title: The relationship between distorted body image and lifestyle among Japanese adolescents: a population-based study.
abstract: BACKGROUND
  Distorted body image plays a significant role in the development of obesity, eating problems, and eating disorders. The aim of this study was to investigate the relationship between distorted body image and lifestyle among Japanese adolescent boys and girls.
  
  
  METHODS
  Subjects were 1731 seventh graders (age 12-13 years) from the Ina-town's junior high schools, Japan, from 2005-2009. The height and weight of each subject were measured. Childhood underweight, overweight, and obesity were defined using the body mass index cutoff points proposed by the International Obesity Task Force. Information regarding the self-perceived weight status and lifestyles (exercise, snacking after dinner, breakfast, wakeup time, bedtime) of each subject was collected using a self-administered questionnaire. Self-perceived weight status was categorized into three groups (thin, normal, or heavy), and compared with the subjects' actual weight status. Body image perception was categorized into the following three groups: an underestimated own weight status group (underestimated group), a correct own weight status group (correct group) and an overestimated own weight status group (overestimated group).
  
  
  RESULTS
  The proportion of boys in the underestimated group was higher than that of girls, while the opposite was true for the overestimated group (P < 0.001). There were no statistically significant differences in lifestyle between the underestimated group and the correct group regardless of sex. In contrast, there were statistically significant differences between the overestimated group and the correct group in the lifestyle factors of exercise among boys and snacking after dinner among girls. The adjusted odds ratio (OR) in boys who exercised daily significantly decreased (OR: 0.35, 95 % CI: 0.16-0.77), while a significantly increased OR was observed in girls who snacked after dinner (OR: 1.53, 95 % CI: 1.07-2.19).
  
  
  CONCLUSIONS
  Adolescent boys tended to underestimate their body weight, whereas adolescent girls were likely to overestimate their body weight. Furthermore, lifestyle factors associated with distorted body image differed by sex, with exercise affecting body image perception among boys and snacking after dinner affecting body image perception among girls. Thus, lifestyle may lead to distorted body image among adolescents.
authors.affiliation: Department of Public Health, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Shirasawa
authors.affiliation: Department of Public Health, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ochiai
authors.affiliation: Department of Public Health, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Hinako
authors.initials: H
authors.lastname: Nanri
authors.affiliation: Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Rimei
authors.initials: R
authors.lastname: Nishimura
authors.affiliation: Department of Public Health, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Ohtsu
authors.affiliation: Department of Public Health, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Hoshino
authors.affiliation: Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Tajima
authors.affiliation: Department of Public Health, Showa University School of Medicine, Tokyo, Japan.
authors.forename: Akatsuki
authors.initials: A
authors.lastname: Kokaze
keywords: Adolescent; Distorted body image; Japanese; Lifestyle; Sex