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The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study.

ABSTRACT: Suboptimal health status (SHS) is the intermediate health state between health and disease, it is medically undiagnosed and is also termed functional somatic syndrome. Although its clinical manifestations are complicated and various, SHS has not reached the disease status. Unhealthy lifestyle is associated with many chronic diseases and mortality. In accordance with the impact of lifestyle on health, it is intriguing to determine the association between unhealthy lifestyle and SHS risk.We conducted a nested case-control study among healthy Chinese college students from March 2012 to September 2013, which was nested in a prospective cohort of 5676 students. We performed 1:1 incidence density sampling with matched controls for birth year, sex, grade, specialty and individual character. SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Exposure was defined as an unhealthy lifestyle per the frequency of six behavioral dimensions from the Health-promoting Lifestyle Profile (HPLP-II).We matched 543 cases of SHS (42.66%) in a cohort of 1273 students during the 1.5 years mean follow-up time with controls. A significant difference (t = 9.79, p < 0.001) and a reduction in HPLP-II total score was present at 1.5 years follow-up (135.93 ± 17.65) compared to baseline (144.48 ± 18.66). A level-response effect was recorded with an increase of the total HPLP-II (every dimension was correlated with a decreased SHS risk). Compared to respondents with the least exposure (excellent level), those reporting a general HPLP-II level were approximately 2.3 times more likely to develop SHS (odd ratio = 2.333, 95% CI = 1.471 to 3.700); and those with less HPLP-II level (good level) were approximately 1.6 times more likely (1.644, 1.119-2.414) to develop SHS (p < 0.05). Our data indicated that unhealthy lifestyle behavior with respect to behavioral dimensions significantly affected SHS likelihood. Further analyses revealed a marked increase (average increased 14.73 points) in lifestyle level among those SHS regression to health after 1.5 years, with respect to the HPLP-II behavioral dimensions, in addition to the total score (t = -15.34, p < 0.001).SHS is highly attributable to unhealthy lifestyles, and the Int. J. Environ. Res. Public Health 2017, 14, 240 2 of 17 mitigation of modifiable lifestyle risk factors may lead to SHS regression. Increased efforts to modify unhealthy lifestyles are necessary to prevent SHS.

SUBMITTER: Chen J

PROVIDER: S-EPMC5369076 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study.

Chen Jieyu J Xiang Hongjie H Jiang Pingping P Yu Lin L Jing Yuan Y Li Fei F Wu Shengwei S Fu Xiuqiong X Liu Yanyan Y Kwan Hiuyee H Luo Ren R Zhao Xiaoshan X Sun Xiaomin X

International journal of environmental research and public health 20170228 3

<h4>Background</h4>Suboptimal health status (SHS) is the intermediate health state between health and disease, it is medically undiagnosed and is also termed functional somatic syndrome. Although its clinical manifestations are complicated and various, SHS has not reached the disease status. Unhealthy lifestyle is associated with many chronic diseases and mortality. In accordance with the impact of lifestyle on health, it is intriguing to determine the association between unhealthy lifestyle and ...[more]

