2

THE EFFECT OF PHYSICAL ACTIVITY IN SOUTHERN

CALIFORNIAN ADOLESCENTS AND HOW IT IMPACTS
THEIR OVERALL QUALITY OF LIFE

Running Head: Affects of physical activity on weight and overall health

among adolescents

Authors:
Lourdes Bautista
Adrianna Bautista
Gabriela Monzonnn
Anna Maria Pelcastre
School of Exercise and Nutritional Sciences, San Diego State University,
San Diego, CA 92182

Corresponding Author:
Mee Young Hong, PhD
Department of Exercise and Nutritional Sciences
San Diego State University
5500 Campanile Drive
San Diego, CA 92182-7251
(619) 594-2392
mhong2@mail.sdsu.edu

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Abstract
Objective
Evaluate the relationship between physical activity, food choice and body self-perception
in Southern California, teenage male and females and how they correspond with BMI.
Methods
Over one thousand three hundred Southern California male and female teenagers were
recruited by students from San Diego State University to participate in a survey that had
different questions that pertained to age, gender, weight, body image, physical activity
and the frequency of consumption of certain foods. In order to administer these surveys,
the students from San Diego State University were required to be certified by SDSUs
Institution Review Board. Once the data was collected, all of the data was inputted into
spreadsheets and was then reviewed once more for accuracy. The statistical analysis was
performed using chi-squared, independent sample T-tests and IBM SPSS software.
Results
The males and females in this study had an average age of 15.82 years and the average
weight for females was 128.22 pounds and the average weight for the males was 153.22
pounds. For both the male and female populations there average BMI was within the
normal ranges. (p<0.001) However, the females categorized themselves more in the
slightly overweight category or very fatty category and the data showed a significant
difference in that the female intake of salad (p<0.000), green vegetables (p<0.000),
yellow vegetables (p<0.018), cruciferous vegetables (p<.0.002), other vegetables
(p<0.007), and fruits (p<0.016) was much higher than that of the male consumption of
these certain foods. Even though this is so, the data still showed that the male population
exercised longer per day (p<0.001) and had more physical activity per week (p<0.000)
than the female population.
Conclusion
In summary, it was found in this study that the males did not have a positive influence in
their choices food even though they were physically active. The males who were
physically active preferred foods that had a high caloric intake and drinks that had a high
fat or sugar content. The females on the other hand opted for the more healthy choices of
food but more of the females in this study categorized themselves as being in the slightly
overweight or fatty category.
Key words: BMI; body image; teenagers; survey; food choice; exercise

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Introduction
In the United States, being overweight and obesity has been growing at an
alarming rate in adults, adolescents and even in children. According to the American
Academy of Pediatrics (AAP), overweight is defined as having a body-mass index (BMI)
above the 95th percentile for children of the same age and sex [1]. Hence, children and
adolescents who possess a BMI greater or equal to the overweight category will have a
greater risk of suffering from diseases associated with adult obesity.
For example, in the article Overweight in Childhood and Adolescence, by
William H. Dietz, M.D., Ph.D, reveals that children are more susceptible in experiencing
elevated blood pressure, hyperlipidemia, hyperinsulinemia, and type 2 diabetes mellitus
[2]. As a result, if the main purpose of todays society is to protect the well being of the
young generation, the main goal should be to create a healthy America by decreasing
obesity among children and adolescents [4]. Therefore, it is important to identify the
populations who are at greater risk of being overweight, their food preferences, and
activity level so that an intervention can take place that would have a positive effect on
their health.
To begin with, studies have demonstrated that food preference is a major
contributor to obtaining and maintaining a healthy life. Unfortunately, in the study Age
and gender differences in childrens food preference, by Lucy J. Cooke and colleagues
exposes that the Top 10 foods in children are French fries, chocolate, pizza, cake and ice
cream, just to name a few. Besides revealing the most preferred food choices in children
from ages 4 to 6, Lucy and colleagues uncovered that age and gender were influencing
factors to food choices; Girls tend to like fruit and vegetables more than boys [3].

