Differences In Health-related Behaviors Research Articles

A Cross-Sectional Nationwide Study of Australians' Health: Are There Differences in Health-Related Behaviors and Psychological Distress Between Teachers and Other Occupations?

Teachers' health behaviors and mental well-being are important for their chronic disease risk and reducing burnout. This study investigates the health-related behaviors and psychological distress of Australian teachers compared with other occupations. Data from the nationally representative Australian National Health Survey (NHS) were analyzed. Employed adults (20-64 years) from 2014/2015 (n = 8455), 2017/2018 (n = 9130), and 2020/2021 (n = 5753) survey waves were included. Logistic regression, adjusted for demographics, compared health-related behaviors (eg, physical activity, diet), and psychological distress among teachers, nonteacher professionals (NTPs; eg, accountants, doctors), and other general occupations (eg, laborers, beauticians). After adjusting for demographics and survey wave, teachers had similar odds as NTPs for meeting physical activity (OR: 1.12, 95% CI: 0.90-1.41), vegetable intake (OR: 0.72, 95% CI: 0.52-1.00), and alcohol consumption (OR: 1.01, 95% CI: 0.83-1.22) guidelines. However, teachers exhibited higher psychological distress (OR: 1.35, 95% CI: 1.01-1.75). Elevated psychological distress levels were observed in all groups in 2020/2021, compared with pre-COVID-19. Compared with NTPs, teachers showed similar or better health-related behaviors, although teachers had higher levels of psychological distress. School executives and policymakers need to implement sustainable measures to prioritise teachers' mental wellbeing.

Reduced Epigenetic Age in Older Adults With High Sense of Purpose in Life.

Psychosocial risk factors have been linked with accelerated epigenetic aging, but little is known about whether psychosocial resilience factors (eg, Sense of Purpose in Life) might reduce epigenetic age acceleration. In this study, we tested if older adults who experience high levels of Purpose might show reduced epigenetic age acceleration. We evaluated the relationship between Purpose and epigenetic age acceleration as measured by 13 DNA methylation (DNAm) "epigenetic clocks" assessed in 1 572 older adults from the Health and Retirement Study (mean age 70 years). We quantified the total association between Purpose and DNAm age acceleration as well as the extent to which that total association might be attributable to demographic factors, chronic disease, other psychosocial variables (eg, positive affect), and health-related behaviors (heavy drinking, smoking, physical activity, and body mass index [BMI]). Purpose in Life was associated with reduced epigenetic age acceleration across 4 "second-generation" DNAm clocks optimized for predicting health and longevity (false discovery rate [FDR] q < 0.0001: PhenoAge, GrimAge, Zhang epigenetic mortality index; FDR q < 0.05: DunedinPoAm). These associations were independent of demographic and psychosocial factors, but substantially attenuated after adjusting for health-related behaviors (drinking, smoking, physical activity, and BMI). Purpose showed no significant association with 9 "first-generation" DNAm epigenetic clocks trained on chronological age. Older adults with greater Purpose in Life show "younger" DNAm epigenetic age acceleration. These results may be due in part to associated differences in health-related behaviors. Results suggest new opportunities to reduce biological age acceleration by enhancing Purpose and its behavioral sequelae in late adulthood.

Association between metabolically obese but normal weight and cardiovascular diseases in Korean menopausal women.

The aim of this study was to present useful data for developing effective health management strategies for cardiovascular disease (CVD) prevention in postmenopausal women by investigating health-related behaviors and the prevalence of CVD for different types of obesity classified according to metabolic health status and body mass index criteria. Using the 2016 Korean National Health and Nutrition Examination Survey VII-1 data, 1,190 menopausal women aged 50 years or older were analyzed in this cross-sectional study. The participants were divided into four groups as follows: metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy but obese, and metabolically obese and obese. Complex-samples general linear analysis, t tests, and logistic regression analysis were used to compare the differences in health-related behaviors and the risk of CVD among the four groups. The risk for stroke was 3.61 times higher (95% CI, 1.18-11.03) in the MONW group than in the MHNW group. We found a strong association between the MONW group of obesity and the risk for CVD, particularly stroke, in postmenopausal women. These findings would serve as valuable evidence for developing and implementing interventions to prevent stroke in postmenopausal women in the MONW group.

