The Correlation between Body Mass Index and Self-Esteem Among Children Ages 9-12 Years Old in A Public Elementary School in Makati City, Philippines

 

Jerickson Abbie S. Flores1aJana F. Fragante1a*Jan Jorge M. Francisco1aJan Paolo P. Dipasupil1aPatrick Steven D. Damaso1bAlfonso L. Gutierrez1bKristian Kent T. Dela Guerra 1bMarckie M. Escudero1bRoyce Ann G. Estella 1bMa. Katrina A. Evasco 1bShaena Gayle S. Galang 1bJeffrey M. Humarang 1bMa. Luisa Villavicencio 1bRogin S. Sison 1b 1aPrincipal Investigators
1bCo-Investigators
1Department of Medical Education and Research, Section of Community Medicine, Makati Medical Center, Makati City, Philippines

*Corresponding Author:Habib Y, Department of pediatrics, Alexandria Police Hospital, Egypt, TEL:(03) 3921595 ; FAX:(03) 3921595 ;E-mail:yossefhabib@yahoo.com

Citation:Jerickson Abbie S. Flores, Jana F. Fragante, Jan Jorge M. Francisco, Jan Paolo P. Dipasupil, Patrick Steven D. Damaso, et al. (2017) The Correlation between Body Mass Index and Self-Esteem Among Children Ages 9-12 Years Old in A Public Elementary School in Makati City, Philippines. Pediatr Primary Physic 1:105.

Copyright: : © 2017 Jana F. Fragante, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Received date:November 18 2017; Accepted date:December 11, 2017; Published date:December 14, 2017

Abstract

Introduction: Malnutrition is one of the rapidly growing health problems affecting the world at present. Children affected are not only at risk for significant health problems, but also face many psychological and social consequences, including low self-esteem. School age children are specifically vulnerable to develop poor self esteem specially when their peers find them physically unattractive. Thus malnutrition, whether obesity or undernourishment, plays a significant role.

Objectives: This research aims to determine if there is a significant difference on the level of self-esteem among Filipino children ages 9-12 years old with abnormal body mass index (BMI) and those children with desirable BMI.

Methodology: Using a cross-sectional study design, the correlation between body mass index (BMI) and self-esteem was observed among children ages 9-12 years old. Participants took the Hare self esteem questionnaire, which is specifically designed to measure self-esteem in school age children. The lowest possible score is 15 and the highest possible score is 45. A total of 1140 students with ages 9-12 years old from Cembo Elementary School (public school) participated in the study.

Results and Conclusion:Among the participants, 239 out of the 1140 have desirable body mass index, 878 are underweight, and 23 are overweight. Using the test questionnaire, the computed mean scores were 36.599, 36.045 and 36.583 for normal, underweight and overweight categories respectively. Using Pearson’s Correlation Test and Spearman’s Correlation Coefficient Test, the study showed positive correlation (p value of 0.047 and 0.004 respectively) between BMI and Self-esteem scores which implied that the higher the BMI, the higher the self-esteem of the participants. However, ANOVA done showed no sufficient evidence that the three groups have different self-esteem scores.

Introduction

Scientific significance

Malnutrition is one of the growing health problems affecting the world at present. Malnourished children are not only at risk for significant health problems, but are also faced with many psychological and social consequences, including low self-esteem. The FNRI, (Food and Nutrition Research Foundation), recently published a study stating that 27 out of 100 Filipinos aged 20 and above are overweight (23.9%), 2 out of 10 children aged 5 years old and below are overweight (1.4%), while 2 out of every 100 children aged 6 to 10 are overweight as well (1.3%). The nutritional study, found that the prevalence of obesity has been increasing since 1998 and of more practical value was the clear observation that the rates of co-morbidities (diabetes, hypertension, elevated serum total cholesterol, LDL-cholesterol and triglycerides) rose with increasing BMI. Another study conducted by Dr. Richard S. Strauss of the University of Medicine and Dentistry of New Jersey in New Brunswick studied 1,520 children from the National Longitudinal Survey of Youth. He looked at their weight and a variety of other factors at ages 9 to 10, and again at ages 13 to 14. The results showed that there is a significant relationship between obesity and changes in self-esteem during early adolescence, noting the increased feelings of sadness, loneliness, and nervousness among those whose self-esteem decreased.

The objective of the study is to determine the effects of different body mass indexes (underweight, normal, overweight) on the level of confidence of children 9-12 years of age. A standardized validated questionnaire was given to the selected participants in order to determine the level of their self-esteem. Their corresponding BMI was meaured and computed by the researchers.

Statement of the Problem

Is there a significant difference on the level of self-esteem among Filipino children ages 9-12 years old with abnormal body mass index (BMI) classification and children with normal BMI?

Research Goals and Objectives

General Objective

The general objective is to determine if there is a significant difference on the level of self-esteem among Filipino children ages 9-12 years old with abnormal body mass index (BMI) classification and children with normal BMI.

Specific Objectives

1. To determine the body mass index (BMI) of Filipino children ages 9-12 years old in a public elementary school in Makati and correlate their level of self esteem based on the validated Hare self esteem questionnaire.

Research Hypothesis

Ho: There is no significant difference between the level of self esteem of Filipino children ages 9-12 years old with abnormal body mass index (BMI) classification and children with normal BMI.

Ha: There is a significant difference between the level of self esteem of Filipino children ages 9-12 years old with abnormal body mass index (BMI) classification and children with normal BMI.

