. 2023 May 8;82(1):104–127. doi: 10.1093/nutrit/nuad044

Table 3.

Summary of included studies on body image satisfaction and dietary habits

Author (year of publication)	Country (study years)	Sample size (% girls)	Age range^a	Body image satisfaction assessment	Body satisfaction categories	Diet assessment	Dietary outcome	Statistical methods	Results
Balluck et al (2016)⁵⁷	Mauritius (2014–2015)	200 (52.0%)	14–17 (15.5±1.1)	FRS of Stunkard	Desire to gain weight/become thicker, desire to lose weight/become thinner, satisfied	54-item semiquantitative FFQ	14 food groups 6 DH indicators (skipped breakfast, skipped lunch, skipped dinner, snacking habits, fast food consumption, and number of meals)	Chi-square test Student t test	Satisfaction was related to higher consumption of fruit.
Ben Ayed et al (2019)⁵⁸	Tunisia (2017–2018)	1210 (59.7%)	12–18 (15.6±2.0)	FRS of Stunkard	Desire to gain weight, desire to lose weight, satisfied	Eating habits questions	7 DH indicators (skipping breakfast, frequency of eating vegetables, fruit, pasta, soda, fast food, and eating between meals)	Chi-square test Univariant logistic regression model Multivariant logistic regression model	Desire to gain weight was related to poorer DHs (more skipping breakfast, eating between meals and fast food, and eating less fruit). Desire to lose weight was associated with healthier DHs (low frequency of skipping breakfast, eating between meals, and soda, pasta, and fast food consumption).
Bibiloni et al (2012)³⁰	Spain (2007–2008)	1231 (53.4%)	12–17 (not described)	FRS of Stunkard	Desire for a thicker body, desire for a thinner body, desire to remain the same	24-hour dietary recall Validated 145-item semiquantitative FFQ	2 dietary patterns (factor analysis): Western (yoghurt and cheese, dairy desserts, red meat, poultry, sausages, eggs, bread, cereals, pasta, rice dishes, pizza, fruit juices, canned fruits, nuts, soft drinks, high-fat foods, other oils and fats, sweets, and chocolates) and Mediterranean (yoghurt and cheese, red meat, poultry, fish and seafood, eggs, legumes, pasta, fresh fruit, fruit juices, vegetables, potatoes and tubercles, and olive oil)	Chi-square test Univariant logistic regression model Multivariant logistic regression model	Desire to lose weight (boys and girls) and satisfaction (girls) were related to less frequently following the Western dietary pattern.
Bibiloni et al (2013)³¹	Spain (2007–2008)	1231 (53.4%)	12–17 (not described)	FRS of Stunkard	Desire for a thicker body, desire for a thinner body, desire to remain the same	Validated 145-item semiquantitative FFQ Eating habits questions (number not described)	28 food groups 2 DH indicators (breakfast habit, number of meals)	Chi-square test Multivariant logistic regression model	Desire to lose weight in boys with excess weight was related to lower intake of red meat, pasta and rice dishes, and oils and fat. Desire to lose weight in girls with excess weight was related to lower intake of dairy desserts and chocolates and a higher frequency of skipping breakfast.
Bibiloni et al (2016)³²	Spain (2007–2008)	1231 (53.4%)	12–17 (not described)	FRS of Stunkard	Desire for a thicker body, desire for a thinner body, desire to remain the same	Kidmed questionnaire	Kidmed score Poor, medium, high adherence to the MedDiet	ANOVA Multivariant logistic regression model	Desire to lose weight in boys was associated with poor adherence to MedDiet.
Hyun et al (2017)⁴⁴	China and South Korea (2011)	406 (0.0%)	15–18 (not described)	DQ: How are you satisfied with your own body shape?	Mean satisfaction with BI	9-item FFQ	DH score (breakfast, fruit, vegetables, protein foods, milk, laver, and kelp intake, and amount and balance of intake during meals)	Student t test Pearson correlation coefficient	Satisfaction was positively correlated with DH score.
Jankauskiene and Baceviciene (2019)³⁷	Lithuania (not described)	579 (51.6%)	14–16 (15.0±0.4)	Not described (Body Weight Discrepancy was measured as the difference between self-reported body weight, and perceived ideal body weight)	Desire to gain weight, desire to lose weight, satisfied	Validated 11-item FFQ Eating habits questions	11 food groups 2 DH indicators (having breakfast, number of meals)	Kruskal–Wallis test	Dissatisfaction was related to lower number of meals a day. A desire to lose weight among girls was associated with a lower frequency of having breakfast.
Lee and Ahn (2007)⁴⁶	South Korea (not specified)	260 (49.6%)	Not described (5th grade)	DQ: How much are you satisfied with your body shape (image)?	Satisfied, neutral, dissatisfied	Eating habits questions	Eating behavior score	ANOVA	Dissatisfaction in girls was related to an unhealthier DH score. BI satisfaction was not related to DHs in boys.
