight and obesity was 22.3% among all participants (30.6% in boys, 13.2% in girls). Females engaged in more risk physical activities (4.12 vs. 3.80, p < 0.05), while males engaged in more risk dietary activities (2.20 vs. 2.02, p < 0.05). Higher number of risk dietary, PA, and sedentary behaviors were all significantly correlated with higher BMI (dietary: r = 0.064; PA: r = 0.099; sedentary: r = 0.161; p < 0.001 for all) and body weight (dietary: r = 0.124; PA: r = 0.128; sedentary: r = 0.222; p < 0.001 for all). Risk sedentary behaviors was a significant risk factor for overweight/obesity (Adjusted Odds Ratio AOR = 1.30, 95% Confidence Interval CI 1.11–1.52). Obesity and unhealthy lifestyle behaviors remain a concern among Chinese adolescents. These results provide an update on the factors contributing to overweight/obesity among adolescents and call for efforts to address obesity among adolescents.     

Prevalence of Excessive Weight and Underweight and Its Associated Knowledge and Lifestyle Behaviors among Urban Private School-Going Adolescents in New Delhi

With rapid urbanization and the Indian nutrition transition, Indian adolescents face a high risk of developing an energy imbalance. This study aims to assess the prevalence of excessive weight, underweight, and associated knowledge and lifestyle behaviors among private school-going adolescents in Delhi. A cross-sectional study was conducted in students (6th–7th grades) of eight randomly selected private schools in Delhi, India in 2019. A self-administered survey was used to assess students’ dietary-and-physical-activity-related knowledge and behavior. Anthropometric measurements (height, weight, and waist circumference) were also conducted. Out of 1567 participants, 7.2% were underweight, 61.3% normal, and 31.5% excess in weight. Underweight was associated with significantly more eating whilst studying for exams (relative risk ratio (RRR) 1.7 (1.0–2.9)). Excessive weight was associated with less incorrect knowledge on behaviors causing overweight (RRR 0.7 (0.5–0.9)), more often reading nutritional labels of packed food items (RRR 0.6 (0.4–0.9)), and less frequent vegetable-intake (RRR 0.7 (0.4–0.9)). Underweight students showed more suboptimal knowledge and unhealthy behaviors, whilst students with excessive weight showed more correct knowledge and healthy behaviors. This study highlights the immediate need for effective health-promoting interventions focused on the importance of healthy lifestyle at least in underweight adolescents.     

Body Weight Statuses and Their Sociodemographic Correlates Among Adolescents in Southern Taiwan: Results Using Two Sets of Cutoff References

PurposeTo examine the differences in the prevalence of overweight and obesity based on the cutoff references established by the International Obesity Task Force (IOTF) and the Working Group on Obesity in China (WGOC), the prevalence of underweight on the IOTF reference, and the sociodemographic correlates of body weight statuses in Taiwanese adolescents.MethodsOverweight and obesity in 10,371 Taiwanese adolescents were determined by the IOTF and WGOC cutoff references for body mass index (BMI). Underweight was determined by the IOTF. The prevalence of overweight and obesity using the IOTF standard were compared to those using the WGOC standard. Associations of body weight statuses with gender, age, residential status, and parental education level were also examined.ResultsUsing the IOTF standard, 3.4% were underweight, 15.2% were overweight, and 6.1% obese, whereas 14.1% were considered overweight and 8.7% were obese by the WGOC standard. For both genders, more adolescents were classified as overweight by the IOTF standard and as obese by the WGOC standard. Although females were more likely to be underweight than males, males were more likely to be overweight or obese than females. For both genders, although older age increased the risk of being underweight, younger age increased the risk of being overweight or obese. For males, living in urban areas was associated with being overweight, and low paternal education level was associated with being obese.ConclusionsThe prevalence of overweight and obesity may differ depending on the reference standard consulted. Paternal education level and urbanicity were associated with gender differences in the proportion of adolescents who were overweight or obese.     

Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents

BACKGROUND: Rapid economic development accompanied by imported Western media, advertising, fashion, and lifestyle in mainland China has resulted in shifts in cultural beliefs and beauty ideals in adolescents. The present study focused on understanding relationships among weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents. METHODS: Data collected in 2002 from 6863 middle and high school students and their parents from four large cities in mainland China were used. Weight status was determined by measured weight and height. Weight perception, media exposure, attitudes, and health behaviors were assessed by a structured questionnaire survey. RESULTS: Boys were more likely to describe themselves as either too thin or relatively thin than girls (37.32% vs. 18.79%), while girls more often considered themselves either relatively heavy or too heavy than boys (50.83% vs. 26.54%). Girls who were actually normal or underweight were more likely than boys to describe themselves as either relatively heavy or very heavy (41.6% vs. 11.6%), while boys who were actually normal or overweight were more likely than girls to believe themselves as underweight (30.9% vs. 15.7%). Girls who were frequently exposed to media from Japan, Korea, Hong Kong, and Taiwan, and placed high value on their physical appearance, were more likely to be dissatisfied with their body weight, which in turn were more likely to restrict consumption of certain foods, smoke cigarettes, and drink alcohol. Similar results were not observed in boys. CONCLUSIONS: Weight dissatisfaction was prevalent in Chinese adolescents and was significantly related to media exposure, attitudes towards physical appearance, and adoption of certain health-risk behaviors in girls. Our findings underscore the importance of sociocultural influences in shaping realistic body image and have implications for prevention and early intervention for establishing health behavioral practices during adolescence.     

Pre-Pregnancy Weight Status Is Associated with Diet Quality and Nutritional Biomarkers during Pregnancy

Although the positive association between pre-pregnancy overweight and obesity with excessive gestational weight gain is well known, it is not clear how pre-pregnancy weight status is associated with gestational weight gain through maternal diet during pregnancy. This study aimed to examine the relationship between pre-pregnancy weight status and diet quality and maternal nutritional biomarkers during pregnancy. Our study included 795 U.S. pregnant women from the National Health and Nutrition Examination Survey, 2003–2012. Pre-pregnancy body mass index (BMI) was calculated based on self-reported pre-pregnancy weight and height. The cutoff points of <18.5 (underweight), 18.5–24.9 (normal), 25.0–29.9 (overweight), and 30 kg/m² (obese) were used to categorize pregnant women’s weight status. Diet quality during pregnancy was assessed by the Healthy Eating Index (HEI)-2010 based on a 24-h recall. Multivariable logistic regressions were used to estimate the odds ratios (OR) and 95% confidence intervals (CI). For all pregnant women included in this study, the mean HEI-2010 (±standard error of the mean (SEM)) was 50.7 (±0.9). Women with obese pre-pregnancy BMI demonstrated significantly lower HEI-2010 compared to those with underweight and normal pre-pregnancy BMI, respectively. In an unadjusted model, women with pre-pregnancy obesity BMI had increased odds for being in the lowest tertile of HEI-2010 (33.4 ± 0.5) compared to those with underweight pre-pregnancy BMI (OR 5.0; 95% CI 2.2–11.4). The inverse association between pre-pregnancy overweight and obesity status and diet quality during pregnancy persisted even after we controlled for physical activity levels (adjusted OR (AOR) 3.8; 95% CI 1.2–11.7, AOR 5.4; 95% CI 2.0–14.5, respectively). Serum folate concentration (ng/mL) was significantly higher in underweight women compared to overweight women (23.4 ± 1.7 vs. 17.0 ± 0.8, p < 0.05). Serum iron concentration (ng/dL) was significantly higher in normal weight women compared to overweight women (86.2 ± 5.0 vs. 68.9 ± 3.0, p < 0.05). An inverse association was found between pre-pregnancy weight status and diet quality and maternal nutritional biomarkers during pregnancy. Poor diet quality as measured by HEI-2010 was shown among overweight and obese women. Nutrition education and interventions need to be targeted to those women entering pregnancy as overweight and obese.     

