Quality of Life Research

, Volume 19, Issue 3, pp 339–349 | Cite as

Are youth BMI and physical activity associated with better or worse than expected health-related quality of life in adulthood? The Physical Activity Longitudinal Study

  • Katya M. Herman
  • Wilma M. Hopman
  • Cora L. Craig
Article

Abstract

Purpose

Body mass index (BMI) and physical activity (PA) affect health-related quality of life (HRQL); however, the long-term impact of youth BMI and PA on adult HRQL is unknown. We investigated the relationship of youth BMI and PA to adult HRQL 22 years later.

Methods

Subjects included 310 participants aged 7 to 18 in the 1981 Canada Fitness Survey, followed up in 2002–2004. The associations of youth BMI and leisure time PA to adult HRQL were examined, comparing to age- and sex-adjusted Canadian SF-36 norms.

Results

Bivariate analyses revealed positive associations between youth overweight and mental aspects of adult HRQL, but little association with physical aspects. In logistic regression adjusting for adult BMI and other covariates, overweight youth were 7 times more likely than healthy weight youth to score at/above the norm on both mental health (MH) and bodily pain, and almost 18 times more likely on the mental component score (MCS). Youth BMI was also positively associated with general health (GH), social functioning, and role emotional. Removing adult BMI from the models led to attenuated associations with mental HRQL and no association with GH. Longitudinal BMI status change was explored, and findings supported the main regression results. Youth PA was not associated with adult HRQL.

Conclusions

Youth overweight conveyed a long-term positive impact on several aspects of adult HRQL, and this impact may be both direct and indirect through BMI change and the effect on adult BMI. Youth PA had no long-term impact on adult HRQL.

Keywords

Body mass index Body weight Exercise Adolescent obesity Longitudinal studies Mental health Quality of life SF-36 BMI change Reversal paradox 

