Intergenerational Perceptions of Body Image in Hispanics: Role of BMI, Gender, and Acculturation Norma Olvera,* Richard Suminski,† and Thomas G. Power‡
Abstract OLVERA, NORMA, RICHARD SUMINSKI, AND THOMAS G. POWER. Intergenerational perceptions of body image in Hispanics: role of BMI, gender, and acculturation. Obes Res. 2005;13:1970 –1979. Objective: To assess role of BMI, gender, and acculturation on maternal and children’s perception of body size, body ideal, and attractiveness. Research Methods and Procedures: Eighty mothers and their 6- to- 12-year-old children (41 boys, 39 girls) participated. Maternal and children’s perceptions of body size (actual and ideal) and attractiveness were assessed through a pictorial instrument. Mother and child height and weight, demographic, and acculturation characteristics were also assessed. Results: Seventy-nine percent of the mothers were overweight, and 32% of the boys and 34% of the girls were overweight or at-risk for overweight. BMI influenced the children’s selection of perceived ideal size. Overweight or at-risk for overweight children were more likely to select thinner figures as the ideal size than non-overweight children. Gender and acculturation differences concerning children’s perceptions of body size and attractiveness were also found. Girls perceived the obese figure as being less attractive than did the boys. More acculturated children were likely to select thinner figures as more attractive than their less acculturated counterparts. Maternal acculturation was
Received for review December 24, 2003. Accepted in final form August 4, 2005. The costs of publication of this article were defrayed, in part, by the payment of page charges. This article must, therefore, be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. *Department of Health and Human Performance, University of Houston, Houston, Texas; †Sport and Exercise Sciences, College of Education, The Ohio State University, Columbus, Ohio; and ‡Department of Human Development, Washington State University, Pullman, Washington. Address correspondence to Norma Olvera, Department of Health and Human Performance, University of Houston, 3855 Holman Street, Room 104, Houston, TX 77204-6015. E-mail:
[email protected] Copyright © 2005 NAASO
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associated positively with the girls’ choice of thinner figures as an ideal body size, but not with the boys. Mothers viewed their daughters’ actual body size and BMI as ideal, although 34% of the girls were at-risk for overweight. Mothers perceived average body size figures as more attractive for their sons. Discussion: Findings from this study provide empirical data about the role of BMI, gender, acculturation, and familial influences on children’s perceptions of actual and ideal body sizes and attractiveness. Key words: ideal body size, BMI, acculturation, Mexican-American children, body image
Introduction Childhood obesity is a major health problem in the United States. For all ages and for ethnic minority groups, childhood obesity has more than doubled between 1980 and 1994. Currently, 15% of children and adolescents are overweight (1–3). Minority children, particularly MexicanAmerican children, are disproportionably at the highest risk of childhood and adult obesity (4,5). Approximately 22% of Mexican-American children were overweight in 1999 to 2000 compared with 12% of non-Hispanic-white children (5). Although the prevalence of overweight among children and adolescents has more than doubled, the pursuit of being thin is common, particularly among girls, for whom thinness is analogous to attractiveness. The cultural emphasis on being thin, associated with the stigma of obesity, may lead youth, particularly girls, to feel dissatisfied with their body figure (6 –9) and to engage in maladaptive behaviors (e.g., cycles of restricting food intake or binge eating) to manipulate their weight (10 –12). This evidence points to the importance of studying the etiology and factors associated with body dissatisfaction. Research suggests that the development of body image dissatisfaction occurs before the onset of puberty. Consis-
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tent evidence suggests that children (particularly girls) as young as 6 to 7 years old already exhibit a preference for body figures thinner than their own (12–15). In a 3-year longitudinal study on children’s body size estimations (16), children’s perception of their ideal figure was thinner than their perceived actual size. Gender differences seemed to manifest at around age 9. As both genders got older, the discrepancy between girls and boys increased; girls reported an increased dissatisfaction with their bodies as they reached puberty, whereas satisfaction level remained constant for boys. The relationship between body size dissatisfaction and overweight, especially among girls, has also been documented. Heavier children report greater body dissatisfaction than their thinner counterparts (6,11,16). Given that the perception of body size and body ideal is culturally bound, ethnicity may be a significant factor to consider in the examination of the perception of ideal body size among minority children. Mexican-American children are of particular interest because they are exposed not only to the