Healthy lifestyle matters: a network analysis of urban Chinese pre‐school children's adiposity, sleep health, mental health, child functioning and health behaviours

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Fang, Y, Liu, J, Zhang, M, Wang, Z, Chen, S, Zheng, C, Cooper, S ORCID: https://orcid.org/0000-0001-5219-5020 and Sun, F, 2025. Healthy lifestyle matters: a network analysis of urban Chinese pre‐school children's adiposity, sleep health, mental health, child functioning and health behaviours. Child: Care, Health and Development, 51 (5): e70144. ISSN 0305-1862

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Official URL: https://doi.org/10.1111/cch.70144

Abstract

Background: In the Chinese context, a greater emphasis is placed on academic skills rather than healthy lifestyles among pre-school children. To promote well-being as a whole, a comprehensive interpretation of multivariant relationships between health, functioning and well-being is necessary for children in this age group.

Methods: The current study adopted a network analysis among 422 urban Chinese pre-school children (57.8 ± 9.7 months, 54.2% boys) to detect the inter-relationships between the variables from nine domains, including demographics, adiposity, physical activity levels, executive function, motor coordination, sleep disturbance, diet health and mental strengths and difficulties. Data was obtained through both questionnaires completed by parents and direct assessment among children.

Results: Findings indicated that poor well-being outcomes were prevalent among the participating children, including risk of central obesity (18.9%), global sleep disturbance (38.4%) and moderate-to-severe mental difficulties (42.6%). The network analysis demonstrated that age fully/partially mediated the associations among child functioning such as executive function and motor coordination. Mental strength, mental difficulties and sleep health had mutual correlations, however, none of them had a significant relationship with age. Furthermore, sex played little role in the network.

Conclusion: This study supports that healthy lifestyle is crucial for Chinese pre-school children to learn and practice. Results of network analysis implies that education on child's mental health are warranted for children, parents and teachers. A balance between academic achievement and child's health well-being should be prioritized in child care and early childhood education.

Item Type:	Journal article
Publication Title:	Child: Care, Health and Development
Creators:	Fang, Y., Liu, J., Zhang, M., Wang, Z., Chen, S., Zheng, C., Cooper, S. and Sun, F.
Publisher:	Wiley
Date:	September 2025
Volume:	51
Number:	5
ISSN:	0305-1862
Identifiers:	Number Type 10.1111/cch.70144 DOI 2487711 Other
Rights:	© 2025 The Author(s). Child: Care, Health and Development published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Divisions:	Schools > School of Science and Technology
Record created by:	Laura Borcherds
Date Added:	22 Aug 2025 16:06
Last Modified:	22 Aug 2025 16:06
URI:	https://irep.ntu.ac.uk/id/eprint/54247