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Xie F, Xie S, Pullenayegum E, Ohinmaa A. Understanding Canadian stakeholders' views on measuring and valuing health for children and adolescents: a qualitative study. Qual Life Res 2024; 33:1415-1422. [PMID: 38438665 PMCID: PMC11045599 DOI: 10.1007/s11136-024-03618-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE Valuing child health is critical to assessing the value of healthcare interventions for children. However, there remain important methodological and normative issues. This qualitative study aimed to understand the views of Canadian stakeholders on these issues. METHODS Stakeholders from health technology assessment (HTA) agencies, pharmaceutical industry representatives, healthcare providers, and academic researchers/scholars were invited to attend an online interview. Semi-structured interviews were designed to focus on: (1) comparing the 3-level and 5-level versions of the EQ-5D-Y; (2) source of preferences for valuation (adults vs. children); (3) perspective of valuation tasks; and (4) methods for valuation (discrete choice experiment [DCE] and its variants versus time trade-off [TTO]). Participants were probed to consider HTA guidelines, cognitive capacity, and potential ethical concerns. All interviews were recorded and transcribed verbatim. Framework analysis with the incidence density method was used to analyze the data. RESULTS Fifteen interviews were conducted between May and September 2022. 66.7% (N = 10) of participants had experience with economic evaluations, and 86.7% (N = 13) were parents. Eleven participants preferred the EQ-5D-Y-5L. 12 participants suggested that adolescents should be directly involved in child health valuation from their own perspective. The participants were split on the ethical concerns. Eight participants did not think that there was ethical concern. 11 participants preferred DCE to TTO. Among the DCE variants, 6 participants preferred the DCE with duration to the DCE with death. CONCLUSIONS Most Canadian stakeholders supported eliciting the preferences of adolescents directly from their own perspective for child health valuation. DCE was preferred if adolescents are directly involved.
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Affiliation(s)
- Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada.
| | - Shitong Xie
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Eleanor Pullenayegum
- The Hospital for Sick Children, Toronto, Canada
- Dalla Lana School of Public Health, The University of Toronto, Toronto, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, Canada
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Liu ZH, Wang YL, Yu YS, Ren Y, Zhang T, Liu HQ, Wu XY. The individual and combined associations of health behaviours with health-related quality of life amongst junior high school students in China. Front Public Health 2023; 11:1283721. [PMID: 37900025 PMCID: PMC10602644 DOI: 10.3389/fpubh.2023.1283721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 09/20/2023] [Indexed: 10/31/2023] Open
Abstract
Objectives This study aimed to investigate the individual and joint associations of sedentary behaviour, physical activity (PA), sleep and breakfast eating on health-related quality of life (HRQoL) amongst Chinese junior high school students. Methods Data were from 783 junior high school students who participated in a health behaviour and health survey in Jining city of Shandong province of China. HRQoL was measured by the EuroQol five-dimensional questionnaire, youth version (EQ-5D-Y). Multivariable logistic and linear regressions were applied to examine the associations between health behaviours and HRQoL. Results Multivariable regression analyses showed that using a computer ≥ 2 h a day (vs. < 2 h/day) is associated with increased likelihood of having health problems in the three EQ-D-Y dimensions, including walking, looking after self and doing usual activities. Lower PA is associated with more problems in feeling worried, sad or unhappy, and with a lower visual analogue scale (VAS) score. Students who had insufficient sleep time (e.g., <7 h/day), and skipped eating breakfast were more likely to experience lower HRQoL in the dimensions of having pain or discomfort, and feeling worried, sad or unhappy, and a lower VAS score than those students who had longer sleep time and no breakfast skipping. Students who reported having the combined ≥ 2 unhealthy behaviours relative to the peers with 0-1 unhealthy behaviours were more likely to have lower HRQoL. Conclusion The findings in the present study underline the importance of promoting healthy behaviours in order to improve HRQoL amongst Chinese junior high school students.
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Affiliation(s)
- Ze Hua Liu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Yi Lin Wang
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Yue Shuang Yu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Yan Ren
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Tong Zhang
- Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Hong Qing Liu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
| | - Xiu Yun Wu
- School of Public Health, Weifang Medical University, Weifang, Shandong, China
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Gaudin V, Stranges S, Wilk P, Sarma S. School nutrition policy and diet quality of children and youth: a quasi-experimental study from Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:613-628. [PMID: 36976487 PMCID: PMC10351299 DOI: 10.17269/s41997-023-00743-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 01/10/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE We investigated the impact of mandatory school nutrition policy on diet quality of Canadian school children using a quasi-experimental study design. METHODS Using 24-h dietary recall data from the 2004 Canadian Community Health Survey (CCHS) Cycle 2.2 and 2015 CCHS - Nutrition, we constructed the Diet Quality Index (DQI). We used multivariable difference-in-differences regressions to quantify the DQI scores associated with school nutrition policy. We conducted stratified analyses by sex, school grade, household income, and food security status to gain additional insights into the impact of nutrition policy. RESULTS We found that mandatory school nutrition policy was associated with an increased DQI score by 3.44 points (95% CI: 1.1, 5.8) during school-hours in intervention provinces relative to control provinces. DQI score was higher among males (3.8 points, 95% CI: 0.6, 7.1) than among females (2.9 points, 95% CI: -0.5, 6.3), and the score among students in elementary schools was higher (5.1 points, 95% CI: 2.3, 8.0) than that among high school students (0.4 points, 95% CI: -3.6, 4.5). We also found that DQI scores were higher for middle-high income and food secure households. CONCLUSION Provincial mandatory school nutrition policy was associated with better diet quality among children and youth in Canada. Our findings suggest that other jurisdictions may consider implementing mandatory school nutrition policy.
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Affiliation(s)
- Victoria Gaudin
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, University of Western Ontario, Room 313, 11465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, University of Western Ontario, Room 313, 11465 Richmond Street, London, ON, N6G 2M1, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, University of Western Ontario, Room 313, 11465 Richmond Street, London, ON, N6G 2M1, Canada
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Sisira Sarma
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, University of Western Ontario, Room 313, 11465 Richmond Street, London, ON, N6G 2M1, Canada.
- Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada.
- Lawson Health Research Institute, London, ON, Canada.
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Bou-Hamad I, Hoteit R, Hijazi S, Ayna D, Romani M, El Morr C. Coping with the COVID-19 pandemic: A cross-sectional study to investigate how mental health, lifestyle, and socio-demographic factors shape students' quality of life. PLoS One 2023; 18:e0288358. [PMID: 37471388 PMCID: PMC10358926 DOI: 10.1371/journal.pone.0288358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/25/2023] [Indexed: 07/22/2023] Open
Abstract
PURPOSE The high prevalence of COVID-19 has had an impact on the Quality of Life (QOL) of people across the world, particularly students. The purpose of this study was to investigate the social, lifestyle, and mental health aspects that are associated with QOL among university students in Lebanon. METHODS A cross-sectional study design was implemented using a convenience sampling approach. Data collection took place between November 2021 and February 2022, involving 329 undergraduate and graduate students from private and public universities. Quality of life was assessed using the Quality-of-Life Scale (QOLS). Descriptive statistics, Cronbach's alpha, and linear regression-based methods were used to analyze the association between QOL and socio-demographic, health-related, lifestyle, and mental health factors. The significance level for statistical analysis was predetermined at α = 0.05. RESULTS The study participants' average (SD) QOL score was 76.03 (15.6) with a Cronbach alpha of 0.911. QOL was positively associated with importance of religion in daily decisions (β = 6.40, p = 0.006), household income (β = 5.25, p = 0.017), general health ratings (β Excellent/poor = 23.52, p <0.001), access to private counseling (β = 4.05, p = 0.020), physical exercise (β = 6.67, p <0.001), and a healthy diet (β = 4.62, p = 0.026); and negatively associated with cigarette smoking (β increased = -6.25, p = 0.030), internet use (β ≥4 hours = -7.01, p = 0.005), depression (β = -0.56, p = 0.002) and stress (β = -0.93, p <0.001). CONCLUSION In conclusion, this study reveals the key factors that positively and negatively influence students' quality of life (QOL). Factors such as religion, higher income, and a healthy diet improve QOL, while depression, stress, excessive internet use, and cigarette smoking negatively impact it. Universities should prioritize initiatives like physical activity promotion, affordable nutritious options, destigmatizing mental health, counseling services, and self-help interventions to support student well-being and enhance their QOL.
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Affiliation(s)
- Imad Bou-Hamad
- Department of Business Information and Decision Systems, Suliman S. Olayan School of Business, American University of Beirut, Beirut, Lebanon
| | - Reem Hoteit
- Department of Internal Medicine, Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Sahar Hijazi
- Faculty of Social Sciences, Lebanese University, Saida, Lebanon
| | - Dinah Ayna
- Faculty of Medicine, Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Romani
- Faculty of Medicine, Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christo El Morr
- School of Health Policy and Management, York University, Toronto, Canada
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Sumaedi S, Sumardjo S, Saleh A, Syukri AF. A model of health-related quality of life during COVID-19 pandemic: the role of food customer loyalty and affordability. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2023. [DOI: 10.1108/ijqrm-04-2021-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
PurposeThis research aims to test the simultaneous effects of the perceived threat of COVID-19, e-health literacy, e-health access barrier, loyalty toward healthy foods in general, loyalty toward functional foods, the affordability of healthy foods in general and the affordability of functional foods on health-related quality of life (HrQoL) during the COVID-19 pandemic.Design/methodology/approachA survey with 400 respondents in Banten, Indonesia, was performed. The data were analyzed using multiple regression analysis.FindingsThe results of the research showed that HrQoL during the COVID-19 pandemic was positively affected by e-health literacy and the affordability of healthy foods in general while negatively affected by the e-health access barrier, the perceived threat of COVID-19 and loyalty toward healthy foods in general. Furthermore, HrQoL was not influenced by loyalty toward and affordability of functional foods.Research limitations/implicationsThis research was conducted in Banten. Due to the operational limitations during the COVID-19 pandemic, this research used a purposive sampling technique. Therefore, the next research should retest the model in different contexts and locations.Practical implicationsTo improve HrQoL during the COVID-19 pandemic, citizens need to be educated on finding and utilizing credible online health information during the COVID-19 pandemic. Governments and health service providers should also strive to offer ease of access to credible online health information. Furthermore, the affordability of healthy foods, in general, should be managed well.Originality/valueA few studies on HrQoL during COVID-19 pandemic were performed. However, there is a lack of paper that examines the role of food customer loyalty and affordability in a model of HrQoL during the COVID-19 pandemic. To the best of the authors’ knowledge, this paper is the first that involved and tested the role of food customer loyalty and affordability in a model of HrQoL during the COVID-19 pandemic.
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Woods N, Seabrook JA, Haines J, Stranges S, Minaker L, O’Connor C, Doherty S, Gilliland J. Breakfast Consumption and Diet Quality of Teens in Southwestern Ontario. Curr Dev Nutr 2023; 7:100003. [PMID: 37180078 PMCID: PMC10111595 DOI: 10.1016/j.cdnut.2022.100003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/27/2022] [Accepted: 10/06/2022] [Indexed: 12/24/2022] Open
Abstract
Background Breakfast skipping has previously been associated with worse diet quality among adolescents; the latter increases the risk of chronic disease. However, many studies do not consider diet quality as a function of calories, which is problematic as skippers tend to consume less energy than consumers. Additionally, due to the lack of one accepted definition of both breakfast skipping and diet quality, it is unclear how differences found may change when using varying definitions. Objectives We aimed to compare the Healthy Eating Index-2015 (HEI-2015) scores and nutrient intakes of teen breakfast skippers and consumers in Southwestern Ontario, Canada. Methods Cross-sectional, baseline data were used from SmartAPPetite, an ongoing nutrition intervention study. Singular 24-h dietary recalls and sociodemographic data from 512 adolescents aged 13-19 y were used to compare HEI-2015 scores and nutrient intakes via multivariable linear regression. Results Previous day breakfast skippers had significantly lower HEI-2015 scores (-4.4; 95% CI: -8.4, -0.4) and significantly lower intakes of calories, saturated fat, and vitamin C, as well as significantly higher intake of sodium and total fat. Conclusions Previous day breakfast consumers had significantly higher diet quality scores and better nutrient intakes than breakfast skippers, although, on average, both had poor diet quality. Consequently, it is unlikely that simply advising teens to consume breakfast will result in meaningful change in diet quality, and more effort should be placed on promoting nutritious breakfasts.
