Body perception index in children and adolescents in deprived neighborhood in Brazil
Obesity is one of the most important health problems, particularly in developing countries and poor populations. Besides, tackling obesity related behavior has not been successful in most intervention policies and recent studies focus on adolescents and children, considered more adaptable. However, to design an acceptable intervention, perceived body image is a valuable tool to better understand personal drives towards a behavior change. Our aim is to compare body perception index (BPI) and WHO body mass index classification (BMC) for children and adolescents in low income neighborhood.
METHODS:
A questionnaire including socioeconomic, health related behavior and perceived body image and anthropometric measurements were applied to 353 individuals from 5 to 19 living in a slum in Rio de Janeiro/Brazil. Analysis was stratified by puberty. The outcome variable is the difference between BMC and BPI (both aggregated in 4 categories: underweight, adequate, overweight and obesity), covariates included mother's education, mother's BMC, family structure and domestic appliances.
RESULTS:
12% of children and 17% of adolescents were classified as overweight/obese. The profile of post-pubertal individuals presented a trend in the comparison between BMC and BPI towards larger images, specially in women (66% BPI>BMC). In children the outcome was less skewed towards higher BPI, 12% classifying themselves in lower classes then the objective measurements. In the regression models for post-pubertal individuals, sex (female) was associated with BPI>BMC. In children, no covariate was significant.
CONCLUSIONS:
In children, the BPI is probably influenced by family opinion. In low income areas, obesity perception in older people does not value thin bodies. However, in adolescents the opinion of pairs are more important, and the media, with all extreme valorization of skinny top-models. Public health intervention on behavior needs to address what is socially valorized, carefully to neither accept inaccessible beauty standards, and consequent inadjustability, nor to under-valorize excess weight in families context.