American cultural emphasis on thinness but also to the more lenient weight view predominant in the MexicanAmerican culture (17,18). There is a paucity of studies conducted on the perception of body size, body ideal, and attractiveness among Mexican-American children (19). Smith and Krejci (20) found that Hispanic children were significantly more satisfied with their body shape than whites, whereas other investigators found no ethnic differences in body dissatisfaction or body pride (19,21). Furthermore, Robinson et al. (22) found that Latina girls manifested equivalent or higher levels of disordered eating attitudes and behaviors as whites. In another study (23), Hispanic girls were found to report significantly higher body image dissatisfaction than African-American girls. Most of these studies have primarily included Hispanic girls (19). Few studies have assessed the role of acculturation on body size preference and dissatisfaction in Mexican-American children. Guinn et al. (24) found that more acculturated Mexican-American adolescents (ages 15 to 19) exhibited greater body dissatisfaction with heavier body size than their less acculturated counterparts. Hall et al. (25), using generational status as a proxy for acculturation, found that Mexican-American girls (ages 7 to 12 years old) preferred thinner figures than their mothers. Girls also ranked their own ideal figure as thinner than their perceived figures. Mothers’ ranking of their daughters’ ideal and actual sizes were congruent. However, none of the previous studies have assessed the role of BMI, gender, and acculturation on the perception of body size, body ideal, and attractiveness in Mexican-American girls, boys, and their mothers, particularly, preadolescent boys. Thus, the purpose of this study was to assess the role of BMI, gender, and acculturation on maternal and children’s perceptions of body size, body ideal, and attractiveness in Mexican-Amer-
ican children and their mothers. Based on the existing literature in this area, we hypothesized that children at-risk for overweight would be more likely than normal-weight children to select thinner figures as ideal body sizes, girls would be more likely to prefer thinner figures as an ideal body size than boys and their mothers, and more acculturated children (those who prefer speaking English during the interview) would be expected to select thinner figures as more attractive than their less acculturated counterparts.
Research Methods and Procedures Participants The sample consisted of 80 Mexican-American motherchild (41 boys and 39 girls) dyads. These families participated in a 4-year NIH-funded study entitled Al Bienestar del Nin˜o (To the Well-being of the Child) to investigate the development of health behaviors in Mexican-American children (26). Baylor College of Medicine Committee for the Protection of Human Subjects reviewed and approved the consent form, instruments, and research protocols used for data collection. Recruitment Procedures U.S. Census data were examined to identify an inner-city neighborhood densely populated by Mexican Americans. Several leaders from the neighborhood (e.g., Catholic priest, social agencies directors, and lay leaders) were contacted to elicit their support for the study. Once support was obtained, families primarily at various Catholic churches and social service agencies were recruited for the study. Families were also recruited through referrals and printed fliers distributed at the neighborhood bus stops, laundry mats, and shops. Specifically, 75% of the families were recruited through Catholic churches, 10% through social agencies, and 15% through referrals and printed fliers distributed in the target area. The detailed recruitment procedure consisted of announcements concerning the purpose of the study, study procedures, and the eligibility criteria given at the end of Catholic mass and in waiting areas at social agencies or other selected recruitment sites. Interested families were given more detailed information about what their participation would entail and contact information for the research team. Questions about the study were also addressed at this time. To participate in this study, families met the following eligibility criteria: both parents must live in the same household and be of Mexican or Mexican-American origin (selfdetermined by subjects) and had a child between the ages 4 and 8 years at baseline. Retention Strategies An extensive amount of time and effort was required by the research team to maintain high levels of subjects’ involvement and to locate families after a change of residence. OBESITY RESEARCH Vol. 13 No. 11 November 2005
