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Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Effect of gender on the association between weight status and health-related quality of life in adolescents

Authors: Emilie Bonsergent, Joseph Benie-Bi, Cédric Baumann, Nelly Agrinier, Sabrina Tessier, Nathalie Thilly, Serge Briançon

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

Some studies have investigated the association between body mass index (BMI) and health-related quality of life (HRQoL) among adolescents, but their results have been discrepant and few paid attention to the role of gender. The present investigation aimed to assess the relationship between weight status and HRQoL in adolescents and to verify whether it was similar in boys and girls.

Methods

Five thousand two hundred and twenty six adolescents aged 14 to 18 years were included in the PRomotion de l’ALIMentation et de l’Activité Physique (PRALIMAP) trial, a 2x2x2 factorial cluster randomized trial performed in 24 high schools in France. Sociodemographic, anthropometric and HRQoL data were collected. BMI was categorized in four classes (thin, normal-weight, overweight, obese). Linear regression models were used to estimate the association between weight status and HRQoL, adjusting for confounders.

Results

The mean age of adolescents was 15.7±0.6 years and their mean BMI was 21.6 ±3.5 kg/m2; 55% were girls. Boys were more often overweight and obese than were girls (overweight: 15.6% vs 14.2%, obese: 4.8% vs 3.3%), and girls were more likely to be thin (5.5% vs 4.5%, p=0.0042). All HRQoL scores were higher for boys (p=<0.0001). Weight status was not associated with physical and social scores neither in boys nor in girls. Conversely, it was associated with mental score, but differently in girls than boys. As compared with normal-weight girls, thin girls had better mental HRQoL (β=+6.17, p=0.0010), and overweight and obese girls had lower mental HRQoL (β=−3.89 and β=−5.90, respectively, p<0.001). Mental HRQoL was lower for thin, overweight and obese boys than for normal-weight boys (β= −4.97, β= −1.68 and β= −3.17, respectively, p<0.0001).

