title: Higher central fat and poor self-body image in short-stature overweight/obese women living in Brazilian shantytowns.
abstract: BACKGROUND
  Short stature in adult life, a possible consequence of poor perinatal conditions, is associated with higher risk of mortality and social disabilities. We aimed to determine whether low-income, overweight/obese, short-stature (SS) women show alterations in body composition, self-body-image perception, and biochemical profile compared to their non-short (NS) counterparts.
  
  
  METHODS
  A cross-sectional study was conducted with women living in shantytowns and mother or relatives to undernourished children treated in a center for recuperation and nutritional education. Inclusion criteria were: (1) age, 19-45 years; (2) stature < 152.3 cm or > 158.7 cm; and (3) body mass index > 25 kg/m2. Socioeconomic, anthropometric, biochemical, and body image data were collected. We analyzed 56 SS and 57 NS women.
  
  
  RESULTS
  The SS group showed a higher waist-to-height ratio (WHtR) (mean: 0.63; standard deviation: 0.06 for SS and mean: 0.60; standard deviation: 0.07 for the NS group; p = 0.02), and, in the adjusted analysis, showed lower fat-free mass (Estimated Marginal Mean for the SS group: 45.7 kg 95% confidence intervals (CI) (45.2-46.2) and for the NS group: 46.9 kg 95% CI (46.4-47.4); p < 0.01) and higher fat mass (Estimated Marginal Mean for the SS group: 32.5 95% CI (31.9-33.0) and for the NS group: 31.4 kg 95% CI (30.9-31.9); p < 0.01). Body mass index was a better predictor of current self-body-image perception for NS women. The SS coefficient values were β = 0.141,SE= 0.059, and R2-Nagelkerke = 0.107, and the NS coefficients values were β = 0.307,SE= 0.058, and R2-Nagelkerke = 0.491 (Z= 2.006; p < 0.05). Considering the obese subgroup, six out of 32 (18.8%) SS women and 14 out of 33 (42.4%) NS women perceived themselves as obese (χ2= 4.27; p = 0.03). This difference remained significant even after adjustment by age, schooling, and number of children (p = 0.04). Only the total thyroxin showed significant differences between groups, lower in SS women (p = 0.04).
  
  
  CONCLUSIONS
  Overweight/obese, low-income SS women have more central adiposity and impaired self-body image perception, and the body mass index is a weaker predictor of it, compared to NS women. Misperception about body size may be linked with an overestimation of health and underestimation of risk, which may lead to a lower utilization of the health care system and inadequate physician counseling. These features may account, at least partially, for the higher mortality risk seen in SS adults.
authors.affiliation: Faculdade de Nutrição, Universidade Federal de Alagoas , Maceió, AL , Brazil.
authors.forename: Nassib Bezerra
authors.initials: NB
authors.lastname: Bueno
authors.affiliation: Faculdade de Nutrição, Universidade Federal de Alagoas , Maceió, AL , Brazil.
authors.forename: Telma Toledo
authors.initials: TT
authors.lastname: Florêncio
authors.affiliation: Faculdade de Nutrição, Universidade Federal de Alagoas , Maceió, AL , Brazil.
authors.forename: Fabiana Albuquerque
authors.initials: FA
authors.lastname: Cavalcante
authors.affiliation: Faculdade de Nutrição, Universidade Federal de Alagoas , Maceió, AL , Brazil.
authors.forename: Isabela Lopes
authors.initials: IL
authors.lastname: Lins
authors.affiliation: Faculdade de Nutrição, Universidade Federal de Alagoas , Maceió, AL , Brazil.
authors.forename: Ana Grotti
authors.initials: AG
authors.lastname: Clemente
authors.affiliation: Departamento de Fisiologia, Universidade Federal de São Paulo , São Paulo, SP , Brazil.
authors.forename: Ana Lydia
authors.initials: AL
authors.lastname: Sawaya
keywords: Body image; DoHaD; Obesity; Social vulnerability; Stunting; Women