Overweight, obesity, and screen-time viewing among Chinese school-aged children: National prevalence estimates from the 2016 Physical Activity and Fitness in China—The Youth Study

Purpose: This study presents the most recent estimates of prevalence of overweight, obesity, and screen-time viewing among Chinese school-aged children. Demographic differences in these estimates between sexes and resident locales were also examined.Methods: Cross-sectional analyses of 116,615 Chinese school children 9 to 17 years of age who participated in the 2016 Physical Activity and Fitness in China—The Youth Study project. Outcomes were the prevalence of children's overweight(85 th ≤ body mass index(BMI) < 95 th percentile) and obesity(BMI ≥95 th percentile)(defined by the Working Group on Obesity in China) and not meeting screen-time viewing recommendations("not meeting" was defined as more than 2 h per day of viewing activities after school). Analyses were conducted on the whole sample and by school grade cohorts(primary, junior middle, and junior high schools), sex, and residence locales(urban, rural).Results: Overall, 14.4%(95% confidence interval(CI): 13.8%–15.0%) of children and adolescents were overweight, 11.9%(95%CI: 11.0%–13.0%) were obese, and 36.8%(95%CI: 34.7%–38.9%) did not meet screen-time viewing recommendations. Across the 3-grade cohorts, boys were more likely to be obese than girls, and primary and junior middle school children living in urban areas were more likely to be obese than those living in rural areas. Primary and junior middle school boys were less likely to meet screen-time recommendations than girls, and junior high school children living in urban areas were less likely to meet screen-time recommendations than school children of the same grades living in rural areas.Conclusion: In 2016, the prevalence of obesity among Chinese school children was about 12%, and about 37% of them did not meet screen-time viewing recommendations. The prevalence of obesity and sedentary behavior was generally higher among boys than among girls, and it was higher for children living in urban areas than for those living in rural areas.

School and community physical activity characteristics and moderate-to-vigorous physical activity among Chinese school-aged children： A multilevel path model analysis

Purpose: The purpose of this study was to examine the association between school and community physical activity(PA) characteristics and levels of moderate-to-vigorous physical activity(MVPA) among Chinese school children.Methods: Data were obtained from the 2016 Physical Activity and Fitness in China—The Youth Study project. Participants were 80,928 school children(Grades 4–12; 39,747 boys, 41,181 girls; mean age = 13 years) and 935 physical education(PE) teachers who completed a study survey.Independent variables included both school-related factors(school-level PA support, availability of and access to PA facilities, and the duration of school PE classes) and community-related factors(the frequency of sports events, sports training opportunities, availability of sports clubs and organizations, and access to PA facilities). The dependent variable was the children's self-reported participation in MVPA. The data were analyzed,in 2017, via multilevel modeling.Results: PA support from school administrators was the only school-level factor significantly related to children's participation in MVPA.Children's perceptions of the frequency of community-sponsored sports events, availability of sports clubs and organizations, and convenient access to PA facilities were associated with a high level of MVPA participation. In regard to residency in urban and rural areas, children attending urban schools who perceived high availability of PA facilities were associated with a low level of participation in MVPA.Conclusion: School support for PA and community PA resources are associated with MVPA among Chinese school children. School PA facilities appear underutilized among urban schools as evidenced by low levels of MVPA among school children.

Associations between parental support for physical activity and moderate-to-vigorous physical activity among Chinese school children： A cross-sectional study

Purpose: The objective of this study was to examine the associations between parental support for physical activity(PA) and levels of moderate-to-vigorous physical activity(MVPA) among Chinese school children.Methods: Study participants were 81,857 school-aged children(aged 9–17 years; mean age = 13 years; 49.0% boys) and their parents or guardians who took part in the 2016 Physical Activity and Fitness in China—The Youth Study project. The independent variables included various forms of parental support for PA ascertained through a survey completed by parents or guardians. The dependent variable was the children's average MVPA in minutes per day by self-report. Structure equation modeling was used to examine the associations between parental support for PA and children's MVPA minutes.Results: The overall mean for MVPA participation time for the child participants was 48.82 ± 28.71 min/day. Significant associations between various forms of parental support and MVPA among children were found. Parental encouragement, accompanying, financial support, involvement,and role modeling for PA were positively associated with a high level of student MVPA participation. Parental PA knowledge-sharing was not associated with MVPA. The patterns of the associations were similar across sex, residence locale(i.e., urban and rural), and school grades(primary,junior middle, and junior high schools).Conclusion: Findings from this study suggest that, among Chinese school children, parental support for PA is important in promoting and facilitating children's participation in MVPA.

