Abstract
The association between body image and eating behaviors or weight control strategies has been demonstrated in the scientific literature, but there is a lack of evidence on the association between weight misperception and food consumption indicators in adolescents. This study aimed to evaluate the association between weight misperception and dietary patterns (DPs) in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA). It was a national school-based cross-sectional study conducted among students aged 12–17 years. Data were collected in the form of anthropometric measurements, responses in self-answered questionnaires, and 24-h dietary recall. The following variables were assessed: weight underestimation and overestimation (independent variables), which were defined as the presence of a disagreement between nutritional status and self-perceived weight; dietary patterns (dependent variables), defined by a posteriori method using principal component factor analysis; and individual and demographic variables (covariates). Data analysis was performed using the Poisson regression models method, stratified by sex. A total of 52,038 adolescents with normal weights were evaluated. The weight misperception prevalence was 34.0% (95% confidence interval [CI]: 33.0, 35.0). Three DPs were identified: “Traditional Brazilian,” “Processed meat sandwiches and coffee,” and “Ultra-processed and sweet foods.” In girls, weight underestimation was directly associated with the “Traditional Brazilian” (1.24; 95% CI: 1.08, 1.43) and “Ultra-processed and sweet foods” DPs (1.29; 95% CI: 1.09, 1.54), and overestimation was inversely associated with all the DPs. In boys, a direct association between underestimation and the “Ultra-processed and sweet foods” DP (1.29; 95% CI: 1.10, 1.51) was found. Overestimation was inversely associated with the “Traditional Brazilian” DP (0.79; 95% CI: 0.63, 0.99). The inverse association between overestimation and the “Traditional Brazilian” DP, and the direct association between underestimation and the “Ultra-processed and sweet foods” DP indicated that weight misperception was related to unhealthy eating habits in Brazilian adolescents.
Highlights
Adolescence is the phase of life between childhood and adulthood
The prevalence of common mental disorders (CMDs) was greater in the girls (38.4%, 95% confidence intervals (95% CIs): 36.7, 39.9] than boys (25.6%, 95% CI: 24.5, 26.6)
When comparing the results of this study with the results of investigations with analogous methodology for extracting dietary patterns, we found that the composition of “Traditional Brazilian” dietary patterns was similar to the namesake pattern identified in other studies of Brazilian adolescents [81,82,83], as well as the “Common Brazilian” pattern identified between adolescents of Fortaleza, Brazil [84]
Summary
Adolescence is the phase of life between childhood and adulthood. According to the World Health Organization, adolescents are individuals in the 10 to 19 years age group. Weight misperception is the disagreement between nutritional status and body weight perception [12,13], and in adolescents, it is associated to eating disorders, restrictive diets, low self-esteem, and higher weight gain in adulthood [11,13,14]. Both weight overestimation, when adolescents perceive themselves to be heavier than they are, and underestimation, when they perceive themselves to be lighter than their current weight, are associated with risk behaviors [9,15]. Among students with normal weight, 65.7% perceived their weight accurately [16]
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