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Verzeletti, Chiara (2010) Obesity and overweight in adolescence: prevalence and food-related lifestyles. [Tesi di dottorato]

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Abstract (inglese)

Obesity and overweight are complex, multifactorial conditions that originate from the reciprocal interactions between genetic, metabolic, social, behavioral, psychological and cultural factors (Kolotkin, Meter, & Williams, 2001). In children and adolescents, obesity and overweight have several adverse effects on physical and psychological health and well-being in the short, medium and long term. Moreover, the prevalence of obesity and overweight has tripled among adolescents over the past two decades in many countries (e.g., Lobstein, Baur, Uauy, & IASO International Obesity Task Force, 2004), underlying the need to identify effective obesity prevention strategies. Thus, understanding individual, environmental, behavioral and relational factors influencing obesity and overweight in adolescence, may support the development of more effective preventive interventions and policies for adolescents and their families.
The present thesis is based on data from the Health Behavior in School-Aged Children (HBSC) survey of the Veneto Region of Italy, and it is composed of three different studies. HBSC is a cross-national survey carried out in collaboration with the World Health Organization (WHO) Regional Office for Europe to provide data and increase understanding concerning young people's health, well-being and their social context.
The aims of the first study of this work were to assess the validity of self-reported height and weight through a comparison between self-reported and measured height and weight in a broad sample of adolescents aged 11 13 and 15 years and to determine the prevalence of overweight and obesity among adolescents from the Veneto region from 2000 to 2006. The purpose of the second study was to examine the association between Body Mass Index (BMI) status (normal weight, overweight and obesity) and dietary patterns, physical activity and food-related lifestyle variables (e.g., television viewing behaviors). Finally, the main aim of the third study was to study the association between adolescents’ body mass, body image, family food-related lifestyles (e.g., frequency of meals with parents), restrictive parenting practices and family functioning (communication with parents and perceived family social support) on adolescents’ body dissatisfaction.
The findings underlined significant differences between self-reported and objective height and weight. After the adjustment of bias in self-reported anthropometric values an increasing prevalence of obesity from 2000 to 2006 was found among adolescents from Veneto Region. Moreover, after controlling for socio-demographic characteristics, results showed that dietary patterns, low levels of physical activity and several food-related lifestyles were associated with obesity and overweight. Finally, the results of the third study underlined the importance of family factors, across different domains, in influencing adolescents’ body dissatisfaction. Family food-related lifestyles and parenting practices were positively associated with adolescents’ weight mass, while higher perceived family social support and communication with father were negatively associated with poor body image and body dissatisfaction. Furthermore, we found that higher body mass and poor body image were positively associated with body dissatisfaction among adolescents.
In conclusion, this work underlined that excess of weight problems are common and are increasing among adolescents from Veneto Region. Obesity and overweight are part of a complex configuration of unhealthy behaviors and lifestyles in which both familial and individual factors play an important role. These findings suggest that prevention programs, targeting adolescents’ obesity and overweight, which frequently are concerned with dietary behaviors and/or physical activity, should also be focused on food-related lifestyle behaviors. Moreover, families should be educated about the importance of food-related family lifestyles and trained to adopt not too strict restrictive food-rules with adolescents. Improving the relationships between parents and adolescents, in terms of social support and communication, especially with fathers, might be able to contribute to improving adolescents’ body dissatisfaction. Finally, preventive programs should be focused on, not only body weight, but also on the image and the dissatisfaction that adolescents experience regarding their body.

Abstract (italiano)

