Clustering of obesogenic behaviors and association with body image among Brazilian adolescents in the national school-based health survey (PeNSE 2015)

Prev Med Rep. 2019 Nov 12:16:101000. doi: 10.1016/j.pmedr.2019.101000. eCollection 2019 Dec.

Abstract

This study aimed to examine the association between clusters of obesogenic behaviors and body image indicators among a population-based sample of Brazilian adolescents. Data from a cross-sectional country representative survey of 9th grade students (N = 102,301) were analyzed. Physical activity (PA), sedentary behavior (SB) and body image indicators (i.e. satisfaction, perception, value, and weight control attitudes and behaviors) were self-reported. Three clusters were previously validated with two-steps cluster analysis: "Health-promoting SB and diet", "Health-promoting PA and diet", and "Health-risk". Multinomial and binary logistic regression were used to associate clusters with body image indicators. Adolescents in the healthier clusters were more likely to be satisfied/very satisfied with body image and perceive themselves as having normal weight than those in the "Health-risk" cluster. Boys in both health-promoting clusters were more likely to consider body image as being important/very important and perceive themselves to be thin/very thin. Adolescents in the "Health-promoting PA and diet" cluster were more likely to be trying to lose or gain weight than those in the "Health-risk" cluster. Girls in the "Health-promoting SB and diet" cluster had lower odds of adopting unhealthy weight control behaviors than those in the "Health-risk" cluster. The effect of obesogenic behaviors on distinct aspects of body image was confirmed and found to vary according to different synergies between adolescents' health-related behavior. These findings provide important insights on the understanding of behavioral profiles which can be targeted to prevent unhealthy weight control behaviors and weight related disorders, especially among girls.

Keywords: Body image; Cluster analysis; Diet; Exercise; Sedentary lifestyle.