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Affiliation(s)
- Nicolas Woods
- Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
| | - Jamie A. Seabrook
- Department of Epidemiology & Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
| | - Jess Haines
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Saverio Stranges
- Department of Epidemiology & Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Family Medicine, The University of Western Ontario, London, Ontario, Canada
- Department of Medicine, The University of Western Ontario, London, Ontario, Canada
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Leia Minaker
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Colleen O’Connor
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Sean Doherty
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environmental Studies, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Jason Gilliland
- Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, The University of Western Ontario, London, Ontario, Canada
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Rasaei N, Daneshzad E, Soveid N, Clark CCT, Mirzaei K. The association between fatty acid quality indices and quality of life among overweight and obese women: A cross-sectional study. Front Public Health 2023; 10:1030726. [PMID: 36777780 PMCID: PMC9908951 DOI: 10.3389/fpubh.2022.1030726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/12/2022] [Indexed: 01/27/2023] Open
Abstract
Background Reduced quality of life (QOL) is a major public health challenge affecting the global population. Fatty acid quality indices (FAQIs) are novel determinants of QOL and may impact various aspects of QOL. Prior research has established a significant link between dietary habits and QOL. However, the association between FAQIs and specific dimensions of QOL has not been established. Therefore, we aimed to investigate the association between FAQIs and QOL in overweight and obese women. Methods In total, 378 adult overweight or obese women participated in this cross-sectional study. Several anthropometric indices, systolic and diastolic blood pressure, and biochemical factors were measured using standard protocols. Dietary intake was assessed using a validated and reliable semi-quantitative food frequency questionnaire (the FFQ, 147 items). The cholesterol-saturated fat index (CSI) and the ratio of omega-6/omega-3 (N6/N3) essential fatty acids consumed were employed as FAQIs. The SF-36 questionnaire was administered to measure QOL. Linear logistic regression was used, in the form of raw and adjusted models, to evaluate the associations between FAQIs and QOL. Results The study sample consisted of 279 participants for whom ω-6/ω-3 ratio was measured and 378 participants for whom CSI was measured. The mean (±SD) age of participants was 36.65 ± 9.07 years. Linear logistic regression, with adjustment for potential confounders, such as age, energy intake, body mass index, employment, and thyroid status, indicated that ω-6/ω-3 intake ratio was negatively and marginally significantly associated with general health (β = -139.94, 95% CI: [-286.54, 6.66]; p = 0.061) and physical role limitations (β= -337.68, 95% CI: [-679.99, 1.61]; p = 0.051). A significant negative association was observed between ω-6/ω-3 intake ratio and social functioning (β = -247.54, 95% CI: [-458.14, -36.94]; p = 0.021), which indicates that obese and overweight women with a higher ω-6/ω-3 intake ratio obtained lower scores on social functioning. Conclusions It was found that FAQI scores were negatively associated with certain QOL measures among overweight and obese Iranian women, suggesting that a higher consumption of fatty acids, especially trans and saturated fatty acids, may be associated with lower QOL.
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Affiliation(s)
- Niloufar Rasaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Elnaz Daneshzad
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Neda Soveid
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran,*Correspondence: Khadijeh Mirzaei ✉
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The importance of eating patterns for health-related quality of life among children aged 10-11 years in Alberta of Canada. Sci Rep 2022; 12:20885. [PMID: 36463245 PMCID: PMC9719497 DOI: 10.1038/s41598-022-23707-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/03/2022] [Indexed: 12/04/2022] Open
Abstract
Children with unhealthy eating behaviours are more likely to experience poor physical and mental health. Few studies have investigated the importance of eating patterns for health-related quality of life (HRQoL) among children. This study aimed to identify common eating patterns, and their associations with HRQoL among Canadian children. Data were collected from 9150 grade five students (aged 10-11 years) in repeat cross-sectional population-based surveys in Alberta, Canada. Students' eating behaviours were analyzed using latent class analysis to identify the eating patterns. We applied multilevel multivariable logistic regression to examine the association of the eating patterns with HRQoL. We identified three groups of children with distinct eating patterns: eating healthy (52%), less healthy (31%) and unhealthy (17%). The first group had a higher proportion of students engaged in healthy eating behaviours. The unhealthy pattern group (third group) included a higher proportion of students with poor eating behaviours. Students' eating behaviours in the second group were healthier than the third group but less healthy than the first group. Children with unhealthy and less healthy patterns were more likely to experience lower HRQoL than children with the healthy pattern. Health promotion programs effective in improving healthy eating patterns may not only reduce the risk for chronic diseases in the long term, but also improve the HRQoL in the short term.
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Association between Dietary Patterns and Physical Fitness among Chinese Children and Adolescents in Shaanxi Province. Nutrients 2022; 14:nu14183677. [PMID: 36145061 PMCID: PMC9503495 DOI: 10.3390/nu14183677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background: This study aims to investigate the associations between dietary patterns (breakfast, egg, dairy products, and sugared beverage intake frequencies) and physical fitness among Chinese children and adolescents in Shaanxi Province. METHODS: Data were extracted from the Chinese National Survey on Students’ Constitution and Health (CNSSCH). The study ultimately included 7305 participants (48.4% male, 51.6% female) aged 6–22 in Shaanxi Province, China. Multiple linear regression was used to examine the association of the frequency of breakfast, egg, dairy product, and sugared beverage intakes with physical fitness. RESULTS: The frequency of breakfast, egg, and dairy product intakes were all independently and positively associated with the level of physical fitness. The frequency of sugared beverage intake was negatively associated with the level of physical fitness. CONCLUSION: Healthier dietary patterns (i.e., higher breakfast, egg, and dairy product intakes and lower sugared beverage intake) were associated with greater physical fitness. Specifically, maintaining a healthy dietary pattern of breakfast, egg, and dairy product intakes can positively affect the strength and endurance performance of children and adolescents. Increased dairy product intake plays a crucial part in boosting the physical fitness total scores of children and adolescents.
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Associations between Food Groups and Health-Related Quality of Life in Korean Adults. Nutrients 2022; 14:nu14173643. [PMID: 36079900 PMCID: PMC9460858 DOI: 10.3390/nu14173643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
This cross-sectional study aimed to determine the associations between food groups and health-related quality of life (HRQoL). The data of 14,979 participants in the Korea National Health and Nutrition Examination Survey from 2016 and 2018 were examined. The HRQoL was assessed with EuroQol-5 Dimension. The 24-h recall test was used to examine the dietary intake of food groups. Males and females accounted for 13.79% and 21.62% of the low HRQoL groups. The males in the lowest tertile of the “vegetables” and “fish and shellfish” food groups were more likely to have a low HRQoL (odds ratio (OR), 95% confidence interval (CI) = 1.25 (1.05–1.65), 1.45 (1.12–1.89), respectively) than those in the highest tertile, whereas those in the lowest tertile of the “cereal and grain products” were less likely to have a low HRQoL (OR (95% CI) = 0.69 (0.52–0.91)). The females in the lowest tertile of the “vegetables” food group were more likely to have a low HRQoL (OR (95% CI) = 1.56 (1.17–3.01)) than those in the highest tertile. After adjusting for confounders indagated with not only dietary but also non-dietary factors such as stress, we found that low HRQoL was significantly associated with food groups of “vegetables”, “fish and shellfish”, and “cereal and grain products” among males and of “vegetables” among females.
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Ryu SA, Choi YJ, An H, Kwon HJ, Ha M, Hong YC, Hong SJ, Hwang HJ. Associations between Dietary Intake and Attention Deficit Hyperactivity Disorder (ADHD) Scores by Repeated Measurements in School-Age Children. Nutrients 2022; 14:nu14142919. [PMID: 35889876 PMCID: PMC9322602 DOI: 10.3390/nu14142919] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in school-age children and adolescents. However, the reported associations between ADHD and single nutrient intake are inconsistent. The aim of the study was to investigate the relationships between dietary intake changes and the prevalence of ADHD over time with repeat measurements using data from the Children Health and Environment Research (CHEER). To assess changes over time, we used data obtained in 2006 and 2008 (Phases 1 and 2). In this study, there were 2899 children aged 8 years or older in Phase 1 and 2120 children aged 9 years or older in Phase 2 from Korea, and the ADHD scores and dietary intake of 1733 children in Phases 1 and 2 were used in the final analysis. The YN group refers to children whose disease had improved in Phase 2, and the NY group refers to children diagnosed with ADHD in Phase 2. A notable within-group result was the increase in vegetable protein (p = 0.03) in the YN group. A between-group comparison showed that significant changes in nutrient intake could be confirmed most in the NY group, and the YN group tended to have a lower nutrient intake than the NY group. In the correlation of changes in nutrient intake and three subtypes (combined, AD, and HD), the total fat (p = 0.048) and animal protein (p = 0.099) showed a positive correlation with the prevalence of AD. Vegetable iron (p = 0.061 and p = 0.044, respectively), zinc (p = 0.022 and p = 0.007, respectively), vegetable protein (p = 0.074), and calcium (p = 0.057) had inhibitory effects on ADHD and its subtype. In conclusion, management of dietary and nutritional status should be considered to ameliorate ADHD and its subtypes in school-age children, and these relationships require further exploration in other settings.
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Affiliation(s)
- Su-a Ryu
- Department of Food and Nutrition, Kyung Hee University, Seoul 02447, Korea; (S.-a.R.); (H.A.)
| | - Yean-Jung Choi
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Korea;
| | - Hyojin An
- Department of Food and Nutrition, Kyung Hee University, Seoul 02447, Korea; (S.-a.R.); (H.A.)
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan 31116, Korea; (H.-J.K.); (M.H.)
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan 31116, Korea; (H.-J.K.); (M.H.)
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 08826, Korea;
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Hyo-Jeong Hwang
- Department of Food and Nutrition, Sahmyook University, Seoul 01795, Korea;
- Correspondence: ; Tel.: +82-2-3399-1653; Fax: +82-2-3399-1655
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12
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Papadaki S, Carayanni V. Health-related quality of life, Mediterranean diet, physical activity and socioeconomic factors of Greek adolescents during COVID-19: A cross sectional study. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-220008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND: Health related quality of life of the adolescents during quarantine and social isolation potentially decreases, with significant alteration on physical activities and nutrition behaviour. OBJECTIVE: The present study investigates the relationship between Greek adolescents’ health related quality of life and socioeconomic factors, lifestyle and dietary characteristics, along with their adherence to the Mediterranean Diet immediately after the lockdown period in Greece. METHODS: A total sample of 459 students aged 12–16 years old were recruited from secondary schools in the area of Athens. The KIDSCREEN-27 questionnaire for children and adolescents, the KIDMED test, the Godin and Shephard Leisure Time Physical Activity Questionnaire and the Family Affluence Scale III, were used for the statistical analysis. T-tests, Kruskal Wallis, Chi-square, Anova tests and multiple regression analyses were employed. RESULTS: Econometric analysis reveals that adolescents’ health related quality of life is higher among boys, adolescents who live with both parents, tend to sleep more during night and do not spend many hours on screen viewing. Also, adolescents with higher family affluence level, being physically active and with a high adherence to the Mediterranean Diet have higher health related quality of life. CONCLUSIONS: Adolescents’ adherence to the Mediterranean Diet, physical activity, socioeconomic characteristics and life style behaviors are highly correlated with perceived health related quality of life during COVID-19 period.
