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The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study

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  • Jieyu Chen

    (School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China)

  • Hongjie Xiang

    (Department of Traditional Chinese Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, Shandong, China)

  • Pingping Jiang

    (School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China)

  • Lin Yu

    (Department of Traditional Chinese Medicine, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510170, Guangdong, China)

  • Yuan Jing

    (School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China)

  • Fei Li

    (School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China)

  • Shengwei Wu

    (School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China)

  • Xiuqiong Fu

    (Centre for Cancer and Inflammation Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China)

  • Yanyan Liu

    (School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China)

  • Hiuyee Kwan

    (Centre for Cancer and Inflammation Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China)

  • Ren Luo

    (School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China)

  • Xiaoshan Zhao

    (School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China)

  • Xiaomin Sun

    (School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China)

Abstract

Background: Suboptimal health status (SHS) is the intermediate health state between health and disease, it is medically undiagnosed and is also termed functional somatic syndrome. Although its clinical manifestations are complicated and various, SHS has not reached the disease status. Unhealthy lifestyle is associated with many chronic diseases and mortality. In accordance with the impact of lifestyle on health, it is intriguing to determine the association between unhealthy lifestyle and SHS risk. Methods: We conducted a nested case-control study among healthy Chinese college students from March 2012 to September 2013, which was nested in a prospective cohort of 5676 students. We performed 1:1 incidence density sampling with matched controls for birth year, sex, grade, specialty and individual character. SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Exposure was defined as an unhealthy lifestyle per the frequency of six behavioral dimensions from the Health-promoting Lifestyle Profile (HPLP-II). Results: We matched 543 cases of SHS (42.66%) in a cohort of 1273 students during the 1.5 years mean follow-up time with controls. A significant difference (t = 9.79, p < 0.001) and a reduction in HPLP-II total score was present at 1.5 years follow-up (135.93 ± 17.65) compared to baseline (144.48 ± 18.66). A level-response effect was recorded with an increase of the total HPLP-II (every dimension was correlated with a decreased SHS risk). Compared to respondents with the least exposure (excellent level), those reporting a general HPLP-II level were approximately 2.3 times more likely to develop SHS (odd ratio = 2.333, 95% CI = 1.471 to 3.700); and those with less HPLP-II level (good level) were approximately 1.6 times more likely (1.644, 1.119–2.414) to develop SHS (p < 0.05). Our data indicated that unhealthy lifestyle behavior with respect to behavioral dimensions significantly affected SHS likelihood. Further analyses revealed a marked increase (average increased 14.73 points) in lifestyle level among those SHS regression to health after 1.5 years, with respect to the HPLP-II behavioral dimensions, in addition to the total score (t = -15.34, p < 0.001). Conclusions: SHS is highly attributable to unhealthy lifestyles, and the Int. J. Environ. Res. Public Health 2017, 14, 240 2 of 17 mitigation of modifiable lifestyle risk factors may lead to SHS regression. Increased efforts to modify unhealthy lifestyles are necessary to prevent SHS.

Suggested Citation

  • Jieyu Chen & Hongjie Xiang & Pingping Jiang & Lin Yu & Yuan Jing & Fei Li & Shengwei Wu & Xiuqiong Fu & Yanyan Liu & Hiuyee Kwan & Ren Luo & Xiaoshan Zhao & Xiaomin Sun, 2017. "The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study," IJERPH, MDPI, vol. 14(3), pages 1-17, February.
  • Handle: RePEc:gam:jijerp:v:14:y:2017:i:3:p:240-:d:91733
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    References listed on IDEAS

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    1. Zhikun Ding & Fungfai Ng, 2007. "Reliability and validity of the Chinese version of McAllister's trust scale," Construction Management and Economics, Taylor & Francis Journals, vol. 25(11), pages 1107-1117.
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    Cited by:

    1. Eun-Ju Lim & Eun-Jung Hyun, 2021. "The Impacts of Pilates and Yoga on Health-Promoting Behaviors and Subjective Health Status," IJERPH, MDPI, vol. 18(7), pages 1-23, April.
    2. Qinliang Liu & Xiaojing Li, 2021. "The Interactions of Media Use, Obesity, and Suboptimal Health Status: A Nationwide Time-Trend Study in China," IJERPH, MDPI, vol. 18(24), pages 1-14, December.
    3. Maja Grujičić & Miloš Ilić & Budimka Novaković & Aleksandra Vrkatić & Zagorka Lozanov-Crvenković, 2022. "Prevalence and Associated Factors of Physical Activity among Medical Students from the Western Balkans," IJERPH, MDPI, vol. 19(13), pages 1-16, June.
    4. Julia Burlaka & Renee M. Johnson & Christina N. Marsack-Topolewski & Kathryn Hughesdon & Jill Owczarzak & Oleksii Serdiuk & Roman Bogdanov & Viktor Burlaka, 2024. "Association between Current Substance Use, Healthy Behaviors, and Depression among Ukrainian College Students," IJERPH, MDPI, vol. 21(5), pages 1-12, May.
    5. Tao Xu & Guangjin Zhu & Shaomei Han, 2020. "Prevalence of Suboptimal Health Status and the Relationships between Suboptimal Health Status and Lifestyle Factors among Chinese Adults Using a Multi-Level Generalized Estimating Equation Model," IJERPH, MDPI, vol. 17(3), pages 1-15, January.
    6. Miloš Ilić & Huiwen Pang & Tomislav Vlaški & Maja Grujičić & Budimka Novaković, 2022. "Motives and Barriers for Regular Physical Activity among Medical Students from the Western Balkans (South-East Europe Region)," IJERPH, MDPI, vol. 19(23), pages 1-21, December.
    7. Khalid A. Bin Abdulrahman & Ahmad M. Khalaf & Fahad B. Bin Abbas & Omran T. Alanezi, 2021. "The Lifestyle of Saudi Medical Students," IJERPH, MDPI, vol. 18(15), pages 1-11, July.

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