中小学生减肥行为及其与体重认知的关系

了解儿童青少年营养状况和减肥行为的流行现状,为探索体重认知与减肥行为的关联提供参考.方法 在2012年卫生公益性行业科研专项全国7个示范基地共选取53 890名中小学生为研究对象,进行体格检查和问卷调查,收集儿童青少年减肥行为与体重认知相关资料.采用多元Logistic回归分析体重认知相关变量与减肥行为的关联.结果 6~18岁儿童青少年消瘦检出率为6.9%,超重肥胖检出率为24.3%.采取过减肥行为的小学生检出率为58.5%,初中生为65.9%,高中生为60.4%.在消瘦学生群体中,体重不满不会增加减肥行为的发生(P=0.29);而认为自己偏胖会增加减肥行为的发生(OR=5.28,95%CI=2.76~ 10.12,P<0.01).在体重正常学生群体中,对自己体重不满或认为自己体重偏胖的学生更容易采取减肥行为(OR=1.09,95%CI=1.03~ 1.16,P<0.01;OR=1.57,95%CI=1.44~1.71,P<0.01).在超重肥胖的学生中,对自己体重不满和认为自己偏胖均会增加减肥行为的发生(P值均<0.01).结论 中国儿童青少年超重肥胖率和减肥行为发生率较高.体重不满是正常体重和超重肥胖学生采取减肥行为的危险因素,且认为自己偏胖是儿童青少年采取减肥行为的危险因素.     

Perception of Weight and Health Status among Women Working at Health Centres of Tehran

Perception of body-weight status is an important determinant of weight-related behaviours and may affect the burden of weight disturbances as a public-health problem. No study has assessed self-perception of the weight status regarding body-fat distribution among health workers to date. The aim of this study was to evaluate the association of the perception of weight and health status among 542 women working at health centres of Tehran. We assessed their perceived body-weight and health status and measured waist- and hip-circumference, weight, and height to calculate waist-to-hip ratio (WHR) as a measure of fat distribution and body mass index (BMI, kg/m²). Women reported their sociodemographic information, and the perceived weight and health status were compared with their actual fatness status, defined based on WHR and BMI, to determine misperception of weight status. Multivariate logistic regression models were performed to assess the predictive effects of various sociodemographic factors and actual fatness on the perception of weight and health status. The results showed that more than 40% of women with normal BMI overestimated their body-weight status while only 15.8% of these women had central obesity. BMI was the most important variable associated with misperceived weight status as normal-weight women had significantly more misperception (OR 8.16, 95% CI 4.82-13.82) than overweight/obese women. WHR did not show any significant relationships with perceived weight status. In addition, perception of health status was not associated with actual fatness indices. It is concluded, BMI was the main predictor of the perception of weight status in female employees. The importance of using body-fat distribution in the perceptions of weight and health status should be emphasized.Key words: Body mass index, Health centres, Perception of health status, Perception of weight status, Waist-to-hip ratio, Iran     

Weight-related teasing,emotional eating,and weight control behaviors in Hispanic and African American girls

PurposeTo assess the association among parent and peer weight-related teasing, emotional eating, and weight control behaviors in minority girls.Methods141 Hispanic and African American preadolescent girls (mean age = 11.1 years, SD = 1.5 years) participated. Most of the participants were of Hispanic origin, had a bicultural orientation, and were obese. Participants completed surveys assessing weight-related teasing, emotional eating, weight control behaviors, demographic, and acculturation characteristics. Body weight and height were also assessed. Hierarchical regression analyses were run to determine the associations among study variables.ResultsFifty-nine percent of participants reported being weight-related teased by peers and 42% participants reported weight-related teasing by parents. Weight-related teasing by parent was associated with emotional eating and binge eating, whereas peer weight-related teasing was only associated with emotional eating.ConclusionsFindings demonstrated the differential association of weight-related teasing from peers and parents to emotional and binge eating in minority girls.     

Body Weight Perception, Unhealthy Weight Control Behaviors, and Suicidal Ideation Among Korean Adolescents

BACKGROUND: This study examined the mediating function of body weight perception (BWP) in the relation between body mass index (BMI) and unhealthy weight control behaviors (UWCBs; eg, fasting, using diet pills, or laxatives), and between BMI and suicidal ideation. It also explored the correlation between exposure to multiple UWCBs and suicidal ideation among Korean adolescents.
METHODS: Data on BMI, BWP, UWCBs, and suicidal ideation were obtained from the 2006 Korean Youth Risk Behavior Web-based Survey, a school-based survey conducted on a nationally representative sample of students in grades 7–12 (36,463 boys and 33,433 girls). Data were analyzed using bivariate and multivariate logistic regression.
RESULTS: BMI was significantly associated with both UWCB and suicidal ideation among boys and girls, even after controlling for covariates. However, the significance and magnitude of the association between BMI and UWCB were considerably attenuated when BWP was added to the model. When BWP was included, the association between overweight BMI status and suicidal ideation became nonsignificant in both sexes, whereas the association between underweight BMI status and suicidal ideation remained significant among boys. Adolescent boys and girls engaging in multiple UWCBs were at greater risk for experiencing suicidal thoughts.
CONCLUSIONS: This study suggests that BWP represents a potential mediator between BMI and UWCB, and between BMI and suicidal ideation among both boys and girls. Thus, school programs addressing issues related to BWP should be developed and targeted at adolescents to reduce the potential risks for both UWCB and suicidal behavior.     