Health and related behaviours of fly-in fly-out workers in the mining industry in Australia: a cross-sectional study

BackgroundFly-In Fly-Out (FIFO), which entails travelling mostly from the urban areas to stay and work in remote areas for designated periods and travel back home to spend designated days of leave, has become a common work arrangement in the mining sector globally. This study examined the mental and physical health of FIFO workers and described their health-related behaviours during on-and off-shift periods.MethodsA cross-sectional study was conducted with FIFO workers (N = 216) in the mining industry in Australia who completed an online survey. Paired t-test and McNemer’s analysis examined the differences in health-related behaviours during workers’ on-and off-shift days. Logistic regression examined the predictors of physical health and psychological distress status of FIFO workers.ResultsWorkers reported longer sleep duration (7.5 ± 1.5 h vs 6.3 ± 1.2 h, p < 0.001) and better sleep quality (78.2% vs 46.3%, p < 0.001) during off-shift nights than on on-shift nights. Smoking prevalence was 26.4%, and workers reported smoking a similar number of cigarettes per day during on-and off-shift days. Most workers reported drinking alcohol (86.1%) and more often at risky levels during off-shift than on-shift days (57.9% vs 34.3%, p < 0.001). Fruits and vegetable consumption was low but with higher vegetable intake during off-shift days (2.8 ± 1.4 vs 2.3 ± 1.3 serves, p < 0.001). Workers had good physical health status (91.2%), but 71.4% were overweight/obese and 33.4% indicated high levels of psychological distress. Working on long shifts (OR 6.63, 95% CI 1.84–23.91) and smoking (OR 7.17, 95% CI 2.67–19.26) were linked to high psychological distress.ConclusionsThe prevalence of psychological distress and risky health behaviours was high. Interventions should aim to reduce psychological distress and support multiple behaviour changes, considering FIFO work-related characteristics including long shift hours.

Domains of Vulnerability, Resilience, Health Habits, and Mental and Physical Health for Health Disparities Research.

Health disparities associated with severe mental illness (SMI) have become a major public health concern. The disparities are not directly due to the SMI. They involve the same leading causes of premature death as in the general population. The causes of the disparities are therefore suspected to reflect differences in health-related behavior and resilience. As with other problems associated with SMI, studying non-clinical populations at risk for future onset provides important clues about pathways, from vulnerability to unhealthy behavior and compromised resilience, to poor health and reduced quality of life. The purpose of this study was to identify possible pathways in a sample of public university students. Four domains of biosystemic functioning with a priori relevance to SMI-related vulnerability and health disparities were identified. Measures reflecting various well-studied constructs within each domain were factor-analyzed to identify common sources of variance within the domains. Relationships between factors in adjacent domains were identified with linear multiple regression. The results reveal strong relationships between common factors across domains that are consistent with pathways from vulnerability to health disparities, to reduced quality of life. Although the results do not provide dispositive evidence of causal pathways, they serve as a guide for further, larger-scale, longitudinal studies to identify causal processes and the pathways they follow to health consequences.

Assessing health-related behaviors among Jordanian children during COVID-19 pandemic: A cross-sectional study

Background:The coronavirus disease identified in 2019 (COVID-19) led to extreme actions being taken by the governments to restrict the spread of this virus. Closure of schools, sport clubs and playgrounds were among these actions; children had to stay indoors and were not allowed to pursue their normal lifestyle activities.Objectives:To assess the differences in health-related behaviors among Jordanian school-aged children (6-16 years) before and during COVID-19 quarantine and to evaluate public’s perception of the role of pharmacists regarding children’s health-related behaviors management.Methods:A cross-sectional study was conducted from August 2020 to January 2021 using an anonymous web-based survey. The survey was developed based on previously published surveys. Evaluation of the validity and reliability of the survey were conducted by a professional committee of clinical pharmacists and a statistician.Results:A total of 230 children, aged 9.02± 2.977 participated in the study. Physical activity and healthy balanced meals decreased (less than 1 hr or 1-3 hrs/week vs 2 meals/day, p= <0.001), whereas daily screen time (1-3 hrs/week vs 4-6 hrs/week, p= <0.001), sleep hours (8-9 hrs/day vs 10-11 hrs/day, p= <0.001) and the ingestion of unhealthy snacks had increased (1-2 meals/day vs. 2-3 meals/day, p=<0.001). A positive perception of pharmacists’ role during the pandemic was revealed.Conclusion:The present study showed that a significant change in children’s health-related behavior happened during the COVID-19 pandemic. Such changes can lead to social, physical and mental health problems. The public perceived community pharmacists as trusted health care professionals during the pandemic.

Genetic testing users in Italy and Germany: Health orientation, health-related habits, and psychological profile.