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Likewise, in the newsletter, Todays Dietician, also makes known that, in a national
random sample of 3,022 infants and toddlers a two day recall was done and 18% to 33%
of toddlers consumed no discrete servings of fruits or vegetables; thus, not meeting their
recommendations [4].
Moreover, not only does food choice affect the health and weight status of
children, but differences in physical activity involvement between genders are also a
major contributor to weight. For instance, in the study, Physical Activity and BMI in a
National Representative Sample of Children and Adolescents, conducted by Arlene E.
Chung and colleagues discovered that adolescents who were classified as under or
healthy weight, tended to have more physical activity than overweight and obese
children. The study also found that generally boys were inclined to be more involved in
physical activity than girls. This study showed that the BMI status was related to physical
activity levels for both boys and girls in childhood and adolescents. However, the study
also found that as children get older, their physical activity decreases [5].
In the study, Associations of Body Mass Index and Obesity with Physical
Activity, Food Choices, Alcohol Intake, and Smoking in the 1982-1997 FINRISK
Studies, by Marjaana Lahti-Koski, this study illustrated that men and women who had
good general health, leisure-time, physical activity, and daily vegetable consumption
were inversely related with obesity [6].
Furthermore, it has been uncovered that body image among girls, especially
among overweight and obese girls, tends to be a major influence in implementing or
hindering physical activity engagement. For example, in the study by Li-Jung Chen,
Body image and physical activity among overweight and obese girls in Taiwan,

6
presents a total of 13 overweight or obese girls, BMI ranging from 23.6 to 31.6, who
express their perception of an ideal body as well as stress their dissatisfaction with their
own body. Interestingly, most of the girls reported that they exercised. However, their
exercise techniques were not sufficient for weight loss [7].
In another study, Body esteem in Chinese adolescents: Effects of gender, age and
weight, conducted by Kwok-Kei Mak et al it shows that boys have a higher body selfesteem than girls but in the study, Body-Esteem Scale for Adolescents and Adults, by
Mendelson BK this study revealed that more girls than boys were more preoccupied with
weight status but they tend to have low self-esteem appearance and body esteem
concerning their weight and this remained the same at any age group [8,9].
The objective of this study was to look at the relationship between physical
activities, food choice, and body self-perception, and how they correspond with BMI, and
to see if there are gender differences between and within findings. As a result, it was
hypothesized that adolescents who had an increased level of physical activity will have
positive influences on their food choices and this will have an inverse relationship on
BMI and adolescents who view themselves as heavy will eat healthier food choices.
Methods
Subjects
Over one thousand and three hundred students from southern California were
recruited to participate in the survey. The recruitment was performed by SDSU
undergraduate students from nutrition 302 lab, spring 2013.The locations visited to
perform the surveys were public high schools, church groups, sports camps and after
school programs. The ages of the participants ranged from fifteen to seventeen years old.

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Both males and females were allowed to participate in the survey and were required to
answer the questionnaire individually. Also, the participants were from different ethnic
groups and no specific characteristics such as life style or level of fitness were required.
Survey Approvals
The San Diego State University Institution Review Board must approve the
survey before anything could be done. Without its approval, the study could not be
initiated. Once approval was obtained, the main investigator was contacted concerning
approval. The main investigator then had to obtain approval from school principals,
teachers, pastors and youth coordinators. Finally, approval consent was obtained from
parents and participants in this survey.
Survey
The survey was divided into five different sections. Questions one to seven were
based on demographic information. This information included Age, gender, ethnicity,
weight, height and years of residence in the United States. The second portion of the
survey got information about life styl regarding dietary habits, exercise and physical
activity level, as well as body image perception. The third portion of the survey was to
obtain information about engagement in particular behaviors. The questions asked
participants what the type of clothes they regularly wore, food restrictions, socialization
and food, and the use of revealing clothes, such as bathing suits, tank tops or shorts.
The fourth section of the survey focused on Dietary information pertaining to how
many meals the student ate per day, if they skipped meals and the main reason for
skipping them, the type of snacks they would eat and how often they are consumed.
Finally, the fifth portion of the survey included a food frequency questionnaire, which in

