The body experience of parents and adolescents with an eating disorder

CILJ ISTRAŽIVANJA: Utvrditi doprinos roditeljske slike o sebi, ITM djeteta i dječjih prehrambenih navika njihovoj debljini, zaokupljenosti vlastitim tijelom i samovrednovanju. ISPITANICI I POSTUPCI: U provedenoj prospektivnoj studiji sudjelovala su 24 djeteta s prekomjernom težinom liječena u Klinici za dječje bolesti, KBC Split i njihovi otac (N=22) i majka (N=24). U istraživanju je sudjelovalo 12 djece u dobi od 9 – 13 godina (4 dječaka i 8 djevojčica) te 12 djece u dobi od 14 – 18 godina (3 dječaka i 9 djevojčica). Istraživanje je provedeno od 01. do 30. lipnja, 2020.godine. Dužina i učinkovitost liječenja djeteta od prekomjerne debljine utvrđena je usporedbom ITM vrijednosti na dan prvog pregleda u usporedbi s trenutnim ITM indeksom djeteta. U ispitivanju su primijenjeni slijedeći upitnici: Sociodemografski semi-strukturirani upitnik izrađen za potrebe ovog istraživanja, Semi-strukturirani upitnik raznolikosti korištenih prehrambenih namirnica u posljednjih mjesec dana. U procjeni doživljaja tijela korišten je standardizirani multidimenzionalni upitnik o dimenzijama zadovoljstva tijelom (MBSRQ–AS). Koristili smo dvije subskale: zaokupljenost izgledom/usmjerenost na vlastito tijelo (Cronbach's alpha 0.811) i skalu samovrednovanja (engl. Cronbach's alpha 0.86). REZULTATI: Prediktori debljine djece različite kronološke dobi su niži mjesečni unos raznolikih ugljikohidrata (t=2,535;p=0,028); Ca (kalcija) putem raznolikih namirnica bogatih kalcijem (t= -2,376;p=0,037); Vit D (vitamina D) putem raznolikih namirnica bogatih Vit D (t=2,781;p=0,018); Vit K (vitamina K) putem raznolikih namirnica bogatih vitaminom K (t=-2,864;p=0,015) i ITM majke (t=4,307;p=0,001). Prediktor debljine djece s obzirom na spol je niži mjesečni unos proteina (t=3,832;p=0,003). ITM djeteta je (t=-2,674;p=0,015) značajan prediktor zaokupljenosti sobom djece muškog i ženskog spola, razlikovni faktor zaokupljenosti sobom djece predadolescentne i adolescentne dobi (t=-4,564;p=0,000) i značajan prediktor razlika u samovrednovanju djece s obzirom na kronološku dob (t=-6,101;p=0,000). Majčina zaokupljenost sobom statistički je značajan prediktor razlika u djetetovoj zaokupljenosti s sobom s obzirom na spol (t=-3,050;p=0,007). Očevo samovrednovanje vlastitog tijela (t=-3,945;p=0,001) statistički je značajan prediktor razlike u samovrednovanju djece muškog i ženskog spola. Djeca u dobi 9-13 godina (mlađi adolescenti) imaju veći rizik za nastanak pretilosti (OR=2,143, 95% CI 0,404-3,882) kao i sva ispitivana djeca, bez obzira na spol i dob, koja unose Fe kroz mali broj raznolikih namirnica bogatih željezom (OR=2,143, 95% CI 0,404-3,882). Vlastitim tijelom manje su zaokupljena: djeca muškog spola (OR=40, 95% CI 37,398-42,062), djeca čije majke nisu zaokupljene sobom (OR=3,4, 95% CI 0,454-6,346), djeca čiji očevi imaju prekomjernu tjelesnu masu (OR=3,333, 95% CI 1,357-5,309) i djeca čiji očevi nisko samovrednuju svoje tijelo (OR=7,5, 95% CI 4,858-10,142). Slabije se samovrednuju: djeca muškog spola (OR=5,333, 95% CI 3,012-7,655), pretila djeca (OR=5, 95% CI 3,175-6,825) i djeca čiji očevi manje veličaju tijelo (OR=2,188, 95% CI 0,26-4,116). ZAKLJUČAK: Djeca u dobi 9-13 godina (mlađi adolescenti) imaju veći rizik za nastanak pretilosti kao i sva ispitivana djeca koja unose željezo kroz mali broj raznolikih namirnica bogatih željezom bez obzira na spol i dob. Značajni prediktori debljine u djece različite kronološke dobi su niži mjesečni unos raznolikih ugljikohidrata i mikronutrijenata i ITM majke, a značajan prediktor debljine s obzirom na spol je niži mjesečni unos proteina. Na vlastito tijelo manje su usmjerena muška djeca, djeca čije majke nisu zaokupljene svojim tijelom, djeca čiji očevi imaju prekomjeran ITM i djeca čiji se očevi nisko samovrednuju. Majčina zaokupljenost sobom statistički je značajan prediktor usmjerenosti na vlastito tijelo s obzirom na spol djeteta. Očevo samovrednovanje utječe na samovrednovanje djece obaju spolova. Slabije se samovrednuju: djeca muškog spola, pretila djeca i djeca čiji očevi manje veličaju tijelo. ITM adolescenta prediktor je njegovog samovrednovanja s obzirom na spol i njegove usmjerenosti na vlastito tijelo s obzirom na spol i kronološku dob.RESEARCH GOAL: To determine the contribution of the