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Miao J, Liu J, Wang Y, Zhang Y, Yuan H. Reliability and validity of SHMS v1.0 for suboptimal health status assessment of Tianjin residents and factors affecting sub-health: A cross-sectional study. Medicine (Baltimore) 2021; 100:e25401. [PMID: 33907094 PMCID: PMC8084056 DOI: 10.1097/md.0000000000025401] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/21/2022] Open
Abstract
ABSTRACT The study aimed to explore the reliability and validity of the Sub-Health Measurement Scale version 1.0 (SHMS v1.0) for the assessment of the suboptimal health status (SHS) of Tianjin residents.This was a cross-sectional study that surveyed 2640 urban residents in Tianjin from June 2016 to January 2018. Demographic and clinical characteristics were collected. Each subject completed the SHMS v1.0 and Short Form-36 (SF-36) scale assessments.The retest coefficient was 0.675. The overall Cronbach's α coefficient was 0.921. The correlation between SHMS v1.0 and SF-36 was 0.781 (P < .01). The SHS frequency increased with age, from 62.4% in participants ≤25 years of age to 72.8% in those ≥ 56 years of age. The multivariable analysis showed that female sex (P < .001), age >25 years old (P = .009), bachelor degree or above (P < .001), obesity (P < .0), regular smoking (P = .043), frequent drinking (P = .045), sleep time < 6 hours (P = .006), working time >10 hours (P < .001), physical exercise <5 times/mo (P < .001), and adverse events >9 (P < .001) were associated with SHS.The prevalence of SHS is high among urban residents in Tianjin.
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Affiliation(s)
| | - Ju Liu
- Treating Potential Disease Department, Traditional Chinese Medicine Hospital of Kunshan, Nanjing, Jiangsu
| | - Yao Wang
- Women's and Children's Health and Family Planning Service Center in Nankai District
| | | | - Hongxia Yuan
- School of Management, Tianjin University of TCM, Tianjin, China
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Ma C, Xu W, Zhou L, Ma S, Wang Y. Association between lifestyle factors and suboptimal health status among Chinese college freshmen: a cross-sectional study. BMC Public Health 2018; 18:105. [PMID: 29304856 PMCID: PMC5755159 DOI: 10.1186/s12889-017-5002-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 12/20/2017] [Indexed: 12/12/2022] Open
Abstract
Background Suboptimal health status (SHS) is the third state between good health and disease. SHS is the clinical or pre-disease status of psychosomatic disease and a major global public health challenge. Although its underlying causes remain unclear, lifestyle is one of the most important factors affecting health status. Methods A cross-sectional survey was conducted at Renmin University of China in September of 2015. Data were collected from college freshmen using a questionnaire covering characteristics, lifestyle, nutrition status, and health status. A total of 6025 questionnaires were distributed during the study period, and 5344 completed responses were received. Results The prevalence rates for the “healthy,” “SHS,” and “disease” groups of college freshmen were 46.7% (2433), 51.2% (2667), and 2.1% (111), respectively. It is notable that health status was significantly positively correlated with lifestyle (Spearman’s r = 0.4435, p < 0.001). The multivariate Logistic regression results showed that students who were relatively younger and students from rural areas had a higher percentage of SHS. Good sleep quality (aOR = 0.650, 95%CI = 0.612–0.690), abundant physical exercise (aOR = 0.889, 95%CI = 0.845–0.933), and adequate nutrition intake (aOR = 0.868, 95%CI = 0.864–0.908) are negatively associated with SHS. Overuse of electronic devices (aOR = 1.066, 95%CI = 1.013–1.121), smoking (aOR = 1.824, 95%CI = 1.195–2.755), and weight loss (aOR = 1.255, 95%CI = 1.043–1.509) are positively associated with SHS. Conclusions Poor lifestyle behaviors are associated with SHS. In particular, the overuse of electronic devices is one of underlying causes of SHS. By altering lifestyle behaviors for the better, the health statuses of these college freshmen can be effectively improved. Electronic supplementary material The online version of this article (10.1186/s12889-017-5002-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chenjin Ma
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Wangli Xu
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Long Zhou
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China
| | - Shuangge Ma
- School of Public Health, Yale University, New Haven, CT, USA
| | - Yu Wang
- Center for Applied Statistics and School of Statistics, Renmin University of China, Beijing, China.
