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Objective@#The American Heart Association released the Life s Essential 8 (LE 8) for the overall evaluation of cardiovascular health (CVH) on individual level. The present study aimed to describe the overall CVH in Chinese school aged children using LE 8 metrics.@*Methods@#Data of the present analysis came from a national representative multicentered cross sectional study conducted in 7 provinces of China in 2013. The original study used a multistage cluster sampling method. A total of 10 326 children aged 5 to 19 years with complete data of health behaviors and health outcomes were included in the study. Children s health behavior indicators included diet, physical activity, nicotine exposure and sleep health. Health outcome factors included body mass index, fast blood glucose, lipid profile and blood pressure.@*Results@#The median CVH score was 73.3 ( IQR =14.4) in boys and 73.4 ( IQR = 13.5) in girls. Compared to children aged ≤9 years, the health behavior scores were lowest in the 13-15 age group, with boys scoring 7.73 lower (95% CI =-8.35--7.12, P <0.01) and girls scoring 9.15 (95% CI =-9.83--8.48, P <0.01) lower. The ≥16 age group had the lowest health outcome scores, with boys scoring 7.85 (95% CI =-9.07--6.63, P <0.01) lower and girls scoring 6.11 (95% CI =-7.12--5.09, P <0.01) lower.@*Conclusions@#Chinese school aged children are generally at a moderate level of cardiovascular health. Specific LE 8 components vary substantially between groups and therefore require targeted intervention strategies.
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Objective@#To investigate the association between the combined effect of height growth and overweight/obesity with elevated blood pressure in Chinese children.@*Methods@#Based on a cohort study of puberty development in Xiamen, a cluster sampling method was used to select 1 313 children whose complete height, weight and blood pressure levels at baseline were obtained in 2017 and during a follow up in 2019. The incidence of elevated blood pressure was compared between four different subgroups, and multivariate Logistic regression was performed to analyze the combined effect in boys and girls.@*Results@#Among 1 313 children, the prevalence of elevated blood pressure at baseline was 25.2%. After 2 years of follow up, the incidence of elevated blood pressure was 19.7% and 23.4% in boys, and 16.6% in girls. After adjusting for factors including age, sex, family history of hypertension, sleep time, intake of fruits, vegetables, sugar sweetened beverages, and meat products, multivariate Logistic regression analyses showed that children in the high height growth and overweight/obesity group were more likely to exhibit a higher incidence of elevated blood pressure (overall:RR=2.41，95%CI=1.44-4.04；boys：RR=2.69，95%CI=1.45-5.02). Among girls, the risk of elevated blood pressure in the low height growth and overweight/obesity group also increased significantly (RR=4.47, 95%CI=1.45-13.75).@*Conclusion@#A large magnitude of height growth and being overweight/obesity were associated with elevated blood pressure in children, especially boys. Therefore, interventions that are targeted toward obesity prevention in children before pubertal growth spurts in height may be beneficial to reduce childhood high blood pressure.
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Objective@#To explore the relationship between nutritional status and puberty onset in boys, and to provide a reference for promoting the development of physical and mental health of boys.@*Methods@#A total of 2 724 boys aged 7 to 12 years from grade 2 to 6 were recruited from Xiamen city by cluster sampling method in 2017. The nutritional status was assessed by physical examination, pubertal developmental status was evaluated by rating scales of Tanner and Prader orchidometer, and puberty timing was determined by the P25 age of puberty onset. The association between nutritional status and puberty onset was estimated by logistic regression model.@*Results@#Pubertal onset was found in 29.0% of the boys and the incidence of early pubertal timing was 2.9%. The prevalence of puberty onset in wasting, normal weight, overweight and obesity boys was 19.6%, 28.7%, 34.4% and 31.5%, respectively. The age of puberty onset was significantly earlier in obese boys (F=3.23, P<0.05). The results of Logistic regression analysis showed that with the increase of BMI, the possibility of puberty onset and risk of early pubertal timing increased. After adjusting for confounding factors, the odds of puberty onset in boys with wasting decreased by 64.0% (OR=0.36, 95%CI=0.22-0.60), the possibility of puberty onset and risk of early pubertal timing in boys with obesity increased by 78.3% (OR=1.78, 95%CI=1.14-2.79) and 192.9% (OR=2.93, 95%CI=1.46-5.86), respectively. These relationships were more pronounced in boys of households with lower economic level (P<0.05).@*Conclusion@#BMI was positively correlated with puberty onset in boys, the odds of puberty onset and risk of early pubertal timing were significantly increased in obese boys, especially in those with low household economic level.