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This was difficult due to multiple changes and the absence of telephones or forwarding addresses in some 35% of cases. Tracking data showed that families changed residence 64 times during the course of the study. To maximize subject retention, several strategies were utilized, including the maintenance of a database containing current phone numbers of neighbors, relatives, and/or friends of the subjects in case they moved and their whereabouts were not known to the researchers; mailing annual contact letters, Christmas, Mother’s day, Father’s day, Valentines day, and birthday cards to the study families; holding Christmas parties at the churches for participating families where they received donated gifts, clothes, toys, and food; and providing interim incentives (e.g., gift certificates and raffle tickets for a stereo or television) to families at the measurement sessions to compensate them for their participation. Measures Family Background. This instrument consisted of 16 questions that assessed age, education, family income, family structure, place of birth, number of family members living in the household, and health history. Anthropometry. Measures of body weight and height were obtained from children and their mother in each year of the 4 years of data collection. Height and weight were assessed using a balance beam scale and a secured stadiometer for measuring weight to the nearest 0.1 kg and height to the nearest 0.1 cm. A bilingual research assistant instructed each subject to remove his or her shoes and socks before stepping on the scale. The height was measured on the scale with the child or mother standing against a vertical stadiometer with both heels and buttocks against it. Each subject’s height and weight were taken two times, and the average of the two measurements was used. The scale was calibrated using standard weights before the measurement period and each week during the measurement session. An exercise physiologist trained two female and one male bilingual research assistants (undergraduate psychology majors) to assess subjects’ height and weight over two sessions. Before the first training session, research assistants read an anthropometry measurement protocol. During the first training session, research assistants observed the exercise physiologist conduct a height and weight measurement demonstration. After the demonstration, research assistants practiced measurement procedures while being observed by the exercise physiologist, who made recommendations and provided feedback. At the completion of this session, research assistants were instructed to practice measuring height and weight in four non-study subjects (two adults and two children) on their own time. At the second training session, the exercise physiologist and research assistants assessed height and weight of six non-study subjects to calculate interrater agreement. Once interrater agreement 1972
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between the exercise physiologist and research assistants reached at least 80%, research assistants began to assess the children in the study. For quality control, 25% of the anthropometry assessments were randomly selected and measured by the exercise physiologist to determine interrater agreement. Any research assistant with ⬍90% interrater agreement was retrained. Acculturation. The Acculturation Rating Scale of Mexican Americans (27) was used to assess acculturation levels of the mothers in this study. This instrument was designed to assess preferences and behavioral tendencies or actual behavior along five dimensions: language familiarity and usage, ethnic interaction, ethnic pride and identity, cultural heritage, and generational proximity. The Acculturation Rating Scale of Mexican Americans consisted of 20 questions scored on a five-point Likert scale, which ranges from very Mexican (1) to very anglicized (5). The acculturation rating score was calculated by the total score (sum of all scores) divided by 20. This instrument has acceptable psychometric properties with a coefficient ␣ of 0.88 and retest reliability over a 5-week period of 0.72. In the present sample, the coefficient ␣ was 0.88. Children’s acculturation level was assessed by the children’s preferred language spoken with interviewers. Using language preference as a proxy for determining acculturation level among children has been useful in assessing relationships between acculturation and health beliefs and behaviors (28 –30). Perceived Actual and Ideal Size and Attractiveness. To assess perceptions of body size, ideal size, and attractiveness, we used a pictorial instrument employed by Hall et al. (25) with Mexican-American children and their mothers. This instrument was selected because it included drawings representing typical Mexican-American children instead of white children. It consisted of five black and white drawings of Mexican-American girls and five drawings of MexicanAmerican boy figures, which differed in body size only (very thin, thin, average, overweight, and obese). These black and white drawings were photographed and mounted on 10- ⫻ 17.75-cm cardboard, laminated, and numbered on the back from one (representing the smallest) through five (representing the largest). Interviewers were trained to present the figures in a standardized order manner (Figures 1, 3, 5, 2, and 4, from left to right) and to ask mothers and children to perform a specific set of four tasks with the figures. Interviewers were trained not to lead participants’ responses in any way by avoiding expressions such as good or correct. Validity of these procedures for Mexican-American families was established in a previous study of mothers and their 7- to 12-year-old daughters (25). In this research, daughters showed greater dissatisfaction with their body size than did mothers; daughters preferred thinner figures and ranked their ideal figure as thinner than their perceived figure.
