Association between Body Image Dissatisfaction and Self-Rated Health, as Mediated by Physical Activity and Eating Habits: Structural Equation Modelling in ELSA-Brasil
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Study Population
2.2. Measurements
2.2.1. Exposure
2.2.2. Outcome
2.2.3. Mediating Variables
2.2.4. Covariables
2.3. Statistical Analysis
2.4. Ethical Considerations
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variables-n (%) | Men | Women | Total | p-Value |
---|---|---|---|---|
Body image | ||||
Satisfied | 1289 (59.3) | 883 (40.7) | 2172 (14.7) | <0.001 |
Dissatisfied at being LI | 770 (67.6) | 369 (32.4) | 1139 (7.7) | |
Dissatisfied at being HI | 4680 (40.8) | 6796 (59.2) | 11476 (77.6) | |
Self-rated health | ||||
Very good | 1808 (42.8) | 2416 (57.2) | 4224 (28.0) | <0.001 |
Good | 3704 (47.1) | 4163 (52.9) | 7867 (52.1) | |
Fair | 1261 (46.5) | 1449 (53.5) | 2710 (17.9) | |
Poor | 110 (36.8) | 189 (63.2) | 299 (2.0) | |
Schooling | ||||
Complete higher education or postgraduate | 3478 (43.7) | 4472 (56.3) | 7950 (52.6) | <0.001 |
Complete upper secondary education | 2270 (43.4) | 2963 (56.6) | 5233 (34.6) | |
Lower secondary education | 574 (55.8) | 454 (44.2) | 1028 (6.8) | |
Less than lower secondary education | 565 (63.2) | 329 (36.8) | 894 (5.9) | |
Age-mean (SD) | 51 (9.3) | 51 (8.9) | 52.1 (9.1) | 0.3458 |
No. chronic diseases | ||||
None | 3403 (41.3) | 4834 (58.7) | 8237 (54.6) | <0.001 |
One | 2363 (49.8) | 2380 (50.2) | 4743 (31.5) | |
Two or more | 1108 (52.8) | 992 (47.2) | 2100 (13.9) | |
Consumption of pizza | ||||
Never or almost never | 1694 (42.6) | 2286 (57.4) | 3980 (26.4) | <0.001 |
One to three times a month | 3204 (44.8) | 3944 (55.2) | 7148 (47.4) | |
Once a week | 1692 (49.3) | 1740 (50.7) | 3432 (22.8) | |
Two to four times a week | 267 (56.1) | 209 (43.9) | 476 (3.2) | |
More than five times a week | 19 (46.3) | 22 (53.7) | 41 (0.3) | |
Consumption of hamburger | ||||
Never or almost never | 4902 (44.2) | 6184 (55.8) | 11086 (73.5) | <0.001 |
One to three times a month | 1307 (48.2) | 1403 (51.8) | 2710 (18.0) | |
Once a week | 478 (51.6) | 449 (48.4) | 927 (6.1) | |
Two to four times a week | 165 (54.5) | 138 (45.5) | 303 (2.0) | |
More than five times a week | 24 (47.1) | 27 (52.9) | 51 (0.3) | |
Consumption of hot dog | ||||
Never or almost never | 5113 (45.5) | 6114 (54.5) | 11227 (74.5) | <0.001 |
One to three times a month | 1390 (44.0) | 1766 (56.0) | 3156 (20.9) | |
Once a week | 304 (52.7) | 273 (47.3) | 577 (3.8) | |
Two to four times a week | 55 (59.8) | 37 (40.2) | 92 (0.6) | |
More than five times a week | 14 (56.0) | 11 (44.0) | 25 (0.2) | |
Consumption of ham/mortadella/salami | ||||
Never or almost never | 2107 (38.11) | 3422 (61.9) | 5529 (36.7) | <0.001 |
One to three times a month | 1667 (45.6) | 1991 (54.4) | 3658 (24.3) | |
Once a week | 1312 (48.8) | 1378 (51.2) | 2690 (17.8) | |
Two to four times a week | 1279 (56.3) | 994 (43.7) | 2273 (15.1) | |
More than five times a week | 511 (55.1) | 416 (44.9) | 927 (6.1) | |
Consumption of fried savouries | ||||
Never or almost never | 3068 (39.3) | 4738 (60.7) | 7806 (51.8) | <0.001 |
One to three times a month | 2263 (46.7) | 2581 (53.3) | 4844 (32.1) | |