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Objective@#To evaluate the physical fitness and its regional distribution of students aged 13-18 years in China, using the National Standards for Students’ Physical Fitness (revised in 2014).@*Methods@#We recruited 105 834 students aged 13 to 18 years from the Chinese National Survey on Students Constitution and Health project in 2014. Related total scores, rates for qualified and for excellence (the proportions of individuals whose total score greater than or equal to 60.0 or 90.0) of these students were gathered. T test was applied to compare means of total score in different groups. χ2 test was used to compare the differences of qualified or excellence rates between different groups while Pearson correlation method was applied to test the relation of each index with per capita GDP.@*Results@#The average score was (70.1±10.7) among students aged 13 to 18 years in China. 88 805 (83.9%) students whose score exceeded 60.0 while 1 734 (1.6%) exceeded 90.0. Average score, rates of both qualified or excellence of students aged 13 to 15 appeared higher than those aged 16 to 18 but lower in males than in females. However, the rate of excellence was much higher in male students. Students living in urban areas showed both lower average score and qualified rate but higher rate of excellence than those living in rural areas. Both qualified and Excellent rates decreased with the increase of age in both sexes. We also noticed that both higher physical fitness and health status appeared in students from the east coast. Pearson correlation coefficient of each index (average score, qualified or Excellent rate) on per capital GDP appeared as 0.56, 0.43 and 0.65, respectively.@*Conclusion@#In 2014, the physical fitness of Chinese students aged 13 to 18 was not satisfactory, with older students and those living in underdeveloped areas, in particular.
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Objective To analyze the epidemiological characteristics of notifiable infectious diseases among Chinese students from 2011 to 2016 and to provide reference for the effective prevention and control programs on infectious disease among students.Methods Both morbidity and mortality of notifiable infectious diseases among Chinese students aged 6-22 years from 2011 to 2016 were analyzed,with main characteristics of the disease described.Results During 2011 to 2016,morbidities of Categories A,B and C infectious diseases among the Chinese students aged 6-22 years showed a decreasing trend,from 248.24/100 000 in 2012 to 158.57/100 000 in 2016.Mortality rates of Category A,B and C infectious diseases had also decreased from 0.12/100 000 in 2011 to 0.07/100 000 in 2016.The average morbidity of the top four diseases from Category A and B infectious diseases appeared as:tuberculosis (16.24/100 000),scarlet fever (9.39/100 000),hepatitis B (7.69/100 000) and bacillary and amebic dysentery (7.15/100 000).The average rates of mortality on the top four diseases appeared as:rabies (0.044 8/100 000),HIV/AIDS (0.027 7/100 000),tuberculosis (0.008 0/100 000) and Japanese encephalitis (0.005 9/100 000).The average rates of morbidity on the top four diseases appeared as:mumps (75.81/100 000),hand-foot-mouth disease (28.55/100 000),other infectious diarrhea (22.41/100 000) and influenza (15.67/100 000) in the Category C.Reported death cases were from hand-foot-mouth disease (11 cases),influenza (9 cases),mumps (1 case) and rubella (1 case).The prevalence rates varied among different student populations,with higher HIV/AIDS,hepatitis B and tuberculosis rates among college and senior high school students,while higher mumps,influenza and hand-foot-mouth disease rates among primary school and junior high school students.Conclusions Both morbidity and mortality of notiflable infectious diseases among Chinese students aged 6-22 years had decreased significantly in 2011-2016.However,the major infectious diseases had become new challenges among students.HIV/AIDS had become a key infectious disease among college students and the relatively high prevalence of tuberculosis was seen in college and high school students.
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Objective@#To understand the nutritional status among Chinese students of five ethnic minorities aged 7-18 years.@*Methods@#Chinese National Survey on Students Constitution and Health in 2014 applied multi-stage stratified cluster random sampling, including 214 354 students from 31 province of China mainland. 73 students whose height or weight information were missing, were excluded. 25 968 minority students aged 7-18 years from Inner Mongolia Autonomous Region, Ningxia Hui Autonomous Region, Xinjiang Uygur Autonomous Region, Guangxi Zhuang Autonomous Region and Jilin Provinces were included for data analysis, including Mongolian (n=5 107), Hui (n=5 308), Uygur (n=5 740), Zhuang (n=5 267) and Korean (n=4 546) students. According to the BMI standard of Working Group on Obesity in China (WGOC) and the new students' health standard of Screening Standard for Malnutrition of School-age Children and Adolescents (WS/T 456-2014) , students were defined as wasting, normal weight, overweight and obesity groups and the nutritional status in different minorities and other characteristics was described and analyszed.