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turn included six different types of foods. Also, the frequency varied in numbers of
consumption per day, week, month and year; and only one check mark was allowed per
food ingredient.
The first group of food was grains and main dishes; some examples were rice,
breakfast cereal, bread, flour tortilla and noodles. The second group of food was tofu and
starches; for example, sweet potato, and legumes, group three covered meat, egg and fish.
Group four asked about consumption of vegetables and fruits and group five questioned
about dairy products. Finally, the last group of food or questions asked information about
fats such as honey, sweets, mayonnaise and peanuts as well as types of beverages like tea,
coffee and sodas.
Experimental Design
At least six hundred or more teenager students from southern California were
needed to answer a four-page survey. No specific requirements or backgrounds about the
participants were required as long as they met the age category of this study, which were
ages thirteen to eighteen years old. The survey entailed a variety of questions to support
the main goal of the study while being able to test the hypothesis at the same time.
Therefore the design of the questionnaire was meant to obtain information to calculate
the BMI of the participant as well as his or her physical activity level. These levels were
identified as three different categories since the frequencies were distributed according to
thirds. The bottom 33 percentile pertained to the low physical activity level or those
individuals who exercised less than 180 minutes per week. The middle 33 percentile
belonged to the moderate physical activity level or those who exercised from 181 to 480
minutes per week and the upper 33 percentile belonged to the high physical activity level

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or those who exercised more than 481 minutes per week respectively. Also these
categories helped to target possible correlations with body self-image among the
participants.
The food choice was measured by a food frequency questionnaire and compared
with the USDA dietary guidelines. Finally, after obtaining the necessary information, the
data was organized and saved in a Microsoft Excel document and later analyzed using
statistic methods such as Chi-squared, Independent Sample T-test and IBM SPSS
software.
Protocols of the Experiment
The survey was conducted by undergraduate students in the nutrition 302 lab from
San Diego State University. They were required to complete the Institution Review Board
tutorial training after receiving an in class preparation from the main study investigator.
After obtaining the perspective approvals and consent forms from parents and student
participants, teams of three to four survey administrators were assigned different groups
to conduct the survey. Once in the location, they introduced themselves while passing out
individual surveys for each participant and gave a brief but clear presentation of how was
the survey to be filled out. After the subjects completed their questionnaires, the survey
administrators collected the forms, put them in envelops and turned the data in to the
main investigator at San Diego State University. Once all the data was gathered, a second
group of the same trained SDSU students, numbered every single survey and typed all the
data entry in the already set Microsoft excel document. Finally, once the data entry was
done and revised for accurateness, the statistical analysis was performed using Chi-

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squared, Independent Sample T-test and IBM SPSS software. The graphs and chart were
designed in order to ease the interpretation of the final results.
Statistical Analysis
In order to evaluate the relationship between physical activity, food choice and
body self-perception among the survey participants, three different statistical methods
were used. The first one was the Chi-squared method which was used to evaluate the
categories of physical activities, food choice and body image perceptions between
genders. The second one was the Independent Sample T-test method and it was used to
evaluate differences and frequencies in height, weight, age, BMI and exercise length
between genders. Finally the IBM SPSS software was also used to reinforce accurateness
of the analysis and the data as a whole.
Results
This study was conducted on 1,266 southern California male and female teenagers
in the span of 3 days to see the correlation between the amount of exercise, food choices
and body image. The survey results for this study showed that the average age of the
female and males in this study was 15.82 years old. (p>0.930) The average weight for the
males was 153.22lb and for the females was 128.22 lb (p<.000) & the BMI for both
populations for both the male and female population was within the normal range.
(p<.001)
In figure 1, it shows the average number of days that the southern California
teenage male and females exercise per week. This table showed that the number of days
exercised was higher in the male population. (p<.165) Figure 2 corresponds with this
table because it shows the amount of time that males and females exercise per day and as

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seen, the male populations exercise time is slightly higher and significantly different than
the female population in this study. (p<.001)
Figure 4 shows the ethnicity distribution among the female population in this
survey. Majority of the female population belonged to the Hispanic or White ethnic
group. The number of White females made up 43% of the population, the Hispanic
females made up 34% and the other 23% were African American, Asian or some other
ethnicity. The females in this survey as shown in figure 3, categorize themselves more
than males as slightly overweight or very fatty, however even though this is so, the male
populations exercise length per day (p<.001) and physical activity per week (p<0.000) is
higher than the female population and shows that there is a significant difference between
the two. More females categorize themselves in the slightly overweight or very fatty
category than the males do but more females have been reported a higher intake of salad
(p<0.000), green vegetables (p<0.000), yellow vegetables (p<0.018), cruciferous
vegetables (p<.0.002), other vegetables (p<0.007), and fruits (p<0.016). More males in
this study consider themselves to be in the fit category than females but it is reported that
the consumption of fattier foods and sugary drinks such as hamburgers (p<0.000), pizza
(p<0.040), whole milk (p<0.000) and regular soda (p<0.000) is significantly different
than the female population.

