BMI, Health Behaviors, and Quality of Life in Children and Adolescents: A School-Based Study

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Existing literature indicates relationships between BMI, physical activity, sleep patterns, eating behavior, and health-related quality of life in children and adolescents. However, many previous studies have used nonpreference-based instruments, which are not suitable for application within economic evaluation. WHAT THIS STUDY ADDS:The Child Health Utility 9D, a new preference-based health-related quality of life instrument for application in economic evaluation in children and adolescents, revealed stronger associations between utilities and sleep patterns or eating behavior than with BMI, physical activity, or sedentary behavior. abstract OBJECTIVE: To explore the relationship between weight status (BMI) and health-related quality of life in children and adolescents through application of the Child Health Utility 9D, a new generic preference-based instrument.METHODS: Data were collected from primary and high school students in rural and metropolitan regions of South Australia. Consenting participants (2588 in grades 4-6 and 765 in grades 9-10) were weighed and measured and categorized as underweight, healthy weight, overweight, or obese according to International Obesity Taskforce BMI cutoff points (primary outcome). Participants also completed a questionnaire including the Child Health Utility 9D and standardized measures of physical activity, sedentary behavior, sleep patterns, and eating behavior (secondary outcomes). Descriptive and multivariate linear regression analyses were undertaken to calculate mean utility differences. RESULTS:In comparison with healthy-weight primary school students, adjusted mean utilities were lower for overweight (20.016, P = .02) or obese (20.039, P = .001) students. For high school students, the adjusted mean utilities were also lower for overweight and obese students but were nonsignificant (20.018, P . .10). Physical activity, sedentary behavior, sleep patterns, and eating behavior were all found to be significantly associated with utilities. CONCLUSIONS:Irrespective of BMI, young people engaging in more physical activities or less sedentary behavior, and having healthier sleep patterns or eating behavior exhibited higher utilities. Associations between utilities and sleep patterns or eating behavior were stronger than the associations with BMI. Future economic evaluations for obesity interventions should more formally investigate the relationship between changes over time in weight status and health-related quality of life for children and adolescents. Pediatrics 2014;133:e868-e874 Childhood overweight and obesity is a key public health issue, with prevalence in Australian children between 20% and 25%, 1-3 and in the United States, it is 35%. 4 Childhood obesity is associated with a range of medical complications and psychological conditions, such as diabetes, cardiovascular disease, gallbladder disease, obstructive sleep apnea, social stigmatization, and low self-esteem. 5,6 Health-related quality of life (HRQoL) is a multidimensional constru...

Flatfoot decreases school functioning among children < 11 years of age

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Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis

“…We modelled the SSB tax on SEIFA groups as a population-based intervention—that is, the lifetime health and cost effects from the tax altered the distribution of BMI among all ages (2–100 years). For individuals aged 2–19 years, who were not modelled as experiencing the included diseases, the disability related to obesity itself was quantified, using the health-related quality of life lost due to obesity before and after the intervention, based on the difference between quality-adjusted life year (QALY) weights [44]. Thus, HALYs gained due to an intervention represent the number of years lived in full health gained, adjusted for morbidity of obesity-related diseases, and obesity as a whole in the population aged less than 20 years.…”

Assessing the Health-Related Quality of Life of Australian Adolescents: An Empirical Comparison of the Child Health Utility 9D and EQ-5D-Y Instruments

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