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Background: Vitamin D is vital in children mainly because of its profound effect on growth, development, immune system and importantly bone health. Recent evidence suggests maintaining 25 (OH) D levels above 20 ng/ml for maximizing health benefits. Objectives were to assess the vitamin D status in children in the age group of 5-15 years attending a tertiary care teaching institute of North India and to analyze the factors which can contribute to vitamin D deficiency in these children. Methods: It was a cross-sectional study. 5-15 years old children attending the outpatient department were included in the study. Children with co morbid conditions that affect vitamin D metabolism and those children on chronic drug treatment and on vitamin D supplementation were excluded from the study. Results: Average age of study population was 8.93±2.02. In the study 170 (18.47%) children among a total of 920 had a normal vitamin D status while the rest 750 children (81.52%) had insufficient vitamin D status (25 hydroxy vitamin D <30 ng/ml). Among these children 190 (26.38%) had suboptimal vitamin D levels, 300 (40%) were deficient, 143 (19.06%) had severe and 117 (15.6%) had very severe deficiency of vitamin D. The average vitamin D level among the study population was 12.33±11.13 ng/ml. There was significant statistical association between vitamin D deficiency and stunting (p=0.003). No statistically significant association was found between outdoor activity. Conclusions: Vitamin D insufficiency was documented in 81.52% of 5-15 years old children and there was a significant association between stunting and vitamin D deficiency.
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Objective:To evaluate the long-term impact of three different outdoor activity intervention strategies on the prevalence of myopia among school-aged children in China.Methods:Cross-sectional data from the Refractive Error Study in Children (RESC) on the baseline prevalence of myopia and 10-year longitudinal data from the Guangzhou Twin Eye Study (GTES) on the baseline incidence of myopia were utilized.The effect size of outdoor activity intervention was derived from longitudinal data of the Guangzhou Outdoor Activity Longitudinal Study (GOALS). Three intervention strategies were proposed: intervention for children in grades 1 to 6 (Strategy A), intervention for children in grades 1 to 3 (Strategy B), and intervention for children from the last year of kindergarten to grade 3 (Strategy C). Outdoor activity interventions across all strategies included an extra 40 minutes of daily outdoor activity time.Simulated analyses assumed that the prevalence of myopia would decrease with declining incidence and increasing school grade, and the degree of myopia among highly myopic children would decrease with delayed myopia onset.This study was approved by the Ethics Committee of Zhongshan Ophthalmic Center (No.2006-5).Results:With prolonged intervention time, the overall prevalence of myopia in children showed a significant declining trend.After 5 years of implementation, Strategy A resulted in a decrease in myopia prevalence from 34.67% to 25.71%, which decreased to 24.89% after 10 years, with an average annual reduction of 0.98%.Strategies B and C had similar long-term effects, with myopia prevalence after 10 years being 26.00% and 26.20% respectively, with an average annual reductions of 0.87% and 0.85%.Strategy A yielded the greatest reduction in myopia severity, with a decrease of -5.94 D after 5 years and -5.88 D after 10 years in the initial 15-year-old highly myopic individuals.Strategy B followed with -6.08 D and -6.02 D after 5 and 10 years, respectively.Conclusions:Implementing intensified outdoor activity intervention among children in grades 1 to 6 may be the recommended strategy to reduce the overall prevalence of myopia in regions with high rates of myopia among school-aged children.
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Objective:To evaluate the accuracy and stability of Eye-Monitor, a smart wearable device, in quantifying environmental risks related to myopia.Methods:A diagnostic test study was conducted.Forty-two subjects aged 18-25 years old were recruited from Shandong University of Traditional Chinese Medicine in December 2021.Forty-two Eye-Monitors were selected from 80 devices using the simple random sampling method.Static and dynamic tests were carried out to compare environmental risks related to myopia.The static tests included measurements under different working distances, different head tilt angles when sitting, and different light intensities.The dynamic tests included measurements under different near-work time, different outdoor activity time, different time watching computers, and different phone viewing time.Eye-Monitor with the largest sum of absolute values of total relative error was selected, Spearman rank correlation analysis was used to analyze the correlation between the set values and Eye-Monitor measurements, and the accuracy of the objectively measured values was evaluated by Bland-Altman consistency analysis.The stability of the objectively measured values from Eye-Monitor was evaluated by the coefficient of variation.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (No.HEC-KS-2021005KY). Written informed consent was obtained from each subject.Results:There were significant correlations between the measured values and setting values in the working distance, head tilt angle when sitting, indoor light intensity, total near-work time, average continuous near-work time, outdoor activity time, time watching computers, and time viewing phones ( rs=0.999, 0.998, 0.999, 0.998, 0.976, 0.959, 0.992, 0.997; all at P<0.001), with the 95% limits of agreement (LoA) of-1.23-2.32 cm, -1.49-4.24°, -13.90-26.90 lx, -6.46-0.11 minutes, -4.50-1.20 minutes, -4.01-1.34 minutes, -2.54-1.94 minutes and-2.15-0.45 minutes, respectively.More than 95% of dots were within the clinically acceptable LoA.The coefficients of variation of the measured values ranged from 1.23%-2.99%, 2.39%-8.25%, 0.87%-8.03%, 1.49%-12.52%, 6.63%-13.59%, 0.00%-14.15%, 1.20%-8.33 and 1.49%-12.51%, respectively, showing good stability.Eye-Monitor had good accuracy in measuring outdoor light intensity (95% LoA: -336.50-130.00 lx). Conclusions:The smart wearable device Eye-Monitor can be used to objectively monitor working distance, head tilt angle when sitting, indoor light intensity, total near-work time, average continuous near-work time, outdoor activity time, time watching computers, and time watching phones, which are with good accuracy and stability.