L’obesità e il sovrappeso sono problematiche multifattoriali la cui origine è influenzata dall’interazione di molteplici fattori di tipo genetico, metabolico, sociale, comportamentale, psicologico e culturale (Kolotkin, Meter, & Williams, 2001). In infanzia e in adolescenza obesità e sovrappeso sono collegate a numerose conseguenze negative che si ripercuotono sul piano della salute e del benessere sia fisico sia psicosociale a breve, medio e lungo termine. Inoltre, negli ultimi vent’anni la prevalenza di questi fenomeni è circa triplicata in numerose nazioni (Lobstein, Baur, Uauy, & IASO International Obesity Task Force, 2004), sottolineando la necessità di identificare strategie preventive efficaci a riguardo. Per queste ragioni, lo studio dei fattori individuali, contestuali, comportamentali e relazionali associati all’obesità e al sovrappeso in età adolescenziale può supportare lo sviluppo di interventi preventivi e politiche più efficaci rivolte agli adolescenti e alle loro famiglie.
Il presente lavoro si basa sui dati della ricerca HBSC (Health Behavior in School-Aged Children) condotta nella regione Veneto ed è suddiviso in tre studi. HBSC è una ricerca trans-nazionale svolta in collaborazione con l’ufficio europeo dell’Organizzazione Mondiale della Sanità con l’obiettivo di incrementare le conoscenze relative alla salute, al benessere e ai contesti sociali in cui vivono gli adolescenti.
Gli obiettivi principali del primo studio di questo lavoro consistevano nel valutare la validità delle misure auto-riferite di peso e altezza da parte degli adolescenti attraverso un confronto tra valori auto-riferiti e misurati di peso e altezza in un ampio campione di adolescenti di 11, 13 e 15 anni, e determinare la prevalenza di obesità e sovrappeso negli adolescenti della regione Veneto dal 2000 al 2006. Il secondo studio, invece, aveva come obiettivo l’analisi dell’associazione tra indice di massa corporea (categorizzato in normopeso, sovrappeso e obesità) e comportamenti alimentari, svolgimento di attività fisica e stili di vita legati all’alimentazione (es., tempo trascorso guardando la televisione). Infine, l’obiettivo principale del terzo studio era determinare l’associazione tra massa corporea, immagine corporea, stili di vita familiari legati all’alimentazione (es., frequenza dei pasti svolti con i genitori), regole parentali restrittive rispetto all’alimentazione e funzionamento familiare (dialogo con i genitori e sostegno sociale familiare percepito) rispetto all’insoddisfazione corporea degli adolescenti.
I risultati evidenziano differenze significative tra valori auto-riferiti e misurati di peso e altezza all’interno del nostro campione. È stato rilevato un aumento della prevalenza del fenomeno dell’obesità tra gli adolescenti della regione Veneto dal 2000 al 2006, dopo aver corretto statisticamente le distorsioni relative ai valori antropometrici auto-riferiti. Inoltre, controllando l’effetto delle caratteristiche socio-demografiche, è stata evidenziata un’associazione tra comportamenti alimentari, bassi livelli di attività fisica e stili di vita legati all’alimentazione in relazione all’obesità e al sovrappeso.
Infine, i risultati del terzo studio sottolineano l’importanza dei diversi fattori familiari considerati in relazione all’insoddisfazione corporea adolescenziale. Gli stili di vita familiari e le pratiche parentali restrittive relative all’alimentazione, risultano positivamente associate all’indice di massa corporea, mentre la percezione di sostegno sociale da parte della famiglia e la comunicazione con la figura paterna risultano negativamente associate all’insoddisfazione per il proprio corpo e ad un’immagine corporea più negativa. Inoltre, massa corporea e immagine corporea negativa risultano positivamente associate con l’insoddisfazione per il proprio corpo tra gli adolescenti.
In conclusione, il presente lavoro sottolinea che i problemi legati all’eccesso ponderale sono diffusi ed in aumento tra gli adolescenti della regione Veneto. L’obesità e il sovrappeso risultano parte di una complessa configurazione di comportamenti e di stili di vita non salutari in cui, sia fattori di tipo individuale, sia fattori di tipo familiare, hanno un importante ruolo. Dai risultati emerge come i programmi di prevenzione per l’obesità e il sovrappeso in età adolescenziale frequentemente centrati sui comportamenti alimentari e/o sull’attività fisica dovrebbero tenere in considerazione anche il ruolo degli stili di vita legati all’alimentazione. Inoltre, le famiglie dovrebbero essere formate relativamente all’importanza degli stili di vita familiari e sull’adozione di regole parentali non troppo restrittive con gli adolescenti. Il miglioramento della relazione tra genitori ed adolescenti, in termini di sostegno sociale e di comunicazione, soprattutto con la figura paterna, risultano importanti fattori protettivi da considerare per il miglioramento dell’insoddisfazione corporea in adolescenza. Infine, i programmi preventivi dovrebbero focalizzarsi non solo sul peso corporeo, ma anche sull’immagine e l’insoddisfazione che gli adolescenti esperiscono verso il proprio corpo.

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Tipo di EPrint:Tesi di dottorato
Relatore:Santinello, Massimo
Dottorato (corsi e scuole):Ciclo 22 > Scuole per il 22simo ciclo > SCIENZE PSICOLOGICHE > PSICOLOGIA DELLO SVILUPPO E DEI PROCESSI DI SOCIALIZZAZIONE
Data di deposito della tesi:NON SPECIFICATO
Anno di Pubblicazione:31 Gennaio 2010
Parole chiave (italiano / inglese):Adolescence, Obesity, Overweight, Body dissatisfaction, Prevalence, Dietary behaviors, Food-related lifestyles, parenting practices, Family functioning
Settori scientifico-disciplinari MIUR:Area 11 - Scienze storiche, filosofiche, pedagogiche e psicologiche > M-PSI/04 Psicologia dello sviluppo e psicologia dell'educazione
Struttura di riferimento:Dipartimenti > Dipartimento di Psicologia dello Sviluppo e della Socializzazione
Codice ID:2911
Depositato il:09 Nov 2010 12:25
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