There are three key strategies for an obese person to loss weight. Topic sentence ( diet ) write information from the article.One supporting point for the first topic sentence from the article to support your topic sentence.(Quote as an evidence from the article) Topic sentence ( exercise ) write information from the articleOne supporting point for the second topic sentence from the article to support your topic sentence.(Quote as an evidence from the article) Topic sentence ( harmful things ) information from the articleOne supporting point for each third and fourth topic sentence from the article to support your topic sentence.(Quote as an evidence from the article) You will write the concluding sentence. Each source cited in the outline must have a References page entry.Link that shows you how to do the refrence page in case you didnt know how to do it: write four main ideas with supporting points from the four articles. Follow the above order and ideas.Each supporting point should have connected to it in the form of a quote or paraphrase (what you will use as your quote sandwich later). Include a citation for each piece of evidence.: Each source cited in the outline must have a References page entry.CLINICAL INQUIRIES From the Family Physicians Inquiries Network How do exercise and diet compare for weight Evidence-based answer Exercise alone produces short-term weight loss that is comparable with that induced by diet, after which a plateau in weight loss appears to occur (strength of recommendation [SOR]: B). Exercise in combination with diet promotes maintenance of weight loss above either intervention alone in both obese and overweight men and women (SOR: A). Exercise-induced weight loss has been Clinical commentary shown to preferentially reduce abdominal fat and increase lean skeletal muscle compared with that induced by diet (SOR: B). Multiple short bouts of exercise per day are as effective as a single long bout in producing weight loss (SOR: B). Adherence improves when exercise can be completed at home or home equipment is used (SOR: B). The real challenge: Motivating patients to exercise The evidence is pretty clear. The real challenge is motivating patients to start and maintain an exercise plan. The key points I make with my patients are: Aim for 5 to 7 times each week. Start slowly I Evidence summary Exercise vs diet: Some conflicting results Studies comparing the effectiveness of exercise and diet in weight reduction have yielded conflicting results. Earlier studies, including a meta-analysis and randomized (noncontrolled) study, favored interventions that included caloric restriction (diet alone or diet plus exercise).^^ However, subjects on caloric restriction regained a significant amount of weight over time (0.9 kg 7.7 at 2-year follow-up). Subjects who did (10 minutes per session) and gradually build (at least to 20 minutes within a few months). Walking is often preferred, but do what you enjoy. Having a buddy work out with you may help you stick with it. Henty Domke, MD St. Marys Health Center, Jefferson City, Missouri aerobic exercise but did not diet lost less weight initially (0.7 kg 2.8) but maintained their weight loss better than those who dieted or dieted with exercise. These earlier studies failed to control for the confounding variable of energy balancethat is, ensuring the amount of calories reduced was comparable with the amount of calories burned through exercise between groups. A more recent randomized controlled trial suggests that aerobic exercise and caloric restriction are equally beneficial in reducing weight for obese men when controlling for negative energy balance.^ However, Stephanie Cudjoe, MD and Shannon Moss, PhD Baylor Family Medicine Residency at Garland, Garland, Texas Loan Nguyen, MD Baylor College of Medicine, Houston, Texas FAST TRACK Exercise alone is comparable with diet for short-term weight loss www.jfponline.com VOL 56, NO 10 / OCTOBER 2007 841 CO UJ cc O < o o How much exercise is best? Government agencies weigh in PHYSICAL ACTIVITY LEVEL Moderate Vigorous (altemative)! DHHS NHLBI Moderate Moderate ACTIVITIES Bicyciing 5-9 mph, level terrain or with a few hills, brisk walking, golf, mowing lawn, recreational j swimming, scrubbing floors/washing windows, tennis (doubles), weight lifting/Nautilus machines/free weights Bicycling more than 10 mph or on steep uphill terrain, circuit training, moving/pushing furniture, mowing lawn (hand mower), racewaiking, jogging, running, swimming laps, tennis (singies) Bicycling (<10 mph), dancing, golf, hiking, light gardening/yard work stretching, walking (3.5 mph), weight iifting (general light workout) Basketball, bicyciing 5 miies/30 min, gardening, running 10 min/mile, social dancing, swimming laps, walking 15-20 min/mile DURATION 30 min FREQUENCY 5 or more days/week NOTES Ail adults 20 mm 60-90 min 30 min 3 or more days/week Daiiy Daily All adults All adults attempting to lose weight Ali adults FAST TRACK Exercising at homeor with a buddyshould help patients adhere to their regimen those who exercised experienced greater fat reduction and maintenance of skeletal muscle mass than those who only restricted calories. Similar findings regarding fat reduction have been reported elsewhere.