The relationship between indoor tanning and body mass index, physical activity, or dietary practices: a systematic review

Abstract

A systemic review was conducted to better understand the relationship between indoor tanning and body mass index (BMI), physical activity, or dietary practices. Articles included in this review were obtained via a systematic search of PubMed following PRISMA guidelines. Available articles were published between September, 2003 and May, 2017 and contained data regarding indoor tanning and BMI, physical activity, or dietary practices. Sixteen publications met final inclusion criteria. Results of this review indicate significant positive associations between indoor tanning and high physical activity levels, playing sports, and both unhealthy and healthy diet and weight control practices. Frequent or dependent indoor tanning was associated with unhealthy dietary practices in most studies or risk for exercise addiction in one study. Results were mixed for BMI. This review demonstrates associations between indoor tanning and physical activity or dietary practices. Despite the use of some unhealthy strategies (e.g., indoor tanning, fasting, vomiting, laxative, or steroid use), common motives for these behaviors include a desire to appear attractive and/or healthy. Findings from this study can help inform future research and possible interventions for individuals engaging in relevant risky health behaviors.

This is a preview of subscription content, log in to check access.

Fig. 1

References

  1. Amrock, S. M., & Weitzman, M. (2014). Adolescent indoor tanning use and unhealthy weight control behaviors. Journal of Developmental and Behavioral Pediatrics: JDBP, 35, 165–171. https://doi.org/10.1097/dbp.0000000000000050

    Article  PubMed  Google Scholar 

  2. Berczik, K., Szabo, A., Griffiths, M. D., et al. (2012). Exercise addiction: Symptoms, diagnosis, epidemiology, and etiology. Substance Use and Misuse, 47, 403–417. https://doi.org/10.3109/10826084.2011.639120

    Article  PubMed  Google Scholar 

  3. Blashill, A. J. (2013). Psychosocial correlates of frequent indoor tanning among adolescent boys. Body Image, 10, 259–262. https://doi.org/10.1016/j.bodyim.2012.11.005

    Article  PubMed  Google Scholar 

  4. Brouse, C. H., Hillyer, G. C., Basch, C. E., & Neugut, A. I. (2011). Geography, facilities, and promotional strategies used to encourage indoor tanning in New York City. Journal of Community Health, 36, 635–639. https://doi.org/10.1007/s10900-010-9354-2

    Article  PubMed  PubMed Central  Google Scholar 

  5. Busch, V., de Leeuw, J. R., de Harder, A., & Schrijvers, A. J. (2013). Changing multiple adolescent health behaviors through school-based interventions: A review of the literature. Journal of School Health, 83, 514–523. https://doi.org/10.1111/josh.12060

    Article  PubMed  Google Scholar 

  6. Cartmel, B., Bale, A. E., Mayne, S. T., et al. (2017). Predictors of tanning dependence in white non-Hispanic females and males. Journal of the European Academy of Dermatology and Venereology, 31, 1223–1228. https://doi.org/10.1111/jdv.14138

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Chinn, S. (2000). A simple method for converting an odds ratio to effect size for use in meta-analysis. Statistics in Medicine, 19, 3127–3131.

    Article  CAS  PubMed  Google Scholar 

  8. Choi, K., Lazovich, D., Southwell, B., Forster, J., Rolnick, S. J., & Jackson, J. (2010). Prevalence and characteristics of indoor tanning use among men and women in the United States. Archives of Dermatology, 146, 1356–1361. https://doi.org/10.1001/archdermatol.2010.355

    Article  PubMed  Google Scholar 

  9. Coups, E. J., Manne, S. L., & Heckman, C. J. (2008). Multiple skin cancer risk behaviors in the U.S. population. American Journal of Preventive Medicine, 34, 87–93. https://doi.org/10.1016/j.amepre.2007.09.032

    Article  PubMed  Google Scholar 

  10. Darlow, S. D., Heckman, C. J., & Munshi, T. (2016). Tan and thin? Associations between attitudes toward thinness, motives to tan and tanning behaviors in adolescent girls. Psychology, Health and Medicine, 21, 618–624. https://doi.org/10.1080/13548506.2015.1093643

    Article  PubMed  Google Scholar 

  11. Demko, C. A., Borawski, E. A., Debanne, S. M., Cooper, K. D., & Stange, K. C. (2003). Use of indoor tanning facilities by white adolescents in the United States. Archives of Pediatrics and Adolescent Medicine, 157, 854–860.

