Relationship between comprehensive healthy lifestyle score and multimorbidity among children and adolescents

Objectives: This study was initiated to examine the relationship of the comprehensive healthy lifestyle score with multimorbidity in children and adolescents. Methods: A cluster random sampling method was employed from October to December 2023, selecting three schools each from Linghe District and Beizhen City in Jinzhou, Liaoning Province, China, with a total student population of 9572 individuals and an effective sample size of 9273 individuals. Informed consent forms have been obtained from all research subjects as well as their parents or guardians. The basic demographic information of the research subjects and their lifestyle-related factors such as physical activity, screen time, sleep time and diet were investigated. The comprehensive healthy lifestyle score was calculated. The subjects were also analysed for the presence of obesity, myopia, scoliosis, dental caries and mental health problems, with two or more of these diseases being defined as ‘multimorbidity’. Statistical analysis was performed using chi-square test, univariate, multivariate analyses, and stratified analysis. Results: The overall prevalence rate of multimorbidity was 66.92%. Among the demographic variables, sex, age group, type of household registration, boarding at school and mother’s educational level were significantly associated with the prevalence of multimorbidity (all P <0.05). After adjusting for all confounding factors, the prevalence ofmultimorbidity in children and adolescents was related to the comprehensive healthy lifestyle score (OR=0.81, 95% CI=0.70–0.94, P <0.05) and physical activity score (OR=0.84, 95% CI=0.75–0.95, P <0.05), with higher values of both being protective. Conclusion: This study showed that multimorbidity in children and adolescents was related to the comprehensive healthy lifestyle score and physical activity score, with higher scores of both being protective against multimorbidity.