[Study of influence of healthy lifestyles on comorbidity and bidirectional association of dental caries and undernutrition in children and adolescents].

Objective: To investigate the impact of healthy lifestyles on the comorbidity and bidirectional associations of dental caries and undernutrition in children and adolescents in Guangxi Zhuang Autonomous Region, and provide scientific evidence for the development of targeted prevention and control strategies. Methods: From September to November 2023, a stratified cluster random sampling study was conducted in students from grade 4 (elementary school) to grade 3 (high school) in 111 counties (districts) in 14 prefectures in Guangxi Zhuang Autonomous Region in terms of physical examination, dental examination and questionnaire survey, and χ² test and binary logistic regression model were used to analyze the epidemiological status and influencing factors. Results: A total of 178 661 children and adolescents were surveyed, with the dental caries detection rate of 57.9% the undernutrition detection rate of 11.1%, and the comorbidity detection rate of 7.1%. The students living in rural counties (7.6%), boys (8.0%), those in Zhuang ethnic group (7.3%), and those aged 20 years (11.7%) had higher rates of comorbidity detection. The detection rate of dental caries in the undernutrition group (69.6%) was significantly higher than that in the non-undernutrition group (61.4%), and the detection rate of undernutrition in the dental caries group (12.3%) was significantly higher than that in the non-dental caries group (9.5%), the differences were significant (all P<0.05). The logistic regression analysis results showed that living in rural counties was the risk factor for the comorbidities. Being girl students, age 10-17 years, belonging to other ethnic groups other than Han and the Zhuang ethnic groups, eating vegetables every day, drinking milk or soybean milk every day, meeting the requirement of daily outdoor activities, and meeting the requirement of daily medium and high intensity exercise ≥60 minutes were the protective factors for the comorbidity. Conclusions: The prevalence of dental caries and undernutrition in children and adolescents in Guangxi Zhuang Autonomous Region was relatively serious, and the comorbidity existed and they might be interrelated. Those living in rural counties, boy students, those in Zhuang ethnic group, and those aged 20 years were key populations for the prevention and control of the comorbidity. Healthy lifestyles such as daily vegetable intake, daily milk or soybean milk intake, daily outdoor activity for ≥1 hour and daily high-intensity exercise for ≥60 minutes play a positive role in the prevention of the comorbidity.