Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, China.
Department of Epidemiology, Capital Institute of Pediatrics, Beijing, 100020, China.
Int J Environ Res Public Health. 2020 Feb 26;17(5):1497. doi: 10.3390/ijerph17051497.
Chinese children are facing health challenges brought by chronic non-communicable diseases, such as physical problems and psychological related health problems. Childhood represents a critical life period when the long-term dietary and lifestyle behaviors are formed. It is necessary to survey the prevalence of suboptimal health status (SHS) among Chinese children and to research the relationship between SHS and lifestyles. This study aimed to examine the prevalence of SHS among Chinese children using a large-scale population survey sample covering school students and nonstudent children, and clarified the relationships between SHS and lifestyle factors using multi-level models controlled for the cluster effect of location and the confounding effect of demographics. Multi-level generalized estimating equation models were used to examine the relationships between SHS and lifestyle factors. Prevalence ratios (PR) and 95% confidence intervals (CI) were used to assess the strength of these relationships. Of the 29,560 children, 14,393 reported one or more SHS symptoms, giving a SHS prevalence of 48.69%. The prevalence of SHS for boys (46.07%) was lower than that for girls (51.05%). After controlling for the cluster effect of living areas and confounding effect of demographic characteristics, lifestyle factors associated with SHS were: less sleep duration, current smokers (PR = 1.085, 95%CI: 1.027-1.147), current drinkers (PR = 1.072, 95%CI: 1.016-1.131), children' parents suffering from chronic diseases (PR = 1.294, 95%CI: 1.179-1.421), poor sleep quality (PR = 1.470, 95%CI: 1.394-1.550), stress (PR = 1.545, 95%CI: 1.398-1.707), negative life events (PR = 1.237, 95%CI: 1.088-1.406), hypertension (PR = 1.046, 95%CI: 1.009-1.084), unhealthy diet choice (PR = 1.091, 95%CI: 1.051-1.133) and irregular meal time (PR = 1.210, 95%CI: 1.163-1.259). Children who could exercise regularly (PR = 0.897, 95%CI: 0.868-0.927) and those with regular medical checkup (PR = 0.891, 95%CI: 0.854-0.929) were associated with lower prevalence probability of SHS. SHS has become a serious public health challenge for Chinese children. Unhealthy lifestyles were closely associated with SHS. Implementation of preventative strategies are needed to reduce the potential SHS burden associated with these widespread high-risk unhealthy lifestyle behaviors.
中国儿童面临着由慢性非传染性疾病带来的健康挑战，例如身体问题和心理相关的健康问题。儿童期是形成长期饮食和生活方式行为的关键生命阶段。有必要调查中国儿童亚最佳健康状况（SHS）的流行情况，并研究 SHS 与生活方式之间的关系。本研究旨在使用涵盖学生和非学生儿童的大规模人群调查样本，检查中国儿童 SHS 的流行情况，并使用多级模型阐明 SHS 与生活方式因素之间的关系，该模型控制了位置的聚类效应和人口统计学特征的混杂效应。使用多级广义估计方程模型检查 SHS 与生活方式因素之间的关系。使用优势比（PR）和 95％置信区间（CI）来评估这些关系的强度。在 29560 名儿童中，有 14393 名报告了一个或多个 SHS 症状，表明 SHS 的患病率为 48.69％。男孩（46.07％）的 SHS 患病率低于女孩（51.05％）。在控制了居住地区的聚类效应和人口统计学特征的混杂效应之后，与 SHS 相关的生活方式因素为：睡眠时间减少，当前吸烟者（PR = 1.085，95％CI：1.027-1.147），当前饮酒者（PR = 1.072，95％CI：1.016-1.131），儿童父母患有慢性病（PR = 1.294，95％CI：1.179-1.421），睡眠质量差（PR = 1.470，95％CI：1.394-1.550），压力（PR = 1.545，95％CI：1.398-1.707），负性生活事件（PR = 1.237，95％CI：1.088-1.406），高血压（PR = 1.046，95％CI：1.009-1.084），不健康的饮食选择（PR = 1.091，95％CI：1.051-1.133）和不规律的进餐时间（PR = 1.210，95％CI：1.163-1.259）。经常锻炼的儿童（PR = 0.897，95％CI：0.868-0.927）和定期进行体检的儿童（PR = 0.891，95％CI：0.854-0.929）与较低的 SHS 患病率概率相关。SHS 已成为中国儿童的严重公共卫生挑战。不健康的生活方式与 SHS 密切相关。需要实施预防策略，以减少与这些广泛的高风险不健康生活方式行为相关的潜在 SHS 负担。
