Effect of gender on the association between weight status and health-related quality of life in adolescents

Abstract

BackgroundSome studies have investigated the association between body mass index (BMI) and health-related quality of life (HRQoL) among adolescents, but their results have been discrepant and few paid attention to the role of gender. The present investigation aimed to assess the relationship between weight status and HRQoL in adolescents and to verify whether it was similar in boys and girls.MethodsFive thousand two hundred and twenty six adolescents aged 14 to 18 years were included in the PRomotion de l’ALIMentation et de l’Activité Physique (PRALIMAP) trial, a 2x2x2 factorial cluster randomized trial performed in 24 high schools in France. Sociodemographic, anthropometric and HRQoL data were collected. BMI was categorized in four classes (thin, normal-weight, overweight, obese). Linear regression models were used to estimate the association between weight status and HRQoL, adjusting for confounders.ResultsThe mean age of adolescents was 15.7±0.6 years and their mean BMI was 21.6 ±3.5 kg/m2; 55% were girls. Boys were more often overweight and obese than were girls (overweight: 15.6% vs 14.2%, obese: 4.8% vs 3.3%), and girls were more likely to be thin (5.5% vs 4.5%, p=0.0042). All HRQoL scores were higher for boys (p=<0.0001). Weight status was not associated with physical and social scores neither in boys nor in girls. Conversely, it was associated with mental score, but differently in girls than boys. As compared with normal-weight girls, thin girls had better mental HRQoL (β=+6.17, p=0.0010), and overweight and obese girls had lower mental HRQoL (β=−3.89 and β=−5.90, respectively, p<0.001). Mental HRQoL was lower for thin, overweight and obese boys than for normal-weight boys (β= −4.97, β= −1.68 and β= −3.17, respectively, p<0.0001).ConclusionsGender can modify the association between weight status and HRQoL in adolescents. Body image could be an important target of public health programs to improve subjective health during adolescence.

The effect of gender and age on the association between weight status and health-related quality of life in Australian adolescents

“…Consequences of obesity also extend to psychological and social aspects of well-being [7] which also are vital to good health. The World Health Organisation Constitution states that health is not merely the absence of disease or infirmity, but a state of complete physical, mental and social well-being [8].…”

Gesundheitsbezogene Lebensqualität von übergewichtigen und adipösen Jugendlichen

“…niedriger Schulbildung eine schlechtere gesundheitsbezogene Lebensqualität aufweisen als Gleichaltrige der hohen Status-bzw. Bildungsgruppe [24,25,26,27]. Vor diesem Hintergrund ist anzunehmen, dass der Zusammenhang zwischen Übergewicht bzw.…”

Qualidade de vida relacionada com a saúde em crianças e adolescentes portugueses: estudo numa população escolar

“…9 O sexo feminino tem sido associado a níveis de QVRS inferiores, tanto na QVRS reportada global como em dimensões específicas. [9][10][11][12] A adolescência parece estar associada a pior perceção de saúde e pior QVRS, verificando-se um decréscimo progressivo ao longo dos anos, que é mais acentuado no sexo feminino.…”

“…Este mesmo padrão está de acordo com outros estudos internacionais, que reportam níveis de QVRS significativamente inferiores à medida que a idade aumenta ao longo da adolescência, em praticamente todas as dimensões analisadas. 10,11,15,16 Estas diferenças na QVRS com a idade têm sido atribuí-das à profunda transição física e social vivida ao longo da adolescência. Na amostra estudada, o sexo feminino não se associou a uma QVRS global significativamente pior, mas identificaram-se valores significativamente inferiores na dimensão bem-estar psicológico.…”

“…9,11,15 Várias razões têm sido propostas para explicar esta diferença, incluindo as mudanças fisioló-gicas pubertárias mais extremas, maior desequilíbrio hormonal, estratégias de coping e adaptação diferentes entre sexos, com predomínio de mecanismos de internalização no sexo feminino e de externalização no sexo masculino, 11,34 maiores exigências sociais e influência dos estereótipos femininos 11,35 e maior preocupação de corresponder às imagens publicitadas nos media. 10,35 Quanto à repercussão do nível de escolaridade parental os resultados foram menos consistentes. Encontrou-se uma associação entre níveis de escolaridade paterna mais alta e valores de QVRS mais elevados.…”