For many countries around the world, summer is in full force. This means lighter clothing and perhaps a holiday involving swimwear of some sort. Along with an eagerly awaited summer comes a raft of body issues and a flurry of wardrobe quandaries: Do last year's shorts still fit? How do I look in a swimsuit? Is this t-shirt too small? Weight and body image questions inevitably arise as people prepare to expose the seasonally unexposed.

Synovate recently surveyed 13,155 people across 19 markets - Argentina, Brazil, Canada, Chile, China, Colombia, Denmark, Egypt, India, Indonesia, Korea, Netherlands, Russia, Romania, Saudi Arabia, Singapore, Turkey, UK and US - for its third Healthy Living survey to understand fitness, weight control and attitudes to food and health.

So, who is body conscious and who is not? Who are the fitness fanatics? Who battles the bulge through eating plans and supplements? Which nations are concerned about childhood obesity? And finally, who are this year's biggest fast food fans?

Tipping the scales, or not?

Do you judge your size by how snug or loose your clothes are, or do you get down to the nitty-gritty of pounds and kilos? Across all markets surveyed, only 5% of respondents said they weigh themselves daily (5% male, 6% female), and 15% do this once a week. Thirty-six percent said they weigh themselves whenever they remember (Turkey 48%, Indonesia 45%, Argentina and China 43%) and, perhaps surprisingly in today's more health conscious societies, 22% claim not to weigh themselves at all, which makes one wonder whether people are really as conscious of their weight as we may think!

Leading the pack was India, with 40% of respondents claiming not to weigh themselves at all, closely followed by Chile (39%), and Indonesia and Romania (both 38%).

Explained Paru Minocha, Executive Director for Synovate India: "Indians' consciousness of fitness has not truly come into being. Indians are more or less complacent about health and fitness; only when there is an advent of illness or a medical emergency do Indians start taking their health and fitness seriously. It also has to do with the traditional clothing. Mass clothing is tailored and so a slight increase in size does not get noticed and, even among urban Indians, major changes in body weight usually take place after child birth or a certain age."

Continues Minocha: "Indians would weigh themselves regularly only if there was a prescription from the doctor to lose weight to help avoid or get rid of certain illnesses due to weight gain. Otherwise, Indians are usually complacent and happy with their bodies."

The more weight conscious scale hoppers, weighing themselves once a week, are respondents from Korea (28%), Argentina (26%) and Brazil (25%).

"Koreans, female and male alike, are very conscious about their appearance. Checking their weight and a following healthy diet is just one part of the story," says Frank Jellinek, Business Development Manager for Synovate Korea.

"There is enormous social pressure to look good, and being beautiful is equal to being successful - this is stimulated by the looks of Korean celebrities. Fitness centres are growing like mushrooms, especially in the Seoul area. The other side of the story is, if you can't run off your weight on a treadmill in one of the country's sprawling gyms, you may opt for a short cut and join the 50% of Korean females in their 20's who have had some form of plastic surgery," Jellinek said.

Added Jill Telford, CEO of Synovate UK, who lived in Asia for 17 years: "This doesn't surprise me - Korea is a looks and body conscious country, famous for cosmetic surgery at an early age to improve looks. Being svelte is part of this culture."

The USA has the highest percentage of respondents weighing themselves daily (12% compared to the overall average of 5%).

Commented Greg Chu, Senior Vice President and Head of Synovate's Custom Healthcare group in the US: "What's interesting is that some health studies suggest that weighing yourself frequently can help you lose weight or better keep your weight under control. If so, Americans may be at the forefront of taking advantage of this insight."

A moment on the lips, a lifetime on the hips

A lapse in concentration and look what happens: your clothes feel snug, the arrow on the scales has moved rather pointedly to the right, and people start telling you that you look "well" instead of trim, fit, fabulous, or any other description that doesn't mean that your face is a little rounder than before. The battle of the bulge is not something new. So what do people around the world do to get themselves back on track?

The top three responses overall were:

• Reduce food intake - 40%
• Increase physical activity - 35% (this was last year's top weight loss strategy at 45%)
• Change types of food that you eat - 25%

Respondents who indicated that they are most likely to step up their physical activity to reduce their weight were those in China (58%), Canada (53%) and USA (53%).

