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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 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 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 describe the situation of insufficient sleep and the association between insufficient sleep and physical exercise,among Chinese Han students aged 9-18 years.Methods We selected 172 197 Chinese Han students aged 9-18 years from the project 2014 Chinese National Survey on Students Constitution and Health.The average sleep duration per day of less than 9 h for children aged 9-12 years and of less than 8 h for adolescents aged 13-18 years,were defined as insufficient sleep.We described the distribution of sleep duration and the prevalence rates of insufficient sleep for each subgroup.Logistic regression models were established to assess the association between insufficient sleep and physical exercise.Results In 2014,6.6％,30.8％,26.3％,20.8％,13.8％ and 1.8％ of the Chinese Han students self-reported sleep duration were ＜6,6-,7-,8-and ≥ 10 h,respectively.The overall prevalence rate of insufficient sleep was 77.2％,with 75.8％ for boys and 78.6％ for girls.No gender disparity was found at each 9-11 age groups.However,in the 12-18 age groups,the prevalence rates for girls were significantly higher than that for boys.The prevalence rates of insufficient sleep for primary school,middle school and high school students were 66.6％,74.1％ and 93.8％,respectively.Rates were increasing with age for children aged 9-12 years and adolescents aged 13-18 years respectively.The three provinces with the lowest prevalence rates of insufficient sleep were Zhejiang (68.8％),Jiangsu (66.7％) and Shaanxi (65.2％).Data from the logistic regression models revealed that,when comparing to those students with only exercise of ＜0.5 h per day,the exercise hours of 0.5-1 h (OR=0.72,95％ CI:0.69-0.74) or ≥1 h (OR=0.46,95％ CI:0.44-0.47) per day seemed as protective factors for insufficient sleep.When compared with physicalexercise frequency ＜2 times per week,the 2 times (OR=0.82,95％CI:0.78-0.86) or ＞2 times (OR=0.65,95％CI:0.62-0.68) frequencies also appeared as protective.Conclusions The prevalence rate of insufficient sleep prevailing among students aged 9-18 years was high,in China.Our data called for setting up effective measures to deal with this situation.
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Objective To describe the situation of insufficient sleep and the association between insufficient sleep and physical exercise,among Chinese Han students aged 9-18 years.Methods We selected 172 197 Chinese Han students aged 9-18 years from the project 2014 Chinese National Survey on Students Constitution and Health.The average sleep duration per day of less than 9 h for children aged 9-12 years and of less than 8 h for adolescents aged 13-18 years,were defined as insufficient sleep.We described the distribution of sleep duration and the prevalence rates of insufficient sleep for each subgroup.Logistic regression models were established to assess the association between insufficient sleep and physical exercise.Results In 2014,6.6％,30.8％,26.3％,20.8％,13.8％ and 1.8％ of the Chinese Han students self-reported sleep duration were ＜6,6-,7-,8-and ≥ 10 h,respectively.The overall prevalence rate of insufficient sleep was 77.2％,with 75.8％ for boys and 78.6％ for girls.No gender disparity was found at each 9-11 age groups.However,in the 12-18 age groups,the prevalence rates for girls were significantly higher than that for boys.The prevalence rates of insufficient sleep for primary school,middle school and high school students were 66.6％,74.1％ and 93.8％,respectively.Rates were increasing with age for children aged 9-12 years and adolescents aged 13-18 years respectively.The three provinces with the lowest prevalence rates of insufficient sleep were Zhejiang (68.8％),Jiangsu (66.7％) and Shaanxi (65.2％).Data from the logistic regression models revealed that,when comparing to those students with only exercise of ＜0.5 h per day,the exercise hours of 0.5-1 h (OR=0.72,95％ CI:0.69-0.74) or ≥1 h (OR=0.46,95％ CI:0.44-0.47) per day seemed as protective factors for insufficient sleep.When compared with physicalexercise frequency ＜2 times per week,the 2 times (OR=0.82,95％CI:0.78-0.86) or ＞2 times (OR=0.65,95％CI:0.62-0.68) frequencies also appeared as protective.Conclusions The prevalence rate of insufficient sleep prevailing among students aged 9-18 years was high,in China.Our data called for setting up effective measures to deal with this situation.