@*Results@#The prevalences of wasting in Zhuang, Hui, Uygur, Korean and Mongolian students were 6.1% (318/5 267), 5.1% (266/5 308), 3.2% (187/5 740), 2.6% (116/4 546) and 1.3% (65/5 107) in descending order (χ2=212.60, P<0.001), respectively. The prevalences of overweight in Korean, Mongolian, Hui, Uygur and Zhuang students were 15.2% (686/4 546), 13.1% (669/5 107), 10.3% (549/5 308), 7.8% (446/5 740) and 7.8% (413/5 267) in descending order (χ2=220.80, P<0.001), respectively. The prevalences of obesity in Korean, Mongolian, Hui, Zhuang and Uygur students were 15.3% (695/4 546), 9.5% (488/5 107), 5.7% (304/5 308), 4.6% (242/5 267) and 3.6% (206/5 740) in descending order (χ2=647.02, P<0.001), respectively. The prevalences of wasting in Mongolian, Uygur and Korean rural students were 1.7% (44/2 623), 3.9% (113/2 868) and 3.4% (74/2 154), higher than urban students (all P values <0.05) which were 0.8% (21/2 484), 2.6% (74/2 872) and 1.8% (42/2 392) in Mongolian, Uygur and Korean students. The prevalence of obesity in Mongolian, Hui, Uygur, Zhuang and Korean urban students were 10.8% (269/2 484), 7.6% (193/2 554), 4.1% (117/2 872), 5.9% (153/2 601) and 16.6% (396/2 392), higher than rural students (all P values <0.05) which were 8.3% (219/2 623), 4.0% (111/2 754), 3.1% (89/2 868), 3.3% (89/2 666) and 13.9% (299/2 154) in Mongolian, Hui, Uygur, Zhuang and Korean students. The prevalence of obesity in Hui, Zhuang and Korean boys were 7.2% (188/2 570), 6.0% (157/2 628) and 17.2% (394/2 282), respectively, higher than that of girls which were 4.2% (116/2 738), 3.3% (85/2 639) and 13.3% (301/2 264) (all P values <0.05).@*Conclusion@#The prevalence of wasting, overweight and obesity varied by ethnic minorities in mainland China. The prevalence of overweight and obesity appears higher among mongolian and Korean students, while the prevalence of wasting was higher in Zhuang students.
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Objective@#This study aimed to explore the association between malnutrition and the level of blood pressure (BP) as well as elevated BP (EBP) in Han students aged 7 to 18 years in China.@*Methods@#170 037 subjects with normal nutritional status and malnutrition were enrolled in this study from 2014 Chinese National Surveys on Students' Constitution and Health with a multi-stage stratified cluster random sampling framework covering 31 provinces, autonomous regions and municipalities after the exclusion of 44 317 overweight and obese students. According to the standard of "Screening Standard for Malnutrition of School-age Children and Adolescents" (WS/T456-2014), the nutritional status of children were classified into two categories, normal nutritional status and malnutrition containing stunting, mild wasting and moderate severe wasting. The level of BP and prevalence of EBP were compared between students with normal nutritional status and malnutrition. The multivariate logistic regression model was used to analyze the association between malnutrition and EBP.@*Results@#The levels of systolic BP (SBP) and diastolic BP (DBP) in Chinese Han students aged 7-18 years who were non-overweight and non-obesity status were (103.4±12.3) and (64.7±9.5) mmHg (1 mmHg=0.133 kPa), respectively. The prevalence of EBP, systolic EBP and diastolic EBP in Chinese Han malnourished students (N=21 012) were 3.1% (n=649), 1.5% (n=324) and 2.1% (n=445), respectively, which was significantly lower than those (N=148 320) with normal nutritional status (4.5% (n=6 707), 2.6% (n=3 872) and 2.7% (n=3 959)), and the corresponding differences were statistically significant (P<0.05). The OR (95%CI) between malnutrition and EBP was 0.68 (0.62-0.73), which were 0.65 (0.58-0.72) and 0.68 (0.60-0.77) for boys and girls. The OR (95%CI) between EBP and stunting as well as mild wasting and moderate severe wasting were 0.69 (0.62-0.77), 0.63 (0.55-0.72) and 0.79 (0.60-1.05), respectively.@*Conclusion@#The level of BP and prevalence of EBP in Chinese Han students with malnutrition were lower than those with normal nutritional status. The negative correlation existed between malnutrition and EBP in Chinese Han students aged 7 to 18 years.
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Objective@#To investigate the prevalence and related factors of dyslipidemia among children and adolescents aged 6-17 years in 7 provinces in China.@*Methods@#Using the method of stratified cluster random sampling, 93 primary and secondary schools were selected from Guangdong, Hunan, Liaoning provinces, Shanghai, Chongqing, Tianjin municipalities and Ningxia Hui Autonomous Region in China, 2012. A total of 16 434 students aged 6-17 years old with completed physical and lipid profiles parameters were selected into this study from above 93 primary and secondary schools. Dyslipidemia was determined by the definition of Expert Advice on Prevention and Treatment of Dyslipidemia in Children and Adolescents in 2009. Logistic regression model was used to explore the factors related to dyslipidemia.@*Results@#The prevalence of elevated total cholesterol, elevated triglyceride, elevated low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol, and dyslipidemia was 5.4% (887 cases), 15.7% (2 578 cases), 3.0% (492 cases), 13.5% (2 221 cases) and 28.5% (4 679 cases) among children and adolescents aged 6-17 years, respectively. Sugary drinks intake ≥once per week (OR=1.14; 95%CI: 1.05-1.24), sedentary time >10 hours per day (OR=1.14, 95%CI: 1.01-1.28), overweight (OR=1.50, 95%CI: 1.33-1.70), and obesity (OR=2.62, 95%CI: 2.31-2.96) were significantly associated with the prevalence of dyslipidemia.@*Conclusion@#The prevalence of dyslipidemia was high among children and adolescents aged 6-17 in 7 provinces in China, 2012. Sugary drinks intake ≥once per week, sedentary time >10 hours per day, overweight and obesity might be the risk factors of dyslipidemia among children and adolescents.
