Quality of Life Research

, Volume 19, Issue 7, pp 943–954 | Cite as

Physical activity, quality of life, weight status and diet in adolescents

  • Spencer E. BoyleEmail author
  • Georgina L. Jones
  • Stephen J. Walters



This cross-sectional study aimed to investigate the relationship between quality of life (QoL), physical activity (PA), diet and overweight status in children 11 to 15 years old.

Study participants

Participants (N = 1,771) children with self-reported physical activity and QoL outcome data.


Cross-sectional survey of four secondary schools, using the PedsQL and EQ-5D QoL instruments; the CAPANS physical activity instrument and a food intake screener questionnaire.


The correlational analysis indicates little or no relationship between self-reported QoL, BMI and moderate to vigorous PA. We found no statistically significant differences between the two groups of children, who achieved the recommended PA guidelines and those who did not, on any of the dimensions of the PedsQL and the EQ-5D utility score. Only on the EQ-5D VAS dimensions score was there a statistically significant difference. Children who self-reported a BMI of overweight to obese had significantly lower QoL on both dimensions of the EQ-5D and every dimension of the PedsQL apart from School functioning.


Overall this study showed mixed results for pupils achieving the recommended targets for physical activity and diet and their relationship with QoL. Hence, further study into PA and diet and their effects on QoL is needed.


Physical activity Adolescents Children Quality of life Weight status Diet 



Special educational needs


General secondary certificate examination


Body mass index


PF PedsQL Physical functioning dimension


PedsQL Emotional functioning


PedsQL Social functioning

PedsQL SchF

PedsQL School functioning


PedsQL Psychosocial health summary score

PedsQL Total

PedsQL Total scale score


Visual analogue scale


Utility overall utility (Tariff)


