Comparison between self-image and body mass index among children living in a slum in Rio de Janeiro, Brazil, 2012

Gama, Sueli Rosa; Cardoso, Letícia de Oliveira; Engstrom, Elyne Montenegro; Carvalho, Marilia Sá

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Epidemiologia e Serviços de Saúde

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Original article • Epidemiol. Serv. Saúde 30 (1) • Jan-Dec 2021 • https://doi.org/10.1590/S1679-49742021000100004 copy

Comparison between self-image and body mass index among children living in a slum in Rio de Janeiro, Brazil, 2012^* * This article is derived from the Ph.D. thesis entitled ‘Overweight in children living in a slum in Rio de Janeiro: a systematic approach’, defended by Sueli Rosa Gama at the Public Health Epidemiology Program, Sergio Arouca National School of Health/ Oswaldo Cruz Institute Foundation, Rio de Janeiro, RJ, 2016. Marilia Sá Carvalho and Elyne Montenegro Engstrom received financial support from the Rio de Janeiro State Carlos Chagas Filho Research Support Program: E_26/2014-203577; E26/110.280/2012. Marilia Sá Carvalho received support from the National Council for Scientific and Technological Development (CNPq)/Ministry of Science, Technology, Innovation and Communication (MCTIC): PQ 309692/2013.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To analyze agreement/discrepancy between body self-image and Body Mass Index (BMI), according to variables related to type of food and environment influence.

Methods

This was a cross-sectional analysis of 195 prepubescent children (≥5 years), attending a Primary Health Care service in Manguinhos, Rio de Janeiro. Z-scores were applied to classify BMI. Self-image was collected using the figure rating scale (silhouettes) validated for children. A multinomial model was used to estimate covariate association with the underestimated/overestimated BMI outcome in relation to self-image.

Results

Overweight children underestimated their BMI, as compared with self-image, more often (58.6%) than obese children (22.0%) and children with adequate BMI (49.0%). This dissociation was correlated to participation in a cash transfer program (OR=2.01 - 95%CI 1.04;3.90) and daily consumption of sugar-sweetened foodstuffs (OR=3.88 - 95%CI 1.05;14.39).

Conclusion

Underestimation of BMI among overweight children should be taken into account by Primary Health Care services, in order to enhance intervention practices.

Keywords:
Body Image; Childhood Obesity; Body Mass Index; Primary Health Care

Variables	Male (88)		Female (107)		Total		p-value^a
Variables	n	%	n	%	n	%
Nutritional assessment							0.279
Adequate	59	67.0	68	63.0	127	65.1
Overweight	15	17.0	13	12.0	28	14.4
Obesity	14	15.9	26	24.1	40	20.5
Body image							0.160
Underweight	15	17.0	24	22.2	39	20.0
Normal	48	54.5	41	38.0	89	45.6
Overweight	12	13.6	21	19.4	33	16.9
Obesity	13	14.8	21	19.4	34	17.4
Maternal schooling (years of study)^b							0.832
<4	14	15.9	19	17.6	33	16.9
4-11	53	60.2	60	55.6	113	57.9
≥12	20	22.7	27	25.0	47	24.1
*Registered with the Bolsa Família* program**							0.835
No	45	51.1	52	49.1	97	49.7
Yes	43	48.9	55	50.9	98	50.3
Mother works outside the home ^c							0.518
No	43	55.7	47	50.0	90	52.3
Yes	39	44.3	54	50.0	93	47.7
>School meals							0.285
No	43	48.9	43	40.2	86	44.1
Yes	45	51.1	64	59.8	109	55.9
Lives with mother ^d							0.635
Yes	77	87.5	97	89.8	174	89.2
No	11	11.5	10	9.3	21	10.8
Lives with father ^d							0.346
Yes	40	45.5	57	53.3	97	49.7
No	48	54.5	50	46.7	98	50.3
Lives with grandmother ^d							0.214
Yes	23	26.1	19	17.6	42	21.5
No	65	73.9	88	88.2	153	78.5
Fatty meat consumption							0.066
Not daily	68	77.3	87	87.3	155	79.5
Daily	20	22.7	20	18.7	40	20.5
Consumption of sweet products							0.918
Not daily	27	30.7	31	29.0	58	29.7
Daily	61	69.3	76	71.0	137	70.3
Consumption of sugar-sweetened drinks							1.000
Not daily	28	31.8	35	32.7	63	32.3
Daily	60	68.2	72	67.3	132	67.7

Response categories	Overestimation versus adequate classification			Underestimation versus adequate classification
Response categories	n	OR^a	95%CI^b	n	OR^a	95%CI^b
Registered with the Bolsa Família program (Yes)	13	1.60	0.67;3.80	39	2.01	1.04;3.90
Consumption of sweet products (daily)	23	3.88	1.05;14.39	40	1.02	0.50;2.07
Consumption of sugar-sweetened drinks	19	0.88	0.33;2.39	36	0.54	0.27;1.06

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
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[1] Correspondence: Sueli Rosa Gama - Rua Leopoldo Bulhões, No. 1480, Manguinhos, Rio de Janeiro, RJ, Brazil. Postcode: 21041-210. E-mail: ileus@ensp.fiocruz.br