Figure 1
Selection process of the study
KCHS = Korean Community Health Survey; BMI = body mass index.
Table 1Participants’ general and health behavior-related characteristics per body image discordance group (N = 59,361).
Characteristics |
Total |
Discordance between body mass index and body image |
|
Concordance |
Discordance |
|
Under-estimation |
Over-estimation |
|
N
|
% (SE) |
n
|
% (SE) |
n
|
% (SE) |
n
|
% (SE) |
|
59,361 |
- |
33,864 |
56.9 (0.2) |
21,262 |
36.0 (0.2) |
4,235 |
7.1 (0.1) |
Gender |
Men |
28,100 |
52.1 (0.2) |
12,559 |
46.2 (0.3) |
15,243 |
52.7 (0.3) |
298 |
1.1 (0.1) |
Women |
31,261 |
47.9 (0.2) |
21,305 |
68.4 (0.3) |
6,019 |
17.8 (0.2) |
3,937 |
13.8 (0.2) |
|
Age (y) |
19–29 |
25,313 |
48.0 (0.2) |
15,554 |
61.0 (0.3) |
7,317 |
29.8 (0.3) |
2,442 |
9.2 (0.2) |
30–39 |
34,048 |
52.0 (0.2) |
18,310 |
53.0 (0.3) |
13,945 |
41.7 (0.3) |
1,793 |
5.2 (0.1) |
|
Education level |
≤ High school |
14,696 |
21.6 (0.2) |
8,012 |
54.1 (0.5) |
5,789 |
39.6 (0.5) |
895 |
6.3 (0.2) |
≥ College |
44,665 |
78.4 (0.2) |
25,852 |
57.6 (0.3) |
15,473 |
35.0 (0.3) |
3,340 |
7.4 (0.1) |
|
Marital status |
Married |
29,401 |
44.4 (0.2) |
16,002 |
53.5 (0.3) |
11,727 |
40.7 (0.3) |
1,672 |
5.7 (0.2) |
Single |
29,960 |
55.6 (0.2) |
17,862 |
59.5 (0.3) |
9,535 |
32.2 (0.3) |
2,563 |
8.3 (0.2) |
|
Employment status |
Employed |
38,760 |
64.6 (0.2) |
20,793 |
53.6 (0.3) |
15,541 |
40.1 (0.3) |
2,426 |
6.3 (0.1) |
Unemployed |
20,601 |
35.4 (0.2) |
13,071 |
62.8 (0.4) |
5,721 |
28.4 (0.4) |
1,809 |
8.8 (0.2) |
|
Smoking status |
Currently smoking |
14,380 |
25.3 (0.2) |
6,469 |
45.8 (0.5) |
7,616 |
52.1 (0.5) |
295 |
2.1 (0.1) |
Ex-smoker |
5,091 |
9.2 (0.2) |
2,237 |
44.7 (0.8) |
2,740 |
53.0 (0.8) |
114 |
2.3 (0.2) |
Non-smoker |
39,890 |
65.5 (0.2) |
25,158 |
62.8 (0.3) |
10,906 |
27.3 (0.3) |
3,826 |
9.8 (0.2) |
|
Alcohol consumption |
Currently drinking |
50,818 |
87.3 (0.2) |
28,747 |
56.5 (0.2) |
18,683 |
36.8 (0.2) |
3,388 |
6.7 (0.1) |
Ex-drinker |
4,824 |
7.5 (0.2) |
2,872 |
58.4 (0.8) |
1,484 |
31.3 (0.8) |
468 |
10.3 (0.5) |
Non-drinker |
3,719 |
5.2 (0.2) |
2,245 |
60.6 (1.0) |
1,095 |
29.1 (0.9) |
379 |
10.3 (0.6) |
|
Breakfast consumption (d/wk) |
≤ 4 |
29,789 |
52.1 (0.2) |
17,010 |
56.8 (0.3) |
