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Title:	Association of body composition with diet, physical activity and psychosocial factors among adolescents during puberty : a longitudinal study
Supervisor:	Poh Bee Koon, Prof. Dr.
Keywords:	Diet Body Weight Universiti Kebangsaan Malaysia -- Dissertations Dissertations, Academic -- Malaysia
Issue Date:	28-May-2020
Description:	The increasing prevalence of childhood obesity warrants the need to track their body composition. The change in body composition can be influenced by various factors. Hence, the aim of this study is to investigate the relationship between dietary intake, physical activity and psychosocial factors with changes in body composition of adolescents after 9 and 18 months from baseline. A total of 234 adolescents (97 boys; 137 girls) aged 10 to 14 years were recruited from national schools in Kuala Lumpur using a single-stage cluster sampling method. Socio-demographic and pubertal stage data were collected. Weight, height, waist circumference (WC) and skinfolds (SKF) thickness were measured; and body mass index (BMI) was calculated. Body fat percentage (%BF) was estimated through bioelectrical impedance analysis (BIA). Dietary intake was assessed by a 3-day dietary record. Physical activity was reported using physical activity questionnaire (PAQ) and pedometer. Sedentary behaviour was assessed using a questionnaire adapted from the Child and Adolescent Physical Activity and Nutrition Survey. Sleep quality was assessed through a Sleep Self Report. Psychosocial aspects were assessed using Stunkard's Figure Rating Scale and the Eating Disorder Inventory-Children (EDI-C). Mean age, weight, height, BMI, WC, sum of four SKF thickness and %BF at baseline were 12.1 ± 1.6 years, 44.0 ± 15.3 kg, 146.4 ± 11.4 cm, 20.1 ± 5.2 kg/m2, 65.2 ± 12.8 cm, 46.3 ± 20.6 mm and 26.1 ± 6.0 %, respectively. Significantly higher in weight, height, WC, BMI and BAZ were found in boys than girls (p<0.001). Girls had a higher sum of four SKF thickness and %BF than boys (p<0.001). Some 85% of participants were at pubertal stages (stage 2 to 4) during baseline, with 13% of participants also entering pubertal stages after 18 months. All anthropometric variables and adiposity indicators increased at both follow-ups (p<0.05). Basal mean PAQ score, pedometer step count, screen time and sleep duration were 2.47 ± 0.59, 9401 ± 3612 steps/day, 6.1 ± 3.4 hours/day and 8.2 ± 1.6 hours/day, respectively. Compared to the baseline, lower mean pedometer step count, higher screen time and reduced sleep duration were observed at the 18-month follow-up (p<0.05). No significant changes in dietary intake were found, however it was noted that there was an increased intake of fats in their diets after 18 months (p<0.05). Aside from that, mean body size dissatisfaction score for girls was higher than boys (0.63 vs. 0.29, p<0.05); with 80% of participants being dissatisfied with their body size at baseline. Further, 16% of participants were found to be at risk of eating disorders (22% of girls; 11% of boys). Participants who desired smaller body sizes and who had heightened levels of eating disorder risk had greater %BF than their counterparts during all three phases. Results from a linear mixed-model showed that total sedentary time, particularly screen time, influenced changes of %BF after adjusting for covariates. Body size dissatisfaction score and certain subscales of EDI-C (Drive for Thinness, Body Dissatisfaction and Introceptive Awareness) were significantly associated with BMI and %BF. In conclusion, participants' reports on sedentary behaviour, body image dissatisfaction and eating disorder risks were related to gains in adiposity over time. These findings suggest that reductions in sedentary behaviour, particularly reductions in screen time, must be emphasized to promote positive changes in body composition and to aid in preventing obesity towards late adolescence. Promotion of a healthy body image should also be integrated across all interventions aimed to address obesity, eating disorders, and other health-related problems among adolescents.,Ph.D.,The increasing prevalence of childhood obesity warrants the need to track their body composition. The change in body composition can be influenced by various factors. Hence, the aim of this study is to investigate the relationship between dietary intake, physical activity and psychosocial factors with changes in body composition of adolescents after 9 and 18 months from baseline. A total of 234 adolescents (97 boys; 137 girls) aged 10 to 14 years were recruited from national schools in Kuala Lumpur using a single-stage cluster sampling method. Socio-demographic and pubertal stage data were collected. Weight, height, waist circumference (WC) and skinfolds (SKF) thickness were measured; and body mass index (BMI) was calculated. Body fat percentage (%BF) was estimated through bioelectrical impedance analysis (BIA). Dietary intake was assessed by a 3-day dietary record. Physical activity was reported using physical activity questionnaire (PAQ) and pedometer. Sedentary behaviour was assessed using a questionnaire adapted from the Child and Adolescent Physical Activity and Nutrition Survey. Sleep quality was assessed through a Sleep Self Report. Psychosocial aspects were assessed using Stunkard's Figure Rating Scale and the Eating Disorder Inventory-Children (EDI-C). Mean age, weight, height, BMI, WC, sum of four SKF thickness and %BF at baseline were 12.1 ± 1.6 years, 44.0 ± 15.3 kg, 146.4 ± 11.4 cm, 20.1 ± 5.2 kg/m2, 65.2 ± 12.8 cm, 46.3 ± 20.6 mm and 26.1 ± 6.0 %, respectively. Significantly higher in weight, height, WC, BMI and BAZ were found in boys than girls (p<0.001). Girls had a higher sum of four SKF thickness and %BF than boys (p<0.001). Some 85% of participants were at pubertal stages (stage 2 to 4) during baseline, with 13% of participants also entering pubertal stages after 18 months. All anthropometric variables and adiposity indicators increased at both follow-ups (p<0.05). Basal mean PAQ score, pedometer step count, screen time and sleep duration were 2.47 ± 0.59, 9401 ± 3612 steps/day, 6.1 ± 3.4 hours/day and 8.2 ± 1.6 hours/day, respectively. Compared to the baseline, lower mean pedometer step count, higher screen time and reduced sleep duration were observed at the 18-month follow-up (p<0.05). No significant changes in dietary intake were found, however it was noted that there was an increased intake of fats in their diets after 18 months (p<0.05). Aside from that, mean body size dissatisfaction score for girls was higher than boys (0.63 vs. 0.29, p<0.05); with 80% of participants being dissatisfied with their body size at baseline. Further, 16% of participants were found to be at risk of eating disorders (22% of girls; 11% of boys). Participants who desired smaller body sizes and who had heightened levels of eating disorder risk had greater %BF than their counterparts during all three phases. Results from a linear mixed-model showed that total sedentary time, particularly screen time, influenced changes of %BF after adjusting for covariates. Body size dissatisfaction score and certain subscales of EDI-C (Drive for Thinness, Body Dissatisfaction and Introceptive Awareness) were significantly associated with BMI and %BF. In conclusion, participants' reports on sedentary behaviour, body image dissatisfaction and eating disorder risks were related to gains in adiposity over time. These findings suggest that reductions in sedentary behaviour, particularly reductions in screen time, must be emphasized to promote positive changes in body composition and to aid in preventing obesity towards late adolescence. Promotion of a healthy body image should also be integrated across all interventions aimed to address obesity, eating disorders, and other health-related problems among adolescents.
Pages:	149
Call Number:	9 Tesis Cd WS132 .A581a 2020
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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