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Objective@#To analyze the change in mortality and major causes of death among Chinese adolescents aged 10-19 years from 1990 to 2016.@*Methods@#Data of death for Chinese adolescents aged 10-19 years were extracted from the Global Burden of Disease Study 2016 (GBD 2016). The data was used to describe the change in mortality of Chinese adolescents from 1990 to 2016.Top 15 causes of death were compared between 1990 and 2016.@*Results@#From 1990 to 2016, the all-cause mortality of Chinese adolescents aged 10-19 years old dropped from 102.5/100 000 to 41.2/100 000, reaching about a half of the global average (78.6/100 000) but still almost twice as high as the average of high-income countries (24.3/100 000) by 2016; the reduction in mortality was higher among females than that among males (decreased 68.7% vs. 54.7%), and among adolescents aged 10-14 years than that among those aged 15-19 years (decreased 62.1% vs. 57.1%). During the 26-year period, the cause-specific mortality of all top 15 causes saw sharp decreases. Among them, communicable, maternal, and nutritional diseases saw the most significant decrease (78.1%), and its proportion in all adolescent deaths fell from 11.1% to 6.1%. Meanwhile, non-communicable diseases and injuries saw relatively small decreases (58.2% and 57.3% respectively), and their proportions rose from 33.4% and 55.6% to 34.8% and 59.1%, respectively. The top 5 causes of death changed from drowning (17.39/100 000 in mortality, 17.0% in proportion), road injuries (14.77/100 000, 14.4%), self-harm (11.44/100 000, 11.2%), leukemia (5.48/100 000, 5.4%) and interpersonal violence (3.12/100 000, 3.0%) in1990 into road injuries (9.27/100 000, 22.5%), drowning (6.83/100 000, 16.6%), leukemia(2.73/100 000, 6.6%), self-harm (2.53/100 000, 6.2%) and congenital birth defects (1.76/100 000, 4.3%) in 2016, and tuberculosis, poisonings and rheumatic heart disease had dropped out of the top 15 in 2016.@*Conclusion@#The mortality of Chinese adolescents aged 10-19 years has decreased significantly, but still higher than developed countries. Since 1990, injuries,especially for road injuries and drowning, have always been the leading causes of death among Chinese adolescents aged 10-19 years, followed by non-communicable diseases.
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Objective@#To analyze the prevalence of physical fitness among Chinese Han students aged 13-18 years in 2014, and explore related influencing factors.@*Methods@#This study recruited 106 881 Han students aged 13-18 years who had taken physical fitness test from Chinese National Survey on Students' Constitution and Health in 2014. After the exclusion of 1 047 students without complete records of physical fitness test, 105 834 students were included in the final analysis. According to the National Student Physical Health Standard modified in 2014, seven indicators including body mass index, vital capacity, 50-m run, sit-and-reach, standing broad jump, pull-ups/curl-ups and endurance run were tested to calculate the total score of students' physical fitness. Students with score ≥60 were regarded as qualified students. Multivariate non-conditional logistic regression model was used to analyze influencing factors of physical fitness.@*Results@#Among Chinese Han students aged 13-18 years, the total score was 70.1±10.7 and the qualified rate was 83.9% (n=88 813). Boys (83.5% (44 197/52 910)) had a lower qualified rate of physical fitness than girls (84.3% (44 616/52 924)) (P<0.001), and 13-15 age group (86.5% (46 255/53 465)) was higher than the 16–18 age group (81.3% (42 558/52 369)) (P<0.001). Except for 16–18-year-old boys from central region, normal body mass index, eastern region, good socioeconomic status, enough PE class, exercise time ≥1 h/d, homework time ≥2 h/d, TV time <1 h/d were all related to high qualified rates of physical fitness (P<0.05).@*Conclusion@#Chinese Han students aged 13-18 years were in good physical condition. The qualified rates of physical fitness were significantly different by gender and age groups. Nutritional status, region, socioeconomic status, PE class, exercise time per day, homework time per day, and TV time per day were related factors of physical fitness.
