Skip to main content
Log in

Weight Perception and Dietary Intake among Chinese Youth, 2004–2009

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

Little is known on the extent of weight misperception and its relation with dietary intake among Chinese youth.

Purpose

The study aimed to investigate extent and correlates of weight misperception and its relation with dietary intake among Chinese youth.

Method

Data pertaining to Chinese youth, 6–17 years of age, from the 2004–2009 China Health and Nutrition Survey (N = 3,923) were analyzed using STATA version 12.1. The heights and weights of the participants were measured by well-trained health workers at the participants' homes or a local clinic following the reference protocol recommended by the World Health Organization. The dietary intake data of the participants were collected on three consecutive days at both the household and individual levels.

Results

Of the children 6–11 years of age, 18.9 % were underweight and 15.3 % were overweight. Among the children 12–17 years of age, 18.3 % were underweight and 8.1 % were overweight. Less than 60 % of Chinese youth accurately estimated their weight status. Nutrition knowledge was positively related to a perception of being overweight (adjusted odds ratio [AOR] = 1.98, p = .007) among children 12–17 years of age. A perception of being overweight was positively associated with fat and protein intake among children 6–11 years of age (p < .05).

Conclusions

A discrepancy exists between the actual and perceived weight status of Chinese youth. Efforts are needed in China to promote accurate weight perception, healthy weight, and eating behaviors.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ma J, Wang Z, Song Y, Hu P, Zhang B. BMI percentile curves for Chinese children aged 7–18 years, in comparison with the WHO and the US Centers for Disease Control and Prevention references. Public Health Nutr. 2010;13(12):1990–6.

    Article  PubMed  Google Scholar 

  2. Tuan NT, Nicklas TA. Age, sex and ethnic differences in the prevalence of underweight and overweight, defined by using the CDC and IOTF cut points in Asian children. Eur J Clin Nutr. 2009;63(11):1305–12.

    Article  CAS  PubMed  Google Scholar 

  3. Cash TF, Pruzinsky TE. Body images: development, deviance, and change. New York: Guilford; 1990.

    Google Scholar 

  4. Xie B, Chou C-P, Spruijt-Metz D, et al. Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents. Prev Med. 2006;42(3):229–34.

    Article  PubMed  Google Scholar 

  5. Brener ND, Eaton DK, Lowry R, McManus T. The association between weight perception and BMI among high school students. Obes Res. 2004;12(11):1866–74.

    Article  PubMed  Google Scholar 

  6. Cheung PCH, Ip PLS, Lam S, Bibby H. A study on body weight perception and weight control behaviours among adolescents in Hong Kong. Hong Kong Med J. 2007;13(1):16.

    PubMed  Google Scholar 

  7. Miller JC, Grant AM, Drummond BF, Williams SM, Taylor RW, Goulding B. DXA measurements confirm that parental perceptions of elevated adiposity in young children are poor. Obesity. 2007;15(1):165–71.

    Article  PubMed  Google Scholar 

  8. Chang VW, Christakis NA. Self-perception of weight appropriateness in the United States. Am J Prev Med. 2003;24(4):332–9.

    Article  PubMed  Google Scholar 

  9. Yan AF, Zhang G, Wang MQ, Stoesen CA, Harris BM. Weight perception and weight control practice in a multiethnic sample of US adolescents. South Med J. 2009;102(4):354.

    Article  PubMed  Google Scholar 

  10. Li Y, Hu X, Ma W, Wu J, Ma G. Body image perceptions among Chinese children and adolescents. Body Image. 2005;2(2):91–103.

    Article  PubMed  Google Scholar 

  11. Xie B, Chou C-P, Spruijt-Metz D, et al. Weight perception, academic performance, and psychological factors in Chinese adolescents. Am J Heal Behav. 2006;30(2):115–24.

    Article  Google Scholar 

  12. Zhang J, Seo D-C, Kolbe L, et al. Comparison of overweight, weight perception, and weight-related practices among high school students in three large Chinese cities and two large U.S. cities. J Adolesc Heal. 2011;48(4):366–72.

    Article  CAS  Google Scholar 

  13. Soh NL, Touyz SW, Surgenor LJ. Eating and body image disturbances across cultures: a review. Eur Eat Disord Rev. 2006;14(1):54–65.

    Article  Google Scholar 

  14. International Monetary Fund. World economic outlook database. Available at: http://www.imf.org/external/pubs/ft/weo/2011/02/weodata/index.aspx (2011). Accessibility verified December 5, 2012.

  15. Borzekowski DLG, Bayer AM. Body image and media use among adolescents. Adolesc Med Clin. 2005;16(2):289–313.

    Article  PubMed  Google Scholar 

  16. Monro F, Huon G. Media-portrayed idealized images, body shame, and appearance anxiety. Int J Eat Disord. 2005;38(1):85–90.

    Article  PubMed  Google Scholar 

  17. Derenne J, Beresin E. Body image, media, and eating disorders. Acad Psychiatry. 2006;30(3):257–61.

    Article  PubMed  Google Scholar 

  18. LaBrosse L, Albrecht JA. Pilot intervention with adolescents to increase knowledge and consumption of folate–rich foods based on the Health Belief Model. Int J Consum Stud. 2013;37(3):271–8.

    Article  Google Scholar 

  19. Pieniak Z, Verbeke W, Scholderer J. Health–related beliefs and consumer knowledge as determinants of fish consumption. J Hum Nutr Diet. 2010;23(5):480–8.