Oellingrath et al (2015)⁴⁰	Norway (2010)	469 (50.5%)	12–13 (12.7±0.3)	Physical Appearance subscale	Low appearance satisfaction, high appearance satisfaction	Modified validated 69-item FFQ (reported by parents)	4 dietary patterns (PCA): Junk/convenience (high-energy processed fast foods, refined grains, cakes, and sweets), Varied Norwegian (fruits and vegetables, brown bread, fish, water, and regular breakfast and lunch, close to official nutritional advice), Snacking (sugar-rich snack items and drinks, low intakes of vegetables and brown bread, low frequency of breakfast and dinner, and high frequency of eating between meals), and Dieting (foods and drinks often associated with weight control, like artificially sweetened drinks and other ‘light’ products)	Multivariant logistic regression model	Low satisfaction in girls was related to more restrictive dietary patterns (Dieting dietary pattern). High satisfaction in girls was related to engaging in a Snacking dietary pattern.
Ribeiro-Silva et al (2017)⁵⁵	Brazil (2009)	1496 (57.1%)	11–17 (not described)	Body Shape Questionnaire	Satisfied, slightly dissatisfied, moderately or highly dissatisfied	Validated 97-item FFQ	3 dietary patterns (factor analysis): Western (sweets and sugars, soft drinks, typical Brazilian dishes pastries, fast food, milk and dairy, oils, beef), Traditional (chicken, fish, eggs, processed meat products, cereals, baked beans), and Vegetarian (granola, roots, vegetables, and fruits)^b	Logistic regression model	Slight and moderate dissatisfaction in adolescents with excess weight was inversely related to unhealthier DHs (Western dietary pattern). High dissatisfaction in adolescents with excess weight was related to healthier diet (Vegetarian dietary pattern).
Ro and Hyun (2012)⁴⁹	China and South Korea (2011–2012)	448 (100%)	15–18 (not described)	Not described (BI was evaluated by adolescents’ body satisfaction on a 5-point scale ranging from ‘very satisfied’, through ‘satisfied’, ‘so-so’, ‘unsatisfied’, to ‘very unsatisfied’) FRS (reference unavailable)	Mean satisfaction with BI	9-item FFQ	DH score (breakfast, fruits, vegetables, protein foods, milk, laver, and kelp intake, and amount and balance of intake during meals)	Student t test Pearson correlation coefficient	BI satisfaction was significantly related to more desirable DHs.
Shaban et al (2016)⁵⁰	Kuwait (2015)	169 (100%)	10–14 (not described)	FRS of Stunkard (desired BI)	Dissatisfaction categories (not described)	DQ: Do you consider your diet to be healthy?	Healthy, and unhealthy	Chi-square test Ordinal regression	Dissatisfaction was marginally related to unhealthier DHs.
Silva et al (2021)⁵⁴	Brazil (2013–2014)	52 038 (49.8%) (adolescents with normal weight)	12–17 (14.7)	DQ: Are you satisfied with your weight? In your opinion, at what level is your current weight?	Misperception (underestimation, overestimation), no misperception^c	24-hour dietary recall	3 dietary patterns (PCA): Traditional Brazilian (rice, beans, vegetables and meat), Processed meat sandwiches and coffee (processed meat, coffee/tea, bread, cheese, oils and fats), and Ultraprocessed and sweet foods (sugar-sweetened beverages, desserts/sweets, and ultraprocessed foods)	Simple Poisson regression models Adjusted multiple regression model stratified by sex	Misperception is related to unhealthy DHs. Underestimation was related to unhealthier dietary patterns (higher odds to Processed meat, sandwiches and coffee and Ultraprocessed and sweet foods dietary patterns). Overestimation was inversely related to the Traditional Brazilian dietary pattern in both girls and boys, and to the Processed meat sandwiches and coffee and Ultraprocessed and sweet foods dietary patterns only in girls.
Tapia-Serrano et al (2021)³⁴	Spain (2018–2019)	2216 (44.2%)	10–16 (13.1±0.90)	Body Image Dimensional Assessment questionnaire	Mean body dissatisfaction	Kidmed questionnaire	Poor, medium, high adherence to the MedDiet	Student t test Pearson correlation	BI dissatisfaction was associated with better adherence to the MedDiet.
Tebar et al (2020)⁵⁶	Brazil (not described)	1074 (55.1%)	10–17 (13.1±3.5)	Brazilian Silhouettes’ Scale	Desire to gain weight, desire to lose weight, satisfied	Validated FFQ	6 food groups	ANOVA Chi-square test Logistic regression model	The desire to lose weight was related to lower intake of fruit and vegetables. The desire to gain weight was related to lower consumption of vegetables and higher consumption of sweets.

Age y.o. (mean ± sd) unless otherwise specified.

The authors also defined this dietary pattern as ‘Restrictive,’ considering the food groups associated with this dietary pattern; we decided to use the term ‘Vegetarian.’

This article misclassified BI satisfaction as perception.

BI, body image; DH, dietary habit; DQ, direct question; FFQ, food-frequency questionnaire; FRS, figure rating scale; MedDiet, Mediterranean diet; PCA, principal component analysis.