* Combining diet and exercise appears to be superior to diet alone, based on the results of a recent meta-analysis of randomized controlled trials.^ However, this meta-analysis did not specify type of exercise, so it is unclear whether outcomes varied by activity. Exercise: is there a dose-response relationsiiip? Several studies have looked at the relationship between duration and intensity for exercise and weight loss. A doseresponse relationship has been observed between the amount of time spent in aerobic exercise per week and the amount of weight lost for overweight women.^^ There appears to be no significant difference in weight loss based on duration of a single aerobic exercise episode; rather, weight loss is similar whether completed in short or long bouts.^-^ One study found that at 12 months, individuals exercising more than 200 minutes per week lost 7.8 kg more (P<.01) than those exercising less than 150 minutes per week.^ Another study noted that at 18 months, subjects exercising more than 200 minutes per week lost 9.6 kg more than subjects exercising less than 150 minutes per week (P<.05).* Studies with energy expenditure, rather than time spent exercising, as the independent variable had similar results. At 18 months, individuals with higher energy expenditure (2500 kcal/week) lost 6.7 kg 8.1 compared with a mean loss of 4.1 8.3 in subjects with lower energy expenditure (maximum of 1000 kcal/week).^ Recommendations from others The National Institutes of Healths National Heart, Lung and Blood Institute,’ the US Department of Health and Human Services, the Centers for Disease 842 VOL 56, NO 10 / OCTOBER 2007 THE JOURNAL OF FAMILY PRACTICE -e s s u r-e Patients should be counseled that this product does not protect against HIV intection.(AIDS) or other sexually transmitted diseases. IMPORTANT NOTEThis information is a BRIEF StJMMARY of the complete prescribing information (Instructions for Use) provided with the product and therefore should not be used as the basis for prescrltjing the product. This summary was prepared by deleting from the compiete Instructions for Use certain text, tables, arid references. The physician shouid be thoroughiy famiiiar with the complete Instructions for Use before using or prescribing this product. INDiCATIOhlS FOR USE: The Essure system is indicated for women who desire permanent birth controi (female sterilization) by biiaterai occiusion of the faiiopian tubes. CONTRAiNDICATIONS: The Essure system should not be used in any patient who: is uncertain about her desire to end fertility Can have only 1 micro-insert placed (inciuding patients with apparent contraiateral proximal tubai occiusion and patients with a suspected unicornuate uterus) Has previously undergone a tubal iigation Or any patient with any of the foiiowing conditions: Pregnancy or suspected pregnancy Delivery or termination of a pregnancy iess than 6 weeks before Essure micro-insert piacement Active or recent upper or iower pelvic infection Known aiiergy to contrast media or known hypersensitivity to nickei confirmed by skin test WARNINGS: The patient must use alternative contraception (cannot reiy on the Essufe micro-inserts for contraception) untii a hysterosaipingogram(HSG), which is performed 3 months post-micro-insert piacement, demonstrates satisfactory micro-insert iocation and tubai occlusion. During this time frame, the patient may be at an increased risk of ectopic pregnancy The EssuK procedure should be considered irreversibie. There are no data on the safety or effectiveness of surgery to reverse the Essure procedure. Any attempt at surgicai reversai wiil iikeiy require uterotubai reimplantation. Pregnancy foiiowing such a procedure carries with it the risk of uterine rupture and serious maternai and fetal morbidity and mortaiity The Essure micro-insert wiii conduct energy if directiy or closeiy contacted by an active eiectrosurgicai device, if this occurs, then there is a risk of patient injury. Theretore, eiectrosurgery