    Article  PubMed  Google Scholar 

  12. Diehl, K., Litaker, D. G., Greinert, R., Zimmermann, S., Breitbart, E. W., & Schneider, S. (2010). The prevalence of current sunbed use and user characteristics: The SUN-Study 2008. International Journal of Public Health, 55, 513–516. https://doi.org/10.1007/s00038-009-0100-4

    Article  PubMed  Google Scholar 

  13. Durlak, J. A. (2009). How to select, calculate, and interpret effect sizes. Journal of Pediatric Psychology, 34, 917–928. https://doi.org/10.1093/jpepsy/jsp004

    Article  PubMed  Google Scholar 

  14. Fiala, B., Kopp, M., & Gunther, V. (1997). Why do young women use sunbeds? A comparative psychological study. British Journal of Dermatology, 137, 950–954.

    Article  CAS  PubMed  Google Scholar 

  15. Fredrickson, B. L., & Roberts, T.-A. (1997). Objectification theory: Toward understanding women’s lived experiences and mental health risks. Psychology of Women Quarterly, 21, 173–206. https://doi.org/10.1111/j.1471-6402.1997.tb00108.x

    Article  Google Scholar 

  16. Friedman, B., English, J. C., 3rd, & Ferris, L. K. (2015). Indoor tanning, skin cancer and the young female patient: A review of the literature. Journal of Pediatric and Adolescent Gynecology, 28, 275–283. https://doi.org/10.1016/j.jpag.2014.07.015

    Article  PubMed  Google Scholar 

  17. Gillen, M. M., & Markey, C. H. (2017). Beauty and the burn: Tanning and other appearance-altering attitudes and behaviors. Psychology, Health and Medicine. https://doi.org/10.1080/13548506.2017.1330544

  18. Green, A. C., Hayman, L. L., & Cooley, M. E. (2015). Multiple health behavior change in adults with or at risk for cancer: A systematic review. American Journal of Health Behavior, 39, 380–394. https://doi.org/10.5993/ajhb.39.3.11

    Article  PubMed  Google Scholar 

  19. Guy, G. P., Jr., Berkowitz, Z., Tai, E., Holman, D. M., Everett Jones, S., & Richardson, L. C. (2014). Indoor tanning among high school students in the United States, 2009 and 2011. JAMA Dermatology, 150, 501–511. https://doi.org/10.1001/jamadermatol.2013.7124

    Article  PubMed  PubMed Central  Google Scholar 

  20. Hale, D. R., Fitzgerald-Yau, N., & Viner, R. M. (2014). A systematic review of effective interventions for reducing multiple health risk behaviors in adolescence. American Journal of Public Health, 104, e19–e41. https://doi.org/10.2105/ajph.2014.301874

    Article  PubMed  PubMed Central  Google Scholar 

  21. Harland, E., Griffith, J., Lu, H., Erickson, T., & Magsino, K. (2016). Health behaviours associated with indoor tanning based on the 2012/13 Manitoba Youth Health Survey. Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice, 36, 149–162.

    Article  CAS  Google Scholar 

  22. Heckman, C. J., Coups, E. J., & Manne, S. L. (2008a). Prevalence and correlates of indoor tanning among US adults. Journal of the American Academy of Dermatology, 58, 769–780. https://doi.org/10.1016/j.jaad.2008.01.020

    Article  PubMed  PubMed Central  Google Scholar 

  23. Heckman, C. J., Egleston, B. L., Wilson, D. B., & Ingersoll, K. S. (2008b). A preliminary investigation of the predictors of tanning dependence. American Journal of Health Behavior, 32, 451–464. https://doi.org/10.5555/ajhb.2008.32.5.451

    Article  PubMed  PubMed Central  Google Scholar 

  24. Heckman, C. J., Wilson, D. B., & Ingersoll, K. S. (2009). The influence of appearance, health, and future orientations on tanning behavior. American Journal of Health Behavior, 33, 238–243.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Holman, D. M., & Watson, M. (2013). Correlates of intentional tanning among adolescents in the United States: A systematic review of the literature. The Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 52, S52–S59. https://doi.org/10.1016/j.jadohealth.2012.09.021

