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 (ptrend=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, ptrend=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 (ptrend=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.
本研究是前瞻性研究，目的是探討容易造成肥胖的行為對青少年生活品質 (QOL)的綜合效應之間的關聯性。研究對象來自雪梨學童調查，共2,353 位學童 (年齡中位數為12.7 歲)，5 年後有1213 位，於17-18 歲被再次調查。學童完成 活動及飲食頻率問卷。不健康的行為計算其得分，指定分數1 點如下：每天小 於60 分鐘的體能活動；每天超過2 小時看螢幕；每週攝取5 次以上鹹味零食和 /或糖果；每天攝取1 份以上碳酸飲料和/或甜香酒；每天沒有攝取2 份以上的水 果和3 份以上的蔬菜。健康有關的生活品質是由兒童生活品質問卷(PedsQL)所 評估。生活型態危險因子有0、1、2、3、4 及5 項的盛行率分別為4.2%、 17.1%、30.7%、30.5%、13.9%及3.6%。在多變項調整後，追蹤5 年結果發 現，兒童有5 項不健康行為比起0 項者，在PedsQL 中，體能總分低9.2 個單位 (ptrend=0.001)。男孩有4 項或5 項生活型態危險因子，相較於同年齡在基準點沒 有或有1 項危險因子者，在追蹤後，有較低整體及體能總分，趨勢的p 值分別 為0.002 及0.01。女孩在5 年後的追蹤，有4 項或5 項生活型態危險因子比起 沒有或有1 項者，在體能總分低4-6 個單位(ptrend=0.004)。學童容易造成肥胖的 生活型態危險因子的項目多寡與後續的生活品質較差是獨立相關，尤其是青春 期的體能健康。這些研究結果，強調針對青少年生活型態的行為，對於促進一 般健康和體適能的重要性。