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Affiliation(s)
- Stamatina Papadaki
- Department of Public and Community Health, University of West Attica, Athens, Greece
| | - Vilelmine Carayanni
- Department of Public and Community Health, University of West Attica, Athens, Greece
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Ahmed M, Schermel A, Lee J, Weippert M, Franco-Arellano B, L'Abbé M. Development of the Food Label Information Program: A Comprehensive Canadian Branded Food Composition Database. Front Nutr 2022; 8:825050. [PMID: 35187026 PMCID: PMC8852278 DOI: 10.3389/fnut.2021.825050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/24/2021] [Indexed: 11/25/2022] Open
Abstract
Objectives Traditional methods for creating food composition databases struggle to cope with the large number of products and the rapid pace of turnover in the food supply. This paper introduces Food Label Information Program (FLIP), a big data approach to the evaluation of the Canadian food supply and presents the latest methods used in the development of this database. Methods The Food Label Information Program (FLIP) is a database of Canadian food and beverage package labels by brand name. The latest iteration of the FLIP, FLIP 2020, was developed using website “scraping” to collect food labeling information (e.g., nutritional composition, price, product images, ingredients, brand, etc.) on all foods and beverages available on seven major Canadian e-grocery retailer websites between May 2020 and February 2021. Results The University of Toronto's Food Label Information Program (FLIP) 2020 was developed in three phases: Phase 1, database development and enhancements; Phase 2, data capture and management of food products and nutrition information; Phase 3, data processing and food categorizing. A total of 74,445 products available on websites of seven retailers and 2 location-specific duplicate retailers were collected for FLIP 2020. Of 57,006 food and beverage products available on seven retailers, nutritional composition data were available for about 60% of the products and ingredients were available for about 45%. Data for energy, protein, carbohydrate, fat, sugar, sodium and saturated fat were present for 54–65% of the products, while fiber information was available for 37%. Food products were classified under multiple categorization systems, including Health Canada's Table of Reference Amounts, Health Canada's sodium categories for guiding benchmark sodium levels, sugar-focused categories and categories specific to various global nutrient profiling models. Conclusions FLIP is a powerful tool for evaluating and monitoring the Canadian food supply environment. The comprehensive sampling and granularity of collection provides power for revealing analyses of the relationship between nutritional quality and marketing of branded foods, timely observation of product reformulation and other changes to the Canadian food supply.
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Affiliation(s)
- Mavra Ahmed
- Department of Nutritional Sciences, Temerty Faculty School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alyssa Schermel
- Department of Nutritional Sciences, Temerty Faculty School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jennifer Lee
- Department of Nutritional Sciences, Temerty Faculty School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Madyson Weippert
- Department of Nutritional Sciences, Temerty Faculty School of Medicine, University of Toronto, Toronto, ON, Canada
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, Temerty Faculty School of Medicine, University of Toronto, Toronto, ON, Canada
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Mary L'Abbé
- Department of Nutritional Sciences, Temerty Faculty School of Medicine, University of Toronto, Toronto, ON, Canada
- *Correspondence: Mary L'Abbé
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14
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Mozzillo E, Zito E, Calcaterra V, Corciulo N, Di Pietro M, Di Sessa A, Franceschi R, Licenziati MR, Maltoni G, Morino G, Predieri B, Street ME, Trifirò G, Gallè F, Franzese A, Valerio G. Poor Health Related Quality of Life and Unhealthy Lifestyle Habits in Weight-Loss Treatment-Seeking Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179355. [PMID: 34501945 PMCID: PMC8431705 DOI: 10.3390/ijerph18179355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/17/2022]
Abstract
Obesity is associated with unhealthy lifestyle behaviors and poor Health Related Quality of Life (HRQOL). The cumulative effect of lifestyle behaviors on HRQOL has been demonstrated in chronically ill adolescents, but not in adolescents with obesity. The present study aimed to assess the association between HRQOL and adherence to the Mediterranean Diet (MD) and/or low levels of physical activity (PA) in a large sample of outpatient adolescents with overweight or obesity seeking weight loss treatment. Four-hundred-twenty participants were enrolled from 10 Italian outpatient clinics. The demographics and anthropometric features, KIDMED scores, and exercise levels of the participants were collected, together with parental features. The HRQOL was assessed by the Pediatric Quality of Life Inventory (PedsQL™), Adolescents Version 4.0. PedsQL total score and functioning subscales were lower in adolescents who reported one or two unhealthy habits. Compared with the high/intermediate groups, the risk of low HRQOL was twice as high for each unit increase in BMI SDS, while the percentage was reduced by 12.2% for every unit increase in the KIDMED score and by 32.3% for each hour increase of exercise. The clustering of these two unhealthy behaviors conferred a 120% higher risk of low HRQOL. Similarly, adolescents displaying better diet quality and/or a physically more active lifestyle have better physical and psychological functioning. Further studies are needed to disclose whether these characteristics may be predictive of better adherence to weight loss treatment.
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Affiliation(s)
- Enza Mozzillo
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples Federico II, 80131 Naples, Italy; (E.M.); (A.F.)
| | - Eugenio Zito
- Department of Social Sciences, University of Naples Federico II, 80138 Naples, Italy;
| | - Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy;
- Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Nicola Corciulo
- Unit of Auxology and Pediatric Endocrinology, Sacred Heart of Jesus Hospital, Gallipoli, 73014 Lecce, Italy;
| | | | - Anna Di Sessa
- Department of Woman, Child, and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | | | - Maria Rosaria Licenziati
- Obesity and Endocrine Disease Unit, Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy;
| | - Giulio Maltoni
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Giuseppe Morino
- Research Unit for Multifactorial Diseases, Bambino Gesù Children’s Hospital, 00165 Rome, Italy;
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of the Mother, Children and Adults—Pediatric Unit University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Maria Elisabeth Street
- Department of Mother and Child, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Giuliana Trifirò
- Endocrinology and Metabolism Division, IRCCS Policlinico San Donato, 20097 Milan, Italy;
| | - Francesca Gallè
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
| | - Adriana Franzese
- Department of Translational Medical Science, Section of Pediatrics, Regional Center of Pediatric Diabetes, University of Naples Federico II, 80131 Naples, Italy; (E.M.); (A.F.)
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, 80133 Naples, Italy;
- Correspondence:
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15
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Leme AC, Muszynski D, Mirotta JA, Caroll N, Hogan JL, Jewell K, Yu J, Fisberg RM, Duncan AM, Ma DWL, Haines J, On Behalf Of The Guelph Family Health Study. Diet Quality of Canadian Preschool Children: Associations with Socio-demographic Characteristics. CAN J DIET PRACT RES 2021; 82:131-135. [PMID: 33876988 DOI: 10.3148/cjdpr-2021-009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To examine associations between preschoolers' diet quality and parent and child socio-demographic variables.Methods: Cross-sectional analysis with 117 preschoolers. Parents reported socio-demographics and their children's diet using 3-day food records. Diet quality was assessed using the Healthy Eating Index (HEI) 2015. Linear regression models were used to analyze associations between socio-demographics and HEI scores.Results: A total of 86% of children had an HEI-2015 score in the "needs improvement" category (51-80 out of a maximum of 100). Children's overall HEI-2015 score was inversely associated with children's age (β = -0.19, 95% CI -0.37, -0.02). Parental education was positively associated with children's overall HEI score (β = 9.58, 95% CI 3.81, 15.35) and with scores for total fruit (β = 1.00, 95% CI 0.39, 1.76), vegetables (β = 1.11, 95% CI 0.03, 2.18), total protein (β = 1.06, 95% CI 0.28, 1.84), and seafood/plant protein (β = 1.67, 95% CI 0.43, 2.89) components. Children who identified as Caucasian (β = 4.29, 95% CI 2.46, 6.14), had a Caucasian parent (β = 3.01, 95% CI 0.78, 5.25), or parents who were born in Canada (β = 2.32, 95% CI 0.53, 4.11) had higher scores for dairy.Conclusion: Our results suggest that preschoolers' diet quality needs improvement and that children's diet quality varies by children's age and parental education level.
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Affiliation(s)
- Ana Carolina Leme
- University of Guelph, Department of Family Relations and Applied Nutrition, Guelph, ON.,University of São Paulo, Department of Nutrition, School of Public Health, Brazil, São Paulo, Brazil.,Center for Excellence in Nutrition and Feeding Difficulties, Children's Hospital Sabará, PENSI Institute, Brazil
| | - Dabrowka Muszynski
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Julia A Mirotta
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Nicholas Caroll
- University of Guelph, Department of Family Relations and Applied Nutrition, Guelph, ON
| | - Jaimie L Hogan
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Kira Jewell
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Jessica Yu
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Regina Mara Fisberg
- University of São Paulo, Department of Nutrition, School of Public Health, Brazil, São Paulo, Brazil
| | - Alison M Duncan
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - David W L Ma
- University of Guelph, Department of Human Health and Nutritional Sciences, Guelph, ON
| | - Jess Haines
- University of Guelph, Department of Family Relations and Applied Nutrition, Guelph, ON
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16
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Wu X, Veugelers PJ, Ohinmaa A. Health Behavior, Health-Related Quality of Life, and Mental Health Among Canadian Children: A Population-Based Cohort Study. Front Nutr 2021; 8:638259. [PMID: 33777992 PMCID: PMC7991792 DOI: 10.3389/fnut.2021.638259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Studies that have reported the associations of diet quality, physical activity (PA), sedentary behavior (SB), and health-related quality of life (HRQoL) with mental health among children and adolescents are predominantly cross-sectional in design. Very few studies have examined the longitudinal relationship of mental health with health behavior and HRQoL among children. This study aimed to investigate the associations of diet quality, PA, SB, and HRQoL among children with mental health disorders throughout childhood. Methods: We linked data from grade five students aged primarily 10 and 11 years who participated in the Raising Healthy Eating and Active Living (REAL) Kids Alberta survey in 2012 in the Canadian province of Alberta with their administrative health care data from birth to 2012. Mental health outcomes included internalizing disorder and attention deficit and hyperactivity disorder (ADHD) defined by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or Tenth Revision, Canadian version (ICD-10-CA). The HRQoL was measured by the EQ-5D-Y, a five-dimensional descriptive system for children and youth. We applied negative binomial regressions to examine the associations between health behaviors, HRQoL, and mental health. Results: Of the 1,352 participating students, 12.31 and 8.32% had a diagnosis of internalizing disorders and ADHDs, respectively, during childhood from birth to the ages of 10–11 years. Students in the highest tertile for diet quality, relative to the lowest tertile, were 56% less likely to have diagnoses of internalizing disorders (incidence rate ratio, IRR = 0.44, 95% CI = 0.23–0.85). Students engaged in less PA (vs. more PA) were more likely to be diagnosed for internalizing disorders (IRR = 1.98, 95% CI = 1.19–3.30). Poorer diet quality, low PA, excessive use of computers/video games, and watching TV were significantly associated with more diagnoses of ADHDs. Children who experienced some or a lot of problems in “feeling worried, sad, or unhappy” and “having pain or discomfort” were more likely to receive diagnoses of internalizing disorders and ADHDs, respectively. Conclusions: These observed associations suggest that health promotion programs targeting promoting diet quality, PA, and HRQoL and reducing SB among children may contribute to improving mental health.
