Elsevier

Public Health

Volume 170, May 2019, Pages 89-94
Public Health

Original Research
Self-rated health and health-related quality of life are related with adolescents' healthy lifestyle

https://doi.org/10.1016/j.puhe.2019.02.022Get rights and content

Highlights

  • Only 1.4% of Portuguese adolescents had a healthy lifestyle.

  • Healthy lifestyle is related with perceived health and quality of life.

  • Public health policies should focus on promoting several lifestyle behaviours.

Abstract

Objectives

Self-rated health (SRH) and health-related quality of life (HRQoL) are related with health outcomes. It is expected that these constructs are also associated with healthy behaviours. Thus, the present study sought to analyse the associations between a healthy lifestyle composite score and SRH and HRQoL among adolescents.

Study design

This was an observational, cross-sectional study.

Methods

Data were obtained from the cross-sectional health behaviour in school-aged children (HBSC) 2014 Portuguese survey. Participants were 5024 adolescents (2373 boys), aged 10–17 years. A composite score of healthy lifestyle was obtained using the combination of the following factors: daily physical activity, sleep at least 8–9 h/night, daily consumption of fruit and vegetables, spend <2 h daily in screen-based behaviours, never drink and never smoke.

Results

Adolescents with a healthy lifestyle had significantly better SRH and higher HRQoL than those who were not engaged in all healthy behaviours.

Conclusions

Healthy lifestyle (composed of physical activity, sleep at least 8–9 h/night, daily consumption of fruit and vegetables, spend <2 h daily in screen-based behaviours, never drink and never smoke) is related to SRH and HRQoL. Promoting a comprehensive approach to these behaviours is a public health strategy to be considered when aiming to improve health, in general, and SRH and HRQoL, in particular.

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

References (39)

  • L. Rajmil et al.

    Effect on health-related quality of life of changes in mental health in children and adolescents

    Health Qual Life Outcomes

    (2009)
  • A.Y. Omorou et al.

    Cumulative and bidirectional association of physical activity and sedentary behaviour with health-related quality of life in adolescents

    Qual Life Res

    (2016)
  • X.Y. Wu et al.

    The influence of physical activity, sedentary behavior on health-related quality of life among the general population of children and adolescents: a systematic review

    PLoS One

    (2017)
  • K.A. Bolton et al.

    The association between self-reported diet quality and health-related quality of life in rural and urban Australian adolescents

    Aust J Rural Health

    (2016)
  • H.M. Wang et al.

    Weight status, quality of life, and cigarette smoking among adolescents in Washington State

    Qual Life Res

    (2013)
  • S.R. Dube et al.

    Smoking and health-related quality of life among U.S. Adolescents

    Nicotine Tob Res

    (2013)
  • R. Heshmat et al.

    Association of passive and active smoking with self-rated health and life satisfaction in Iranian children and adolescents: the CASPIAN IV study

    Bmj Open

    (2017)
  • C. Currie et al.

    Social determinants of health and well-being among young people: health behaviour in school-aged children (HBSC) study : international report from the 2009/2010 survey

    (2012)
  • E.L. Idler et al.

    Self-rated health and mortality: a review of twenty-seven community studies

    J Health Soc Behav

    (1997)
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