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

BMC Public Health

Serge Briançon³  Nathalie Thilly³  Sabrina Tessier¹  Nelly Agrinier³  Cédric Baumann³  Joseph Benie-Bi²  Emilie Bonsergent² 

[1] UMR U557 INSERM/U1125 Inra/CNAM/Paris 13, SBMH-Paris 13 University, Bobigny, France;University of Lorraine, Faculty of Medicine, School of Public Health, Nancy, France;Nancy University Hospital, Department of Clinical Epidemiology and Evaluation, Nancy, France

关键词: High school;    Adolescents;    Weight status;    Health-related quality of life;   

Others  :  1162811
DOI  :  10.1186/1471-2458-12-997

 received in 2012-06-07, accepted in 2012-09-28,  发布年份 2012

【 摘 要 】

Background

Some 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.

Methods

Five 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.

Results

The 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).

Conclusions

Gender 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.

【 授权许可】

   
2012 Bonsergent et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Lobstein T, Baur L, Uauy R: Obesity in children and young people: a crisis in public health. Obes Rev 2004, 5(Suppl 1):4-104.
• [2]Kirchengast S: Gender Differences in Body Composition from Childhood to Old Age: An Evolutionary Point of View. J Life Sci 2010, 2:1-10.
• [3]Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA 2012, 307:483-490.
• [4]Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000, 320:1240-1243.
• [5]De Peretti C, Castetbon K: Surpoids et obésité chez les adolescents scolarisés en classe de troisième. Études et résultats 2004, 283:1-4.
• [6]Programme National Nutrition Santé (PNNS): Colloque. Étude nationale nutrition santé ENNS, 2006: Situation nutritionnelle en France en 2006 selon les indicateurs d'objectif et les repères du Programme National Nutrition Santé (PNNS). Saint-Maurice: Institut de Veille Sanitaire (InVS); 2007. Maladies chroniques et traumatismes
• [7]Engeland A, Bjorge T, Tverdal A, Sogaard AJ: Obesity in adolescence and adulthood and the risk of adult mortality. Epidemiology 2004, 15:79-85.
• [8]Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS: Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics 2001, 108:712-718.
• [9]Koplan JP, Liverman CT, Kraak VI: Extent and Consequences of Childhood Obesity. In Preventing Childhood Obesity: Health in the Balance. Washington, DC: The national academies press; 2005:54-78.
• [10]Wang LY, Chyen D, Lee S, Lowry R: The association between body mass index in adolescence and obesity in adulthood. J Adolesc Health 2008, 42:512-518.
• [11]Kumanyika SK, Obarzanek E, Stettler N, Bell R, Field AE, Fortmann SP, et al.: Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on population and prevention science). Circulation 2008, 118:428-464.
• [12]Williams J, Wake M, Hesketh K, Maher E, Waters E: Health-related quality of life of overweight and obese children. JAMA 2005, 293:70-76.
• [13]Evans DR: Enhancing quality of life in the population at large. Soc Indic Res 1994, 33:47-88.
• [14]MacKeigan LD, Pathak DS: Overview of health-related quality-of-life measures. Am J Hosp Pharm 1992, 49:2236-2245.
• [15]World Health Organisation: Health promotion glossary. Switzerland: Geneva; 1998:1-36.
• [16]Story MT, Neumark-Stzainer DR, Sherwood NE, Holt K, Sofka D, Trowbridge FL, et al.: Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics 2002, 110:210-214.
• [17]Story M, Nanney MS, Schwartz MB: Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. Milbank Q 2009, 87:71-100.
• [18]Bergman MM, Scott J: Young adolescents' wellbeing and health-risk behaviours: gender and socio-economic differences. J Adolesc 2001, 24:183-197.
• [19]Bisegger C, Cloetta B, Von RU, Abel T, Ravens-Sieberer U: Health-related quality of life: gender differences in childhood and adolescence. Soz Praventivmed 2005, 50:281-291.
• [20]Michel G, Bisegger C, Fuhr DC, Abel T: Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis. Qual Life Res 2009, 18:1147-1157.
• [21]Fallon EM, Tanofsky-Kraff M, Norman AC, McDuffie JR, Taylor ED, Cohen ML, et al.: Health-related quality of life in overweight and nonoverweight black and white adolescents. J Pediatr 2005, 147:443-450.
• [22]Swallen KC, Reither EN, Haas SA, Meier AM: Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics 2005, 115:340-347.
