Background The directionality of the association of physical activity (PA) and sedentary behaviour (SB) with health-related quality of life (HRQoL) remains unknown in adolescents. This study aimed to ...investigate the association of 2-year cumulative level of PA and SB with HRQoL and the reverse association. Methods We included 1445 adolescents in France from a 2-year longitudinal study with three follow-up times (PRALIMAP trial). At each follow-up, adolescents completed the International Physical Activity Questionnaire for PA and SB and the Duke Health Profile for HRQoL. Statistical analyses involved linear and logistic regressions adjusted for socio-demographic characteristics. Results The cumulative number of times an adolescent achieved the PA recommendations during the 2 years was associated with better physical, mental, social and general HRQoL (p for trend <0.0001). In contrast, high SB predicted low HRQoL for most dimensions except social HRQoL (p = 0.12). Combining PA and SB, the effect of recommended PA on HRQoL was offset in part by high SB. In the reverse association, high HRQoL predicted high PA (overall, vigorous, moderate and recommended PA), but was not associated with SB. Conclusions The association between PA and HRQoL was cumulative and bidirectional among adolescents, whereas low HRQoL seemed to be a consequence of high SB rather than a cause (cumulative but not bidirectional). Promoting recommended PA and low SB may help improve HRQoL among adolescents, with a possible virtuous cycle with regard to PA.
Social differences among adolescents in physical activity and sedentary behaviour have been identified but are not well explained. The current study aimed to identify socioeconomic, family and ...school-related associated factors with physical activity and sedentary behaviour among high-school adolescents.
This was a cross-sectional analysis of T0 physical activity and sedentary behaviour of 2523 students 14 - 18 years old recruited for the PRALIMAP trial from 24 French state-run high schools. Data were collected by self-administered questionnaire at the start of grade 10. Adolescents completed the International Physical Activity Questionnaire for physical activity and sedentary behaviour and an ad hoc questionnaire for active commuting and sport participation. Statistical analyses involved linear and logistic regressions.
Socioeconomic, family or school variables were associated with levels of physical activity and sedentary behaviour for both boys and girls, but no factor, except perceived parental physical activity level, was associated with total energy expenditure (total physical activity) for either gender. Adolescents with privileged and less privileged socioeconomic status reported the same total amount of energy expenditure.
Total physical activity score alone is not sufficient to assess the physical activity of adolescents. These findings may have implications for better understanding of social inequalities in this context and recommendations to prevent overweight.
This trial is registered at ClinicalTrials.gov ( NCT00814554 ). The date of registration: 23 December 2008. Registration was not required at the time of the start of PRALIMAP for public health and prevention programmes and trials.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The interdependence among eating behaviour (EB), physical activity (PA) and sedentary time (ST) suggests simultaneously identifying homogeneous profiles and describing their changes. This study aimed ...to (1) identify cross-sectional lifestyle behaviour profiles and their 2-year changes among French school-age adolescents and (2) identify factors associated with these profiles and changes. Longitudinal data from adolescents who participated in the PRomotion de l’ALIMentation et de l’Activité Physique trial were used. PA and ST were assessed with the International Physical Activity Questionnaire and EB with a FFQ. Profiles at baseline and their changes were identified by latent transition analysis. Multinomial logistic regression models were used to identify factors associated with profiles and their changes. Among 2390 adolescents included (14–18 years), five baseline profiles that differed mainly in EB were identified: ‘healthy diet and high PA (7·9 %)’, ‘big eater and moderate to high PA (23·8 %)’, ‘healthy diet and low PA (31·2 %)’, ‘restrictive diet and moderate PA (20·6 %)’ and ‘sugar products, nibbling and moderate PA (16·5 %)’. Young adolescents, those who were overweight or obese and socially advantaged, were more in the ‘healthy diet and low PA’ than others. Boys, older and socially less advantaged adolescents exhibited more ‘unfavourable’ than ‘mixed’ changes, while adolescents with overweight or obesity had less ‘unfavourable’ than ‘mixed’ changes. In conclusion, adolescents were twice the number in the least than the most favourable profile. Findings highlighted the importance of EB among adolescents and suggest taking adolescents’ sociodemographic and weight characteristics into account in interventions aimed at acting on adolescents’ behaviours.
