Compared to Chinese population in China, Chinese Americans have increased risk for obesity due to immigration and environmental changes. Obesity has been identified as a major source of unsustainable health costs, morbidity and mortality due to multiple chronic illnesses, including hypertension, type 2 diabetes, cardiovascular diseases and certain types of cancer. Obesity indicators generally include Body Mass Index (BMI), waist circumference, hip circumference, weight to hip ratio, weight to height ratio, fasting blood glucose and Glycated hemoglobin (HbA1C). Accuracy of body weight perception is an individual’s perception of their body weight in comparison with actual body weight and is associated with weight related behaviors. Chinese Americans have increased risk for obesity but no studies have examined the impact of accuracy of body weight perception on obesity, obesity indicators and chronic illness.
Methods:
This study used a descriptive and cross-sectional design. Participants were recruited from metropolitan New York area. Data included demographic information, accuracy of perception of body weight, anthropometric measures (weight, height, BMI, waist circumference, hip circumference, weight to height ratio, weight to hip ratio, fasting plasma glucose and HbA1C). Chronic illnesses were assessed using a researcher developed self-report checklist and verified by medical record review.
Results:
Among the 162 Chinese Americans in the study, 52 participants (32%) did not perceive their body weight correctly. Significantly more male (p=0.003), older (p=0.003), and less educated (p=0.047) participants had incorrect accuracy of body weight perception. Participants with incorrect perception of body weight had higher HbA1C (p=0.004) and hypertension (p=0.035). Accuracy of perception of body weight significantly predicted waist circumference (p<.001), hip circumference (p<.001), weight to height ratio (p=0.001), BMI (p<.001) and weight (p<.001) even after controlling for all demographic factors. Of 94 (58%) participants had fewer than three chronic illnesses and 68 (42%) had three or more chronic illnesses. The three most common chronic illnesses in this population were diabetes (65.4%), hypertension (46.9%), and eye problem (38.3%). Controlling for all demographic factors, numbers of chronic illnesses remained significant associations with obesity indicators of waist circumference (p=0.006), hip circumference (p=0.020), weight to height ratio (p=0.011), HbA1C (p=0.026). Obesity indicators also had significant associations with individual chronic illness of diabetes, hypertension, heart diseases, eye and foot problems.
Conclusion:
One third of Chinese Americans did not perceive their body weight correctly. Accuracy of perception of body weight significantly predicted abnormal values of obesity indicators even after controlling for all demographic factors. General obesity indicator (BMI), central obesity indicators (waist circumference, hip circumference, weight to height ratio) and HbA1c were significantly associated with chronic illnesses. Nursing practice and interventions need to address perception of body weight, gender and age differences to promote normal values of obesity indicators so as to prevent obesity and chronic illnesses among this population.
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