Quality of life in overweight and obese young Chinese children: A mixed-method study

Health and Quality of Life Outcomes (Impact Factor: 2.12). 03/2013; 11(1):33. DOI: 10.1186/1477-7525-11-33
Source: PubMed


Obesity among young children in Hong Kong has become a public health problem. This study explored associations between Chinese parent reported children’s quality of life (QoL), socio-demographics and young children’s weight status from 27 preschool settings.

A mixed-method approach, including quantitative and qualitative tools, was employed for this cross-sectional study. Quantitative data were collected from 336 Chinese parents of children aged 2–7 years. Paediatric Quality of Life Inventory 4.0 (PedsQL, v 4.0) and a questionnaire about parents’ socio-demographics were used. In-depth interviews with mothers, teachers and children from a larger sample were the basis of 10 case studies. Quantitative data were analysed using chi-square analysis, one-way ANOVA and logistic regression. Qualitative data were analysed according to a multi-level framework that established linkages with quantitative data.

The children’s Body Mass Index (BMI) ranged from 11.3 to 28.0 kg/m2 and was classified into four weight groups. ANOVAs showed that the normal-weight children had significantly higher PedsQL scores in Physical Functioning than obese children (mean difference = 14.19, p < .0083) and significantly higher scores in School Functioning than overweight children (mean difference = 10.15, p < .0083). Results of logistic regression showed that relative to normal-weight children, obese children had a 2–5 times higher odds of showing problems in Physical, Social Functioning and School Performance. Overweight children had 2 times higher odds of problems in Social Functioning, and underweight children had a 2 times higher odds of problems in Physical Functioning. Children’s age (χ2 = 21.71, df = 3, p < 0.01), and housing (χ2 = 33.00, df = 9, p < 0.01) were associated with their weight. The case studies further act as a supplement to the quantitative data that children showed emotional problems across different abnormal weight statues; and the association between children’s weight status and well-being might be affected by multiple childcare arrangements and familial immigration status.

This study is one of only a few studies that have examined parents’, teachers’ and young children’s own perceptions of the children’s quality of life across different weight statuses. The results are discussed in terms of their implications for intervention.

Full-text preview

Available from:
  • [Show abstract] [Hide abstract]
    ABSTRACT: Childhood obesity is associated with psychological problems, but little is known about its association with emotional disturbance (ED) in the educational setting, especially by gender. In the population representative Elementary School Children's Nutrition and Health Survey in Taiwan 2001-2002 of children aged 6-13 (n=2283), we have considered whether ED is associated with obesity by gender. Schoolchildren were assessed with the modified scale for assessing emotional disturbance questionnaires. For some subscales, boys and girls had ED associations with obesity which were bidirectional. With normal weight as referent and relevant adjustments, the significant ED subscales predictable by obesity were relationship problems (RP) in boys (odds ratio, OR=1.89 with 95% CI: 1.08-3.30) and inappropriate behavior (IB) in girls (OR=2.88: 95% CI: 1.47-5.61). Conversely, with 'no-specific-ED' as referent, obesity was predictable by fully-adjusted specific-EDs in the same subscales, namely RP in boys (OR=1.88 with 95% CI: 1.13-3.13) and IB in girls (OR=3.03: 95% CI: 1.57-5.85). Child obesity prevalence showed no trend with school grade from 1 to 6, but for aggregate ED and most of its subscales the prevalence increased with grade (P for trend <0.01). Thus, there is some dissociation of obesity and ED as judged by their trend presence with school grade. Where obesity and ED occurred together (for inability-to-learn and unhappiness or depression), there were upward trends with grade (P<0.01). There are probably some selected bidirectional pathogenicities for obesity-ED associations with different expression in boys and girls and during elementary education. This provides some policy direction while mechanisms and causality require elucidation.
    Research in developmental disabilities 08/2013; 34(10):3504-3516. DOI:10.1016/j.ridd.2013.06.023 · 4.41 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite small- and wide-scale prevention efforts to curb obesity, the percentage of children classified as overweight and obese has remained relatively consistent in the last decade. As school personnel are increasingly pressured to enhance student performance, many educators use food as a reward to motivate and reinforce positive behavior and high achievement. Yet, many educators have missed the link between student health and academic achievement. Based on a review of the literature, this article explores the link between childhood obesity and adverse mental and physical health, learning, and behavior outcomes. The role in providing children with food as a reward in the relationship between obesity and detrimental health and performance outcomes are examined. The use of food as a reward is pervasive in school classrooms. Although there is a paucity of research in this area, the few studies published in this area show detrimental outcomes for children in the areas of physical health, learning, and behavior. It is imperative that educators understand the adverse outcomes associated with using food as a reward for good behavior and achievement. This study provides alternatives to using food as a reward and outlines future directions for research. © 2015, American School Health Association.
    Journal of School Health 09/2015; 85(9):648-58. DOI:10.1111/josh.12294 · 1.43 Impact Factor