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Bidirectional associations between overweight and health-related quality of life from 4–11 years: Longitudinal Study of Australian Children

International Journal of Obesity volume 37, pages 1307–1313 (2013)Cite this article

Subjects

Abstract

Background:

Temporal pathways of known associations between overweight and poor health-related quality of life (HRQoL) in adolescents remain poorly documented. This study aims to (1) examine timing and strength of the association between HRQoL and body mass index (BMI) in childhood, and (2) investigate directionality and impact of cumulative burden in any observed HRQoL–BMI associations.

Design, setting and participants:

Participants were 3898 children in the population-based Longitudinal Study of Australian Children (LSAC) assessed at four biennial waves from ages 4–5 (2004) to 10–11 years (2010).

Main measures:

At every wave, parents completed the Pediatric Quality of Life Inventory, and measured BMI (kg m−2) was converted into BMIz and overweight using international norms.

Analyses:

Linear and logistic regressions.

Results:

Overweight first became cross-sectionally associated with HRQoL at 6–7 years of age, with linear associations between poorer HRQoL (physical and psychosocial health) and higher BMI developing by 8–9 years and strengthening by 10–11 years. Longitudinal analyses revealed cumulative relationships such that the number of times a child was overweight between the ages 4 and 11 years predicted progressively poorer scores on both physical and psychosocial health at 10–11 years (P-values for trend <0.001). In the weaker reverse associations, children with poor (vs persistently good) physical health at any wave had slightly higher mean BMIz at age 10–11 years, but this difference was small (0.14, 95% confidence interval (CI): 0.04, 0.24) and not cumulative; results for psychosocial health were even weaker, with mixed subscale findings.

Conclusions:

Middle childhood appears to be the critical period in which HRQoL–BMI comorbidities emerge and strengthen, first among children with clinically relevant conditions, that is, overweight or poor HRQoL, and then more generally across the whole range of BMI. Poorer HRQoL seemed predominantly a consequence of higher BMI, rather than a cause, suggesting that effective promotion of healthy weight could benefit multiple aspects of children’s well-being.

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Acknowledgements

The Longitudinal Study of Australian Children is conducted in partnership between the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA), the Australian Institute of Family Studies (AIFS) and the Australian Bureau of Statistics (ABS). The findings and views reported are those of the authors and should not be attributed to FaHCSIA, AIFS or the ABS. We thank all the parents and children for their continuing support and participation in the LSAC. PWJ was supported by the Netherlands Organization for Scientific Research (NWO) and the Marie Cofund Action (Rubicon grant 446-11-010), and by the Ter Meulen Fund of the Royal Netherlands Academy of Arts and Sciences (KNAW). MW was supported by NHMRC Population Health Career Development Award 546405, and FKM by NHMRC Public Health Capacity Building Grant 436914 and NHMRC Early Career Fellowship 1037449. All research at the Murdoch Childrens Research Institute is supported by the Victorian Government’s Operational Infrastructure Program. This work also received support from the ‘Parenting Australia’s Children’ research group at the Parenting Research Centre.

Author information

Authors and Affiliations

  1. Murdoch Childrens Research Institute, Melbourne, Victoria, Australia

    P W Jansen, F K Mensah, S Clifford, J M Nicholson & M Wake

  2. Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands

    P W Jansen

  3. Clinical Epidemiology and Biostatistics Unit, Royal Children’s Hospital, Melbourne, Victoria, Australia

    F K Mensah

  4. Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia

    F K Mensah & M Wake

  5. Parenting Research Centre, Melbourne, Victoria, Australia

    J M Nicholson

  6. Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Victoria, Australia

    M Wake

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Correspondence to P W Jansen.

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Jansen, P., Mensah, F., Clifford, S. et al. Bidirectional associations between overweight and health-related quality of life from 4–11 years: Longitudinal Study of Australian Children. Int J Obes 37, 1307–1313 (2013). https://doi.org/10.1038/ijo.2013.71

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