ECSS Paris 2023: OP-MH26
INTRODUCTION: Adolescent obesity and depressive symptoms have risen concurrently, often co-occurring and increasing disease burden. Physical activity (PA) and diet are key modifiable factors but evidence integrating PA temporal distribution and adherence to the planetary health diet (PHDI-green) in relation to multimorbidity remains limited, particularly regarding sex differences. This study examined sex-specific associations of PA and PHDI-green adherence with obesity, depressive symptoms and multimorbidity. METHODS: From 2022 to 2024, a stratified cluster random sample of adolescents aged 11–18 years was selected in Zhejiang Province. PA and dietary behaviors were assessed through standardized questionnaires. PHDI-green, defined as daily consumption of both fruits and vegetables with at least one type each, reflecting the plant-based components of the EAT–Lancet diet. Depressive symptoms were measured using the CES-D scale, and multimorbidity was defined as the coexistence of obesity and depressive symptoms. Temporal trends were examined using χ² tests. Sex-stratified logistic regression, population attributable fraction (PAF) analyses, and joint exposure analyses were conducted with adjustment for covariates. RESULTS: Obesity prevalence increased (χ² for trend = 6.20, P=0.0128) and depressive symptoms rose(χ² for trend = 8.77, P=0.003) , while multimorbidity remained stable (P=0.058). Boys consistently showed higher prevalence of obesity (9.4% vs 4.0%) and multimorbidity (1.5% vs 1.0%), whereas girls had higher depressive symptoms (22.0% vs 17.1%; all P<0.001), with a widening sex gap over time. High weekend PA and adherence to PHDI-green were all associated with significantly lower odds of overweight among both sexes (all P<0.001). Both moderate and high weekend PA showed stronger protective associations with depressive symptoms in girls (all P for sex difference<0.001), whereas PHDI-green adherence was more strongly associated with reduced depressive symptoms in boys (boys: OR = 0.63, 95% CI 0.61-0.65; girls: OR = 0.66, 95% CI 0.64-0.68; P for sex difference<0.001). For multimorbidity, higher weekly PA, moderate-to-high weekend PA and PHDI-green adherence were protective in both sexes (all P<0.001). PAF analyses identified low weekend PA as the leading attributable risk factor among girls (obesity 10.2%, depressive symptoms 31.3%, multimorbidity 35.6%), whereas non-adherence to PHDI-green was most important among boys (obesity 7.0%, depressive symptoms 23.8%, multimorbidity 21.9%). Joint analyses showed the lowest risk of all outcomes among adolescents with high weekend PA and PHDI-green adherence, particularly for multimorbidity (boys: OR = 0.40, 95% CI: 0.34-0.46; girls: OR = 0.33, 95% CI: 0.26-0.43). CONCLUSION: Weekend PA emerged as a critical window for health promotion, particularly among girls, while PHDI-green adherence played a more prominent protective role among boys. These findings support sex-sensitive, time-targeted lifestyle interventions to improve adolescent health.
