Lineamientos de uso turístico para el Salado de Consotá

The following analyses use the same techniques as in the previous sections to examine body dissatisfaction and dieting as predictors o f three health promoting behaviours linked to weight control: involvement in healthy eating practices, consumption of fruit and vegetables and physical activity. As before, dichotomised health behaviour measures were entered as dependent variables into a binary logistic regression, with dieting or body dissatisfaction or both as predictor variables and with BMI and puberty as covariates.

6.2.3.1 Healthv eating habits

The first health behaviour variable to be examined was the AFHC healthy eating habits scale. The results of this analysis are shown in table 6.7.

Healthy eating habits were predicted by dieting intensity (Wald %^[3]=38.94 p<0.001) such that both moderate and frequent dieters were found to have an elevated chance of being in the healthy eating group compared with the non­ dieters. The highest odds of being a healthy eater were found in the moderate dieting group which had an odds ratio of 2.9. The association with body dissatisfaction was weaker. The overall Wald Chi-square for the variable was non-significant (Wald %^[3]=4.85 ns) although pairwise comparisons with the index category produced a significant effect for the dissatisfied group who were more likely to be in the healthy eating group, with an odds ratio o f 1.7.

Chapter 6. Cross-sectional analyses: Body dissatisfaction as a predictor

Table 6.7 Logistic regressions: Dieting intensity, body dissatisfaction and healthy eating habits

Wald

^

ratio Confidence Interval 1. Categorical independent variable: Dieting intensity

No dieting 38.94 *** 1

Occasional Dieting 1.35 ns 1.25 0.86-1.84 Moderate Dieting 29.54 *** 2.86 1.96-4.18 Frequent dieting 20.55 *** 2.44 1.66-3.59 2. Categorical independent variable: Body dissatisfaction Very Satisfied 4.85 ns 1

Satisfied 1.83 ns 1.40 0.86-2.27

Dissatisfied 4 .4 6 * 1.72 1.04-2.84 Very dissatisfied 2.30 ns 1.58 0.87-2.85 3. Categorical independent variable: Dieting and Body dissatisfaction

No dieting 39.20 *** 1 Occasional dieting 1.63 ns 1.30 0.87-1.95 Moderate dieting 29.75 *** 3.09 2.06-4.63 Frequent dieting 21.44 *** 2.74 1.79-4.21 Very Satisfied 4.54 ns 1 Satisfied 0.09 ns 1.08 0.65-1.80 Dissatisfied 0.07 ns 0.92 0.53-1.63 Very dissatisfied 1.77 ns 0.63 0.32-1.24

* p<0.05 **p<0.01 ***p<0.001 Other variables in the model: BMI, Pubertal development Chi-square value for the index category is the value for the variable as a whole.

When dieting intensity and body dissatisfaction were entered into the equation together the effects of body dissatisfaction became non significant (Wald

X^[3]=4.54 ns), but the effects of being a moderate or frequent dieter remained

strong (Wald x^[3]=39.20 p<0.001). The greatest likelihood o f having an above median level of healthy eating habits was associated with moderate level dieting.

Chapter 6. Cross-sectional analyses: Body dissatisfaction as a predictor

6.2.3.2 Fruit and vegetable consumption

The analyses were repeated, this time with five or more fruit and vegetable servings per day as the dichotomous dependent variable. Results o f this analysis can be seen in table 6.8.

Table 6.8 Logistic regressions: Dieting intensity, body dissatisfaction and consumption of five or more fruit and vegetables a day.

Wald Odds ratio 95%

Confidence Interval 1. Categorical independent variable: Dieting

N o dieting 17.49 *** 1

Occasional Dieting 0.23 ns 1.10 0.75-1.61 Moderate Dieting 10.02 ** 1.83 1.26-2.67 Frequent dieting 11.70*** 1.95 1.33-2.87 2. Categorical independent variable: Body dissatisfaction Very Satisfied 0.96 ns 1

Satisfied 0.25 ns 1.13 0.70-1.81

Dissatisfied 0.65 ns 1.22 0.75-2.00

Very dissatisfied 0.05 ns 1.07 0.59-1.92 3. Categorical independent variable: Dieting and Body dissatisfaction No dieting 19.67 *** 1 Occasional dieting 0.65 ns 1.18 0.79-1.77 Moderate dieting 11.97*** 2.03 1.36-3.02 Frequent dieting 13.62*** 2.24 1.45-3.40 Very Satisfied 2.85 ns 1 Satisfied 0.07 ns 0.94 0.57-1.53 Dissatisfied 0.81 ns 0.78 0.45-1.35 Very dissatisfied 1.86 ns 0.63 0.33-1.22

* p<0.05 **p<0.01 ***p<0.001 Other variables in the model: BMI, Pubertal development Chi-square value for the index category is the value for the variable as a whole.