Neighborhood environment,physical activity,and quality of life in adults:Intermediary effects of personal and psychosocial factors

Background: Studies have indicated that there is a positive and indirect relationship between physical activity(PA) and quality of life(QoL). The current study examined this relationship through a social cognitive model with consideration to the intermediary effects of exercise self-efficacy,and physical(PCS, physical component summary) and psychological(MCS, mental component summary) health. Additionally, this model was widened to include concepts from the ecological theory, and any causal associations among neighborhood environment, PA, and QoL.Methods: Six hundred and eighty-four physically active adults(39.16 ± 13.52 years, mean ± SD), living in Athens, Greece, completed a series of questionnaires measuring PA, QoL, exercise self-efficacy, PCS, MCS, neighborhood environment, and family and friend support for PA. The examined models were analyzed using structural equation modeling.Results: The social cognitive and ecological models proved to be of appropriate fit. Within the social cognitive model, PA positively affected QoL through the mediating effects of exercise self-efficacy, PCS, and MCS. With regards to the ecological model, neighborhood environment positively influenced QoL through the intermediary effects of family support for PA, exercise self-efficacy, PA, PCS, and MCS.Conclusion: Results indicated that the most important mediators in the examined models were exercise self-efficacy and health. Further, findings demonstrated the role of neighborhood environment in enhancing PA and QoL. Future studies should be carried out applying longitudinal data for a better understanding of these associations over time.

Prevalence and correlates of meeting the muscle-strengthening exercise recommendations among Chinese children and adolescents:Results from 2019 Physical Activity and Fitness in China—The Youth Study

Purpose This study aimed to describe the national prevalence of Chinese children and adolescents who met the World Health Organization muscle-strengthening exercise(MSE)recommendations and identify correlates of meeting the MSE recommendations.Methods Cross-sectional data from the 2019 Physical Activity and Fitness in China—The Youth Study,a nationally representative sample of Chinese children and adolescents(n=80,413;mean age=13.7 years;53.9%girls)and their parents,were analyzed.Children and adolescents who reported engaging≥3 days(up to 7 days)of MSE per week were classified as meeting the MSE recommendations.MSE,demographics,lifestyle behaviors(sport participation,moderate-to-vigorous physical activity,screen time,and sleep duration),exercise intention,peer and parental support,and parental MSE participation were assessed through self-reports.Logistic regression models were used to determine the correlates of meeting the MSE recommendations.The analyses were completed in 2020.Results Overall,39.3%of children and adolescents met the MSE recommendations.Girls,10th-12th graders,minorities,those from lower income households and those from families with lower parental education were less likely to meet the MSE recommendations.Children and adolescents who were proficient in≥2 sports were more likely to meet the MSE recommendations(adjusted odds ratio(aOR)=1.44,95%confidence interval(95%CI):1.26-1.65),as were those with more moderate-to-vigorous physical activity(aOR=1.57,95%CI:1.53-1.61).Additionally,children and adolescents with high exercise intention(aOR=1.60,95%CI:1.51-1.69),those whose parents met the adult MSE recommendations(aOR=1.46,95%CI:1.40-1.52),and those who received high peer(aOR=1.27,95%CI:1.20-1.34)and parental support(aOR=1.07,95%CI:1.04-1.12)were more likely to meet the MSE recommendations.Conclusion Less than two-fifths of Chinese children and adolescents met the World Health Organization MSE recommendations.The correlates identified in our study can help inform the development of school and community based strategies and policies to enhance participation in MSE and improve muscular fitness of all Chinese children and adolescents.