shouid be avoided in procedures undertaken on the uterine cornua and proximai fajiopian tubes without either hysteroscopic visuaiization of the micro-inserts, or visuaiization of the proximai portion of the faiiopian tube via open surgical procedures or laparoscopy. During Laparoscopic Assisted Vaginai Hysterectomy (LAVH) and other procedures in which electrosurgicai instruments couid contact the serosa of the faiiopian tube, instruments should not be piaced more proximal than the ampuilary portion of the tube Bench studies suggest that endometrial abiation using radio frequency (RF) energy wili cause significant damage to surrounding tissue if an active RF instrument comes into direct contact with the Essure micro-inserts. Consequently, if using RF energy to perform endometrial abiation, direct contact with the Essure micro-inserts shouid be avoided. Ciobai auto-abiative systems that empioy RF energy should not be used in women with the Essure micro-inserts in piace Bencti and ciinicai studies demonstrated that thermal endometriai ablation of the uterus can be safely and effectiveiy performed with the Gynecare THERMACHOICE Uterine Baiioon System immediateiy foiiowing Essure micro-insert piacement. No specific studies have been conducted to evaiuate Essure expuision rates or contraception rates foiiowing fssure-THERMACHOICE procedures. No other thermal endometriai abiation teciinologies have been studied in conjunction with Essure There are no data regarding cryoabiation techniques or the use of iaser for endometriai abiation of the uterus with the Essure micro-inserts in place There are aiso no data regarding the use of endometrial ablation devices that operate at microwave frequencies with the Essure rtiicro-inserts in piace. The use of microwave energy near metallic impiants has been shown to pose significant risk of serious injury to patients. Use of microwave endometrial ablation devices near the Essure micro-inserts therefore should be avoided Aithough not reported in the ciinicai trials of the fssure system, there is a theoreticai increased risk of ectopic pregnancy in patients with the Essure micro-inserts, shouid they become pregnant A very smali percentage of women in the Essure ciinicai triais reported recurrent or persistent peivic pain, and oniy 1 Vi^oman requested device rerrioval due to pain. However, if device removai is required for any reason, it wiil iikeiy require surgery, inciuding an abdominai incision and generai anesthesia, and possibie hysterectomy Patients may decide, in future years, to undergo in vitro fertiiization (iVF) to become pregnant. The effects of the Essure micro-inserts on the success of iVF are unknown, if pregnancy is achieved, the risks of the micro-insert to the patient, to the fetus, and to the continuation of a pregnancy are also unknown PRECAUTIONS: Women should be counseled that: No contraceptive is 100% effective. Ectopic and intrauterine pregnancy can occur in contraceptive failure, even years after the procedure Data on the Essure micro-inserts beyond 5 years are not yet avaiiabie and may be different from current data Women who undergo steriiization at a reiativeiy young age are at greater risk of regretting their decision to undergo sterilization Any intrauterine procedure performed without hysteroscopic visualization following Essure microinsert impiantation couid interrupt the abiiity of the Essure micro-inserts to prevent pregnancy. Foiiowing such procedures, device retention and iocation shouid be verified by hysteroscopy, x-ray, or ultrasound. In addition, the presence of the Essure micro-inserts can invoive risks associated with intrauterine procedures that, at this time, have not been identified Performing endomefriat ablation irrimediately foiiowing piacement of Essure micro-inserts may increase the risk of post-ablation tubal sterilization syndrome, a rare condition that has been reported in women with a history of tubai steriiization who undergo endometriai ablation Testing to ensure safety and compatibiiity with magnetic resonance imaging (MRi) has been conducted using a 1.5 testa magnet. The Essure micro-inserts were found to be MR safe at this fieid strength. Test resufe at 1.5 tesia indicate zero magnetic force and RF heating of 0.6C in a phantom when a whoie body specitic absorption rate (SAR) of 1.3 W/kg was appiied. The presence of the micro-inserts produces an fvlR artifact, which wili obscure imaging of iocal tissue. The artifact is expected to be iarger at higher fieid strength ADVERSE EVENTS: A total of 745 women underwent the Essure procedure in 2 separate ciinicai investigations to evaiuate