Prevalence and associated factors of unhealthy lifestyles among urbanchildren aged 7 to 12 years in Qingdao

Abstract

Objective To investigate the prevalence of unhealthy lifestyles among urban children aged 7 - 12 years in Qingdao, and to identify associated demographic factors, so as to provide evidence for early intervention. Methods From September to November 2023, a cluster random sampling survey was conducted in five primary schools in urban Qingdao. Demographic characteristics and lifestyle-related behaviors were collected using questionnaires. Four unhealthy lifestyle domains were defined based on published evidence and guidelines: excessive screen exposure, insufficient physical activity, insufficient sleep, and unhealthy diet. Differences across demographic subgroups were compared, and logistic regression analysis was performed to explore associated factors. Results A total of 2 232 valid questionnaires were included. Overall, 57.2% of children had two or more unhealthy lifestyle behaviors. Logistic regression analyses showed that older age was associated with excessive screen exposure (OR=1.194, 95%CI: 1.027 - 1.389). Low family income (OR=1.578,95%CI: 1.007 - 2.475) and fathers with a college education (OR=1.315, 95%CI: 1.012 - 1.710) were associated with insufficient physical activity, whereas being an only child was associated with lower odds of insufficient physical activity (OR=0.161, 95%CI: 0.132 - 0.196). Older age (OR=1.090, 95%CI:1.022 - 1.163) and mothers with a college education (OR=1.568, 95%CI: 1.174 - 2.094) were associated with insufficient sleep. Older age (OR=1.081, 95%CI: 1.014 - 1.153) and low family income (OR=1.906, 95%CI: 1.144 - 3.173) were associated with unhealthy diet, while girls had lower odds of an unhealthy diet (OR=0.716, 95%CI: 0.586 - 0.876). Older age (OR=1.171, 95%CI: 1.072 - 1.279) and low family income (OR=2.622, 95%CI:1.321 - 5.206) were also associated with the coexistence of multiple unhealthy lifestyle behaviors, whereas girls (OR=0.678, 95%CI: 0.513 - 0.898) and only children (OR=0.295, 95%CI: 0.213 - 0.409) had lower risks of such coexisting behaviors. Conclusions Unhealthy lifestyles are prevalent among urban children aged 7 - 12 years in Qingdao, and are associated with age, sex, only-child status, and family socioeconomic factors. Comprehensive interventions targeting high-risk populations should be implemented, with a core focus on reducing sedentary screen time, promoting regular physical activity and adequate sleep, and improving dietary patterns.

Keywords

lifestyle / screen exposure / physical activity / diet / sleep / social environment