title: Psychosocial Quality-of-Life, Lifestyle and Adiposity: A Longitudinal Study in Pre-schoolers (Ballabeina Study).
abstract: In obesity prevention, understanding psychosocial influences in early life is pivotal. Reviews reported contradictory results and a lack of longitudinal studies focusing on underlying lifestyle factors. This study tested whether psychosocial Quality-Of-Life (QOL) was associated with pre-schoolers' lifestyle and adiposity changes over one school year and whether lifestyle moderated the latter. It was hypothesised that QOL might not impact adiposity in everybody but that this might depend on preceding lifestyle.
  
  
  
  Longitudinal data from 291 Swiss pre-schoolers (initially 3.9-6.3 years) was available. The following measures were used in longitudinal regressions: psychosocial QOL by PedsQL, adiposity (BMI z-score, waist, fat%), diet (food frequency), sedentary time and accelerometer-based activity.
  
  
  
  Concerning lifestyle, low psychosocial QOL was only related to unfavourable changes in diet (less fruit β = 0.21 and more fat intake β = -0.28) and lower physical activity (β = 0.21). Longitudinal QOL-adiposity relations appeared only after moderation by lifestyle factors (beta-range 0.13-0.67). Low psychosocial QOL was associated with increased adiposity in children with an unhealthy diet intake or high sedentary time. By contrast, low psychosocial QOL was associated with decreasing adiposity in high fruit consumers or more physically active pre-schoolers.
  
  
  
  Results emphasise the need for testing moderation in the QOL-adiposity relation. An unhealthy diet can be a vulnerability factor and high physical activity a protective factor in QOL-related adiposity. Consequently, QOL and lifestyle should be targeted concurrently in multi-factorial obesity prevention. The environment should be an 'activity encouraging, healthy food zone' that minimises opportunities for stress-induced eating. In addition, appropriate stress coping skills should be acquired.
authors.affiliation: Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 4K3, Ghent, B-9000, Belgium. Nathalie.michels@ugent.be.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Michels
authors.affiliation: Institute for Social and Preventive Medicine, University of Zürich, Zürich, Switzerland.
authors.forename: Kriemler
authors.initials: K
authors.lastname: Susi
authors.affiliation: Department of Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
authors.forename: Pedro M
authors.initials: PM
authors.lastname: Marques-Vidal
authors.affiliation: Department of Pediatrics, Pediatric Gastroenterology Unit, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Nydegger
authors.affiliation: Diabetes and Metabolism & Division of Pediatric Endocrinology, Service of Endocrinology, Diabetes and Obesity, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
authors.forename: Jardena J
authors.initials: JJ
authors.lastname: Puder
mesh_terms: D000223:Adaptation, Psychological; D050154:Adiposity; D002648:Child; D002675:Child, Preschool; D004032:Diet; D004435:Eating; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology; D011788:Quality of Life
keywords: Children; Diet; Obesity; Physical activity; Quality of life
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