BackgroundRapid advances in genomic knowledge and widespread access to the web contributed to the development of genetic services by private companies or medical laboratories. In the European landscape, though, there is not a single coherent regulatory approach to genetic testing (GT). The study aimed to investigate differences and similarities between two populations of GT users, Italians and Germans, in terms of health‐related behaviors, psychological characteristics, and attitudes toward genetic information.MethodsNinety‐nine Italian GT users from one private genetic company and 64 Germans GT users from one medical laboratory, completed an ad hoc self‐administered questionnaire.ResultsResults showed significant differences in health‐related behaviors (unhealthy eating behaviors, smoking behaviors, and frequency in medical check‐ups), with Germans reporting higher levels of unhealthy eating habits and smoking behaviors than Italians; Italian users also were more medically controlled. Furthermore, German participants were less willing to change their lifestyle following the GT results compared to Italian participants. Regarding psychological variables, German users felt more confident about their physical well‐being and they seemed more motivated than Italians to avoid becoming unhealthy. Finally, two samples differed in the way they accessed genetic testing (with the Italians guided predominately by a physician in contrast with the Germans who were recommended by friends) and managed genetic testing results (with Italian participants significantly more willing to share results with doctors than German participants, who preferred sharing with the family).ConclusionThe analysis of cultural and organizational differences could help in defining adequate guidelines for counseling, and provide inputs for regulators in different European contexts.

Sociodemographic disparity in health-related behaviours and dietary habits among public workers in China: a cross-sectional study

ObjectiveWe aimed to estimate the distribution of health-related behaviours and dietary habits by sociodemographics among public workers in China.DesignCross-sectional study.SettingA representative sample was obtained from 10 government-run institutions in Hunan...

The health implications of distrust in the food system: findings from the dimensions of trust in food systems scale (DOTIFS scale)

BackgroundConsumer trust in food systems is essential for consumers, food industry, policy makers and regulators. Yet no comprehensive tool for measuring consumer trust in food systems exists. Similarly, the impact that trust in the food system has on health-related food behaviours is yet to be empirically examined. The aim of this research was to develop a comprehensive instrument to measure trust in the food system (the Dimensions of Trust in Food Systems Scale (DOTIFS scale) and use it to explore whether trust in the food system impacts consumers’ health-related behaviours.MethodsThe DOTIFS scale was developed using sociological theories of trust and pre-existing instruments measuring aspects of trust. It was pilot tested and content validity was assessed with 85 participants. A mixed-methods exploration of the health-related behaviours of 18 conveniently sampled Australian consumers with differing trust scores determined by the DOTIFS scale was then conducted. During March–July 2019 shopping- and home-observations were used to assess participants’ food safety practices and exposure to public health fortification programs, while the CSIRO Healthy Diet Score determined their adherence to national dietary guidelines.ResultsThe DOTIFS scale was found to have high comprehension, ease of use and content validity. Statistical analysis showed scale scores significantly trended as predicted by participants’ stated level of trust. Differences were found in the way individuals with more or less trust in the food system comply with national dietary guidelines, are exposed to public health fortification programs, and adhere to recommended food safety practices.ConclusionsThe DOTIFS scale is a comprehensive, sociologically- and empirically- informed assessment of consumer trust in food systems that can be self-administered online to large populations and used to measure changes in consumer trust over time. The differences in health-related behaviours between individuals with varying levels of trust warrant further investigation.

Gender-differences in predictors for time to metabolic syndrome resolution: A secondary analysis of a randomized controlled trial study.

Understanding gender differences in health-related behaviors and their impacts is a crucial aspect of effective primary care. We studied gender-based differences in predictors of metabolic syndrome (MetS) resolution among newly diagnosed MetS patients. This study was a secondary analysis of a prospective clinical trial study comprising of 637 middle-aged and older adults (226 men and 411 women) who underwent a regular health checkup and were newly diagnosed with MetS at 16 different health clinics of 14 metropolitan cities and provinces. We conducted Cox proportional hazard analysis to estimate cumulative probability of MetS resolution within a 12‐month observation period. Among the 637 patients, 47.6% of participants achieved MetS resolution. The resolution rate was similar among men and women (44.7% and 49.1%, respectively, P = 0.320). Low household income (Hazard ratio = 2.62, 95% confidence interval: 1.13–6.08) and current employment (2.29, 1.26–4.13) were associated with a higher cumulative probability of MetS resolution in men than in women. For women, however, longer sleeping hours (1.18, 1.04–1.34) and living with a partner (1.58, 1.06–2.35) were positive predictors of MetS resolution. Being overweight (0.63, 0.44–0.89) was associated with lower cumulative probability of MetS resolution in women than in men. The factors associated with cumulative probability of MetS resolution within the 12-month follow-up were different between men and women. These findings facilitate further exploration on gender-based differences in risk factors for less optimal improvements in MetS.