Deconstructing athletes’sleep:A systematic review of the influence of age,sex,athletic expertise,sport type,and season on sleep characteristics

Purpose:This systematic review aimed to describe objective sleep parameters for athletes under different conditions and address potential sleep issues in this specific population.Methods:PubMed and Scopus were searched from inception to April 2019.Included studies measured sleep only via objective evaluation tools such as polysomnography or actigraphy.The modified version of the Newcastle-Ottawa Scale was used for the quality assessment of the studies.Results:Eighty-one studies were included,of which 56 were classified as medium quality,5 studies as low quality,and 20 studies as high quality.A total of 1830 athletes were monitored over 18,958 nights.Average values for sleep-related parameters were calculated for all athletes according to sex,age,athletic expertise level,training season,and type of sport.Athletes slept on average 7.2±1.1 h/night(mean±SD),with 86.3%±6.8%sleep efficiency(SE).In all datasets,the athletes’mean total sleep time was<8 h.SE was low for young athletes(80.3%±8.8%).Reduced SE was attributed to high wake after sleep onset rather than sleep onset latency.During heavy training periods,sleep duration and SE were on average 36 min and 0.8%less compared to pre-season and 42 min and 3.0%less compared to in-season training periods,respectively.Conclusion:Athletes’sleep duration was found to be short with low SE,in comparison to the general consensus for non-athlete healthy adults.Notable sleep issues were revealed in young athletes.Sleep quality and architecture tend to change across different training periods.

Associations of Sport Participation with Depression and Anxiety among Chinese Minority Adolescents

This study aimed to explore associations of sport participation with anxiety and depressive symptoms among Chi-nese minority adolescents.A cross-sectional study was conducted among Chinese adolescents in Tibet.A conve-nience sample method was used to select participants.Finally,1452 students completed the survey and 1421(52.10%girls,Grades 4–9,13.46±1.41 years old)adolescents met the inclusion criteria of analysis.Sociodemo-graphic variables,sport participation,depression and anxiety were evaluated by self-reported questionnaires.Among 1421 participants,80%of adolescents lived in rural area and more than fourfifths of participants had siblings.The parent’s education level of participants was mostly middle school and below.The prevalence of par-ticipating in sport more than 3 times per week was only 7%.More than one-third of adolescents reported they never engaged in sport and 36.5%of adolescents took part in sport 1–3 times per month.In comparison with participants who never engaging in sport participation,those who engaging in one to three time/month(OR=0.71%,95%CI:0.54–0.93)and more than 3 times/week(OR=0.50%,95%CI:0.32–0.79)were less likely to report severe depression symptoms.Compared with participants who never had sport participation,only those counterparts who engaged in sport more than 3 times/week had lower odds for severe anxiety(OR=0.46%,95%CI:0.29–0.73).These results indicated that engaging in sport participation was negatively associated with depres-sion and anxiety.There is an urgent need to improve the level of sport participation for Chinese minority ado-lescents,and to explore the mechanism of exercise under hypoxia on mental health.

No independent associations between physical activity and clinical outcomes among hospitalized patients with moderate to severe COVID-19

Background:Regular physical activity(PA)has been postulated to improve,or at least maintain,immunity across the life span.However,the link between physical(in)activity and coronavirus disease 2019(COVID-19)remains to be established.This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19.Methods:Hospitalized patients with COVID-19(mean age:54.9 years)were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo(a quaternary referral teaching hospital)and from Ibirapuera Field Hospital,both located in Sao Paulo,Brazil.PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity.The primary outcome was hospital length of stay.The secondary outcomes were mortality,admission to the intensive care unit(ICU),and mechanical ventilation requirement.Results:The median hospital length of stay was 7.0§4.0 days,median§IQR;3.3%of patients died,13.8%were admitted to the ICU,and 8.6%required mechanical ventilation.Adjusted linear regression models showed that PA indices were not associated with hospital length of stay(work index:b=-0.57(95%confidence interval(95%CI):-1.80 to 0.65),p=0.355;sport index:b=0.43(95%CI:-0.94 to 1.80),p=0.536;leisure-time index:b=1.18(95%CI:-0.22 to 2.59),p=0.099;and total activity index:b=0.20(95%CI:-0.48 to 0.87),p=0.563).None of the PA indices were associated with mortality,admission to the ICU,or mechanical ventilation requirement(all p>0.050).Conclusion:Among hospitalized patients with COVID-19,PA did not independently associate with hospital length of stay or any other clinically relevant outcomes.These findings should be interpreted as meaning that,among already hospitalized patients with more severe forms of COVID-19,being active is a potential protective factor likely outweighed by a cluster of comorbidities(e.g.,type 2 diabetes,hypertension,weight excess)and older age,suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.