Abbreviations

HRQL

Health-related quality of life

BMI

Body mass index

PA

Physical activity

CFS

Canada Fitness Survey

CSWB

Campbell Survey of Wellbeing

PALS

Physical Activity Longitudinal Study

SF-36

Medical Outcomes Study Short Form 36

KKD

Kilocalories kilogram−1 day−1

SD

Standard deviation

OR

Odds ratio

CI

Confidence interval

PF

Physical functioning

RP

Role physical

BP

Bodily pain

GH

General health

VT

Vitality

SF

Social functioning

RE

Role emotional

MH

Mental health

PCS

Physical component summary

MCS

Mental component summary

References

  1. 1.
    Haslam, D. W., & James, W. P. (2005). Obesity. Lancet, 366, 1197–1209.CrossRefPubMedGoogle Scholar
  2. 2.
    Bouchard, C., Blair, S. N., & Haskell, W. L. (Eds.). (2007). Physical activity and health. Champaign, IL: Human Kinetics.Google Scholar
  3. 3.
    Warburton, D., Katzmarzyk, P. T., Rhodes, R. E., & Shephard, R. J. (2007). Evidence-informed physical activity guidelines for Canadian adults. Applied Physiology, Nutrition, and Metabolism, 32, S16–S68.CrossRefGoogle Scholar
  4. 4.
    Statistics Canada (2006) Health Indicators, June 2006. Government of Canada, Ottawa, ON, pp. Catalogue No. 82-221-XIE. www.statcan.ca/english/freepub/82-221-XIE/82-221-XIE2006001.htm.
  5. 5.
    Cameron, C., Wolfe, R., & Craig, C.L. (2007) Physical activity among Canadians: The current situation. In: Physical activity and sport: Encouraging children to be active. Canadian Fitness and Lifestyle Research Institute, Ottawa, ON, pp. 5–31.Google Scholar
  6. 6.
    Bize, R., Johnson, J. A., & Plotnikoff, R. C. (2007). Physical activity level and health-related quality of life in the general adult population: A systematic review. Preventive Medicine, 45, 401–415.CrossRefPubMedGoogle Scholar
  7. 7.
    Kolotkin, R. L., Meter, K., & Williams, G. R. (2001). Quality of life and obesity. Obesity Reviews, 2, 219–229.CrossRefPubMedGoogle Scholar
  8. 8.
    Hassan, M. K., Joshi, A. V., Madhavan, S. S., & Amonkar, M. M. (2003). Obesity and health-related quality of life: A cross-sectional analysis of the US population. International Journal of Obesity and Related Metabolic Disorders, 27, 1227–1232.CrossRefPubMedGoogle Scholar
  9. 9.
    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, 520–528.CrossRefPubMedGoogle Scholar
  10. 10.
    Friedlander, S. L., Larkin, E. K., Rosen, C. L., Palermo, T. M., & Redline, S. (2003). Decreased quality of life associated with obesity in school-aged children. Archives of Pediatric and Adolescent Medicine, 157, 1206–1211.CrossRefGoogle Scholar
  11. 11.
    Sagatun, A., Sogaard, A. J., Bjertness, E., Selmer, R., & Heyerdahl, S. (2007). The association between weekly hours of physical activity and mental health: A three-year follow-up study of 15–16-year-old students in the city of Oslo, Norway. BMC Public Health, 7, 155.CrossRefPubMedGoogle Scholar
  12. 12.
    Sanchez-Lopez, M., Salcedo-Aguilar, F., Solera-Martinez, M., Moya-Martinez, P., Notario-Pacheco, B., & Martinez-Vizcaino, V. (2008) Physical activity and quality of life in schoolchildren aged 11–13 years of Cuenca, Spain. Scandinavian Journal of Medicine and Science in Sports, 19, 879–884.CrossRefPubMedGoogle Scholar
  13. 13.
    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, 340–347.CrossRefPubMedGoogle Scholar
  14. 14.
    Williams, J., Wake, M., Hesketh, K., Maher, E., & Waters, E. (2005). Health-related quality of life of overweight and obese children. Journal of the American Medical Association, 293, 70–76.CrossRefPubMedGoogle Scholar
  15. 15.
    Hopman, W. M., Berger, C., Joseph, L., Barr, S. I., Gao, Y., Prior, J. C., et al. (2007). The association between body mass index and health-related quality of life: Data from CaMos, a stratified population study. Quality of Life Research, 16, 1595–1603.CrossRefPubMedGoogle Scholar
  16. 16.
    Lopez-Garcia, E., Banegas Banegas, J. R., Gutierrez-Fisac, J. L., Perez-Regadera, A. G., Ganan, L. D., & Rodriguez-Artalejo, F. (2003). Relation between body weight and health-related quality of life among the elderly in Spain. International Journal of Obesity and Related Metabolic Disorders, 27, 701–709.CrossRefPubMedGoogle Scholar
  17. 17.
    Jorm, A. F., Korten, A. E., Christensen, H., Jacomb, P. A., Rodgers, B., & Parslow, R. A. (2003). Association of obesity with anxiety, depression and emotional well-being: A community survey. Australian and New Zealand Journal of Public Health, 27, 434–440.CrossRefPubMedGoogle Scholar
  18. 18.
    Must, A., & Strauss, R. S. (1999). Risks and consequences of childhood and adolescent obesity. International Journal of Obesity and Related Metabolic Disorders, 23 Suppl 2, S2–S11.CrossRefPubMedGoogle Scholar