Discussion
When analyzing the results in the food choice consumption for both boys and
girls, it was exposed that males had a higher intake of cereal, hamburger, pizza, meat,
processed meat, eggs, and seafood (fish and shellfish). On the contrary, girls had a greater

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intake of fruits and vegetables; for example, green, yellow, and cruciferous vegies, to
name a few. Earlier research has also reported that healthier food choices and
consumption of fruits and vegetables in males is a lot less popular than in females [3]
In contrast, Perez-Rodrigo reported in his study that there were fewer gender
differences in the preferences of food choices of Spanish individuals from ages 2 to 24
years; however, with regards to childrens dislikes, vegetables were reported being least
preferred [4,11]. An explanation to why boys were more likely to consume high fat,
processed, and sugary foods may be linked to the notion that they do not view food as
affecting their body frame. On the contrary, girls who consume high vegetable and fruit
may be related to their perceived notion of health and body image [8].
The results in this study also showed that males had a higher weight and BMI
compared to girls, with a mean of 69.50 kg and 58.16 kg, as well as BMI of 23.17 and
22.06 respectively. Thus, results are coherent with the Statistical Fact Sheet 2013
Update that denotes that males weigh more than females; however, in the fact sheet it
demonstrates that there is a greater number of overweight or obese boys than there is
girls, 33.0% and 30.4% respectively. In spite of the results, the present study reveals that
even though males weighed more than girls they both fell under the normal weight
category, in terms of their BMI. A limitation of the study was that it did not categorize
ethnicities with the corresponding BMI or weight, which would allow comparison of
ethnicity differences and how it plays a role in BMI and weight [12].
When comparing exercise frequency between genders, the data from the study
illustrates that, on average, males spend more time in physical activity than females. For
instance, males exercise 548.53 minutes per week, whereas girls exercised 395.45

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minutes per week. The study by Chung, also found that children that were underweight or
had a healthy weight spent more time exercising than overweight, obese, and very obese
children, which supports the studys hypothesis that physical activity has an inverse
relationship with BMI. However, underweight children were less active than healthy
weight children in Chungs study. The results might be related to the acceptance of their
body frame and consider excess physical activity as unnecessary [5].
The study also found that males were more likely to be physically active than the
female counterparts in the same category. For example, the study found that the duration
of physical activity of males was 117.79 minutes compared to girls, which was 88.31
minutes. Corresponding with the results found in the study, Chung found that boys were
more physically active than girls [5].
Differences in physical activity levels between gender reveal that 41.9% of males
were physically active compared to 28.6% in females. The results correlate with Niclasen
study that showed that 26.3% of boys fell in the vigorous physically active category and
17.6% of girls fell in the vigorous physically active. However, there were differences
with this study and the study done by Niclasen regarding physical activity levels between
genders in the moderate physical activity category. In this study more boys were less
moderate physically active than girls, 34.1% and 36.8% respectively, whereas Niclasen
found that boys remained more moderate active than girls by 33.4% and 24.2%
respectively. The difference between boys and girls in the second category of physical
activity level (moderate physical activity) may come from the way that Niclasen obtained
and classified this category [10].

