A cluster randomized trial of a comprehensive intervention nesting family and clinic into school centered implementation to reduce myopia and obesity among children and adolescents in Beijing, China: study protocol.

BACKGROUND: Myopia and obesity in children and adolescents have become serious public health problems that endanger public health, especially in China. Unhealthy lifestyle behaviors are environmental drivers of both myopia and obesity. This protocol describes a study to evaluate the effectiveness of "22510SS", that is 2 h of daytime outdoor activities ('2'); Limit screen time to no more than 2 h per day ('2'); Consume at least 5 servings of fruits and vegetables daily ('5'); Attain 1 h of physical activity daily ('1'); Consume 0 sugar-sweetened beverages ('0'); Reasonable sleep duration ('S'); Regular supervision ('S'). A school-based, multifaceted intervention strategy for myopia and obesity prevention, and to assess and explore the implementation of "22510SS" with regards to acceptability, feasibility, adoption, usage and maintenance. METHODS AND ANALYSIS: This study aims to develop a comprehensive intervention strategy "22510SS" based on the socio-ecological model, and A two-arm cluster randomized trial with a parallel-group of a 1:1 allocation ratio in 36 primary and secondary schools to test its evidence-based intervention programs on the effects and implementation of myopia and obesity epidemics in children and adolescents in grades 4 and 7. The primary outcomes will include differences in visual acuity, body mass index, outdoor activity indicators, screen time, fruit and vegetable intake, high-quality protein intake, sugar-sweetened beverage intake, sleep duration, and level of monitoring among children and adolescents. Secondary outcomes will assess the acceptability, feasibility, uptake, use, and maintenance of the intervention. Effects on the primary and secondary outcomes will be analyzed using linear and logistic regression analyses, as well as difference-in-difference analysis, taking into account cluster effects and possible confounding factors. Process assessments will also be conducted through quantitative and qualitative analyses, including acceptability, feasibility, gender, adoption, implementation, and sustainability. DISCUSSION: This study will evaluate the effectiveness of "22510SS" and examine its implementation in the school-based network nesting family and clinic. Following this intervention study, the integrated intervention program focused on myopia and obesity among children and adolescents have great potential to be implemented in China to promote and support healthy lifestyle behavior change and reduce the risk of myopia and obesity in children and adolescents. TRIAL REGISTRATION: NCT05275959. Registered 23 Mach 2022.

[Value of body fat mass measured by bioelectrical impedance analysis in predicting abnormal blood pressure and abnormal glucose metabolism in children].

OBJECTIVE: To study the value of body fat mass measured by bioelectrical impedance analysis (BIA) in predicting abnormal blood pressure and abnormal glucose metabolism in children. METHODS: Stratified cluster sampling was used to select the students aged 6-16 years, and a questionnaire survey and physical examination were performed. The BIA apparatus was used to measure body fat mass. Body mass index (BMI), body fat mass index (FMI), and fat mass percentage (FMP) were calculated. Fasting blood glucose level were measured. RESULTS: A total of 14 293 children were enrolled, among whom boys accounted for 49.89%. In boys and girls, the percentile values (P60, P65, P70, P75, P80, P85, P90, P95) of FMI and FMP fitted by the LMS method were taken as the cut-off values. Based on the receiver operating characteristic curve analysis, the P70 values with a better value in predicting abnormal blood pressure and blood glucose metabolism were selected as the cut-off values for excessive body fat. When FMI or FMP was controlled below P70, the incidence of abnormal blood pressure or abnormal glucose metabolism may be decreased in 8.25%-43.24% of the children. CONCLUSIONS: The evaluation of obesity based on FMI and FMP has a certain value in screening for hypertension and hyperglycemia in children, which can be further verified in the future prevention and treatment of obesity and related chronic diseases in children.

A 9 year follow up study on vital capacity of 3 197 students in Tongzhou district / 中国学校卫生

Objective@#To understand the dynamic change rule and trend of the vital capacity of students in Tongzhou district, and to provide data support for the development of targeted physical exercise intervention mode.@*Methods@#According to the routine physical examination data of students in Tongzhou District in the academic year 2011-2019, the physical examination data of 3 197 students with complete physical examination information were selected according to the proportion of students in urban areas and towns and gender differences. SPSS 17.0 was used for statistical analysis of the screening data.@*Results@#The mean vital capacity of 3 197 students increased with the increase of grades. Except for grade 2 to grade 5 of primary school and grade 2 to grade 3 of junior high school, the mean vital capacity of urban students was higher than that of rural students ( P <0.05). The mean vital capacity of male students was higher than that of female students in all grades ( P <0.05). The vital capacity of male students and female students increased rapidly twice in grade 5 of primary school and grade 3 of junior high school( P <0.05), the growth rate of male students in two stages was larger than that of female students, the increase rates were 277.21 and 400.20 mL. The mean vital capacity was shown in this way:obese>overweight>normal weight>malnutrition ( P <0.05). The excellent rate of vital capacity evaluation in girls was higher than that in boys from grade 3 of primary school to grade 2 of junior middle school ( P <0.05). Except for grade 1 and 2 of primary school, the excellent rate of vital capacity evaluation in other grades was found as follows:obese>overweight>normal weight>malnutrition. The failure rate of boys was higher than that of girls ( P <0.05), except grade 3 of primary school. The failure rate from grade 5 to grade 3 showed the trend:malnutrition>normal weight>overweight>obesity ( P <0.05). In different groups, the failure rate of grade 1 of primary school and grade 1 of junior high school were the two peaks, which basically showed a decreasing trend followed by decreasing one.@*Conclusion@#The level of vital capacity of students in Tongzhou District is relatively low, so the school, family and society should focus on students vital capacity level. It should be one of the key tasks to enhance the physical quality of the students to increase the vital capacity of the boys and the students with abnormal weight.