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Objective: To analyze the epidemiological characteristics of notifiable infectious diseases among Chinese students from 2011 to 2016 and to provide reference for the effective prevention and control programs on infectious disease among students. Methods: Both morbidity and mortality of notifiable infectious diseases among Chinese students aged 6-22 years from 2011 to 2016 were analyzed, with main characteristics of the disease described. Results: During 2011 to 2016, morbidities of Categories A, B and C infectious diseases among the Chinese students aged 6-22 years showed a decreasing trend, from 248.24/100 000 in 2012 to 158.57/100 000 in 2016. Mortality rates of Category A, B and C infectious diseases had also decreased from 0.12/100 000 in 2011 to 0.07/100 000 in 2016. The average morbidity of the top four diseases from Category A and B infectious diseases appeared as: tuberculosis (16.24/100 000), scarlet fever (9.39/100 000), hepatitis B (7.69/100 000) and bacillary and amebic dysentery (7.15/100 000). The average rates of mortality on the top four diseases appeared as: rabies (0.044 8/100 000), HIV/AIDS (0.027 7/100 000), tuberculosis (0.008 0/100 000) and Japanese encephalitis (0.005 9/100 000). The average rates of morbidity on the top four diseases appeared as: mumps (75.81/100 000), hand-foot-mouth disease (28.55/100 000), other infectious diarrhea (22.41/100 000) and influenza (15.67/100 000) in the Category C. Reported death cases were from hand-foot-mouth disease (11 cases), influenza (9 cases), mumps (1 case) and rubella (1 case). The prevalence rates varied among different student populations, with higher HIV/AIDS, hepatitis B and tuberculosis rates among college and senior high school students, while higher mumps, influenza and hand-foot-mouth disease rates among primary school and junior high school students. Conclusions: Both morbidity and mortality of notifiable infectious diseases among Chinese students aged 6-22 years had decreased significantly in 2011-2016. However, the major infectious diseases had become new challenges among students. HIV/AIDS had become a key infectious disease among college students and the relatively high prevalence of tuberculosis was seen in college and high school students.
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Adolescente , Niño , Humanos , Adulto Joven , China/epidemiología , Enfermedades Transmisibles/epidemiología , Notificación de Enfermedades/estadística & datos numéricos , Vigilancia de la Población/métodos , Prevalencia , Estudiantes/estadística & datos numéricosRESUMEN
Objective: To understand and analyze the current situation and secular trends for prevalence of malnutrition among Chinese children and adolescents aged 7-18 years from 2005 to 2014, and to provide important scientific basis for students' nutrition improvement.Methods: All the subjects aged 7-18 years in both sexes were sampled from 2005, 2010 and 2014 Chinese National Surveys on Students Constitution and Health.According to the new students' health standard of Screening Standard for Malnutrition of school-age children and adolescents(WS/T456-2014) in 2014 of China, the nutritional status of children in 31 provinces (autonomous regions and municipalities, excluding Hong Kong, Macao and Taiwan province) were analyzed and compared in different ages, genders, regions and provinces from 2005 to 2014.The Tibetan students was used with the data of Tibetan minority and all the other students from 30 provinces (autonomous regions, municipalities) were Han minority.Results: The prevalence of malnutrition of children and adolescents of Han minority aged 7-18 years in 2014 was 10.0%.The prevalence of malnutrition components, including stunting, mild wasting and moderate severe wasting, were 0.8%, 3.7%, and 5.5%.Compared with 2005 and 2010, the prevalence of malnutrition of Han children and adolescents in 2014 had declined with 5.0 and 2.6 percentage points, respectively, and its components had declined with 1.0, 1.8, 2.2 and 0.4, 1.1, 1.2 percentage points, respectively.The prevalence of malnutrition of 2014 in boys was higher than in girls (11.1% vs.8.9%), the rural was higher than the urban (11.0% vs.9.1%) and the west (11.7%) was higher than the east (9.0%) and the middle (9.2%).Mild wasting of Chinese children and adolescents aged 7-18 years was the main component in malnutrition and the stunting in the Han and Tibetan children and adolescents only accounted for 8.0% and 7.5%, respectively.Compared with 2005 and 2010, the prevalence of malnutrition for Chinese children and adolescents aged 7-18 years in 2014 had declined with various extents constantly, and there was a statistically significant difference among three surveys (P<0.05).Provinces (autonomous regions, municipalities) with high prevalence of malnutrition mainly concentrated in the southwest of China from 2005 to 2014.Compared with 2005 and 2010, the prevalence of malnutrition declined in 31 provinces (autonomous regions, municipalities) of China in 2014.The number of provinces (autonomous regions, municipalities) with high prevalence of malnutrition decreased constantly and increased for the number of province (autonomous regions, municipalities) with low prevalence.Conclusion: The prevalence of malnutrition among Chinese children and adolescents aged 7-18 years had declined from 2005 to 2014, but the total prevalence of malnutrition was still high.Mild wasting was the main component in malnutrition and the prevalence of stunting was low.Provinces (autonomous regions, municipalities) with high prevalence of malnutrition mainly concentrated in the southwest of China.
