Interplay of physical activity, self-rated health, and life satisfaction among large-bodied adolescents in Europe and North America: analysis using clustered binary mixed effects logit modelling

Abstract Background There is a dearth of studies focused on the impact of self-rated health on life satisfaction among large-bodied adolescents, as well as the moderating role of physical activity in this relationship. Large-bodied adolescents refers to young people (usually aged 10–19 years) whose...

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Main Authors: Michael Safo Oduro, Eniola Fasola, Prince Peprah, Isaac Yeboah Addo
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23626-y
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author Michael Safo Oduro
Eniola Fasola
Prince Peprah
Isaac Yeboah Addo
author_facet Michael Safo Oduro
Eniola Fasola
Prince Peprah
Isaac Yeboah Addo
author_sort Michael Safo Oduro
collection DOAJ
description Abstract Background There is a dearth of studies focused on the impact of self-rated health on life satisfaction among large-bodied adolescents, as well as the moderating role of physical activity in this relationship. Large-bodied adolescents refers to young people (usually aged 10–19 years) whose body size falls within the overweight or obese range as defined by the World Health Organisation’s Growth Reference, based on age- and sex-specific body mass index (BMI) percentiles. This study aimed to address the gap in research by examining the association between self-rated health and life satisfaction in a diverse sample of large-bodied adolescents from 39 countries and regions in Europe and North America. The moderating role of physical activity in the association was also examined. Methods The study analysed data from the Health Behaviour in School-aged Children (HBSC) survey, involving a sample of 24,839 large-bodied adolescents. Three sequential binary mixed effects logit models were fitted: the first assessing self-rated health alone, the second adjusting for multiple covariates, and the third incorporating an interaction term between physical activity and self-rated health. The analysis was performed using R Software (v4.1.2), with significance determined at a level of 0.05. Results The results show that adolescents who rated their health as “poor” were a little more than six times (AOR = 6.32, 95%CI: 5.30–7.54, p < 0.001) as likely to report lower life satisfaction compared to those who rated their health as “excellent”. Those who rated their health as “good” had 1.71 times higher odds (AOR = 1.71, 95%CI: 1.44–2.04, p < 0.001) of reporting lower life satisfaction compared to those who rated their health as “excellent”. The analysis further indicated that physical activity plays a partial moderating role in the relationship between self-rated health and life satisfaction. Participants who considered themselves “somewhat active” reported higher life satisfaction compared to their “inactive” peers (AOR = 0.58, p = 0.031, 95% CI: 0.36–0.95). Conclusions The study supports the hypothesis that poorer self-rated health is associated with lower life satisfaction among large-bodied adolescents. It further suggests that increased physical activity can ‘partly’ buffer the negative effects of poor self-rated health on life satisfaction. These findings emphasise the importance of interventions promoting physical activity and positive self-care to improve general well-being in large-bodied adolescents.
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spelling doaj-art-0004e3eaabd446a1beb8844b157100892025-08-20T04:03:11ZengBMCBMC Public Health1471-24582025-07-0125111410.1186/s12889-025-23626-yInterplay of physical activity, self-rated health, and life satisfaction among large-bodied adolescents in Europe and North America: analysis using clustered binary mixed effects logit modellingMichael Safo Oduro0Eniola Fasola1Prince Peprah2Isaac Yeboah Addo3Pfizer Research and Development, PSSM Data SciencesDepartment of Agricultural and Resource Economics, University of ConnecticutAustralian Institute of Health Innovation, Macquarie UniversityCentre for Social Research in Health, University of New South WalesAbstract Background There is a dearth of studies focused on the impact of self-rated health on life satisfaction among large-bodied adolescents, as well as the moderating role of physical activity in this relationship. Large-bodied adolescents refers to young people (usually aged 10–19 years) whose body size falls within the overweight or obese range as defined by the World Health Organisation’s Growth Reference, based on age- and sex-specific body mass index (BMI) percentiles. This study aimed to address the gap in research by examining the association between self-rated health and life satisfaction in a diverse sample of large-bodied adolescents from 39 countries and regions in Europe and North America. The moderating role of physical activity in the association was also examined. Methods The study analysed data from the Health Behaviour in School-aged Children (HBSC) survey, involving a sample of 24,839 large-bodied adolescents. Three sequential binary mixed effects logit models were fitted: the first assessing self-rated health alone, the second adjusting for multiple covariates, and the third incorporating an interaction term between physical activity and self-rated health. The analysis was performed using R Software (v4.1.2), with significance determined at a level of 0.05. Results The results show that adolescents who rated their health as “poor” were a little more than six times (AOR = 6.32, 95%CI: 5.30–7.54, p < 0.001) as likely to report lower life satisfaction compared to those who rated their health as “excellent”. Those who rated their health as “good” had 1.71 times higher odds (AOR = 1.71, 95%CI: 1.44–2.04, p < 0.001) of reporting lower life satisfaction compared to those who rated their health as “excellent”. The analysis further indicated that physical activity plays a partial moderating role in the relationship between self-rated health and life satisfaction. Participants who considered themselves “somewhat active” reported higher life satisfaction compared to their “inactive” peers (AOR = 0.58, p = 0.031, 95% CI: 0.36–0.95). Conclusions The study supports the hypothesis that poorer self-rated health is associated with lower life satisfaction among large-bodied adolescents. It further suggests that increased physical activity can ‘partly’ buffer the negative effects of poor self-rated health on life satisfaction. These findings emphasise the importance of interventions promoting physical activity and positive self-care to improve general well-being in large-bodied adolescents.https://doi.org/10.1186/s12889-025-23626-yAdolescentsSelf-Rated healthLife satisfactionPhysical activityObesityOverweight
spellingShingle Michael Safo Oduro
Eniola Fasola
Prince Peprah
Isaac Yeboah Addo
Interplay of physical activity, self-rated health, and life satisfaction among large-bodied adolescents in Europe and North America: analysis using clustered binary mixed effects logit modelling
BMC Public Health
Adolescents
Self-Rated health
Life satisfaction
Physical activity
Obesity
Overweight
title Interplay of physical activity, self-rated health, and life satisfaction among large-bodied adolescents in Europe and North America: analysis using clustered binary mixed effects logit modelling
title_full Interplay of physical activity, self-rated health, and life satisfaction among large-bodied adolescents in Europe and North America: analysis using clustered binary mixed effects logit modelling
title_fullStr Interplay of physical activity, self-rated health, and life satisfaction among large-bodied adolescents in Europe and North America: analysis using clustered binary mixed effects logit modelling
title_full_unstemmed Interplay of physical activity, self-rated health, and life satisfaction among large-bodied adolescents in Europe and North America: analysis using clustered binary mixed effects logit modelling
title_short Interplay of physical activity, self-rated health, and life satisfaction among large-bodied adolescents in Europe and North America: analysis using clustered binary mixed effects logit modelling
title_sort interplay of physical activity self rated health and life satisfaction among large bodied adolescents in europe and north america analysis using clustered binary mixed effects logit modelling
topic Adolescents
Self-Rated health
Life satisfaction
Physical activity
Obesity
Overweight
url https://doi.org/10.1186/s12889-025-23626-y
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