This study aimed to describe the discrepancy between body satisfaction change and weight change among adolescents following a 2-year school-based intervention, to identify associated sociodemographic ...factors, and to explore possible associations with perceived health indicators. We used data from a northeastern France representative adolescents sample (14–18 years old) who participated in the PRALIMAP (PRomotion de l'ALIMentation et de l'Activité Physique) study (2006–2009). Weight change was measured by the change in body mass index z-score from the start to the end of the study. Body satisfaction and self-perceived health (anxiety, depression, eating disorder and quality of life) changes were assessed using self-administered questionnaires. Discrepancy between body satisfaction change and weight change was described with cross-tabulations, and subdivided into optimism/pessimism (i.e. positive/negative body satisfaction change compared to weight change). Sociodemographic factors associated with discrepancy were determined by multivariate logistic regression models. Adjusted linear regression models described 2-year change in weight and self-perceived health according to discrepancy. Among the 3279 adolescents included (aged 15.1 ± 0.6 years), the proportion of discrepancy was 74.8% (pessimism = 41.6%; optimism = 33.2%). Discrepancy, especially pessimism, was higher in boys than in girls (OR = 1.44 1.19; 1.74, p = .0002), and in socially advantaged adolescents (OR = 1.82 1.20; 2.74, p = .004) than in disadvantage ones. Body satisfaction change was rather in line with anxiety, depression and quality of life changes than weight change. Body satisfaction change should be considered in overweight and obesity prevention interventions alongside body weight change, and could be used as indicator of long-term behavior maintenance.
Clinical trials registry and number:ClinicalTrials.gov (NCT01688453).
•Discrepancy between body satisfaction and weight change is high among adolescents.•Boys are more likely to be discrepant than girls.•Discrepancy is higher among socially advantaged adolescents than disadvantage ones.•Body satisfaction is rather in line with perceived health than with weight change.•Body satisfaction should be used alongside weight in health promotion interventions.
This study aimed to quantify the 2-year mediating effects of physical activity (PA) and eating behavior (EB) on socioeconomic and sex inequalities in quality of life (QoL) among French adolescents.
...Adolescents from a 2-year school-based trial were included. PA and EB were assessed at baseline, 1 year, and 2 years using the International Physical Activity Questionnaire and an eating habits questionnaire, respectively. QoL was measured at 2 years using the Duke Health Profile questionnaire. The mediating effect of adherence to PA and EB guidelines in the associations between socioeconomic status or sex and QoL was analyzed with a counterfactual method.
Among the 3562 included adolescents (mean age, 15.2 0.6 y), being a boy and having a high socioeconomic status was associated with high QoL. Differences in QoL by socioeconomic status were mediated by adherence to guidelines for PA (up to 10.2%) and EB (up to 8.8%), and differences in QoL by sex were predominantly mediated by adherence to guidelines for PA (up to 163.8%).
Policies, programs, and interventions designed to reduce socioeconomic and sex inequalities in QoL among adolescents could use PA and EB as leverage.
Social differences in prevalence of overweight and obesity among adolescents, known as the weight social gradient, could be explained by differences in behaviours between social classes. This study ...examined the respective association of physical activity (PA), sedentary behaviour (SB) and weight status with adolescents' socioeconomic status. We used cross-sectional data for 1935 adolescents (13–18 years old) with overweight or obesity who participated in the PRALIMAP-INÉS (PRomotion de l'ALImentation et de l'Activité Physique - INÉgalités de Santé) trial conducted in northeastern France between 2012 and 2015. Adolescents completed the International Physical Activity Questionnaire for PA and SB and the Family Affluence Scale for socioeconomic status. Weight status was assessed by the body mass index (BMI) and BMI z-score. Social gradient of weight status, PA and SB were described according to the Family Affluence Scale (slopes) and evidenced by the linear trend test (p). Adolescents' socioeconomic status was positively associated with PA practice (frequency, vigorous PA and leisure-time PA), but there was no association with their SB. The results confirmed a significant weight social gradient: BMI (β = 0.37, p < .0001) and BMI z-score (β = 0.07, p = .0001). The weight social gradient in adolescents was mostly associated with PA (5.7% to 8.1%) rather than SB (2.7% to 5.7%). Nearly 14% of BMI z-scores could be related to a combined PA and SB effect. PA was found an important factor of weight social gradient in adolescence. Actions aimed at preventing weight social inequalities among adolescents could include PA promotion as lever.
ClinicalTrials.gov (NCT01688453).
•Adolescents' socioeconomic status was positively associated with physical activity.•Sedentary behaviour did not differ across socioeconomic groups.•Adolescents exhibit socioeconomic inequalities in weight status.•Weight social gradient was mainly affected by physical activity.•Regular physical activity should be promoted among less advantaged adolescents.