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Procedure Because participant families were part of a longitudinal study, data on family background, acculturation, anthropometry, and perceived body size, body ideal, and attractiveness were collected along with other instruments during two measurement sessions in the 3rd year of the study. At the first measurement session, a bilingual research assistant interviewed the mother in her preferred language about her and her family background characteristics, such as age, education, occupation, and family health history, among other measures. This interview was conducted at a home visit after the mother had signed the consent form. Maternal acculturation was also administrated at this time. At the second session, mothers’ and their children’s perceptions of attractiveness and body size and maternal and child weights and heights were assessed in a nearby laboratory at the University of Houston. Bilingual research assistants interviewed mothers and children individually in their preferred language. To assess mothers’ perceptions of attractiveness and body size, the research assistant placed a 10- ⫻ 17.75-cm drawing of figures of Mexican-American girls or boys (determined by the gender of the target child) on a table. Then, the interviewer asked each mother to order the figures by size from the smallest to the biggest to ensure that all participants understood task (all participants correctly ordered the pictures), rank the figures by attractiveness from the least good looking to the most good looking, select the figure that best matched the size of her child, and select the ideal size for her child. The interviewer recorded each maternal response on an answer sheet. We followed similar procedures to assess perceptions of body size, body ideal, and attractiveness in children. After mothers and children completed the attractiveness and body size assessments, their height and weight were measured. The data collection sessions lasted 30 minutes per subject. To ensure the highest rate of participation at these measurement sessions, transportation and childcare were provided to study families. Each family received $40 annually for their participation. Statistical Analyses Descriptive statistics were estimated for each of the measures (e.g., BMI, perceptions of actual and ideal body sizes, and acculturation). All data were inspected for outliers, missing or undefined values. The first step of the analysis consisted of exploratory examination of the distribution of all of the variables. Graphic methods, including box plots, were employed to examine distributions. To determine obesity status, BMI [weight (kilograms)/height (meters squared)] was calculated for each child and mother. Child BMI values were then used to identify the age- and genderspecific percentile for each subject using the Centers for Disease Control and Prevention guidelines (http://www.cdc. gov/nccdphp/dnpa/bmi/bmi-for-age.htm). Non-overweight
children were classified with a percentile ⬍ 85 percentile. Overweight or at-risk of overweight children had a percentile equal to or higher than the 85th percentile. Mothers’ obesity status was determined using the World Health Organization obesity classification. Mothers with a BMI ⬍ 25 were classified as non-overweight, and mothers with a BMI ⱖ25 were categorized as overweight. Pearson correlation coefficients were calculated to examine the relationships among children’s perceptions of their actual and ideal body sizes, BMI, and selected maternal and child demographic and acculturation variables. The percentage of daughters and sons who perceived their ideal body size as thinner, heavier, or the same as their perception of their actual body size was calculated. 2 Analyses were used to determine whether the congruence between perceptions of ideal and actual body size (thinner, heavier, or the same) varied as a function of gender or weight status (non-overweight or overweight or at-risk for overweight). MannWhitney U non-parametric tests were used to assess whether the median attractiveness rankings of the five figures differed among mothers, sons, and daughters. All statistical analyses were conducted using SPSS statistical package, version 11.0. The level of significance for all statistical procedures was set at p ⬍ 0.05.
