Health-Related Quality of Life and Lifestyle Behavior Clusters in School-Aged Children from 12 Countries

Dorothea Dumuid; Timothy Olds; Lucy K Lewis; Josep Antoni Martin-Fernández; Peter T Katzmarzyk; Tiago Barreira; Stephanie T Broyles; Jean-Philippe Chaput; Mikael Fogelholm; Gang Hu; Rebecca Kuriyan; Anura Kurpad; Estelle V Lambert; José Maia; Victor Matsudo; Vincent O Onywera; Olga L Sarmiento; Martyn Standage; Mark S Tremblay; Catrine Tudor-Locke; Pei Zhao; Fiona Gillison; Carol Maher; International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) research group

doi:10.1016/j.jpeds.2016.12.048

Health-Related Quality of Life and Lifestyle Behavior Clusters in School-Aged Children from 12 Countries

J Pediatr. 2017 Apr:183:178-183.e2. doi: 10.1016/j.jpeds.2016.12.048. Epub 2017 Jan 10.

Authors

Dorothea Dumuid¹, Timothy Olds², Lucy K Lewis³, Josep Antoni Martin-Fernández⁴, Peter T Katzmarzyk⁵, Tiago Barreira⁶, Stephanie T Broyles⁵, Jean-Philippe Chaput⁷, Mikael Fogelholm⁸, Gang Hu⁵, Rebecca Kuriyan⁹, Anura Kurpad⁹, Estelle V Lambert¹⁰, José Maia¹¹, Victor Matsudo¹², Vincent O Onywera¹³, Olga L Sarmiento¹⁴, Martyn Standage¹⁵, Mark S Tremblay⁷, Catrine Tudor-Locke¹⁶, Pei Zhao¹⁷, Fiona Gillison¹⁵, Carol Maher²; International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) research group

Affiliations

¹ School of Health Sciences, University of South Australia. Electronic address: Dorothea.dumuid@mymail.unisa.edu.au.
² School of Health Sciences, University of South Australia.
³ School of Health Sciences, University of South Australia; School of Health Sciences, Flinders University, Adelaide, Australia.
⁴ Department of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain.
⁵ Population Science, Pennington Biomedical Research Center, Baton Rouge, LA.
⁶ Population Science, Pennington Biomedical Research Center, Baton Rouge, LA; School of Education, Syracuse University, Syracuse, NY.
⁷ Healthy Active Living and Obesity Research, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
⁸ Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
⁹ Department of Nutrition, St John's Research Institute, Karnataka, India.
¹⁰ Department of Human Biology, University of Cape Town, Cape Town, South Africa.
¹¹ Faculty of Sport, University of Porto, Porto, Portugal.
¹² Center for the Study of Physical Fitness Laboratory of São Caetano do Sul (CELAFISCS), São Caetano do Sul, Brazil.
¹³ Department of Recreation Management and Exercise Science, Kenyatta University, Nairobi City, Kenya.
¹⁴ School of Medicine, University of the Andes, Bogotá, Colombia.
¹⁵ Department for Health, University of Bath, Bath, UK.
¹⁶ Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA.
¹⁷ Tianjin Women's and Children's Health Center, Tianjin, China.

PMID: 28081885
DOI: 10.1016/j.jpeds.2016.12.048

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.

Keywords: compositional analysis; diet; physical activity; screen time; sedentary behavior.

Publication types

Comparative Study
Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Body Mass Index
Child
Child Behavior*
Cluster Analysis
Cross-Sectional Studies
Environment*
Female
Health Behavior
Humans
Incidence
Internationality
Life Style
Linear Models
Male
Pediatric Obesity / diagnosis
Pediatric Obesity / epidemiology*
Pediatric Obesity / psychology*
Quality of Life*
Risk Assessment
Severity of Illness Index

Associated data

ClinicalTrials.gov/NCT01722500