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

      research-article
      ,
      BMC Public Health
      BioMed Central
      Dieting, Body weight concerns, Body image, Body dissatisfaction, Overweight, Adolescents

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          Abstract

          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.

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          Most cited references33

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          Multiple health behaviours: overview and implications.

          More remains unknown than known about how to optimize multiple health behaviour change.
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            The Health Behaviour in School-aged Children: WHO Collaborative Cross-National (HBSC) study: origins, concept, history and development 1982-2008.

            This paper traces the history of the HBSC study from its origins in the early 1980's to the present day describing how it was first conceptualised scientifically and how this influenced issues of study design. The challenges of managing a cross-national study are explained as are changes and adaptations over time with growth of the study from 3 to over forty country members. The key partnership with the World Health Organisation and its benefits are presented. With developments in scientific management and theoretical perspectives, HBSC has made a substantial contribution to the area of youth health. The last decade has seen increased dissemination to policy makers and evidence that scientific information arising from the study has influenced strategic policy development and practical health improvement programmes. This paper considers some of the key success factors and challenges for the study as it attempts to maximise its scientific output and channels the research findings into health improvement for young people. Future challenges for the study are also considered.
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              Accuracy of adolescent self-report of height and weight in assessing overweight status: a literature review.

              To examine the accuracy of self-reported height and weight data to classify adolescent overweight status. Self-reported height and weight are commonly used with minimal consideration of accuracy. Eleven studies (4 nationally representative, 7 convenience sample or locally based). Peer-reviewed articles of studies conducted in the United States that compared self-reported and directly measured height, weight, and/or body mass index data to classify overweight among adolescents. Self-reported and directly measured height and weight. Overweight prevalence; missing data, bias, and accuracy. Studies varied in examination of bias. Sensitivity of self-reported data for classification of overweight ranged from 55% to 76% (4 of 4 studies). Overweight prevalence was -0.4% to -17.7% lower when body mass index was based on self-reported data vs directly measured data (5 of 5 studies). Females underestimated weight more than males (ranges, -4.0 to -1.0 kg vs -2.6 to 1.5 kg, respectively) (9 of 9 studies); overweight individuals underestimated weight more than nonoverweight individuals (6 of 6 studies). Missing self-reported data ranged from 0% to 23% (9 of 9 studies). There was inadequate information on bias by age and race/ethnicity. Self-reported data are valuable if the only source of data. However, self-reported data underestimate overweight prevalence and there is bias by sex and weight status. Lower sensitivities of self-reported data indicate that one-fourth to one-half of those overweight would be missed. Other potential biases in self-reported data, such as across subgroups, need further clarification. The feasibility of collecting directly measured height and weight data on a state/community level should be explored because directly measured data are more accurate.
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                Author and article information

                Contributors
                christina.berg@ped.gu.se
                christel.larsson@gu.se
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                5 February 2020
                5 February 2020
                2020
                : 20
                : 187
                Affiliations
                ISNI 0000 0000 9919 9582, GRID grid.8761.8, Department of Food and Nutrition, and Sport Science, , University of Gothenburg, ; Box 300, 405 30 Göteborg, Sweden
                Author information
                http://orcid.org/0000-0002-7953-5037
                Article
                8295
                10.1186/s12889-020-8295-7
                7003420
                32024489
                bb77ec65-0cb3-4566-9714-79ba9e7aa4d5
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 25 November 2019
                : 28 January 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Public health
                dieting,body weight concerns,body image,body dissatisfaction,overweight,adolescents
                Public health
                dieting, body weight concerns, body image, body dissatisfaction, overweight, adolescents

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