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      The independent and combined effects of single-child status and ideal lifestyle on clustered cardio-metabolic risk factors among Chinese children and adolescents

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          Abstract

          Background

          Cardio-metabolic risk factors (CMRFs) represent the accumulation of metabolic abnormalities, significantly increasing the likelihood of cardiovascular diseases. Although studies assessed the independent association of single-child status and lifestyle risk factors with components of CMRFs or clustered CMRFs, little has been known about the combined effect of single-child status and lifestyles on clustered CMRFs as well as sex differences.

          Materials and methods

          Data was collected from a cross-sectional survey conducted in September 2013 in China. A total of 13,859 children and adolescents aged 7–18 years with blood samples were included. Anthropometric measurements and serum biochemical indexes were collected to assess clustered CMRFs, while questionnaires were used to obtain single-child status, lifestyle information, and characteristics of children and their parents. Mixed effect logistic regression was applied to analyze the independent and the combined effects of single-child status and ideal lifestyle category on clustered CMRFs.

          Results

          The prevalence of clustered CMRFs was 3.4%, with a higher prevalence in boys (4.0%) than girls (2.7%). Children and adolescents with clustered CMRFs had a higher proportion of single children (76.6 vs. 69.7%) and unfavorable lifestyles (62.1 vs. 29.2%) compared with their peers with non-clustered CMRFs. Both single children (OR = 1.67, 95% CI: 1.32–2.11) and unfavorable lifestyles (OR = 9.03, 95% CI: 6.26–13.02) were associated with an increased risk of clustered CMRFs. The risk of clustered CMRFs increased significantly (OR = 12.79, 95% CI: 6.67–24.52) when single children and an unfavorable lifestyle were combined, which was almost neutralized (OR = 1.33, 95% CI: 0.63–2.82) when single children adhered to a favorable lifestyle. However, no sex differences were observed in this study.

          Conclusion

          Single children with unfavorable lifestyles were associated with an obvious risk of clustered CMRFs, which might be partially offset by expanding family size (the number of siblings) or establishing a favorable lifestyle. A birth-friendly social environment as well as a family environment with a favorable lifestyle are encouraged in China.

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          Most cited references51

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Diagnosis and Classification of Diabetes Mellitus

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              Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association's strategic Impact Goal through 2020 and beyond.

              This document details the procedures and recommendations of the Goals and Metrics Committee of the Strategic Planning Task Force of the American Heart Association, which developed the 2020 Impact Goals for the organization. The committee was charged with defining a new concept, cardiovascular health, and determining the metrics needed to monitor it over time. Ideal cardiovascular health, a concept well supported in the literature, is defined by the presence of both ideal health behaviors (nonsmoking, body mass index <25 kg/m(2), physical activity at goal levels, and pursuit of a diet consistent with current guideline recommendations) and ideal health factors (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, and fasting blood glucose <100 mg/dL). Appropriate levels for children are also provided. With the use of levels that span the entire range of the same metrics, cardiovascular health status for the whole population is defined as poor, intermediate, or ideal. These metrics will be monitored to determine the changing prevalence of cardiovascular health status and define achievement of the Impact Goal. In addition, the committee recommends goals for further reductions in cardiovascular disease and stroke mortality. Thus, the committee recommends the following Impact Goals: "By 2020, to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%." These goals will require new strategic directions for the American Heart Association in its research, clinical, public health, and advocacy programs for cardiovascular health promotion and disease prevention in the next decade and beyond.
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                Author and article information

                Contributors
                Journal
                Front Nutr
                Front Nutr
                Front. Nutr.
                Frontiers in Nutrition
                Frontiers Media S.A.
                2296-861X
                29 August 2022
                2022
                : 9
                : 987334
                Affiliations
                [1] 1Institute of Child and Adolescent Health, School of Public Health, Peking University , Beijing, China
                [2] 2National Health Commission Key Laboratory of Reproductive Health, Peking University , Beijing, China
                Author notes

                Edited by: Yong Zhao, Chongqing Medical University, China

                Reviewed by: Mingzhi Zhang, Soochow University, China; Linghui Meng, Independent Researcher, Beijing, China

                *Correspondence: Yi Song, songyi@ 123456bjmu.edu.cn

                This article was submitted to Nutritional Epidemiology, a section of the journal Frontiers in Nutrition

                Article
                10.3389/fnut.2022.987334
                9464906
                63766885-efb2-4986-a226-49ff311d5389
                Copyright © 2022 Dang, Ma, Liu, Zhong, Shi, Cai, Dong, Zou, Ma, Song and Ma.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 06 July 2022
                : 01 August 2022
                Page count
                Figures: 4, Tables: 1, Equations: 0, References: 51, Pages: 10, Words: 5964
                Funding
                Funded by: Natural Science Foundation of Beijing Municipality, doi 10.13039/501100004826;
                Categories
                Nutrition
                Original Research

                single-child,ideal lifestyle,clustered cmrfs,children,adolescents

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