A significant effect for dieting was found (Wald %^[3]=17.49 p<0.001). Moderate and frequent dieters were more likely than non dieters to eat five or more servings of fruit and vegetables a day, with the highest odds of meeting this target found in the frequent dieters who had an odds ratio of 2.0. There was

Chapter 6. Cross-sectional analyses: Body dissatisfaction as a predictor

no significant effect of body dissatisfaction (Wald x^[3]=0.96 ns) on fruit and vegetable intake. When both dieting and body dissatisfaction were entered into the analysis together the effects of moderate and frequent dieting remained (Wald x^[3]=19.67 p<0.001) with the frequent dieters having over twice the odds ratio of eating five fhiit and vegetables daily compared with the non dieters. Body dissatisfaction remained non-significant (Wald x^[3]=2.85 ns).

6.2.3.3 Phvsical activitv

Finally the analyses were carried out using physical activity as the dichotomous dependent variable. Results of this analysis can be seen in table 6.9.

Table 6.9 Logistic regressions: Dieting intensity, body dissatisfaction and involvement in physical activity

Wald Odds ratio 95%

Confidence Interval 1. Categorical independent variable: Dieting

No dieting 9.64 * 1

Occasional dieting 0.11 ns 0.93 0.65-1.36 Moderate dieting 3.01 ns 1.39 0.96-2.02 Frequent dieting 6 .2 0 * 1.64 1.11-2.41 2. Categorical independent variable: Body dissatisfaction Very Satisfied 9.44 * 1

Satisfied 6.41* 0.53 0.33-0.87

Dissatisfied 2.20 ns 0.68 0.41-1.13 Very dissatisfied 5.94 * 0.48 0.26-0.86 3. Categorical independent variable: Dieting and Body dissatisfaction

No dieting 13.93 ** 1 Occasional dieting 0.05 ns 1.05 0.71-1.55 Moderate dieting 5.95 * 1.64 1.10-2.45 Frequent dieting 9.87 ** 1.98 1.29-3.04 Very Satisfied 12.54** 1 Satisfied 7.75** 0.49 0.30-0.81 Dissatisfied 5.64* 0.51 0.29-0.89 Very dissatisfied 11.57 *** 0.32 0.16-0.61

* p<0.05 **p<0.01 ***p<0.001 Other variables in the model: BMI, Pubertal development Chi-square value for the index category is the value for the variable as a whole.

Chapter 6. Cross-sectional analyses: Body dissatisfaction as a predictor

There was a significant effect o f dieting group on activity (Wald %^[3]=9.64 p<0.05) such that the most frequent dieters were somewhat more likely to be in the high activity group than the non dieters, with an odds ratio of 1.6. Body dissatisfaction, however, had the opposite effect (Wald X^[3]=9.44 p<0.05) with both those who said that they were satisfied and those who said they were very dissatisfied being less likely than those who were very satisfied to be in the high activity group.

When both dieting and body dissatisfaction were added into the analysis together these results for dieting were accentuated (Wald x^[3]=13.93 p<0.01), with moderate dieters having 1.6 times higher odds, and frequent dieters having twice the odds of being in the high activity group compared with non dieters. An accentuated effect for body dissatisfaction was also found (Wald x^[3]=12.54 p<0.001). The satisfied, dissatisfied and very dissatisfied groups all had lower odds o f being in the high activity group than the very satisfied group. The lowest odds were found in the very dissatisfied group who had an odds ratio of 0.32 compared with the very satisfied group.

6.3 Discussion

The analyses presented above aimed to examine whether some o f the psychological and behavioural factors that have been linked with dieting are more closely associated with body dissatisfaction. Results o f analyses in which both dieting and body dissatisfaction were entered as independent variables seem to support the proposition that the importance of body dissatisfaction in relation to psychological distress and eating disturbances may have been underestimated.