In regards to physical activity, boys who are involved in track and field sports had greater possibility of being in the normal weight group. Involvement in organized physical activity has been shown to be a protective affect for the development of obesity [ 36 , 37 ], however there is no clear impression as to what type of sport activity has a stronger effect.
Track and field sports are more widely followed in Greece and this is reflected in the present study. The sociocultural differences, the differences in lifestyle habits and the lack of infrastructure in rural areas [ 36 ], that preclude the access of adolescents to gyms and sports facilities seems to have a more serious impact on the weight of girls than boys.
A limitation of the present study is the cross-sectional design which does not allow for causality conclusions and the self-reporting of information regarding sports participation and diet habits which is a source of bias. Longitudinal data are necessary to further unravel the complex interplay between the outcome and the above mentioned covariates.
Strong points of the study are the large representative sample, the nationwide participation that increases the external validity of this study. The current data support the hypothesis that beliefs and habits play an important and the perception role towards the development of obesity, however different factors may be protective as well as risk factors among the two genders.
As was explicitly analyzed in the results section distinctive risk or protective factors emerged for the girls and boys. Regarding their impressions, the fear of obesity was protective for girls and for boys, whereas preoccupation with diets is a risk factor for obesity for both sexes. More healthy choices in mid-day snacks-such as bread-and frequent meals are protective factors for both sexes Gender dimorphic factors were recognized and these are the choice of food based on the calorie content for girls, frequent snacking for boys.
Also, daily whole milk consumption at breakfast is associated with obesity in girls—although this consumption is more frequent for boys-, and high fat products consumption at breakfast that is more frequent for boys are related to increased risk for obesity for boys. On the other hand, regular cocoa milk consumption that is more frequent in boys than girls, seems to have a protective effect against obesity only for boys.
Also girls seem to be more vulnerable to some sociodemographic factors such as age and geographic area. It is known that, beyond the biological differences and differences due to society or culture including food choices and dietary concerns, the levels of resting energy expenditure and energy requirements are different between girls and boys and the results of this study support these differences [ 38 ]. Regarding physical activity habits and perceptions, sex differences in engage in outdoor sport activities is evident in our study and this more frequent participation of boys emerges in this study as a protective factor against obesity as well [ 30 , 36 ].
A theoretical implication of these differences is that exposure to different role models, family dynamics as well as exposure to advertisements may affect the way children and adolescents appreciate weight status and factors correlating with weight control.
A practical implication is that the way doctors, parents and teachers approach children and adolescents promoting the healthy habits is of paramount importance as it can lead to negative or positive behaviors. An important finding of the present study is that the preoccupation with diets and dieting emerges as a risk factor for overweight and obesity.
The tentative message is that positive role modeling and early education regarding healthy choices is desirable. Trying to understand more what the children think and criticize less could be helpful in helping them internalize health perceptions and follow healthy habits. The search for the perfect diet can have the opposite effect on BMI and this applies to both genders.
Furthermore, the adherence to a five-mealplan per day has a protective effect and can prevent the development of obesity. As public health measures are concerned, applying a prevention plan that includes psychological assessment and intervention taking into consideration the developmental differences of boys and girls as well as their perceptions which should be appreciated.
Furthermore, ministry of education can implement measures for elementary schools on a regular basis and not as an intervention project of short duration taking into consideration the aspects of self-image, fear of obesity, preoccupation with dieting and diets.
Having breakfast and mid-day snack at school together with the teachers routinely, will support the five meal plan per day. Further research projects can address on a longitudinal basis, in prospective studies, the effect of alleviation of barriers on adoption of healthy life style habits considering the different needs of both sexes.
Also, this analysis indicates that a number of perceptions and attitudes that correlate with obesity are sex dimorphic. A better understanding of trends in boys and girls nutrition habits and physical activity patterns within different weight status, seems to be a priority.
Interventions should be tailored according to sex in order to support adolescents to maintain healthy life style habits. Bold: The t -student was used to calculate the p -value. Maximum likelihood estimates of Partial proportional odds model obese versus other BMI categories. All authors critically reviewed and approved the final version of the manuscript for publication. All authors have read and agreed to the published version of the manuscript.