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Affiliation(s)
- Xiuyun Wu
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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17
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The Role of Physical Activity and School Physical Education in Enhancing School Satisfaction and Life Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041689. [PMID: 33578713 PMCID: PMC7916464 DOI: 10.3390/ijerph18041689] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Abstract
The aim of this study was to understand the role of school satisfaction on life satisfaction, according to gender, age, body mass index (BMI), and physical activity (PA) level. This was a cross-sectional descriptive study, carried out on 2823 adolescents (1396 boys and 1427 girls), aged between 12 and 16. A specific questionnaire to measure life satisfaction (Brief Multidimensional Student Life Satisfaction Scale (BMSLSS)), a questionnaire to measure satisfaction with school (“Life circumstances of Young people: School”), and the International Physical Activity Questionnaire (IPAQ) were used to analyze PA practice. Gender, age, and BMI were used as control variables. In general, the main results showed that school satisfaction had a clear role in life satisfaction. Similarly, the findings allowed us to conclude that the role of school satisfaction on life satisfaction was more evident in male school children, those who were older, or those who have a higher BMI. The regular practice of PA enhanced school satisfaction and its role on life satisfaction. Therefore, it is very important to assess the importance of school satisfaction as a determinant of quality of life and the adoption of healthy habits, recognizing the fundamental role of teachers in this regard.
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18
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Davison J, Stewart-Knox B, Connolly P, Lloyd K, Dunne L, Bunting B. Exploring the association between mental wellbeing, health-related quality of life, family affluence and food choice in adolescents. Appetite 2020; 158:105020. [PMID: 33171225 DOI: 10.1016/j.appet.2020.105020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 09/24/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022]
Abstract
Young people choose energy-dense, nutrient-poor diets, yet understanding of potential determinants is limited. Associations between food choices, mental wellbeing, health-related quality of life (HRQoL) and family affluence were explored to identify targets for intervention to promote dietary health and wellbeing in young people. Adolescents were recruited via post-primary schools in the UK and surveyed at two time-points when aged 13-14 years and 15-16 years. The questionnaire enquired about mental wellbeing using the Short Warwick-Edinburgh Mental Wellbeing Scale, HRQoL using the KIDSCREEN-10, socio-economic status using the Family Affluence Scale and food choice by Food Frequency Questionnaire (FFQ). With missing and anomalous cases excluded, the sample comprised 1208 cases. Factor analysis on the FFQ indicated five food choice factors: 'Junk Food'; 'Meat'; 'Healthy Protein'; 'Fruit/Vegetables'; 'Bread/Dairy'. Multivariate regression analysis indicated that frequent consumption of Junk Food was associated with being male and lower mental wellbeing. Frequent Meat intake was associated with being male and with lower HRQoL. Frequent choice of Bread/Dairy foods was more common among males and associated with higher wellbeing and greater affluence. Those who consumed Fruit/Vegetables frequently were more likely to be female, have higher HRQoL, higher mental wellbeing, and greater family affluence. These direct associations endured between time points. The dietary factors were not mutually exclusive. Those who frequently chose Junk Food were less likely to choose Fruit/Vegetables. Frequent choice of Meat was associated with more frequent choice of Junk Food and Healthy Protein. Intervention to improve dietary and psychological health in young people should target males, those in less affluent households, seek to reduce consumption of 'junk' food, and increase fruit and vegetable intake.
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Affiliation(s)
- Jenny Davison
- Psychology Research Institute, Ulster University, Cromore Road, Coleraine, Northern Ireland, BT52 1SA, UK.
| | - Barbara Stewart-Knox
- Division of Psychology, University of Bradford, Bradford, West Yorkshire, BD7 1DP, UK
| | - Paul Connolly
- Faculty of Arts and Social Sciences, Lancaster University, FASS Building, Lancaster, LA1 4YL, UK
| | - Katrina Lloyd
- Centre for Evidence and Social Innovation, Queens University Belfast, University Road, Belfast, Northern Ireland, BT7 1NN, UK
| | - Laura Dunne
- Centre for Evidence and Social Innovation, Queens University Belfast, University Road, Belfast, Northern Ireland, BT7 1NN, UK
| | - Brendan Bunting
- Psychology Research Institute, Ulster University, Cromore Road, Coleraine, Northern Ireland, BT52 1SA, UK
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Yarmohammadi S, Ghaffari M, Yarmohammadi H, Hosseini Koukamari P, Ramezankhani A. Relationship between Quality of Life and Body Image Perception in Iranian Medical Students: Structural Equation Modeling. Int J Prev Med 2020; 11:159. [PMID: 33312468 PMCID: PMC7716616 DOI: 10.4103/ijpvm.ijpvm_203_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 09/30/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The body image is a complex concept that influences various factors, one of these factors is the quality of life. The present study aimed to investigate the relationship between quality of life and body image perception in the medical students of Shahid Beheshti University of Medical Sciences. METHODS This descriptive study was carried out on 400 students of Shahid Beheshti University of Medical Sciences using a stratified random sampling method and the samples were selected from each faculty in 2017 using simple random sampling Questionnaires (PSDQ) and (SF-12) were used. Data were analyzed using mean and standard deviation and t-test, Mann-Whitney U, ANOVA, kelmogrouf smirnouf test and Spearman Correlation to SPSS 16 software and structural equation modeling (SEM) was to test the relationships between the three parameters (quality of life, body image, and demographic characteristics) using AMOS24 software. RESULTS The findings show Quality of life significantly correlated with two demographic variables: location and exercising of students. Body image perception significantly correlated merely with the body mass index and exercising. The Structural Equation Modeling (SEM) results confirmed a positive and direct relationship between the quality of life and body image perception. CONCLUSIONS The results showed that there is a significant relationship between body image perception and quality of life. Therefore, by modifying and improving the students' quality of life in the dormitories, the level of students' self-concept can be raised in order to prevent the physical and psychological complications of this group of community.
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Affiliation(s)
- Soudabeh Yarmohammadi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohtasham Ghaffari
- Department of Public Health, Environmental and Occupational Hazards Control Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Yarmohammadi
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parisa Hosseini Koukamari
- Department of Health Education and Health Promotion, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Ramezankhani
- Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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20
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Physical Activity and Its Relationship with Life Satisfaction among Middle School Students: A Cross-Culture Study. SUSTAINABILITY 2020. [DOI: 10.3390/su12176932] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined the association between physical activity (PA) levels and life satisfaction for middle school students from Macau, Taipei, and Qianjiang. A total of 1002 middle school students (grades 7 to 9) were recruited in 2015 from three cities (Macau, N = 322; Taipei, N = 325; and Qianjiang, N = 355). Physical Activity Rank Scale-3 was used to evaluate the frequency, intensity, and duration of the PA. Further, students’ PA behaviors and life satisfaction were assessed using the Multidimensional Students’ Life Satisfaction Scale (MSLSS) devised by Zhang. Descriptive statistics, Pearson’s correlation, t-test, and one-way ANOVA were conducted to process the data. In both Macau and Taipei, the life satisfaction of adolescents was significantly associated with adolescents’ amount of PA (p < 0.05). A significant relationship was observed between self-satisfaction and PA in students from both Macau and Taipei (p < 0.05). The study results indicate the importance of life experience in PA. The more PA that a student engaged in, the higher the level of life satisfaction they obtained. There was a significant difference in the overall life satisfaction among adolescents in Macau, Taipei, and Qianjiang.
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21
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Health-related quality of life of Portuguese children and adolescents according to diet quality and food intake. Qual Life Res 2020; 29:2197-2207. [PMID: 32219706 DOI: 10.1007/s11136-020-02475-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The implication of adolescence diet quality and of certain specific foods' intake on HRQoL remain underexplored, and little importance has been given to biological changes (e.g. growth, maturation, dimorphism, body composition), that remarkably increase the variability of diet and physical activity behaviours. The aim of this study was to analyse the relationship between diet quality and food intake with HRQoL in adolescents, considering maturity, body composition, and physical activity level. METHODS In total 669 Portuguese adolescents aged 10-17 years, attending three secondary schools, were enrolled in this cross-sectional study. Diet quality was assessed by Diet Quality International-Index (DQI-I), physical activity level was self-reported, and the HRQoL was assessed by the KIDSCREEN-52 questionnaire. The KIDSCREEN-52 includes ten dimensions (physical well-being, psychological well-being, moods and emotions, self-perception, autonomy, parent relations and home life, social support and peers, school environment, social acceptance and bullying and financial resources) and it allowed to compute a general index of the HRQoL (KIDSCREEN-10 index) through a selection of 10 items out of the KIDSCREEN-52 list. Fat mass was obtained by skinfold thickness. Maturity was objectively measured. The level of significance was set at α = 0.05. RESULTS Boys scored higher in HRQoL and in physical well-being, self-perception, autonomy, parent relations and home life than girls. Intakes of unhealthy foods were negatively correlated with physical well-being, self-perception, and social acceptance and bullying, while healthy foods were positively correlated with psychological well-being, moods and emotions, self-perception, and school environment. The DQI-I showed to be positively correlated with physical well-being. Participants who reported to have a higher DQI-I (≥ 60) perceived better their school environment and social acceptance and bullying. However, those results were not determined by diet quality but rather by bone age and physical activity level. CONCLUSION Our results showed that boys reported higher HRQoL and higher scores in the majority of HRQoL dimensions, compared to girls. The intake of unhealthy foods was negatively correlated with some HRQoL dimensions, whilst healthy foods showed positive correlations with some HRQoL dimensions. Biological maturity and physical activity level revealed to be important confounders in the study of diet quality and perception of school environment and social acceptance and bullying in adolescents.
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22
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The association between disordered eating and health-related quality of life among children and adolescents: A systematic review of population-based studies. PLoS One 2019; 14:e0222777. [PMID: 31584956 PMCID: PMC6777752 DOI: 10.1371/journal.pone.0222777] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 09/06/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous studies have documented that disordered eating is associated with a wide range of impaired physical and mental health conditions among children and adolescents. The relationship between disordered eating and health-related quality of life (HRQOL) has been predominantly examined in children and adolescents who are overweight or obese or suffer from chronic illnesses. In the last decade, several studies have been conducted to investigate the relationship between disordered eating and HRQOL among school and community children and adolescents. No systematic review or meta-analysis has synthesized the findings from these population-based studies. The purpose of this systematic review and meta-analysis was to synthesize the relationship between disordered eating and HRQOL among the general population of children and adolescents. METHODS We performed a computer search for the English language literature using the databases PUBMED, EMBASE and PSYCINFO to retrieve eligible studies published between 1946 and August 9, 2018. We also searched the relevant articles using PubMed related article search features and manually examined the reference lists of the retrieved full text articles selected from the database search. The association between disordered eating and HRQOL was synthesized using both a qualitative method and a meta-analysis. The review was conducted adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. RESULTS We identified eight studies that met the inclusion criteria and were included in the final synthesis. The studies included six cross-sectional studies and two longitudinal studies. The systematic review found that disordered eating attitudes and behaviors were associated with lower HRQOL among children and adolescents. Children and adolescents with bulimia nervosa (BN), binge eating disorder (BED), purging disorder (PD) and other eating disorder symptoms had poorer HRQOL than their healthy peers without the eating disorder conditions. The meta-analysis using four out of the eight studies showed that disordered eating was significantly associated with poor psychosocial health and lower overall HRQOL among children and adolescents. CONCLUSION The present review reveals that disordered eating behaviors and eating disorders are associated with decreased HRQOL in children and adolescents. More prospective studies are needed to ascertain the directions in the relationship between disordered eating and HRQOL among children and adolescents. The findings of this review suggest that health programs for promoting healthy eating and reducing disordered eating behaviors among school children and adolescents may help to enhance the HRQOL and overall health status of these individuals.
