Background: Insufficient sleep and skipping breakfast are very common phenomena in China and have been proposed as possible causes of overweight/obesity, but the results of former studies remain inconsistent. Objective: To investigate the individual and joint association of insufficient sleep and skipping breakfast with overweight/obesity among children and adolescents in Jiangsu Province, China. Methods: Participants were 36 849 students aged 8-17 years from the 2019-2020 project "Surveillance for common disease and health risk factors among students." Self-reported insufficient sleep and skipping breakfast were ascertained by selfreported sleep duration and breakfast habit. Overweight/obesity was assessed according to the gender-and age-specific body mass index. We used logistic regression models to explore the association of sleep and breakfast with overweight/obesity, and stratification analyses to test age or gender differences. Results: The overall prevalence of overweight/obesity was 33.2%. Insufficient sleep (OR = 1.09, 95% CI = 1.03-1.16) or skipping breakfast (OR = 1.14, 95% CI = 1.07-1.21) was associated with overweight/obesity. Compared to participants with 'sufficient sleep and breakfast', ORs were 1.25 (95% CI = 1.15-1.35) for those with 'both insufficient sleep and skipping breakfast'. The separate and joint association of sleep and breakfast with overweight/obesity remained generally consistent across different age and gender subgroups, except that the 8-12-year-olds group and female students appear more susceptible. Conclusions: Insufficient sleep and skipping breakfast were jointly associated with overweight/obesity in children and adolescents. Appropriate attention should be paid to these modifiable behaviours including sleep and breakfast in the context of the rapidly growing obesity epidemic among children and adolescents.

Background: The Prevalence of myopia is increasing in China. This study aimed to explore the distribution of spherical equivalent (SE) and its association with age, body mass index (BMI), gender in a non-myopic Chinese children population aged 6 to 12 years. Methods: A total of 6362 students were recruited for ophthalmological investigation. Demographic and myopia related behavioral information was collected. SE value was measured by the Topcon RM-8900 or KR-800autorefractors. Potential independent risk factors were determined with Odds Ratio (OR) and 95% Confidence Interval (CI) by logistic regression analysis. We further constructed the nomogram model to predict future onset of myopia.Results: Among the study population, 3900 (61.3%) were non-myopic. The prevalence of myopia is 38.0% for boys and 39.5% for girls. The average SE values were 0.50±0.70 D for boys and 0.60±0.80 D for girls. The mean SE values decreased with age, and the value of height and BMI took on a stable trend. Threshold values for myopia varied across age groups and gender. Paternal myopia (OR: 1.22, 95%CI: 1.01-1.48), near-work activities on weekends (2.56, 1.17-5.61), and outdoor activities (0.68, 0.54-0.86) were associated with potential myopic in students. Conclusion: A series of age-gender based SE threshold values were established to predict myopia in Chinese children aged 6 to 12 years. High risk factors for myopia included paternal myopia, near-work activities on weekends, and outdoor activities. Countermeasures are encouraged to reverse the increasing trend of myopia in children.

Purpose. This study aims to increase our understanding of the relationship between family and myopia in Chinese children. Methods. Students had a physical examination and were required to provide the necessary demographic information. Children and their guardians from different family types were required to fill in a questionnaire concerning myopia factors. Results. In this study, the prevalence of myopia in enrolled students aged 6–17 is 55.5%. The proportion of the nuclear family, extended family, single-parent family, and left-behind family is 40.6%, 43.7%, 11.1%, and 4.6%, respectively. Myopia rates from different family types by the order (nuclear family, extended family, single-parent family, and left-behind family) are 60.0%, 52.0%, 54.7%, and 50.9% taking on a decreasing trend, which shows an opposite trend comparing with elevated blood pressure, dental caries, and obesity. The interaction effect of the family type and region, physical examination, lifestyle (including diet habits, near work, outdoor activities, and sleep), and types of lamps and whether scolded by parents can have a significant impact on myopia. For primary school students (grade: 1–5), the prevalence of myopia in the nuclear family was a bit higher than that of myopia in the left-behind family, but for children in junior and senior high schools, both prevalences stayed similar. Conclusions. In this study, education pressure and time outdoors are still at play, and this kind of effect shows different phenomena in different families. Therefore, previous interventions would still work, and then the most critical challenge would be to ensure that left-behind children completed more schooling.