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To be classified as being involved in vigorous physical activity (VPA) individuals
must have had be breathing heavily and must sweat for a specific amount of time during
their workout. Being classified as moderate physically active, the individual must have
been physically active for at least 60 minutes for a specific amount of days. However,
classifying vigorous activity in terms of sweating can be misleading since people may
have different definitions to the term sweat. A person may define sweating as one who is
drenched in sweat, whereas others might consider sweating as soon as they feel their
body moist. Taking this into consideration, a person self-reporting the amount of sweat
during exercise can create improper categorization for physical activity level. Another
aspect to consider are that the individuals may have hyperhidrosis, which is a condition,
characterized by excessive sweating due to over hyperactive sweat glands. According to
Dr. Karamanoukian, 1% to 3% of the population is diagnosed with this condition and
because of this a person might self-report to have been vigorously exercising when they
could have really been in a different category [13].
When looking over at the differences in body image between genders, the study
concluded that majority of the males had a positive body image than girls. For example,
most boys perceived themselves as being fit than girls. However, more girls viewed
themselves as being little overweight than boys. Consequently, it has been revealed that
girls with body dissatisfaction leads to a lower motivation to exercise which can furtherer
contribute to increase weight, increase negative perception of body, and have lower selfesteem. Similarly, in the study conducted by Kwok-Kei Mak the outcomes of this study
done are consistent with the findings that boys tend to have higher self-esteem than girls
since they are not as pressured have a slender body [8].

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The relationship between poor self-esteem and higher BMI in girls does not
correlate with the present study since their mean BMI is under ideal body weight. A
hypothetical explanation of these differences can be associated with the distorted ideal
body perception that young girls are being bombarded with the media, peers, strict
parents, and coaches, which are constantly enforcing the notion that a girls waist
circumference should be as small as possible so that they can be more popular, beautiful,
look healthier, and/or be recruited in sports [7,9].
In conclusion, the study found that boys who were physically active did not have
a positive influence in their food choices since they preferred foods that had a high
caloric value and high contents of fat and sugar. On the other hand, girls that were
physically active opted for healthier foods and had an ideal BMI. Interestingly, the study
found that boys were more physically active, in terms of time and level, than girls; yet,
boys tended to have a slightly higher BMI. This study did find that an increase in physical
activity negatively influenced BMI for both boys and girls since the mean of the students
BMI fell in the ideal range. Nevertheless, the study lacked to demonstrate the effects of
meal frequency and meal skipping on BMI.

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References:
1. http://www.aap.org
2. Dietz H. W, Overweight in Children and Adolescence. N ENGL J MED, 2004;9:
855-857.
3. Cooke J. L, Wardle J, Age and Gender Differences in the Childrens Food
Preference. British Journal of Nutrition, 2005; 93: 741-746.
4. Palmer S, RD, Raising Healthy Eaters Through Balance and Variety. Todays
Dietician, 2009; 10: 32-37.
5. Chung A, Steiner M, Skinner A, Perrin E, Physical Activity and BMI In a
Nationally Representative Sample of Children and Adolescents. Clinical
Pediatrics, 2012; 51(2): 122-129.
6. Lahti-Koski M, Pietinen P, Helivaara M, Vartiainen E, Associations of Body
Mass Index and Obesity with Physical Activity, Food Choices, Alcohol Intake,
and Smoking in the 1982-1997 FINRISK Studies,1,2,3. Am J Clin Nutr, 2002;75
(5): 809-817.
7. Li-Jung Chen , Kenneth R. Fox, Anne M. Haase, Body Image and Physical
Activity Among Overweight and Obese Girls in Taiwan. Women's Studies
International Forum, 2010; 33: 234-243.
8. Mak K., Pang J., Ho R., Lai C. Body Esteem in Chinese Adolescents: Effect of
Gender, Age, and Weight. Journal of Health Psychology; 2013 18(1): 46-54.
9. Mendelson B., Mendelson M., White D. Body-esteem scale for adolescents and
adults. Journal of Personality Assessment; 2001 76(1): 90-106.
10. Niclasen B., Petzold M., Schnohr C. The Association Between High Recreational
Physical Activity and Physical Activity as a Part of Daily Living in Adolescents
and Availability of Local Indoor Sports Facilities and Sports Clubs. Scandinavian
Journal of Public Health; 2012 40(7): 614.
11. Perez-Rodrigo C. Ribas L., Serra-Majem L, Aranceta J. Food Preferences of
Spanish Children and Young People: The en kid study. Eur J Clin Nutr; 2003 57,
S45-S48.
12. Statistical Fact Sheet 2013 Update. Overweight and Obesity.
http://www.heart.org/statistics
13. Six Things You Didnt Know About Sweat: Find Some Surprising Facts About
Why, When, and How We Perspire. http://www.mnn.com/health/fitness-wellbeing/stories/6-things-you-didnt-know-about-sweat. 4 October 2011. Visited on 5
May 2013.