Physical exercise,Sedentary Behaviour,Sleep and Depression Symptoms in Chinese Young Adults During the COVID-19 Pandemic:A Compositional Isotemporal Analysis

Numerous studies links movement activity(e.g.,physical activity,sedentary behavior[SB],and sleep)with mental health or illness indicators during the COVID-19 pandemic;however,research has typically examined time-use behaviors independently,rather than considering daily activity as a 24-hour time-use composition.This cross-sec-tional study aimed to use compositional isotemporal analysis to estimate the association between reallocation of time-use behaviors and depression symptoms in young adults in China.Participants(n=1475;68.0%of female;20.7[1.60]years)reported their time spent in moderate to vigorous physical activity(MVPA),light physical activ-ity(LPA),SB,and sleep.Replacing SB with sleep,LPA,and MVPA at 5,10,or 15 min was significantly associated with lower estimated depression symptoms scores.For example,adding MVPA from SB at 15 min was associated with lower depression symptoms scores(estimated difference:-0.13[-0.17,-0.09]).The associations between reallocation of time use behaviors with depression symptoms scores were slightly differentiated.Our results emphasize the importance of increased MVPA and decreased SB as well as their mutual replacements for lowering the risks of depression symptoms in young adults during the COVID-19 pandemic.Our results can inform policy to develop effective plans and strategies for mental health promotion.

Cross-Sectional Associations of Lifestyle Behaviors with Depressive Symptoms in Adolescents

This study aimed to examine the associations between lifestyle behaviors and depressive symptoms in adolescents.Self-reported data from the 2019 Youth Risk Behavior Survey(YRBS)was analyzed.Depressive symptoms were set as the outcome variable.Movement variables(physical activity,muscle-strengthening exercise,physical education attendance,sports team participation,television watching,video or computer games,and sleep),eating behaviors(fruit intake,vegetable intake,milk intake,and eating breakfast or not),and substance use(alcohol use and cigarette use)were included as explanatory variables.Binary logistic regression was used to explore the asso-ciations between lifestyle behaviors and depressive symptoms after adjusting for sex,age,grade,race,and weight status.Of 13,677 participants who completed the investigation,girls were more than boys(50.3%vs.48.6%).The proportion of participants in grades 9,10,11,and 12 was 26.6,27.2,24.3,and 20.8,respectively.Of them,the prevalence of depressive symptoms was 36.0%(weighted%:36.7%[35.1%,38.3%]).Among all the lifestyle behaviors included,participating in no sports teams(OR=1.53[1.32,1.77]),spending more than 2 h in video or computer games(OR=1.64[1.40,1.92]),sleeping less than 8 h nightly(OR=1.79[1.45,2.20]),not eating breakfast(OR=1.56[1.37,1.78]),alcohol use(OR=1.74[1.49,2.02]),and cigarette use(OR=1.83[1.42,2.37])were associated with higher odds of depressive symptoms.To reduce depressive symptoms in adolescents,interventions can consider encouraging adolescents to engage in team sports activity,limit time for video or com-puter games,sleep enough,regularly eat breakfast,and avoid using alcohol and cigarette.Future studies are encouraged to verify our researchfindings by using a more improved study design.

Meeting 24-h movement guidelines: Prevalence, correlates, and the relationships with overweight and obesity among Chinese children and adolescents