Abstract IA24: Effect of migration to the US on health characteristics of the African diaspora

Abstract People of African descent have migrated to Philadelphia since the 17th century. First arriving by forced migration and then voluntary migration, the current Black population is heterogeneous, consisting of individuals of US ancestry (direct descendants of enslaved Africans in the US) and individuals of African and Caribbean ancestry (descendants or individuals who have voluntarily migrated to the US post-slavery). While Africa is the common ancestral origin of these Black subgroups, migrants' (whether newly arrived or settled) health characteristics usually differ from the health characteristics represented in their native country. Recent data from our US-based cohort of diverse Black participants (The Cancer Prevention Project of Philadelphia—CAP3) reveal distinct differences in health-related behaviors between US-born Blacks, Caribbean immigrants, and African immigrants. As length of time in the US increased, cancer screening habits, smoking, and BMI increase and suggest that as immigrants begin to assimilate with the dominant culture, they learn both positive and negative health behaviors. Citation Format: Camille Ragin. Effect of migration to the US on health characteristics of the African diaspora [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr IA24.

Group-Based Care in Adults and Adolescents With Hypertension and CKD: A Feasibility Study

Rationale & ObjectiveGroup-based care provides an opportunity to increase patient access to providers without increasing physician time and is effective in the management of chronic diseases in the general population. This model of care has not been investigated in chronic kidney disease (CKD).Study DesignRandomized controlled trial in adults (n = 50); observational study in adolescents (n = 10).Setting & ParticipantsAdults and adolescents with CKD and hypertension in the Bronx, NY.InterventionGroup-based care (monthly sessions over 6 months) versus usual care in adults. All adolescents received group-based care and were analyzed separately.OutcomesParticipant attendance and satisfaction with group-based care were used to evaluate intervention feasibility. The primary clinical outcome was change in mean 24-hour ambulatory blood pressure. Secondary outcomes included physical activity, medication adherence, quality of life, and sodium intake as assessed by 24-hour urinary sodium excretion and food frequency questionnaires.ResultsAmong adults randomly assigned to group-based care, attendance was high (77% of participants attended ≥3 sessions) and most reported higher satisfaction. Mean 24-hour ambulatory systolic blood pressure decreased by −4.2 (95% CI, −13.3 to 5.8) mm Hg in group-based care patients compared with usual care at 6 months but this was not statistically significant. Similarly, we did not detect significant differences in health-related behaviors (such as medication adherence, sodium intake, and physical activity) or quality-of-life measures between the 2 groups. Among the adolescents, attendance was very poor; self-reported satisfaction, although high, did not change from baseline compared with the 6-month follow-up.LimitationsSmall study size, missing data.ConclusionsGroup-based care is feasible and acceptable among adults with hypertension and CKD. However, a larger trial is needed to determine the effect on blood pressure and health-related behaviors. Patient participation may limit the effectiveness of group-based care models in adolescents.FundingNational Institutes of Health R34 DK102174.Trial registrationhttps://clinicaltrials.gov/show/NCT02467894.

Infections as a potential long-term risk following childhood leukemia

SummaryLeukemia is the most common childhood cancer. While infections are a frequent and potentially severe complication while on treatment, less is known about the risk for infections following therapy completion. In this article, we propose that leukemia survivors might be at increased risk of infections following therapy completion than the general population, independently of potential confounders such as age, sex and Down syndrome. This association is conceivably due to several factors. First, therapy-induced immune dysfunction of both the humoral and cellular compartments appears to last for several years following anti-cancer therapy and after hematopoietic stem cell transplantation. Second, clinical and epidemiological research has shown leukemia survivors are disproportionally affected by comorbidities related to leukemia treatment and its complications, such as diabetes and obesity, which may induce secondary immunodeficiency and infections. Last, differences in health-related behaviors between leukemia survivors and the general population (such as re-vaccination practices) may affect the baseline risk of infections. Although under-represented in the epidemiological literature as a possible late effect of childhood leukemia and its treatment, it is plausible that leukemia survivors are at increased risk of infections for several years when compared to the general population and their siblings. Further research is needed to empirically test these hypotheses.