10,605 |
36.0 (0.3) |
2,174 |
7.2 (0.2) |
≥ 5 |
29,572 |
47.9 (0.2) |
16,854 |
56.9 (0.3) |
10,657 |
36.0 (0.3) |
2,061 |
7.1 (0.2) |
|
Sleep duration (h/d) |
≤ 5 |
6,719 |
12.2 (0.2) |
3,701 |
55.0 (0.7) |
2,586 |
38.7 (0.7) |
432 |
6.3 (0.3) |
6–8 |
49,721 |
83.2 (0.2) |
28,311 |
56.7 (0.2) |
17,880 |
36.1 (0.2) |
3,530 |
7.2 (0.1) |
≥ 9 |
2,921 |
4.6 (0.2) |
1,852 |
64.1 (1.0) |
796 |
26.5 (0.9) |
273 |
9.4 (0.6) |
|
Perception of stress |
Yes |
18,783 |
32.4 (0.2) |
10,628 |
56.3 (0.4) |
6,820 |
36.6 (0.4) |
1,335 |
7.1 (0.2) |
No |
40,578 |
67.6 (0.2) |
23,236 |
57.1 (0.3) |
14,442 |
35.7 (0.3) |
2,900 |
7.2 (0.1) |
|
Perception of depression |
Yes |
3,540 |
6.1 (0.2) |
2,164 |
59.7 (0.9) |
1,054 |
30.5 (0.9) |
322 |
9.7 (0.6) |
No |
55,821 |
93.9 (0.2) |
31,700 |
56.7 (0.2) |
20,208 |
36.3 (0.2) |
3,913 |
7.0 (0.1) |
|
Perceived health status |
Good |
32,060 |
54.4 (0.2) |
18,317 |
57.1 (0.3) |
11,584 |
36.2 (0.3) |
2,159 |
6.7 (0.2) |
Average |
24,233 |
40.6 (0.2) |
13,723 |
56.1 (0.4) |
8,683 |
36.2 (0.3) |
1,827 |
7.7 (0.2) |
Poor |
3,068 |
5.0 (0.2) |
1,824 |
60.6 (1.0) |
995 |
31.2 (0.9) |
249 |
8.2 (0.6) |
|
Physical activity |
Yes |
23,803 |
43.8 (0.2) |
13,576 |
56.9 (0.4) |
8,544 |
36.1 (0.4) |
1,683 |
7.0 (0.2) |
No |
35,558 |
56.2 (0.2) |
20,288 |
56.8 (0.3) |
12,718 |
35.9 (0.3) |
2,552 |
7.3 (0.2) |
|
Weight control behavior |
Yes |
42,077 |
72.0 (0.2) |
23,553 |
55.5 (0.3) |
16,140 |
38.7 (0.3) |
2,384 |
5.8 (0.1) |
No |
17,284 |
28.0 (0.2) |
10,311 |
60.3 (0.4) |
5,122 |
29.0 (0.4) |
1,851 |
10.7 (0.3) |
|
Body mass index (kg/m2) |
Underweight |
5,046 |
8.6 (0.1) |
937 |
18.9 (0.6) |
0 |
0 |
4,109 |
81.1 (0.6) |
Normal weight |
30,031 |
50.7 (0.2) |
29,175 |
96.9 (0.1) |
730 |
2.7 (0.1) |
126 |
0.4 (0.0) |
Obese |
24,284 |
40.7 (0.2) |
3,752 |
15.0 (0.3) |
20,532 |
85.0 (0.3) |
0 |
0 |
|
Body image |
Slender |
1,680 |
3.0 (0.1) |
937 |
54.2 (1.4) |
743 |
45.8 (1.4) |
0 |
0 |
Average |
53,798 |
90.7 (0.1) |
29,175 |
54.2 (0.2) |
20,519 |
38.2 (0.2) |
4,104 |
7.7 (0.1) |
Obese |
3,883 |
6.3 (0.1) |
3,752 |
96.8 (0.3) |
0 |
0 |
131 |
3.2 (0.3) |
Table 2The associations between concordance and discordance of body image and general and health behavior-related characteristics (N = 59,361).