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Objective@#To investigate the influencing factors for myopia among primary and secondary school students in Suzhou, so as to provide basis for myopia prevention and control. @*Methods@#The students in Grade 4-12 were recruited by stratified cluster random sampling method. Gender, grade, parents＇ myopia history, outdoor activity time and video display terminal time were collected through the questionnaire of National Surveillance Program of Influencing Factors for Common Diseases and Health in Students. Uncorrected visual acuity and cycloplegic refraction were tested. Multivariate logistic regression analysis was performed to explore myopia-related factors.@*Results@#A total of 990 questionnaires were distributed, and 882 valid questionnaires were recovered, with an effective rate of 89.09%. The prevalence rate of myopia was 78.23% ( 690 cases ). Multivariate logistic regression analysis showed that females ( OR=1.703, 95%CI: 1.173-2.474 ) , middle school students ( OR:5.597-11.949, 95%CI: 3.573-28.349 ) , both parents＇myopia ( OR=2.445, 95%CI: 1.597-3.742 ) , video display terminal time over 3 hours per day ( OR=2.026, 95%CI: 1.235-3.325 ) were risk factors for myopia; outdoor activity time over 2 hours per day ( OR: 0.493-0.510, 95%CI: 0.273-0.943 ) was a protective factor for myopia. @*Conclusion@#The prevalence of myopia among primary and secondary school students in Suzhou is 78.23%. Gender, grade, parents＇ myopia history, outdoor activity time and video display terminal time are influencing factors for myopia.
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Abstract@#China has one of the world’s highest prevalence of myopia in children and adolescents, and children are developing myopia earlier. Myopia has become a important issues affecting children and adolescents health, as well as a significant public health concern. There has been continuing debate over the role of nature and nurture in the aetiology of myopia, growing evidence showed that environmental factors has a determine effect on myopia.The randomized controlled trials has assured the relationship between time outdoors and myopia. Based on reviewed published articles, survey and intervention studies and school health practices, according to the principle of school organization, student participation and family cooperation, the authors proposed outdoors activities as initiative for myopia prevention and control in children and adolescents. The detail recommendation contents, levels were list out.
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Objective To analyze the mechanism of the influencing factors of myopia for junior high school students in China. Methods Based on the follow-up to 7 119 students in the 3 waves of questionnaire survey of the Chinese Education Panel Survey in junior high school stage, and the variables on students’ myopia status, myopia influencing factors, and two kinds of risk behaviors of myopia including near visual activities and outdoor activities, the mediation effects of the myopia risk behaviors were tested by Logistic regression model. Results The myopia prevalence of 9th graders before junior high school graduation was 66.36%. Time on writing homework significantly increased the risk of myopia，the odds ratio (OR) was 1.17，the 95% confidence interval (CI) was 1.13-1.21, and the time on outdoor sports significantly decreased the risk of myopia (OR=0.80，95% CI:0.75-0.86). Before and after including the risk behaviors into the model, the myopia risk OR(95% CI) of female centralized from 1.84(1.66-2.04) to 1.69(1.51-1.88), the myopia risk OR(95% CI) of urban students’centralized from 1.19(1.03-1.37) to 1.16(1.00-1.34), the myopia risk OR(95% CI) of only children’centralized from 1.20(1.06-1.36) to 1.18(1.04-1.33). With reference to not myopic for both parents, the myopia risk OR(95% CI) of students having one myopic parent centralized from 2.47(2.12-2.88) to 2.44(2.09-2.85), the myopia risk OR(95% CI) of students having parent without myopic centralized from 4.25(3.09-5.86) to 4.13(3.00-5.69). Conclusions Gender, urban and rural, only child, and myopic parents are influencing factors of myopia. These factors have effects on myopia via two kinds of risk behaviors including outdoor activities and near visual activities.
