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Park, Hyun, and Lee: Weight Control Behaviors, Health-related Quality of Life and Nutritional Status by Overestimation of Body Image among Young Korean Females: Data from the Fifth Korea National Health and Nutrition Examination Survey, 2010–2011
Research Article

Korean J Community Nutr 2015;20(5):362-374.

Published online: 20 January 2015

DOI: https://doi.org/10.5720/kjcn.2015.20.5.362

Weight Control Behaviors, Health-related Quality of Life and Nutritional Status by Overestimation of Body Image among Young Korean Females: Data from the Fifth Korea National Health and Nutrition Examination Survey, 2010–2011

Seulki Park1), Taisun Hyun2), Hongmie Lee1), †

1)Department of Food Science & Nutrition, Daejin University, Pochoeon, Keonggi, Korea

2)Department of Food and Nutrition, Chungbuk National University, Cheongju, Chungbuk, Korea

†Corresponding author Hongmie Lee Department of Food Science & Nutrition, Daejin University, 1007, Hoguk-ro, Pocheon-si, Gyeonggi 11159, Korea Tel: (031) 539-1862 Fax: (031) 539-1860 E-mail: hmlee@daejin.ac.kr

Received 20 August 2015       Revised 22 September 2015       Accepted 13 October 2015

Copyright © 2015 Journal of the Korean Society of Community Nutrition

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study was performed to investigate the effects of overestimation of their own body shape on weight control behaviors, mental condition, physical activity, dietary behavior, health-related quality of life, and nutritional status among young Korean females. Methods: A total of 1,514 women aged 20–39 years who are not pregnant and lactating among those who participated in the Fifth Korea National Health and Nutrition Examination Survey (2010∼2011), were analyzed and grouped into underestimation (n=120), normal estimation (NE, n=840), and overestimation (OE, n=554), based on their body perception compared to actual percent ideal body weights. Variables were compared between OE group and NE group. Results: The subjects in OE group were significantly younger (29.5 vs. 30.5 years, respectively p < 0.05) and had lower body mass index (20.9 vs. 22.2 respectively, p < 0.01), health-related quality of life measured by EQ-5D (EuroQol-5 Dimension)(0.97 vs. 0.98 respectively, p < 0.05), nutrition adequacy ratio (NAR) of protein (0.91 vs. 0.93 respectively, p < 0.05), phosphorous (0.93 vs. 0.96 respectively, p < 0.05), and iron (0.70 vs. 0.75 respectively, p<0.01), and index of nutrition quality (INQ) of iron (0.84 vs. 0.89 respectively, p < 0.05) compared to those in the NE group. The results of logistic regression showed that unmarried status (OR 1.32; 1.01∼1.72) and severely underweight/underweight status (OR 1.94; 1.01∼3.75)/(OR 1.81; 1.34∼2.45) were significantly related to the probability of overestimation by the subjects. Significantly more women in OE group practiced fasting, skipping meals, and taking prescribed pills to lose body weights and had skipped breakfast compared to those in the NE group. Conclusions: The results of this study suggested that the Korean young women's distorted perception of own body shape may be associated with undesirable weight control behavior, low quality of life, and lower nutritional status. Therefore, nutrition education for this group should include information on correct body shape perception and its importance.

Keywords: weight perception, health-related quality of life, nutrition intake

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Table 1.
The distribution of the study participants according to weight status and subjective weight perception
Subjective weight perception Weight status
Severe under weight Under weight Normal weight Over weight Obese Total
Very thin 24 (42.9)1)a2) 10 (4.5)c − − − 34 (662.7)
Somewhat thin 27 (50.0)b 119 (42.6)a 21 (2.4)c − − 167 (611.9)
Normal 3 (7.1)b 164 (52.0)b) 450 (57.9)a 13 (8.2)c 3 (2.0)c 633 (641.2)
Somewhat fat − 2 (0.9)b 315 (38.0)b 133 (71.9)a 73 (35.7)c 523 (632.7)
Very fat − − 13 (1.7)b 30 (19.9)b 114 (62.3)a 157 (611.5)
Total 54 (64.2) 295 (20.3) 799 (50.2) 176 (12.1) 190 (13.2) 1,514 (100.0)

1) N (%) 2) a: 840 (56.4%) of total 1,514 estimated own weight status normally, b: 554 (35.5%) of total 1,514 overestimated own weight, c: 120 (8.1%) of total 1,514 underestimated own weight, all of whom were not included for further analysis

