| Objective This study aimed to study the current situation of screen related factors,dietary behaviours and overweight and obesity among pupils of 4—5 grades in Chongqing,and analyse the relationship between screen related factors with dietary behaviours and overweight and obesity.Therefore,this study can provide scientific reference and targeted suggestions for health education and policy formulation on pupils’ screen behaviours,dietary behaviours and overweight and obesity.Methods This study is a cross-sectional study.The contents of the questionnaire included the socio-demographic information(17 entries),screen related factors(7 entries),and dietary behaviours(12 entries).Students in grades 4 and 5 who met the inclusion criteria in more than280 primary schools in 31 districts and counties of Chongqing were coordinated to participate in the survey.The study was an online survey(through the “Questionnaire Star” platform).The survey was carried out jointly with the Chongqing Municipal Education Department,and the questionnaire was completed with the cooperation of the district and county education departments and primary schools.The investigation period was from September to October 2020.A total of 28,387 electronic questionnaires were collected,with 22,762 valid questionnaires.Use Stata16 software to analyse the data.The chi-square test was used for the univariate analysis,and the logistic regression was used for multivariate analysis.Result The mean age of the pupils was 9.7 years.The pupils in fourth and fifth grade accounted for 46.8% and 53.2%,respectively.Boys and girls accounted for 50.6% and 49.4%,respectively.67.2% of the pupils lived in cities or towns,and 81.0% had an average weekly pocket money of 0-10 yuan.And overweight and obese pupils accounted for 22.2%.The incidence of unreasonable screen related factors in pupils was relatively high.The proportions of average ST exceeding 2 h/d on weekdays,weekends,and a week were 16.5%,47.5% and 26.9%,respectively.Compared with before the Coronavirus Disease 2019(COVID-19)pandemic,48.1% of the students had increased ST during the epidemic.25.0% of the students watched electronic screens in the toilet.The top three types of food advertisements that students often see while watching electronic screens were dairy and dairy products(53.6%),sugary beverages(45.3%)and baked foods(40.6%).The proportions of1-2,3-4,and 5-6 kinds of unhealthy food advertisements that students often see while watching electronic screens were 42.4%,23.9%,and12.2%,respectively.24.8% of the students had their own mobile phone,10.4% of students have a TV in their bedroom.The unreasonable meal behaviours of the pupils was relatively high.Students who skipped 1-2,3-4,5-6,and >6 meals in the past 7 days accounted for 20.2%,4.7%,1.4%,and 2.9%,respectively.Students who ate a meal <1 time/week,1-3 times/week,4-6 times/week and >6times/week while watching electronic screens accounted for 23.2%,14.6%,2.2% and 2.0%,respectively.The incidence of unreasonable snacking behaviours of the pupils was relatively high.23.9% of the students ate snacks >3 times a day on average in the past 7 days.19.1% of the students responded that they consumed more snacks during the COVID-19 pandemic than before the pandemic.The proportions of the students eating snacks <1 time/week,1-3 times/week,4-6 times/week,>6 times/week while watching electronic screens were 30.1%,29.3%,3.1% and 1.7%,respectively.Among the types of snacks that students often eat while watching electronic screens,the top 5 are: pastries,fresh vegetables and fruits,beverages,milk and dairy products,fried foods.Among the 5 snacks,fried foods and beverages are unhealthy snacks.The results of students eating snacks while watching electronic screens in different scenes showed,the percentages of students who ate snacks while watching electronic screens at home,taking transportation,going out were 96.2%,27.3%,40.5%,respectively.The proportion of students who ate snacks while watching a movie in the cinema was 75.6%,and the proportion of students who ate snacks while taking online classes during the COVID-19 pandemic is 26.5%.The results of multivariate logistic regression analysis showed that pupils’ screen related factors can significantly influence their dietary behaviours and overweight and obesity.The risk factors for students skipping at least one meal in the past 7 days included ST >2 h/d,watching electronic screens in the toilet,often viewing 1-2 kinds of unhealthy food advertisements when watching electronic screens;while not having a cell phone and not having a TV in their bedroom were the protective factors(p<0.01).The risk factors for eating snacks >3 times a day included ST >2 h/d,watching electronic screens in the toilet,often viewing 3-4 or 5-6 kinds of unhealthy food advertisements while watching electronic screens;while not having a cell phone was the protective factor(p<0.01).The risk factors for students eating meals while watching electronic screens included ST >2 h/d,watching electronic screens in the toilet,often viewing 1-2 or 3-4 or 5-6 kinds of unhealthy food advertisements when watching electronic screens(p<0.01);while not having a cell phone was the protective factor(p<0.01).The risk and protective factors for students eating snacks while watching electronic screens were the same as the influencing factors for eating meals while watching electronic screens.The risk factors for students’ overweight and obesity included ST >2 h/d and watching electronic screens in the toilet.Conclusions The incidence of unreasonable screen behaviours,dietary behaviours,and overweight and obesity among pupils in Chongqing were relatively high.The screen related factors of pupils had a significant influence on their unreasonable dietary behaviours and overweight and obesity.Future interventions should explore the effect of improving pupils’ screen related factors on improving their dietary behaviours and controlling childhood overweight and obesity. |
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