Conclusions

Gender can modify the association between weight status and HRQoL in adolescents. Body image could be an important target of public health programs to improve subjective health during adolescence.
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Literature
1.
go back to reference Lobstein T, Baur L, Uauy R: Obesity in children and young people: a crisis in public health. Obes Rev. 2004, 5 (Suppl 1): 4-104.CrossRefPubMed Lobstein T, Baur L, Uauy R: Obesity in children and young people: a crisis in public health. Obes Rev. 2004, 5 (Suppl 1): 4-104.CrossRefPubMed
2.
go back to reference Kirchengast S: Gender Differences in Body Composition from Childhood to Old Age: An Evolutionary Point of View. J Life Sci. 2010, 2: 1-10. Kirchengast S: Gender Differences in Body Composition from Childhood to Old Age: An Evolutionary Point of View. J Life Sci. 2010, 2: 1-10.
3.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012, 307: 483-490. 10.1001/jama.2012.40.CrossRefPubMed Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA. 2012, 307: 483-490. 10.1001/jama.2012.40.CrossRefPubMed
4.
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000, 320: 1240-1243. 10.1136/bmj.320.7244.1240.CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000, 320: 1240-1243. 10.1136/bmj.320.7244.1240.CrossRefPubMedPubMedCentral
5.
go back to reference De Peretti C, Castetbon K: Surpoids et obésité chez les adolescents scolarisés en classe de troisième. Études et résultats. 2004, 283: 1-4. De Peretti C, Castetbon K: Surpoids et obésité chez les adolescents scolarisés en classe de troisième. Études et résultats. 2004, 283: 1-4.
6.
go back to reference Programme National Nutrition Santé (PNNS): Colloque. Étude nationale nutrition santé ENNS, 2006: Situation nutritionnelle en France en 2006 selon les indicateurs d'objectif et les repères du Programme National Nutrition Santé (PNNS). 2007, Saint-Maurice: Institut de Veille Sanitaire (InVS), Maladies chroniques et traumatismes Programme National Nutrition Santé (PNNS): Colloque. Étude nationale nutrition santé ENNS, 2006: Situation nutritionnelle en France en 2006 selon les indicateurs d'objectif et les repères du Programme National Nutrition Santé (PNNS). 2007, Saint-Maurice: Institut de Veille Sanitaire (InVS), Maladies chroniques et traumatismes
7.
go back to reference Engeland A, Bjorge T, Tverdal A, Sogaard AJ: Obesity in adolescence and adulthood and the risk of adult mortality. Epidemiology. 2004, 15: 79-85. 10.1097/01.ede.0000100148.40711.59.CrossRefPubMed Engeland A, Bjorge T, Tverdal A, Sogaard AJ: Obesity in adolescence and adulthood and the risk of adult mortality. Epidemiology. 2004, 15: 79-85. 10.1097/01.ede.0000100148.40711.59.CrossRefPubMed
8.
go back to reference Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS: Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics. 2001, 108: 712-718. 10.1542/peds.108.3.712.CrossRefPubMed Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS: Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics. 2001, 108: 712-718. 10.1542/peds.108.3.712.CrossRefPubMed
9.
go back to reference Koplan JP, Liverman CT, Kraak VI: Extent and Consequences of Childhood Obesity. Preventing Childhood Obesity: Health in the Balance. 2005, Washington, DC: The national academies press, 54-78. Koplan JP, Liverman CT, Kraak VI: Extent and Consequences of Childhood Obesity. Preventing Childhood Obesity: Health in the Balance. 2005, Washington, DC: The national academies press, 54-78.
10.
go back to reference Wang LY, Chyen D, Lee S, Lowry R: The association between body mass index in adolescence and obesity in adulthood. J Adolesc Health. 2008, 42: 512-518. 10.1016/j.jadohealth.2007.10.010.CrossRefPubMed Wang LY, Chyen D, Lee S, Lowry R: The association between body mass index in adolescence and obesity in adulthood. J Adolesc Health. 2008, 42: 512-518. 10.1016/j.jadohealth.2007.10.010.CrossRefPubMed
11.
go back to reference Kumanyika SK, Obarzanek E, Stettler N, Bell R, Field AE, Fortmann SP, et al: Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on population and prevention science). Circulation. 2008, 118: 428-464. 10.1161/CIRCULATIONAHA.108.189702.CrossRefPubMed Kumanyika SK, Obarzanek E, Stettler N, Bell R, Field AE, Fortmann SP, et al: Population-based prevention of obesity: the need for comprehensive promotion of healthful eating, physical activity, and energy balance: a scientific statement from American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention (formerly the expert panel on population and prevention science). Circulation. 2008, 118: 428-464. 10.1161/CIRCULATIONAHA.108.189702.CrossRefPubMed