Table 2.
The distribution of the study participants according to weight perception and weight status
Actual weight status Weight perception
Under estimation Normal estimation Over estimation Total
Severe underweight − 24 (13.2) 30 (16.8) 54 (114.2)
Underweight 110 (11.3)1) 119 (15.3) 166 (30.3) 295 (120.3)
Normal weight 121 (14.8) 450 (51.5) 328 (56.1) 799 (150.2)
Overweight 113 (12.4) 133 (15.5) 30 (16.8) 176 (112.1)
Obese 176 (61.5) 114 (14.5) − 190 (113.2)
Total 120 (18.1) 840 (56.4) 554 (35.5) 1,514 (100.0)

1) N (%)

Table 3.
General characteristics of the study participants by weight perception
Variables Weight perception P-value
Normal estimation Over estimation Total
(n=840) (n=554) (n=1,394)
Age (year) 130.5± 0.251) 129.5± 0.33 130.1± 0.21 < 0.019∗
Height (cm) 160.6± 0.22 161.0± 0.29 160.7± 0.18 < 0.252
Weight (kg) 157.3± 0.51 154.2± 0.35 156.1± 0.35 < 0.001∗∗∗
PIBW2) (%) 103.0± 0.87 196.9± 0.58 100.6± 0.59 < 0.001∗∗∗
BMI3) (kg/m2) 122.2± 0.19 120.9± 0.12 121.7± 0.13 < 0.001∗∗∗

1) Mean± SE 2) Percent ideal body weight 3) Body mass index ∗: p < 0.05, ∗∗∗: p < 0.001 by Student's t test.

Table 4.
Odds ratios for prevalence of overestimation according to general characteristics of the study participants
General characteristics N (%) OR (95% CI)1)
Age group 30∼39 355 (50.6) 1.00
20∼29 199 (49.4) 1.13 (0.88∼1.45)
Marital status Married 351 (52.6) 1.00
Unmarried 203 (47.4) 1.32 (1.01∼1.72)
Region Urban area 500 (91.0) 1.00
Rural area 54 (69.0) 1.48 (0.94∼2.32)
Income level Low 119 (35.6) 1.00
Mid-low 149 (26.2) 1.27 (0.88∼1.83)
Mid-high 139 (25.4) 1.14 (0.81∼1.59)
High 147 (22.8) 1.21 (0.83∼1.77)
Educational level Elementary school 2 (60.4) 1.00
Middle school 7 (62.1) 2.48 (0.32∼19.12)
High school 211 (39.1) 1.40 (0.24∼8.10)
College 334 (58.4) 1.73 (0.30∼9.90)
Body shape Normal weight 328 (56.1) 1.00
Severe underweight 30 (66.8) 1.94 (1.01∼3.75)
Underweight 166 (30.3) 1.81 (1.34∼2.45)
Overweight 30 (66.8) 0.40 (0.25∼0.66)
Occupation Unemployed 290 (48.1) 1.00
Administrator 110 (20.5) 0.98 (0.70∼1.39)
Office job 65 (13.1) 0.79 (0.53∼1.18)
Sales and service 65 (12.9) 0.99 (0.67∼1.49)
Labor 24 (65.4) 0.83 (0.42∼1.66)

1) Odds ratio (95% confidence interval)

Table 5.
Experience and methods of weight control by weight perception
Variables Weight perception P-value
Normal estimation Over estimation Total
(n=840) (n=554) (n=1,394)
Weight control to lose or maintain
Yes 557 (68.2)1) 386 (67.7) 963 (68.0) 0.859
No 263 (31.8) 168 (32.3) 431 (32.0)
Method used for weight control
Exercise
Yes 354 (61.9) 227 (56.7) 581 (59.9) 0.176
No 223 (38.1) 159 (43.3) 382 (40.1)
Fasting
Yes 5 (60.5) 12 (63.3) 17 (61.6) 0.001∗∗
No 572 (99.5) 374 (96.7) 946 (98.4)
Reducing food intakes
Yes 394 (67.8) 278 (68.5) 672 (68.1) 0.848
No 183 (32.2) 108 (31.5) 291 (31.9)
Skipping meals
Yes 70 (13.8) 67 (20.1) 137 (16.2) 0.048∗
No 507 (86.2) 319 (79.8) 826 (83.8)
Un-prescribed pills
Yes 2 (60.4) 6 (61.7) 8 (60.9) 0.099
No 575 (99.6) 380 (98.3) 955 (99.1)
Prescribed pills
Yes 29 (65.4) 33 (10.4) 62 (67.4) 0.039∗
No 548 (94.6) 353 (89.6) 901 (92.6)
Herbal medicine
Yes 19 (63.0) 18 (65.8) 37 (64.1) 0.066
No 558 (97.0) 368 (94.2) 926 (95.9)
Health functional food
Yes 31 (64.8) 31 (67.5) 62 (65.8) 0.142
No 546 (95.2) 355 (92.5) 901 (94.2)
One-food diet
Yes 14 (62.2) 8 (62.2) 22 (62.2) 0.961
No 563 (97.8) 378 (97.8) 941 (97.8)

