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Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model.

ABSTRACT: 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.

SUBMITTER: Xu T

PROVIDER: S-EPMC7084743 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model.

Xu Tao T Liu Junting J Zhu Guangjin G Han Shaomei S

International journal of environmental research and public health 20200226 5

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 ...[more]

PMID: 32110905

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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:BackgroundAntibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China.MethodsEnglish and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies. In addition, we explored the risk factors of antibiotic utilization in Chinese children using qualitative analysis.ResultsOf 10,075 studies identified, 98 eligible studies were included after excluded duplicated studies. A total of 79 studies reported prevalence and 42 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8% (35 studies, 95% confidence interval (CI): 55.1-72.4%), and 81.3% (41 studies, 95% CI: 77.3-85.2%), respectively. In addition, the overall prevalence of caregiver's self-medicating of antibiotics for children at home was 37.8% (4 studies, 95% CI: 7.9-67.6%). The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue.ConclusionThe prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic, especially in rural setting.

Project description:BackgroundObesity is a risk factor for many chronic diseases, and its prevalence and trends vary among populations. Saudi Arabia shows a greater rise in prevalence than many other countries. We aimed to study the association between several chronic disorders, demographic, and lifestyle factors with increased body mass index (BMI) in the adult population of Jeddah.MethodsData were obtained from a door-to-door cross sectional study. A three-stage stratified cluster sampling technique was adopted. Individuals in selected households agreeing to participate were interviewed to complete a predesigned questionnaire covering demographic and lifestyle variables, medical history, and family history of chronic diseases. This was followed by anthropometric and blood pressure measurements. A random capillary plasma glucose (RPG) was measured, followed by further testing using fasting plasma glucose and glycated hemoglobin (HbA1c) to verify whether participants were normal, diabetic, or prediabetic. Multiple logistic regression analyses were used to adjust for confounding factors.ResultsA total of 1419 individuals were included in the study: 667 men and 752 women. The prevalence of overweight and obesity was 35.1 and 34.8%, respectively, in men, and 30.1% and 35.6%, respectively, in women. Both overweight and obesity increased in prevalence to 60 years of age, and decreased in the oldest age group in both sexes. After adjusting for age, risk of obesity in men was increased with having a postgraduate degree [odds ratio (OR), 95%CI = 2.48, 1.1-5.61] and decreased with increased physical activity (OR, 95%CI = 0.49, 0.26-0.91). Risk of prediabetes and diabetes was increased in obese women (OR, 95%CI = 2.94, 1.34-6.44, and 3.61, 1.58-8.26 respectively), that of hypertension in obese men (OR, 95%CI =2.62, 1.41-4.87), and that of dyslipidemia in both sexes (OR, 95%CI = 2.60, 1.40-4.83 in men, and 2.0, 1.01-3.85 in women). A family history of dyslipidemia was associated with reduced risk of obesity among women (OR, 95%CI = 0.33, 0.12-0.92), whereas, in people with above normal weight (BMI ⩾25), there was increased risks of prediabetes, diabetes, and dyslipidemia among women (OR, 95%CI = 2.50, 1.21-5.17; 3.20, 1.45-7.03, and 1.88, 1.02-3.49, respectively ), and of hypertension among men (OR, 95%CI = 1.80, 1.00-3.23).ConclusionsThe prevalence of overweight and obesity in the Saudi population remain high, indicating ineffectiveness or lack of preventive measures. Risk of prediabetes, diabetes, dyslipidemia, and hypertension increased with increasing BMI, with some sex differences in these associations.

Project description:BackgroundThe aim of the study was to examine the relations of individual lifestyle factors and its composite score with healthy ageing among Chinese adults.MethodWe included 14 159 participants aged 45-74 years at baseline from the Singapore Chinese Health Study, a population-based prospective cohort. A protective lifestyle score (0-5 scale) was calculated at baseline (1993-1998) and updated at the second follow-up visit (2006-2010) on the basis of optimal body mass index (18.5-22.9 kg/m2), healthy diet (upper 40% of the Alternative Healthy Eating Index score), being physically active (≥2 h/wk of moderate activity or ≥0.5 h/wk of strenuous activity), nonsmoking (never smoking), and low-to-moderate alcohol drinking (>0 to ≤14 drinks/wk for men and >0 to ≤7 drinks/wk for women). Healthy ageing was assessed at the third follow-up visit (2014-2016) and was defined as absence of specific chronic diseases, absence of cognitive impairment and limitations in instrumental activities of daily living, good mental and overall self-perceived health, good physical functioning, and no function-limiting pain.ResultsAbout 20.0% (2834) of the participants met the criteria of healthy ageing after a median follow-up of 20 years. Each 1-point increase in the protective lifestyle score computed at baseline and second follow-up visits was associated with higher likelihood of healthy ageing by 25% (95% CI: 20%-30%) and 24% (18%-29%), respectively. The population-attributable risk percent of adherence to 4-5 protective lifestyle factors was 34.3% (95% CI: 25.3%-42.3%) at baseline and 31.3% (23.0%-38.7%) at second follow-up visits for healthy ageing. In addition, positive increase in lifestyle scores from baseline to second follow-up visits was also significantly associated with a higher likelihood of healthy ageing with an odds ratio of 1.18 (95% CI: 1.12%-1.24%) for each increment in protective lifestyle score.ConclusionsOur findings confirmed that adopting healthy lifestyle factors, even after midlife, was associated with healthy ageing at old age.

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Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model.

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Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model.

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