Abstract
BackgroundThere is evidence that overweight and obesity in children is associated with poor Physical Fitness and consequently lower Health-related Quality of Life (HRQoL). However, this linear-causal relationship between Weight Status → Physical Fitness → HRQoL is not enough to fully understand this phenomenon. Therefore, need to know, through mediation analysis, how operate the Physical Fitness between weight status and HRQoL dimensions.PurposeThe aim of this study was to determine which HRQoL dimensions are mediated through Physical Fitness in obese (including overweight) and normal weight children. The study also examined the association between Physical Fitness, Body Mass Index (BMI) and HRQoL.MethodsA total of 233 overweight/obese children and 105 normal-weight children participated in the study. Children were recruited from public educational centers and a public weight loss program. BMI, Physical Fitness (upper limb, central body and lower limb strength; agility and range of motion) and HRQoL (PedsQL and VAS) were measured. Simple mediation analyses by gender, through PROCESS macro developed by Preacher and Hayes, were performed in order to analyze whether Physical Fitness computed as z-score, is a mediator in the relation between weight status (normal weight or overweight/obesity) and HRQoL dimensions. \\itionally, unequal-variances t statistics were executed to know differences in BMI, Physical Fitness components and HRQoL dimensions between groups, and correlations to know the associations between weight status, Physical Fitness z-score and HRQoL.ResultsOur results, indicated association between the Physical Fitness z-score and HRQoL dimensions in overweight/obese children. Regarding to mediation analysis, the results showed that the negative association between overweight/obesity and HRQoL is softened by the level of Physical Fitness. Therefore Physical Fitness is a mediator in the relationship between overweight/obesity children and the most of dimensions of HRQoL, except the School functioning in boys and the School and Emotional functioning in girls.ConclusionsThe negative effect of overweight or obesity on HRQoL inn children, is mitigated by Physical Fitness. Consequently, the Physical Fitness is a mediator on HRQoL in most dimensions, especially daily living, in schoolchildren.
Highlights
There is evidence that overweight and obesity in children is associated with poor Physical Fitness and lower Health-related Quality of Life (HRQoL)
Simple mediation analyses by gender, through PROCESS macro developed by Preacher and Hayes, were performed in order to analyze whether Physical Fitness computed as z-score, is a mediator in the relation between weight status and HRQoL dimensions. \itionally, unequal-variances t statistics were executed to know differences in Body Mass Index (BMI), Physical Fitness components and HRQoL dimensions between groups, and correlations to know the associations between weight status, Physical Fitness z-score and HRQoL
The results showed that the negative association between overweight/ obesity and HRQoL is softened by the level of Physical Fitness
Summary
There is evidence that overweight and obesity in children is associated with poor Physical Fitness and lower Health-related Quality of Life (HRQoL). This linear-causal relationship between Weight Status → Physical Fitness → HRQoL is not enough to fully understand this phenomenon. Children and adolescents who are overweight or obese have a poor physical fitness (PF) level, e.g. in muscular strength [7, 8] and cardiorespiratory endurance [9, 10], and show low motor skill and coordination performance [11]. The description of the simple and direct relationship between BMI-PF-HRQoL is not enough to fully understand and obtain evidence about these causal phenomena
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