1) N (%) ∗: p < 0.05, ∗∗: p < 0.01 by χ

2 test

Table 6.
Mental condition and quality of life by weight perception
Variables Weight perception P-value
Normal estimation Over estimation Total
(n=840) (n=554) (n=1,394)
Feeling stress
Much 282 (36.7)1) 198 (40.1) 480 (38.0) 0.313
A little 558 (63.3) 356 (59.9) 914 (62.0)
Feel depressed
Yes 102 (14.5) 78 (15.1) 180 (14.7) 0.795
No 738 (85.6) 476 (84.9) 1,214 (85.3)
Thinking of suicide
Yes 113 (15.1) 96 (19.6) 209 (16.9) 0.115
No 727 (84.9) 458 (80.4) 1,185 (83.1)
Counseling at a mental clinic
Yes 2 (63.6) 12 (62.1) 34 (63.1) 0.206
No 818 (96.4) 542 (97.9) 1,360 (96.9)
EQ-5D2) 0.98± 0.003) 0.97± 0.00 0.97± 0.00 0.025∗
EQ-VAS4) 74.7± 0.55 73.5± 0.71 74.2± 0.43 0.177

1) N (%) 2) Euro Quality of Life – 5 Dimension 3) Mean± SE 4) Euro Quality – visual analog scale ∗: P < 0.05 by Student's t-test

Table 7.
Dietary habits by weight perception
Variables Weight perception P-value
Normal estimation Over estimation Total
(n=840) (n=554) (n=1,394)
Skip breakfast
Yes 279 (38.4)1) 222 (46.8) 501 (41.6) 0.008∗∗
No 561 (61.6) 332 (53.2) 893 (58.4)
Skip lunch
Yes 85 (12.5) 68 (14.1) 153 (13.1) 0.517
No 755 (87.5) 486 (85.9) 1,241 (86.9)
Skip dinner
Yes 71 (69.7) 45 (68.7) 116 (69.3) 0.566
No 769 (90.3) 509 (91.3) 1,278 (90.7)
Have breakfast with family
Yes 392 (52.7) 295 (60.9) 687 (55.9) 0.011∗
No 448 (47.3) 259 (39.1) 707 (44.1)
Have lunch with family
Yes 173 (20.4) 110 (18.9) 283 (19.8) 0.532
No 667 (79.6) 444 (81.1) 1,111 (80.2)
Have dinner with family
Yes 619 (67.9) 408 (67.0) 1,027 (67.6) 0.741
No 221 (32.1) 146 (33.0) 367 (32.4)
Know about nutrition labels
Yes 794 (93.8) 521 (93.1) 1,315 (93.5) 0.705
No 46 (66.2) 33 (66.9) 79 (66.5)
Use nutrition labels when food is consumed
Yes 407 (51.3) 283 (52.9) 690 (51.9) 0.626
No 386 (48.7) 238 (47.1) 624 (48.1)
Eating out (times/week) 3.53± 0.292) 3.44± 0.13 3.49± 0.10 0.574