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@#AIM: To analyze the vision distribution and its related risk factors of two teenager aviation schools in Western China. <p>METHODS: The study was a cross-sectional survey. A total of 233 participants were randomly selected from two teenager aviation schools in Western China in November and December of 2017, which were all qualified through the standard of physical examination by Air Force. Distance visual acuity of students was checked and questionnaires about influencing factors of vision were filled voluntarily. Mann-Whitney <i>U</i> rank-sum test and chi-square test were applied for single factor analysis, and Multiple factor Logistic regression analysis was used for the main influence factors of the vision difference. <p>RESULTS: The proportion of students with less than 0.8 eyesight in school B of Grade 2 and Grade 3 were 18.6% and 45.9%, which was significantly higher than that of 2.6% and 20% of school A. The well-vision distribution in school B of Grade 2 and Grade 3 were lower than that of school A(<i>P</i><0.05). Single factor analysis showed that school reading and writing time in school B of Grade 2(360min, average: 180-535min)and Grade 3(470min, average: 440-500min)were higher than that of school A(Greade 2: 200min, average: 180-315min; Grade 3: 440min, average: 400-480min; <i>P</i><0.05); and outdoor activity time of the two grades(Grade 2: 420min, average: 325-516min and Grade 3: 378min, average: 265-515min)were lower than that of school A(Grade 2: 510min, average: 439-681min and Grade 3: 440min, average: 370-601min; <i>P</i><0.05), and the proportion of students whose mother had a senior high school degree or above in school B was lower than that of school A(<i>P</i>=0.032). Multiple factor Logistic regression analysis showed that reading and writing time was a risk factor for vision loss(<i>OR</i>=1.109, <i>P</i>=0.010)and outdoor activity time was a protective factor(<i>OR</i>=0.986, <i>P</i>=0.001). Mothers' education background, father's educational background, parents' myopia, primary school enrollment age, class time and electronic product using time were not the main factors affecting the vision. <p>CONCLUSION: More reading and writing time and less outdoor activity time are the main factors for loss of vision, the key point of school myopia prevention needs to coordinate the time between reading, writing and outdoor activity.
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AIM: To analyze the electronic product use time, writing time, playing piano time and outdoor activity time and the distribution of myopia in 586 cases of school age children in our hospital. ·METHODS: A retrospective analysis of 586 cases of children aged 6 to 12 years old in the outpatient department was established. Personalized files were used to record the uncorrected visual acuity, optometry, slit lamp, fundus mirror and strabismus. The cumulative use time of electronic products ( including computer, mobile phone, iPad) , writing time, whether to play the piano and outdoor activities time with the eye situation were recorded. Statistical analysis of the age group of myopia, the cumulative use of electronic age in different age groups, writing time, whether playing piano and outdoor activities and the distribution of myopia occurred. · RESULTS: ( 1 ) With the increasing of age, the distribution of uncorrected eyesight was in children mostly mild myopia, and the proportion of mild myopia was significantly higher than that of moderate and high myopia. ( 2 ) Electronic products use time distribution:the proportion of playing electronic products ( including mobilephone, computers, iPad) accounted for 76. 8%, of which 9 years old, 10 years old the cumulative use of electronic products with a long time was higher than other age groups. ( 3 ) Distribution of writing time: the proportion of write homework ≤1h was significantly lower than the proportion of writing homework > 1h (37. 2% vs 62. 8%), of which 9 and 10 years old children cumulative write time was higher than other age group. ( 4 ) Distribution of playing the piano: the proportion of playing piano time less than 1h was significantly higher than the proportion of playing piano time more than 1h ( 89. 1% vs 10. 9%). ( 5 ) Distribution of outdoor activities: the proportion of outdoor activities ≤1h in children at school age was significantly higher than that of outdoor activities > 1h (91. 8% vs 8. 9%). ·CONCLUSION: With the age exposure to electronic products becoming younger, heavy learning tasks and less outdoor activities, myopia occurred in advance of age. So health examination and eye guidance, reducing the amount of work appropriately, increasing outdoor activities will slow the development of early childhood myopia.
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OBJECTIVES: This study was intended to examine the seasonal differences in outdoor activity times and dietary vitamin D intakes, and explicates their relative impact on improving serum 25-(OH) vitamin D status among Korean young women. METHODS: A cross-sectional study was conducted with 135 free-living women aged 19-39 years in Daegu-Kyungbook, Korea. We compared the results from 52 women for the summer and 83 women for the winter. Dietary intake of vitamin D was assessed by 24 hour recall method for non-consecutive three days as well as by food frequency method. Daily outdoor activity times were derived from 24 hour physical activity diary. RESULTS: The average dietary intake of vitamin D of the participants by 24 hour recall method was 3.1 microg during the summer, 3.3 microg during the winter, showing no significant difference between the two seasons. Times spent on outdoor activities (p < 0.01) in the summer (= 23.8 +/- 23.6 min) were much longer than that in the winter (= 10.8 +/- 13.4 min). The serum 25-(OH) vitamin D levels of participants were 17.5 +/- 7.5 ng/mL in the summer and 13.4 +/- 4.3 ng/mL in the winter, showing that the latter was significantly lower than that of the former (p < 0.001). The serum 25-(OH) vitamin D levels of subjects were positively related to outdoor activities (r = 0.315, p < 0.05) during the summer, while related to dietary intake (r = 0.252, p < 0.05) during the winter. CONCLUSIONS: In order to improve the current vitamin D status of Korean young women, nutrition education programs should focus on increasing more dietary intake especially during the winter, and performing more outdoor activities in other seasons.