PMID: 28264509

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Project description:BackgroundLifestyle choices reflect the beliefs that individuals attribute to aspects of life. This construct can be assessed with the Individual Lifestyle Profile (PEVI) questionnaire, which measures elements of Nutrition, Physical Activity, Preventive Behaviors, Social Relationships and Stress Management.ObjectiveThe objective of this study was to estimate the psychometric properties of the PEVI applied to a sample of Brazilian university students, identifying the prevalence of each lifestyle component according to participants' age, sex, weight status, course area/field and economic stratum and to estimate the contribution of these characteristics on physical and psychological lifestyle.MethodsThe PEVI data was analyzed by confirmatory factor analysis, using the indexes chi-square per degrees of freedom ratio (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI) and Root Mean Square Error of Approximation (RMSEA). First-order and second-order models (physical and psychological lifestyle) were tested. Prevalences of lifestyle components were calculated and compared by participants' age, sex, weight status, course area/field and economic stratum. A hypothetical causal structural model was elaborated to investigate the impact of sample characteristics on physical and psychological lifestyles. This model was evaluated considering the global fit to the data (χ2/df, CFI, TLI and RMSEA) and the hypothetical causal trajectories (β) (α = 5%).ResultsA sample of 1,303 students was used. The mean age was 20.9 (standard deviation = 2.8) years, 66.8% of participants were females, 63.4% had weights in the normal range and 73.7% were students of the social and exact sciences. The PEVI data showed an adequate fit for both the first- (χ2/df = 2.03, CFI = 0.98; TLI = 0.97; RMSEA = 0.04) and second-order (χ2/df = 2.25; CFI = 0.97; TLI = 0.97; RMSEA = 0.04) models. There was a higher prevalence of unfavorable physical and psychological lifestyle choices among females, among underweight and obese individuals, in older students and in those with lower economic strata. Moreover, negative behaviors in physical lifestyle were more prevalent in students from human/social/exact sciences and worse psychological lifestyle was observed among health sciences students. These results were confirmed by a structural model.ConclusionThe PEVI data presented validity and reliability. Negative lifestyle choices had high prevalence among students. Moreover, individual characteristics had different impact on physical and psychological lifestyle choices.

Project description:BackgroundSuboptimal health status (SHS) is an intermediate health status between health and illness, a syndrome characterised by the perception of health complaints, general weakness and low energy. This study aimed to investigate the prevalence of SHS and the correlation between SHS and psychological symptoms among Chinese college students and to identify the SHS-related risk factors from the perspective of predictive, preventive and personalised medicine (PPPM).MethodsA cross-sectional study was conducted among 4119 college students who were enrolled from Taishan Medical University and Baoji Vocational and Technical College in the eastern and western areas of China. SHS levels of the participants were measured by an established self-reporting Suboptimal Health Status Questionnaire-25 (SHSQ-25). Psychosomatic conditions were estimated by the self-rating Symptom Checklist-90 (SCL-90) scale. Spearman correlation analysis was applied to analyse the relationship between SHSQ-25 scores and SCL-90 estimates. Logistic regression analysis was applied for multivariate analysis.ResultsThe prevalence of SHS was 21.0% (864/4119), with 23.3% (701/3005) for female students and 14.6% (163/1114) for male students. The prevalence of general positive psychological symptom was 14.2% (586/4119), with 15.6% (470/3005) for female students and 10.4% (116/1114) for male students. A strong correlation was identified between SHS score and SCL-90 estimates, with the correlation coefficient (r) of 0.719. Logistic regression showed that variables significantly associated with SHS were somatisation (adjusted odds ratio (aOR) = 3.185, 95% confidence interval [CI] = 2.048-4.953), obsessive-compulsive (aOR = 3.518, 95% CI = 2.834-4.368), interpersonal sensitivity (aOR = 1.883, 95% CI = 1.439-2.463) and depression (aOR = 1.847, 95% CI = 1.335-2.554).ConclusionsOur findings confirm that there is a high prevalence of SHS among college students and there is a strong association between SHS and psychological symptoms among Chinese college students. High susceptibility of SHS occurs particularly in vulnerable groups: female students, sophomore students, medical students and students from rural area. Identification of SHS and prompt application of personalised psychological health-supporting activities will promote college students' health status.