  1. 1.
    Biddle, S., Sallis, J. F., & Cavill, N. (Eds.). (1998). Young and active? Young people and health-enhancing physical activity–evidence and implications. London: Health Education Authority.Google Scholar
  2. 2.
    U.S. Department of Health and Human Services. (1996). Physical Activity and Health: A Report of the Surgeon General. Atlanta, GA: Centres for Disease Control.Google Scholar
  3. 3.
    Bouchard, C., Shephard, R. J., & Stephens, T. (Eds.). (1994). Physical activity fitness and health. International proceedings and consensus statement. Champaign, IL: Human Kinetics.Google Scholar
  4. 4.
    Paffenbarger, R., & Olsen, E. (1996). Lifefit: An effective exercise programme for optimal health and a longer life. Champaign IL: Human Kinetics.Google Scholar
  5. 5.
    Trembley, M. S., & Willms, J. D. (2003). Is the Canadian childhood obesity epidemic related to physical inactivity? International Journal of Obesity, 27(9), 1100–1105.CrossRefGoogle Scholar
  6. 6.
    Haskel, W. L., Lee, I., Pate, R. R., Powell, K. E., Blair, S. N., Frankiln, B. A., et al. (2007). Physical activity and public health updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116, 1081–1093.CrossRefGoogle Scholar
  7. 7.
    Department of Health. (2004). At least five a week: Evidence on the impact of physical activity and its relationship to health. A Report from the Chief Medical Officer. London: Department of Health Publications.Google Scholar
  8. 8.
    Bize, R., Johnson, J. A., & Plotnikof, R. (2007). The association between health-related quality of life and physical activity level among the general adult population: A systematic review. Preventive Medicine, 10, 1016.Google Scholar
  9. 9.
    Chen, X., Sekine, M., Hamanishi, S., Yamagami, T., & Kagamimori, S. (2005). Associations of lifestyle factors with quality of life (QOL) in Japanese children: A 3-year follow-up of the Toyama Birth Cohort Study. Child: Care. Health & Development, 31(4), 433–439.CrossRefGoogle Scholar
  10. 10.
    Shoup, J. A., Gattshall, M., Dandamudi, P., & Estabrooks, P. (2008). Physical activity, quality of life and weight status in overweight children. Quality of Life Research, 17, 407–412.CrossRefPubMedGoogle Scholar
  11. 11.
    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
  12. 12.
    Friedlander, S. L., Larkin, E. K., Rosen, C. L., Palermo, T. L., & Redline, S. (2003). Decreased quality of life associated with obesity in school-aged children. Archives of Pediatrics and Adolescent Medicine, 157, 1206–1211.CrossRefPubMedGoogle Scholar
  13. 13.
    Pinhaus-Hamiel, O., Singer, S., Pilpel, N., Fradkin, A., Modan, D., & Reichman, B. (2006). HRQOL among children and adolescents: Associations with obesity. International Journal of Obesity, 30, 267–272.CrossRefGoogle Scholar
  14. 14.
    Boyle, S. E. (2008). Evaluation of physical activity levels among adolescents in the Southwest and Northwest: consideration of health issues. A PhD Study. Sheffield, UK: The University of Sheffield.Google Scholar
  15. 15.
    McCormack G, Giles-Corti B. (2002). Report to the physical activity taskforce, evaluation and monitoring group: An assessment of self-report questionnaires and motion sensors for measuring physical activity in children. WA, Australia: Department of Public Health, The University of Western Australia.Google Scholar
  16. 16.
    Hands, B., Parker, H., Glasson, C., Brinkman, S., & Read, H. (2004). Results of Western Australian child and adolescent physical activity and nutrition survey 2003 (CAPANS. Physical Activity Technical Report. Australia: The University of Notre Dame.Google Scholar
  17. 17.
    Block, G., Gillespie, C., Rosenbaum, E. H., & Jenson, C. (2000). A rapid food screener to assess fat and fruit and vegetable intake. American Journal of Preventive Medicine, 18(4), 284–288.CrossRefPubMedGoogle Scholar
  18. 18.
    Cole, T. J., Freeman, J. V., & Preece, M. A. (1990). Body mass index reference curves for the UK. Archives of Disease in Childhood, 73, 25–29.CrossRefGoogle Scholar
  19. 19.
    DH (Central Health Monitoring Unit, Health Improvement Directorate–Public Health). Health Profile of England. London: Department of Health, 2006.Google Scholar
  20. 20.
    The EuroQol Group. (1990). EuroQol–a new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208.CrossRefGoogle Scholar
  21. 21.
    Varni, J. W., Burwinkle, T. M., & Seid, M. (2006). The PedsQL 4.0 as a school population health measure: Feasibility, reliability, and validity. Quality of Life Research, 15, 203–215.CrossRefPubMedGoogle Scholar
  22. 22.
    Wille, N., & Ravens-Sieberer U. (2006). Age-appropriateness of the EQ-5D adult and child-friendly version–Testing the feasibility, reliability and validity in children and adolescents. In 23rd Scientific Plenary Meeting of the EuroQol Group in Barcelona, Spain: September 14–16. Edited by: Badía X. Barcelona: IMS Health, pp 217–229.Google Scholar
  23. 23.
    Eidt-Koch. D., Mittendorf, T., Greiner, W. (2009). Cross-sectional validity of the EQ-5D-Y as a generic health outcome instrument in children and adolescents with cystic fibrosis in Germany. BMC Pediatrics, 9, 55. doi:  10.1186/1471-2431-9-55.
  24. 24.
    Dolan, P., Gudex, C., Kind, P., & Williams, A. (1995). A social tariff for the EuroQol: Results from a UK general population survey. Centre for Health Economics Discussion Paper No. 138. York: University of York.Google Scholar
  25. 25.
    Walters, S. J. (2009). Quality of life outcomes in clinical trials and health care evaluation: a practical guide to analysis and interpretation. Chichester: Wiley.CrossRefGoogle Scholar
  26. 26.