  19. 19.
    Strong, W. B., Malina, R. M., Blimkie, C. J., Daniels, S. R., Dishman, R. K., Gutin, B., et al. (2005). Evidence based physical activity for school-age youth. Journal of Pediatrics, 146, 732–737.CrossRefPubMedGoogle Scholar
  20. 20.
    Wang, F., & Veugelers, P. J. (2008). Self-esteem and cognitive development in the era of the childhood obesity epidemic. Obesity Reviews, 9, 615–623.CrossRefPubMedGoogle Scholar
  21. 21.
    Janssen, I., Craig, W. M., Boyce, W. F., & Pickett, W. (2004). Associations between overweight and obesity with bullying behaviors in school-aged children. Pediatrics, 113, 1187–1194.CrossRefPubMedGoogle Scholar
  22. 22.
    Story, M. T., Neumark-Stzainer, D. R., Sherwood, N. E., Holt, K., Sofka, D., Trowbridge, F. L., et al. (2002). Management of child and adolescent obesity: Attitudes, barriers, skills, and training needs among health care professionals. Pediatrics, 110, 210–214.PubMedGoogle Scholar
  23. 23.
    Stephens, T., Craig, C. L., & Ferris, B. F. (1986). Adult physical activity in Canada: Findings from the Canada Fitness Survey I. Canadian Journal of Public Health, 77, 285–290.Google Scholar
  24. 24.
    Stephens, T., & Craig, C. L. (1990). The well-being of Canadians: Highlights of the 1988 Campbell’s Survey on Well-Being. Ottawa, ON: Canadian Fitness and Lifestyle Research Institute.Google Scholar
  25. 25.
    Craig, C. L., Gauvin, L., Cragg, S., Katzmarzyk, P. T., Stephens, T., Russell, et al. (2005). Towards a social epidemiological perspective on physical activity and health: The aims, design, and methods of the Physical Activity Longitudinal Study (PALS). Journal of Physical Activity and Health, 2, 272–284.Google Scholar
  26. 26.
    Cole, T. J., Bellizzi, M. C., Flegal, K. M., & Dietz, W. H. (2000). Establishing a standard definition for child overweight and obesity worldwide: International survey. British Medical Journal, 320, 1240–1243.CrossRefPubMedGoogle Scholar
  27. 27.
    World Health Organization. (1998). Obesity. Preventing and managing the global epidemic. Report of a WHO consultation on obesity. World Health Organization, Geneva.Google Scholar
  28. 28.
    Taylor, H., Jacobs, D. R., Schucker, B., Knudsen, J., Leon, A. S., & DeBacker, G. (1978). A questionnaire for the assessment of leisure time physical activities. Journal of Chronic Diseases, 31, 741–755.CrossRefPubMedGoogle Scholar
  29. 29.
    Craig, C. L., Russell, S. J., & Cameron, C. (2002). Reliability and validity of Canada’s Physical Activity Monitor for assessing trends. Medicine and Science in Sports and Exercise, 34, 1462–1467.CrossRefPubMedGoogle Scholar
  30. 30.
    Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, A. M., Strath, S. J., et al. (2000). Compendium of physical activities: An update of activity codes and MET intensities. Medicine and Science in Sports and Exercise, 32(9 Suppl), S498–S504.PubMedGoogle Scholar
  31. 31.
    Institute of Medicine (2002) Physical Activity. In: Dietary reference intakes: Energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (pp. 880–935). Washington, DC: National Academy Press. www.nap.edu/books/0309085373/html.
  32. 32.
    Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 health survey manual and interpretation guide. The Health Institute. Boston, MA: New England Medical Centre.Google Scholar
  33. 33.
    Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 Physical and mental health summary scales: A user’s manual. Boston, MA: The Health Institute.Google Scholar
  34. 34.
    Hopman, W. M., Towheed, T., Anastassiades, T., Tenenhouse, A., Poliquin, S., Berger, C., et al. (2000). Canadian normative data for the SF-36 health survey. Canadian Multicentre Osteoporosis Study research group. Canadian Medical Association Journal, 163, 265–271.PubMedGoogle Scholar
  35. 35.
    Wadden, T. A., Foster, G. D., Stunkard, A. J., & Linowitz, J. R. (1989). Dissatisfaction with weight and figure in obese girls: Discontent but not depression. International Journal of Obesity, 13, 89–97.PubMedGoogle Scholar
  36. 36.
    Hopman, W. M., Berger, C., Joseph, L., Towheed, T., VandenKerkhof, E., Anastassiades, T., et al. (2006). The natural progression of health-related quality of life: Results of a five-year prospective study of SF-36 scores in a normative population. Quality of Life Research, 15, 527–536.CrossRefPubMedGoogle Scholar
  37. 37.
    Lucas, A., Fewtrell, M. S., & Cole, T. J. (1999). Fetal origins of adult disease—The hypothesis revisited. British Medical Journal, 319, 245–249.PubMedGoogle Scholar
  38. 38.
    Tu, Y. K., West, R., Ellison, G. T. H., & Gilthorpe, M. S. (2005). Why evidence for the fetal origins of adult disease might be a statistical artifact: The “reversal paradox” for the relation between birth weight and blood pressure in later life. American Journal of Epidemiology, 161, 27–32.CrossRefPubMedGoogle Scholar