parent’s self-image, child’s BMI, and children’s eating habits to their obesity, appearance orientation and appearance evaluation. SUBJECTS AND METHODS: A prospective study included 24 overweight children, who were treated at the Clinic for Children’s Disease of the Clinical Hospital Center in Split, as well as their father (N=22) and mother (N=24). The study involved 12 children aged 9-13 years (4 boys and 8 girls) and 12 children aged 14-18 years (3 boys and 9 girls). The survey was conducted from June 1 to 30, 2020. The length and effectiveness of the treatment of an overweight child were determined by comparing the BMI value on the day of the first examination, compared to the child’s current BMI index. The following questionnaires were used in the study: Socio-demographic semi-structured questionnaire developed for the purposes of this research, and Semi-structured questionnaire on the diversity of food used in the last month. A standardized Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS) was used to assess body image. Two subscales were used: appearance orientation (Cronbach's alpha 0.811) and self-evaluation scale (Cronbach's alpha 0.86). RESULTS: Predictors of childhood obesity of different chronological age are lower monthly intake of various carbohydrates (t=2.535;p=0.028); Ca (calcium) through a variety of calcium-rich food (t=-2.376;p=0.037); Vit D (vitamin D) through a variety of food rich in Vit D (t=2.781;p=0.018); Vit K (vitamin K) through a variety of food rich in vitamin K (t=-2.864;p=0.015) and the mother’s BMI (t=4.307;p=0.001). The child’s BMI (t=-2.674;p=0.015) is a significant predictor of self-occupation in both male and female children, a differential factor of self-occupation of a preadolescent and adolescent age (t=-4.564;p=0.000) and a significant predictor of self-evaluation of a preadolescent and adolescent age (t=-6,101; p=0,000). The father’s appearance evaluation of his own body (t=-3.945;p=0.001) is a statistically significant predictor of the difference in the appearance evaluation of male and female children. The mother’s appearance orientation is a statistically significant predictor of the difference in the appearance orientation of male and female children (t=-3,050; p=0,007). Children aged 9-13 years (younger adolescents) have a higher risk of developing obesity (OR=2,143, 95% CI 0.404-3.882), as do all the children in the survey who consume iron through a small number of a variety of iron-rich food, regardless of gender and age (OR=2,143, 95% CI 0,404-3,882). Those who are less preoccupied with their own body are: male children (OR=40, 95% CI 37,398-42,062), children whose mothers are not preoccupied with themselves (OR=3,4, 95% CI 0,454-6,346), children whose father is overweight (OR=3,333, 95% CI 1,357-5,309) and children whose father has low appearance evaluation (OR=7,5, 95% CI 4,858-10,142). Those who have weaker appearance evaluation are: male children (OR=5,333, 95% CI 3,012-7,655), obese children (OR=5, 95% CI 3,175-6,825) and children whose fathers don’t glorify their body (OR = 2,188, 95% CI 0,26-4.116). CONCLUSION: Children aged 9-13 years (younger adolescents) have a higher risk of developing obesity, as do all the children in the survey who consume iron through a small number of a variety of iron-rich food, regardless of gender and age. Significant predictors of obesity in children of different chronological age are lower monthly intake of a variety of carbohydrates and micronutrients. Furthermore, a significant predictor of obesity, with respect to gender, is lower monthly protein intake. Male children, children whose mothers are not preoccupied with their bodies, children whose fathers have an excessive BMI and children whose father has low appearance evaluation are less focused on their own body. Mother’s appearance orientation is a statistically significant predictor of the difference in the appearance orientation of male and female children. Father’s appearance evaluation affects the appearance evaluation of children of both sexes. Male children, obese children and children whose fathers don’t glorify their body have weaker appearance evaluation. The BMI of an adolescent is a predictor of his appearance evaluation with respect to gender and his focus on his own body with respect to gender and chronological age