1) N (%) 2) Mean± SE ∗: p < 0.05, ∗∗: p < 0.01 by χ

2 test

Table 8.
Daily nutrients intakes and macronutrients energy ratio by weight perception
Variables Weight perception P-value
Normal estimation Over estimation Total
(n=840) (n=554) (n=1,394)
Energy (kcal) 1,813.02± 232.61)2 1,736.02± 240.1 1,722.02± 225.3 0.160
Protein (g) 68.72± 222.1 65.02± 222.1 64.82± 221.4 0.249
Fat (g) 44.82± 221.4 45.02± 221.6 42.52± 221.1 0.921
Carbohydrates (g) 280.02± 224.3 264.02± 225.8 267.02± 223.6 0.024∗
Dietary fiber (g) 6.12± 220.2 5.92± 220.3 6.02± 221.2 0.676
Calcium (mg) 449.02± 211.3 445.02± 214.9 446.02± 228.8 0.810
Phosphorous (mg) 1,054.02± 219.8 1,022.02± 227.7 1,020.02± 216.0 0.372
Iron (mg) 12.62± 220.3 11.82± 220.5 12.12± 220.3 0.170
Sodium (mg) 4,384.02± 114.0 4,289.02± 154.0 4,233.02± 295.3 0.634
Potassium (mg) 2,680.02± 253.7 2,589.02± 274.9 2,619.02± 244.6 0.342
Vitamin A (μgRE) 719.02± 225.6 688.02± 240.3 697.02± 223.7 0.513
Carotene (μg) 3,455.02± 132.0 3,407.02± 219.0 3,409.02± 130.0 0.842
Retinol (μg) 118.02± 227.3 108.02± 226.3 114.02± 225.3 0.283
Vitamin B1 (mg) 1.23± 220.03 1.20± 220.03 1.18± 220.03 0.867
Vitamin B2 (mg) 1.16± 220.03 1.14± 220.03 1.15± 220.02 0.149
Niacin (mg) 15.52± 220.4 15.62± 220.5 15.12± 220.3 0.949
Vitamin C (mg) 99.32± 223.9 98.62± 224.1 99.82± 223.2 0.900
Macronutrients energy ratio (%)
Carbohydrates 63.32± 220.5 62.12± 220.6 63.22± 220.4 0.172
Protein 15.12± 220.2 14.72± 220.2 14.92± 220.2 0.283
Fat 21.32± 220.4 22.42± 220.5 21.52± 220.3 0.061

1) Mean± SE adjusted for age, weight, BMI, marital status, and weight status ∗: P < 0.05 by Student's t-test

Table 9.
NAR and MAR by weight perception
Variables Weight perception P-value
Normal estimation Over- estimation Total
(n=840) (n=554) (n=1,394)
NAR1)
Protein 0.93± 0.012) 0.91± 0.01 0.92± 0.01 0.026∗
Calcium 0.63± 0.01 0.61± 0.02 0.61± 0.02 0.365
Phosphorous 0.96± 0.01 0.93± 0.01 0.95± 0.01 0.036∗
Iron 0.75± 0.01 0.70± 0.02 0.73± 0.01 0.007∗∗
Vitamin A 0.74± 0.02 0.71± 0.02 0.73± 0.01 0.181
Vitamin B1 0.85± 0.01 0.82± 0.01 0.84± 0.01 0.122
Vitamin B2 0.82± 0.01 0.78± 0.01 0.80± 0.01 0.608
Niacin 0.85± 0.01 0.83± 0.01 0.84± 0.01 0.102
Vitamin C 0.99± 0.04 0.99± 0.04 1.00± 0.03 0.900
MAR3) 0.84± 0.01 0.81± 0.01 0.83± 0.01 0.095

1) Nutrient adequacy ratio 2) Mean± SE adjusted for age, weight, BMI, marital status and weight status 3) Mean nutrient adequacy ratio ∗: p < 0.05, ∗∗: p < 0.01 by Student's t-test

Table 10.
Index of nutrition quality by weight perception
Variables Weight perception P-value
Normal perception Over perception Total
(n=840) (n=554) (n=1,394)
Protein 1.13± 0.011) 1.14± 0.02 1.14± 0.01 0.936
Calcium 0.73± 0.01 0.74± 0.02 0.74± 0.01 0.965
Phosphorous 1.18± 0.12 1.18± 0.12 1.18± 0.01 0.863
Iron 0.89± 0.02 0.84± 0.02 0.88± 0.01 0.014∗
Vitamin A 0.89± 0.02 0.87± 0.02 0.89± 0.02 0.544
Vitamin B1 1.01± 0.01 1.00± 0.02 1.00± 0.01 0.847
Vitamin B2 0.96± 0.02 0.95± 0.01 0.96± 0.01 0.469
Niacin 1.02± 0.03 1.01± 0.01 1.02± 0.01 0.609
Vitamin C 1.15± 0.04 1.14± 0.04 1.15± 0.03 0.926

1) Mean± SE adjusted for age, weight, body mass index, marital status, and weight status ∗: P < 0.05 by Student's t-test

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