Abstract
Objectives
Public health interventions for adolescent “obesity prevention” have focused predominantly on individualistic health behaviours (e.g., diet and physical activity) at the expense of recognizing body weight diversity and the array of social factors (e.g., stigma and discrimination of marginalized identities) that may be linked to weight status. Research is needed to examine the extent to which individualistic health behaviours versus social factors contribute to weight status in adolescents. As such, the aim of this study was to investigate the relative contribution of individualistic health behaviours versus social factors to objective and perceptual indices of weight status.
Methods
Cross-sectional survey data were collected as part of the Toronto Public Health Student Survey and comprised students 12 to 19 years of age (N = 5515). Measures included perceived and objective weight status, social and demographic factors (e.g., gender, sexual orientation, school connectedness), and health behaviours (e.g., physical activity, nutritious consumption).
Results
Findings from latent variable regression models partially supported hypotheses, whereby social factors (i.e., age, sex, socio-economic access, sexual minority status) contribute similar amounts of variance, or relatively more variance in weight indices, compared to health behaviours (e.g., physical activity, nutritious consumption).
Conclusion
Contrary to traditional views of adolescent weight status, physical activity (i.e., school-based, individual, active transport) and nutritious consumption (i.e., fruits, vegetables, milk) were not associated with weight status, when considering social factors. These findings challenge the utility of public health approaches that target individualistic behaviours as critical risk factors in “obesity prevention” efforts in adolescence.
Résumé
Objectifs
En matière de « prévention de l’obésité » chez les adolescents, les interventions en santé publique ont essentiellement porté leur attention sur les comportements de santé individualistes (par exemple, alimentation et activité physique), aux dépens de la valorisation de la diversité des poids corporels et de l’ensemble des facteurs sociaux (par exemple, stigmatisation et discrimination des identités marginalisées), qui sont parfois associés au statut pondéral. Des recherches sont toutefois indispensables afin de déterminer le degré de corrélation entre les comportements de santé individualistes et les facteurs sociaux susceptibles de favoriser le poids chez les adolescents. Par conséquent, il convient de se pencher sur le rôle joué par les comportements de santé individualistes face aux facteurs sociaux dans la détermination des indices objectifs et perceptifs du poids.
Méthodes
Les données recueillies lors de cette étude transversale ont été obtenues dans le cadre du Toronto Public Health Student Survey et ont été recueillies auprès d’étudiants âgés de 12 à 19 ans (N = 5 515). Les mesures prises comprenaient le statut de poids perçu et objectif, les facteurs sociaux et démographiques (par exemple, le sexe, l’orientation sexuelle, les rapports avec l’école) et les comportements liés à la santé (par exemple, l’activité physique, la consommation de substances nutritives).
Résultats
Les conclusions tirées des modèles de régression à variables latentes ont confirmé en partie les hypothèses selon lesquelles les facteurs sociaux (âge, sexe, accès socio-économique, statut de minorité sexuelle) apportent une variance similaire, ou relativement plus importante, aux indices de poids comparativement aux comportements liés à la santé (par exemple, l’activité physique, la consommation d’aliments nutritifs).
Conclusion
À la différence des vues traditionnelles sur le statut pondéral des adolescents, l’activité physique (c’est-à-dire à l’école, individuellement, dans les transports actifs) et la consommation de substances nutritives (c’est-à-dire de fruits, de légumes, de lait) n’ont pas fait l’objet d’une corrélation avec le statut pondéral, compte tenu des facteurs sociaux. Ces résultats contestent l’utilité des approches de santé publique axées sur les comportements individualistes à titre de facteurs de risque déterminants dans les efforts de « prévention de l’obésité » à l’adolescence.
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Notes
Survey questions regarding gender identity and sexual orientation were only asked to a subset of students, depending on school policies.
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Acknowledgements
We would like to acknowledge the support of Dr. David McKeown, Paul Fleiszer, Vincenza Pietropaolo, Loren Vanderlinden, and Toronto Public Health staff involved in project planning and data collection and processing. The methodology pertaining to the present study has been published in a government report (Corson et al. (2015). Toronto Public Health: 2014 Toronto Public Health Student Survey: Research Methods. https://www.toronto.ca/wp-content/uploads/2017/12/8c33-tph-student-health-survey-web-final-aoda.pdf), and all contributors have agreed to this publication.
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EP: conceptualization; writing—original draft, review, and editing
BDS: conceptualization; formal analysis
LC: conceptualization; writing—review and editing
CF: conceptualization; writing—review and editing
KLH: writing—literature review and components of original draft
CMS: supervision; writing—review and editing
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Pila, E., Sylvester, B.D., Corson, L. et al. Relative contributions of health behaviours versus social factors on perceived and objective weight status in Canadian adolescents. Can J Public Health 112, 464–472 (2021). https://doi.org/10.17269/s41997-020-00458-4
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DOI: https://doi.org/10.17269/s41997-020-00458-4