Department of Global Public Health and Primary Care, Research Group for General Practice, Årstadveien 17, 5018, Bergen, Norway.
Department of Research and Development, District General Hospital of Førde, 6800, Førde, Norway.
BMC Public Health. 2021 Mar 12;21(1):496. doi: 10.1186/s12889-021-10553-x.
Impaired self-rated health (SRH) and self-esteem (SE) in adolescents are associated with increased body mass index (BMI). These associations are often studied using cross-sectional designs; we performed a longitudinal cohort survey to examine them.
A longitudinal cohort study of 1225 Norwegian high school students, with SRH, SE and BMI as primary outcomes. We reported the results from temporal causal and residual change analyses separately, with odds ratios (ORs) and standardised regression coefficients (b) and 95% confidence limits.
Body and weight concerns had unfavourable effects on SRH and SE, which both had favourable effects on each other. Increased BMI had unfavourable effects on SRH, but less so on SE. Body and weight concerns impacted SE change only among girls. Paradoxically, the intention of becoming thinner was associated with an increase in BMI, and the intention of becoming fatter predicted a decrease in BMI during the 2 years. SE and SRH were associated with a leaner body after 2 years.
This study confirms that body concerns had unfavourable effects on subjective health, and that positive self-concepts predicted a leaner body. Health promotion strategies built on body acceptance should be increasingly emphasised in clinical and public health practice.
青少年自评健康状况不佳和自尊心低与体重指数增加有关。这些关联通常使用横断面设计进行研究；我们进行了一项纵向队列调查来检验它们。
对 1225 名挪威高中生进行了一项纵向队列研究，将自评健康、自尊心和体重指数作为主要结局。我们分别报告了时间因果和残差变化分析的结果，包括比值比（ORs）和标准化回归系数（b）及其 95%置信区间。
身体和体重担忧对自评健康和自尊心有不利影响，而两者之间相互有有利影响。体重指数增加对自评健康有不利影响，但对自尊心的影响较小。身体和体重担忧仅对女孩的自尊心变化有影响。矛盾的是，变瘦的意图与 BMI 的增加有关，而变胖的意图则预示着在两年内 BMI 的下降。自尊心和自评健康与两年后更瘦的体型有关。
本研究证实，身体担忧对主观健康有不利影响，而积极的自我概念预示着更瘦的体型。在临床和公共卫生实践中，应越来越强调基于身体接受的健康促进策略。
