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School- and Individual-level Predictors of Weight Status Misperception among Korean Adolescents: A National Online Survey.

ABSTRACT: Growing body of literature has reported that weight status estimation pattern, including accurate-, under-, and overestimation, was associated with weight related behaviors and weight change among adolescents and young adults. However, there have been a few studies investigating the potential role of school contexts in shaping adolescents' weight status estimation pattern among Korea adolescents.The aim of the present study was to investigate the association between weight status misperception patterns and factors at individual-, family-, and school-level, simultaneously, and whether there was significant between schools variation in the distribution of each weight status misperception pattern, underestimation and overestimation respectively, among Korean adolescents aged 12-18 years.Data from the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), 2012, a nationally representative online survey of 72,228 students (boys = 37,229, girls = 34,999) from a total of 797 middle and high schools were used. Sex stratified multilevel random intercept multinomial logistic models where adolescents (level 1) were nested within schools (level 2) were performed.At the school level, attending a school with higher average BMI (kg/m2) was positively associated with weight status underestimation, and inversely associated with weight status overestimation among boys and girls. Single-sex schooling was positively associated with weight status underestimation among girls. At the family level, higher household income (high/middle versus low) was inversely associated with both weight status under- and overestimation among boys and girls. Higher maternal education (equal to or more than college graduate versus equal to or less than high school graduate) was positively associated with weight status overestimation among boys, and living with both parents (compared to not living with both parents) was inversely associated with weight status underestimation among girls. At the individual level, high academic achievement (compared to low) was positively associated with weight status underestimation among boys and girls.While further research with prospective designs and objectively measured anthropometric information is needed, school environmental factors such as sex composition and school average BMI, as well as, family contexts such as socioeconomic status need to be considered when developing and implementing obesity prevention programs.

SUBMITTER: Kim Y

PROVIDER: S-EPMC4856343 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Project description:Introduction: Few studies have examined the association between the individual-, family-, and school-level ecological correlates and physical fitness among Chinese children and adolescents, which is the purpose of the present study. Methods: A total of 157,168 children and adolescents, 10-18 years of age, with physical fitness data in 2014, participated in the study. Physical fitness was assessed, using six tests: forced vital capacity, standing long jump, sit and reach, body muscle strength, 50-m dash, and endurance running. Scores were aggregated to form a summary physical fitness indicator (PFI), which was then classified into five levels: low, low-middle, middle, middle-high, and high. Each option of individual-, family-, and school-level measures were constructed into a positive or negative correlate of physical fitness and then accumulated as a composite ecological score. Results: Among the 20 individual-, family-, and school-level correlates, 18 were found to be significantly associated with PFI, with high PFI levels being correlated with the positive group of correlates and low PFI levels correlated with the negative group of correlates (p < 0.05). High scores of ecological correlates were associated with a high level of PFI [adjusted odds ratio (OR) = 1.06, 95% CI: 1.06, 1.07)] whereas low scores were associated with a low level of PFI (OR = 0.95, 95% CI:0.95, 0.95). The ecological correlates at the individual, school- and family-levels were shown to be significantly related to high PFI among Chinese children and adolescents aged 10-18 years with different ORs of 5.97 (95% CI: 5.51, 6.47), 3.94 (3.66, 4.24), and 1.25 (1.19, 1.31). The PAR% of 20 cumulative factors effects due to the negative and positive responses for low PFI levels were 35.9 and 16.1%, and, for high PFI levels, were 15.3 and 24.1%, among Chinese children and adolescents, respectively. Compared with the correlates at family and school levels, the correlates at individual levels had the largest PAR%. Conclusion: Individual-, family-, and school-multilevel factors had a significant cumulative association with either improving or worsening aspects of physical fitness. Individual level factors remain at the core of physical fitness improvement. Comprehensive policies and measures are urgently needed to enhance the physical fitness of Chinese children and adolescents through involving further individual and environmental factors.

Project description:INTRODUCTION:Tobacco smoking is the largest preventable cause of global mortality, with its prevalence increasing in Sub-Saharan Africa, particularly among adolescents. We sought to determine the factors associated with tobacco smoking among Nigerian school adolescents and investigate the interaction between school location and socioeconomic status (SES). METHODS:Using a cross-sectional study design, 4332 eighth to tenth grade students in rural and urban secondary schools in Enugu State, Nigeria, were selected by stratified two-stage cluster sampling. We collected data using a modified Global Youth Tobacco Survey (GYTS) Core Questionnaire. Outcome measures were current smoking of cigarettes and other smoked tobacco. Multilevel mixed effects logistic regression models were used to determine factors associated with current tobacco smoking and were considered statistically significant at p<0.05. RESULTS:Prevalences of current smoking of cigarettes and other smoked tobacco were 13.3% (95% CI: 11.3-15.7) and 5.8% (95% CI: 4.6-7.2), respectively. Possession of higher weekly allowance, exposure to secondhand smoke or tobacco advertisements, having smoking parents, friends or classmates who smoke, and sale of cigarettes near school, were positively associated with current smoking of tobacco. Female sex, having both parents employed and being exposed to tobacco teaching in school were negatively associated with current cigarette smoking while increasing age and high father's SES were negatively associated with current smoking of other tobacco products. There was an interaction between school location and father's SES in the association with cigarette smoking. The higher odds of smoking in rural versus urban schools were much higher for students with fathers of high SES compared to low SES. In rural schools, high SES was associated with higher odds of smoking, but in urban schools low SES was associated with higher odds of smoking. CONCLUSIONS Environmental factors are associated with adolescent tobacco smoking. Tobacco control programs should use targeted strategies that vary depending on the local context.

Project description:Exercise may sensitize individuals with overweight and obesity to appetitive signals (e.g., hunger and fullness cues), overriding trait eating behaviors that contribute to overeating and obesity, such as uncontrolled eating. The objective of the current study was to measure predictors of objective ad libitum energy intake at a laboratory-based, post-exercise test-meal in adolescents ranging in weight status from overweight to severe obesity. We hypothesized that appetitive states, rather than appetitive traits, would be the strongest predictors of energy intake at a post-exercise test-meal, after controlling for body size. At Baseline, 30 adolescents (ages 10-16 years, 50% female (F), 43% non-Hispanic white (NHW), 83% with obesity (OB)) completed state and trait appetite measures and an ad libitum dinner meal following intensive exercise. Nineteen of those participants (47% F, 32% NHW, 79% OB) completed identical assessments two years later (Year 2). Energy intake (kcal) at each time point was adjusted for fat-free mass index (i.e., body size). Adjusted energy intake was reliable from Baseline to Year 2 (ICC = 0.84). Multiple pre-meal appetite ratings were associated with test-meal energy intake. In stepwise linear regression models, pre-meal prospective food consumption was the strongest and only significant predictor of test-meal energy intake at both Baseline (R2 = 0.25, p = 0.005) and Year 2 (R2 = 0.41, p = 0.003). Baseline post-exercise energy intake was associated with weight change over two years (R2 = 0.24, p = 0.04), but not with change in fat mass (p = 0.11). Appetitive traits were not associated with weight or body composition change (p > 0.22). State appetite cues were the strongest predictors of post-exercise energy intake, independent of body size. Future studies should examine whether long-term exercise programs enhance responsiveness to homeostatic appetite signals in youth with overweight and obesity, with a goal to reduce excess energy intake and risk for weight gain over time.

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School- and Individual-level Predictors of Weight Status Misperception among Korean Adolescents: A National Online Survey.

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