Project description:BackgroundHigher education students exhibit heightened sensitivity to environmental changes as they navigate the critical transition from adolescence to adulthood. The coronavirus disease 2019 (COVID-19) pandemic has posed unprecedented challenges to universities worldwide, exemplifying a crisis that profoundly affects the learning outcomes and psychological status of college students. Although it is known that campus lockdown has triggered dramatic changes in lifestyles, learning outcomes, and psychological statuses, in-depth knowledge of the causal relationships among these changes remains largely unclear.MethodsHere, we conducted a cross-sectional survey designed to assess the impact of campus closure during COVID-19 on lifestyle, educational performance, and anxiety levels among college students. We surveyed over 3,500 junior college, undergraduate and graduate participants from 94 colleges/universities across 30 provinces, municipalities, and autonomous regions in China.We employed structural equation modeling (SEM) to explore the relationships between changes in lifestyle, educational performance, and levels of anxiety associated with campus open or closure regulations during the COVID-19 pandemic.ResultsOur results discovered that sleep duration, physical activity involvement, and social connections were crucial for sustaining students' learning outcomes and mental health. The shift to online learning and campus lockdown exacerbated stressors, contributing to heightened anxiety (β = 0.066), disrupted sleep patterns, and enhanced physical activity (β = 0.070) and reduced learning effect (β = -0.059). Sleep patterns were disrupted by the campus lockdown, an effect mediated by the degradation of relationships among classmates. Nonetheless, the best-fitting SEM uncovered the intricate relationships among lifestyle changes, learning outcomes, and psychological status in response to sudden environmental changes (Fisher's C = 80.949, P = 0.328). These results highlight the critical role of adaptable, supportive campus policies tailored to meet the diverse needs and interests of students during and beyond crises (Fisher's C = 59.568, P = 0.809).ConclusionsOur study advocates for a holistic approach that addresses the multifaceted aspects of student life to cultivate a resilient academic community. This approach contributes to a deeper understanding of the effects of sudden environmental changes on students' psychological well-being and academic performance in the post-pandemic era.

Project description:BackgroundWeb-based multiple health behavior change (MHBC) interventions have demonstrated effectiveness in promoting physical activity (PA) and fruit and vegetable consumption (FVC) among Chinese college students. However, there is limited research examining their effects on promoting a healthy lifestyle (ie, adhering to both PA and FVC behavioral recommendations) among Chinese college students. In addition, the salient psychosocial mediators of successful MHBC interventions need to be researched.ObjectiveThis study aims to examine the effectiveness of a previous 8-week web-based MHBC program for promoting a healthy lifestyle and enhancing the psychosocial determinants (intention, self-efficacy, planning, and social support) of behavior change among Chinese college students. Furthermore, the study aims to identify whether changes in these psychosocial determinants mediate intervention effectiveness on the immediate and sustained lifestyle changes.MethodsThis was a secondary analysis for a 3-arm randomized controlled trial. Chinese college students (N=552) were randomly assigned to 1 of 3 groups: a PA-first group (4-week PA intervention followed by 4-week FVC intervention), an FVC-first group (4-week FVC intervention followed by 4-week PA intervention), and a placebo control group. The intervention content was designed based on the health action process approach model. Data for analyses were collected at baseline (T0), postintervention assessment (T1), and 12-week follow-up assessment (T2).ResultsAt baseline, 13.9% (77/552) of the participants maintained a healthy lifestyle. After 8 weeks, more (200/552, 36.2%) participants achieved a healthy lifestyle. PA-first and FVC-first groups were, respectively, 3.24 times and 5 times more likely to adopt a healthy lifestyle than the control group at T1. After 12 weeks, 35.5% (196/552) of the participants adopted a healthy lifestyle. Intervention groups were approximately 2.99 times (PA first) and 4.07 times (FVC first) more likely to adopt a healthy lifestyle than the control group at T2. Intervention effects favored both intervention groups in self-efficacy and planning for PA and in intention and planning for FVC compared with the control condition. In addition, changes in PA self-efficacy and FVC intention mediated intervention effectiveness on the immediate lifestyle change after 8 weeks. Changes in FVC intention were identified as a salient mediator for facilitating sustained lifestyle change after 12 weeks.ConclusionsThis study provides empirical evidence for the effectiveness of an 8-week theory- and web-based MHBC intervention program on promoting a healthy lifestyle, self-efficacy and planning for PA, and intention and planning for FVC among Chinese college students. These research findings add new knowledge to the underlying psychosocial mechanisms of successful MHBC interventions. Overall, this study has considerable implications for future web-based MHBC research and practice in terms of addressing PA self-efficacy and FVC intention and helping students to adopt and maintain a healthy lifestyle independently of whether PA or FVC is addressed first.Trial registrationClinicalTrials.gov NCT03627949; https://clinicaltrials.gov/ct2/show/NCT03627949.

Dataset Information

The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study.

Publications

The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study.

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