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Objective: To analyze the prevalence of reduced visual acuity (VA) and to examine the association between reduced visual acuity and influencing factors among Chinese Han students, so as to provide bases for the prevention and treatment of reduced visual acuity.Methods: Subjects were from 2014 Chinese National Surveys on Students' Constitution and Health (CNSSCH).In this survey, 261 832 Han students aged 7-22 years participated.Unaided distance VA was measured using a retro-illuminated lgMAR chart with tumbling-E optotypes.Ametropia was determined by using serial bronchoscopy.Logistic regression was used to assess the association between reduced visual acuity and influencing factors.ArcMap 10 was used to map the regional distribution of reduced visual acuity.Results: Nationwide, the overall prevalence of reduced visual acuity was 66.6%, and was highest among the urban girls (73.5%).The prevalence of myopia was 60.8% and accounted for more than 90% among the students with reduced visual acuity.Compared with 2010 CNSSCH, the increments of reduced visual acuity were highest in the students aged 13-15 years (6.8 percentage points).The prevalence of reduced visual acuity ranged from 50.6% to 76.2% in each province (autonomous region, municipality) in 2014 CNSSCH.The top three of the prevalence of reduced visual acuity were Jiangsu (76.2%), Zhejiang (76.0%) and Shandong (75.9%), and the lowest three were Hainan (50.6%), Guizhou (53.9%) and Xinjiang (57.6%).Logistic regression showed that the girls, urban students, and students who spent ≥2 h per day in their after school homework were more likely to develop reduced visual acuity, but the students with physical activity time ≥2 h per day were less likely to develop reduced visual acuity.Conclusion: Although the situation was different in each province (autonomous region, municipality), reduced visual acuity has become a public concern affecting the health of students in China.Based on the intervention on the key populations, such as urban girls and pre adolescent students, we should also continue to strengthen the prevention and control for reduced visual acuity among all students.
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Objective To explore the prevalence of physical activity time ＜1 hour and related factors in students aged 9-22 years in China.Methods A total of 220 159 students (110 039 boys and 110 120 girls) aged 9-22 years who completed the questionnaire of physical activity and lifestyle behaviors were selected from "2014 National Physical Fitness and Health Surveillance" for the current study.All the participants were divided into 2 groups,i.e.physical activity time ＜ 1 hour and physical activity time ≥ 1 hour according the suggestion of Central Government,stratified by age and gender.x2 tests were used to compare the difference in the prevalence of physical activity time ＜ 1 hour between boys and girls in every age groups.Univariate and multivariate log-binomial regression models were used to explore the factors that influenced the prevalence of physical activity time ＜ 1 hour.Results The boy's prevalence of physical activity time ＜1 hour was 73.3％,with the lowest (57.0％) in 9-years-old group,and highest (82.5％) in 18 years old group.The girl's prevalence of physical activity time ＜ 1 hour was 79.1％,with the lowest (60.1％) in 9-years-old group,and highest (89.8％) in 21 years old group.Overall,The prevalence of physical activity time ＜ 1 hour was significantly higher in girls than in boys (P＜0.001),and the prevalence were significantly higher in girls than in boys in all the age groups (P＜0.001),and it was observed that the prevalence of physical activity ＜ 1 hour increased with age in both boys and girls (P＜0.001).Multivariate log-binomial regression model found that being girl (PR=1.05,95％CI:1.05-1.06),parents' disliking children to participate physical activity (PR=1.08,95％CI:1.07-1.09),heavy homework (PR=1.13,95％CI:1.12-1.14),long homework time (PR=1.08,95％CI:1.07-1.08),long time spending on electronic screen watching (PR=1.01,95％CI:1.00-1.01) and disliking physical class (PR=1.11,95％CI:1.10-1.12) could be the risk factors for physical activity time ＜ 1 hour,however,living in rural area (PR=0.99,95％CI:0.98-0.99) and no supporting from parents for children to participate physical activity (PR=0.99,95％CI:1.98-1.00) could be the protective factors,but no consistent association with the time of TV watching was observed (P=0.226).Conclusions The prevalence of physical activity time ＜ 1 hour was high in students aged 9-22 years in China.Female,parents;disliking children to participate physical activity,heavy homework,long homework time,long electronic screen watching time and disliking physical class might be the risk factors.