    Article  Google Scholar 

  26. Huang, C. M., & Kirchhof, M. G. (2017). A cross-sectional study of indoor tanning in fitness centres. Journal of Cutaneous Medicine and Surgery, 21, 401–407. https://doi.org/10.1177/1203475417706059

    Article  PubMed  Google Scholar 

  27. James, E., Freund, M., Booth, A., et al. (2016). Comparative efficacy of simultaneous versus sequential multiple health behavior change interventions among adults: A systematic review of randomised trials. Preventive Medicine, 89, 211–223. https://doi.org/10.1016/j.ypmed.2016.06.012

    Article  PubMed  Google Scholar 

  28. Jardine, A., Bright, M., Knight, L., Perina, H., Vardon, P., & Harper, C. (2012). Does physical activity increase the risk of unsafe sun exposure? Health Promotion Journal of Australia: Official Journal of Australian Association of Health Promotion Professionals, 23, 52–57.

    Article  Google Scholar 

  29. Knight, J. M., Kirincich, A. N., Farmer, E. R., & Hood, A. F. (2002). Awareness of the risks of tanning lamps does not influence behavior among college students. Archives of Dermatology, 138, 1311–1315.

    Article  PubMed  Google Scholar 

  30. Knight, A., Shakeshaft, A., Havard, A., Maple, M., Foley, C., & Shakeshaft, B. (2017). The quality and effectiveness of interventions that target multiple risk factors among young people: A systematic review. Australian and New Zealand Journal of Public Health, 41, 54–60. https://doi.org/10.1111/1753-6405.12573

    Article  PubMed  Google Scholar 

  31. Landolfi, E. (2013). Exercise addiction. Sports Medicine, 43, 111–119. https://doi.org/10.1007/s40279-012-0013-x

    Article  PubMed  Google Scholar 

  32. Meader, N., King, K., Moe-Byrne, T., et al. (2016). A systematic review on the clustering and co-occurrence of multiple risk behaviours. BMC Public Health, 16, 657. https://doi.org/10.1186/s12889-016-3373-6

    Article  PubMed  PubMed Central  Google Scholar 

  33. Meader, N., King, K., Wright, K., et al. (2017). Multiple risk behavior interventions: Meta-analyses of RCTs. American Journal of Preventive Medicine, 53, e19–e30. https://doi.org/10.1016/j.amepre.2017.01.032

    Article  PubMed  Google Scholar 

  34. Meyer, M. K. H., Koster, B., Juul, L., et al. (2017). Sunbed use among 64,000 Danish students and the associations with demographic factors, health-related behaviours, and appearance-related factors. Preventive Medicine, 100, 17–24. https://doi.org/10.1016/j.ypmed.2017.03.012

    Article  PubMed  Google Scholar 

  35. Miyamoto, J., Berkowitz, Z., Jones, S. E., & Saraiya, M. (2012). Indoor tanning device use among male high school students in the United States. The Journal of adolescent health: Official publication of the Society for Adolescent Medicine., 50, 308–310. https://doi.org/10.1016/j.jadohealth.2011.08.007

    Article  Google Scholar 

  36. Moore, S. C., Lee, I., Weiderpass, E., et al. (2016). Association of leisure-time physical activity with risk of 26 types of cancer in 1.44 million adults. JAMA Internal Medicine, 176, 816–825. https://doi.org/10.1001/jamainternmed.2016.1548

    Article  PubMed  PubMed Central  Google Scholar 

  37. O’Riordan, D. L., Field, A. E., Geller, A. C., et al. (2006). Frequent tanning bed use, weight concerns, and other health risk behaviors in adolescent females (United States). Cancer Causes and Control, 17, 679–686.

    Article  PubMed  Google Scholar 

  38. Pagoto, S. L., Nahar, V. K., Frisard, C., et al. (2018). A comparison of tanning habits among gym tanners and other tanners. JAMA Dermatology, 154, 1090–1091. https://doi.org/10.1001/jamadermatol.2018.1779

    Article  PubMed  PubMed Central  Google Scholar 

  39. Petit, A., Karila, L., Chalmin, F., & Lejoyeaux, M. (2014). Phenomenology and psychopathology of excessive indoor tanning. International Journal of Dermatology, 53, 664–672.