12.
go back to reference Williams J, Wake M, Hesketh K, Maher E, Waters E: Health-related quality of life of overweight and obese children. JAMA. 2005, 293: 70-76. 10.1001/jama.293.1.70.CrossRefPubMed Williams J, Wake M, Hesketh K, Maher E, Waters E: Health-related quality of life of overweight and obese children. JAMA. 2005, 293: 70-76. 10.1001/jama.293.1.70.CrossRefPubMed
13.
go back to reference Evans DR: Enhancing quality of life in the population at large. Soc Indic Res. 1994, 33: 47-88. 10.1007/BF01078958.CrossRef Evans DR: Enhancing quality of life in the population at large. Soc Indic Res. 1994, 33: 47-88. 10.1007/BF01078958.CrossRef
14.
go back to reference MacKeigan LD, Pathak DS: Overview of health-related quality-of-life measures. Am J Hosp Pharm. 1992, 49: 2236-2245.PubMed MacKeigan LD, Pathak DS: Overview of health-related quality-of-life measures. Am J Hosp Pharm. 1992, 49: 2236-2245.PubMed
15.
go back to reference World Health Organisation: Health promotion glossary. 1998, Switzerland: Geneva, 1-36. World Health Organisation: Health promotion glossary. 1998, Switzerland: Geneva, 1-36.
16.
go back to reference Story MT, Neumark-Stzainer DR, Sherwood NE, Holt K, Sofka D, Trowbridge FL, et al: Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics. 2002, 110: 210-214.PubMed Story MT, Neumark-Stzainer DR, Sherwood NE, Holt K, Sofka D, Trowbridge FL, et al: Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics. 2002, 110: 210-214.PubMed
17.
go back to reference Story M, Nanney MS, Schwartz MB: Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. Milbank Q. 2009, 87: 71-100. 10.1111/j.1468-0009.2009.00548.x.CrossRefPubMedPubMedCentral Story M, Nanney MS, Schwartz MB: Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity. Milbank Q. 2009, 87: 71-100. 10.1111/j.1468-0009.2009.00548.x.CrossRefPubMedPubMedCentral
18.
go back to reference Bergman MM, Scott J: Young adolescents' wellbeing and health-risk behaviours: gender and socio-economic differences. J Adolesc. 2001, 24: 183-197. 10.1006/jado.2001.0378.CrossRefPubMed Bergman MM, Scott J: Young adolescents' wellbeing and health-risk behaviours: gender and socio-economic differences. J Adolesc. 2001, 24: 183-197. 10.1006/jado.2001.0378.CrossRefPubMed
19.
go back to reference Bisegger C, Cloetta B, Von RU, Abel T, Ravens-Sieberer U: Health-related quality of life: gender differences in childhood and adolescence. Soz Praventivmed. 2005, 50: 281-291. 10.1007/s00038-005-4094-2.CrossRefPubMed Bisegger C, Cloetta B, Von RU, Abel T, Ravens-Sieberer U: Health-related quality of life: gender differences in childhood and adolescence. Soz Praventivmed. 2005, 50: 281-291. 10.1007/s00038-005-4094-2.CrossRefPubMed
20.
go back to reference Michel G, Bisegger C, Fuhr DC, Abel T: Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis. Qual Life Res. 2009, 18: 1147-1157. 10.1007/s11136-009-9538-3.CrossRefPubMed Michel G, Bisegger C, Fuhr DC, Abel T: Age and gender differences in health-related quality of life of children and adolescents in Europe: a multilevel analysis. Qual Life Res. 2009, 18: 1147-1157. 10.1007/s11136-009-9538-3.CrossRefPubMed
21.
go back to reference Fallon EM, Tanofsky-Kraff M, Norman AC, McDuffie JR, Taylor ED, Cohen ML, et al: Health-related quality of life in overweight and nonoverweight black and white adolescents. J Pediatr. 2005, 147: 443-450. 10.1016/j.jpeds.2005.05.039.CrossRefPubMedPubMedCentral Fallon EM, Tanofsky-Kraff M, Norman AC, McDuffie JR, Taylor ED, Cohen ML, et al: Health-related quality of life in overweight and nonoverweight black and white adolescents. J Pediatr. 2005, 147: 443-450. 10.1016/j.jpeds.2005.05.039.CrossRefPubMedPubMedCentral
22.
go back to reference Swallen KC, Reither EN, Haas SA, Meier AM: Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics. 2005, 115: 340-347. 10.1542/peds.2004-0678.CrossRefPubMed Swallen KC, Reither EN, Haas SA, Meier AM: Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics. 2005, 115: 340-347. 10.1542/peds.2004-0678.CrossRefPubMed
23.
go back to reference Pinhas-Hamiel O, Singer S, Pilpel N, Fradkin A, Modan D, Reichman B: Health-related quality of life among children and adolescents: associations with obesity. Int J Obes (Lond). 2006, 30: 267-272. 10.1038/sj.ijo.0803107.CrossRef Pinhas-Hamiel O, Singer S, Pilpel N, Fradkin A, Modan D, Reichman B: Health-related quality of life among children and adolescents: associations with obesity. Int J Obes (Lond). 2006, 30: 267-272. 10.1038/sj.ijo.0803107.CrossRef
24.