the safety and effectiveness of the fssuresystem (227 in the Phase II study and 518 women in the Pivotai triai). Some women underwent more than 1 procedure if successfui biiaterai piacement was not achieved in the initiai procedure. Placement of at least 1 Essure micro-insert was achieved in 682 women (206 in the Phase II study and 476 in the Pivotal triai). Adverse events, which prevented reiiance on the Essure device for contraception, were reported as foliows: failure to piace 2 micro-inserts in first procedure (14%), initiai tubai patency (3.5%), expuision (2.2%), perforation (1.8%), or other unsatisfactory device iocation (0.6%). Ail ot the patients who experienced tutial patency at the 3-month HSG were found to have bilateral occlusion at a repeat HSG performed at approximateiy 6 months after the Essure procedure. In addition, all of the patients wtio chose to undergo a second fssure procedure foiiowing a micro-insert expulsion achieved successfui micro-insert placement and were subsequently able to rely on the Essure micro-inserts for confraception. The most frequent adverse events and side effects reported as a result of the hysteroscopic procedure to piace the Essure micro-inserts were as foiiows: cramping (29.6%), pain (12.9%), nausea/vomiting (10.8%), dizziness/iightheadedness (8.8%), and bieeding/spotting (6.8%). Hypervoiemia occurred in <1% of cases. During the first year of reiiance on the Essure micro-inserts for contraception (approximately 15 months after micro-insert piacement). the foiiowing episodes were reported as at ieast possibly reiated to the fssuremicro-inserts: back pain (9.0%), abdominai pain (3.8%), dyspareunia (3.6%). Aii other events occurred in iess than 3% of women. PATIENT INFORfHATION: Please see Patient Information Booklet. PHYSICIAN INFORMATION: For complete prescribing information physicians should refer to the Cssure System Instructions for Use. Oonceptus Incorporated 331 East Eveiyn Avenue, Mountain View, CA 94041 USA Trademark of ETHiCON, INC. CC-0366 08Sep05F CO UJ O < o o Control and Preventions Healthy People 2010^^ recommend between 30 to 90 minutes of daily moderate physical activity, and that this activity be done at least 5 days a weekor even 7 days per weekdepending on whether a persons goal is weight maintenance or weight loss. Another option, offered by the CDC, is that people do 20 minutes of vigorous activity 3 days or more per week. All of the groups recommend staying within caloric intake requirements (TABLE). References 1. Miller we , Koceja DM, Hamilton EJ. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. IntJ Obes 1997; 21:941-947. 2. Skender M, Goodrick G, Del Junco D. Comparison of 2 year weight loss trends in behavioral treatments of obesity: Diet, Exercise, and Combination interventions. JAmer DietAssoc 1996; 96:342-346. 3. Ross R, Freeman JA, Janssen I. Exercise alone is an effective strategy for reducing obesity and related comorbidities. Exerc Sport Sci Rev 2000; 28:165-170. 4. Tsai A, Sandretto A, Chung Y Dieting is more effective in reducing weight but exercise is more effective in reducing fat during the early phase of a weight-reducing program in healthy humans. J Nut Biochem 2003; 14:541-549. 5. Curioni C, Lourenco P. Long-term weight loss after diet and exercise: a systematic review. Internat J Obes 2005; 29:1168-1174. 6. Jakicic J, Marcus B, Gallagher K, Napolitano M, Lang W. Effect of exercise duration and intensity on weight loss in overweight, sedentary women, a randomized trial. JAMA 2003; 290:1323-1330. 7. Jakicic J, Winters C. Lang W, Wing R. Effects of intermittent exercise and use of home exercise equipment on adherence, weight loss, and fitness in overweight women- a randomized trial. JAMA 1999; 282:1554-1560. 8. Schmidt W, Biwer C, Kalscheuer L. Effects of long versus short bout exercise on fitness and weight loss in overweight females. J Am Coll Nutr 2001; 20:494-501. 9. Jeffrey RW, Wing RR, Sherwood NE, Tate DF. Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Am J Clin Nutr 2003; 78:684-689. 10. National Institutes of Health, National Heart, Lung, and Blood Institute. Ciinicai Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. Obes Res 1998; 6:6-26. 11. Department of Health and Human Services. Dietary guidelines for Americans 2005 [Internet monograph]. Washington, DC: Department of Health and Human Services; 2005. Available at: www.health.gov/dietaryguideIines/dga2005/document/html/chapter4.htm. Accessed on September 4, 2007. 