• [23]Pinhas-Hamiel O, Singer S, Pilpel N, Fradkin A, Modan D, Reichman B: Health-related quality of life among children and adolescents: associations with obesity. Int J Obes (Lond) 2006, 30:267-272.
• [24]de Beer M, Hofsteenge GH, Koot HM, Hirasing RA, de Waal HA D-v, Gemke RJ: Health-related-quality-of-life in obese adolescents is decreased and inversely related to BMI. Acta Paediatr 2007, 96:710-714.
• [25]Tsiros MD, Olds T, Buckley JD, Grimshaw P, Brennan L, Walkley J, et al.: Health-related quality of life in obese children and adolescents. Int J Obes (Lond) 2009, 33:387-400.
• [26]Keating CL, Moodie ML, Swinburn BA: The health-related quality of life of overweight and obese adolescents–a study measuring body mass index and adolescent-reported perceptions. Int J Pediatr Obes 2011, 6:434-441.
• [27]Song AY, Rubin JP, Thomas V, Dudas JR, Marra KG, Fernstrom MH: Body image and quality of life in post massive weight loss body contouring patients. Obesity (Silver Spring) 2006, 14:1626-1636.
• [28]Briançon S, Bonsergent E, Agrinier N, Tessier S, Legrand K, Lecomte E, et al.: PRALIMAP: study protocol for a high school-based, factorial cluster randomised interventional trial of three overweight and obesity prevention strategies. Trials 2010, 11:119. BioMed Central Full Text
• [29]INSEE (Institut National de la Statistique et des Études Économiques), DARES (Ministère des affaires sociales, du travail et de la solidarité): Nomenclature des professions et catégories socioprofessionnelles des emplois salariés d’entreprise PCS – ESE 2003. http://www.insee.fr/fr/methodes/default.asp?page=nomenclatures/pcsese/pcsese2003/pcsese2003.htm webcite (accessed in 2012)
• [30]Cole TJ, Flegal KM, Nicholls D, Jackson AA: Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ 2007, 335:194.
• [31]Parkerson GR Jr, Broadhead WE, Tse CK: The Duke Health Profile. A 17-item measure of health and dysfunction. Med Care 1990, 28:1056-1072.
• [32]Vo TX, Guillemin F, Deschamps JP: Psychometric properties of the DUKE Health Profile-adolescent version (DHP-A): a generic instrument for adolescents. Qual Life Res 2005, 14:2229-2234.
• [33]Guillemin F, Paul-Dauphin A, Virion JM, Bouchet C, Briancon S: The DUKE health profile: a generic instrument to measure the quality of life tied to health. Sante Publique 1997, 9:35-44.
• [34]World Health Organization: Official Records of the World Health Organization. 2nd edition. New-York; 1946.
• [35]Goldstein H: Multilevel statistical models. 4th edition. Hoboken: Wiley; 2011.
• [36]Cohane GH, Pope HG Jr: Body image in boys: a review of the literature. Int J Eat Disord 2001, 29:373-379.
• [37]Duncan MJ, Al Nakeeb Y, Nevill AM, Jones MV: Body dissatisfaction, body fat and physical activity in British children. Int J Pediatr Obes 2006, 1:89-95.
• [38]Bergström E, Stenlud D, Svedjehäll B: Assessment of body perception among Swedish adolescents and young adults. J Adolesc Health 2000, 26:43-57.
• [39]ter Bogt TF, van Dorsselaer SA, Monshouwer K, Verdurmen JE, Engels RC, Vollebergh WA: Body mass index and body weight perception as risk factors for internalizing and externalizing problem behavior among adolescents. J Adolesc Health 2006, 39:27-34.
• [40]Unterhalter G, Farell S, Mohr C: Selective memory bias for words reflecting sexe specific body image concerns. Eat Behav 2007, 8:382-389.
• [41]Lawler M, Nixon E: Body dissatisfaction among adolescents boys and girls: the effect of body mass, peer appearance culture and internationalization of appearance ideals. J Youth Adolesc 2011, 40:59-71.
• [42]El Ansari W, Vodder Clausen S, Mabhala A, Stock C: How do i look? Body image perceptions among university students from England ans Denmark. Int J Environ Res Public Health 2010, 7:583-595.
• [43]Pearce MJ, Boergers J, Prinstein MJ: Adolescent obesity, overt and relational peer victimization, and romantic relationships. Obes Res 2002, 10:386-393.
• [44]Bradford-Hill A: The environment and disease: assocation or causation? Proc R Soc Med 1965, 58:295-300.
• [45]Zwiauer K, Caroli M, Malecka-Tendera E, Poskitt E: Clinical features, adverse effects and outcome. In Child and adolescent obesity. Causes and consequences. Prevention and mangement. Edited by Burniat W, Cole TJ, Lissau I, Poskitt E. Cambridge: Cambridge University Press; 2002:1-416.