Is there an association between early weight status and utility-based health-related quality of life in young children?



Few studies focus on the health-related quality of life (HRQoL) of preschool children with overweight or obesity. This is relevant for evaluation of obesity prevention trials using a quality-adjusted life year (QALY) framework. This study examined the association between weight status in the preschool years and HRQoL at age 5 years, using a preference-based instrument.


HRQoL [based on parent proxy version of the Health Utilities Index Mark 3 (HUI3)] and weight status were measured in children born in Australia between 2007 and 2009. Children’s health status was scored across eight attributes of the HUI3—vision, hearing, speech, ambulation, dexterity, emotion, cognition and pain, and these were used to calculate a multi-attribute utility score. Ordinary least squares (OLS), Tobit and two-part regressions were used to model the association between weight status and multi-attribute utility.


Of the 368 children for whom weight status and HUI3 data were available, around 40% had overweight/obesity. After adjusting for child’s sex, maternal education, marital status and household income, no significant association between weight status in the preschool years and multi-attribute utility scores at 5 years was found.


Alternative approaches for capturing the effects of weight status in the preschool years on preference-based HRQoL outcomes should be tested. The application of the QALY framework to economic evaluations of obesity-related interventions in young children should also consider longitudinal effects over the life-course.

Clinical Trial Registration The Healthy Beginnings Trial was registered with the Australian Clinical Trial Registry (ACTRNO12607000168459).

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EJT and VB gratefully acknowledge funding support from the NHMRC Centre of Research Excellence in Early Prevention of Obesity in Childhood (#1101675). EJT also acknowledge funding support from NHMRC project Grants #393112 and #1003780. We sincerely thank all the participating families in the Healthy Beginnings Trial (HBT). We also thank Lauren Viney and Maxine Goodwin for assistance with data collection and data entry relating to HBT.


The study was funded from NHMRC project Grants #393112 and #1003780, and NHMRC Centre of Research Excellence in Early Prevention of Obesity in Childhood (EPOCH) (#1101675). The funder had no role in the study, and the researchers were independent from the funder.

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Correspondence to Eng Joo Tan.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Sydney Local Health District Research Ethics Review Committee (X10-0312; and HREC/10/RPAH/546).

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Informed consent was obtained from all individual participants included in the study.

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Tan, E.J., Brown, V., Petrou, S. et al. Is there an association between early weight status and utility-based health-related quality of life in young children?. Qual Life Res 27, 2851–2858 (2018).

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  • Obesity
  • Child health
  • Health-related quality of life
  • HUI
  • Utility
  • Childhood obesity