12. Healthy People 2010 [Web site]. Rockville, Md: Office of Disease Prevention and Health Promotion, US Department of Health and Human Services; 2002. Available at: www.healthypeople.gov/document/html/volume2/ 22physical.htm. Accessed on September 4, 2007.ISSN 2304-3415, Russian Open Medical Journal 2012; 1: 0308 1 Preventive medicine 2012, LLC Science and Innovations, Saratov, Russia www.romj.org Original article Do different groups have different risk factors for dieting and exercise as body management strategies? Behshid Garrusi, Mohammad Reza Baneshi, Fatemeh Amiri Kerman University of Medical Sciences, Kerman, Iran Received 17 October 2012, Revised 27 Oct 2012, Accepted 31 Oct 2012. 2012, Garrusi B., Baneshi M.R., Amiri F. 2012, Russian Open Medical Journal Abstract: Aim Body change strategies are activities that could be potentially harmful. Individuals may use different methods for achieving advertised ideal body. Some of demographic and psychosocial contributing factors could be affect decision regarding body management activities. In Iran there is a few research about this matter, therefore the aim of this study was exploring risk factors in body management. Materials and Methods In this cross sectional study, 400 people participated thatincluding general population, university students and body building clubs attainders. The self administrated questionnaire based on reliable sources of body image that evaluated its validity and validity. Statistical analysis was done by using central indexes and distribution and logistic regression. Data analysis was done by software of SPSS 16. Results Marital status, education, economic status, age and BMI had no relation with body management strategies. Birthplace effects on choose of diet and exercise. Gender is only had effect on exercise choosing. Use of Western TV had effect on doing exercise. Pressure of relatives was an important factor in decision about dieting. Self steam and compare of appearance with others affected choosing of dieting. There were no differences between selected groups. Conclusion In spite of similarities between body dissatisfaction and its management strategies with other studies in Iran, there is necessity for future studies. Keywords: dieting, exercise, body image, Iran. Cite as Garrusi B, Baneshi MR, Amiri F. Do different groups have different risk factors for dieting and exercise as body management strategies? Russian Open Medical Journal 2012; 1: 0308. Correspondence to Behshid Garrusi. Address: Department of Community Medicine, Afzallipour Medical School, Kerman University of Medical Sciences, Kerman, Iran(IR). Tel: +983413224613. Fax: +983413221671. Email: [email protected], [email protected]. Introduction While concerns about ones body and degree of physical attractiveness have been a part of history, these concerns have become more intense in recent decades. Body image has been defined as the perception of overall physic cal appearance .It consider a multidimensional issue that includes perception, attitude, feeling and the effects of these perceptions on the individuals behaviors [1] Body size estimation, attractiveness and ones feelings about theseare among the aspects of body image [1]. Body image is the mental representation aboutown body. Body satisfaction and its related problems were, in the past, known as a western culture phenomenon; however, recent studies are finding that it is now a worldwide matter. Despite previous beliefs, body concerns and eating disorders are increasing in Asian countries, and in some of these societies, their prevalence is similar to that of western cultures [2, 3]. In recent decades, the emphasis for the ideal women has been on thinness, while the emphasis for the ideal man has been on muscledevelopment/masculinity [4]. These body characteristics are considered symbols of success, self control and sexual attractiveness in women and empowerment in men [1, 4]. There are multiple differences between Asian cultures that can affect an individuals perceptions, attitudes and behaviors [5]. For example, in east Asia, Japanese women suffer more from eating disorders and body dissatisfaction than Taiwanese women [6]. Researchers contend that there are many cultural differences within east Asian countries [7] as well as significant differences between eastern and western Asian cultures. Body image and body satisfaction can be affected by many sociocultural factors [8, 9]. Culture plays a significant role in the conceptualization of beauty and attractiveness [8]. Desire for achieving of Ideal body, could be cause some of health consequences ,such aseating disorders and unhealthy behaviors for body change. Body dissatisfaction is correlated with various attempts to change ones body, and