Journal of affective disorders · 2025
Longitudinal associations of waist-to-height ratio on psychological well-being and quality of life in children - the Health Oriented Pedagogical Project (HOPP).
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Fredriksen Per Morten, Goswami Nandu, Mamen Asgeir
Аннотация
BACKGROUND: Pediatric overweight and obesity are increasing globally, posing both physical and psychological risks. While waist-to-height ratio (WHtR) is a well-established measure for predicting metabolic and cardiovascular risks, its association with psychological well-being and quality of life (QoL) is less explored. This study examines the relationship between WHtR, QoL, and emotional health in children, while also assessing the moderating role of socioeconomic status (SES).
METHODS: Data from the Health Oriented Pedagogical Project (HOPP), a longitudinal Norwegian study of 2297 children (boys 50.3 %) aged 6-12 years, were analyzed. WHtR, QoL (Inventory of Life Quality in Children, ILC), and emotional health (Strength and Difficulties Questionnaire, SDQ) were measured annually across 5 years. Linear mixed-effects model was used to accommodate the repeated-measures design, tested for associations between WHtR and psychological outcomes, adjusting for SES, physical activity, and fitness.
RESULTS: Higher WHtR was significantly associated with lower QoL in both child self-reports and parental proxies. WHtR was also linked to higher SDQ total difficulties, particularly internalizing problems such as emotional and peer-related issues. Moderation analysis showed that SES intensified the negative effects of WHtR on QoL, with children from higher SES families experiencing greater psychosocial difficulties. Increased parental concern about weight stigma and heightened body image awareness may contribute to this effect.
CONCLUSION: WHtR is a useful predictor of both metabolic and psychological well-being in children. Its ease of measurement makes it a practical screening tool for identifying those at risk of psychosocial challenges, particularly in higher SES groups. Integrating WHtR into routine pediatric health assessments could help guide early interventions to improve mental health outcomes.
METHODS: Data from the Health Oriented Pedagogical Project (HOPP), a longitudinal Norwegian study of 2297 children (boys 50.3 %) aged 6-12 years, were analyzed. WHtR, QoL (Inventory of Life Quality in Children, ILC), and emotional health (Strength and Difficulties Questionnaire, SDQ) were measured annually across 5 years. Linear mixed-effects model was used to accommodate the repeated-measures design, tested for associations between WHtR and psychological outcomes, adjusting for SES, physical activity, and fitness.
RESULTS: Higher WHtR was significantly associated with lower QoL in both child self-reports and parental proxies. WHtR was also linked to higher SDQ total difficulties, particularly internalizing problems such as emotional and peer-related issues. Moderation analysis showed that SES intensified the negative effects of WHtR on QoL, with children from higher SES families experiencing greater psychosocial difficulties. Increased parental concern about weight stigma and heightened body image awareness may contribute to this effect.
CONCLUSION: WHtR is a useful predictor of both metabolic and psychological well-being in children. Its ease of measurement makes it a practical screening tool for identifying those at risk of psychosocial challenges, particularly in higher SES groups. Integrating WHtR into routine pediatric health assessments could help guide early interventions to improve mental health outcomes.