Results Demographic Characteristics As shown in Table 1, mothers’ mean age was 34 years old, and the mean age for children was 9 years. Maternal educational attainment was limited with over 50% of the mothers having ⬍8 years of formal education. Approximately three-quarters of the mothers were homemakers. Although most of the husbands were employed, the median annual family income was lower than the national median income for Hispanic families (31). Almost all mothers were born in Mexico, and 92% preferred speaking Spanish during the interview, whereas 78% and 85% of the boys and girls, respectively, preferred speaking English. Five families withdrew from the study and were replaced with families with similar demographic traits including same child’s gender and age. The sample size was then maintained at 80 mother-child dyads. Prevalence of Overweight As shown in Table 2, 32% of the boys and 34% of the girls were characterized as overweight or at-risk for overweight, whereas 79% of the mothers were overweight. Maternal BMI was significantly correlated with the child BMI, whereas maternal educational attainment, acculturation level, and income were not (see Table 3). Associations among Child’s BMI and Perceived Ideal Size and Actual Size Presented in Figure 1 are the percentages of girls and boys who perceived their ideal body size as thinner, heavier, OBESITY RESEARCH Vol. 13 No. 11 November 2005
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Table 1. Demographic characteristics
Age (years) Mean SD Range Education Less than 8th grade Some high school High school Some college Vocational/technical Associate 2 year Occupation Managers Labor/service operators Retail Homemakers Student Median family income Acculturation* Mean SD Range
Mothers (n ⴝ 80)
Boys (n ⴝ 41)
Girls (n ⴝ 39)
34.3 5.6 24 to 50
8.7 1.4 6 to 11
9.2 1.4 7 to 12
51% 12% 29% 4% 3% 1% 3% 10% 10% 76% 1% $10,000 to $19,999 1.8 0.5 1.1 to 3.4
* Acculturation range ⫽ 1, very Mexican to 5, very anglicized. Sum of percentages might exceed 100% because percentages were rounded up.
or the same as their actual body size. Approximately 44% of boys and 41% of girls perceived their ideal body size as being thinner than their actual body size. A surprising percentage of boys (26.8%) and girls (30.8%) perceived their ideal body size as being heavier than their actual body size. Nearly one-third of the boys (29.3%) and girls (28.2%) perceived their ideal and actual body sizes as similar. The frequency of congruence between perceived and ideal body sizes varied as a function of weight status [2 (4,80) ⫽ 28.1; p ⬍ 0.001] but not gender [2 (2) ⫽ 0.16; p ⫽ 0.93]. Non-overweight children were more likely to select a heavier ideal (42.6%), whereas overweight or at-risk for overweight children selected a thinner ideal (88.9%). For boys and girls, perceptions of ideal body size were moderately correlated with their perceptions of actual body size, but they were not associated with their BMI (see Table 3). Maternal Perception of Child’s Ideal and Actual Size as Related to Child’s BMI As shown in Table 3, maternal perception of their daughter’s ideal body size was related to their daughter’s BMI 1974
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(r ⫽ 0.34; p ⬍ 0.05) but not their son’s BMI (r ⫽ ⫺0.10, not significant, respectively). Similarly, both the daughters’ and mothers’ perceptions of actual body size were positively associated with the daughters’ BMI. Daughters’ and their mothers’ perceptions of the child’s actual body size were positively correlated. Mothers’ perceptions of their sons’ actual body size were significantly and positively correlated with their son’s BMI. Boys’ perceptions of their actual body size were not related to their BMI, nor were they related to their mothers’ perceptions of their child’s actual body size. Association of Child’s Gender and Perceived Ideal and Attractiveness Although no gender differences in perceived ideal were found, gender differences regarding children’s attractiveness ranking were shown (see Figure 2). Mann-Whitney U non-parametric tests were used to assess whether the median attractiveness rankings of the five figures differed between boys and girls. Girls perceived the obese figure as being less attractive (U ⫽ 580.0; p ⫽ 0.02) and the very thin