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Oosterhoff M, Joore MA, Bartelink NHM, Winkens B, Schayck OCP, Bosma H. Longitudinal analysis of health disparities in childhood. Arch Dis Child 2019; 104:781-788. [PMID: 30948361 DOI: 10.1136/archdischild-2018-316482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/06/2019] [Accepted: 03/08/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Combatting disparities in health outcomes among children is a major public health concern. This study focuses on two questions: (1) To what extent does socioeconomic status (SES) contribute to disparities in health outcomes? and (2) To what extent can social inequalities in health outcomes be explained by differences in children's health behaviours? DESIGN This study included 2-year follow-up data of 1259 children (4-12 years of age) who participated in the 'Healthy Primary School of the Future' project (ClinicalTrials.gov NCT02800616). SES was measured by maternal and paternal education and household income (adjusted for family size). Health outcomes were body mass index (BMI) z-score, health resource use, school absenteeism, health-related quality of life and psychosocial health, measured over 2 years of follow-up (2015-2017). Health behaviours included physical activity, and consumption of fruits, vegetables and sweetened beverages. Associations between SES and baseline health behaviours were examined, and mixed models for repeated measures were used to assess associations between SES and health outcomes over 2 years of follow-up. RESULTS A high socioeconomic background was significantly associated with better health outcomes (all outcomes). For example, children with a low SES had higher BMI z-scores (beta coefficient: 0.42, 95% CI 0.22 to 0.62) and higher consumption healthcare costs (ratio of mean costs: 2.21, 95% CI 1.57 to 3.10). Effects of SES changed very little after controlling for health behaviours. DISCUSSION Our findings strongly suggest that socioeconomic background has a pervasive impact on disparities in child health, but gives little support to the idea that social inequalities in child health can be tackled by means of lifestyle interventions.
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Affiliation(s)
- Marije Oosterhoff
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC+)/Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Manuela A Joore
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC+)/Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Nina H M Bartelink
- Department of Health Promotion, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bjorn Winkens
- Department of Methodology and Statistics, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Onno C P Schayck
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Department of Social Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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24
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Wu XY, Zhuang LH, Li W, Guo HW, Zhang JH, Zhao YK, Hu JW, Gao QQ, Luo S, Ohinmaa A, Veugelers PJ. The influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents: a systematic review and meta-analysis. Qual Life Res 2019; 28:1989-2015. [PMID: 30875010 DOI: 10.1007/s11136-019-02162-4] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The association between diet quality, dietary behavior and health-related quality of life has been mostly examined in children and adolescents with specific chronic diseases. No systematic review has synthesized the influence of diet quality and dietary behavior on health-related quality of life in the general population of children and adolescents. The purpose of this study was to systematically review the primary studies that evaluated the association between diet quality, dietary behavior and health-related quality of life in the general population of children and adolescents and to synthesize the findings for the association. METHODS A computer search in the databases of MEDLINE, EMBASE and PSYCINFO was performed to retrieve English language studies that were published from 1946 up to April 8, 2018. We also screened the PubMed-related articles and the reference lists of the existing relevant literature to identify other eligible studies. We synthesized the association between diet quality, dietary behavior and health-related quality of life using both a qualitative method and meta-analysis. We reported the review following up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guideline. RESULTS Seventeen studies were included in the synthesis including twelve cross-sectional studies and five longitudinal studies. We found that diet quality and dietary behavior were associated with health-related quality of life in children and adolescents. The positive effect of healthy diets on health-related quality of life was observed for multiple domains of health-related quality of life, including physical, school and emotional functioning, and psychosocial quality of life. We observed a dose-response relationship between the diet exposure and health-related quality of life, where an unhealthy dietary behavior or lower diet quality was associated with decreased health-related quality of life among children and adolescents. CONCLUSION The findings of the systematic review suggest the importance of promoting healthy diets and nutrition for good health-related quality of life among children and adolescents. Future research is needed to strengthen the evidence for prospective relationships and for the dose-response effect between diet quality, dietary behavior and health-related quality of life among children and adolescents.
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Affiliation(s)
- Xiu Yun Wu
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China.
| | - Li Hui Zhuang
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China.
| | - Wei Li
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Hong Wei Guo
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Jian Hua Zhang
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Yan Kui Zhao
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Jin Wei Hu
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Qian Qian Gao
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Sheng Luo
- School of Public Health and Management, Weifang Medical University, 7166 Baotong West Street, 261053, Weifang, Shandong, China
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, 350 University Terrace, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, 350 University Terrace, 8303 - 112 Street, Edmonton, AB, T6G 2T4, Canada
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Moeijes J, van Busschbach JT, Wieringa TH, Kone J, Bosscher RJ, Twisk JWR. Sports participation and health-related quality of life in children: results of a cross-sectional study. Health Qual Life Outcomes 2019; 17:64. [PMID: 30987637 PMCID: PMC6466683 DOI: 10.1186/s12955-019-1124-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 03/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background In children physical activity has been shown to be associated with health-related quality of life (HRQoL). This study further explores this association for specific characteristics of sports participation, namely membership of a sports club, frequency of sports participation, performing individual versus team sports, performing indoor versus outdoor sports, while differentiating between specific dimensions in the physical, psychological and social domain of HRQoL. Methods Cross-sectional data were collected from Dutch primary school children aged 10 to 12 years. They completed the Movement and Sports Monitor Questionnaire Youth aged 8 to 12 years (MSMQ) and the KIDSCREEN-52, an HRQoL questionnaire for children and adolescents. The data were examined using linear multilevel analyses because of the clustering of children in schools. Results The questionnaires were completed by 1876 children (response rate 81.3%). Membership of a sports club, moderate or high frequency of sports participation, and performing outdoor sports were all significantly associated with better HRQoL. These associations were largely found in the physical domain of HRQoL, to a lesser degree in the social domain, and to a limited extent in the psychological domain. Conclusion The association between sports participation and HRQoL in children depends on both characteristics of sports participation and the domain of life that is concerned. These differences offer starting points for developing tailor-made sports programs for children. Electronic supplementary material The online version of this article (10.1186/s12955-019-1124-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Janet Moeijes
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands. .,Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers (AMC and VUMC), Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands.
| | - Jooske T van Busschbach
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands.,University of Groningen, University Medical Center Groningen, University Center for Psychiatry, P.O. Box 30001, 9700, RB, Groningen, The Netherlands
| | - Thomas H Wieringa
- Department of Medical Psychology, Amsterdam University Medical Centers (AMC and VUMC), Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081, BT, Amsterdam, the Netherlands
| | - Jordy Kone
- School of Health Care Studies, Hanze University of Applied Sciences Groningen, P.O. Box 30030, 9700, RM, Groningen, The Netherlands.,Department of Health and Welfare, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands
| | - Ruud J Bosscher
- Department of Human Movement and Education, Windesheim University of Applied Sciences, Campus 2-6, Zwolle, 8017CA, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Centers (AMC and VUMC), Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands
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Brown V, Tan EJ, Hayes AJ, Petrou S, Moodie ML. Utility values for childhood obesity interventions: a systematic review and meta-analysis of the evidence for use in economic evaluation. Obes Rev 2018; 19:905-916. [PMID: 29356315 DOI: 10.1111/obr.12672] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/12/2017] [Accepted: 12/19/2017] [Indexed: 12/11/2022]
Abstract
Rigorous estimates of preference-based utilities are important inputs into economic evaluations of childhood obesity interventions, yet no published review currently exists examining utility by weight status in paediatric populations. A comprehensive systematic literature review and meta-analysis was therefore undertaken, pooling data on preference-based health state utilities by weight status in children using a random-effects model. Tests for heterogeneity were performed, and publication bias was assessed. Of 3,434 potentially relevant studies identified, 11 met our eligibility criteria. Estimates of Cohen's d statistic suggested a small effect of weight status on preference-based utilities. Mean utility values were estimated as 0.85 (95% uncertainty interval [UI] 0.84-0.87), 0.83 (95% UI 0.81-0.85), 0.82 (95% UI 0.79-0.84) and 0.83 (95% UI 0.80-0.86) for healthy weight, overweight, obese and overweight/obese states, respectively. Meta-analysis of studies reporting utility values for both healthy weight and overweight/obese participants found a statistically significant weighted mean difference (0.015, 95% UI 0.003-0.026). A small but statistically significant difference was also estimated between healthy weight and overweight participants (0.011, 95% UI 0.004-0.018). Study findings suggest that paediatric-specific benefits of obesity interventions may not be well reflected by available utility measures, potentially underestimating cost-effectiveness if weight loss in childhood/adolescence improves health or well-being.
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Affiliation(s)
- V Brown
- Deakin Health Economics, Global Obesity Centre (GLOBE), Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
| | - E J Tan
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia.,School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - A J Hayes
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia.,School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - S Petrou
- Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia.,Warwick Medical School, University of Warwick, Coventry, UK
| | - M L Moodie
- Deakin Health Economics, Global Obesity Centre (GLOBE), Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia.,Centre for Research Excellence in Early Prevention of Obesity in Childhood, Sydney, NSW, Australia
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27
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Evaristo S, Moreira C, Santos R, Lopes L, Abreu S, Agostinis-Sobrinho C, Oliveira-Santos J, Mota J. Associations between health-related quality of life and body mass index in Portuguese adolescents: LabMed physical activity study. Int J Adolesc Med Health 2018; 31:/j/ijamh.ahead-of-print/ijamh-2017-0066/ijamh-2017-0066.xml. [PMID: 29432203 DOI: 10.1515/ijamh-2017-0066] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 07/13/2017] [Indexed: 12/15/2022]
Abstract
Background In adolescence there are several biological and physiological changes associated with overweight and obesity. Objective The purpose of this study was to analyze the associations between health-related quality of life (HRQoL) and body mass index (BMI) in adolescents. Methods This is a cross-sectional analysis of 957 Portuguese adolescents (446 girls and 511 boys) aged 12-18 years. A series of variables were collected: (a) HRQoL was assessed using the KIDSCREEN-10 questionnaire; (b) socioeconomic status (SES) was measured using the Family Affluence Scale; (c) body composition (weigh, height) were measured and BMI was calculated and, (d) pubertal stage was assessed with Tanner stages; (e) the 20-m shuttle-run was used to estimate cardiorespiratory fitness. Regression models and mediation analysis were performed to assess the association between HRQoL and BMI. Results HRQoL was significantly higher in boys than girls (p < 0.05). The prevalence of overweight and obesity was 23.5% and 6.7% in girls, and 21.3% and 5% in boys, respectively. HRQoL was inversely and significantly associated with BMI in boys (B = -0.130; p < 0.05) and girls (B = -0.148; p < 0.05) after controlling for age, pubertal stage and SES. Cardiorespiratory fitness act as a full mediator variable on the relationship between BMI and HRQoL in adolescents (p < 0.05). Conclusion Our results suggest that cardiorespiratory fitness acted as a full mediator in the relationship between BMI and HRQoL, in adolescents. Public health policies targeting a wealthy weight and an improved physical fitness level could be a strategy of particular interest for improving the HRQoL of adolescents.
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Affiliation(s)
- Sofia Evaristo
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Carla Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, R. Plácido Costa, 91, 4200 450Porto, Portugal, Phone: +351-22-5074786, Fax: +351-22-5500689
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.,Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW,Australia
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Sandra Abreu
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - César Agostinis-Sobrinho
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - José Oliveira-Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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Dumuid D, Maher C, Lewis LK, Stanford TE, Martín Fernández JA, Ratcliffe J, Katzmarzyk PT, Barreira TV, Chaput JP, Fogelholm M, Hu G, Maia J, Sarmiento OL, Standage M, Tremblay MS, Tudor-Locke C, Olds T. Human development index, children's health-related quality of life and movement behaviors: a compositional data analysis. Qual Life Res 2018; 27:1473-1482. [PMID: 29362939 DOI: 10.1007/s11136-018-1791-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Health-related quality of life has been related to physical activity, sedentary behavior, and sleep among children from developed nations. These relationships have rarely been assessed in developing nations, nor have behaviors been considered in their true context, as mutually exclusive and exhaustive parts of the movement behavior composition. This study aimed to explore whether children's health-related quality of life is related to their movement behavior composition and if the relationship differs according to human development index. METHODS Children aged 9-11 years (n = 5855), from the 12-nation cross-sectional observational International Study of Childhood Obesity, Lifestyle and the Environment 2011-2013, self-reported their health-related quality of life (KIDSCREEN-10). Daily movement behaviors were from 24-h, 7-day accelerometry. Isometric log-ratio mixed-effect linear models were used to calculate estimates for difference in health-related quality of life for the reallocation of time between daily movement behaviors. RESULTS Children from countries of higher human development index reported stronger positive relationships between health-related quality of life and moderate-to-vigorous physical activity, relative to the remaining behaviors (r = 0.75, p = 0.005) than those from lower human development index countries. In the very high human development index strata alone, health-related quality of life was significantly related to the movement behavior composition (p = 0.005), with moderate-to-vigorous physical activity (relative to remaining behaviors) being positively associated with health-related quality of life. CONCLUSIONS The relationship between children's health-related quality of life and their movement behaviors is moderated by their country's human development index. This should be considered when 24-h movement behavior guidelines are developed for children around the world.
