Is ideal body image related to obesity and lifestyle behaviours in African American adolescents?

Background Childhood obesity epidemic has become a public health issue in the USA, especially among African American youths. Research on the association between ideal body image (IBI) and obesity and related lifestyle factors among African American children and adolescents is limited. Methods Data collected from 402 low-income African American adolescents aged 10-14 years in four Chicago public schools were used. Questionnaires were used to assess IBI, weight perception, weight control practices, and self-efficacy towards food and physical activity. Body mass index was calculated using measured weight and height. Associations between IBI and weight perception, overweight/obesity and lifestyle behaviours were assessed using linear and logistic regression models. Results The most frequently chosen ideal body size was the fourth of eight silhouettes (from thinnest to heaviest) for boys (55%) and girls (49%). Overweight and obese girls selected larger ideal body figures than the others (trend test: P<0.001). Compared with those with middle ideal body figures, girls who selected smaller ones were twice as likely to have an unhealthy diet as indicated by less fruit and milk consumption; the odds ratios (ORs) and 95% confidence intervals (95% CIs) were 2.40 (1.15-5.02) for fruits intake (<once/week) and 2.13 (1.06-4.29) for milk consumption (<once/day), respectively. Boys with larger IBI were less likely to eat snack often [≥once/day; OR=0.11 (0.02-0.50)]. Girls with larger IBI were less likely to spend more screen time [OR=0.12 (0.02-0.70)] and reported better food choice intentions (P<0.05). Overweight and obese boys and girls appeared to have better food choice intentions and food self-efficacy than their non-overweight peers (trend test: both P<0.01). Conclusions Ideal body image is associated with weight status, food self-efficacy and lifestyle behaviours among low-income African American adolescents.