Conceptual Framework

Figure 1: Conceptual Framework.

Scope of the Study

The study focused on children ages 9-12 years old of Cembo elementary school as the study population, Standardized self-esteem questionnaire as the intervention, and self-esteem scores as outcome.

Definition of Terms

Body Mass Index (BMI): It is defined as the individual's body weight divided by the square of the height. It does not actually measure the percentage of body fat, but is used to estimate a healthy body weight based on a person's height [1-4].

Self-Esteem: stable sense of personal worth or worthiness that is closely related to the discrepancy between your self-image and your ideal self.

Methodology

Research Design

The research study design is cross-sectional. Participants’ BMI was computed according to their weight and height, and they were asked to answer the standardized Hare’s self-esteem questionnaire. The answer to the said questionnaire was properly evaluated according to its standardized scale.

Sample Population

The study population involved children ages 9 to 12 years old, male and female. The total population was categorized into Normal, Underweight, and Overweight, depending on their computed BMI using the formula:

BMI= mass(kg)/ height2(m2)

Inclusion criteria are the following:

• Children ages 9 to 12 years old, Male or Female

• With parents that signed the Informed consent

• Ability to read and understand English / Filipino

Exclusion criteria:

• Children who have deformities, physically and mentally challenged. (e.g. children with ADHD syndrome, deaf, blind).

The sample population chosen for this study is composed of students from Cembo elementary school ages 9-12 years old.

Testing Instrument

The testing instrument was a questionnaire that included items designed to elicit information regarding self-esteem. HARE SELF-ESTEEM SCALE (cited in Corcoran and Fischer 1987), which is specifically designed to measure self-esteem in school age children. The questionnaire was scored numerically using 1, 2 and 3: 1 is the lowest indicator of self-esteem; 2 is the middle indicator; 3 is the highest indicator. Therefore, the lowest possible score is 15 and the highest possible score is 45. [1] suggests that the mid-line of low and high self-esteem should be taken from the actual scores attained not the total range of possible scores.

Physical assessments included such as the height (in meters) and weight (in kilograms) measured on calibrated instruments.

Results and Discussion

A total of 1140 students with ages 9-12 years old from Cembo Elementary School (Public School) participated in the study. Based on the Body Mass Index Classification, 239 out of the 1140 participants have normal or optimal weight; 878 are underweight and 23 are overweight. (Figure 3)

Figure 3: BMI Classification of students age 9-12 years old.

All the 1140 participants answered the standardized Hare’s self-esteem questionnaire. The mean score of the standardized Hare’s self-esteem questionnaire was computed based on the students’ BMI Classification. The computed mean scores were 36.599, 36.045 and 36.583 for normal, underweight and overweight categories respectively. (Figure 4) (Table 1)

Figure 4: Mean scores of Students 9-12 years old in the Hare’s self-esteem questionnaire according to BMI classification.

Table 1: Pearson’s Correlation Test and Spearman’s Correlation Coefficient Test on BMI and Self –esteem scores.

  Pearson's correlation coefficient test (parametric test):Spearman's correlation coefficient test (non parametric test):
Observed value 0.078 0.112
Two-tailed p-value 0.047 0.004
Alpha 0.05 0.05

Conclusion: At the level of significance Alpha=0.050 the decision is to reject the null hypothesis of absence of correlation. In other words, the correlation is significant.

The study showed that there is a weak positive correlation between BMI and Self-esteem scores. This implies that the higher the BMI, the higher the self-esteem of the participants. Children who are underweight have a lower total mean score in the Hare’s self-esteem questionnaire. (Table 2)

Table 2: ANOVA and Post Hoc Analysis (Tukey’s HSD) of Mean Scores based on BMI Classification.

Tukey (HSD)/ Analysis of the difference between groups with a confidence range of 95.00%

Categories Difference Standardized difference Critical Value Pr.>Diff Significant
2~1 0.554 1.453 2.349 0.314 No
2~3 0.015 0.013 2.349 1.000 No
3~1 0.539 0.467 2.349 0.887 No

Tukey’s critical value: 3.322

However, when ANOVA was done to compare the Self-esteem scores of the different BMI classifications, there is no sufficient evidence that the three groups have different self-esteem scores.

Conclusion and Recommendations

This study showed that there is a weak positive correlation between BMI and Self-esteem scores. This denotes that the higher the BMI, the higher will be the self-esteem of the children. Children who are underweight have a lower total mean score in the Hare’s self-esteem questionnaire. Nonetheless, when ANOVA was done to compare the Self-esteem scores of the different BMI classifications, there is no sufficient evidence that the three groups have different self-esteem scores.

The authors of this paper would like to recommend that further researches be done to investigate the relationship between the degree of malnutrition and the level of self-esteem. The same study may also be conducted in a private school setting and may include greater number of participants who are under the categories of overweight and obese. Comparison between males and females may also be performed. Results of the studies may also be used as a guide by the children’s parents, psychologists or guidance counselors in the prevention of depression and other mental health problems triggered by poor self-esteem.

Acknowledgements

Approximately six thousand and five hundred pesos (P 6,500) will be allocated for this research

References

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  3. Metapsychology Online Reviews (2007) Obese Children at Increased Risk For Low Self-Esteem
  4. Wikipedia (2010) Self-Esteem, Body Mass Index.
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