Health-related quality of life and body mass index among US adolescents
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To examine the magnitude of differences in health-related quality of life (HRQOL) by body mass index (BMI) in a population-based sample of United States adolescents overall and by sex, and to provide national prevalence estimates of reported HRQOL outcomes for not only obese and overweight but also underweight adolescents.
From the 2001 through 2010 cross-sectional National Health and Nutrition Examination Surveys, we estimated the percentages of four HRQOL outcomes—self-rated health, physically unhealthy days, mentally unhealthy days, and activity limitation days—in four BMI categories—obese, overweight, normal weight, and underweight—of approximately 6,000 US adolescents aged 12–17 years. We also estimated the percentages for boys and girls separately.
Substantial gaps in self-rated health exist between normal-weight adolescents and those who are obese and overweight, but not underweight. Eighteen percent (95 % CI 15–22) of obese adolescents reported fair or poor health compared to only 5 % (95 % CI 4–7) of normal-weight adolescents. Thirty-seven percent (95 % CI 33–42) of obese adolescents reported excellent or very good health, compared to 65 % (94 % CI 63–67) of normal-weight adolescents. However, all BMI groups reported similar percentages of physically unhealthy days, mentally unhealthy days, and activity limitation days. The associations between HRQOL and BMI groups did not vary by sex. Boys generally reported significantly better self-rated health and mental health than girls. Specifically, obese boys reported better self-rated health, mental health, and fewer activity limitation days than obese girls.
Substantially, significant differences in some domains of HRQOL are found between above normal-weight and normal-weight US adolescents. This relationship between BMI and HRQOL is robust and observed among both boys and girls.
- U.S. Department of Health and Human Services. (2010). The Surgeon General’s vision for a healthy and fit nation. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General.
- Ogden, C., & Carroll, M. (2012). Prevalence of obesity among children and adolescents: United States, trends 1963–1965 through 2007–2008. Atlanta: Centers for Disease Control and Prevention National Center for Health Statistics. http://www.cdc.gov/nchs/data/hestat/obesity_child_07_08/obesity_child_07_08.pdf. Accessed November 2, 2012.
- Ogden, C. L., Carroll, M. D., Kit, B. K., et al. (2012). Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA, 307, 483–490. CrossRef
- U.S. Department of Health and Human Services. (2012). Office of disease prevention and health promotion. Healthy People 2020. Washington, DC. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=29. Accessed November 10, 2012.
- Must, A. (1996). Morbidity and mortality associated with elevated body weight in children and adolescents. The American Journal of Clinical Nutrition, 63(3), 445S–447S.
- Dietz, W. H. (1998). Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics, 101(3), 518–525.
- Kolotkin, R. L., Zeller, M., Modi, A. C., Samsa, G. P., Quinlan, N. P., Yanovski, J. A., et al. (2012). Assessing weight‐related quality of life in adolescents. Obesity, 14(3), 448–457. CrossRef
- Varni, J. W., Burwinkle, T. M., Jacobs, J. R., Gottschalk, M., Kaufman, F., & Jones, K. L. (2003). The PedsQL in type 1 and type 2 diabetes reliability and validity of the pediatric quality of life inventory generic core scales and type 1 diabetes module. Diabetes Care, 26(3), 631–637. CrossRef
- Sinha, R., Fisch, G., Teague, B., et al. (2002). Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. New England Journal Medicine, 346(11), 802–810. CrossRef
- Varni, J., W., Limbers, C. A., & Burwinkle, T. M. (2007). Impaired health-related quality of life in children and adolescents with chronic conditions: A comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL™ 4.0 Generic Core Scales. Health and Quality of Life Outcomes, 5, 43. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1964786/pdf/1477-7525-5-43.pdf. Accessed November 19, 2012.
- Freedman, D. S., Dietz, W. H., Srinivasan, S. R., & Berenson, G. S. (1999). The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics, 103(6 pt 1), 1175–1182. CrossRef
- Ul-Haq, Z., Mackay, D. F., Fenwick, E., et al. (2012). Meta-analysis of the association between body mass index and health-related quality of life among children and adolescents, assessed using the Pediatric Quality of Life Inventory Index. The Journal of Pediatrics. http://www.ncbi.nlm.nih.gov/pubmed/22959137. Accessed November 9, 2012.
