Healthy Lifestyle Matters: A Network Analysis of Urban Chinese Pre-School Children's Adiposity, Sleep Health, Mental Health, Child Functioning and Health Behaviours.

BACKGROUND

In the Chinese context, a greater emphasis is placed on academic skills rather than healthy lifestyles among pre-school children. To promote well-being as a whole, a comprehensive interpretation of multivariant relationships between health, functioning and well-being is necessary for children in this age group.

METHODS

The current study adopted a network analysis among 422 urban Chinese pre-school children (57.8 ± 9.7 months, 54.2% boys) to detect the inter-relationships between the variables from nine domains, including demographics, adiposity, physical activity levels, executive function, motor coordination, sleep disturbance, diet health and mental strengths and difficulties. Data was obtained through both questionnaires completed by parents and direct assessment among children.

RESULTS

Findings indicated that poor well-being outcomes were prevalent among the participating children, including risk of central obesity (18.9%), global sleep disturbance (38.4%) and moderate-to-severe mental difficulties (42.6%). The network analysis demonstrated that age fully/partially mediated the associations among child functioning such as executive function and motor coordination. Mental strength, mental difficulties and sleep health had mutual correlations, however, none of them had a significant relationship with age. Furthermore, sex played little role in the network.

CONCLUSION

This study supports that healthy lifestyle is crucial for Chinese pre-school children to learn and practice. Results of network analysis implies that education on child's mental health are warranted for children, parents and teachers. A balance between academic achievement and child's health well-being should be prioritized in child care and early childhood education.