Healthy lifestyles and body mass index as correlates of body image dissatisfaction in primary schoolchildren

Background: Body image is a representation of the self that develops from an early age. Such representations are likely to be associated with lifestyle choices. Objective: The purpose of this study was to explore the relationships between health behaviours (i.e., physical activity, screen time and adherence to the Mediterranean diet), body mass index (BMI) and body image dissatisfaction among primary schoolchildren. Methods: A total of 782 pupils (age 7.92 +/- 1.36 years), 405 boys (age 8.01 +/- 1.38 years) and 377 girls (age 7.95 +/- 1.33 years) from the Southeast region of Portugal, answered a survey containing the Mediterranean Diet Quality Index (KIDMED) to measure eating patterns and gender congruent Figure Rating Scales to measure body image dissatisfaction. Children also had their weight and height measured to calculate BMI. Based on the Krece Plus quick test, parents reported on children's physical activity and screen time. Results: Girls reported being less active, t(619) = 2.29, p = .022, d = 0.19; adhering more to the Mediterranean diet, t(775) = -3.92, p <.001, d = -0.29; and having higher body image dissatisfaction than boys, t(773) = -2.53, p = .012, d = -0.19. There was a significant association between BMI and body image dissatisfaction, chi(2)(4) = 79.34, p < .001. Moreover, 22.5% of the children with normal BMI perceived being overweight/obese. Gender (beta = 0.085, p = .036) and BMI (beta = 0.40, p < .001), but not lifestyle variables, predicted body image dissatisfaction (R-2 = .173). Conclusions: Physical activity, screen time, and adherence to a Mediterranean diet were not associated with body image dissatisfaction. However, BMI was positively associated with body image dissatisfaction. Children are not accurate in estimating their body size which can lead to body image dissatisfaction and attempts to control body weight.