    Varni JW, Limbers C, Burwinckle TM. (2007). Literature review: health-related quality of life measurement in pediatric oncology: hearing the voices of the children. Journal of Pediatric Psychology, March: 1–13.Google Scholar
  27. 27.
    Walters, S. J., & Brazier, J. E. (2005). Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Quality of Life Research, 14, 1523–1532.CrossRefPubMedGoogle Scholar
  28. 28.
    Vuillemin, A., Boini, S., Bertais, S., Tessier, S., Oppert, J.-M., Hercberg, S., et al. (2007). Association between leisure-time physical activity and health-related quality of life changes over time. Preventive Medicine, 44(3), 202–208.CrossRefPubMedGoogle Scholar
  29. 29.
    Shibata, A., Oka, K., Nakamura, Y., & Muraoka, I. (2007). Recommended level of physical activity and health related quality of life among Japanese adults. Health and Quality of Life Outcomes, 5, 64.CrossRefPubMedGoogle Scholar
  30. 30.
    Kruger, J., Bowles, H. R., Jones, D. A., Ainsworth, B. E., & Kohl, H. W. (2007). Health-related quality of life, BMI and physical activity among US adults (≥18 years): National Physical Activity and Weight Loss Survey, 2002. International Journal of Obesity, 31, 321–327.CrossRefPubMedGoogle Scholar
  31. 31.
    Malmberg, J., Miilunpalo, S., Pasanen, M., Vuori, I., & Oja, P. (2005). Characteristics of leisure time physical activity associated with a risk of decline in perceived health–a 10 year follow-up of middle-aged and elderly men and women. Preventive Medicine, 41(1), 141–150.CrossRefPubMedGoogle Scholar
  32. 32.
    Brown, D. W., Balluz, L. S., Heath, G. W., Moriarity, D. G., Ford, E. S., Giles, H. W., et al. (2003). Associations between recommended levels of physical activity and health-related quality of life. Findings from the 2001 behavioural risk factor surveillance system (BRFSS) survey. Preventive Medicine, 37(5), 520–528.CrossRefPubMedGoogle Scholar
  33. 33.
    Wendel-Vos, G. C. W., Shuit, A. J., Tijhuis, M. A. R., & Kromhout, D. (2004). Leisure time physical activity and health-related quality of life: Cross-sectional and longitudinal associations. Quality of Life Research, 13, 667–677.CrossRefPubMedGoogle Scholar
  34. 34.
    De Beer, M., Hofsteenge, G. H., Koot, H. M., Hirasing, R. A., Delemarre-van de Waal, H. A., & Gemke, R. J. B. (2007). Health-related-quality-of-life in obese adolescents is decreased and inversely related to BMI. Acta Paediatrica, 96(5), 710–714.CrossRefPubMedGoogle Scholar
  35. 35.
    Fallon, E. M., Tanofsky-Kraff, M., Norman, A. C., McDuffie, J. R., Taylor, E. D., Cohen, M. L., et al. (2005). Health-related quality of life in overweight and nonoverweight black and white adolescents. Journal of Pediatrics, 147(4), 443–450.CrossRefPubMedGoogle Scholar
  36. 36.
    Amaral, O., Pereira, C., Veiga, N., Tavares, I., Sanganho, M., & Catela, N. (2005). Overweight and health related quality of life in Portuguese adolescents. European Journal of Public Health, 15(supp 1), 89–90.Google Scholar
  37. 37.
    Zeller, M. H., & Modi, A. C. (2006). Predictors of health-related quality of life in obese youth. Obesity, 14(1), 122–130.CrossRefPubMedGoogle Scholar
  38. 38.
    Hughes, A. R., Farewell, K., Harris, D., & Reilly, J. J. (2007). Quality of life in a clinical sample of obese children. International Journal of Obesity, 31(1), 39–44.CrossRefPubMedGoogle Scholar
  39. 39.
    Plaisted, C. S., Lin, P. H., Ard, J. D., McClure, M. L., & Svetkey, L. P. (1999). The effects of dietary patterns on quality of life a substudy of the dietary approaches to stop hypertension trial. Journal of the American Dietetic Association, 99(8 S1), S84–S89.CrossRefPubMedGoogle Scholar
  40. 40.
    Hassan, M. K., Joshi, A. V., Madhavan, S. S., & Amonkar, M. M. (2004). Obesity and health related quality of life: A cross-sectional analysis of the US Population. International Journal of Obesity, 27, 1227–1232.CrossRefGoogle Scholar
  41. 41.
    NHS Information Centre. (2006). Statistics on obesity, physical activity and diet: England, 2006. The NHS Information Centre, Lifestyles Statistics.Google Scholar
  42. 42.
    Ofsted. Inspection Reports. Published Online @ on 01/11/05.
  43. 43.
    Welk, G. J., Corbin, C. B., & Dale, D. (2000). Measurement issues in the assessment of physical activity in children. Research Quarterly for Exercise and Sport, 71(2), 59–73.Google Scholar
  44. 44.
    Crocker, P. R. E., Bailey, D. A., Faulkner, R. A., Kowalski, K. C., & McGrath, R. (1997). Measuring general levels of physical activity: Preliminary evidence for the physical activity questionnaire for older children. Medicine and Science in Sports and Exercise, 29(10), 1344–1349.PubMedGoogle Scholar
  45. 45.
    Sallis, J. F., & Owen, N. (1999). Physical activity and behavioural medicine. London: Sage Publications.Google Scholar
  46. 46.
    Voss, L. D., & Bailey, B. J. (1994). Equipping the community to measure children’s height: The reliability of portable instruments. Archives of Disease in Childhood, 70, 469–471.CrossRefPubMedGoogle Scholar
  47. 47.
    Strauss, R. S. (1999). Comparison of measured and self reported weight and height in a cross sectional sample of young adolescents. International Journal of Obesity Related Metabolic Disorders, 8, 904–908.CrossRefGoogle Scholar
  48. 48.
    Goodman, E., Hinden, B. R., & Khandelwal, S. (2000). Accuracy of teen and parental reports of obesity and body mass index. Paediatrics, 106(1), 52–58.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Spencer E. Boyle
    • 1
    Email author
  • Georgina L. Jones
    • 1
  • Stephen J. Walters
    • 1
  1. 1.Medical Statistics Group, School of Health and Related ResearchUniversity of SheffieldSheffieldUK

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