go back to reference de Beer M, Hofsteenge GH, Koot HM, Hirasing RA, de Waal HA D-v, Gemke RJ: Health-related-quality-of-life in obese adolescents is decreased and inversely related to BMI. Acta Paediatr. 2007, 96: 710-714. 10.1111/j.1651-2227.2007.00243.x.CrossRefPubMed de Beer M, Hofsteenge GH, Koot HM, Hirasing RA, de Waal HA D-v, Gemke RJ: Health-related-quality-of-life in obese adolescents is decreased and inversely related to BMI. Acta Paediatr. 2007, 96: 710-714. 10.1111/j.1651-2227.2007.00243.x.CrossRefPubMed
25.
go back to reference Tsiros MD, Olds T, Buckley JD, Grimshaw P, Brennan L, Walkley J, et al: Health-related quality of life in obese children and adolescents. Int J Obes (Lond). 2009, 33: 387-400. 10.1038/ijo.2009.42.CrossRef Tsiros MD, Olds T, Buckley JD, Grimshaw P, Brennan L, Walkley J, et al: Health-related quality of life in obese children and adolescents. Int J Obes (Lond). 2009, 33: 387-400. 10.1038/ijo.2009.42.CrossRef
26.
go back to reference Keating CL, Moodie ML, Swinburn BA: The health-related quality of life of overweight and obese adolescents–a study measuring body mass index and adolescent-reported perceptions. Int J Pediatr Obes. 2011, 6: 434-441. 10.3109/17477166.2011.590197.CrossRefPubMed Keating CL, Moodie ML, Swinburn BA: The health-related quality of life of overweight and obese adolescents–a study measuring body mass index and adolescent-reported perceptions. Int J Pediatr Obes. 2011, 6: 434-441. 10.3109/17477166.2011.590197.CrossRefPubMed
27.
go back to reference Song AY, Rubin JP, Thomas V, Dudas JR, Marra KG, Fernstrom MH: Body image and quality of life in post massive weight loss body contouring patients. Obesity (Silver Spring). 2006, 14: 1626-1636. 10.1038/oby.2006.187.CrossRef Song AY, Rubin JP, Thomas V, Dudas JR, Marra KG, Fernstrom MH: Body image and quality of life in post massive weight loss body contouring patients. Obesity (Silver Spring). 2006, 14: 1626-1636. 10.1038/oby.2006.187.CrossRef
28.
go back to reference Briançon S, Bonsergent E, Agrinier N, Tessier S, Legrand K, Lecomte E, et al: PRALIMAP: study protocol for a high school-based, factorial cluster randomised interventional trial of three overweight and obesity prevention strategies. Trials. 2010, 11: 119-10.1186/1745-6215-11-119.CrossRefPubMedPubMedCentral Briançon S, Bonsergent E, Agrinier N, Tessier S, Legrand K, Lecomte E, et al: PRALIMAP: study protocol for a high school-based, factorial cluster randomised interventional trial of three overweight and obesity prevention strategies. Trials. 2010, 11: 119-10.1186/1745-6215-11-119.CrossRefPubMedPubMedCentral
30.
go back to reference Cole TJ, Flegal KM, Nicholls D, Jackson AA: Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007, 335: 194-10.1136/bmj.39238.399444.55.CrossRefPubMedPubMedCentral Cole TJ, Flegal KM, Nicholls D, Jackson AA: Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007, 335: 194-10.1136/bmj.39238.399444.55.CrossRefPubMedPubMedCentral
31.
go back to reference Parkerson GR, Broadhead WE, Tse CK: The Duke Health Profile. A 17-item measure of health and dysfunction. Med Care. 1990, 28: 1056-1072. 10.1097/00005650-199011000-00007.CrossRefPubMed Parkerson GR, Broadhead WE, Tse CK: The Duke Health Profile. A 17-item measure of health and dysfunction. Med Care. 1990, 28: 1056-1072. 10.1097/00005650-199011000-00007.CrossRefPubMed
32.
go back to reference Vo TX, Guillemin F, Deschamps JP: Psychometric properties of the DUKE Health Profile-adolescent version (DHP-A): a generic instrument for adolescents. Qual Life Res. 2005, 14: 2229-2234. 10.1007/s11136-005-7021-3.CrossRefPubMed Vo TX, Guillemin F, Deschamps JP: Psychometric properties of the DUKE Health Profile-adolescent version (DHP-A): a generic instrument for adolescents. Qual Life Res. 2005, 14: 2229-2234. 10.1007/s11136-005-7021-3.CrossRefPubMed
33.
go back to reference Guillemin F, Paul-Dauphin A, Virion JM, Bouchet C, Briancon S: The DUKE health profile: a generic instrument to measure the quality of life tied to health. Sante Publique. 1997, 9: 35-44.PubMed Guillemin F, Paul-Dauphin A, Virion JM, Bouchet C, Briancon S: The DUKE health profile: a generic instrument to measure the quality of life tied to health. Sante Publique. 1997, 9: 35-44.PubMed
34.
go back to reference World Health Organization: Official Records of the World Health Organization. 1946, New-York, 2 World Health Organization: Official Records of the World Health Organization. 1946, New-York, 2
35.
go back to reference Goldstein H: Multilevel statistical models. 2011, Hoboken: Wiley, 4 Goldstein H: Multilevel statistical models. 2011, Hoboken: Wiley, 4
36.
