A cross-sectional study of Health Related Quality of Life and body mass index in a Norwegian school sample (8–18 years): a comparison of child and parent perspectives

BACKGROUND Because consequences of pediatric overweight and obesity are largely psychosocial, the aim of this study was to describe health related quality of life (HRQoL), the prevalence of overweight and obesity, and to examine the relationships between HRQoL and body mass index (BMI), age, and gender in a Norwegian sample of schoolchildren. In addition, because children are dependent upon their parents' judgment of their condition, the aim was also to compare child- and parent-reported HRQoL and BMI, age, and gender. METHODS This cross-sectional study involved 1238 children (8-18 years) and 828 parents. HRQoL was measured with the Norwegian version of the KIDSCREEN-52, child and parent version. Child BMI was calculated based on objective measures of height and weight, and adjusted for age and gender. Multiple regressions were used to determine how variations in BMI, age, and gender affected child- and parent-reported HRQoL. RESULTS HRQoL decreased significantly with age and girls had lower HRQoL than boys on the majority of the KIDSCREEN subscales. Of the total sample, approximately 16% were overweight and 3% were obese. BMI contributed significantly to explaining the variations in the KIDSCREEN subscales of Physical well-being and Self-perception. Higher BMI was associated with lower HRQoL scores. Although there were significant differences between child and parent ratings on most KIDSCREEN subscales, the direction of the differences varied. In some scales, parents rated their child's HRQoL higher than the child, and in some scales lower. Increasing age of the child seems to increase the differences, while gender and the child being overweight and/or obese affected the differences to a smaller extent. CONCLUSIONS This study showed that almost 20% of the children and adolescents in a representative Norwegian school sample were overweight or obese. Age and gender were the most significant factors associated with variations in HRQoL in the sample; however, increasing BMI added to the negative effect of other factors. The study also found substantial differences between the child and parent ratings of the child's HRQoL. Misinterpretations of the child's well-being might result in less targeted actions to improve the child's HRQoL.