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Table 2. Anthropometry data
Weight (kg) Mean SD Range Height (cm) Mean SD Range BMI Mean SD Range Weight status Non-overweight Overweight or at-risk of overweight
Mothers of boys
Mothers of girls
Boys (n ⴝ 41)
Girls (n ⴝ 39)
74.7 (16.8) 53.6 to 128.9
70.5 (16.2) 43.9 to 125.3
31.1 (7.6) 20.9 to 53.6
34.3 (12.6) 18.6 to 70.8
156.7 (5.8) 147.3 to 171.5
156.0 (5.8) 144.8 to 170.2
129.5 (7.7) 116.8 to 146.1
131.9 (9.9) 114.3 to 154.9
30.4 (7.7) 20.9 to 58.0
29.0 (6.3) 17.0 to 51.4
18.5 (3.6) 14.1 to 28.9
19.4 (5.2) 11.3 to 33.8
7 (17%) 13 (83%)
10 (26%) 13 (74%)
28 (68%) 13 (32%)
26 (67%) 13 (34%)
Percentages may not sum to 100% because they were rounded up. Children’s non-overweight, BMI ⬍ 85th age-/gender-specific percentile. Children’s at-risk of overweight, BMI ⱖ 85th age-/gender-specific percentile. Mothers’ non-overweight, BMI ⬍ 25. Mothers’ overweight, BMI ⱖ 25
figure as more attractive (U ⫽ 551.5; p ⫽ 0.02) than boys. The girls indicated that the obese figure was not very good looking (mean ⫽ 2.1, SD ⫽ 1.6), whereas the boys viewed the obese figure as okay looking (mean ⫽ 3.0, SD ⫽ 1.8). The attractiveness ranking correlation (index) indicated that girls were more likely to consider thinner figures as more attractive than boys (r ⫽ ⫺0.27; p ⬍ 0.05). Associations between Children and Mothers’ Attractiveness Ranking Also shown in Figure 2 are data indicating that sons perceived the average figure as less attractive compared with their mothers (U ⫽ 567.0; p ⫽ 0.01). The mothers of sons indicated that the average figure was good looking (mean ⫽ 3.9, SD ⫽ 1.4), whereas the sons perceived the average figure as okay looking (mean ⫽ 3.1, SD ⫽ 1.4). No significant differences in rankings of attractiveness were noted between mothers and their daughters (U ⬎ 579.0; p ⬎ 0.06) and between mothers (of girls and boys) (U ⬎ 689.5; p ⬎ 0.28). Role of Maternal and Child’s Acculturation on Perceived Ideal Size Although maternal level of acculturation was limited, results indicted that maternal acculturation was correlated negatively with girls’ ideal body size figure (r ⫽ ⫺0.34;
p ⬍ 0.05) but not with boys’ ideal body size figure (r ⫽ ⫺0.13; p ⬍ not significant). More acculturated mothers had girls who chose thinner figures as an ideal body figure than less acculturated mothers. Similarly, children who preferred speaking English during the interview were likely to consider thinner figures as more attractive than those children who spoke Spanish (r ⫽ ⫺0.30; p ⬍ 0.01).
Discussion The purpose of this study was to assess the role of BMI, gender, and acculturation on maternal and children’s perception of body size, body ideal, and attractiveness in a sample of low-income Mexican-American families. Findings from this study indicate that BMI influenced children’s perceived ideal figure. Children who were overweight or at-risk for overweight were more likely to perceive thinner figures as ideal than did non-overweight children. In contrast, non-overweight children were more likely to perceive a heavier figure as ideal. This finding is consistent with previous research that suggests that higher BMI was associated with greater body dissatisfaction (32–36). Child’s BMI was also related to maternal perception of the child’s actual and ideal. Mothers and girls were better than boys in accurately assessing body size according to BMI. Other studies have found similar results (37). Although mothers were able to accurately assess their child’s OBESITY RESEARCH Vol. 13 No. 11 November 2005
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* p ⬍ 0.05. † p ⬍ 0.001.