    Article  CAS  PubMed  Google Scholar 

  20. Takeda S, Akamatsu R, Horiguchi I, Marui E. Relationship among food-safety knowledge, beliefs, and risk-reduction behavior in university students in Japan. J Nutr Educ Behav. 2011;43(6):449–54.

    Article  PubMed  Google Scholar 

  21. Rosenstock IM. The health belief model and preventive health behavior. Heal Educ Behav. 1974;2(4):354–86.

    Google Scholar 

  22. Popkin BM, Du S, Zhai F, Zhang B. Cohort profile: the China Health and Nutrition Survey—monitoring and understanding socio-economic and health change in China, 1989–2011. Int J Epidemiol. 2010;39(6):1435–40.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Beghin I, Cap M, Dujardin B. A guide to nutritional assessment. Geneva: World Health Organization; 1988.

    Google Scholar 

  24. World Health Organization. WHO Expert Committee on Physical Status: the use and interpretation of anthropometry: report of a WHO expert committee. World Health Organization, 1995

  25. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240–3.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007;335(7612):194–7.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Du S, Mroz TA, Zhai F, Popkin BM. Rapid income growth adversely affects diet quality in China—particularly for the poor! Sci Soc Sci. 2004;59(7):1505–15.

    Google Scholar 

  28. Yang Y, Wang G, The PX. Chinese food composition table. Beijing: Medical Publishing House of Beijing University; 2002.

    Google Scholar 

  29. Yang Y. Chinese food composition table 2004. Beijing: Peking University Medical Press; 2005.

    Google Scholar 

  30. Parvanta SA, Brown JD, Du S, Zimmer CR, Zhao X, Zhai F. Television use and snacking behaviors among children and adolescents in China. J Adolesc Health. 2010;46(4):339–45.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Zhang J, Seo DC, Kolbe L, Middlestadt S, Zhao W. Trends in overweight among school children and adolescents in seven Chinese Provinces, from 1991–2004. Int J Pediatr Obes. 2010;5(5):375–82.

    Article  PubMed  Google Scholar 

  32. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice. San Francisco: Jossey-Bass; 2008.

    Google Scholar 

  33. Daddario DK. A review of the use of the health belief model for weight management. Medsurg Nurs. 2007;16(6):363–6.

    PubMed  Google Scholar 

  34. James DCS, Pobee JW, Oxidine D, Brown L, Joshi G. Using the health belief ,model to develop culturally appropriate weight-management materials for African-American women. J Acad Nutr Diet. 2012;112(5):664–70.

    Article  PubMed  Google Scholar 

  35. Xie B, Liu C, Chou C-P, et al. Weight perception and psychological factors in Chinese adolescents. J Adolesc Health. 2003;33(3):202–10.

    Article  PubMed  Google Scholar 

  36. ter Bogt TFM, van Dorsselaer SAFM, Monshouwer K, Verdurmen JEE, Engels RCME, Vollebergh WAM. Body mass index and body weight perception as risk factors for internalizing and externalizing problem behavior among adolescents. J Adolesc Health. 2006;39(1):27–34.

    Article  PubMed  Google Scholar 

  37. Corson PW, Andersen A. Body image issues among boys and men. In: Cash TF, Pruzinsky T, editors. Body image: a handbook of theory, research, and clinical practice. New York: Guilford; 2002. p. 192–9.

    Google Scholar 

  38. Thompson J, Cafri GE. The muscular ideal: psychological, social, and medical perspectives. Washington, DC: American Psychological Association; 2007.

    Google Scholar 

  39. Ji CY, Sun JL. Regional and population variability of body mass index among Chinese school children and adolescents. World J Pediatr. 2006;1(2):29.

    Google Scholar 

  40. Ji CY, Cheng TO. Epidemic increase in overweight and obesity in Chinese children from 1985 to 2005. Int J Cardiol. 2009;132(1):1–10.

    Article  PubMed  Google Scholar 

  41. Shi Z, Lien N, Kumar BN, Holmboe-Ottesen G. Perceptions of weight and associated factors of adolescents in Jiangsu Province. China Pub Health Nutr. 2007;10(3):298–305.

    Google Scholar 

  42. Tiggemann M, Pickering AS. Role of television in adolescent women's body dissatisfaction and drive for thinness. Int J Eat Disord. 1996;20(2):199–203.

    Article  CAS  PubMed  Google Scholar 

  43. Jiang J, Rosenqvist U, Wang H, Greiner T, Lian G, Sarkadi A. Influence of grandparents on eating behaviors of young children in Chinese three-generation families. Appetite. 2007;48(3):377–83.

    Article  PubMed  Google Scholar 

  44. Towns N, D'Auria J. Parental perceptions of their child's overweight: an integrative review of the literature. J Pediatr Nurs. 2009;24(2):115–30.

    Article  PubMed  Google Scholar 

  45. Patrick H, Nicklas TA. A review of family and social determinants of children's eating patterns and diet quality. J Am Coll Nutr. 2005;24(2):83–92.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research uses data from China Health and Nutrition Survey (CHNS). We thank the National Institute of Nutrition and Food Safety, China Center for Disease Control and Prevention, Carolina Population Center, the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, and R01-HD38700), and the Fogarty International Center, NIH for financial support for the CHNS data collection and analysis files from 1989 to 2006 and both parties plus the China–Japan Friendship Hospital, Ministry of Health for support for CHNS 2009 and future surveys.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dong-Chul Seo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Niu, J., Seo, DC. & Lohrmann, D.K. Weight Perception and Dietary Intake among Chinese Youth, 2004–2009. Int.J. Behav. Med. 21, 691–699 (2014). https://doi.org/10.1007/s12529-013-9332-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-013-9332-z

Keywords

Navigation