GENDER DIFFERENCES IN HEALTH-RELATED BEHAVIORS OF RETIRED PEOPLE IN TAIWAN

Many studies have indicated that lifestyles and health behaviors are important factors associated with elderly health. However, few studies have focused on such issues in Taiwan. The purposes of this study were to examine the gender differences in health-related behaviors of retired people in Taiwan. We used face-to-face interviews to collect 20 health-related behaviors among retired people aged 50-74 in Taiwan. A total of 3131 retired sample was collected including 1754 male (56.0%) and 1377 female (44.0%). The health behaviors were designed as binary variables. If the retirees executed exactly on the behavior within a month, they got 5 scores, otherwise, they got 0 scores. Then, we used factor analysis with Varimax Rotation to detect factors associated with the 20 health behaviors. Results showed that six factors were related to these 20 behaviors after conducting factor analysis. These six factors were named as 1) No tobacco, alcohol and betel nut, 2) Periodic health examination, 3) Correct medication, 4) Good habits, 5) Normal sleep and no pressure, (6) No high-fat and pickled foods. Gender differences were found in three factors: 1, 5 and 6. More female practiced every behavior in factor 1 and factor 6 than male (68.7%, 55.5% vs. 43.6%, 50.3%, p<.001, respectively). However, the male had better behaviors in factor 5 than female (54.0% vs. 47.3%, p<.001). We hope these findings could help design different health promotion programs for retirees of different genders.

Socioeconomic Status Moderates the Effects of Health Cognitions on Health Behaviors within Participants: Two Multibehavior Studies.

Socioeconomic differences in health-related behaviors are a major cause of health inequalities. However, the mechanisms (mediation/moderation) by which socioeconomic status (SES) affects health behavior are a topic of ongoing debate. Current research on SES as moderator of the health cognitions-health behavior relation is inconsistent. Previous studies are limited by diverse operationalizations of SES and health behaviors, demographically narrow samples, and between-person designs addressing within-person processes. This paper presents two studies addressing these shortcomings in a within-person multibehavior framework using hierarchical linear models. Two online studies, one cross-sectional and one 4 week longitudinal, assessed 1,005 (Study 1; Amazon MTurk; USA only) and 1,273 participants (Study 2; Prolific; international). Self-reports of multiple SES indicators (education, income, occupation status; ZIP code in Study 1), health cognitions (from the theory of planned behavior), and measures of six health behaviors were taken. Multilevel models with cross-level interactions tested whether the within-person relationships between health cognitions and behaviors differed by between-person SES. Education significantly moderated intention-behavior and attitude-behavior relationships in both studies, with more educated individuals showing stronger positive relationships. In addition, ZIP-level SES (Study 1) moderated attitude-behavior effects such that these relationships were stronger in participants living in areas with higher SES. Education appears to be an important resource for the translation of intentions and attitudes into behavior. Other SES indicators showed less consistent effects. This has implications for interventions aiming at increasing intentions to change health behaviors, as some interventions might inadvertently increase health inequalities.

Examining the Feasibility and Effectiveness of a Community-Based Obesity Prevention Program

ABSTRACTBackground: Latinos in the United States are at heightened risk for obesity and health disparities, yet community-based interventions to promote health are limited. Purpose: This research examined the feasibility and efficacy of a culturally relevant obesity prevention program (Vivir Sano), which included stress reduction and behavioral lifestyle intervention components. Methods: In phase 1, focus groups were completed with 21 residents of an affordable housing community to assess program needs and interests. In phase 2, 41 primarily Latino adults living in several neighboring affordable housing communities enrolled in the intervention. Twenty-three (56%) completed both pre- and postassessments (per protocol group). We examined pre–post differences in health-related behaviors, knowledge, and attitudes. Results: Over 96% of participants who completed a posttest satisfaction questionnaire reported that they were likely or very likely to use the skills learned in the program. Approximately 85% reported that the program moderately or significantly improved their health. An analysis of variance (ANOVA) indicated that the per protocol group increased weekly vegetable consumption by 4.2 servings (Cohen’s d = 0.48). Translation to Health Education Practice: We discuss barriers and lessons learned related to implementing obesity prevention programming in affordable housing communities, where residents are more likely to experience chronic stress and food insecurity.