Characteristics |
Concordance (n = 33,864) |
Under-estimation (n = 21,262) |
χ2
|
p
|
Concordance (n = 33,864) |
Over-estimation (n = 4,235) |
χ2
|
p
|
|
|
%(SE) |
%(SE) |
%(SE) |
%(SE) |
Gender |
Men |
45.2(0.3) |
54.8(0.3) |
6,133.89 |
< 0.001 |
97.7(0.1) |
2.3(0.1) |
1,898.81 |
< 0.001 |
Women |
78.0(0.3) |
22.0(0.3) |
|
|
83.2(0.3) |
16.8(0.3) |
|
|
|
Age (y) |
19–29 |
67.2(0.3) |
32.8(0.3) |
725.52 |
< 0.001 |
86.8(0.3) |
13.2(0.3) |
164.87 |
< 0.001 |
30–39 |
56.0(0.3) |
44.0(0.3) |
|
|
91.0(0.2) |
9.0(0.2) |
|
|
|
Educational level |
≤ High school |
57.7(0.5) |
42.3(0.5) |
80.45 |
< 0.001 |
89.5(0.4) |
10.5(0.4) |
5.04 |
0.040 |
≥ College |
62.2(0.3) |
37.8(0.3) |
|
|
88.6(0.2) |
11.4(0.2) |
|
|
|
Marital status |
Married |
56.8(0.3) |
43.2(0.3) |
381.21 |
< 0.001 |
90.3(0.3) |
9.7(0.3) |
61.21 |
< 0.001 |
Single |
64.9(0.3) |
35.1(0.3) |
|
|
87.8(0.3) |
12.2(0.3) |
|
|
|
Employment status |
Employed |
57.2(0.3) |
42.8(0.3) |
720.40 |
< 0.001 |
89.5(0.2) |
10.5(0.2) |
27.31 |
< 0.001 |
Unemployed |
68.9(0.4) |
31.1(0.4) |
|
|
87.8(0.3) |
12.2(0.3) |
|
|
|
Smoking status |
Currently smoking |
46.7(0.5) |
53.3(0.5) |
2,894.53 |
< 0.001 |
95.6(0.3) |
4.4(0.3) |
596.29 |
< 0.001 |
Ex-smoker |
45.7(0.8) |
54.3(0.8) |
|
|
95.2(0.5) |
4.8(0.5) |
|
|
Non-smoker |
69.7(0.3) |
30.3(0.3) |
|
|
86.5(0.2) |
13.5(0.2) |
|
|
|
Alcohol consumption |
Currently drinking |
60.6(0.3) |
39.4(0.3) |
80.81 |
< 0.001 |
89.4(0.2) |
10.6(0.2) |
78.09 |
< 0.001 |
Ex-drinker |
65.1(0.8) |
34.9(0.8) |
|
|
85.0(0.7) |
15.0(0.7) |
|
|
Non-drinker |
67.5(1.0) |
32.5(1.0) |
|
|
85.5(0.9) |
14.5(0.9) |
|
|
|
Breakfast consumption (d/wk) |
≤4 |
61.2(0.3) |
38.8(0.3) |
0.06 |
0.825 |
88.7(0.3) |
11.3(0.3) |
0.39 |
0.581 |
≥5 |
61.3(0.3) |
38.7(0.3) |
|
|
88.9(0.3) |
11.1(0.3) |
|
|
|
Sleep duration (h/d) |
≤5 |
58.7(0.7) |
41.3(0.7) |
113.91 |
< 0.001 |
89.8(0.5) |
10.2(0.5) |
9.30 |
0.025 |
6–8 |
61.1(0.3) |
38.9(0.3) |
|
|
88.8(0.2) |
11.2(0.2) |
|
|
≥9 |
70.8(1.0) |
29.2(1.0) |
|
|
87.2(0.8) |
12.8(0.8) |
|
|
|
Perception of stress |
Yes |
60.6(0.4) |
39.4(0.4) |
4.63 |
0.061 |
88.9(0.3) |
11.1(0.3) |
0.05 |
0.845 |
No |
61.6(0.3) |
38.4(0.3) |
|
|
88.8(0.2) |
11.2(0.2) |
|
|
|
Perception of depression |
Yes |
66.2(0.9) |
33.8(0.9) |
35.82 |
< 0.001 |
86.0(0.8) |
14.0(0.8) |
21.71 |
< 0.001 |
No |
60.9(0.2) |
39.1(0.2) |
|
|
89.0(0.2) |
11.0(0.2) |
|
|
|
Perceived health status |
Good |
61.2(0.3) |
38.8(0.3) |
29.05 |
< 0.001 |
89.5(0.2) |
10.5(0.2) |
22.29 |
< 0.001 |
Average |
60.8(0.4) |
39.2(0.4) |
|
|
88.0(0.3) |