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Objective@#To discuss the main causes and risk factors of disability and death among current Chinese adolescents.@*Methods@#Subnational data of China from Global Burden of Disease Study 2015 (GBD 2015) was used to rank the causes and risk factors leading to death and disability adjusted life years (DALY) in Chinese adolescents aged between 10 and 19 years old, and thereby to analyze the main cauese and risk factors of death and DALY among Chinese adolescents in different genders.@*Results@#In 2015, among Chinese adolescents aged 10-19 years old, the total DALY was 13 million 490 thousand years, and the total number of deaths was 63 258 cases. The top 3 causes of DALY were skin and subcutaneous diseases, iron-deficiency anemia and road injuries, resulting in DALY (constituent ratio) of 1 411 (10.5%), 1 094 (8.1%) and 1 029 (7.6%) thousand years respectively. The top 3 causes of death were road injuries, drowning and leukemia, causing 13 881 (21.9%), 9 895 (15.6%) and 4 620 (7.3%) deaths (constituent ratio) respectively. The top 3 risk factors of DALY were iron deficiency, alcohol use and drug use, causing 1 094 (8.1%), 487 (3.6%) and 220 thousand years (1.6%) DALY (constituent ratio) respectively. The top 3 risk factors of death were alcohol use, occupational injuries and drug use, causing 5 957 (9.4%), 1 523 (2.4%) and 810 (1.3%) deaths respectively.@*Conclusion@#Unintentional injury was the top cause of DALY and death in Chinese adolescents, followed by skin and subcutaneous diseases and iron-deficiency anemia. Iron deficiency and alcohol use were the top two risk factors of DALY and death.
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Objective@#To investigate the characteristics of geographic distribution and change trend of myopia prevalence for children and adolescents aged 7-18 years old from 2005 to 2014, which provides the basis for the prevention of myopia.@*Methods@#Research material was selected from the data of 2005, 2010, and 2014 Chinese National Survey on Students Constitution and Health, including 31 provinces (with the exception of Hong Kong, Macao, and Taiwan). The complete detection data of binoculus in children and adolescents aged 7-18 years old were selected as our research objects. The research objects of three studies were 233 505, 216 474, and 215 160, respectively. We analyzed the characteristics of geographic distribution and change trend of myopia prevalence for children and adolescents aged 7-18 years old in 31 provinces from 2005 to 2014.@*Results@#The overall myopia detection rates in Chinese children and adolescents aged 7 to 18 years old in 31 provinces were 47.4% (111 707/235 505), 55.6% (120 456/216 474), and 57.2% (122 965/215 160) in 2005, 2010 and 2014, respectively. The growth range in this two phases were 8.0 percentage points, and 1.6 percentage points, respectively, and the difference was statistically significant (P<0.05). The detection rate of Myopia was growing quickly from 2005 to 2010 and only three provinces were in the situation of decline state including Tianjin, Hainan, and Ningxia. 90.3 percent (28/31) of provinces were in the situation of growth state and the growth range was 1.3%-22.3%. The growth of myopia was in the situation of slowdown from 2010 to 2014, and 38.7 percent (12/31) of the provinces were in negative growth districts including Hebei, Shanxi, Inner Mongolia, Zhejiang, Fujian, Shandong, Hubei, Guangxi, Guizhou, Tibet, Qianghai, and Xinjiang. The growth range in other provinces was 0.4%-24.7%.@*Conclusion@#The myopia detection rate was at a higher level and growing constantly in China. There was large difference for myopia of children and adolescents among the 31 provinces. However, the overall growth rate of myopia in children and adolescents was in the situation of a relatively low level form 2010 to 2014.
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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 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 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 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.