Few studies have focused on relating physical activity (PA) and sedentary behaviour (SB) to identify homogeneous groups. This study aimed to identify patterns of PA and SB in France general ...population and their correlates.
A sample of 3294 (mean age 44 ± 17 years) from the general population in France was included. PA and SB were assessed by the World Health Organization Global Physical Activity Questionnaire. Cluster analysis was used to identify PA and SB patterns, with polytomous logistic regression to identify their correlates.
Five clusters were identified: (i) 'low total PA, active-transportation and low SB' (41%), (ii) 'low total PA and moderate SB' (22%), (iii) 'low total PA, leisure-time PA and high SB' (15%), (iv) 'high total PA, moderate occupational PA and moderate SB' (17%) and (v) 'high total PA, vigorous occupational PA and low SB' (5%). Occupational PA substantially contributed to total PA which depended on socioeconomic status (SES): low total PA and high SB in higher SES and high total PA and low SB in lower SES.
Based on PA and SB, French adults were clustered into groups with socioeconomic differences emphasizing that adapted interventions may be more beneficial for health.
Contexte : L’importance de l’activité physique (AP) et des inégalités sociales afférentes, dans la prévention et la prise en charge de l’obésité fait l’objet de débats. Notre objectif était ...d’identifier, au sein du programme PRALIMAP-INÉS, les déterminants de la participation d’adolescents en surpoids de milieu défavorisé. Méthodes : Cinq séances collectives dont deux spécifiques à l’AP et des activités adaptées individuelles ont été animées par des diététiciens, professionnels de l’activité physique et psychologues. Elles ont été proposées à 411 adolescents de 13 à 18 ans en situation de surpoids et d’obésité de milieu défavorisé et participant à PRALIMAP-INÉS, dans 35 collèges et lycées vosgiens. Résultats : La participation à au moins une séance collective était meilleure chez les collégiens comparée aux lycéens (OR = 2,2) et chez ceux qui déclaraient des difficultés financières pour payer une licence (OR = 5,8). Le nombre de séance augmentait avec l’indice de masse corporelle ; il était plus élevé chez les collégiens (+ 0,7 séance) et plus faible chez ceux déclarant des difficultés financières (– 1,1 séance). La participation à un entretien en AP était significativement meilleure chez les filles (OR = 1,8), chez ceux qui participaient à l’Union Nationale du Sport Scolaire (OR = 2,4) et qui déclaraient ne pas avoir d’amis avec qui pratiquer (OR = 2,7). Les niveaux d’AP et de sédentarité n’étaient pas associés à la participation. Conclusions : La participation initiale aux activités collectives PRALIMAP-INÉS était élevée chez les adolescents défavorisés avec difficultés financières mais son maintien tout au long du programme était chez eux plus difficile. Identifier les leviers du maintien de la participation est un défi majeur pour la pérennité du programme.
Purpose
To examine the respective and combined impact of “hypothetical” functional impairment (FI) and burden of comorbidities accrual on a 5-year risk of health utility (HU) loss in osteoarthritis ...(OA).
Methods
Participants of the Knee and Hip Osteoarthritis Long-term Assessment (KHOALA) study with a 5-year follow-up were included. FI, number of comorbidities and HU were measured annually by the WOMAC, Functional Comorbidity Index and Short-Form 6D, respectively. We estimated the population risk of HU loss (PRD: population risk difference, PRR: population risk ratio) under hypothetical FI and comorbidities using the parametric G-formula. Then, mediation analysis investigated the causal mechanism of comorbidities on HU through FI by estimating total, direct and indirect effects.
Results
We examined data from 767 patients (68.8% women; 61.6 years). The estimated 5-year risk of HU loss was 47.5% 41.9; 52.2 under natural course and 24.9% 15.5; 34.2 when imposing “
Patient acceptable function and No comorbidity
” corresponding to a PRD = − 22.6 − 26.5; − 21.2 and a PRR = 0.5 0.4; 0.6. The estimated total risk of HU loss comparing “
Two comorbidities
” versus “
No comorbidity
” was significant without mediation effect of FI: Total = 10.1% 6.8; 12.9; direct = 8.0% 2.7; 13.1; indirect = 2.1% − 2.0; 5.2.
Conclusions
FI and comorbidities are important and independent determinants of HU loss in patient with OA. Half of cases (50%) of HU loss during 5 years could be avoided by preventing comorbidities (30%) and limiting FI under patient acceptable function (20%). Caregivers should additionally pay close attention to the prevention and the treatment of comorbidities in routine management of OA.
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