Shared risk and protective factors for overweight and disordered eating in adolescents

BACKGROUND: Weight-related problems, including obesity, eating disorders, and disordered eating, are major public health problems in adolescents. The identification of shared risk and protective factors for these problems can guide the development of relevant interventions to a broad spectrum of weight-related problems. This paper examines the prevalence and co-occurrence of overweight, binge eating, and extreme weight-control behaviors (vomiting, diet pills, laxatives, and diuretics) in adolescents and identifies shared risk and protective factors from within the socioenvironmental, personal, and behavioral domains for these three adverse weight-related outcomes. METHODS: Data were collected at Time 1 (1998-1999) and Time 2 (2003-2004) on 2516 adolescents participating in Project EAT (Eating Among Teens). Data were analyzed in 2006-2007. RESULTS: Weight-related problems were identified in 44% of the female subjects and 29% of the male subjects. About 40% of overweight girls and 20% of overweight boys engaged in at least one of the disordered eating behaviors (binge eating and/or extreme weight control). Weight-teasing by family, personal weight concerns, and dieting/unhealthy weight-control behaviors strongly and consistently predicted overweight status, binge eating, and extreme weight-control behaviors after 5 years. Family meals, regular meal patterns, and media exposure to messages about weight loss were also associated with weight-related outcomes, although the strength and consistency of associations differed across outcomes and gender. CONCLUSIONS: Weight-specific socioenvironmental, personal, and behavioral variables are strong and consistent predictors of overweight status, binge eating, and extreme weight-control behaviors later in adolescence. These findings support the need for research to determine if decreasing weight-related social pressures, personal weight concerns, and unhealthy weight-control behaviors can contribute to reductions in obesity in children and adolescents.     

Fatty,Fatty, Two-by-Four: Weight-Teasing History and Disturbed Eating in Young Adult Women