They had no involvement in the collection, analysis, and interpretation of data or in writing of the manuscript. The data presented in this study are available on request from the corresponding author. National Center for Biotechnology Information , U. Journal List Children Basel v. Children Basel. Published online Apr 3. Find articles by Elpis Vlachopapadopoulou. Find articles by Dimitra Koutsouki. Gregory C. Find articles by Gregory C. Find articles by Theodora Psaltopoulou.
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Received Feb 7; Accepted Mar Associated Data Data Availability Statement The data presented in this study are available on request from the corresponding author. Abstract Background : The aim of the present study was to examine the effects of socioeconomic status, nutrition and physical activity lifestyle habits and perceptions on Body Mass Index BMI in children aged 12—15 years in Greece. Keywords: adolescents, nutrition habits, nutrition perceptions, Body Mass Index BMI category, overweight, obesity, physical activity habits, physical activity perceptions, Greece.
Introduction The prevalence of obesity during childhood and adolescence has risen significantly over the last decades, specifically according to NHANES study the rate of obesity during adolescence has quadrupled [ 1 ] The World Health Organization WHO has announced that childhood and adolescent obesity is the number one problem of public health and advises on actions needed to halt the progression of obesity epidemic [ 2 ]. Measurement Anthropometric measurements were conducted by sixteen health professionals, hired and trained for the purposes of this study.
Questionnaires Two structured questionnaires were developed and administered to the parents and students. Descriptive Statistics-Outcome Descriptive statistics were calculated for the remained variables.
Ordered logistic models For ordered dependent variables Y , the ordered logit model is often the natural choice. Results 3. Predictors which violated the parallel regression assumption Geographic area is a significant predictor only in the second binary model, when comparing obesity with other BMI categories. Discussion In the present study we addressed habits and beliefs that possibly lead to certain behaviors and choices in regards to eating and physical activity habits.
The subjective judgment of the level of activity and degree of physical fitness was addressed The use of statistical tests and models has revealed the importance of a constellation of factors that correlate with higher BMI that are sex dimorphic.
Appendix A Figure A1. Open in a separate window. Figure A2. The first 15 well projected variables for the first two dimensions. Table A1 Regions and Prefectures included in the sample. Appendix B Table A5 Log—likelihood and likelihood ratio estimates. Author Contributions V. Informed Consent Statement Informed consent was obtained from all subjects involved in the study. Data Availability Statement The data presented in this study are available on request from the corresponding author.
Conflicts of Interest The authors declare no conflict of interest. References 1. Golden N. Preventing obesity and eating disorders in adolescents. WHO; Geneva, Switzerland: Spinelli A. Prevalence of severe obesity among primary school children in 21 European countries.
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BMC Public Health. Block J. Manippa V. Healthiness or calories? Side biases in food perception and preference. Dallacker M. The frequency of family meals and nutritional health in children: A meta-analysis. Marangoni F. Snacking in nutrition and health. Food Sci. Ramires V. Longitudinal association between physical activity and body fat during adolescence: A systematic review.
Loth K. Styne D. Pediatric obesity-assessment, treatment, and prevention: An endocrine society clinical practice guideline. Body image dissatisfaction and dietary patterns according to nutritional status in adolescents. This website is not intended for residents of New Mexico.
Selecting these links will take you away from Cigna. Cigna may not control the content or links of non-Cigna websites. Overview Medicare Coverage Options. Broker Resources. Individuals and Families. Health and Wellness. Wellness Library. Topic Overview Your body mass index BMI and waist size affect your risk of type 2 diabetes , high blood pressure , high cholesterol , and coronary artery disease. Current as of: March 17, Related Links Weight Management Obesity.
Overview Medicare Coverage Options. Broker Resources. Individuals and Families. Health and Wellness. Wellness Library. Body mass index BMI for adults. For adults 20 years and older: A BMI below A BMI of A BMI of 25 to A BMI of 30 to A BMI of 40 or higher purple is considered extreme obesity.
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