Read CV Qu LuECSS Paris 2023: OP-MH26
INTRODUCTION: Low muscle strength is a well-established biomarker of functional capacity, disability risk, and healthy aging. As populations undergo rapid urbanization and demographic transition, secular changes in muscle strength may substantially affect future health burden. However, long-term regional patterns remain insufficiently understood in large developing countries.To examine 20-year age–period–cohort (APC) trends in low muscle strength among Chinese adults and to explore regional disparities across seven major geographical areas. METHODS: Data were derived from five waves of the National Physical Fitness Surveillance conducted between 2000 and 2020 (n = 854,897). Survey waves represented five calendar periods: 1998–2002, 2003–2007, 2008–2012, 2013–2017, and 2018–2022. Adults aged 20–69 years were categorized into ten five-year age groups (20–24 to 65–69 years), generating 14 birth cohorts from 1935–1939 to 2000–2004.China was divided into seven geographical regions: Northeast, North, South, Northwest, East, Central, and Southwest China. Handgrip strength was used to define low muscle strength according to standardized national criteria. Weighted logistic regression models estimated regional risks, and APC modeling was applied to disentangle independent age, period, and cohort effects, allowing identification of net drift and generational shifts. RESULTS: Marked regional divergence was observed over the 20-year period. South China demonstrated the most pronounced increase in prevalence, rising from 2.8% in 2000 to 6.6% in 2020 (+3.8 percentage points), shifting from the lowest to the highest national level. In contrast, North China showed minimal fluctuation (4.1%–4.8%). Northeast and North China experienced overall declines, whereas East and Central China showed modest increases. Northwest China remained relatively stable at a comparatively favorable national level, while Southwest China consistently maintained a relatively high prevalence across two decades. Significant interregional differences were present in each survey year (p < 0.001). APC analyses revealed positive net drift in all regions except Northeast and North China. The steepest annual increase was observed in South China (6.531%, 95% CI: 5.510%–7.561%), followed by East (3.095%), Central (2.217%), Northwest (1.998%), and Southwest China (1.336%). Age effects demonstrated progressive risk accumulation with advancing age, while cohort patterns suggested deterioration among more recent birth cohorts in several regions, particularly in rapidly urbanizing areas. CONCLUSION: Over two decades, low muscle strength among Chinese adults has exhibited substantial regional heterogeneity and emerging cohort-related deterioration. These findings highlight the urgent need for region-specific resistance training promotion and muscle-strengthening strategies, particularly in areas undergoing rapid socioeconomic transition. Addressing generational declines in muscle strength may be critical for mitigating future functional impairment.
Read CV xu zhangECSS Paris 2023: OP-MH26
INTRODUCTION: To investigate the association between sedentary time and cognitive impairment risk in Chinese older adults and examine whether physical exercise moderates this relationship. METHODS: This cross-sectional study analyzed data from 29,046 adults aged 60-79 years participating in the 2025 Sixth National Physical Fitness Surveillance of China. Daily sedentary time(sitting/reclining excluding sleep)and physical exercise levels(adequate:≥3 sessions/week of moderate-to-vigorous intensity)were collected through structured questionnaires, and cognitive impairment risk was screened using the AD8(cutoff≥2). After controlling for potential confounding factors including sex, age, residence, educational level, geographical region, marital status, living arrangement, smoking status,and alcohol consumption, multiple logistic regression models were applied to analyze the association between sedentary time and cognitive impairment risk. Subsequently, stratified analyses were conducted to explore the strength of associations across different subgroups, and the moderating effect of physical exercise on the sedentary-cognition relationship was further examined. Finally, sensitivity analyses were performed to verify the robustness of the results. RESULTS: This study included 29,046 Chinese older adults aged 60-79 years, with an overall screening-positive rate for cognitive impairment risk of 14.0%. Multiple logistic regression analysis revealed that, after adjusting for multiple confounding factors and using the 0-120 minutes/day sedentary group as reference, the odds ratios (OR) for cognitive impairment risk were 1.35 (95%CI: 1.23-1.48), 1.62 (1.47-1.79), and 1.89 (1.72-2.07) for sedentary time of 120-180 minutes, 180-240 minutes, and ≥240 minutes/day, respectively, demonstrating a significant dose-response relationship (P<0.001). Stratified analyses found that the association between sedentary time and cognitive impairment risk showed similar effect sizes across sex groups, but significantly stronger effects were observed among rural and oldest-old (75-79 years) populations. Moderation analysis of physical exercise levels indicated that physical exercise could significantly buffer the negative impact of sedentary behavior on cognitive function (interaction P=0.02). Additionally, various sensitivity analyses confirmed the robustness of the results. CONCLUSION: Based on national large-sample data, this study systematically reveals a significant dose-response association between sedentary time and cognitive impairment risk in Chinese older adults, whereby longer sedentary time corresponds to greater cognitive impairment risk. Simultaneously, physical exercise can effectively attenuate the adverse effects of sedentary behavior on cognitive function, demonstrating an important protective role. Rural older adults and the oldest-old population represent high-risk groups for sedentary-related cognitive impairment risk and warrant priority attention.
Read CV Zong Hao SUNECSS Paris 2023: OP-MH26