Objective. We investigated the long-term effect of weight teasing during childhood.Methods. Young adult women (n = 1533; aged 18–26 years) from 3 large universities participated in a survey (Fall 2009 to Spring 2010) that assessed disturbed eating behaviors; weight status at ages 6, 12, and 16 years; and weight-teasing history.Results. Nearly half of the participants were weight-teased as a child. Participants who experienced childhood weight teasing were significantly more likely to have disturbed eating behaviors now than non–weight-teased peers. As the variety of weight teasing insults recalled increased, so did disturbed eating behaviors and current body mass index. Those who recalled their weight at ages 6, 12, or 16 years as being heavier than average endured weight teasing significantly more frequently and felt greater distress than their lighter counterparts.Conclusions. Weight teasing may contribute to the development of disturbed eating and eating disorders in young women. Health care professionals, parents, teachers, and other childcare givers must help shift social norms to make weight teasing as unacceptable as other types of bullying. To protect the health of children, efforts to make weight teasing unacceptable are warranted.Nearly one quarter of the population is subjected to taunts and jeers, such as “chubby,” “tubby,” and “fatso,” during their lifetimes.1 Weight-related teasing is especially prevalent during childhood and adolescence,2,3 and may be on the rise with the increasing rates of overweight and obesity in youths.4 At greatest risk for being teased are those who have “violated” social norms.5 Social norms, a construct of the Theory of Reasoned Action and Theory of Planned Behavior,6 are “written and unwritten rules that define ‘appropriate’ thoughts, feelings, and behaviors of a culture and exert pressure on people to believe and behave in a certain way.”7^(p152) In fact, overweight youths are the targets of weight-related teasing more often than their average-weight peers—about one fifth of average-weight girls and nearly half of overweight girls report being teased about their weight at least a few times each year.2 Females are at greater risk for weight-teasing insults than males,8 perhaps because of greater societal pressures to achieve the “thin ideal” body type.9,10According to Haines et al., “Despite increased media and research attention on bullying and hate speech, weight-related teasing and the biased weight-related norms that influence such behaviors do not appear to be abating.”11^(pS23) The prevalence and persistence of weight teasing is troubling because of the pernicious effects it can have on physical and emotional health.12 Weight-related teasing can lead to poorer overall health, diminished social well-being, and body dissatisfaction.13 Even more worrisome are longitudinal research findings linking weight teasing insults to disturbed eating behaviors.14,15Disturbed eating includes unhealthy or extreme weight-control behaviors, such as self-induced vomiting and medication misuse (e.g., laxatives), and binge eating.16,17 These practices can escalate into a full-blown eating disorder.16,17 Longitudinal data indicate that disturbed eating behaviors are common in adolescence and track into young adulthood, thereby placing youths at an increased eating-disorder risk.18Little is known about the long-term effects of weight teasing during childhood on eating behaviors. In addition, previous investigations of weight-related teasing and disturbed eating practices did not use instruments that assessed the full array of eating disorder diagnostic criteria elucidated in the Diagnostic Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).19 Previous weight-teasing research also has neglected exploration of other salient disturbed eating behaviors, such as emotional eating, disinhibited eating, and dichotomous thinking with regard to food. Increased emotional eating (i.e., eating in response to a mood) and disinhibited eating (i.e., uncontrolled eating) are common among dieters and binge eaters.20,21 Although identified as a common factor among those who have eating disorders,22 dichotomous thinking (i.e., rigid, “black and white” cognitive thinking style) remains an understudied psychological construct.22,23 The rigid dietary “rules” in dichotomous thinking (e.g., good food vs bad food) may help maintain disturbed eating behaviors and increase the frequency of behaviors (e.g., binge eating, purging) following any breach of dietary rules.24 This “all or nothing” attitude toward eating may place an individual at risk for eating disorders.The goal of this research was to expand our understanding of the long-term effect of weight teasing during childhood on a broad array of current disturbed eating behaviors of healthy young adult women. A second goal was to explore relationships among recollections of body weight during the growing years, frequency and effect of weight-teasing insults, and current disturbed eating behaviors.     

Weight Change across Adulthood in Relation to Non-Alcoholic Fatty Liver Disease among Non-Obese Individuals

Background: To investigate the associations of weight change patterns across adulthood with the risk of non-alcoholic fatty liver disease (NAFLD). Methods: Using data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018 cycle, we performed a retrospective cohort study with 2212 non-obese participants aged 36 years old over. Weight change patterns were categorized as “stable non-obese”, “early adulthood weight gain”, “middle and late adulthood weight gain” and “revert to non-obese” according to the body mass index (BMI) at age 25, 10 years prior and at baseline. Vibration-controlled transient elastography (VCTE) was performed to diagnose NAFLD. Modified Poisson regression was used to quantify the associations of weight change patterns with NAFLD. Results: Compared with participants in the “stable non-obese” group, those who gained weight at early or middle and late adulthood had an increased risk of NAFLD, with an adjusted rate ratio (RR) of 2.19 (95% CI 1.64–2.91) and 1.92 (95% CI 1.40–2.62), respectively. The risk of NAFLD in “revert to the non-obese” group showed no significant difference with the stable non-obese group. If the association of weight change and NAFLD was causal, we estimated that 73.09% (95% CI 55.62–82.93%) of incident NAFLD would be prevented if the total population had a normal BMI across adulthood. Conclusions: Weight gain to obese at early or middle and late adulthood was associated with an evaluated risk of NAFLD. A large proportion would have been prevented with effective weight intervention.     

Personal Weight Status Classification and Health Literacy Among Supplemental Nutrition Assistance Program (SNAP) Participants

The purpose of this study was to examine the conceptual gap between self-perceived weight and body mass index (BMI), and to assess the knowledge gap between perceived importance of following dietary guidelines and health literacy levels. Adults (n = 131) eligible for the Supplemental Nutrition Assistance Program (SNAP) were interviewed at eleven SNAP regional offices in Maryland. Based on BMI calculated from self-reported height and weight, 65.6 % of participants were overweight or obese while 40.5 % perceived that they were overweight or obese. In sub-group analysis categorized by BMI, only 20.0 % in the overweight and 20.0 % in the obese group correctly perceived themselves as being overweight or obese. Following dietary guidelines was perceived as important by a majority of participants, but only 43.5 % had adequate health literacy. Conceptual and knowledge gaps between self-perception and objective health status existed in the low-income SNAP-eligible sample. Future studies need to address these gaps because misperceived weight status and insufficient health literacy are critical barriers to inducing behavioral change.     