Commented Jonathan Roberts, Research Director for Synovate Healthcare in China: "Obesity is a growing concern in China with some estimates putting childhood obesity at 20%. Obesity is just one of the so-called lifestyle diseases linked to the rapid urbanisation in China. In the latest healthcare reform, the government has placed a focus on reducing preventable health complications. The Chronic Disease Control (CDC) department is tasked with widespread disease education and awareness, which is hoped to translate into improved diet and physical activity."

Respondents who were most likely to deal with additional pounds by reducing their food intake were those in the US (57%), Egypt (56%), and Canada and Argentina (52%).

Explained Chu in the US: "The media and advertising in the US have been hammering in the message that the best way to lose weight is to take in fewer calories than you expend. So it's not surprising that Americans turn to reducing food intake to lose weight—particularly if they don't have time for more dramatic changes in lifestyle, like building in a more regular and consistent exercise program."

A rather fortunate 27% of respondents across all markets claim that their weight does not change. As with last year's survey, this was topped by the Indians at 49% (a 4% drop from last year's figure). Indonesia followed with 38%, and Turkey and Colombia both with 36%.

Commented Monica Gangwani, Director of Synovate Healthcare in India: "While there is an overall rising trend of health consciousness, good health is largely linked to immunity from illness and diseases as well as the energy and stamina to carry on routine activities without feeling tired. So people seem to be comfortable with their body weight even as they aspire for size zero figures and 6-pack flat abs!

Continued Gangwani: "The other issue of Indians being unaware of their weight ties in with our finding that 40% of Indian respondents said they do not weigh themselves. It also reflects a classic denial and 'all's well' syndrome that characterises the Indian population where self perception matters more than actual measurement."

Piling on the pounds: Quick fixes, fad diets or a lifetime of calorie counting?

Low fat food products, weight loss promising supplements, meal replacements, metabolism-increasing medication... the list goes on and our supermarket shelves and advertising boards are full of answers to shed those unwanted pounds. But do any of us really buy into it? For 40% of respondents, the answer is no (topped by respondents in Indonesia 66%, Singapore 55%, and India 54%). But for the others, the top three strategies that have been used or are being used across all markets to maintain or reduce weight are:

• Low fat products - 32%
• Low carbohydrate food products - 16%
• Gym membership / exercise classes / personal trainer - 16%

Argentina has the highest percentage of respondents taking action, with 64% eating low-fat products to maintain or lose weight (followed by Denmark at 53%), 61% ordering smaller portions at restaurants or ordering a meal to share (followed by the US at 26% - overall across markets was only 12%), and 52% taking a gym membership (followed by Brazil at 31%) compared to an overall average of just 16%.

Diet plans such as Atkins, the South Beach diet and others are not popular across the board with only 6% of respondents saying they use these, and individual market figures ranging from 2% to 12%. The exception was respondents in China whose take up of these diets is 23%, significantly higher than the overall average.

Feeling good

It is common knowledge that food is not simply a functional transaction to keep ourselves going. It tastes good, we enjoy it, and it has cultural and social meaning. Eating the 'wrong' things can be comforting - 26% of respondents tend to eat junk food when feeling down, led by the US (47%), Canada (41%) and the UK (40%).

Commented Jill Telford, CEO of Synovate in the UK: "There's nothing like a sugar or chocolate fix to make us happy, as many Brits know, and we have an enormous range of snack brands to delight and comfort us when we are feeling down or just need a boost. Bridget Jones and the Vicar of Dibley both demonstrate this in a humorous way. It may not be a coincidence that these markets indulging in comfort food are largely in the northern hemisphere, with the associated long winters and lack of sunlight, which are known to cause SAD (Seasonal Affective Disorder) syndrome."

Added Chu in the US: "Particularly in these stressful economic times, the appeal of a cheeseburger at a drive-thru goes well beyond convenience to comfort. That rice cracker and fat-free yogurt may be fine for lunch when you are feeling totally zen, but for so many Americans these days, there is lot to worry about, and they have more need for the comfort found in the simple things—like food."

Denying ourselves what we really want can often be hard! Thirty-nine percent of respondents agreed that life is too short to deny yourself whatever you want, even though it might be unhealthy. This was highest among respondents in Romania and Singapore at 55%, Korea (49%) and Argentina (47%).

Conversely, 84% of respondents agree that eating healthy food makes them feel better (led by Colombia, Egypt and Indonesia at 95%, and Brazil and Chile at 94%).