12.0(0.3) |
|
|
Poor |
66.1(1.0) |
33.9(1.0) |
|
|
88.1(0.8) |
11.9(0.8) |
|
|
|
Physical activity |
Yes |
61.2(0.4) |
38.8(0.4) |
0.03 |
0.878 |
89.1(0.3) |
10.9(0.3) |
1.98 |
0.207 |
No |
61.3(0.3) |
38.7(0.3) |
|
|
88.6(0.2) |
11.4(0.2) |
|
|
|
Weight control behavior |
Yes |
58.9(0.3) |
41.1(0.3) |
339.03 |
< 0.001 |
90.6(0.2) |
9.4(0.2) |
267.66 |
< 0.001 |
No |
67.5(0.4) |
32.5(0.4) |
|
|
84.9(0.4) |
15.1(0.4) |
|
|
Table 3Multivariable logistic regression analysis of factors for underestimation (N = 55,126).
Characteristics |
Unadjusted |
Adjusted†
|
|
OR (95% CI) |
OR (95% CI) |
Gender |
Men |
4.40 (4.21–4.59)*
|
5.26 (4.98–5.57)*
|
Women |
1.00 (reference) |
1.00 (reference) |
|
Age (y) |
19–29 |
0.62 (0.60–0.65)*
|
0.74 (0.70–0.78)*
|
30–39 |
1.00 (reference) |
1.00 (reference) |
|
Education level |
≤ High school |
1.21 (1.15–1.26)*
|
1.21 (1.15–1.28)*
|
≥ College |
1.00 (reference) |
1.00 (reference) |
|
Marital status |
Married |
1.41 (1.36–1.46)*
|
1.59 (1.50–1.68)*
|
Single |
1.00 (reference) |
1.00 (reference) |
|
Employment status |
Employed |
1.66 (1.59–1.73)*
|
1.00 (0.95–1.06) |
Unemployed |
1.00 (reference) |
1.00 (reference) |
|
Smoking status |
Currently smoking |
2.62 (2.50–2.74)*
|
1.13 (1.07–1.20)*
|
Ex-smoker |
2.73 (2.55–2.92)*
|
1.15 (1.06–1.24)*
|
Non-smoker |
1.00 (reference) |
1.00 (reference) |
|
Alcohol consumption |
Currently drinking |
1.36 (1.24–1.48)*
|
0.97 (0.88–1.08) |
Ex-drinker |
1.12 (1.00–1.25) |
1.25 (1.10–1.42)*
|
Non-drinker |
1.00 (reference) |
1.00 (reference) |
|
Breakfast consumption (d/w) |
≤ 4 |
1.00 (1.00–1.04) |
0.96 (0.92–1.01) |
≥ 5 |
1.00 (reference) |
1.00 (reference) |
|
Sleep duration (h/d) |
≤ 5 |
1.71 (1.53–1.90)*
|
1.15 (1.01–1.30)*
|
6–8 |
1.54 (1.40–1.70)*
|
1.13 (1.01–1.26)*
|
≥ 9 |
1.00 (reference) |
1.00 (reference) |
|
Perception of stress |
Yes |
1.04 (1.00–1.09) |
1.02 (0.97–1.07) |
No |
1.00 (reference) |
1.00 (reference) |
|
Perception of depression |
Yes |
0.80 (0.73–0.87)*
|
0.94 (0.85–1.03) |
No |
1.00 (reference) |
1.00 (reference) |
|
Perceived health status |
Good |
1.24 (1.13–1.35)*
|
1.25 (1.12–1.38)*
|
Average |
1.26 (1.15–1.38)*
|
1.32 (1.18–1.46)*
|
Poor |
1.00 (reference) |
1.00 (reference) |
|
Physical activity |
Yes |
1.00 (0.96–1.04) |
0.96 (0.92–0.99)*
|
No |
1.00 (reference) |
1.00 (reference) |
|
Weight control behavior |
Yes |
1.45 (1.39–1.52)*
|
2.05 (1.95–2.16)*
|
No |
1.00 (reference) |
1.00 (reference) |
Table 4Multivariable logistic regression analysis of factors for overestimation (N = 38,099).