    Article  PubMed  Google Scholar 

  40. Qin, J., Holman, D. M., Jones, S. E., Berkowitz, Z., & Guy, G. P., Jr. (2018). State Indoor tanning laws and prevalence of indoor tanning among US high school students, 2009–2015. American Journal of Public Health, 108, 951–956. https://doi.org/10.2105/ajph.2018.304414

    Article  PubMed  PubMed Central  Google Scholar 

  41. Razzoli, M., Pearson, C., Crow, S., & Bartolomucci, A. (2017). Stress, overeating, and obesity: Insights from human studies and preclinical models. Neuroscience and Biobehavioral Reviews, 76, 154–162. https://doi.org/10.1016/j.neubiorev.2017.01.026

    Article  PubMed  PubMed Central  Google Scholar 

  42. Santos, I., Sniehotta, F. F., Marques, M. M., Carraca, E. V., & Teixeira, P. J. (2017). Prevalence of personal weight control attempts in adults: A systematic review and meta-analysis. Obesity Reviews : An Official Journal of the International Association for the Study of Obesity, 18, 32–50. https://doi.org/10.1111/obr.12466

    Article  CAS  Google Scholar 

  43. Schneider, S., & Kramer, H. (2010). Who uses sunbeds? A systematic literature review of risk groups in developed countries. Journal of the European Academy of Dermatology and Venereology, 24, 639–648. https://doi.org/10.1111/j.1468-3083.2009.03509.x

    Article  CAS  PubMed  Google Scholar 

  44. Schwebel, D. C. (2014). Adolescent tanning, disordered eating, and risk taking. Journal of Developmental and Behavioral Pediatrics: JDBP, 35, 225–227.

    Article  PubMed  Google Scholar 

  45. Seidenberg, A. B., Mahalingam-Dhingra, A., Weinstock, M. A., Sinclair, C., & Geller, A. C. (2015). Youth indoor tanning and skin cancer prevention: Lessons from tobacco control. American Journal of Preventive Medicine, 48, 188–194. https://doi.org/10.1016/j.amepre.2014.08.034

    Article  PubMed  Google Scholar 

  46. Tran, A. D., Aalborg, J., Asdigian, N. L., et al. (2012). Parents’ perceptions of skin cancer threat and children’s physical activity. Preventing Chronic Disease, 9, E143. https://doi.org/10.5888/pcd9.110345

    Article  PubMed  PubMed Central  Google Scholar 

  47. Webb, M. J., Kauer, S. D., Ozer, E. M., Haller, D. M., & Sanci, L. A. (2016). Does screening for and intervening with multiple health compromising behaviours and mental health disorders amongst young people attending primary care improve health outcomes? A systematic review. BMC Family Practice, 17, 104. https://doi.org/10.1186/s12875-016-0504-1

    Article  PubMed  PubMed Central  Google Scholar 

  48. Williams Merten, J., King, J. L., Walsh-Childers, K., Vilaro, M. J., & Pomeranz, J. L. (2015). Skin cancer risk and other health risk behaviors: A scoping review. American Journal of Lifestyle Medicine., 11, 182–196. https://doi.org/10.1177/1559827615594350

    Article  Google Scholar 

  49. Yoo, J.-J., & Kim, H.-Y. (2012). Adolescents’ body-tanning behaviours: Influences of gender, body mass index, sociocultural attitudes towards appearance and body satisfaction. International Journal of Consumer Studies, 36, 360–366. https://doi.org/10.1111/j.1470-6431.2011.01009.x

    Article  Google Scholar 

Download references

Acknowledgments

The authors thank Mary Riley for her assistance with manuscript preparation and Kristen Sorice for her review and feedback on an earlier version of the manuscript.

Funding

This study was funded by the National Cancer Institute (P30CA006927, P30CA072720).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Carolyn J. Heckman.

Ethics declarations

Conflict of interest

Carolyn J. Heckman and Marissa Manning declare that they have no conflict of interest.

Human and animal rights and Informed consent

This article does not contain any studies with human participants or animals performed by any of the authors

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Heckman, C.J., Manning, M. The relationship between indoor tanning and body mass index, physical activity, or dietary practices: a systematic review. J Behav Med 42, 188–203 (2019). https://doi.org/10.1007/s10865-018-9991-y

Download citation

Keywords

  • Indoor tanning
  • Physical activity
  • Weight
  • BMI
  • Diet
  • Systematic review