Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China.
Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
Health Qual Life Outcomes. 2021 Jan 6;19(1):8. doi: 10.1186/s12955-020-01657-w.
To investigate associations of five typical lifestyle-related behavioral risk factors (insufficient physical activity, prolonged screen viewing, deprived sleeping, consumption of fast food and sugar-sweetened beverage) with health-related quality of life (HRQoL) among school students in China.
Students aged 9-17 years (grades 4-12) were randomly selected from primary and high schools in Nanjing, China, to participate in this cross-sectional study in 2018. The outcome variable, HRQoL, was assessed using the Child Health Utility 9D (CHU9D) instrument and scored from 0 (worst) to 1 (best). Physical activity (including screen viewing and sleeping) and dietary intake were measured using a validated Physical Activity Scale and Food Frequency Questionnaire, respectively. Lifestyle-related behaviors were categorized as sufficient/insufficient or no/yes, and their associations with HRQoL were assessed using mixed-effects linear regression models.
Overall, 4388 participants completed the questionnaire (response rate = 97.6%). Students with insufficient physical activity [mean difference (MD) = - 0.03; 95% confidence interval (CI) = - 0.04, - 0.01], prolonged screen time (MD = - 0.06; 95% CI = - 0.07, - 0.04), insufficient sleeping time (MD = - 0.04; 95% CI = - 0.07, - 0.02), consumption of sugar-sweetened beverage (MD = - 0.02; 95% CI = - 0.03, - 0.01) or fast food intake (MD = - 0.03; 95% CI = - 0.04, - 0.02) reported significantly lower HRQoL scores. When considered additively, each additional lifestyle-related risk factor was associated with an average decrease of 0.03 units (95% CI: - 0.03, - 0.02) CHU9D score.
For Chinese students, HRQoL was positively associated with physical activity and sleep duration, but negatively with screen time and consumption of sugar-sweetened beverage and fast food. Moreover, lifestyle-related behaviors may have an additive effect on HRQoL.
研究中国学生中五种典型的与生活方式相关的行为风险因素（体力活动不足、长时间屏幕观看、睡眠不足、快餐和含糖饮料摄入）与健康相关的生活质量（HRQoL）之间的关联。
2018 年，从中国南京的小学和中学中随机选择 9-17 岁的学生（4-12 年级）参加这项横断面研究。使用儿童健康效用 9 维度（CHU9D）工具评估结局变量 HRQoL，得分从 0（最差）到 1（最佳）。体力活动（包括屏幕观看和睡眠）和饮食摄入分别使用经过验证的体力活动量表和食物频率问卷进行测量。生活方式相关行为分为充足/不足够或无/有，并使用混合效应线性回归模型评估其与 HRQoL 的关联。
总体而言，4388 名参与者完成了问卷（应答率为 97.6%）。体力活动不足（平均差异 [MD] = -0.03；95%置信区间 [CI] = -0.04，-0.01）、长时间屏幕时间（MD = -0.06；95% CI = -0.07，-0.04）、睡眠不足（MD = -0.04；95% CI = -0.07，-0.02）、摄入含糖饮料（MD = -0.02；95% CI = -0.03，-0.01）或快餐摄入（MD = -0.03；95% CI = -0.04，-0.02）的学生报告的 HRQoL 评分显著较低。当考虑累加时，每增加一个与生活方式相关的风险因素与平均降低 0.03 个 CHU9D 评分（95% CI：-0.03，-0.02）相关。
对于中国学生，HRQoL 与体力活动和睡眠时间呈正相关，与屏幕时间以及含糖饮料和快餐的摄入呈负相关。此外，生活方式相关行为可能对 HRQoL 具有累加效应。
