Influence of obesogenic behaviors on health-related quality of life in adolescents

We aimed to prospectively examine the association between the combined effects of obesogenic behaviors on quality of life (QOL) in adolescents. Of 2353 Sydney schoolchildren surveyed (median age 12.7 years), 1,213 were re-examined 5 years later at age 17-18. Children completed activity and food-frequency questionnaires. An unhealthy behavior score was calculated, allocating 1 point for the following: ≤60 minutes of total physical activity/ day; ≥2 hours of screen time/ day; consumed salty snack foods and/or confectionery ≥5 times per week; ≥1 serves of soft drinks and/or cordial/ day; and not consuming both ≥2 serves of fruit and ≥3 serves of vegetables/ day. Health-related QOL was assessed by the Pediatric Quality of Life Inventory (PedsQL). The prevalence of 0, 1, 2, 3, 4, and 5 lifestyle risk factors was 4.2%, 17.1%, 30.7%, 30.5%, 13.9% and 3.6%, respectively. After multivariable- adjustment, children engaging in 5 versus 0 unhealthy behaviors had 9.2-units lower PedsQL physical summary score (p _trend=0.001), five years later. Boys reporting 4 or 5 lifestyle risk factors compared to their peers reporting none or one at baseline, had lower total and physical summary scores at follow-up, p _trend=0.02 and 0.01, respectively. Girls engaging in 4 or 5 versus 0 or 1 unhealthy behaviors, had 4.6-units lower physical summary score (p _trend=0.04), five years later. The number of obesogenic lifestyle risk factors was independently associated with subsequent poorer QOL, particularly physical health, during adolescence. These findings underscore the importance of targeting lifestyle behaviors to promote general well-being and physical functioning in adolescents.