these efforts can begin in children as young as 5yearsold [10, 11]. The most accepted method is dieting, a method that can result inanorexia, if successful and encouraged by others,orbulimia, which hascompensatory activities such as induced vomiting and theuse of laxatives [12]. As previously stated, females wish to be thinner, and males wish to be more masculine [10]. These desires can cause males to exercise excessively and engage in steroid use,whilefemalesprefer dieting strategies or surgery. In somestudies,however,body image dissatisfaction negatively correlated with physical activity, especially among adolescent girls [10]. The aim of thisidentifying ofbody change strategiesthat were chosen by different groups in one Iranian sample. [ ISSN 2304-3415, Russian Open Medical Journal 2012; 1: 0308 2 Preventive medicine 2012, LLC Science and Innovations, Saratov, Russia www.romj.org Material and Methods This populationbased study was carried out in Kerman, the capital of the largest province in Iran. The main outcomes of the study include body change strategies. We focused on two main methods: diet (restricted food, induced vomiting) and exercise (heavy exercise for masculinity or weight reduction). In this study, was done in three different group, general population, university students and body building (gym) users. These participants were selected) by multistage sampling. Selfadministrated questionnaire include below parts: Demographic variables: Age (>20, <20 years), gender (male, female), economical status (fair to medium and good to excellent), marital status (married, single), place of birth (big cities, small cities and village), BMI (cutoffs at 18.5, 24.9, and 29.9, subjects were categorised into four groups: BMI<18.5 (thin), BMI=18.524.9 (normal), BMI=2529.9 (overweight), BMI>30 (obese), use of media (TV, fashion magazine). Sociocultural variables: This parts evaluated comparison of body with others {Physical Appearance Comparison Scale (PACS)}, that had acceptable reliability and validity in Persian [13], perceived pressure from relatives {Perceived Sociocultural Pressure Scale (PSPS)}, Body Satisfaction (Figure Rating Scale ) that subjects were classified into three groups: no body dissatisfaction their current and ideal shapes were the same), mild dissatisfaction (BD score of 1), and severe dissatisfaction (the difference was greater than 1), and Self Steam {Rosenberg self steam scale (RES)}. This study was approved by Ethical Committee of Kerman Medical Sciences University. Statistical analysis Descriptive statistics were used to summarise the data. A series of multifactorial logistic regression models were applied to identify the factors that influence each of the outcomes or body management methods (i.e., diet, exercise). The results are presented in terms of the odds ratio (OR), associated 95% confidence intervals (CI), and Pvalue. In addition, the probability of outcomes was estimated from developed logistic models. The estimated probabilities were then compared with the observed individuals status to calculate the correct classification proportion. P<0.05 was considered as significant. Results About 48.5% (149) of 400 respondents were female. The mean (SD) for age in three groups (general population, university students, gym users) were 27.6 (8.36), 23.13 (3.29), 22.09 (2.19) years, respectively. Some of demographic characteristics of respondents were shown in Table 1. Mean of BMI in three groups were 23.75 (4.12), 49 (3.5), 22.90 (2.96) kg/m2 inprevious groups (Table 1). Frequencies of Body Dissatisfaction categories in participants were listed in Table 2. Regarding the factors that encourage people to manage their body shape through dieting, we find that pressure from relatives (PSPS) (CI 95%: 0.830.95, P=0.01, own comparison with others (PACS) (CI 95%: 1.011.16, P=0.029), self steam (CI 95%: 1.011.38, P=0.029) where are all influencing variables (Table 3). Belonging to specific group, and gender, there were no effect for decision regarding choose of body image strategies. With respect to exercise, we find that gender (CI 95%: 0.19 0.68, P<0.001) and use of western TV (CI 95%: 1.163.92, P=0.014), were important factors. It shows that other factors such as scores of PACS, and PSPS or other sociocultural variables, there were not influencing factors. Choosing of body management strategies had not affect by belonging to special groups. Place of birth had significant effect on dieting (CI 95%: 1.35 13.01, P=0.013) and exercise (CI 95%: 0.120.80, P=0.016). Participants who were born in big cities were 4.1 times more likely to manage their body shape