Illness and determinants of health-related quality of life in a cross-sectional sample of schoolchildren in different weight categories.

Aim: To study associations between health-related quality of life (HRQoL), frequency of illness, and weight in primary school children in southern Germany.

Methods: Data from baseline measurements of the outcome evaluation of a teacher based health promotion programme ("Join the Healthy Boat") were analysed. Parents provided information about their children's HRQoL (KINDL(R), EQ5D-Y Visual Analogue Scale). The number of visits to a physician, children's days of absence because of sickness, and parental days of absence from work due to their children's illness during the last year of school/kindergarten were queried. Children's weight status was determined by body mass index (BMI), central obesity by waist to height ratio (WHtR ≥0.5).

Results: From 1,888 children (7.1±0.6 years), 7.8% were underweight, 82% had normal weight, 5.7% were overweight and 4.4% obese. 8.4% of all children were centrally obese. Bivariate analysis showed no significant differences for parental absence and visits to a physician in weight groups classified by BMI, but obese children had more sick days than non-obese. Centrally obese children differed significantly from the rest in the number of sick days and visits to a physician, but not in the frequency of parental absence. In regression analyses, central obesity correlated significantly with EQ5D-Y VAS, KINDL(R) total score and the subscales of "psyche", "family" and "friends". BMI weight groups showed no significant associations.

Conclusions: Central obesity but not BMI derived overweight and obesity is associated with HRQoL and visits to a physician in primary school children. Future studies should include WHtR. Preventive measures for children should focus on a reduction of or slowed increase in waist circumference.