The health knowledge mechanism: evidence on the link between education and health lifestyle in the Philippines

Studies have found substantial differences in health-related behavior and health care usage between educational groups, which may explain part of the well-documented educational gradient in health. The allocative efficiency hypothesis offers a behavioral explanation for these reported differences. According to this theory, the educated possess more health knowledge and information, allowing them to make better health choices. We perform a mediation analysis to study this mechanism using original survey data from the Philippines, a lower-middle-income country. As an extension of previous empirical research, we construct a comprehensive index that captures different dimensions of health knowledge. Using generalized propensity scores, we find strong support for the allocative efficiency argument. Schooling is significantly associated with health knowledge levels, which explain up to 69% of the education effect on health lifestyle. This corresponds to twice the mediation strength of economic resources, suggesting an important role of this factor in explaining education effects on health decisions.

Health status, health related behaviours and chronic health indicators in people with Tourette Syndrome: A Canadian population-based study

Tourette Syndrome (TS) is a childhood onset neuropsychiatric disorder. The objective of this study was to compare self-perceived health status, health-related behaviours, and chronic health conditions in individuals with and without TS using population-based data. Data were derived from Canadian Community Health Survey (CCHS) 2010 and 2011 cycles. The CCHS is a national population-based cross-sectional survey that collects information related to health status for Canadians. We evaluated the association between TS and self-perceived health, health related behaviours and chronic health conditions. 122,884 Canadians participated with 122 participants diagnosed with TS. After controlling for age and sex, the TS population was significantly less likely to have good self-perceived physical health and significantly more likely to need help with instrumental activities of daily living. More individuals with TS were diagnosed with an anxiety disorder, a mood disorder, or asthma. We observed no significant differences in health related behaviours between individuals with TS and the general population other than a higher odds of consultation for mental health. Individuals with TS experience a higher frequency of anxiety and mood disorders, and require more assistance with activities of daily living than the general population.

Differences in health-related behaviors between middle school, high school, and college students in Jiangsu province, China.

Increasing rates of obesity among Chinese adolescents has become a major public health concern in recent years. Studies have shown that factors such as food choices, physical activity, and screen time play important roles in fostering obesity. We examined a number of biological and social determinants that influence these factors. To determine whether dietary behavior, physical activity, and screen time varied among students in different stages of their education. Students in 13 cities across Jiangsu Province completed an anonymous survey assessing demographics and various health-related behaviors in a controlled setting. The survey population ranged from middle school students to undergraduates. 55,361 surveys were returned, and 46,611 (84.2%) were usable for the analysis. Multiple linear regression models were used to investigate the relationship between four behavioral factors (dietary behavior, screen time, physical activity, and moderate exercise) and seven predictors (gender, age, BMI, mother's education, nearsightedness, allowance, and geographic region). Baseline characteristics of the survey population analyzed by education level (middle school, high school, college and beyond) showed moderate differences in demographics among the three groups. Physical activity, moderate exercise, and dietary behavior decreased with educational level, while screen time increased. All predictors in the four considered regression models were statistically significant. This unique, large-scale survey of Chinese students in a region of contrasting economic development revealed numerous relationships between health-related diet and physical-activity, region, and education level. These findings can inform the development of measures to counteract the rise of obesity in China.

BMI-specific associations between health-related behaviours and overweight - a longitudinal study among Norwegian adolescents.

To investigate BMI-specific associations between health-related behaviours in early adolescence and the likelihood of overweight in mid-adolescence in a sample of Norwegian adolescents. Longitudinal study of 393 adolescents recruited from schools in Telemark County, Norway. Parents reported baseline data on children's behavioural variables and background data (at age 12-13 years). Dietary data were reported by means of a retrospective FFQ. Eating patterns were identified using principal component analysis. Height and weight were measured at baseline and 3-year follow-up. BMI-specific differences in health-related behaviours (eating patterns, physical activity and screen time) at baseline were analysed using cross-tabulation and Pearson's χ 2 test (Fisher's test). Associations between early health-related behaviours and the likelihood of later overweight were examined using multiple logistic regression. Primary and secondary schools, Telemark, Norway. Children (n 393) in 7th grade (mean age 12·7 (sd 0·3) years), followed up in 10th grade, and parents. A moderate to high intake of a varied Norwegian eating pattern combined with moderate-to-vigorous physical activity ≥1 h/d in the 7th grade were associated with a reduced likelihood of being overweight in the 10th grade, but only among already overweight adolescents (adjusted OR=0·2; 95 % CI 0·1, 1·0). Screen time of >3 h/d in the 7th grade was associated with an increased likelihood of subsequent overweight only among adolescents with an initial normal weight (adjusted OR=2·8; 95 % CI 1·1, 7·3). BMI-specific associations were observed between health-related behaviours in early adolescence and the likelihood of being overweight in mid-adolescence.