  39. 39.
    Tu, Y. K., Gunnell, D., & Gilthorpe, M. S. (2008). Simpson’s paradox, Lord’s paradox, and suppression effects are the same phenomenon—The reversal paradox. Emerging Themes in Epidemiology, 5, 2. doi:10.1186/1742-7622-5-2.CrossRefPubMedGoogle Scholar
  40. 40.
    Herman, K. M., Craig, C. L., Gauvin, L., & Katzmarzyk, P. T. (2009). Tracking of obesity and physical activity from childhood to adulthood: The Physical Activity Longitudinal Study. International Journal of Pediatric Obesity, 4, 281–288.CrossRefPubMedGoogle Scholar
  41. 41.
    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, 160–170.CrossRefPubMedGoogle Scholar
  42. 42.
    Ni Mhurchu, C., Bennett, D., Lin, R., Hackett, M., Jull, A., & Rodgers, A. (2004). Obesity and health-related quality of life: Results from a weight loss trial. New Zealand Medical Journal, 117, U1211.PubMedGoogle Scholar
  43. 43.
    Huang, I. C., Frangakis, C., & Wu, A. W. (2006). The relationship of excess body weight and health-related quality of life: Evidence from a population study in Taiwan. International Journal of Obesity, 30, 1250–1259.CrossRefPubMedGoogle Scholar
  44. 44.
    Larsson, U., Karlsson, J., & Sullivan, M. (2002). Impact of overweight and obesity on health-related quality of life—A Swedish population study. International Journal of Obesity and Related Metabolic Disorders, 26, 417–424.CrossRefPubMedGoogle Scholar
  45. 45.
    Brown, W. J., Mishra, G., Lee, C., & Bauman, A. (2000). Leisure time physical activity in Australian women: Relationship with well being and symptoms. Research Quarterly in Exercise and Sport, 71, 206–216.Google Scholar
  46. 46.
    Lee, C., & Russell, A. (2003). Effects of physical activity on emotional well-being among older Australian women: Cross-sectional and longitudinal analyses. Journal of Psychosomatic Research, 54, 155–160.CrossRefPubMedGoogle Scholar
  47. 47.
    Morimoto, T., Oguma, Y., Yamazaki, S., Sokejima, S., Nakayama, T., & Fukuhara, S. (2006). Gender differences in effects of physical activity on quality of life and resource utilization. Quality of Life Research, 15, 537–546.CrossRefPubMedGoogle Scholar
  48. 48.
    Vuillemin, A., Boini, S., Bertrais, S., Tessier, S., Oppert, J. M., Hercberg, S., et al. (2005). Leisure time physical activity and health-related quality of life. Preventive Medicine, 41, 562–569.CrossRefPubMedGoogle Scholar
  49. 49.
    Asbury, E. A., Chandrruangphen, P., & Collins, P. (2006). The importance of continued exercise participation in quality of life and psychological well-being in previously inactive postmenopausal women: A pilot study. Menopause, 13, 561–567.CrossRefPubMedGoogle Scholar
  50. 50.
    Paffenbarger, R. S., Jr., Hyde, R. T., Wing, A. L., & Hsieh, C. C. (1986). Physical activity, all-cause mortality, and longevity of college alumni. New England Journal of Medicine, 314, 605–613.PubMedCrossRefGoogle Scholar
  51. 51.
    Kohl, H. W., I. I. I., Fulton, J. E., & Caspersen, C. J. (2000). Assessment of physical activity among children and adolescents: A review and synthesis. Preventive Medicine, 31, S54–S76.CrossRefGoogle Scholar
  52. 52.
    Connor-Gorber, S., Tremblay, M., Moher, D., & Gorber, B. (2007). A comparison of direct vs. self-report measures for assessing height, weight and body mass index: A systematic review. Obesity Reviews, 8, 307–326.CrossRefGoogle Scholar
  53. 53.
    Nyholm, M., Gullberg, B., Merlo, J., Lundqvist-Persson, C., Rastam, L., & Lindblad, U. (2007). The validity of obesity based on self-reported weight and height: Implications for population studies. Obesity, 15, 197–208.CrossRefPubMedGoogle Scholar
  54. 54.
    Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. Journal of the American Medical Association, 289, 1813–1819.CrossRefPubMedGoogle Scholar
  55. 55.
    Pinhas-Hamiel, O., Singer, S., Pilpel, N., Fradkin, A., Modan, D., & Reichman, B. (2006). Health-related quality of life among children and adolescents: Associations with obesity. International Journal of Obesity, 30, 267–272.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Katya M. Herman
    • 1
  • Wilma M. Hopman
    • 2
  • Cora L. Craig
    • 3
    • 4
  1. 1.School of Kinesiology & Health StudiesQueen’s UniversityKingstonCanada
  2. 2.Clinical Research Centre, Kingston General Hospital, and Department of Community Health and EpidemiologyQueen’s UniversityKingstonCanada
  3. 3.Canadian Fitness & Lifestyle Research InstituteOttawaCanada
  4. 4.School of Public HealthUniversity of SydneySydneyAustralia

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