A matter of taste

What about fast food? It turns out that attitudes towards fast food haven't changed much since Synovate conducted this same survey in February 2009. Almost a third of respondents (29%) surveyed across the 19 markets this year admitted to liking the taste of fast food too much to give it up. This year's fast food fanatics are Saudi Arabians, with 58% of respondents agreeing that they like the taste of fast food too much to give it up, followed by the US (49%), Brazil (44%) and the UK (42%).

Contrary to this, 69% of respondents across all markets watch their food intake carefully and strive to be healthy. Interestingly, this is led by Brazil (along with Colombia) at 80%, which was also the nation with the second highest percentage of fast foods lovers.

Chile, Indonesia and Turkey are close behind, with 79% of respondents in each market claiming to watch their food intake.

A weighty issue: Who to blame?

Unhealthy habits, stress, busy schedules, or the influence of advertising and the media and lack of involvement from the government - what is the real cause? Is it an individual's lack of discipline or simply a reflection of the lifestyles we lead today? Or are some of us simply genetically disposed to carry more weight?

The top factors from the survey respondents were:

• Unhealthy food habits like eating at irregular hours (17%)
• Unhealthy food choices (17%)
• Lack of exercise (16%)
• No self-discipline / control (11%)
• Genetics / runs in the family (10%)
• Fast food (10%)

Across all markets surveyed, 75% of respondents agreed that food companies (manufacturers and restaurants) have a responsibility to offer healthy food options. The highest level of agreement came from China (90%), Chile (87%) and Singapore (85%).

Conversely, 45% of respondents from Turkey and a third of Egyptians do not agree that food companies have a responsibility to offer healthy food options.

Opinions were also divided on the matter of whether or not food companies (food manufacturers and restaurants) offer enough healthy food options. While 48% of respondents across all markets agreed that they do - led by the Netherlands (71%), Indonesia (70%) and China (55%) - there was a firm sense of disagreement from Egypt (70%), Turkey (68%) and Korea (68%).

Tamer El Naggar, Managing Director of Synovate North Africa commented on the Egypt findings: "The most advertised food products are cooking fats (ghee & oil), beverages and processed meat products. The local cuisine is quite fatty and delivering on "tastes like our parents/grandparents cuisine" is a key message in local advertising. Healthier options can be perceived as a departure from "authentic" & true tastes. However, lately communication of healthy food and using healthy cooking equipment has taken place in the Egyptian market, targeting mainly niche socio economic classes."

Obesity: Child's play

Childhood obesity is not a new topic. Technological advancements and the increased accessibility of computer-based entertainment for children means the digital age is often cited as a major factor in the prevalence of childhood obesity in certain markets. So, how worried are we?

Nearly a third (32%) of all respondents agree that they are worried about the issue of childhood obesity in their own home, with the strongest level of agreement coming from Brazil (82%), Chile (76%) and Egypt (75%). Over half (58%) of respondents agree that they are worried about the issue of childhood obesity in their country with the leading nations again being Chile (95%), Brazil (90%) and Egypt (80%).

Commented Rafael Céspedes, Managing Director of Synovate in Chile: "Childhood obesity has become a problem in Chile. In fact, it is one of the countries with the highest prevalence of child obesity, which is contributing to a number of chronic diseases. So much so that the National Congress is debating whether there should be a tax on the sale of unhealthy food."

According to Egypt's El Nagger: "With Egypt having a fairly young population (a third is younger than 15 years old), kids constitute a large segment for food companies, and an overwhelming majority of food commercials revolve around beverages & snacks. Egyptian parents are becoming more conscious of this potential impact."

On the other end of the scale, respondents in Denmark (83%), The UK (81%) and the US (80%) have the highest levels of disagreement with the statement 'I am worried about the issue of childhood obesity in my own home', yet they do agree that they are worried about childhood obesity in their country (71%, 66% and 69% respectively).

Said Telford in the UK: "There is a lot of press coverage on childhood obesity in the UK, giving the impression that it is a major problem. This might explain the apparent contradiction in home and country perceptions of the problem by magnifying the latter."

Added Chu in the US: "Childhood obesity appears to be one of those problems which people have an easier time recognising as a general problem than as a real issue at home. The term itself is one that many parents are reluctant to place on their own children."

Overall, 61% of respondents agree that food companies can help prevent childhood obesity. This was highest in Colombia (88%), Chile (84%), UK (73%).