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Limburg K, Sattel H, Dinkel A, Radziej K, Becker-Bense S, Lahmann C. Course and predictors of DSM-5 somatic symptom disorder in patients with vertigo and dizziness symptoms - A longitudinal study. Compr Psychiatry 2017; 77:1-11. [PMID: 28535434 DOI: 10.1016/j.comppsych.2017.05.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/01/2017] [Accepted: 05/08/2017] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Somatic symptom disorder (SSD) is a diagnosis that was newly included in DSM-5. Currently, data on the course of SSD are largely lacking. The present study aimed to evaluate the natural course of SSD in a one-year follow-up study in patients with vertigo and dizziness (VD) symptoms. METHODS We investigated n=239 outpatients presenting in a tertiary care neurological setting over a one-year period. Patients had a medical examination at baseline and completed self-report questionnaires, which were re-assessed after 12months. DSM-5 SSD was assigned retrospectively. We evaluated the prevalence of SSD at baseline and 12-month follow-up and investigated predictors of the persistence of SSD during the study period. RESULTS The prevalence rate of SSD was 36% at baseline and 62% at 12-months follow-up. The persistence rate of SSD was 82% and the incidence rate was high, leading to a markedly increased prevalence rate at follow-up. Risk factors for persistent SSD were a self-concept of bodily weakness (OR: 1.52, 95% CI: 1.30-1.78) and an increase of depression during the study period (OR: 1.11, 95% CI: 1.02-1.22). Further, the diagnosis of an anxiety disorder (OR: 7.52, 95% CI: 1.17-48.23) or both anxiety and depressive disorder (OR: 23.14, 95% CI: 2.14-249.91) at baseline were significant predictors. CONCLUSIONS Our findings point out that SSD is highly prevalent in patients with VD symptoms, the incidence of the disorder widely outweighs its remission. Potential predictors of a persistence of SSD are discussed and can be chosen as a focus in therapy.
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Affiliation(s)
- Karina Limburg
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität, Klinikum Großhadern, Munich, Germany.
| | - Heribert Sattel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Katharina Radziej
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität, Klinikum Großhadern, Munich, Germany
| | - Sandra Becker-Bense
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität, Klinikum Großhadern, Munich, Germany
| | - Claas Lahmann
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität, Klinikum Großhadern, Munich, Germany; Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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Do socio-cultural factors influence college students' self-rated health status and health-promoting lifestyles? A cross-sectional multicenter study in Dalian, China. BMC Public Health 2017; 17:478. [PMID: 28525995 PMCID: PMC5438535 DOI: 10.1186/s12889-017-4411-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 05/09/2017] [Indexed: 12/28/2022] Open
Abstract
Background An unhealthy lifestyle of college students is an important public health concern, but few studies have been undertaken to examine the role of socio-cultural differences. Methods For this cross-sectional comparative study, data on college students’ health-promoting lifestyles (HPL), as measured using the Health-Promoting Lifestyle Profile (HPLP-II) scale, and self-rated health status (SRH) as measured by Sub-Optimal Health Measurement Scale (SHMS V1.0) were collected from 829 college students. Results The sample of 829 college students included 504 (60.8%) Chinese and 325 (39.2%) international students. Chinese students had higher scores in overall health-promoting lifestyle (HPL) (P < 0.001, eta squared =0.113) and in all the six subclasses than their international counterparts. In relation to health status evaluation, the two groups varied in physiological health (P < 0.001, eta squared = 0.095) and social health (P = 0.020, eta squared = 0.007) but there was no significant difference in psychological health subscale (P = 0.156, eta squared = 0.002). HPL was predicted by financial status among the Chinese group and by student’s major, age and level of education in the international group. Body mass index (BMI) and financial status emerged as predictors of the three subscales of SHMS V1.0 in the Chinese group and also of physiological and psychological subscales in the international group. Gender was associated with psychological health in both groups. Smoking status was a predictor of psychological health in both groups and also of social health in the international group. The level of education emerged as a predictor of social health in the international group. Regression analyses revealed a significant association between health status and healthy lifestyle (P < 0.001). In reference to participants with “excellent” lifestyle, participants with moderate lifestyle were at a 4.5 times higher risk of developing suboptimal health status (SHS) (OR: 4.5,95% CI:2.2-9.99) and those with a ‘general’ lifestyle were at a 3.2 times higher risk SHS (OR: 3.2, 95% CI: 1.5-7.18). Good and moderate HPLP-II levels of nutrition are associated with low risk of suboptimal health status (OR: 0,41 and 0,25, respectively). Participants in good and moderate HPLP-II levels of interpersonal relations are associated with higher risk of suboptimal health (OR:2,7 and 3,01 respectively) than those in excellent levels of HPLP-II. Conclusion Collectively, these findings provide a convincing body of evidence to support the role of socio-cultural factors as key determinants of the HPL and SRH of college students.
