Body image dissatisfaction is a concern for adolescents’ mental and physical well-being, and the role of body mass index (BMI) and physical activity (PA) in it is still unclear. This study investigates the associations of BMI and PA with body image, separately for boys and girls, in a large sample of Finnish adolescents. We also examine the associations of BMI with body image in varying PA levels. A total of 10,496 adolescents (girls 52.6%) were included in the analyses. Body image was assessed using a pictorial tool, and categorized as wishing for a smaller body, being satisfied, and wishing for a bigger body. BMI (kg/m2) was categorized as thin, normal weight, and overweight/obese. Self-reported PA was divided into three similar-sized categories as low, moderate, and high PA levels. Adjusted ordinal regression analyses were conducted. Our results show that adolescents with thinness had higher odds of wishing for a bigger body compared to their normal-weight peers, while adolescents with overweight/obesity had smaller odds of wishing for a bigger body. Adolescents in low and middle PA levels had lower odds of wishing for a bigger body compared to adolescents in the high PA level. Yet, the PA level modified the associations between BMI and body image, especially in adolescents with thinness and more so in girls than in boys. These findings highlight the need to pay attention to healthy weight gain and PA in adolescents to support their body image satisfaction.
Background Combining process evaluation data with effectiveness data and examining the possible mediators of intervention effects elicits valuable knowledge about how and for whom these interventions are effective. The aim of this study was to examine whether the parental degree of implementation (DOI) of a home-involving preschool intervention affected children’s food consumption via home mediators. Methods The five-month Increased Health and Wellbeing in Preschools (DAGIS) intervention involved 476 participating children aged 3–6 years and was conducted in 2017–2018. Parents reported children’s food consumption (g/day) outside childcare hours, the availability of foods at home, role modelling of food consumption, and the norms related to food consumption. In addition, parents reported the extent to which they had implemented the intervention program at home. Mediation analyses were conducted to examine the effect of low and high DOI compared to control group on the change in children’s consumption of fruit and vegetables (FV), sugary everyday foods, sugary treats, and sugar-sweetened beverages (SSB) via food availability in the home, parental role modelling and parental norms. Results Compared to the control group, there was a direct effect of a high DOI on diminishing consumption of SSB (B -27.71, 95% CI -49.05, -4.80). No indirect effects were detected. In the high DOI group, a change in parental norm was associated with increased FV consumption showing an indirect effect (B 4.31, 95% CI 0.23, 10.59). In the low DOI group, there was an indirect effect via decreased food availability leading to decreased sugary everyday food consumption (B -2.17, 95% CI -5.09, -0.09). Conclusions Combining process evaluation and effectiveness data revealed a decrease in children’s SSB consumption only in the high DOI group, as well as indirect effects on children’s consumption of FV and sugary everyday foods. In order to gain more intervention effects, further studies are required in order to examine parental facilitators and barriers to the implementation of interventions and how to impact effectively the determinants of the targeted behavior. Trial registration ISRCTN57165350 (8 January, 2015).
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