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Affiliation(s)
- Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia.
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Lucy K Lewis
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia.,School of Health Sciences, Flinders University, Adelaide, Australia
| | - Tyman E Stanford
- LBT Innovations, Adelaide, Australia.,School of Mathematical Sciences, The University of Adelaide, Adelaide, Australia
| | | | - Julie Ratcliffe
- Institute for Choice, University of South Australia, Adelaide, Australia
| | | | - Tiago V Barreira
- Pennington Biomedical Research Center, Baton Rouge, USA.,School of Education, Syracuse University, New York, USA
| | | | - Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, USA
| | - José Maia
- Faculty of Sport, University of Porto, Porto, Portugal
| | | | | | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Catrine Tudor-Locke
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, USA
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia
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Truelove S, Johnson AM, Vanderloo LM, Driediger M, Burke SM, Irwin JD, Timmons BW, Gaston A, Tucker P. Preschoolers' health-related quality of life following the implementation of a childcare physical activity intervention. Appl Physiol Nutr Metab 2017; 43:453-459. [PMID: 29207249 DOI: 10.1139/apnm-2017-0396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Being active offers many physical and emotional benefits contributing to a higher health-related quality of life (HRQoL); however, this relationship remains unexplored among preschoolers (aged 2.5-5 years). This study examined the impact of the Supporting Physical Activity in the Childcare Environment (SPACE), which was an intervention implemented using a cluster randomized controlled trial on preschoolers' HRQoL. Childcare centres were randomly allocated to the experimental (n = 11) or control (n = 11) conditions, and preschoolers' HRQoL was measured using the parent-report Pediatric Quality of Life Inventory 4.0 (3 subscales: physical, psychosocial, and total HRQoL) at baseline, post-intervention (i.e., week 8), and 6- and 12-month follow-up. A linear mixed-effects model was used to determine if preschoolers in the experimental condition displayed an increased HRQoL post-intervention and at follow-up compared with preschoolers in the control condition. Preschoolers (n = 234) with HRQoL data at baseline and one additional time-point were retained for analyses. Body mass index was not found to impact significantly on the intervention, and no statistically significant interaction effects were found for any of the 3 HRQoL variables. In conclusion, the SPACE intervention had no impact on preschoolers' HRQoL. Given the scarcity of research in this population, additional exploration is necessary to better understand the potential impact of physical activity participation on preschoolers' HRQoL.
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Affiliation(s)
- Stephanie Truelove
- a Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
| | - Andrew M Johnson
- b School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON N6G IH1, Canada
| | - Leigh M Vanderloo
- a Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
| | - Molly Driediger
- c School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
| | - Shauna M Burke
- b School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON N6G IH1, Canada
| | - Jennifer D Irwin
- b School of Health Studies, Faculty of Health Sciences, University of Western Ontario, London, ON N6G IH1, Canada
| | - Brian W Timmons
- d Child Health & Exercise Medicine Program, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Anca Gaston
- e School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
| | - Patricia Tucker
- c School of Occupational Therapy, Faculty of Health Sciences, University of Western Ontario, London, ON N6G 1H1, Canada
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30
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The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: A systematic review. PLoS One 2017; 12:e0187668. [PMID: 29121640 PMCID: PMC5679623 DOI: 10.1371/journal.pone.0187668] [Citation(s) in RCA: 309] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/24/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The association between physical activity, sedentary behavior and health-related quality of life in children and adolescents has been mostly investigated in those young people with chronic disease conditions. No systematic review to date has synthesized the relationship between physical activity, sedentary behavior and health-related quality of life in the general healthy population of children and adolescents. The purpose of this study was to review systematically the existing literature that evaluated the relations between physical activity, sedentary behavior and health-related quality of life in the general population of children and adolescents. METHODS We conducted a computer search for English language literature from databases of MEDLINE, EMBASE, PSYCINFO and PubMed-related articles as well as the reference lists of existing literature between 1946 and the second week of January 2017 to retrieve eligible studies. We included the studies that assessed associations between physical activity and/or sedentary behavior and health-related quality of life among the general population of children and adolescents aged between 3-18 years. The study design included cross-sectional, longitudinal and health intervention studies. We excluded the studies that examined associations between physical activity, sedentary behavior and health-related quality of life among children and adolescents with specific chronic diseases, and other studies and reports including reviews, meta-analyses, study protocols, comments, letters, case reports and guidelines. We followed up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement in the reporting of this review. The risk of bias of the primary studies was assessed by the Newcastle-Ottawa Scale. We synthesized the difference in health-related quality of life scores between different levels of physical activity and sedentary time. RESULTS In total, 31 studies met the inclusion criteria and were synthesized in the review. Most of the included studies used a cross-sectional design (n = 21). There were six longitudinal studies and three school-based physical activity intervention studies. One study used both cross-sectional and longitudinal designs. We found that higher levels of physical activity were associated with better health-related quality of life and increased time of sedentary behavior was linked to lower health-related quality of life among children and adolescents. A dose-response relation between physical activity, sedentary behavior and health-related quality of life was observed in several studies suggesting that the higher frequency of physical activity or the less time being sedentary, the better the health-related quality of life. CONCLUSIONS The findings in this study suggest that school health programs promoting active lifestyles among children and adolescents may contribute to the improvement of health-related quality of life. Future research is needed to extend studies on longitudinal relationships between physical activity, sedentary behavior and health-related quality of life, and on effects of physical activity interventions on health-related quality of life among children and youth.
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31
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Tercedor P, Villa-González E, Ávila-García M, Díaz-Piedra C, Martínez-Baena A, Soriano-Maldonado A, Pérez-López IJ, García-Rodríguez I, Mandic S, Palomares-Cuadros J, Segura-Jiménez V, Huertas-Delgado FJ. A school-based physical activity promotion intervention in children: rationale and study protocol for the PREVIENE Project. BMC Public Health 2017; 17:748. [PMID: 28950837 PMCID: PMC5615806 DOI: 10.1186/s12889-017-4788-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/21/2017] [Indexed: 01/12/2023] Open
Abstract
Background The lack of physical activity and increasing time spent in sedentary behaviours during childhood place importance on developing low cost, easy-toimplement school-based interventions to increase physical activity among children. The PREVIENE Project will evaluate the effectiveness of five innovative, simple, and feasible interventions (active commuting to/from school, active Physical Education lessons, active school recess, sleep health promotion, and an integrated program incorporating all 4 interventions) to improve physical activity, fitness, anthropometry, sleep health, academic achievement, and health-related quality of life in primary school children. Methods A total of 300 children (grade 3; 8-9 years of age) from six schools in Granada (Spain) will be enrolled in one of the 8-week interventions (one intervention per school; 50 children per school) or a control group (no intervention school; 50 children). Outcomes will include physical activity (measured by accelerometry), physical fitness (assessed using the ALPHA fitness battery), and anthropometry (height, weight and waist circumference). Furthermore, they will include sleep health (measured by accelerometers, a sleep diary, and sleep health questionnaires), academic achievement (grades from the official school’s records), and health-related quality of life (child and parental questionnaires). To assess the effectiveness of the different interventions on objectively measured PA and the other outcomes, the generalized linear model will be used. Discussion The PREVIENE Project will provide the information about the effectiveness and implementation of different school-based interventions for physical activity promotion in primary school children.
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Affiliation(s)
- Pablo Tercedor
- PA-HELP "Physical Activity for HEalth Promotion" Research Group, Granada, Spain. .,Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
| | - Emilio Villa-González
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,PROFITH "PROmoting FITness and Health through physical activity" Research Group, Granada, Spain
| | - Manuel Ávila-García
- PA-HELP "Physical Activity for HEalth Promotion" Research Group, Granada, Spain.,Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Carolina Díaz-Piedra
- "Mind, Brain, and Behavior" Research Center, University of Granada, Granada, Spain
| | - Alejandro Martínez-Baena
- "Physical Activity and Pedagogy" Research Unit, Department of Physical Education and Sport, School of Sport Sciences, University of Valencia, Valencia, Spain
| | - Alberto Soriano-Maldonado
- "SPORT" Research Group, Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
| | - Isaac José Pérez-López
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,"Physical Education and Social Transformation" Research Group, Granada, Spain
| | - Inmaculada García-Rodríguez
- PA-HELP "Physical Activity for HEalth Promotion" Research Group, Granada, Spain.,Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Sandra Mandic
- Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Juan Palomares-Cuadros
- "Curricular Design, Development and Innovation in the Area of Physical Education Didactics" Research Group, Department of Physical Education and Sport, International University of La Rioja, La Rioja, Spain
| | - Víctor Segura-Jiménez
- PA-HELP "Physical Activity for HEalth Promotion" Research Group, Granada, Spain.,Department of Physical Education, School of Education Sciences, University of Cádiz, Cádiz, Spain
| | - Francisco Javier Huertas-Delgado
- PA-HELP "Physical Activity for HEalth Promotion" Research Group, Granada, Spain.,Teaching School La Inmaculada, University of Granada, Granada, Spain
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Sampasa-Kanyinga H, Standage M, Tremblay MS, Katzmarzyk PT, Hu G, Kuriyan R, Maher C, Maia J, Olds T, Sarmiento OL, Tudor-Locke C, Chaput JP. Associations between meeting combinations of 24-h movement guidelines and health-related quality of life in children from 12 countries. Public Health 2017; 153:16-24. [PMID: 28818582 DOI: 10.1016/j.puhe.2017.07.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 05/09/2017] [Accepted: 07/07/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine whether meeting vs not meeting movement/non-movement guidelines (moderate-to-vigorous physical activity [MVPA], screen time, sleep duration), and combinations of these recommendations, are associated with health-related quality of life (HRQoL) in children from 12 countries in five major geographic regions of the world and explore whether the associations vary by study site. STUDY DESIGN Observational, multinational cross-sectional study. METHODS This study included 6106 children aged 9-11 years from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. Participants completed the KIDSCREEN-10 to provide a global measure of their HRQoL. Sleep duration and MVPA were assessed using 24-h accelerometry. Screen time was assessed through self-report. Meeting the recommendations was defined as ≥60 min/day for MVPA, ≤2 h/day for screen time, and between 9 and 11 h/night for sleep duration. Age, sex, highest parental education, unhealthy diet pattern score, and body mass index z-score were included as covariates in statistical models. RESULTS In the full sample, children meeting the screen time recommendation, the screen time + sleep recommendation, and all three recommendations had significantly better HRQoL than children not meeting any of these guidelines. Differences in HRQoL scores between sites were also found within combinations of movement/non-movement behaviors. For example, while children in Australia, Canada, and USA self-reported better HRQoL when meeting all three recommendations, children in Kenya and Portugal reported significantly lower HRQoL when meeting all three recommendations (relative to not meeting any). CONCLUSIONS Self-reported HRQoL is generally higher when children meet established movement/non-movement recommendations. However, differences between study sites also suggest that interventions aimed at improving lifestyle behaviors and HRQoL should be locally and culturally adapted.
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Affiliation(s)
- H Sampasa-Kanyinga
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
| | - M Standage
- Department for Health, University of Bath, Bath, United Kingdom
| | - M S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - P T Katzmarzyk
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - G Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - R Kuriyan
- Department of Nutrition, St. John's Research Institute, Bangalore, India
| | - C Maher
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia
| | - J Maia
- CIFI2D, Faculdade de Desporto, University of Porto, Porto, Portugal
| | - T Olds
- Alliance for Research in Exercise Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, Australia
| | - O L Sarmiento
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - C Tudor-Locke
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - J-P Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
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Dumuid D, Olds T, Lewis LK, Martin-Fernández JA, Katzmarzyk PT, Barreira T, Broyles ST, Chaput JP, Fogelholm M, Hu G, Kuriyan R, Kurpad A, Lambert EV, Maia J, Matsudo V, Onywera VO, Sarmiento OL, Standage M, Tremblay MS, Tudor-Locke C, Zhao P, Gillison F, Maher C. Health-Related Quality of Life and Lifestyle Behavior Clusters in School-Aged Children from 12 Countries. J Pediatr 2017; 183:178-183.e2. [PMID: 28081885 DOI: 10.1016/j.jpeds.2016.12.048] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 11/10/2016] [Accepted: 12/19/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the relationship between children's lifestyles and health-related quality of life and to explore whether this relationship varies among children from different world regions. STUDY DESIGN This study used cross-sectional data from the International Study of Childhood Obesity, Lifestyle and the Environment. Children (9-11 years) were recruited from sites in 12 nations (n = 5759). Clustering input variables were 24-hour accelerometry and self-reported diet and screen time. Health-related quality of life was self-reported with KIDSCREEN-10. Cluster analyses (using compositional analysis techniques) were performed on a site-wise basis. Lifestyle behavior cluster characteristics were compared between sites. The relationship between cluster membership and health-related quality of life was assessed with the use of linear models. RESULTS Lifestyle behavior clusters were similar across the 12 sites, with clusters commonly characterized by (1) high physical activity (actives); (2) high sedentary behavior (sitters); (3) high screen time/unhealthy eating pattern (junk-food screenies); and (4) low screen time/healthy eating pattern and moderate physical activity/sedentary behavior (all-rounders). Health-related quality of life was greatest in the all-rounders cluster. CONCLUSIONS Children from different world regions clustered into groups of similar lifestyle behaviors. Cluster membership was related to differing health-related quality of life, with children from the all-rounders cluster consistently reporting greatest health-related quality of life at sites around the world. Findings support the importance of a healthy combination of lifestyle behaviors in childhood: low screen time, healthy eating pattern, and balanced daily activity behaviors (physical activity and sedentary behavior). TRIAL REGISTRATION ClinicalTrials.gov: NCT01722500.
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Affiliation(s)
| | - Timothy Olds
- School of Health Sciences, University of South Australia
| | - Lucy K Lewis
- School of Health Sciences, University of South Australia; School of Health Sciences, Flinders University, Adelaide, Australia
| | | | - Peter T Katzmarzyk
- Population Science, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Tiago Barreira
- Population Science, Pennington Biomedical Research Center, Baton Rouge, LA; School of Education, Syracuse University, Syracuse, NY
| | | | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Gang Hu
- Population Science, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Rebecca Kuriyan
- Department of Nutrition, St John's Research Institute, Karnataka, India
| | - Anura Kurpad
- Department of Nutrition, St John's Research Institute, Karnataka, India
| | - Estelle V Lambert
- Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - José Maia
- Faculty of Sport, University of Porto, Porto, Portugal
| | - Victor Matsudo
- Center for the Study of Physical Fitness Laboratory of São Caetano do Sul (CELAFISCS), São Caetano do Sul, Brazil
| | - Vincent O Onywera
- Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi City, Kenya
| | | | | | - Mark S Tremblay
- Healthy Active Living and Obesity Research, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | | | - Pei Zhao
- Tianjin Women's and Children's Health Center, Tianjin, China
| | | | - Carol Maher
- School of Health Sciences, University of South Australia
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Wu X, Kirk SFL, Ohinmaa A, Veugelers P. Health behaviours, body weight and self-esteem among grade five students in Canada. SPRINGERPLUS 2016; 5:1099. [PMID: 27468400 PMCID: PMC4947077 DOI: 10.1186/s40064-016-2744-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 07/02/2016] [Indexed: 12/02/2022]
Abstract
Purpose This study sought to identify the principal components of self-esteem and the health behavioural determinants of these components among grade five students. Methods We analysed data from a population-based survey among 4918 grade five students, who are primarily 10 and 11 years of age, and their parents in the Canadian province of Nova Scotia. The survey comprised the Harvard Youth and Adolescent Questionnaire, parental reporting of students’ physical activity (PA) and time spent watching television or using computer/video games. Students heights and weights were objectively measured. We applied principal component analysis (PCA) to derive the components of self-esteem, and multilevel, multivariable logistic regression to quantify associations of diet quality, PA, sedentary behaviour and body weight with these components of self-esteem. Results PCA identified four components for self-esteem: self-perception, externalizing problems, internalizing problems, social-perception. Influences of health behaviours and body weight on self-esteem varied across the components. Better diet quality was associated with higher self-perception and fewer externalizing problems. Less PA and more use of computer/video games were related to lower self-perception and social-perception. Excessive TV watching was associated with more internalizing problems. Students classified as obese were more likely to report low self- and social-perception, and to experience fewer externalizing problems relative to students classified as normal weight. Conclusion This study demonstrates independent influences of diet quality, physical activity, sedentary behaviour and body weight on four aspects of self-esteem among children. These findings suggest that school programs and health promotion strategies that target health behaviours may benefit self-esteem in childhood, and mental health and quality of life later in life.
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Affiliation(s)
- Xiuyun Wu
- School of Health and Human Performance, Dalhousie University, Halifax, NS Canada
| | - Sara F L Kirk
- School of Health and Human Performance, Dalhousie University, Halifax, NS Canada ; IWK Health Centre, Halifax, NS Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, 350 University Terrace, 8303 - 112 Street, Edmonton, AB T6G 2T4 Canada
| | - Paul Veugelers
- School of Public Health, University of Alberta, 350 University Terrace, 8303 - 112 Street, Edmonton, AB T6G 2T4 Canada
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Gopinath B, Flood VM, Burlutsky G, Louie JCY, Baur LA, Mitchell P. Dairy Food Consumption and Health-Related Quality of Life in Boys: Preliminary Findings from a 5-Year Cohort Study. J Am Coll Nutr 2016; 35:522-558. [DOI: 10.1080/07315724.2015.1075444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Impaired quality of life in treatment-seeking obese children of Dutch, Moroccan, Turkish and Surinamese descent. Public Health Nutr 2016. [DOI: 10.1017/s1368980015002074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo determine the health-related quality of life (HRQOL) of overweight and obese multi-ethnic children compared with normal-weight children; and to investigate differences in HRQOL between self- and parent-proxy reports and ethnic groups.DesignProspective cross-sectional study.SettingOut-patient clinic where children and their parents filled out a validated HRQOL questionnaire (KIDSCREEN-52) and height, weight, waist circumference and fat percentage were measured.SubjectsOverweight and obese children, aged 8–18 years (mean BMIZ-score 3·2 (sd0·6)), from the obesity out-patient clinic.ResultsThree hundred and eight self- and 213 parent-proxy reported questionnaires were completed. Global HRQOL and the Physical Wellbeing, Moods & Emotions and Self-Perception subscales were markedly reduced in our multi-ethnic obese cohort, relative to the Dutch reference values. Parent proxies reported significantly lower on the global HRQOL and the Physical Wellbeing, Moods & Emotions and Bullying subscales. In Caucasian children, multivariate analyses showed that BMI was associated with the quality-of-life subscales Moods & Emotions, Self-Perception and Bullying.ConclusionsHRQOL was markedly reduced in our multi-ethnic overweight and obese out-patient clinic cohort, with significantly lower parent-proxy scores compared with self-reported scores. We believe intervention programmes aiming to improve HRQOL should be directed to both parents and children, while ethnic-specific programmes to enhance HRQOL seem of less importance.
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Bolton KA, Jacka F, Allender S, Kremer P, Gibbs L, Waters E, de Silva A. The association between self-reported diet quality and health-related quality of life in rural and urban Australian adolescents. Aust J Rural Health 2016; 24:317-325. [DOI: 10.1111/ajr.12275] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2015] [Indexed: 12/01/2022] Open
Affiliation(s)
- Kristy A. Bolton
- WHO Collaborating Centre for Obesity Prevention; Deakin University; Geelong Victoria Australia
| | - Felice Jacka
- Division of Nutritional Psychiatry Research; IMPACT Strategic Research Centre; Deakin University; Geelong Victoria Australia
- Department of Psychiatry; The University of Melbourne; Melbourne Victoria Australia
- Centre for Adolescent Health; Murdoch Children's Research Institute; Melbourne Victoria Australia
- Black Dog Institute; Sydney New South Wales Australia
| | - Steven Allender
- WHO Collaborating Centre for Obesity Prevention; Deakin University; Geelong Victoria Australia
| | - Peter Kremer
- School of Exercise and Nutrition Sciences; Deakin University; Geelong Victoria Australia
- Centre for Social and Early Emotional Development; Deakin University; Geelong Australia
| | - Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
| | - Elizabeth Waters
- Jack Brockhoff Child Health and Wellbeing Program; Melbourne School of Population and Global Health; The University of Melbourne; Carlton Victoria Australia
| | - Andrea de Silva
- Centre of Applied Oral Health Research; Dental Health Services Victoria; Carlton Victoria Australia
- Melbourne Dental School; The University of Melbourne; Carlton Victoria Australia
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Losasso C, Cappa V, Neuhouser ML, Giaccone V, Andrighetto I, Ricci A. Students' Consumption of Beverages and Snacks at School and Away from School: A Case Study in the North East of Italy. Front Nutr 2015; 2:30. [PMID: 26501063 PMCID: PMC4595772 DOI: 10.3389/fnut.2015.00030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/22/2015] [Indexed: 11/22/2022] Open
Abstract
In North-East Italy (the Veneto region), several public school nutrition policies have been developed to reduce the consumption of high-caloric snacks and beverages. However, little is known about whether the policies actually influence students’ dietary behaviors. In order to address this point, a multi-center cross-sectional survey of 691 Italian students was conducted. Students completed the Beverage and Snack Questionnaire, which assesses the consumption of beverages and snacks at school and out of school. Three-level Poisson Models with random intercept with students (level 1 units) nested into classroom (level 2 units), and nested into schools (level 3 units), were used to examine the influence of the school setting vs. the out of school environment (independent variable) on students’ consumption of sweet beverages, snacks, milk-based beverages, low-carbohydrate drinks, fruit, and vegetables (dependent variable) (p ≤ 0.05). The results showed a significantly higher consumption of sweet beverages, snacks, milk-based beverages, low-carbohydrate drinks, fruit, and vegetables out-of-the school, suggesting a school-protective association Thus, the policies aimed to limit or deny access to unhealthy foods in the school environment may play an important role in promoting more healthful dietary patterns for school children. Additional studies should be conducted to compare students’ dietary behaviors between schools with nutrition policies to those without nutrition policies.
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Affiliation(s)
- Carmen Losasso
- Risk Analysis and Public Health Department, Istituto Zooprofilattico Sperimentale delle Venezie , Legnaro , Italy
| | - Veronica Cappa
- Risk Analysis and Public Health Department, Istituto Zooprofilattico Sperimentale delle Venezie , Legnaro , Italy
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center , Seattle, WA , USA
| | - Valerio Giaccone
- Animal Medicine, Production and Health, University of Padua , Padua , Italy
| | - Igino Andrighetto
- Animal Medicine, Production and Health, University of Padua , Padua , Italy
| | - Antonia Ricci
- Risk Analysis and Public Health Department, Istituto Zooprofilattico Sperimentale delle Venezie , Legnaro , Italy
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A mixed-methods exploration of implementation of a comprehensive school healthy eating model one year after scale-up. Public Health Nutr 2015; 19:924-34. [PMID: 25990045 DOI: 10.1017/s1368980015001482] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To study the implementation of a school-based healthy eating (HE) model one year after scale-up in British Columbia (BC). Specifically, to examine implementation of Action Schools! BC (AS! BC) and its influence on implementation of classroom HE activities, and to explore factors associated with implementation. DESIGN Diffusion of Innovations, Social Cognitive and Organizational Change theories guided our approach. We used a mixed-methods research design including focus group interviews (seven schools, sixty-two implementers) and a cross-sectional multistage survey to principals (n 36, 92 % response rate) and teachers of grades 4 to 7 (n 168, 70 % response rate). Self-reported implementation of classroom HE activities and reported use of specific AS! BC HE activities were primary implementation measures. Thematic analysis of focus group data and multilevel mixed-effect logistic regression analyses of survey data were conducted. SETTING Elementary schools across BC, Canada. SUBJECTS Thirty-nine school districts, thirty-six principals, 168 grade 4 to 7 teachers. RESULTS Forty-two per cent of teachers in registered schools were implementing AS! BC HE in their classrooms. Users were 6·25 times more likely to have delivered a HE lesson in the past week. Implementation facilitators were school champions, technical support and access to resources; barriers were lack of time, loss of leadership or momentum. Implementation predictors were teacher training, self-efficacy, experience with the physical activity component of AS! BC, supportive school climate and parental post-secondary education. CONCLUSIONS Our findings reinforce that continued teacher training and support are important public health investments that contribute to successful implementation of school-based HE models after scale-up.
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Ruano-Rodríguez C, Serra-Majem L, Dubois D. Assessing the impact of dietary habits on health-related quality of life requires contextual measurement tools. Front Pharmacol 2015; 6:101. [PMID: 26005420 PMCID: PMC4424859 DOI: 10.3389/fphar.2015.00101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 04/23/2015] [Indexed: 12/11/2022] Open
Abstract
The increase of non-communicable diseases at all ages has fostered the general concern for sustaining population health worldwide. Unhealthy lifestyles and dietary habits impacting physical and psycho-social health are well known risk factors for developing life threatening diseases. Identifying the determinants of quality of life is an important task from a Public Health perspective. Consumer-Reported Outcome measures of health-related quality of life (HRQoL) are becoming increasingly necessary and relevant in the field of nutrition. However, quality of life questionnaires are seldom used in the nutrition field. We conducted a scientific literature search to find out the questionnaires used to determine the association between dietary habits and quality of life. A total of 13 studies were eligible for inclusion. Across these studies the short form-36, a generic (non-disease specific) HRQoL measurement instrument was the most widely used. However, generic measures may have limited content validity in the context of dietary habits interventions. We recommend additional contextual diet-specific HRQoL measures are also needed for evaluating the impact of diet habits on daily life functioning and well-being.
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Affiliation(s)
- Cristina Ruano-Rodríguez
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria , Las Palmas de Gran Canaria, Spain ; Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III , Madrid, Spain
| | - Lluis Serra-Majem
- Nutrition Research Group, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria , Las Palmas de Gran Canaria, Spain ; Ciber Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos III , Madrid, Spain
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Food security status among grade 5 students in Nova Scotia, Canada and its association with health outcomes. Public Health Nutr 2014; 18:2943-51. [DOI: 10.1017/s1368980014001414] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveFood security (FS) exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their needs. The present research sought to determine whether students from households experiencing moderate or severe food insecurity (FI) had poorer diet quality, higher body weights and poorer psychosocial outcomes than students from households classed as having high FS or marginal FI status.DesignPopulation-based survey conducted in schools. Multiple regression analysis was used to explore associations between FS status (high FS; marginal, moderate, severe FI), dietary behaviours and intake, and health-related outcomes (body weight, quality of life, mood, peer relationships, externalizing problems).SettingNova Scotia, Canada.SubjectsGrade 5 students (n5853), aged 10–11 years, with complete information on FS status and student outcomes.ResultsIn this sample, rates of household FS were 73·5 % (high FS), 8·3 % (marginal FI) 10·2 % (moderate FI) and 7·1 % (severe FI status). Students living in households experiencing moderate or severe FI had poorer diet quality, higher BMI and poorer psychosocial outcomes than students classed as having high FS or marginal FI.ConclusionsThese findings provide important evidence for policy makers on the prevalence of FI among families in Nova Scotia with grade 5 children and its relationship with childhood nutrition, psychosocial and quality of life factors, and weight status.
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Attorp A, Scott JE, Yew AC, Rhodes RE, Barr SI, Naylor PJ. Associations between socioeconomic, parental and home environment factors and fruit and vegetable consumption of children in grades five and six in British Columbia, Canada. BMC Public Health 2014; 14:150. [PMID: 24517088 PMCID: PMC3929144 DOI: 10.1186/1471-2458-14-150] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 02/07/2014] [Indexed: 11/24/2022] Open
Abstract
Background Regular fruit and vegetable (FV) consumption has been associated with reduced chronic disease risk. Evidence from adults shows a social gradient in FV consumption. Evidence from pre-adolescent children varies and there is little Canadian data. This study assessed the FV intake of school children in British Columbia (BC), Canada to determine whether socio-economic status (SES), parental and the home environment factors were related to FV consumption. Methods As part of the BC School Fruit and Vegetable Nutrition Program, 773 British Columbia fifth-and sixth-grade school children (Mean age 11.3 years; range 10.3-12.5) and their parents were surveyed to determine FV consumption and overall dietary intake. Students completed a web-based 24-hour dietary food recall, and a student measure of socio-economic status (The Family Affluence Scale). Parents completed a self-administered survey about their education, income, home environment and perceptions of their neighbourhood and children’s eating habits. Correlations and multiple regression analyses were used to examine the association between SES, parental and home environment factors and FV consumption. Results Approximately 85.8% of children in this study failed to meet minimum Canadian guidelines for FV intake (6 servings). Parent income and education were not significantly associated with child FV consumption but were associated with each other, child-reported family affluence, neighbourhood environment, access to FV, and eating at the table or in front of the television. Significant positive associations were found between FV consumption and child-reported family affluence, meal-time habits, neighbourhood environment and parent perceptions of the healthiness of their child’s diet; however, these correlations were weak (ranging from .089-.115). Multiple regression analysis showed that only child-reported family affluence significantly predicted FV consumption (std-β = 0.096 95% CI = 0.01 to 0.27). Conclusions The majority of children in our study were not meeting guidelines for FV intake irrespective of SES, parent perceptions or home environment, making this a population wide concern. An almost trivial socio-economic gradient was observed for the child-reported SES measure only. These results are consistent with several other studies of children. Longitudinal research is needed to further explore individual and social factors associated with FV consumption in childhood and their development over time.
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Affiliation(s)
| | | | | | | | | | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, STN CSC, Victoria, BC V8W 3P1, Canada.
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Buttitta M, Iliescu C, Rousseau A, Guerrien A. Quality of life in overweight and obese children and adolescents: a literature review. Qual Life Res 2013; 23:1117-39. [PMID: 24249217 DOI: 10.1007/s11136-013-0568-5] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of the study is to present a literature review on quality-of-life (QOL) assessment in overweight or obese children and adolescents in order to identify the most affected dimensions and better understand associated factors. METHODS The ERIC, FRANCIS, MEDLINE, PsycARTICLES, PsycINFO, and Academic Search Premier databases were searched for articles reporting cross-sectional QOL studies in obese children and adolescents published in English before January 2013. The reference lists of retained articles were also screened. RESULTS Among the 34 articles retained for the analysis, only three did not report lower QOL among obese youth. Clinical populations appeared to be more affected than the general population. Several variables were associated with QOL such as self-image, bullying, bodily pain, quality of food intake, physical activity, screen time, parents' educational level, and weight status. CONCLUSIONS Identifying variables associated with lower QOL in obese children and adolescents offers new perspectives for prevention and care. Further research is needed to better elucidate these findings. Better understanding QOL is a key element essential for the treatment for childhood and adolescent obesity.
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Petersen S, Moodie M, Mavoa H, Waqa G, Goundar R, Swinburn B. Relationship between overweight and health-related quality of life in secondary school children in Fiji: results from a cross-sectional population-based study. Int J Obes (Lond) 2013; 38:539-46. [PMID: 24232500 DOI: 10.1038/ijo.2013.212] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 09/03/2013] [Accepted: 11/04/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the relationship between excess weight (overweight and obesity) and health-related quality of life (HRQoL) in a sample of secondary school children in Fiji, by gender, age and ethnicity. METHODS The study comprised 8947 children from forms 3-6 (age 12-18 years) in 18 secondary schools on Viti Levu, the main island of Fiji. Body mass index (BMI) was calculated from measured height and weight, and weight status was classified according to the International Obesity Task Force recommendations. HRQoL was measured by the self-report version of the Pediatric Quality of Life Inventory 4.0. RESULTS HRQoL was similar in children with obesity and normal weight. Generally, this was replicated when analyzed separately by gender and ethnicity, but age stratification revealed disparities. In 12-14-year-old children, obesity was associated with better HRQoL, owing to better social and school functioning and well-being, and in 15-18-year olds with poorer HRQoL, owing to worse physical, emotional and social functioning and well-being (Cohen's d 0.2-0.3). Children with a BMI in the overweight range also reported a slightly lower HRQoL than children with a BMI in the normal weight range, but although statistically significant, the size of this difference was trivial (Cohen's d <0.2). DISCUSSION The results suggest that, overall there is no meaningful negative association between excess weight and HRQoL in secondary school children in Fiji. This is in contradiction to the negative relationship between excess weight and HRQoL shown in studies from other countries and cultures. The assumption that a large body size is associated with a lower quality of life cannot be held universally. Although a generally low HRQoL among children in Fiji may be masking or overriding the potential effect of excess weight on HRQoL, socio-economic and/or socio-cultural factors, may help to explain these relationships.
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Affiliation(s)
- S Petersen
- 1] Deakin Health Economics, Faculty of Health, Deakin University, Melbourne, Victoria, Australia [2] WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria, Australia [3] Child and Adolescent Psychiatry, Clinical Sciences, Umeå University, Umeå, Sweden
| | - M Moodie
- 1] Deakin Health Economics, Faculty of Health, Deakin University, Melbourne, Victoria, Australia [2] WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - H Mavoa
- WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - G Waqa
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - R Goundar
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), Fiji School of Medicine, College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
| | - B Swinburn
- 1] WHO Collaborating Centre for Obesity Prevention, Faculty of Health, Deakin University, Melbourne, Victoria, Australia [2] School of Population Health, University of Auckland, Auckland, New Zealand
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Abstract
The term diet quality has recently gained considerable attention in nutritional research. Despite widespread use, it is often poorly defined and remains difficult to measure. Confusion surrounds the term, as there is no consensus on how to define quality of the diet or to pin down a framework for producing a standard indicator. The composite and cut-off selection of most diet quality indices depend on investigator choices in line with research objectives. In addition to the frequently used dietary compliance-based approach, innovative approaches have emerged to construct diet quality indices based on antioxidant and anti-inflammatory profiles of diet. Different viewpoints and overlapping interests may yield different interpretations. Most of the unresolved issues are related directly or indirectly to the multidimensional and open-textured nature of the concept. This review aims to elucidate several debated key points to understand the reasons behind this confusion and address the complexity of how to define and quantify this concept. A standardized and well-defined framework of diet quality is of great importance for both consumers and scientists from different disciplines.
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Affiliation(s)
- Ala'a Alkerwi
- Centre de Recherche Public de la Santé, Centre d'Etudes en Santé, Grand-Duchy of Luxembourg.
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