四川省3.6万成年居民健康生活方式遵循情况

The healthy lifestyle compliance of 36000 adult residents in Sichuan Province

目的了解四川省成年居民4种健康生活方式的遵循情况和相关影响因素,分析其对全因死亡的潜在健康益处,并提出有针对性的健康促进策略。方法采用多阶段整群抽样的方法,随机抽取四川省8个县(区),调查参与2015年9月―2019年11月心血管病高危人群早期筛查与综合干预项目的成年居民的4种健康生活方式情况,包括不吸烟、不饮酒或适量饮酒、充足的身体活动、健康饮食。采用多变量回归模型对个人特征与遵循4种健康生活方式的关系进行分析,利用Cox回归模型对全因死亡风险比(hazard ratio,HR)及其95%CI进行估计。结果本研究共纳入36066名35~<75岁常住居民,调查对象中不吸烟者占74.6%、不饮酒或适量饮酒者占96.2%、有充足身体活动者占29.2%、遵循健康饮食者占6.2%,仅有2.7%的调查对象遵循上述所有的4种健康生活方式。女性、老年人、非农民、城市居民、高收入或高学历人群、有心血管病史的对象更有可能遵循所有4种健康生活方式(均P<0.001)。在随访2.4年后发现,坚持≥3种健康生活方式、坚持充足身体活动和不吸烟的人群有更低的全因死亡率风险[调整年龄和性别后,HR=0.47(95%CI:0.22~0.96),HR=0.63(95%CI:0.52~0.75),HR=0.79(95%CI:0.64~0.98)]。结论四川省成年居民对充足身体活动和健康饮食的遵循情况不理想,应作为健康促进的重点方向,并针对不同的危险因素采取针对性措施,以取得更好的防控效果。

Objective To explore the adherence of four healthy lifestyles,related influencing factors,and potential health benefits for all-cause deaths among adult residents in Sichuan Province,and propose targeted health promotion strategies.Methods Using the multi-stage cluster sampling method,8 counties(districts)in the province were randomly selected for the four healthy lifestyle conditions of the surveyed residents from 2015 to 2019,including non-smoking,non-drinking or moderate drinking,adequate physical activity,and healthy diet.The relationship between individual characteristics and following the four healthy lifestyle was analyzed using multivariable regression models,and Cox regression models estimated the risk ratios of all-cause deaths(HR)and their 95%confidence intervals.Results A total of 36066 permanent residents aged 35 to 75 years were included in this study.Among the respondents,74.6%were non-smokers,96.2%were non-alcoholic or moderate alcohol,29.2%had sufficient physical activity,6.2%followed a healthy diet,and only 2.7%of the respondents followed all the above four healthy lifestyles.Women,the elderly,non-farmers,urban residents,people with high income or high education,or people with a history of cardiovascular disease were more likely to follow all four healthy lifestyles(P<0.001).After 2.4 years of follow-up,those adhering to three or more healthy lifestyles,adherence to adequate exercise,and non-smoking had lower all-cause mortality[adjusting for age and sex,HR=0.47(95%CI:0.22-0.96),HR=0.63(95%CI:0.52-0.75),and HR=0.79(95%CI:0.64-0.98)].Conclusions Compliance with adequate physical activity and a healthy diet for adult residents in Sichuan Province is not ideal,which should be the focus of health promotion,and targeted measures should be taken to control different risk factors to achieve better prevention and control effects.