Background:Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health,although it has been under-studied in China.Hence,this study aimed to investigate the prevalence of meeting the 24-h movement guidelines,its correlates,and its relationships with body mass index in children and adolescents in China.Methods:Cross-sectional data from the 2017 Youth Study in China of 114,072 children and adolescents(mean age=13.75 years,49.18%boys)were used.Meeting 24-h movement guidelines(60 min of daily moderate-to-vigorous physical activity,2 h of daily leisure screen time,911 h and 810 h nightly sleep duration for 613-year-olds and 1417-year-olds,respectively)and height and weight of all participants were assessed.The prevalence of meeting the 24-h movement guidelines and World Health Organization weight status categories were determined.Generalized linear models were used to determine the correlates of meeting the 24-h movement guidelines and the relationships of meeting the 24-h movement guidelines with overweight(OW)and obesity(OB).Results:Only 5.12%of Chinese children and adolescents met the 24-h movement guidelines,and 22.44%were classified as OW/OB.Older children and adolescents were less likely to meet the 24-h movement guidelines.Parental education level and family income were positively related to meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines showed lower odds ratios for OW/OB.Compared with participants meeting the 24-h movement guidelines,boys in 4th6th grades met none of the recommendations(OR=1.22,95%CI:1.061.40),met the screen time recommendation only(OR=1.13,95%CI:1.011.28),met the nightly sleep duration recommendation only(OR=1.14,95%CI:1.031.28),and had significantly higher odds ratios for OW/OB.Similar trends were observed for girls in 4th6th grades:meeting none of the guidelines(OR=1.35,95%CI:1.141.59),meeting sleep duration guidelines only(OR=1.23,95%CI:1.081.39),and meeting moderate-to-vigorous physical activity+nightly sleep duration guidelines(OR=1.24,95%CI:1.011.54).For girls in 7th9th grades,the following trend was observed:meeting none of the guidelines(OR=1.30,95%CI:1.011.67).Conclusion:Very few Chinese children and adolescents met the 24-h movement guidelines.Age(negatively correlated),parental education level,and family income(both positively correlated)were correlates of meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines were more likely to have lower risks for OW/OB,especially in the youngest age group(Grades 46);and girls in the middle age group(Grades 79)were also more likely to have lower risks for OW/OB.Further research studies should explore additional correlates and determinants for meeting the 24-h movement guidelines.Also,future studies should use longitudinal or interventional designs to determine the relationships between meeting the 24-h movement guidelines and OW/OB and other health indicators,while taking sex and age differences into account.

Exercise training in hypertension:Role of microRNAs

Hypertension is a complex disease that constitutes an important public health problem and demands many studies in order to understand the molecular mechanisms involving his pathophysiology. Therefore, an increasing number of studies have been conducted and new therapies are continually being discovered. In this context, exercise training has emerged as an important non-pharmacological therapy to treat hypertensive patients, minimizing the side effects of pharmacological therapies and frequently contributing to allow pharmacotherapy to be suspended. Several mechanisms have been associated with the pathogenesis of hypertension, such as hyperactivity of the sympathetic nervous system and renin-angiotensin aldosterone system,impaired endothelial nitric oxide production, increased oxygen-reactive species, vascular thickening and stiffening, cardiac hypertrophy, impaired angiogenesis, and sometimes genetic predisposition. With the advent of microRNAs(miRNAs), new insights have been added to the perspectives for the treatment of this disease, and exercise training has been shown to be able to modulate the miRNAs associated with it. Elucidation of the relationship between exercise training and miRNAs in the pathogenesis of hypertension is fundamental in order to understand how exercise modulates the cardiovascular system at genetic level. This can be promising even for the development of new drugs. This article is a review of how exercise training acts on hypertension by means of specific miRNAs in the heart, vascular system, and skeletal muscle.

Promoting physical activity among Chinese youth:No time to wait

Dear Editor,In the December 2016 issue of Journal of Sport and Health Science,Dr.Barbara E.Ainsworth highlighted a global view of youth physical activity(PA)based on the results from the Global Matrix 2.0.~1Joining 38 countries on 6 continents,China,as the most populous country in the world,has for the first time presented its 2016 Report Card on 9 indicators of PA.Unfortunately,China’s inaugural Report Card shows an F rating assigned to both the overall PA level and sedentary

Neuromuscular interactions around the knee in children, adults and elderly

Although injury and neuromuscular activation patterns may be common for all individuals, there are certain factors which differentiate neuromuscular activity responses between children, adults and elderly. The purpose of this study is to review recent evidence on age differences in neural activation and muscle balances around the knee when performing single joint movements. Particularly, current evidence indicates that there are some interesting similarities in the neuromuscular mechanisms by which children or the elderly differ compared with adults. Both children and elderly display a lower absolute muscle strength capacity than adults which cannot fully be explained by differences in muscle mass. Quadriceps activation failure is a common symptom ofall knee injuries, irrespective of age but it is likely that its effect is more evident in children or adults. While one might expect that antagonist co-activation would differ between age categories, it appears that this is not the case. Although hamstring: quadriceps ratio levels are altered after knee injury, it is not clear whether this is an age specific response. Finally, evidence suggests that both children and the elderly display less stiffness of the quadriceps muscle-tendon unit than adults which affects their knee joint function.