- Pinhas-Hamiel, O., Singer, S., Pilpel, N., Fradkin, A., Modan, D., & Reichman, B. (2005). Health-related quality of life among children and adolescents: associations with obesity. International Journal of Obesity, 30(2), 267–272. CrossRef
- Tsiros, M. D., Olds, T., Buckley, J. D., Grimshaw, P., Brennan, L., Walkley, J., et al. (2009). Health-related quality of life in obese children and adolescents. International Journal of Obesity, 33(4), 387–400. CrossRef
- Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. JAMA, 289(14), 1813–1819. CrossRef
- Zeller, M. H., & Modi, A. C. (2012). Predictors of health‐related quality of life in obese youth. Obesity, 14(1), 122–130. CrossRef
- Doll, H. A., Petersen, S. E., & Stewart-Brown, S. L. (2000). Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obesity Research, 8(2), 160–170. CrossRef
- Swallen, K. C., Reither, E. N., Haas, S. A., & Meier, A. M. (2005). Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics, 115(2), 340–347. CrossRef
- Williams, J., Wake, M., Hesketh, K., Maher, E., & Waters, E. (2005). Health-related quality of life of overweight and obese children. JAMA, 293, 70–76. CrossRef
- Gopinath, B., Baur, L. A., Burlutsky, G., & Mitchell, P. (2013). Adiposity adversely influences quality of life among adolescents. Journal of Adolescent Health. http://www.sciencedirect.com/science/article/pii/S1054139X12007884. Accessed February 4, 2013.
- Centers for Disease Control and Prevention (CDC). (2000). Measuring health days: Population assessment of health-related quality of life. Atlanta, GA: US Department of Health and Human Services, CDC. http://www.cdc.gov/hrqol/pdfs/mhd.pdf. Accessed September 20, 2012.
- Moriarty, D. G., Zack, M. M, & Kobau, R. (2003). The centers for disease control and prevention’s healthy days measures—Population tracking of perceived physical and mental health over time. Health and Quality of Life Outcomes, 1, 37. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC201011/. Accessed September 20, 2012.
- Keating, C. L., Moodie, M. L., & Swinburn, B. A. (2001). The health‐related quality of life of overweight and obese adolescents—A study measuring body mass index and adolescent‐reported perceptions. International Journal of Pediatric Obesity, 6(5–6), 434–441.
- Williams, J. W., Canterford, L., Hesketh, K. D., et al. (2011). Changes in body mass index and health related quality of life from childhood to adolescence. International Journal of Pediatric Obesity, 6, e442–e448. CrossRef
- Research Support Services, Inc. (2011). Cognitive testing of HRQOL interview guide for adolescents. Findings.
- Zullig, K. J., Valois, R. F., Huebner, E. S., et al. (2004). Evaluating the performance of the Centers for Disease Control and Prevention core Health-Related Quality of Life scale with adolescents. Public Health Reports, 119(6), 577–584. CrossRef
- Centers for Disease Control and Prevention (CDC). (2012). National Center for Health Statistics (NCHS). National Health and Nutrition Examination Survey Data. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC); 2001–2010. http://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm. Accessed September 20, 2012.
- Freedman, D. S., Wang, J., Thornton, J. C., et al. (2009). Classification of body fatness by body mass index-or-age categories among children. Archives of Pediatrics and Adolescent Medicine, 163(9), 805–811. CrossRef
- Freedman, D. S., & Sherry, B. (2009). The validity of BMI as an indicator of body fatness and risk among children. Pediatrics, 124(Supplement 1), S23–S34. CrossRef
- Centers for Disease Control and Prevention, National Center for Health Statistics. (2012). CDC growth charts: United States. http://www.cdc.gov/growthcharts/. Accessed October 10, 2012.
- Ogden, C. L., & Flegal, K. M. (2010). Changes in terminology for childhood overweight and obesity. National health statistics reports; no 25. Hyattsville, MD: National Center for Health Statistics. http://www.cdc.gov/nchs/data/nhsr/nhsr025.pdf. Accessed October 10, 2012.
- Thompson, M. L., Myers, J. E., & Kriebel, D. (1998). Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? Occupational and Environmental Medicine, 55(4), 272–277. CrossRef
- Research Triangle Institute. (2010). SUDAAN language manual, release 10.0. Research Triangle Park (NC): Research Triangle Institute.
- Brown, D. W., Balluz, L. S., Heath, G. W., Moriarty, D. G., Ford, E. S., Giles, W. H., et al. (2003). Associations between recommended levels of physical activity and health-related quality of life findings from the 2001 behavioral risk factor surveillance system (BRFSS) survey. Preventive Medicine, 37(5), 520–528. doi:10.1016/S0091-7435(03)00179-8. CrossRef
- Ogden, C. L., Lamb, M. M., Carroll, M. D., & Flegal, K. M. (2010). Obesity and socioeconomic status in children: United Sates 198801994 and 2005–2008. NCHS data brief no 51. Hyattsville, MD: National Center for Health Statistics.
- Health-related quality of life and body mass index among US adolescents
Quality of Life Research
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- Body mass index
- Health-related quality of life (HRQOL)
- National Health and Nutrition Examination Surveys (NHANES)
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- Author Affiliations
- 1. Division of Population Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS F-78, Atlanta, GA, 30341, USA
- 2. Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA