Is obesity associated with reduced health-related quality of life in Latino, Black and White children in the community?

J L Wallander, S Kerbawy, S Toomey, R Lowry, M N Elliott, S L Escobar-Chaves, L Franzini, M A Schuster, J L Wallander, S Kerbawy, S Toomey, R Lowry, M N Elliott, S L Escobar-Chaves, L Franzini, M A Schuster

Abstract

Objective: Few studies have examined the impact of obesity on health-related quality of life (HRQOL) in non-clinical community samples of children, and methodological limitations have hindered drawing firm conclusions, especially whether the impact is similar across racial/ethnic groups. The present aims were to examine at what levels of non-normal weight, school-aged children experience lower HRQOL and whether this differs among racial/ethnic groups, when controlling for socioeconomic status (SES) differences.

Design: Cross-sectional community cohort survey.

Subjects and methods: Data are from the Healthy Passages, reporting on 4824 Latino, black and white 5th graders in a population-based survey conducted in three United States metropolitan areas. Children's weight status was classified from measured weight and height into underweight (1%), normal weight (52%), overweight (19%), obese (13%) and extremely obese (14%). Children reported their own HRQOL using the Pediatric Quality of Life Inventory and additional scales addressing global self-worth, physical appearance and body satisfaction. Parents reported children's overall health status.

Results: Each increment in higher non-healthy weight class-overweight to obese to extremely obese-was associated with significantly lower scores in more domains of psychosocial HRQOL compared with that in normal weight. However, only extremely obese children reported significantly lower physical HRQOL. Differences among weight classes remained when adjusting for SES and were independent of race/ethnicity. Underweight children generally reported HRQOL that was not significantly different from normal weight children.

Conclusions: Overweight, obese and extremely obese 5th graders on average experience worse HRQOL than normal weight children, especially in psychosocial domains including self-worth and peer relationships, regardless of race/ethnicity. If messages can be conveyed in a sensitive and supportive manner, the desire to improve HRQOL could provide additional motivation for children and their parents in addressing unhealthy weight.

References

    1. Ogden CL, Yanovski SZ, Carroll MD, Flegal KM. The epidemiology of obesity. Gastroenterology. 2007;132:2087–2101.
    1. Wang Y, Beydoun MA. The obesity epidemic in the United States—gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiol Rev. 2007;29:6–28.
    1. Ogden CL, Carroll MD, Curtin LR, Lamb LR, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007-2008. JAMA. 2010;303:242–249.
    1. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: International survey. BMJ. 2000;320:1240–1243.
    1. Ogden CL, Carroll MD, Flegal KM. High body mass index for age among US children and adolescents, 2003-2006. JAMA. 2008;299:2401–2405.
    1. Dietz WH. Health consequences of obesity on youth: childhood predictors of adult disease. Pediatrics. 1998;110:215–221.
    1. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr. 2007;150:12–17.
    1. World Health Organization Constitution of the World Health Organization World Health Organization: New York; Available online at: accessed 4 October 20101948
    1. Griffiths LJ, Parsons TJ, Hill AJ. Self-esteem and quality of life in obese children and adolescents: a systematic review. Int J Pediatr Obes. 2010;5:282–304.
    1. Tsiros MD, Olds T, Buckley JD, Grimshaw P, Brennan L, Walkley J, et al. Health related quality of life in obese children and adolescents. Int J Obes. 2009;33:387–400.
    1. Koot HM, Wallander JL. Quality of Life in Children and Adolescents: Concepts, Methods, and Findings. Harwood Academic Publishers: London, United Kingdom; 2001.
    1. Varni JW, Burwinkle TM, Seid M, Skarr D. The PedsHRQOL 4.0 as a pediatric population health measure: Feasibility, reliability, and validity. Ambul Pediatr. 2003;3:329–341.
    1. Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA. 2003;289:1813–1819.
    1. Ingerski LM, Janicke DM, Silverstein JH. Brief report: quality of life in overweight youth—the role of multiple informants and perceived social support. J Pediatr Psychol. 2011;32:869–874.
    1. Arif AA, Rohrer JE. The relationship between obesity, hyperglycemia symptoms, and health-related quality of life among Latino and non-Latino white children and adolescents. BMC Fam Pract. 2006;7:3.
    1. Swallen KC, Reither EN, Haas SA, Meier AM. Overweight, obesity, and health-related quality of life among adolescents: the National Longitudinal Study of Adolescent Health. Pediatrics. 2005;115:340–347.
    1. Miech RA, Kumanyika SK, Stettler N, Link BC, Phelan JC, Chang VW. Trends in the association of poverty with overweight among US adolescents, 1971–2004. JAMA. 2006;295:2385–2393.
    1. Braveman P, Barclay C. Health disparities beginning in childhood: a life-course perspective. Pediatrics. 2009;124 (Suppl 3:S163–S175.
    1. Schuster MA, Elliott MN, Kanouse D, Wallander JL, Tortolero SR, Ratner BA, et al. Racial and ethnic health disparities among fifth-graders in three cities. New Engl J Med. 2012;367:735–745.
    1. Windle M, Grunbaum JA, Elliott M, Tortolero SR, Berry S, Gilliland J, et al. Healthy Passages: a multilevel, multimethod longitudinal study of adolescent health. Am J Prev Med. 2004;27:164–172.
    1. Centers for Disease Control and Prevention, National Center for Health Statistics NHANES III: Anthropometric procedures199898–4083.
    1. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, et al. CDC growth charts: United States. Adv Data. 2000;314:1–27.
    1. Varni JW, Seid M, Kurtin PS. The PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales in healthy and patient populations. Med Care. 2001;39:800–812.
    1. Limbers CA, Newman DA, Varni JW. Factorial invariance of child self-report across race/ethnicity groups: a multigroup confirmatory factor analysis approach utilizing the PedsQLTM 4.0 Generic Core Scales. Ann Epidemiol. 2009;19:575–581.
    1. Harter S.The development of self-representationIn Damon W, (Series Eds) Eisenberg N, (Volume Ed)Handbook of Child Psychology: Vol 3. Social, Emotional, and Personality Development5th EdnWiley: New York; 553–617.1998
    1. Erermis S, Cetin N, Tamar M, Bukusoglu N, Akdeniz F, Goksen D. Is obesity a risk factor for psychopathology among adolescents. Pediatr Int. 2004;46:296–301.
    1. Banis HT, Varni JW, Wallander JL, Korsch BM, Jay SM, Adler R, et al. Psychological and social adjustment of obese children and their families. Child Care Health Dev. 1988;14:157–174.
    1. Collins ME. Body figure perceptions and preferences among preadolescent children. Intl J Eat Disord. 1991;10:199–208.
    1. Wood KC, Becker JA, Thompson JK. Body image dissatisfaction in preadolescent children. J App Dev Psychol. 1996;17:85–100.
    1. Wallander JL, Taylor W, Grunbaum JA, Franklin F, Harrison G, Kelder S, et al. Weight status, quality of life, and self-concept in Black, Latino, and White children. Obesity. 2009;17:1363–1368.
    1. Veron-Guidry S, Williamson DA. Development of a body image assessment procedure for children and preadolescents. Intl J Eat Disord. 1996;20:287–293.
    1. National Center for Health Statistics Examination and health history findings among children and youth Vital Health Stat 1972. Series 11, No. 129.
    1. Bauman LJ, Silver EJ, Stein RE. Cumulative social disadvantage and child health. Pediatrics. 2006;117:1321–1328.
    1. Kohen DE, Brehaut JC, Garner RE, Miller AR, Lach LM, Klasssen AF, et al. Conceptualizing childhood health problems using survey data: A comparison of key indicators. BMC Pediatr. 2007;7:40.
    1. Williams DR, Collins C. US socioeconomic and racial differences in health: patterns and explanations. Ann Rev Sociol. 1995;21:349–386.
    1. Kaufman JS, Cooper RS, McGee DL. Socioeconomic status and health in blacks and whites: the problem of residual confounding and the resiliency of race. Epidemiology. 1997;8:621–628.
    1. Williams DR. Race, socioeconomic status, and health: the added effects of racism and discrimination. Ann NY Acad Sci. 1999;896:173–188.
    1. Wallander JL, Fradkin CD, Chien AT, Mrug S, Banspach SW, Davies S, et al. Racial/ethnic disparities in quality of life and health in children are largely mediated by family contextual differences. Acad Pediatr. 2012;12:532–538.
    1. Varni JW, Linbers CA, Burwinkle TM. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities using the PedsQLTM 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5:43.

Source: PubMed

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