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Objective To understand and evaluate the prevalence of myopia and its trend in children and adolescents aged 7-18 years in Han ethnic group in China from 2005 to 2014,and provide evidence for the prevention of myopia.Methods The data of 2005,2010 and 2014 Chinese National Students Constitution and Health Surveys were collected.The children and adolescents with complete detection data of binoculus were selected as study subjects.The sample size of three studies were 233 108,215 319 and 212 743,respectively.The method of curve fitting was used to simulate the myopia detection increase model and analyze the gender and area specific myopia detection increase trends and characteristics from 2005 to 2014.Results The overall myopia detection rate increased gradually in the children and adolescents aged 7 to 18,which was 47.5％ in 2005,55.5％ in 2010 and 57.1％ in 2014,respectively.The increase slowed in 2014.A "parabola" shape of myopia detection increase rate was observed.Myopia detection rate increased with age before puberty and decreased with age after puberty gradually.A "cross phenomenon" of myopia detection increase was observed in boys and girls between urban and rural areas.The increase of myopia detection was mainly in urban students before puberty and in rural students after puberty.The age of myopia prevalence peak has become earlier constantly in children and adolescents aged 7-18 years from 2005 to 2014,which was 13 years old in 2005,12 years old in 2010 and 11 years old in 2014.The increase rate was about 7％.During 2005-2014,the increase rate of myopia detection gradually increased in younger students and tended to zero in older students.Conclusion The detection rate of myopia was still high in children and adolescents in China.The age of myopia prevalence peak has become earlier gradually.
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Objective To understand the physical endurance level of primary and middle school students in China in 2014,and identify the factors influencing students' physical endurance.Methods Data were collected from "National School Student Physical Fitness and Health Surveillance in 2014",a total of 142 708 primary and middle school students with complete information were included in the analysis.The age,gender and area specific failure rates of endurance running of students were analyzed,the differences were analyzed with x2 test,and the factors influencing students' physical endurance were identified with log-binomial regression model.Results Among the 142 708 students,the failure rate of endurance running was 21.6％ (30 867/142 708).The failure rate was 23.7％ (16 891/71 388) in boys and 19.6％ (13 976/71 320) in girls (x2=347.73,P＜0.05).And it was 24.8％ in students in urban area (17 713/71 378),higher than that in students in rural area (18.4％,13 154/71 330) (x2=855.29,P＜0.05).The failure rate of endurance running showed an upward trend with age.Insufficient physical education class hour (OR=1.13,95％CI:1.11-1.15),not taking breakfast daily (OR=1.22,95％ CI:1.20-1.25),daily physical exercise time ＜ 1 hour (OR=1.44,95％CI:1.40-1.48),the screen watching time ＞2 hours (OR=1.16,95％CI:1.14-1.19) and overweight or obesity (OR=1.90,95％ CI:1.86-1.95) might be the risk factors for the failure of physical endurance.Conclusion The physical endurance of primary and secondary students in China was not optimistic,and the factors influencing their physical endurance included gender,living area,physical education class time,daily homework time,breakfast,daily exercise time and nutrition status.
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Objective To understand and evaluate the characteristics of geographic distribution of high blood pressure prevalence in children and adolescents aged 7-18 years in China in 2014,and provide evidence for the prevention of hypertension in children and adolescents.Methods The data of 2014 Chinese National Surveys on Students Constitution and Health conducting 31 provinces (except Hong Kong,Macao and Taiwan) were collected.A total of 216 299 children and adolescents who had complete blood pressure records were selected as study subjects.The low,middle and high prevalence areas were identified according to their high blood pressure detection rates in the children and adolescents,＜4％,4％-7％ and ＞7％,to analyze the geographic distribution of high blood pressure prevalence in the children and adolescents.The environmental data in the capitals of 31 provinces in 2014 were collected to analyze the correlation between environmental factors and blood pressure Z score in the children and adolescents.Results The average detection rates of high blood pressure was 6.4％ in 31 provinces (1.5％-14.2％).The high prevalence areas were mainly distributed in the eastern China,especially the Circum-Bohai sea area,low prevalence areas were mainly distributed in the central and western areas of China and some provinces in the east.Correlation analysis results showed that the annual average temperature,annual average air humidity and local altitude were negatively correlated with blood pressure Z score,including diastolic and systolic blood pressure,in both boys and girls.The annual average sunshine time,PM2.5 and PM10 concentrations,content of SO2 were positively correlated with blood pressure Z score in both boys and girls.Conclusions There was a significant difference in high blood pressure of children and adolescents among 31 provinces.More attention should be paid to the children and adolescents living high prevalence area.And it is necessary to understand environmental factors which can affect the blood pressure of children and adolescents.