Characteristics |
Unadjusted |
Adjusted†
|
|
OR (95% CI) |
OR (95% CI) |
Gender |
Men |
0.12 (0.10–0.13)*
|
0.09 (0.07–0.10)*
|
Women |
1.00 (reference) |
1.00 (reference) |
|
Age (y) |
19–29 |
1.53 (1.42–1.65)*
|
1.48 (1.33–1.63)*
|
30–39 |
1.00 (reference) |
1.00 (reference) |
|
Education level |
≤ High school |
0.91 (0.83–0.99)*
|
1.00 (0.91–1.11) |
≥ College |
1.00 (reference) |
1.00 (reference) |
|
Marital status |
Married |
0.77 (0.71–0.83)*
|
0.67 (0.60–0.74)*
|
Single |
1.00 (reference) |
1.00 (reference) |
|
Employment status |
Employed |
0.84 (0.78–0.91)*
|
1.03 (0.96–1.12) |
Unemployed |
1.00 (reference) |
1.00 (reference) |
|
Smoking status |
Currently smoking |
0.29 (0.26–0.33)*
|
1.15 (0.97–1.36) |
Ex-smoker |
0.32 (0.26–0.41)*
|
0.83 (0.66–1.05) |
Non-smoker |
1.00 (reference) |
1.00 (reference) |
|
Alcohol consumption |
Currently drinking |
0.70 (0.61–0.81)*
|
0.88 (0.75–1.02) |
Ex-drinker |
1.04 (0.87–1.24) |
1.04 (0.86–1.25) |
Non-drinker |
1.00 (reference) |
1.00 (reference) |
|
Breakfast consumption (d/wk) |
≤ 4 |
1.02 (0.95–1.10) |
1.03 (0.96–1.11) |
≥ 5 |
1.00 (reference) |
1.00 (reference) |
|
Sleep duration (h/d) |
≤ 5 |
0.78 (0.65–0.93)*
|
0.97 (0.80–1.17) |
6–8 |
0.86 (0.74–0.99)*
|
1.02 (0.87–1.21) |
≥ 9 |
1.00 (reference) |
1.00 (reference) |
|
Perception of stress |
Yes |
0.99 (0.92–1.07) |
0.93 (0.84–1.01) |
No |
1.00 (reference) |
1.00 (reference) |
|
Perception of depression |
Yes |
1.32 (1.16–1.51)*
|
1.21 (1.05–1.39)*
|
No |
1.00 (reference) |
1.00 (reference) |
|
Perceived health status |
Good |
0.87 (0.74–1.01) |
0.91 (0.77–1.07) |
Average |
1.01 (0.87–1.18) |
0.99 (0.84–1.17) |
Poor |
1.00 (reference) |
1.00 (reference) |
|
Physical activity |
Yes |
0.96 (0.89–1.03) |
1.02 (0.95–1.10) |
No |
1.00 (reference) |
1.00 (reference) |
|
Weight control behavior |
Yes |
0.58 (0.54–0.63)*
|
0.41 (0.38–0.44)*
|
No |
1.00 (reference) |
1.00 (reference) |