Weight status and health-related quality of life during childhood and adolescence: effects of age and socioeconomic position

Abstract

Background: Overweight and obesity in children is associated with poor health-related quality of life (HRQoL), but the nuances of this relationship across different age and socio-demographic groups are not well-established. The aim of this study is to examine how the association between weight status and HRQoL changes with age and socioeconomic position (SEP) throughout childhood and adolescence. Methods: We used data from the Longitudinal Study of Australian Children (LSAC); a cohort study in which children were interviewed biennially from ages 4-5 to 16-17. Measurements of HRQoL (using PedsQL TM), BMI, and sociodemographic characteristics were collected at each interview. Of the 4983 children recruited into the study, we included data from 4083 children (a total of 24 446 observations). We used generalised estimating equations to assess whether age and SEP modified the association between weight status and HRQoL, after controlling for sex, long-term medical condition, language spoken to child and maternal smoking status. Results: Age was a significant modifier of the association between weight status and HRQoL, with adjustment for known predictors of HRQoL (P<0.001). At age 4, children with obesity had, on average, a 0.99 (95% CI 0.02 to 1.96) point lower PedsQL total score than children at healthy weight. This difference became clinically important by age 9 at 4.50 (95% CI 3.86 to 5.13) points and increased to 6.69 (95% CI 5.74 to 7.64) points by age 17. There was no evidence that SEP modified the relationship between weight status and HRQoL (P>0.05). Conclusions: Our results demonstrate that the relationship between overweight and obesity status and poor HRQoL is strengthened with increasing age through childhood and adolescence, but is not affected by SEP. Paediatricians, researchers and carers of children with obesity should acknowledge HRQoL outcomes, particularly for older children and adolescents.

COVID‐19 related anxiety in children and adolescents with severe obesity: A mixed‐methods study

“…Moreover, our relatively large sample size allowed us to reach data saturation. A strength of our quantitative analyses is the comparison of PedsQL scores before and during the COVID‐19 outbreak, as it is known that quality of life is already compromised in children with severe obesity 12,13 . A limitation of this study is its cross‐sectional analysis; follow‐up studies are needed to evaluate the course and effect of COVID‐19 related anxiety on weight‐related health and will be performed for our patient group.…”

“…Moreover, we noticed COVID‐19 related concerns during our regular contacts with children and their parents at the outpatient clinic of our paediatric obesity centre when the governmental lockdown measures in the Netherlands were effectuated. On top of that, quality of life is already known to be diminished in children with severe obesity in comparison to the general population 12,13 . However, no studies have assessed such psychological aspects of the COVID‐19 outbreak in children and adolescents with obesity.…”

Health-related quality of life in individuals with syndromic autism spectrum disorders

“…The PedsQL 4.0 is one of the most widely studied assessments of child QOL reports[10-14]. As an assessment instrument, it provides a modular approach in measuring health-related quality of life (HRQoL) in healthy children as well as those with acute or chronic conditions across four domains: physical, emotional, social, and school functioning.…”

“…These dimensions are reflected in the survey as four scales comprising physical (8 items), emotional (5 items), social (5 items), and school functioning (5 items). From these four core scales, a total quality of life score (based on all items) was calculated[14]. The survey consisted of 23 items in the format: “In the past ONE month, how much of a problem has your child had with…,” rated on a five-point Likert scale: ( 0 = Never a problem, 1 = Almost never a problem, 2 = Sometimes a problem, 3 = Often a problem, 4 = Almost always a problem) .…”

Childhood Obesity in Serbia on the Rise

“…Considering the scale of the problem and numerous adverse health effects of overweight and obesity [ 11 , 12 , 13 , 14 , 15 , 16 ], it is of vital importance to develop policies concerning prevention, monitoring, and treatment of childhood obesity. In order to provide a European-wide harmonized surveillance system for childhood obesity, the World Health Organization (WHO) Regional Office for Europe launched the WHO European Childhood Obesity Surveillance Initiative (COSI) in 2006.…”