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Chen J, Xiang H, Jiang P, Yu L, Jing Y, Li F, Wu S, Fu X, Liu Y, Kwan H, Luo R, Zhao X, Sun X. The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030240. [PMID: 28264509 PMCID: PMC5369076 DOI: 10.3390/ijerph14030240] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 02/16/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Suboptimal health status (SHS) is the intermediate health state between health and disease, it is medically undiagnosed and is also termed functional somatic syndrome. Although its clinical manifestations are complicated and various, SHS has not reached the disease status. Unhealthy lifestyle is associated with many chronic diseases and mortality. In accordance with the impact of lifestyle on health, it is intriguing to determine the association between unhealthy lifestyle and SHS risk. METHODS We conducted a nested case-control study among healthy Chinese college students from March 2012 to September 2013, which was nested in a prospective cohort of 5676 students. We performed 1:1 incidence density sampling with matched controls for birth year, sex, grade, specialty and individual character. SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Exposure was defined as an unhealthy lifestyle per the frequency of six behavioral dimensions from the Health-promoting Lifestyle Profile (HPLP-II). RESULTS We matched 543 cases of SHS (42.66%) in a cohort of 1273 students during the 1.5 years mean follow-up time with controls. A significant difference (t = 9.79, p < 0.001) and a reduction in HPLP-II total score was present at 1.5 years follow-up (135.93 ± 17.65) compared to baseline (144.48 ± 18.66). A level-response effect was recorded with an increase of the total HPLP-II (every dimension was correlated with a decreased SHS risk). Compared to respondents with the least exposure (excellent level), those reporting a general HPLP-II level were approximately 2.3 times more likely to develop SHS (odd ratio = 2.333, 95% CI = 1.471 to 3.700); and those with less HPLP-II level (good level) were approximately 1.6 times more likely (1.644, 1.119-2.414) to develop SHS (p < 0.05). Our data indicated that unhealthy lifestyle behavior with respect to behavioral dimensions significantly affected SHS likelihood. Further analyses revealed a marked increase (average increased 14.73 points) in lifestyle level among those SHS regression to health after 1.5 years, with respect to the HPLP-II behavioral dimensions, in addition to the total score (t = -15.34, p < 0.001). CONCLUSIONS SHS is highly attributable to unhealthy lifestyles, and the Int. J. Environ. Res. Public Health 2017, 14, 240 2 of 17 mitigation of modifiable lifestyle risk factors may lead to SHS regression. Increased efforts to modify unhealthy lifestyles are necessary to prevent SHS.
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Affiliation(s)
- Jieyu Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Hongjie Xiang
- Department of Traditional Chinese Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, Shandong, China.
| | - Pingping Jiang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Lin Yu
- Department of Traditional Chinese Medicine, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510170, Guangdong, China.
| | - Yuan Jing
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Fei Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Shengwei Wu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Xiuqiong Fu
- Centre for Cancer and Inflammation Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China.
| | - Yanyan Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Hiuyee Kwan
- Centre for Cancer and Inflammation Research, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China.
| | - Ren Luo
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Xiaoshan Zhao
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
| | - Xiaomin Sun
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China.
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DSM-5 somatic symptom disorder in patients with vertigo and dizziness symptoms. J Psychosom Res 2016; 91:26-32. [PMID: 27894459 DOI: 10.1016/j.jpsychores.2016.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/11/2016] [Accepted: 10/16/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE DSM-5 somatic symptom disorder (SSD) could potentially be a highly relevant diagnosis for patients with vertigo and dizziness. The criteria of SSD, particularly the B-criterion with its three components (cognitive, affective, behavioral), have however not yet been investigated in this patient group. METHODS We evaluated a large sample (n=399) of outpatients presenting in a neurological setting. Physical examinations and a psychometric assessment (SCID-I) were conducted; patients completed self-report questionnaires. The diagnosis of SSD was assigned retrospectively. The prevalence of SSD, its diagnostic criteria, and its overlap with former DSM-IV somatoform disorders were evaluated; comparisons were drawn between (1) patients fulfilling different components of the B-criterion and (2) patients with diagnoses after DSM-IV vs. DSM-5. RESULTS SSD was almost twice as common as DSM-IV somatoform disorders. Patients with all three components of the B-criterion reported the highest impairment levels. Patients with both DSM-IV somatoform disorders and DSM-5 SSD were more impaired compared to groups with one of the diagnoses; patients with DSM-IV somatoform disorders only were more impaired than those with SSD only. CONCLUSIONS Our findings demonstrate that SSD is highly prevalent in patients with vertigo and dizziness. The classification of severity based on the number of psychological symptoms appears valid and may assist in finding suitable treatment options according to clinical practice guidelines. Future studies should investigate the overlap of SSD and other psychiatric disorders, this may assist in better defining the diagnostic criteria of SSD.