go back to reference Cohane GH, Pope HG: Body image in boys: a review of the literature. Int J Eat Disord. 2001, 29: 373-379. 10.1002/eat.1033.CrossRefPubMed Cohane GH, Pope HG: Body image in boys: a review of the literature. Int J Eat Disord. 2001, 29: 373-379. 10.1002/eat.1033.CrossRefPubMed
37.
go back to reference Duncan MJ, Al Nakeeb Y, Nevill AM, Jones MV: Body dissatisfaction, body fat and physical activity in British children. Int J Pediatr Obes. 2006, 1: 89-95. 10.1080/17477160600569420.CrossRefPubMed Duncan MJ, Al Nakeeb Y, Nevill AM, Jones MV: Body dissatisfaction, body fat and physical activity in British children. Int J Pediatr Obes. 2006, 1: 89-95. 10.1080/17477160600569420.CrossRefPubMed
38.
go back to reference Bergström E, Stenlud D, Svedjehäll B: Assessment of body perception among Swedish adolescents and young adults. J Adolesc Health. 2000, 26: 43-57.CrossRef Bergström E, Stenlud D, Svedjehäll B: Assessment of body perception among Swedish adolescents and young adults. J Adolesc Health. 2000, 26: 43-57.CrossRef
39.
go back to reference ter Bogt TF, van Dorsselaer SA, Monshouwer K, Verdurmen JE, Engels RC, Vollebergh WA: Body mass index and body weight perception as risk factors for internalizing and externalizing problem behavior among adolescents. J Adolesc Health. 2006, 39: 27-34. 10.1016/j.jadohealth.2005.09.007.CrossRefPubMed ter Bogt TF, van Dorsselaer SA, Monshouwer K, Verdurmen JE, Engels RC, Vollebergh WA: Body mass index and body weight perception as risk factors for internalizing and externalizing problem behavior among adolescents. J Adolesc Health. 2006, 39: 27-34. 10.1016/j.jadohealth.2005.09.007.CrossRefPubMed
40.
go back to reference Unterhalter G, Farell S, Mohr C: Selective memory bias for words reflecting sexe specific body image concerns. Eat Behav. 2007, 8: 382-389. 10.1016/j.eatbeh.2006.11.015.CrossRefPubMed Unterhalter G, Farell S, Mohr C: Selective memory bias for words reflecting sexe specific body image concerns. Eat Behav. 2007, 8: 382-389. 10.1016/j.eatbeh.2006.11.015.CrossRefPubMed
41.
go back to reference Lawler M, Nixon E: Body dissatisfaction among adolescents boys and girls: the effect of body mass, peer appearance culture and internationalization of appearance ideals. J Youth Adolesc. 2011, 40: 59-71. 10.1007/s10964-009-9500-2.CrossRefPubMed Lawler M, Nixon E: Body dissatisfaction among adolescents boys and girls: the effect of body mass, peer appearance culture and internationalization of appearance ideals. J Youth Adolesc. 2011, 40: 59-71. 10.1007/s10964-009-9500-2.CrossRefPubMed
42.
go back to reference El Ansari W, Vodder Clausen S, Mabhala A, Stock C: How do i look? Body image perceptions among university students from England ans Denmark. Int J Environ Res Public Health. 2010, 7: 583-595. 10.3390/ijerph7020583.CrossRefPubMed El Ansari W, Vodder Clausen S, Mabhala A, Stock C: How do i look? Body image perceptions among university students from England ans Denmark. Int J Environ Res Public Health. 2010, 7: 583-595. 10.3390/ijerph7020583.CrossRefPubMed
43.
go back to reference Pearce MJ, Boergers J, Prinstein MJ: Adolescent obesity, overt and relational peer victimization, and romantic relationships. Obes Res. 2002, 10: 386-393. 10.1038/oby.2002.53.CrossRefPubMed Pearce MJ, Boergers J, Prinstein MJ: Adolescent obesity, overt and relational peer victimization, and romantic relationships. Obes Res. 2002, 10: 386-393. 10.1038/oby.2002.53.CrossRefPubMed
44.
go back to reference Bradford-Hill A: The environment and disease: assocation or causation?. Proc R Soc Med. 1965, 58: 295-300. Bradford-Hill A: The environment and disease: assocation or causation?. Proc R Soc Med. 1965, 58: 295-300.
45.
go back to reference Zwiauer K, Caroli M, Malecka-Tendera E, Poskitt E: Clinical features, adverse effects and outcome. Child and adolescent obesity. Causes and consequences. Prevention and mangement. Edited by: Burniat W, Cole TJ, Lissau I, Poskitt E. 2002, Cambridge: Cambridge University Press, 1-416. Zwiauer K, Caroli M, Malecka-Tendera E, Poskitt E: Clinical features, adverse effects and outcome. Child and adolescent obesity. Causes and consequences. Prevention and mangement. Edited by: Burniat W, Cole TJ, Lissau I, Poskitt E. 2002, Cambridge: Cambridge University Press, 1-416.
Metadata
Title
Effect of gender on the association between weight status and health-related quality of life in adolescents
Authors
Emilie Bonsergent
Joseph Benie-Bi
Cédric Baumann
Nelly Agrinier
Sabrina Tessier
Nathalie Thilly
Serge Briançon
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-997

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