Original ResearchSelf-rated health and health-related quality of life are related with adolescents' healthy lifestyle
Introduction
Recently, psychosocial aspects of health have gained interest. Constructs such as health perception, and health-related quality of life (HRQoL) are included in a broader domain because they pertain to positive health.1 Self-rated health (SRH) is a significant predictor of morbidity and mortality,2, 3 it is related to health biomarkers2, 4 and it is an indicator of physiological states among adolescents and adults.5, 6 HRQoL has been related to several physical and mental health outcomes.7, 8
With SRH and HRQoL being related with better health outcomes,3, 4, 6 it is expected that these constructs are also associated with healthy behaviours. In fact, regular physical activity, less sedentary time,9, 10 a healthy diet11 and non-smoking habits12, 13, 14 have been reported to be associated with better SRH and HRQoL.
Studies have focused on the relationship of SRH and HRQoL with a particular health outcome and individual behaviours.9, 10, 14 To the best of our knowledge, there is no study addressing the use of a healthy lifestyle composite score with SRH and HRQoL. Combining several health behaviours to create a measure that expresses a healthy lifestyle measure could be important to public health policy. This influences the way in which programs that set up to promote healthy lifestyles are developed. Therefore, this study aimed to analyse the associations between a healthy lifestyle composite score and SRH and HRQoL among adolescents.
Section snippets
Participants and procedures
The data were obtained from the HBSC 2014 Portuguese survey. The HBSC survey is conducted every four years in several European and Northern American countries. The HBSC population includes adolescents aged 11, 13 and 15 years who attend regular schools.15 The purpose of the survey is to gain an understanding of adolescents' health and well-being to describe the social and psychological determinants of their health. The survey is conducted using a self-administered questionnaire completed in
Results
Table 1 presents the characteristics of this study's sample and the prevalence of healthy lifestyle behaviours. Prevalence ranged from 14.9% (95% confidence interval [CI]: 13.9–15.9%) for those engaging in daily physical activity and 92.3% (95% CI: 91.5–93.0%) for those reporting to be non-smokers. Only 1.4% (95% CI: 1.1–1.8%) of adolescents could be considered having a healthy lifestyle, achieving all six healthy behaviours.
The relationship between SRH, HRQoL, healthy behaviours and healthy
Discussion
The aim of this study was to analyse the association between a healthy lifestyle composite score and SRH and HRQoL in adolescents. Those with a healthy lifestyle had better health perception and higher HRQoL. From the association between SRH, HRQoL and each healthy behaviour, engaging in physical activity every day, sleeping at least 8/9 h per night, consuming fruit and vegetables daily, not drinking alcohol and not smoking tobacco were significantly related with both SRH and HRQoL. Only
Acknowledgements
The authors thank the adolescents for their participation in the study and the teachers for their assistance in helping collecting data.
Ethical approval
Ethical approval was sought from the university ethics boards or other authorities associated with the research team in each country. This research was conducted in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki).
Funding
None declared.
Competing interests
The authors declare that there are no conflicts of interest. HBSC is an international study
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