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Carson AJ, Stone J, Hansen CH, Duncan R, Cavanagh J, Matthews K, Murray G, Sharpe M. Somatic symptom count scores do not identify patients with symptoms unexplained by disease: a prospective cohort study of neurology outpatients. J Neurol Neurosurg Psychiatry 2015; 86:295-301. [PMID: 24935983 DOI: 10.1136/jnnp-2014-308234] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Somatic symptoms unexplained by disease are common in all medical settings. The process of identifying such patients requires a clinical assessment often supported by clinical tests. Such assessments are time-consuming and expensive. Consequently the observation that such patients tend to report a greater number of symptom has led to the use of self-rated somatic symptom counts as a simpler and cheaper diagnostic aid and proxy measure for epidemiological surveys. However, despite their increasing popularity there is little evidence to support their validity. METHODS We tested the score on a commonly used self-rated symptom questionnaire- the Patient Health Questionnaire (PHQ 15) (plus enhanced iterations including an additional 10 items on specific neurological symptoms and an additional 5 items on mental state) for diagnostic sensitivity and specificity against a medical assessment (with 18 months follow-up) in a prospective cohort study of 3781 newly attending patients at neurology clinics in Scotland, UK. RESULTS We found 1144/3781 new outpatients had symptoms that were unexplained by disease. The patients with symptoms unexplained by disease reported higher symptoms count scores (PHQ 15: 5.6 (95% CI 5.4 to 5.8) vs 4.2 (4.1 to 4.4) p<0.0001). However, the PHQ15 performed little better than chance in its ability to identify patients with symptoms unexplained by disease. The findings with the enhanced scales were similar. CONCLUSIONS Self-rated symptom count scores should not be used to identify patients with symptoms unexplained by disease.
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Affiliation(s)
- Alan J Carson
- Department of Psychiatry, University of Edinburgh, Edinburgh, UK Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK
| | - Jon Stone
- Department of Clinical Neurosciences, University of Edinburgh, Edinburgh, UK
| | | | - Rod Duncan
- Department of Neurology, University of Otago, Christchurch, New Zealand
| | | | - Keith Matthews
- Division of Neuroscience, University of Dundee, Dundee, UK
| | - G Murray
- Department of Public Health Sciences, University of Edinburgh Medical School, Edinburgh, UK
| | - Michael Sharpe
- Department of Psychiatry, University of Oxford, Oxford, UK
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Chen J, Cheng J, Liu Y, Tang Y, Sun X, Wang T, Xiao Y, Li F, Xiang L, Jiang P, Wu S, Wu L, Luo R, Zhao X. Associations between breakfast eating habits and health-promoting lifestyle, suboptimal health status in Southern China: a population based, cross sectional study. J Transl Med 2014; 12:348. [PMID: 25496597 PMCID: PMC4269950 DOI: 10.1186/s12967-014-0348-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 12/01/2014] [Indexed: 12/28/2022] Open
Abstract
Background Suboptimal health status (SHS) is the intermediate health state between health and disease, refers to medically undiagnosed or functional somatic syndromes, and has been a major global public health challenge. However, both the etiology and mechanisms associated with SHS are still unclear. Breakfast eating behavior is a dietary pattern marker and previous studies have presented evidence of associations between failure to consume breakfast and increased diseases. Accordingly, in view of the significance of breakfast eating behaviors with respect to health status, the associations between breakfast eating habits and healthy lifestyle, SHS require further elucidation. Methods A cross-sectional survey was conducted within a clustered sample of 24,159 individuals aged 12–80 years in 2012–13 within the population of Southern China. Breakfast eating habits were categorically defined by consumption frequency (‘scarcely, sometimes or always’). Health-promoting lifestyle was assessed via the health-promoting lifestyle profile (HPLP-II). SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Results Of the 24,159 participants, the prevalence rates for the ‘health’ , ‘SHS’ , and ‘disease’ were 18.8%, 46.0%, and 35.2%, respectively. Overall, 19.6% of participants reported ‘scarce’ breakfast eating habits, with frequent breakfast eaters scoring higher on both HPLP-II and SHMS V1.0. After demographic adjustment, regression analyses revealed a significant association between breakfast eating habits and healthy lifestyle (p <0.001). There were lower levels of breakfast consumption regularity amongst individuals with SHS than those with disease. Categorically ‘scarce’ breakfast eaters were approximately three times more likely to be assigned SHS (OR: 2.745, 95% CI: 2.468-3.053), while infrequent breakfast eaters (‘sometimes’) were just less than twice as likely to be assessed as being of SHS (OR: 1.731, 95% CI: 1.595-1.879). Conclusions Breakfast eating habits are significantly associated with a healthy lifestyle, and appear to be a useful predictor of a healthy lifestyle. Irregular breakfast eating habits are related to an increased risk of SHS; increased breakfast eating frequency may contribute to lowering the prevalence of SHS in Southern China. Electronic supplementary material The online version of this article (doi:10.1186/s12967-014-0348-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Ren Luo
- Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, China.
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