Abstract
BackgroundTo investigate the association between weight status and health-related quality of life (HRQOL) among pupils in Guangzhou, China.MethodsThe study comprised 5781 children aged 8–12 years from 29 schools. Height and weight were objectively measured using standardized methods, and BMI z-score derived using the age and sex specific WHO reference 2007 for 5–19 years. Weight status was classified as underweight (<−2SD), healthy weight (between -2SD and 1SD), overweight/obesity (>1SD). HRQOL was measured by the self-report version of the Pediatric Quality of Life Inventory 4.0.ResultsAfter controlling for gender, age, school type, parental education, and family income, HRQOL scores were significantly lower in overweight/obese compared with healthy weight children only in the social functioning domain (β = −1.93, p = 0.001). Compared with healthy weight children, underweight children had significantly lower total (β = −1.47, p = 0.05) and physical summary scores (β = −2.18, p = 0.02). Subgroup analysis for gender indicated that compared to healthy weight, total (β = −1.96, p = 0.02), psychosocial (β = −2.40, p = 0.01), social functioning (β = −3.36, p = 0.001), and school functioning (β = −2.19, p = 0.03) scores were lower in overweight/obese girls, but not boys. On the other hand, being underweight was associated with lower physical functioning (β = −2.27, p = 0.047) in girls, and lower social functioning (β = −3.63, p = 0.01) in boys. The associations were mainly observed in children aged 10 and over, but were not significant in younger children. Children from private schools had generally lower HRQOL compared to those in public schools, but the associations with weight status were similar in both groups.ConclusionsThe relationship between overweight/obesity and HRQOL in children in China is not as prominent as that seen in children in western or high-income countries. However, there appears to be gender and age differences, with more of an impact of overweight on HRQOL in girls and older children compared with boys and younger children. Underweight is also associated with lower HRQOL. Future intervention to prevent both obesity and undernutrition may have a positive impact on the HRQOL in children in China.
Highlights
To investigate the association between weight status and health-related quality of life (HRQOL) among pupils in Guangzhou, China
Most studies that examine the relationship between weight status and HRQOL have been conducted in western or other high income countries and much of the evidence for an adverse relationship is based on studies in clinical populations [9, 17], the effect of weight status on HRQOL among children living in the community in lower income countries, such as China, has been rarely studied
Sampling and participants The analysis presented comes from a sub-group of participants drawn from a larger study; a crosssectional study undertaken in Guangzhou, which aimed to determine the prevalence and risk factors for overweight and obesity in children age 5–12 years
Summary
To investigate the association between weight status and health-related quality of life (HRQOL) among pupils in Guangzhou, China. In China, a country which has been undergoing a substantial economic transition in the past few decades, the prevalence of childhood overweight and obesity has increased from 1.1 to 9.6% between 1985 and 2010 [3]. Obesity has well documented adverse physical health consequences both in childhood and adulthood, including increased risk of cardiometabolic disease and some cancers [5,6,7,8]. In addition there is growing evidence that obesity in childhood and adolescence has a detrimental effect on health-related quality of life (HRQOL) [9,10,11,12,13,14], with severely obese children having HRQOL that is comparable to that of children with cancer [15]. Most studies that examine the relationship between weight status and HRQOL have been conducted in western or other high income countries and much of the evidence for an adverse relationship is based on studies in clinical populations [9, 17], the effect of weight status on HRQOL among children living in the community in lower income countries, such as China, has been rarely studied
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