Body weight perception among Bahraini adolescents

BACKGROUND: This study examines the relationship between actual weight status and perceptions of body weight in Bahraini adolescents. The study also investigates the adolescents' perceptions of parents' and peers' opinions of weight. METHODS: A cross-sectional survey of 447 Bahraini male and female adolescents aged 12-17 years was conducted. Weight and height were measured and body mass index (BMI) was calculated. A short questionnaire was used to obtain their attitudes towards their weight status, as well as the attitudes of their parents and friends. The nine figure silhouettes illustration was used to measure perception of ideal body image and how it compares with their current body weight. RESULTS: The results revealed a significant discrepancy between adolescents' perception of body weight and actual BMI. There was a tendency for teenagers to underestimate their weight status, which was especially noteworthy among the overweight and obese. More than half of the girls and about one-third of the boys expressed discontent with their current body weight. One-third (33.5%) and 26.6% of the adolescents thought that their parents and their peers, respectively, would consider them to be overweight or obese. The percentage of adolescents who reported parental or peer underestimation was higher among those classified as overweight or obese than it was among those who were of normal weight. CONCLUSION: The study shows the existence of a distorted body image as reflected by failure of many overweight or obese adolescents to perceive themselves as such. Among Bahraini adolescents weight-related beliefs and attitudes exist at two ends of the spectrum: a tolerance of obesity at one end and an exaggerated concern for its occurrence at the other.     

Birth Weight,Maternal Body Mass Index,and Early Childhood Growth: A Prospective Birth Cohort Study in China

Background

The relations of birth weight and maternal body mass index (BMI) to overweight remain unresolved. We prospectively examined the relations of birth weight with various anthropometric measures at age 3 to 6 years, the effect of maternal BMI, and the patterns of these relations in an analysis using 9 birth weight categories.

Methods

The subjects were 210 172 singleton infants born alive with a gestational age ≥28 weeks between October 1993 and December 1996; the subjects were followed up in 2000. Birth weight, maternal height and weight, and other relevant information were measured or collected prospectively. Overweight and underweight were defined by using National Center for Health Statistics/World Health Organization reference data. Logistic regression models were used to estimate relative risks. Analyses stratified by quartile of maternal BMI were performed to examine the effects of maternal BMI on the associations of birth weight with overweight and underweight.

Results

Birth weight was linearly associated with height, weight, and BMI at age 3–6 years. Adjustment for maternal BMI did not alter this association. Birth weight was positively associated with overweight and negatively associated with underweight. The relation curves for both overweight and underweight resembled half of a flat parabolic curve. The associations for overweight and underweight were slightly stronger for the highest and lowest quartiles of maternal BMI, respectively.

Conclusions

Higher birth weight is associated with an increased risk for childhood overweight, and lower birth weight with an increased risk for underweight. The associations between birth weight and early childhood anthropometric growth measures could not explained by maternal BMI.Key words: birth weight, overweight, underweight, maternal body mass index     

Does perception equal reality? Weight misperception in relation to weight-related attitudes and behaviors among overweight and obese US adults

Background  

Weight misperception might preclude the adoption of healthful weight-related attitudes and behaviors among overweight and obese individuals, yet limited research exists in this area. We examined associations between weight misperception and several weight-related attitudes and behaviors among a nationally representative sample of overweight and obese US adults.     