Boys Age BMI Actual Ideal Girls Age BMI Actual Ideal Mothers Age BMI Actual Ideal Acculturation Income Education
BMI
0.33 0.28 0.18 0.50† 0.05 0.64† 0.14 ⫺0.10 ⫺0.30 0.13 ⫺0.19 0.01 ⫺0.24 ⫺0.23
⫺0.01 ⫺0.14 0.29 0.13 ⫺0.16
Age
0.06 ⫺0.05 0.01 0.14 ⫺0.17 ⫺0.09 ⫺0.27
0.41†
0.13 ⫺0.19 ⫺0.27 0.29 ⫺0.13 ⫺0.11 ⫺0.07
Actual Ideal
Boys
⫺0.03 0.46† 0.39* 0.25 ⫺0.24 ⫺0.23 ⫺0.13
0.30 ⫺0.01 0.13 ⫺0.05 ⫺0.27 0.21 ⫺0.17
⫺0.03 0.52† 0.86† 0.34* ⫺0.25 ⫺0.18 ⫺0.26
Actual
0.34*
BMI
Girls
0.14 ⫺0.01 0.54† ⫺0.02 ⫺0.11
Age
Child variables
⫺0.10 0.17 ⫺0.16 0.07 ⫺0.34* ⫺0.30 ⫺0.18
Ideal
BMI
0.43† 0.42†
0.38†
Actual Ideal Acculturation Income Education
0.14 0.14 0.25* ⫺0.12 0.04 0.14 ⫺0.12 ⫺0.10 ⫺0.12 0.05 ⫺0.08 ⫺0.10 ⫺0.07 ⫺0.11 ⫺0.26* ⫺0.10 ⫺0.34† ⫺0.12
Age
Maternal variables: mothers
Table 3. Relationships among the children’s perceptions of actual and ideal body size, BMI, and selected variables
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Figure 1: Children’s perception of their ideal body size as thinner, the same as, or heavier than their actual body size.
body size, they viewed their daughters’ BMI as an ideal body despite the fact that one of three girls studied were overweight. These findings indicate that Mexican-American mothers may have a more acceptable view of childhood obesity and may fail to perceive an overweight problem for their children (38). Obesity prevention programs designed for Mexican-American mothers should provide information about a healthy weight status for their children. The hypothesis that girls would have been more likely to prefer thinner figures as an ideal body size than their mothers and boys was partially supported. When comparing boys’ and girls’ ranking of attractiveness, results from this study are consistent with previous research. Girls perceived the obese figure as being less attractive than boys and were likely to consider thinner figures as more attractive than boys (11–16). It appears that girls based their judgments of attractiveness on weight, whereas boys did not. Boys may
Figure 2: Perceptions of attractiveness for mothers and their children.
equate heavy figures with muscularity and strength (39 – 41). Mother-daughter dyads did not differ significantly in their ranking of varied size figures by attractiveness. However, mother-son dyads did differ in their attractiveness ranking. Mothers considered the average size figure of a boy as more attractive than their sons. This perception may be associated with the cultural value that mothers expect their sons to be robust to reflect strength and muscularity (41). Acculturation was a significant factor associated with child and maternal perception of body ideal. More acculturated children (those who preferred speaking English during the interview) perceived thinner figures as more attractive than did their less acculturated counterparts. Furthermore, more acculturated mothers had girls who perceived thinner figures for their ideal body figure; however, maternal acculturation level was not associated with boys’ perceived ideal size. Thus, Mexican-American girls, more so than Mexican-American boys, may be receiving contradictory messages about ideal body size from their mothers and from the mainstream cultural view about thinness. This could generate greater dissatisfaction with body size in more acculturated compared with less acculturated girls. This assumption has been supported by Guinn et al. (24), who found that more acculturated Mexican-American girls were more likely to express body dissatisfaction with larger figures than less acculturated girls. There are several limitations that may affect the generalization of the study’s findings. The first limitation was that our sample was restricted to immigrant mothers and their children from a low-income inner-city community with limited acculturation level. We have no way of knowing how variations in income or social class might influence the results, which may be different in higher socioeconomic status Hispanic populations. Our study’s participants were