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Introduction: The aim of this cross-sectional study was to investigate the association between breakfast patterns and executive function among adolescents in Shanghai, China. Methods: In 2022, we randomly recruited 3,012 adolescents aged 12-13 years from all administrative districts in Shanghai. Breakfast information was collected by parents using a one-day recall method. Executive function was measured using the Behavior Rating Inventory of Executive Function-Parent Version. Latent Class Analysis was performed to identify breakfast patterns based on the food groups in the Diet Quality Questionnaire for China. Results: Breakfast patterns were classified into three categories: "Egg and milk foods", "Grain foods", and "Abundant foods", except for adolescents who skipped breakfast. Logistic regression was used to estimate the multivariate odds ratio (ORs) and 95% confidence intervals (95% CI) for the association between breakfast patterns and potential executive dysfunction. Adolescents in the "Abundant foods" class had a lower risk of executive dysfunction in terms of initiate (OR: 0.36; 95% CI: 0.17-0.76), and organization of materials (OR: 0.18; 95% CI: 0.04-0.94), compared to those who skipped breakfast. Similarly, the breakfast patterns of "Grain foods" and "Egg and milk foods" were associated with a lower risk of executive dysfunction, including initiate and working memory. Discussion: Our findings suggest that breakfast patterns were associated with executive function. The improvement of breakfast patterns among adolescents should be a significant public health intervention.
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Objective@#To understand the prevalence and trend of diet related behaviors among secondary school students in Shanghai, and to provide a scientific basis for developing appropriate health education strategies.@*Methods@#Anonymous questionnaire surveys were conducted among 71 291 students selected by multi stage stratified cluster sampling method from junior high schools,senior high schools and vocational schools in Shanghai in the year of 2008,2012,2015,2017,2019. The questionnaire adopted was "Shanghai adolescent health related behavior questionnaire". Test for trend test were applied for the analysis of the prevalence of their dietary behaviors.@*Results@#The proportion of middle school students nutritional status within the normal range in each survey year were 73.40 %, 72.60%, 68.06%, 68.73%, 67.53%, respectively, while the rate of overweight and obesity increased from 13.17% in 2008 to 23.73% in 2019. The proportion of "eating fried food" decreased significantly by year, from 12.05 % to 4.23% (male, APC=-7.94%, t =-4.33, female, APC= -9.29%, t=-7.71, P <0.05) respectively. And the proportion of "eating dessert" also decreased significantly by year, from 31.66% to 11.14% (male, APC=-8.41%, t =-6.37, female, APC=-8.67%, t=-6.96, P <0.05). In the five surveys, the percentages of healthy diet related behaviors of secondary school students were 12.81%-21.82%, no significant upward trend was observed in the whole( P >0.05). The proportion of diet-related behaviors of nutrition unbalance and easily leading to obesity decreased significantly from 35.47% to 17.00%(APC=-6.71%, t= -5.00 , P <0.05). The proportion of diet related behavior of nutrition unbalance and not easily leading to obesity increased significantly from 39.15% to 60.16%(APC=3.46%, t=6.18, P <0.05).@*Conclusion@#Overweight and obesity among secondary school students in Shanghai are increasing during the past decade, and the proportion of healthy dietary behaviors is low. The knowledge of rational diet should be publicized among these students in order to develop healthy dietary behaviors.
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Objective@#To evaluate adolescents’ self-esteem and explore its influencing factors in order to provide basic evidence for improving self-esteem level and mental health of adolescents.@*Methods@#A total of 5 709 adolescents of different characteristics from both urban and rural areas in six provinces were investigated anonymously with the method of computer-assisted self-interview (CASI). Self-esteem was evaluated by Self-Esteem Scale (SES, scored 10-40 points).@*Results@#The average score of self-esteem was 28.15,28.40, 28.97 and 27.45 point for junior high students, senior high students, college students and out-of-school adolescents, respectively. The difference of the scores among the four groups was statistically significant(F=27.64, 14.41, P<0.01). More than 80% adolescents felt they were people of worth, were able to do things as most other people, took a positive attitude toward themselves and were satisfied with themselves. About 50% of adolescents thought they were no good at all at times. Less than 20% adolescents thought they had enough respect for themselves. About 11.57% to 22.22% of adolescents felt sad about their own gender, about 37.56% to 61.49% of adolescents often or sometimes felt sad about their body image. The multiple linear regression analysis showed that those who had a good overall feeling of family, satisfied with their own gender, and less worried about their body image tended to have a higher self-esteem scores among 4 groups(P<0.01). Other related influencing factors included parental education level, family economic status, only-child or not, birth place and parental preference for gender of their child.@*Conclusion@#Adolescents’ self-esteem was fair, and many factors were associated with it. It is necessary to strengthen the education on gender equality among parents and adolescents and to pay more attention to mental health of the adolescents, who were in rural areas, with poor family atmosphere and economic status.