Background: This study aimed to explore the distribution of spherical equivalent (SE) and its association with age, BMI, sex in a non-myopic Chinese children population aged 6 to 12 years. Alarming threshold values were proposed to predict the future onset of myopia, and relationship between alert values and myopia related factors was explored.Methods: Demographic information was gathered from an ophthalmic examination taken by a total of 6362 students. SE value was obtained by the application of autorefractors. Some of the parents filled in a questionnaire of factors related to myopia among children.Results: Among 6362 students, 3900 (61.3%) were non-myopic. The prevalence of myopia is 38.0% for boys and 39.5% for girls. The average SE values were 0.50±0.70 D for boys and 0.60±0.80 D for girls. The mean SE values decreased with age, and the value of height and BMI took on a stable trend. Alarming threshold values for myopia were set as follows: for children aged 6 years, 0.40-0.60 D for boys and 0.80-1.00 D for girls; for children aged 7 years, 0.40-0.60 D for boys and 0.30-0.50 D for girls; for children aged 8 years, 0.20-0.40 D for boys and 0.30-0.50D for girls; for children aged 9 years, 0.20-0.40 D for boys and 0.30-0.40D for girls; for children aged 10 years, 0.10-0.30 D for boys and 0.30D for girls; for children aged 11 years, 0.10-0.30 D for boys and -0.30-0.30 D for girls; for children aged 12, -0.10-0.10 D for boys and -0.30-0.10 D for girls. Paternal myopia (OR: 1.22, 95%CI: 1.01-1.48), near work on weekends (OR: 2.56, 95%CI: 1.17-5.61), and outdoor activities (OR: 0.68, 95%CI: 0.54-0.86) had an impact on non-myopic students with myopic alarming threshold.Conclusion: This study described a distribution of refraction for non-myopic students in Jiangsu Province, China. A series of alert values were proposed to provide early warning reference for Chinese children aged 6 to 12 years. Paternal myopia, near work, and outdoor activities had an impact on non-myopic students with myopic alert threshold, and sensitive continuous data concerning risk factors mentioned above should be explored to be used as an early alert value in the future.

School bullying is a worldwide problem. Although previous studies examined the association between different lifestyle behaviors and bullying victimization, the complex co‐occurrence of these behaviors was not identified, and their association with the risk of being bullied remains unclear. We aimed to identify the behavioral patterns of adolescents and to explore their association with bullying victimization. This cross‐sectional study employed data from the “Surveillance for Common Diseases and Health Risk Factors among Students” project implemented in Jiangsu Province of China in 2019, and a total of 25,379 school‐enrolled students were included. We used a latent class analysis to identify behavioral patterns and a regression mixture model to explore various demographic characteristics, such as age, sex, and family structure in relation to bullying victimization across different patterns. We considered respondents having targeted behaviors, including smoking, alcohol consumption, illicit drug use, sugar consumption, no fruit consumption, low physical activity, electronic media use, and insufficient sleep. Four behavioral patterns were identified, including the “adolescents without apparent targeted behaviors” (19.65%), “substance and electronic media users” (12.76%), “typical electronic media users” (54.49%), and “typical substance users” (8.10%). The risk of being bullied was the highest in the “substance and electronic media users” (probability: 0.33), tripled that in “adolescents without apparent targeted behaviors” (odds ratio: 3.60, 95% confidence interval: 3.01–4.30). Risk of being bullied was reduced for those "substance and electronic media users" living with a nuclear family. Behavioral patterns and their association with being bullied differ between groups of school‐aged adolescents. To better inform decision‐making based on the current real‐world findings, the implementation of bullying prevention programs could target specific behavioral patterns.