Objective To evaluate the effect of childhood obesity intervention on body shape perception among primary school students,and to further explore the mediating role of body shape perception in changes in obesity indicators,in order to provide scientific evidence for future effective intervention strategies. Methods A randomized controlled trial for childhood obesity prevention was carried out in 8 primary schools in Changzhi from 2018 to 2019,and 393 children in grade four were included.A questionnaire was used to collect children's body shape perception,along with anthropometric measurements.Generalized estimating equation models were used to analyze the effect of intervention on children's body shape perception,and the mediation model was used to explore the role of body perception in changes in obesity indicators. Results After one year intervention,the proportion of the children's body shape perception conducive to weight loss (overestimated or correctly estimated) increased from 58.1% to 74.2% in the intervention group,while the proportion in the control group only increased from 53.8% to 58.4%.Compared to the controls,the intervention group showed a greater improvement on the proportion of body size perception conducive to weight loss(OR=1.638,95%CI:1.007 - 2.663,P<0.05).Stratified analysis revealed that the intervention had a larger effect on body shape perception for those who were overweight/obese(OR=2.247,95%CI:1.169~4.320) and for girls(OR=2.195,95%CI:1.080~4.458).Mediation analysis showed that changes in body shape perception played a mediating role in the relationship between comprehensive intervention and changes in body mass index(Za*Zb=-0.13,95%CI:-0.30 - -0.01)and waist circumference(Za*Zb=-0.85,95%CI:-1.87 - -0.08),but not in body fat percentage. Conclusions Comprehensive intervention can effectively improve children's body shape perception,and changes in body shape perception act as a mediator in improvements to obesity indicators.Incorporating body shape perception into comprehensive interventions can enhance the effectiveness of childhood obesity interventions.
Key words
obesity /
body perception /
mediating effect /
comprehersive intervention /
children
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