Health self-perception and its association with physical activity and nutritional status in adolescents

Silva, Alison Oliveira da; Diniz, Paula R.B.; Santos, Maria E.P.; Ritti-Dias, Raphael M.; Farah, Breno Q.; Tassitano, Rafael M.; Oliveira, Luciano M.F.T.

doi:10.1016/j.jped.2018.05.007

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Original articles • J. Pediatr. (Rio J.) 95 (4) • Jul-Aug 2019 • https://doi.org/10.1016/j.jped.2018.05.007 copy

Health self-perception and its association with physical activity and nutritional status in adolescents^☆ ☆ Please cite this article as: Silva AO, Diniz PR, Santos ME, Ritti-Dias RM, Farah BQ, Tassitano RM, et al. Health self-perception and its association with physical activity and nutritional status in adolescents. J Pediatr (Rio J). 2019;95:458 -65. , ^☆☆ ☆☆ Study conducted at Universidade de Pernambuco (UPE), Recife, PE, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To evaluate the association between total physical activities, physical activity in free time and nutritional status with self-perceived health in adolescents of both genders.

Methods:

This is a quantitative study that integrates the school-based, cross-sectional epidemiological survey with statewide coverage, whose sample consisted of 6261 adolescents (14 -19 years old) selected by random conglomerate sampling. Data were collected using the Global School-based Student Health Survey. The chi-squared test (χ ²) and the Poisson regression model with robust variance were used in the data analyses.

Results:

It was observed that 27.3% of the adolescents had a negative health self-perception, which was higher among girls (33.0% vs. 19.0%, p < 0.001). After adjusting for potential confounding factors, it was observed that boys who did not practice physical activity during free time (PR = 1.44, 95% CI: 1.15 -1.81) and were classified as insufficiently active (PR = 1.27, 95% CI: 1.04 -1.56), as well as girls who did not practice physical activity during free time (PR = 1.15, 95% CI: 1.02 -1.29) and were classified as overweight (PR = 1.27, 95% CI: 1.01 -1.29) had a greater chance of negative health self-perception.

Conclusion:

Behavioral issues may have different effects on health self-perception when comparing boys with girls. Negative health self-perception was associated with nutritional status in girls and a lower level of physical activity in boys, and the practice of physical activity in the free time was considered a protective factor against a negative health self-perception for adolescents of both genders.

KEYWORDS
Adolescent health; Physical activity; Lifestyle; Prevalence

Variables	Health self-perception						p-value
	Positive		Negative		Total
	4548 (72.7%)		1711 (27.3%)		6259
	n	%	n	%	n	%
Gender							<0.001
Male	2043	81.0	478	19.0	2521	40.3
Female	2504	67.0	1231	33.0	3735	59.7
Age (years)							0.001
14 -15	1022	75.8	326	24.2	1348	21.5
16 -17	2427	72.6	916	27.4	3343	53.4
18 -19	1099	70.1	469	29.9	1568	25.1
Occupation							0.722
Works	1006	72.4	384	27.6	1390	22.3
Does not work	3535	72.9	1317	27.1	4852	77.7
Place of residence							<0.001
Urban	3429	73.9	1214	26.1	4643	74.5
Rural	1098	69.2	489	30.8	1587	25.5
Maternal schooling							<0.001
>8 years of study	1458	76.7	442	23.3	1900	35.3
≤8 years of study	2478	71.0	1012	29.0	3490	64.7
Physical activity in free time							<0.001
Yes	3051	76.2	953	23.8	4004	64.0
No	1491	66.3	758	33.7	2249	36.0
Level of physical activity							<0.001
Active	1665	76.0	525	24.0	2190	35.1
Insufficiently active	2862	70.8	1182	29.2	4044	64.9
Preferred leisure type							<0.001
Active leisure	1752	78.2	487	21.8	2239	40.4
Passive leisure	2296	69.5	1006	30.5	3302	59.6
Nutritional status							0.003
Normal weight	3706	73.1	1362	26.9	5068	83.5
Overweight	687	68.5	316	31.5	1003	16.5

Variable	Negative health self-perception
	PR			PR
	Crude	95% CI	p-value	Adjusted	95% CI	p-value
Physical activity level			0.001			0.019
Active	1			1
Insufficiently active	1.37	1.13 -1.67		1.27	1.04 -1.56
Physical activity in free time			<0.001			0.002
Yes	1			1
No	1.54	1.26 -1.89		1.44	1.15 -1.81
Preferred leisure type			0.067			0.825
Active leisure	1			1
Passive leisure	1.20	0.99 -1.45		1.02	0.83 -1.27
Nutritional status			0.647			0.625
Normal weight	1			1
Overweight	0.94	0.72 -1.22		0.94	0.72 -1.22

Variables	Negative health self-perception
	PR			PR
	Crude	95% CI	p-value	Adjusted	95% CI	p-value
Physical activity level			0.762			0.933
Active	1			1
Insufficiently active	1.02	0.90 -1.15		0.99	0.88 -1.13
Physical activity in free time			<0.001			0.019
Yes	1			1
No	1.18	1.06 -1.31		1.15	1.02 -1.29
Favorite leisure activity			0.030			0.140
Active leisure	1			1
Passive leisure	1.16	1.02 -1.34		1.14	0.97 -1.29
Nutritional status			0.001			0.037
Normal weight	1			1
Overweight	1.24	1.10 -1.42		1.27	1.01 -1.29

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[1] * Corresponding author. E-mail:alison.oli@hotmail.com (A.O. Silva).