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Psychosocial quality-of-life, lifestyle and adiposity : a longitudinal study in pre-schoolers (Ballabeina study)

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Abstract
Purpose: In obesity prevention, understanding psychosocial influences in early life is pivotal. Reviews reported contradictory results and a lack of longitudinal studies focusing on underlying lifestyle factors. This study tested whether psychosocial Quality-Of-Life (QOL) was associated with pre-schoolers' lifestyle and adiposity changes over one school year and whether lifestyle moderated the latter. It was hypothesised that QOL might not impact adiposity in everybody but that this might depend on preceding lifestyle. Method: Longitudinal data from 291 Swiss pre-schoolers (initially 3.9-6.3 years) was available. The following measures were used in longitudinal regressions: psychosocial QOL by PedsQL, adiposity (BMI z-score, waist, fat%), diet (food frequency), sedentary time and accelerometer-based activity. Results: Concerning lifestyle, low psychosocial QOL was only related to unfavourable changes in diet (less fruit beta = 0.21 and more fat intake beta = -0.28) and lower physical activity (beta = 0.21). Longitudinal QOL-adiposity relations appeared only after moderation by lifestyle factors (beta-range 0.13-0.67). Low psychosocial QOL was associated with increased adiposity in children with an unhealthy diet intake or high sedentary time. By contrast, low psychosocial QOL was associated with decreasing adiposity in high fruit consumers or more physically active pre-schoolers. Conclusion: Results emphasise the need for testing moderation in the QOL-adiposity relation. An unhealthy diet can be a vulnerability factor and high physical activity a protective factor in QOL-related adiposity. Consequently, QOL and lifestyle should be targeted concurrently in multi-factorial obesity prevention. The environment should be an 'activity encouraging, healthy food zone' that minimises opportunities for stress-induced eating. In addition, appropriate stress coping skills should be acquired.
Keywords
Quality of life, Children, Obesity, Diet, Physical activity, FOOD-FREQUENCY QUESTIONNAIRE, POPULATION HEALTH MEASURE, BODY-MASS INDEX, TO-HEIGHT RATIO, PHYSICAL-ACTIVITY, MENTAL-HEALTH, DEPRESSIVE SYMPTOMS, CHRONIC STRESS, CHILDREN, ADOLESCENTS

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Chicago
Michels, Nathalie, Kriemler Susi, Pedro M Marques-Vidal, Andreas Nydegger, and Jardena J Puder. 2016. “Psychosocial Quality-of-life, Lifestyle and Adiposity : a Longitudinal Study in Pre-schoolers (Ballabeina Study).” International Journal of Behavioral Medicine 23 (3): 383–392.
APA
Michels, N., Susi, K., Marques-Vidal, P. M., Nydegger, A., & Puder, J. J. (2016). Psychosocial quality-of-life, lifestyle and adiposity : a longitudinal study in pre-schoolers (Ballabeina study). INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE, 23(3), 383–392.
Vancouver
1.
Michels N, Susi K, Marques-Vidal PM, Nydegger A, Puder JJ. Psychosocial quality-of-life, lifestyle and adiposity : a longitudinal study in pre-schoolers (Ballabeina study). INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE. 2016;23(3):383–92.
MLA
Michels, Nathalie, Kriemler Susi, Pedro M Marques-Vidal, et al. “Psychosocial Quality-of-life, Lifestyle and Adiposity : a Longitudinal Study in Pre-schoolers (Ballabeina Study).” INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE 23.3 (2016): 383–392. Print.
@article{7213478,
  abstract     = {Purpose: In obesity prevention, understanding psychosocial influences in early life is pivotal. Reviews reported contradictory results and a lack of longitudinal studies focusing on underlying lifestyle factors. This study tested whether psychosocial Quality-Of-Life (QOL) was associated with pre-schoolers' lifestyle and adiposity changes over one school year and whether lifestyle moderated the latter. It was hypothesised that QOL might not impact adiposity in everybody but that this might depend on preceding lifestyle. 
Method: Longitudinal data from 291 Swiss pre-schoolers (initially 3.9-6.3 years) was available. The following measures were used in longitudinal regressions: psychosocial QOL by PedsQL, adiposity (BMI z-score, waist, fat\%), diet (food frequency), sedentary time and accelerometer-based activity. 
Results: Concerning lifestyle, low psychosocial QOL was only related to unfavourable changes in diet (less fruit beta = 0.21 and more fat intake beta = -0.28) and lower physical activity (beta = 0.21). Longitudinal QOL-adiposity relations appeared only after moderation by lifestyle factors (beta-range 0.13-0.67). Low psychosocial QOL was associated with increased adiposity in children with an unhealthy diet intake or high sedentary time. By contrast, low psychosocial QOL was associated with decreasing adiposity in high fruit consumers or more physically active pre-schoolers. 
Conclusion: Results emphasise the need for testing moderation in the QOL-adiposity relation. An unhealthy diet can be a vulnerability factor and high physical activity a protective factor in QOL-related adiposity. Consequently, QOL and lifestyle should be targeted concurrently in multi-factorial obesity prevention. The environment should be an 'activity encouraging, healthy food zone' that minimises opportunities for stress-induced eating. In addition, appropriate stress coping skills should be acquired.},
  author       = {Michels, Nathalie and Susi, Kriemler and Marques-Vidal, Pedro M and Nydegger, Andreas and Puder, Jardena J},
  issn         = {1070-5503},
  journal      = {INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE},
  keyword      = {Quality of life,Children,Obesity,Diet,Physical activity,FOOD-FREQUENCY QUESTIONNAIRE,POPULATION HEALTH MEASURE,BODY-MASS INDEX,TO-HEIGHT RATIO,PHYSICAL-ACTIVITY,MENTAL-HEALTH,DEPRESSIVE SYMPTOMS,CHRONIC STRESS,CHILDREN,ADOLESCENTS},
  language     = {eng},
  number       = {3},
  pages        = {383--392},
  title        = {Psychosocial quality-of-life, lifestyle and adiposity : a longitudinal study in pre-schoolers (Ballabeina study)},
  volume       = {23},
  year         = {2016},
}

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