Association of dietary behaviors, physical activity and altitude with nutritional status among children and adolescents

ZHANG Dengcheng; JIANG Jianuo; CHEN Li; PUBU Zhuoma; TAN Liming; ZHANG Xiuhong; YANG Tian; DONG Ziqi; QIN Yang; LU Zhenting; MA Jun; DONG Yanhui

doi:10.16835/j.cnki.1000-9817.2025246

Volume 46 Issue 10

Oct. 2025

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Article Navigation > CHINESE JOURNAL OF SCHOOL HEALTH > 2025 > 46(10): 1411-1415

ZHANG Dengcheng, JIANG Jianuo, CHEN Li, PUBU Zhuoma, TAN Liming, ZHANG Xiuhong, YANG Tian, DONG Ziqi, QIN Yang, LU Zhenting, MA Jun, DONG Yanhui. Association of dietary behaviors, physical activity and altitude with nutritional status among children and adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(10): 1411-1415. doi: 10.16835/j.cnki.1000-9817.2025246

Citation:

ZHANG Dengcheng, JIANG Jianuo, CHEN Li, PUBU Zhuoma, TAN Liming, ZHANG Xiuhong, YANG Tian, DONG Ziqi, QIN Yang, LU Zhenting, MA Jun, DONG Yanhui. Association of dietary behaviors, physical activity and altitude with nutritional status among children and adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(10): 1411-1415. doi: 10.16835/j.cnki.1000-9817.2025246

Citation:

ZHANG Dengcheng, JIANG Jianuo, CHEN Li, PUBU Zhuoma, TAN Liming, ZHANG Xiuhong, YANG Tian, DONG Ziqi, QIN Yang, LU Zhenting, MA Jun, DONG Yanhui. Association of dietary behaviors, physical activity and altitude with nutritional status among children and adolescents[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(10): 1411-1415. doi: 10.16835/j.cnki.1000-9817.2025246

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Association of dietary behaviors, physical activity and altitude with nutritional status among children and adolescents

doi: 10.16835/j.cnki.1000-9817.2025246

1.
School of Public Health/Institute of Child and Adolescent Health, Peking University, Beijing 100191, China

Received Date: 2025-03-26
Rev Recd Date: 2025-04-21
Publish Date: 2025-10-25

Abstract

Abstract

Objective To analyze the association between altitudes and nutritional status of children and adolescents, and to explore the moderating effects of dietary behaviors and physical activity, so as to provide a scientific basis for developing lifestyle interventions tailored to local conditions. Methods From September to November 2023, physical examinations and questionnaire surveys were conducted among children and adolescents aged 7-17 in two autonomous regions, Inner Mongolia and Xizang, with a final sample of 156 511 participants by the stratified cluster random sampling method. Height and weight were measured to calculate body mass index (BMI). Sociodemographic characteristics, dietary behaviors, and physical activity were collected via questionnaires, while the altitude of each participant's school was obtained using Amap. Logistic regression was performed to examine the relationship between altitudes and nutritional status. Interaction terms and stratified analyses were applied to assess the moderating effects of dietary behaviors and physical activity. Restricted cubic spline (RCS) were used for visualization. Results In 2023, the prevalence of wasting and overweight/obesity among children and adolescents in Xizang were 9.7% and 9.0%, respectively, compared to 2.9% and 22.0% in Inner Mongolia. Logistic regression analysis results showed that for every 1 km increase in altitude, the risk of wasting increased, while the risk of overweight/obesity decreased (OR=1.43, 0.19, both P < 0.05). The results of the stratified analysis showed that compared to those living at altitudes < 1 km, children and adolescents with healthy diets showed no significant association between altitudes (1- < 2 and 2- < 3 km) and wasting (OR=1.22, 0.75, both P>0.05), whereas significant associations were observed at 3- < 4 and ≥4 km altitudes (OR=2.25, 2.89, both P < 0.05). In contrast, unhealthy dietary groups showed statistically significant associations across altitudes (OR=1.18-4.04, all P < 0.05), consistent with RCS results. No moderating effects were observed for physical activity on the altitude-wasting association or for dietary behaviors and physical activity combined on the altitude-overweight/obesity association (P_interaction=0.63, 0.10, 0.53). Conclusion Healthy dietary behaviors play a critical role in improving the nutritional status of children and adolescents and reducing regional disparities, providing a scientific foundation for public health policy formulation and implementation.
- Food habits,
- Motor activity,
- Altitude,
- Nutritional status,
- Regression analysis,
- Child,
- Adolescent

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References(26)

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