Association of Body Mass Index with Ischemic and Hemorrhagic Stroke

Data on the association between body mass index (BMI) and stroke are scarce. We aimed to examine the association between BMI and incident stroke (ischemic or hemorrhagic) and to clarify the relationship between underweight, overweight, and obesity and stroke risk stratified by sex. We analyzed the JMDC Claims Database between January 2005 and April 2020 including 2,740,778 healthy individuals (Median (interquartile) age, 45 (38–53) years; 56.2% men; median (interquartile) BMI, 22.3 (20.2–24.8) kg/m²). None of the participants had a history of cardiovascular disease. Each participant was categorized as underweight (BMI <18.5 kg/m²), normal weight (BMI 18.5–24.9 kg/m²), overweight (BMI 25.0–29.9 kg/m²), or obese (BMI ≥ 30 kg/m²). We investigated the association of BMI with incidence stroke in men and women using the Cox regression model. We used restricted cubic spline (RCS) functions to identify the association of BMI as a continuous parameter with incident stroke. The incidence (95% confidence interval) of total stroke, ischemic stroke, and hemorrhagic stroke was 32.5 (32.0–32.9), 28.1 (27.6–28.5), and 5.5 (5.3–5.7) per 10,000 person-years in men, whereas 25.7 (25.1–26.2), 22.5 (22.0–23.0), and 4.0 (3.8–4.2) per 10,000 person-years in women, respectively. Multivariable Cox regression analysis showed that overweight and obesity were associated with a higher incidence of total and ischemic stroke in both men and women. Underweight, overweight, and obesity were associated with a higher hemorrhagic stroke incidence in men, but not in women. Restricted cubic spline showed that the risk of ischemic stroke increased in a BMI dose-dependent manner in both men and women, whereas there was a U-shaped relationship between BMI and the hemorrhagic stroke risk in men. In conclusion, overweight and obesity were associated with a greater incidence of stroke and ischemic stroke in both men and women. Furthermore, underweight, overweight, and obesity were associated with a higher hemorrhagic stroke risk in men. Our results would help in the risk stratification of future stroke based on BMI.     

Weight perception and psychological factors in Chinese adolescents.

PURPOSE: To investigate the pattern of weight perception and its relationship with psychological distress among Chinese adolescents. METHODS: A sub-cohort of 2179 healthy Chinese adolescents randomly selected from schools in Wuhan, China, including 1156 boys and 1023 girls 11 to 15 years of age was included in the current study. Weight, height, self-perceptions of weight status, depressive psychological symptoms including anxiety, depression, perceived peer isolation, and other constructs were measured by a structured questionnaire. A General Linear Model was used to compare psychological differences between actual and perceived weight groups. RESULTS: Perceived underweight was more likely to occur in boys, whereas perceived overweight was more likely to occur in girls. Compared with objective body weight status defined by the International Obesity Task Force (IOTF) and the World Health Organization (WHO) age- and gender-specific body mass index (BMI) cutoffs, girls were more likely to misperceive themselves as overweight, whereas relatively more boys misclassified their weight status as underweight. After adjusting for age, parents' educational attainment, and urban residence, perceived overweight boys and girls were more likely to experience anxiety and depression than perceived normal and underweight subjects (p <.05). Perceived overweight girls and perceived underweight boys experienced higher peer isolation than other groups (p <.05). Significant differences were not found in social support, school connectedness, trouble with teachers, and family disharmony among different weight-perception groups. CONCLUSIONS: Our results suggested distortion of weight perception was prevalent, and may have detrimental psychological influences in Chinese adolescents.     

Underweight and Weight Change Increases End-Stage Renal Disease Risk in Patients with Diabetes: A Nationwide Population-Based Cohort Study

Weight variability has known as a risk factor for cardiovascular events and mortality. However, its effect on end-stage renal disease (ESRD) development remains controversial. We investigated the relationship between weight change and ESRD risk. Overall, 97,029 patients with DM aged >20 years were selected from the Korean National Health Screening Program 2009–2012. Weight change was defined as differences in body weight from the index year to 2 years later. Newly diagnosed ESRD was observed until 2017 end. Over a 5.1-year median follow-up period, ESRD was newly diagnosed in 7932 (4.81%) DM patients. BMI < 18.5 kg/m² and waist circumferences <85/80 and >100/95 cm were ESRD risk factors. ESRD risk increased with increasing weight change; ≥10% weight loss (hazard ratio [HR], 1.247) followed by ≥10% weight gain (1.247) was associated with a higher HR than ≤5% weight change after adjusting for several confounding factors. The association between weight change and ESRD risk in a subgroup analysis was significantly stronger in patients aged <65 years, without proteinuria, with BMI ≥ 25, with DM duration <5 years, and prescribed less than 3 classes of DM medication. Underweight patients showed higher ESRD risks than overweight patients. Weight loss >10% was associated with the fastest decline in renal function.