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

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

Dorothea Dumuid  1 , Timothy Olds  2 , Lucy K Lewis  3 , Josep Antoni Martin-Fernández  4 , Peter T Katzmarzyk  5 , Tiago Barreira  6 , Stephanie T Broyles  5 , Jean-Philippe Chaput  7 , Mikael Fogelholm  8 , Gang Hu  5 , Rebecca Kuriyan  9 , Anura Kurpad  9 , Estelle V Lambert  10 , José Maia  11 , Victor Matsudo  12 , Vincent O Onywera  13 , Olga L Sarmiento  14 , Martyn Standage  15 , Mark S Tremblay  7 , Catrine Tudor-Locke  16 , Pei Zhao  17 , Fiona Gillison  15 , Carol Maher  2 ; International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) research group
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Free article
Comparative Study

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

Dorothea Dumuid et al. J Pediatr. 2017 Apr.
Free article

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.

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