Health-related quality of life, obesity, and fitness in schoolchildren: the Cuenca study
The purpose of this study was to analyze the association of weight status and physical fitness with health-related quality of life (HRQoL) and to examine the independent association of body mass index (BMI), cardiorespiratory fitness (CRF) and musculoskeletal fitness (MF) with HRQoL in schoolchildren.
Cross-sectional study of 1,158 schoolchildren, 8–11 years, from 20 schools in the Cuenca province, Spain. We measured weight, height, and physical fitness, measured by CRF (20-m shuttle run test) and MF index by summing the age–sex z scores of handgrip strength test/weight + standing broad jump test. Self-reported HRQoL was measured by KIDSCREEN-52 questionnaire.
Normal weight boys scored better in physical well-being, mood and emotions, autonomy, and social support and peers dimensions than overweight/obese boys. The mean in self-perception dimensions was lower in obese girls compared to normal weight or overweight girls. Higher levels of CRF and MF were associated with better physical well-being in both genders. Multiple linear regression models showed that the influence of MF in boys and CRF in girls on HRQoL was greater than that of overweight.
This is one of the first studies that assess the association of CRF and MF with HRQoL while controlling for BMI. CRF and MF are closely related to HRQoL, in particular to physical well-being. Improving fitness could be a strategy of particular interest for improving the HRQoL of schoolchildren.
KeywordsHealth-related quality of life Schoolchildren Cardiorespiratory fitness Musculoskeletal fitness Obesity
Body mass index
Health-related quality of life
Musculoskeletal fitness index
We thank the schools, families, and children for their enthusiastic participation in the study. This study was funded by the Ministry of Education and Science-Junta de Comunidades de Castilla-La Mancha (PII1I09-0259-9898 and POII10-0208-5325), and Ministry of Health (FIS PI081297). Additional funding was obtained from the Research Network on Preventative Activities and Health Promotion (Ref.—RD06/0018/0038).
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
- 1.Martinez Vizcaino, V., Salcedo Aguilar, F., Franquelo Gutierrez, R., Torrijos Regidor, R., Morant Sanchez, A., Solera Martinez, M., et al. (2006). Prevalence of obesity and trends in cardiovascular risk factors among Spanish school children, 1992–2004: the Cuenca (Spain) study. Medicina Clinica (Barc), 126(18), 681–685.CrossRefGoogle Scholar
- 3.Martinez-Vizcaino, V., Sanchez Lopez, M., Moya Martinez, P., Solera Martinez, M., Notario Pacheco, B., Salcedo Aguilar, F., et al. (2009). Trends in excess weight and thinness among Spanish schoolchildren in the period 1992–2004: the Cuenca study. Public Health Nutrition, 12(7), 1015–1018.PubMedCrossRefGoogle Scholar
- 10.Ottova, V., Erhart, M., Rajmil, L., Dettenborn-Betz, L., & Ravens-Sieberer, U. (2011). Overweight and its impact on the health-related quality of life in children and adolescents: results from the European KIDSCREEN survey. Qual Life Res.Google Scholar
- 12.Sanchez-Lopez, M., Salcedo-Aguilar, F., Solera-Martinez, M., Moya-Martinez, P., Notario-Pacheco, B., & Martinez-Vizcaino, V. (2009). Physical activity and quality of life in schoolchildren aged 11–13 years of Cuenca Spain. Scandinavian Journal of Medicine and Science in Sports, 19(6), 879–884.PubMedCrossRefGoogle Scholar
- 17.Bonhauser, M., Fernandez, G., Puschel, K., Yanez, F., Montero, J., Thompson, B., et al. (2005). Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trial. Health Promotion International, 20(2), 113–122.PubMedCrossRefGoogle Scholar
- 21.Robitail, S., Simeoni, M. C., Erhart, M., Ravens-Sieberer, U., Bruil, J., & Auquier, P. (2006). Validation of the European proxy KIDSCREEN-52 pilot test health-related quality of life questionnaire: first results. J Adolesc Health, 39(4), 596 e591–e510.Google Scholar
- 22.Palacio-Vieira, J. A., Villalonga-Olives, E., Valderas, J. M., Espallargues, M., Herdman, M., Berra, S., et al. (2008). Changes in health-related quality of life (HRQoL) in a population-based sample of children and adolescents after 3 years of follow-up. Quality of Life Research, 17(10), 1207–1215.PubMedCrossRefGoogle Scholar
- 38.Wanderley, F. A., Silva, G., Marques, E., Oliveira, J., Mota, J., & Carvalho, J. (2011). Associations between objectively assessed physical activity levels and fitness and self-reported health-related quality of life in community-dwelling older adults. Quality of Life Research, 20(9), 1371–1378.PubMedCrossRefGoogle Scholar
- 39.Lee, D. C., Sui, X., Artero, E. G., Lee, I. M., Church, T. S., McAuley, P. A., et al. (2011). Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men: the aerobics center longitudinal study. Circulation, 124(23), 2483–2490.PubMedCrossRefGoogle Scholar
- 40.Kruger, J., Bowles, H. R., Jones, D. A., Ainsworth, B. E., & Kohl, H. W, 3rd. (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 (London), 31(2), 321–327.CrossRefGoogle Scholar