Hunsberger Monica, Lehtinen-Jacks Susanna, Mehlig Kirsten, Gwozdz Wencke, Russo Paola, Michels Nathalie, Bammann Karin, Pigeot Iris, Fernández-Alvira Juan Miguel, Thumann Barbara Franziska, Molnar Dénes, Veidebaum Toomas, Hadjigeorgiou Charalambos, Lissner Lauren
Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Box 453, 40530, Gothenburg, Sweden.
School of Health Sciences (HES), FI-33014 University of Tampere, Tampere, Finland.
BMC Public Health. 2016 Sep 8;16(1):949. doi: 10.1186/s12889-016-3626-4.
The negative impact of childhood overweight on psychosocial well-being has been demonstrated in a number of studies. There is also evidence that psychosocial well-being may influence future overweight. We examined the bidirectional association between childhood overweight and psychosocial well-being in children from a large European cohort. The dual aim was to investigate the chronology of associations between overweight and psychosocial health indicators and the extent to which these associations may be explained by parental education.
Participants from the IDEFICS study were recruited from eight countries between September 2007 and June 2008 when the children were aged 2 to 9.9 years old. Children and families provided data on lifestyle, psychosocial well-being, and measured anthropometry at baseline and at follow-up 2 years later. This study includes children with weight, height, and psychosocial well-being measurements at both time points (n = 7,831). Psychosocial well-being was measured by the KINDL® and Strengths and Difficulties Questionnaire respectively. The first instrument measures health-related quality of life including emotional well-being, self-esteem, parent relations and social relations while the second measures well-being based on emotional symptoms, conduct problems and peer-related problems. Logistic regression was used for modeling longitudinal associations.
Children who were overweight at baseline had increased risk of poor health-related quality of life (odds ratio (OR) = 1.23; 95 % confidence interval (CI):1.03-1.48) measured 2 years later; this association was unidirectional. In contrast to health-related quality of life, poor well-being at baseline was associated with increased risk of overweight (OR = 1.39; 95 % CI:1.03-1.86) at 2 year follow-up; this association was also only observed in one direction. Adjustment for parental education did not change our findings.
Our findings indicate that the association between overweight and psychosocial well-being may be bidirectional but varies by assessment measures. Future research should further investigate which aspects of psychosocial well-being are most likely to precede overweight and which are more likely to be consequences of overweight.
多项研究已证实儿童期超重对心理社会幸福感有负面影响。也有证据表明心理社会幸福感可能会影响未来的超重情况。我们在一个大型欧洲队列研究中，考察了儿童期超重与心理社会幸福感之间的双向关联。双重目的是研究超重与心理社会健康指标之间关联的时间顺序，以及这些关联在多大程度上可由父母教育来解释。
IDEFICS研究的参与者于2007年9月至2008年6月从八个国家招募，当时儿童年龄在2至9.9岁之间。儿童及其家庭在基线时以及两年后的随访中提供了关于生活方式、心理社会幸福感和人体测量数据。本研究纳入了在两个时间点均有体重、身高和心理社会幸福感测量值的儿童（n = 7831）。心理社会幸福感分别通过儿童生活质量量表（KINDL®）和长处与困难问卷进行测量。第一种工具测量与健康相关的生活质量，包括情绪幸福感、自尊、亲子关系和社会关系，而第二种工具则基于情绪症状、行为问题和同伴相关问题来测量幸福感。采用逻辑回归对纵向关联进行建模。
基线时超重的儿童在两年后出现与健康相关生活质量差的风险增加（优势比（OR）= 1.23；95%置信区间（CI）：1.03 - 1.48）；这种关联是单向的。与健康相关生活质量不同，基线时幸福感差与两年随访时超重风险增加相关（OR = 1.39；95% CI：1.03 - 1.86）；这种关联也仅在一个方向上观察到。对父母教育进行调整并未改变我们的研究结果。
我们的研究结果表明，超重与心理社会幸福感之间的关联可能是双向的，但因评估指标而异。未来的研究应进一步调查心理社会幸福感的哪些方面最有可能先于超重出现，以及哪些更有可能是超重的后果。