Motor Profile of Late Preterm Infants: A Systematic Review of the Last Decade

Motor development at late preterm infants has significant importance as it composes the picture of the severe evidences of motor impairments or other developmental difficulties. Early detection is crucial as early intervention is the unique immediate solution option to catch up the developmental milestones. Method: Α systematic search for scientific articles of the decade 2010-2020 investigating the motor profile of late preterm infants was conducted. Results: The search identified 9 studies, many of which highlighted the risk of motor and developmental delays even at 36 months of age. Conclusions: The stability of motor and developmental delays indicates the need of further investigation at a later age and intervention to avoid possible academic difficulties.

Efficacy of electroacupunture at Zusanli(ST36)on jumping-injured muscle based on transcriptome sequencing and genes analysis

METHODS:In the present study,female SpragueDawley rats were randomly divided into four groups with 6 of each,including normal control group(NC),jumpinginduced muscle injury model group(JI),JI with electroacupuncture stimulation treatment group(EA),and JI with non-electroacupuncture stimulation group(NEA).Transmission electron microscopy,transcriptome sequencing and analysis,prediction of protein interaction networks,real-time polymerase chain reaction verification,and Western blotting were performed on the gastrocnemius muscle of ipsilateral lower limbs.RESULTS:The structural repair of injured gastrocnemius myofibers following jumping training in EA rats was better than that of NEA rats.A total of 136 genes were differentially expressed in EA rats relative to JI rats,with 55 genes upregulated and 81 genes downregulated.According to results of transcriptome analysis,and prediction of protein mutual interaction by the online STRING database,Heat shock protein beta-7(Hspb7)and myozenin2(Myoz2)genes were targeted.Expressions of Hspb7 and Myoz2 mRNAs were increased in EA rats relative to JI rats(P<0.05).The expression of Hspb7 protein was upregulated in EA rats relative to that in NC,JI,and NEA rats(P<0.01,<0.05,and<0.05,respectively).The expression of Myoz2 protein was upregulated in EA rats relative to that in NC and JI rats(both P<0.01,respectively).CONCLUSIONS:The present results suggest that electroacupuncture stimulation at Zusanli(ST36)could improve muscle healing following jumping-induced muscle injury,owing to the upregulation of Hspb7 and Myoz2 proteins.

Yin and Yang of Body Composition Assessment

Objectve：To define if such crucial body composition parameters like body density（Db） and body surface area（BSA） could be considered in the frame of yin-yang concept,i.e.,one of the most popular in conventional biomedical science theories of Chinese medicine.Methods：Standardized Eurofit Pysical Fitness Test Battery reports of 715 junior school children have been evaluated for association of their body composition parameters with corresponding motoric fitness test results.Equations for BSA and Db calculation included height,weight,and skin-fold thickness values of the tests.Results：Correlative analysis of major physical fitness parameters,obtained from 715 junior school children,demonstrated that participants with high BSA/Db ratio had better yang-featured anaerobic performance,whereas those with low BSA/Db ratio presented with better yin-featured aerobic performance.This result coincided with proposed suggestions to treat BSA as external yang component and Db as internal yin component of body composition.Calculated confidence intervals for BSA/ Db ratio ranged between 1.073-1.15,which can be accepted as optimal for junior school children yang/yin ratio of body composition.Conclusion：Easily accessible BSA and Db can provide specialists with useful preliminary information for generating reasonable exercise and nutritional programs.

Muscle-Strengthening Exercise Links with Lower Odds for Depression in Adolescents

Purpose:Physical activity is a well-recognized protective factor against depression in adolescents.As a compo-nent of physical activity,muscle strengthening exercise(MSE)is also viewed as a correlate associated with lower risks of depression in adults.However,little is known about the association in adolescents.This study aimed to explore the association between MSE and depression in a sample of Chinese adolescents.Method:A self-reported questionnaire was used for data collection including variables of MSE,depression(assessed by Children’s Depres-sion Inventory)and selected sociodemographic factors(e.g.,sex,grade,height and weight[for body mass index]).Generalized Linear Models was utilized to estimate the association between MSE and depression.Results:Results showed a negative association between MSE and depression(Beta=–0.66;both MSE and depression were treated as continuous variables).When treating MSE(meeting or not meeting the recommendations)and depression as binary variables,odds ratio for depression in adolescents not meeting the MSE recommendation was significant higher(odd ratio=1.50,95%CI:1.15–1.96)than those meeting the MSE recommendations.Conclusions:This study found that MSE may be a protective factor against MSE in adolescents.Future studies are encouraged to confirm or negate our studyfinding using improved study design.