through dieting. Born in big cities was increased chance of using exercise as a body change strategies about 30% (Table 4). Table 1. Demographic characteristics of respondents Variable Level Frequency Percent Age <20 85 21.2 >20 315 78.8 Gender Female 194 48.5 Male 206 51.5 Marital status Single 279 69.8 Married 121 30.2 Education University degree 73 18.2 High school or lower 327 81.8 Economic Status Fairmedium 246 61.5 Goodexcellent 154 38.5 Table 2. Distribution of body dissatisfaction General population University Students Gym users Body Mild BD 14.3% 17.8% 8.0% Dissatisfaction (BD) Severe BD 6.8% 9.5% 3.5% BD=Body Dissatisfaction Table 3. Identification of factors that encourage people to diet as a way to manage their body shape through a multi factorial logistic regression Variable OR CI 95% Plevel Age 0.50 0.391.47 0.407 Gender 1.03 0.591.79 0.931 Education 0.93 0.461.90 0.85 Marital status 0.61 0.331.10 0.102 Place of Birth 4.19 1.3513.01 0.013 Economic Status 1.74 1.03.04 0.05 Western TV 0.66 0.391.11 0.118 Study Group: Body building (gym )users University students 1.66 1.16 0.773.61 0.612.19 0.197 0.652 PSPS (Perceived SocioCultural Pressure Scale) 0.89 0.830.95 0.01 PACS (Physical Appearance Comparison Scale) 1.08 1.011.16 0.029 BMI (Body Mass Index) 0.97 0.911.05 0.474 Body Dissatisfaction (BD): Mild BD Severe BD 0.60 1.151.38 0.341.06 0.532.50 0.081 0.727 RES (Rosenberg Self Steam) 1.38 1.011.38 0.029 ISSN 2304-3415, Russian Open Medical Journal 2012; 1: 0308 3 Preventive medicine [ 2012, LLC Science and Innovations, Saratov, Russia www.romj.org Table 4. Identification of factors that encourage people to exercise as a way to manage their body shape through a multi factorial logistic regression Variable OR CI 95% Plevel Age 0.95 0.481.90 0.888 Gender 0.36 0.190.68 0.001 Education 0.54 0.231.26 0.155 Marital status 2.09 1.014.32 0.48 Place of Birth 0.30 0.120.80 0.016 Economic Status 1.01 0.551.40 0.979 Western TV 2.13 1.163.92 0.014 Study Group: Body building (gym )users University students 1.30 1.49 0.533.19 0.742.99 0.563 0.261 PSPS (Perceived SocioCultural Pressure Scale) 1.04 0.961.12 0.34 PACS (Physical Appearance Comparison Scale) 1.00 0.931.08 0.953 BMI (Body Mass Index) 0.97 0.901.05 0.479 Body Dissatisfaction (BD): Mild BD Severe BD 0.78 0.81 0.411.46 0.361.84 0.436 0.62 RES (Rosenberg Self Steam) 1.14 0.971.35 0.124 Discussion Among contributing factors that could be affect decision about body change activities, body dissatisfaction is considered as an important factors. Body dissatisfaction is known significant predictors of body change activities for women [14]. The desire for thinness as an appearancerelated reason for exercise is associated with body dissatisfaction and low selfesteem. In some studies, however, body image dissatisfaction negatively correlated with physical activity, especially among adolescent girls [15]. Some studies found that body satisfaction in women has a greater effect on selfesteem than in men. Chronic dieters have increased body dissatisfaction and lower selfesteem [16]. It was surprising that in recent study, body dissatisfaction had no effect on body management strategies. Body image and body satisfaction can be affected by many sociocultural factors [8], that may be a greater role in body change activities. Although this effect on dieting was evident in both genders, dieting was more prominent in males [17]. However, according previous studies, we found that self esteem had contributing effect on body change activities especially in dieting. Sociocultural variables are important factors that contribute to body dissatisfaction and related problems such as desire for body management strategies. One of the sociocultural factors that may affect an individuals desire to be thin or masculine and a persons decision regarding body change strategies is perceived pressure from family, friends and/or the media [8]. One of the social groups for comparison is the peer group. Peer groups have a significant effect on body satisfaction and body change activities. The effect of peers with ideal body types was associated with longer periods of exercise, especially for women. Although this comparison appears higher in females, peer effect on body satisfaction and decisions about body changes are found in both genders [4]. In our study, dieting was influenced by comparison with others and family and peer pressures. Body image is affected by environment and cultural issues. In big cities, individuals are more prone to media or social pressure such as fashion, magazines, beauty contest. In addition, in big cities, social situa