Original ArticlesHealth-Related Quality of Life and Lifestyle Behavior Clusters in School-Aged Children from 12 Countries
Section snippets
Methods
Data from the cross-sectional International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) were used (ClinicalTrials.gov: NCT01722500). A detailed description of the ISCOLE protocol can be found in the work of Katzmarzyk et al.18
Participants were recruited from schools in study sites spread across 12 countries (Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, England, and the US). From these schools, children aged 9-11 years were
Results
Participants were enrolled from September 2011 to December 2013, and their characteristics are presented in Table I. Children's self-reported HRQoL differed between sites (Table II). Children from higher-income countries tended to report greater HRQoL than children from low-to-middle income countries (correlation between HRQoL and world bank classification: r = 0.74, P = .01, and between HRQoL and human development index: r = 0.62, P = .03).
Three similar clusters were identified across most of
Discussion
Remarkable commonality was observed in lifestyle behavior patterns throughout the world, with each country having a cluster characterized by (1) high sedentary behavior, (2) high PA, and (3) a combination of high screen time and unhealthy eating pattern. A fourth cluster, characterized by low screen/healthy eating and moderate PA (all-rounders), was absent in Kenya, South Africa, and Brazil, suggesting that this lifestyle behavior pattern may be more common in higher-income nations.
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This study used data from the International Study of Childhood Obesity, Lifestyle and Environment (ISCOLE), which was funded by The Coca-Cola Company. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of this manuscript. The authors declare no conflicts of interest.
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List of members of the ISCOLE research group is available at www.jpeds.com (Appendix).