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Objective To explore the association between cesarean section and obesity in child and adolescent.Methods In this study,a total number of 42 758 primary and middle school students aged between 6 and 17 were selected,using the stratified cluster sampling method in 93 primary and middle schools in Hunan,Ningxia,Tianjin,Chongqing,Liaoning,Shanghai and Guangdong provinces and autonomous regions.Log-Binomial regression model was used to analyze the association between cesarean section and obesity in childhood or adolescent.Results Mean age of the subjects was (10.5±3.2) years.The overall rate of cesarean section among subjects attending primary or secondary schools was 42.3％,with 55.9％ in boys and,40.6％ in girls respectively and with difference statistically significant (P＜0.001).The rate on obesity among those that received cesarean section (17.6％) was significantly higher than those who experienced vaginal delivery (10.2％) (P＜0.001).Results from the log-binomial regression model showed that cesarean section significantly increased the risk of obesity in child and adolescent (OR=1.72,95％CI:1.63-1.82;P＜0.001).After adjusting for factors as sex,residential areas (urban or rural),feeding patterns,frequencies of milk-feeding,eating high-energy foods,eating fried foods and the levels of parental education,family income,parental obesity,physical activity levels,gestational age and birth weight etc.,the differences were still statistically significant (OR=1.48,95％ CI:1.39-1.57;P＜0.001).Conclusion The rate of cesarean section among pregnant women in China appeared high which may significantly increase the risk of obesity in child or adolescent.
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Objective To explore the prevalence of physical activity time ＜1 hour and related factors in students aged 9-22 years in China.Methods A total of 220 159 students (110 039 boys and 110 120 girls) aged 9-22 years who completed the questionnaire of physical activity and lifestyle behaviors were selected from "2014 National Physical Fitness and Health Surveillance" for the current study.All the participants were divided into 2 groups,i.e.physical activity time ＜ 1 hour and physical activity time ≥ 1 hour according the suggestion of Central Government,stratified by age and gender.x2 tests were used to compare the difference in the prevalence of physical activity time ＜ 1 hour between boys and girls in every age groups.Univariate and multivariate log-binomial regression models were used to explore the factors that influenced the prevalence of physical activity time ＜ 1 hour.Results The boy's prevalence of physical activity time ＜1 hour was 73.3％,with the lowest (57.0％) in 9-years-old group,and highest (82.5％) in 18 years old group.The girl's prevalence of physical activity time ＜ 1 hour was 79.1％,with the lowest (60.1％) in 9-years-old group,and highest (89.8％) in 21 years old group.Overall,The prevalence of physical activity time ＜ 1 hour was significantly higher in girls than in boys (P＜0.001),and the prevalence were significantly higher in girls than in boys in all the age groups (P＜0.001),and it was observed that the prevalence of physical activity ＜ 1 hour increased with age in both boys and girls (P＜0.001).Multivariate log-binomial regression model found that being girl (PR=1.05,95％CI:1.05-1.06),parents' disliking children to participate physical activity (PR=1.08,95％CI:1.07-1.09),heavy homework (PR=1.13,95％CI:1.12-1.14),long homework time (PR=1.08,95％CI:1.07-1.08),long time spending on electronic screen watching (PR=1.01,95％CI:1.00-1.01) and disliking physical class (PR=1.11,95％CI:1.10-1.12) could be the risk factors for physical activity time ＜ 1 hour,however,living in rural area (PR=0.99,95％CI:0.98-0.99) and no supporting from parents for children to participate physical activity (PR=0.99,95％CI:1.98-1.00) could be the protective factors,but no consistent association with the time of TV watching was observed (P=0.226).Conclusions The prevalence of physical activity time ＜ 1 hour was high in students aged 9-22 years in China.Female,parents;disliking children to participate physical activity,heavy homework,long homework time,long electronic screen watching time and disliking physical class might be the risk factors.
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Objective To understand and evaluate the prevalence of myopia and its trend in children and adolescents aged 7-18 years in Han ethnic group in China from 2005 to 2014,and provide evidence for the prevention of myopia.Methods The data of 2005,2010 and 2014 Chinese National Students Constitution and Health Surveys were collected.The children and adolescents with complete detection data of binoculus were selected as study subjects.The sample size of three studies were 233 108,215 319 and 212 743,respectively.The method of curve fitting was used to simulate the myopia detection increase model and analyze the gender and area specific myopia detection increase trends and characteristics from 2005 to 2014.Results The overall myopia detection rate increased gradually in the children and adolescents aged 7 to 18,which was 47.5％ in 2005,55.5％ in 2010 and 57.1％ in 2014,respectively.The increase slowed in 2014.A "parabola" shape of myopia detection increase rate was observed.Myopia detection rate increased with age before puberty and decreased with age after puberty gradually.A "cross phenomenon" of myopia detection increase was observed in boys and girls between urban and rural areas.The increase of myopia detection was mainly in urban students before puberty and in rural students after puberty.The age of myopia prevalence peak has become earlier constantly in children and adolescents aged 7-18 years from 2005 to 2014,which was 13 years old in 2005,12 years old in 2010 and 11 years old in 2014.The increase rate was about 7％.During 2005-2014,the increase rate of myopia detection gradually increased in younger students and tended to zero in older students.Conclusion The detection rate of myopia was still high in children and adolescents in China.The age of myopia prevalence peak has become earlier gradually.