Once a week | 1032 (61.2) | 655 (38.8) | 1687 (11.2) | |
Two to four times a week | 437 (71.3) | 176 (28.7) | 613 (4.1) | |
More than five times a week | 76 (59.8) | 51 (40.2) | 127 (0.8) | |
Consumption of soft drinks | ||||
Never or almost never | 1591 (37.8) | 2617 (62.2) | 4208 (27.9) | <0.001 |
One to three times a month | 1051 (42.7) | 1412 (57.3) | 2463 (16.3) | |
Once a week | 1374 (41.7) | 1924 (58.3) | 3298 (21.9) | |
Two to four times a week | 1570 (54.9) | 1291 (45.1) | 2861 (19.0) | |
More than five times a week | 1290 (57.4) | 957 (42.6) | 2247 (14.9) | |
Walking | ||||
Does 150 or more minutes/week | 1224 (53.0) | 1087 (47.0) | 2311 (15.5) | <0.001 |
Does less than 150 min/week | 1794 (48.6) | 1897 (51.4) | 3691 (24.8) | |
Does none | 3771 (42.5) | 5107 (57.5) | 8878 (59.7) | |
Moderate physical activity | ||||
Does 150 or more minutes/week | 530 (46.3) | 615 (53.7) | 1145 (7.7) | <0.001 |
Does less than 150 min/week | 1099 (50.4) | 1082 (49.6) | 2181 (14.7) | |
Does none | 5158 (44.6) | 6399 (55.4) | 11557 (77.7) | |
Strong physical activity | ||||
Does 75 or more minutes/week | 1580 (56.3) | 1225 (43.6) | 2808 (18.9) | <0.001 |
Does less than 75 min/week | 350 (68.5) | 161 (31.5) | 511 (3.4) | |
Does none | 4858 (42.0) | 6710 (58.0) | 11568 (77.7) |
Measurement Model | Standardised Coefficient | |
---|---|---|
Men | Women | |
Eating habits | ||
Consumption of pizza | 0.513 (0.490;0.536) *** | 0.533 (0.511;0.555) *** |
Consumption of hamburger | 0.619 (0.590;0.647) *** | 0.595 (0.567–0.623) *** |
Consumption of hot dog | 0.627 (0.598;0.655) *** | 0.634 (0.608;0.661) *** |
Consumption of ham/mortadella/salami | 0.508 (0.484;0.532) *** | 0.511 (0.489;0.533) *** |
Consumption of fried savouries | 0.511 (0.487;0.536) *** | 0.522 (0.498;0.545) *** |
Consumption of soft drinks | 0.468 (0.445;0.491) *** | 0.530 (0.509;0.552) *** |
Leisure-time Physical activity | ||
Walking | 0.389 (0.348;0.430) *** | 0.448 (0.413;0.484) *** |
Moderate activity | 0.405 (0.361;0.449) *** | 0.512 (0.470;0.555) *** |
Strong activity | 0.691(0.636;0.747) *** | 0.604 (0.561;0.648) *** |
Model goodness of fit | ||
CFI | 0.934 | |
TLI | 0.948 | |
RMSEA | 0.036 (90% CI: 0.034–0.039) | |
Structural model (Direct effects) | ||
1. Self-rated health | ||
Dissatisfied at being LI | 0.074 (0.044;0.104) *** | 0.041 (0.012;0.071) ** |
Dissatisfied at being HI | 0.120 (0.089–0.151) *** | 0.064 (0.036;0.092) *** |
Schooling | 0.182 (0.152;0.213) *** | 0.112 (0.078;0.147) *** |
Age | −0.013 (−0.042;0.017) | −0.004 (−0.033;0.025) |
No. chronic diseases | 0.236 (0.208;0.263) *** | 0.235 (0.209;0.261) *** |
Unhealthy eating habits | 0.006 (−0.028;0.040) | −0.036 (−0.074;0.001) |
Physical activity | 0.273 (0.229;0.318) *** | 0.346 (0.295;0.397) *** |
2. Unhealthy eating habits | ||
Dissatisfied at being LI | 0.074 (0.040;0.109) *** | 0.084 (0.053;0.115) *** |
Dissatisfied at being HI | 0.143 (0.108;0.178) *** | 0.145 (0.114;0.177) *** |
Schooling | −0.053 (−0.082;−0.023) *** | −0.037 (−0.063;−0.010) ** |
Age | −0.306 (−0.335; −0.276) *** | −0.379 (−0.406;−0.352) *** |
No. chronic diseases | 0.035 (0.004;0.066) * | 0.035 (0.007;0.064) * |
3. Insufficient physical activity | ||