entirely of Mexican descent; thus, the results may not apply to other Hispanic families such as Cubans and Puerto Ricans. Future research should examine these issues across a wide range of social class, acculturation level, diverse BMI status, and ethnic groups. A second limitation is the lack of data on sexual maturation. Sexual maturation or puberty status could be a potential confounder because studies show that obesity is associated with sexual maturation in adolescents, particularly among girls (42– 44). However, the data analysis was primarily exploratory using correlation coefficients as measures of associations. Despite these limitations, this is one of the few studies conducted with low-income, Spanish-speaking families that provides empirical data on the role of BMI, gender, and acculturation on perceptions of body size, ideal body size, and attractiveness in Mexican-American boys and girls and their mothers. Research on the factors associated with body image among Mexican-American children is a matter of public health concern because there is an increased prevalence of childhood obesity in this population (45– 47). OBESITY RESEARCH Vol. 13 No. 11 November 2005
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Acknowledgments We extend our appreciation to the research assistants who were responsible for the recruitment, translation, and data collection and entry. They contributed greatly to the development of the study, and their input was appreciated. Finally, we acknowledge the Mexican-American families who participated in this study, who provided valuable health information and allowed us to come to their homes. This research was supported by National Institute of Child Health and Human Development Grant HD 23991. References 1. Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among US children and adolescents, 1999 –2000. J Am Med Assoc. 2002;288:1728 –32. 2. Dietz WH. Special focus nutrition and physical activity: preventing obesity among children. Natl Cent Chronic Dis Prev Health Prom. 2000;13:12–7. 3. Rosner B, Prineas R, Leggie J, Daniels SR. Percentiles for body mass index in U.S. children 5 to 17 years of age. J Pediatric. 1998;132:212–21. 4. Dwyer JT, Stone EJ, Yang M, et al. Prevalence of marked overweight and obesity in a multiethnic pediatric population: findings from the Child and Adolescent Trial for Cardiovascular Health (CATCH) study. J Am Diet Assoc. 2000;100: 1149 –56. 5. Flegal KM, Ogden CL, Carroll MD. Prevalence and trend in overweight in Mexican-American adults and children. Nutr Rev. 2004;62:S144 – 8. 6. Resemble GD, Lewis M. The relations among body image, physical attractiveness, and body mass in adolescence. Child Develop. 1999;71:50 – 64. 7. Smolak L, Levine MP. Body image in children. In Thompson JK, Smolak L, eds. Body Image, Eating Disorders, and Obesity in Youth: Theory, Assessment, Treatment, and Prevention. Washington, DC: American Psychological Association; 2001. 8. Thompson SH, Corwin SJ, Sargent RG. Ideal body size beliefs and weight concerns of fourth-grade children. Int J Eat Disord. 1997;20:279 – 84. 9. Tiggemann M, Wilson-Barrett E. Children’s figure ratings: relationship to self-esteem and negative stereotyping. Int J Eat Disord. 1998;23:83– 8. 10. Ackard DM, Peterson CB. Association between puberty and disordered eating, body image, and other psychological variables. Int J Eat Disord. 2001;29:187–94. 11. Gardner RM, Stark K, Friedman BN, Jackson NA. Predictors of eating disorder scores in children ages 6 through 14: a longitudinal study. J Psychosom Res. 2000;49:199 –205. 12. Kostanski M, Gullone E. Dieting and body image in the child’s world: conceptualization and behavior. J Genet Psychol. 1999;160:488 –99. 13. Thelen MH, Power AL, Lawrence C, Kuhnert ME. Eating and body image concerns among children. J Clin Child Psychol. 1992;21:41– 6. 14. Kelly C, Ricciardelli LA, Clarke JD. Problem eating attitudes and behaviors in young children. Int J Eat Disord. 1999;25:281– 6. 1978
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