Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Str. 62-66, 12101, Berlin, Germany.
BMC Public Health. 2020 Nov 16;20(1):1722. doi: 10.1186/s12889-020-09834-8.
The well-being of persons with overweight and obesity, in particular of children and adolescents, may be impaired. The present study investigates the health-related quality of life (HRQoL) of girls and boys with overweight and obesity living in Germany as compared to those of normal-weight, while taking a selection of relevant determinants of HRQoL into account.
The sample comprises 1771 children and adolescents aged 11 to 17 years that took part in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents (KIGGS Wave 2, 2014-2017). Sex-and age-specific BMI (kg/m) percentiles were utilized to classify overweight and obesity. HRQoL was measured with the KIDSCREEN-27 questionnaire, which gathers detailed information about the five dimensions physical and psychological well-being, well-being regarding peers (i.e., social acceptance), parents (i.e., autonomy) and within the school environment. Multiple regression analyses were performed with HRQoL dimensions as outcomes to test for differences between children and adolescents with normal-weight vs. those with overweight and vs. those with obesity, separately for girls and boys. In a next step, age, physical activity, media consumption, social support and self-efficacy were considered as potential confounders in the analyses.
18.7% of the children and adolescents under study were affected by overweight and among them 8.0% by obesity. After adjusting for potential confounders, overweight and obesity were associated with lower physical well-being as compared to normal weight in both sexes (boys with overweight: standardized beta [β] = -.14, standard error [SE] = .03, p < .001, and obesity: β = -.16, SE = .03, p < .001; girls with overweight: β = -.09, SE = .04, p = .011, and obesity: β = -.11, SE = .03, p = .003). Results moreover suggest lower levels of psychological (β = -.10, SE = .04, p = .002) and parent-related well-being (β = -.08, SE = .04, p = .036) of boys with obesity as compared to normal-weight peers.
HRQoL of German children and adolescents with overweight and obesity is impaired according to physical well-being in general, while psychological and parent-related well-being is particularly affected in boys. Public health approaches should therefore promote children and adolescents with overweight and obesity by improving diverse facets of HRQoL as well as relevant associated factors (i.e., media consumption, self-efficacy) in general and in boys in particular.
超重和肥胖人群，尤其是儿童和青少年的健康状况可能会受到影响。本研究调查了生活在德国的超重和肥胖儿童和青少年的健康相关生活质量（HRQoL），并考虑了一些与 HRQoL 相关的决定因素。
本研究样本包括 1771 名年龄在 11 至 17 岁的儿童和青少年，他们参加了德国儿童和青少年健康访谈和调查（KIGGS 第 2 波，2014-2017 年）。利用性别和年龄特异性 BMI（kg/m）百分位数将超重和肥胖进行分类。使用 KIDSCREEN-27 问卷测量 HRQoL，该问卷详细收集了五个维度的信息，包括身体和心理幸福感、同伴关系（即社会接纳）、父母关系（即自主）和学校环境。将 HRQoL 维度作为结果进行多元回归分析，以测试男孩和女孩中正常体重组与超重组和肥胖组之间的差异。在下一步中，将年龄、体育活动、媒体消费、社会支持和自我效能考虑为分析中的潜在混杂因素。
在所研究的儿童和青少年中，有 18.7%超重，其中 8.0%肥胖。在调整了潜在混杂因素后，与正常体重相比，超重和肥胖与男孩的身体幸福感降低有关（超重：标准化β[β] = -.14，标准误差[SE] =.03，p <.001，肥胖：β = -.16，SE =.03，p <.001；女孩超重：β = -.09，SE =.04，p =.011，肥胖：β = -.11，SE =.03，p =.003）。研究结果还表明，肥胖男孩的心理（β= -.10，SE=.04，p =.002）和父母相关的幸福感（β= -.08，SE=.04，p =.036）水平低于正常体重的同龄人。
根据一般身体幸福感，德国超重和肥胖儿童和青少年的 HRQoL 受损，而男孩的心理和父母相关的幸福感尤其受到影响。因此，公共卫生措施应通过提高 HRQoL 的各个方面以及相关因素（即媒体消费、自我效能）来促进超重和肥胖的儿童和青少年，尤其是男孩。