Dissatisfied at being LI | 0.047(0.001;0.092) * | 0.087 (0.042;0.133) *** |
Dissatisfied at being HI | 0.094 (0.048;0.139) *** | 0.067 (0.025;0.109) ** |
Schooling | 0.316 (0.275;0.357) *** | 0.427 (0.389;0.465) *** |
Age | −0.012 (−0.056;0.032) | −0.098 (−0.140;−0.056) *** |
No. chronic diseases | 0.096 (0.053;0.139) *** | 0.072 (0.032;0.112) *** |
Unhealthy eating habits | 0.091 (0.038;0.144) ** | 0.254 (0.202;0.306) *** |
Indirect Effects | Coefficient Standardised | |
---|---|---|
Men | Women | |
Indirect effects of dissatisfaction at being LI | ||
Dissatisfied at being LI->Unhealthy eating habits->Poor self-rated health | 0.000 (−0.002;0.003) | −0.003 (−0.006;0.000) |
Dissatisfied at being LI->Insufficient physical activity->Poor self-rated health | 0.013 (0.000;0.025) * | 0.030 (0.014;0.047) *** |
Dissatisfied at being LI->Unhealthy eating habits->Insufficient physical activity->Poor self-rated health | 0.002 (0.000;0.003) * | 0.007 (0.004;0.011) *** |
Total indirect effect | 0.015 (0.002;0.028) * | 0.035 (0.018;0.051) *** |
Indirect effects of dissatisfaction at being HI | ||
Dissatisfied at being HI->Unhealthy eating habits->Poor self-rated health | 0.001 (−0.004;0.006) | −0.005 (−0.011;0.000) |
Dissatisfied at being HI->Insufficient physical activity->Poor self-rated health | 0.026 (0.012;0.039) *** | 0.023 (0.008;0.038) ** |
Dissatisfied at being HI->Unhealthy eating habits->Insufficient physical activity->Poor self-rated health | 0.004 (0.001;0.006) ** | 0.013 (0.008;0.017) *** |
Total indirect effect | 0.030 (0.016;0.044) *** | 0.031 (0.015;0.046) *** |
Model goodness of fit | ||
CFI | 0.930 | |
TLI | 0.923 | |
RMSEA (90%CI) | 0.030 (0.029;0.032) |
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De Oliveira da Silva, P.; Miguez Nery Guimarães, J.; Härter Griep, R.; Caetano Prates Melo, E.; Maria Alvim Matos, S.; Del Carmem Molina, M.; Maria Barreto, S.; De Jesus Mendes da Fonseca, M. Association between Body Image Dissatisfaction and Self-Rated Health, as Mediated by Physical Activity and Eating Habits: Structural Equation Modelling in ELSA-Brasil. Int. J. Environ. Res. Public Health 2018, 15, 790. https://doi.org/10.3390/ijerph15040790
De Oliveira da Silva P, Miguez Nery Guimarães J, Härter Griep R, Caetano Prates Melo E, Maria Alvim Matos S, Del Carmem Molina M, Maria Barreto S, De Jesus Mendes da Fonseca M. Association between Body Image Dissatisfaction and Self-Rated Health, as Mediated by Physical Activity and Eating Habits: Structural Equation Modelling in ELSA-Brasil. International Journal of Environmental Research and Public Health. 2018; 15(4):790. https://doi.org/10.3390/ijerph15040790
Chicago/Turabian StyleDe Oliveira da Silva, Patricia, Joanna Miguez Nery Guimarães, Rosane Härter Griep, Enirtes Caetano Prates Melo, Sheila Maria Alvim Matos, Maria Del Carmem Molina, Sandhi Maria Barreto, and Maria De Jesus Mendes da Fonseca. 2018. "Association between Body Image Dissatisfaction and Self-Rated Health, as Mediated by Physical Activity and Eating Habits: Structural Equation Modelling in ELSA-Brasil" International Journal of Environmental Research and Public Health 15, no. 4: 790. https://doi.org/10.3390/ijerph15040790