Body image distortion among Brazilian and Portuguese women with children: A comparative study between the ELSA-Brasil and Generation XXI cohorts

Prev Med. 2022 Nov;164:107316. doi: 10.1016/j.ypmed.2022.107316. Epub 2022 Oct 20.


Solid evidence indicates that body image distortion is associated with various physical and mental health problems in women (e.g. Lee and Lee, 2016; Mölbert et al., 2017; Raj and Ploriya, 2020; Sagar, 2005; Shin et al., 2015). Furthermore, body image has been shown to vary according to life context and stage, particularly after a woman has had children. This scenario justifies the comparison between different countries and cultures. The objective of the present study was to evaluate the prevalence and associated factors of body image distortion/accuracy in Brazilian and Portuguese women with children. The study assessed women selected from two epidemiological cohorts: ELSA-Brasil in Brazil (n = 1468) and Generation XXI in Portugal (n = 3380). The data analyzed were based on multidimensional questionnaires from which sociodemographic and family characteristics as well as data associated with lifestyle and health were obtained. The results show that most women in both cohorts had an accurate perception of their own body size. In cases of distorted self-perception, the likelihood of the Brazilian women perceiving themselves as being heavier was greater if they had had cancer, whereas the Portuguese women were less likely to perceive themselves as heavier when they had less schooling. Perceiving themselves as thinner than they actually are, was associated with poorer self-perception of their own state of health in the Brazilian women and with poorer schooling in both the Brazilian and Portuguese women. The present findings contribute towards improving understanding of the influence of body image distortion on the health and wellbeing of Brazilian and Portuguese women, possibly leading to the implementation of health-promoting policies in both countries.

Keywords: Body image; ELSA-Brasil cohort; Epidemiology; Generation XXI cohort; Women's health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Image*
  • Brazil / epidemiology
  • Child
  • Ethnicity*
  • Female
  • Humans
  • Life Style
  • Longitudinal Studies
  • Portugal