Imagem corporal e estado nutricional de crianças

Abstract

Introduction: The body image is directly associated to issues related to body weight, to eating disorder and to quality of life provided by the corporal satisfaction. The plausibility of the relation between the nutritional status and the body image is justified by the classification of the first as a gold standard and the second as an event vulnerable to distortion. Objectives: To evaluate corporal self-perception in schoolchildren who attend the public education system of the city of Campina Grande and to examine the relation with sex, age and the Body Mass Index/Age and to ascertain the concordance between the nutritional status noticed by the mother and the diagnosed in preschool children. Material and methods: Two studies with independent methodologies were performed in order to reach both prefixed objectives. The first one was a cross-sectional study performed with 1081 schoolchildren aged between 5 and 10 years. The nutritional status of the children was estimated by the BMI. The corporal perception was evaluated considering the sight, the satisfaction and the corporal idealization based on the Children’s Body Image Scale created by Truby and Paxton. The second one was a prospective cohort study conducted in day care centers with 269 children younger than 5 years. The infant nutritional status was expressed by means of the Z-score of weight/stature at two different moments within a year. The maternal perception of the nutritional status was obtained at the second observation, by asking the mother her perception about the weight of the child. The agreement between the maternal perception of the nutritional status of the child and the diagnostic criteria of the WHO was obtained by means of the weighted kappa test, at a significance level of 5% (p<0.05). Results: In the study with the schoolchildren, the level of corporal dissatisfaction among them was of 86%. It was observed that 75.9% of the overweight children and 73.7% of the obese ones perceive themselves slimmer. About 94.7% of the overweight students, 98% of the obese ones and 41.8% of the eutrophic ones indicated they would like to be slimmer, whilst 83.3% of the malnourished wished to be fatter. The most distorted view of the body was verified among the older children and the boys. For the corporal satisfaction, significant differences were found according to the BMI. Regarding the corporal idealization, the biggest discrepancy was observed among the older schoolchildren. The work developed with children younger than 5 years pointed out the discordance between the maternal perception and the reference from the WHO being of 32.7%, with kappa of 0.122, considered negligible. A concordance between the maternal perception and the reference from the WHO was observed for the children diagnosed with overweight, regardless of gender and age bracket, with a moderated concordance between the girls and the children aged between 36 and 59 months. Conclusions: The results of this paper indicate a notableprevalence of body image distortion among schoolchildren, especially those who areoverweight, who see themselves slimmer, in addition to idealize a leaner figure and beingdissatisfied with their body. At the evaluation of children younger than 5 years, results pointout a concordance between the maternal perception and the diagnosed only on the cases with overweight children. Nevertheless, besides this relative congruence, a considerable percentageof the mothers who underestimate the overweight in their children is highlighted. It isconcluded, further, that the corporal perception may present specificities related to demographic variables and the real nutritional status. The importance of the findings alerts topublic policies and the health promotion.