LIFESTYLE EFFECTS ON THE HEALTH OF CHILDREN: A CROSS-SECTIONAL STUDY IN SHOPIAN DISTRICT OF JAMMU AND KASHMIR
Main Article Content
Keywords
Lifestyle behaviors; Physical activity; Screen time; Sleep duration; Diet quality; Body mass index; Academic performance; Mental health; Children; Kashmir; Cross-sectional study
Abstract
Background: Lifestyle patterns during childhood play a pivotal role in determining physical, psychological, and cognitive health outcomes throughout life. Rapid technological advancement, reduced physical activity, and poor dietary habits have led to increasing lifestyle-related health challenges in children. Despite growing concern, limited region-specific evidence exists from northern India, particularly from Kashmir, where cultural and environmental factors uniquely shape children’s routines. This study aimed to evaluate the relationship between lifestyle behaviors and health outcomes among school- aged children in the Shopian District of Jammu and Kashmir.
Aim: To assess the association between key lifestyle factors diet quality, physical activity, screen exposure, and sleep duration and indicators of child health, including body mass index (BMI), mental well-being, and academic performance.
Methods: A cross-sectional study was conducted among 100 children aged 6–12 years selected through multistage random sampling from five schools in Shopian District. Data on lifestyle factors were collected using a prevalidated structured questionnaire covering diet, physical activity, screen exposure, and sleep duration. A composite lifestyle score (0– 100) was calculated by combining standardized subscores for each domain, and participants were classified into Healthy and Unhealthy lifestyle groups using the median split method. BMI was measured using WHO Child Growth Standards, mental health was assessed using a modified Strengths and Difficulties Questionnaire, and academic performance was derived from school records. Statistical analyses included t-tests, chi- square tests, Pearson correlation, and multivariable linear regression using SPSS version 29. Statistical significance was set at p < 0.05.
Results: The mean age of participants was 9.21 ± 1.91 years, with equal representation of both sexes. Children in the Healthy lifestyle group exhibited significantly higher diet scores (6.78 ± 1.14 vs 5.38 ± 1.34, p < 0.001), greater physical activity (68.5 ± 24.1 vs 51.9 ± 22.6 minutes/day, p = 0.001), longer sleep duration (9.36 ± 0.78 vs 8.62 ± 0.82 hours/night, p < 0.001), and lower screen exposure (2.88 ± 0.91 vs 3.42 ± 1.02 hours/day, p = 0.0067). Academic performance was significantly better in the Healthy group (75.45 ± 6.20% vs 69.78 ± 7.01%, p < 0.001). BMI and mental health scores were more favorable among Healthy children, though not statistically significant (p > 0.05). Lifestyle score correlated negatively with BMI (r = –0.269, p = 0.0068) and positively with academic performance (r = 0.541, p < 0.001). In multivariable regression, lifestyle score independently predicted lower BMI after adjusting for age and sex (β = –0.066, p = 0.007).
Conclusion: Healthy lifestyle behaviors comprising balanced diet, adequate physical activity, limited screen exposure, and sufficient sleep are significantly associated with improved academic performance and lower BMI among children in Shopian District. These findings underscore the need for school- and community-based interventions promoting integrated lifestyle modification to enhance overall child health. Targeted parental education and policy measures focusing on balanced routines, outdoor activity, and regulated media use are strongly recommended.
References
2. American Academy of Pediatrics. (2016a). Media and young minds. Pediatrics, 138(5), e20162591. https://publications.aap.org/pediatrics/article/138/5/e20162591/60503/Media- and-Young-Minds
3. American Academy of Pediatrics. (2016b). Media use in school-aged children and adolescents. Pediatrics, 138(5), e20162592.
https://publications.aap.org/pediatrics/article/138/5/e20162592/60321/Media-Use-in- School-Aged-Children-and-Adolescents
4. American Academy of Pediatrics. (2025, May 22). Screen time guidelines. https://www.aap.org/en/patient-care/media-and-children/center-of-excellence-on-social- media-and-youth-mental-health/qa-portal/qa-portal-library/qa-portal-library- questions/screen-time-guidelines/
5. Chaput, J.-P., Willumsen, J., Bull, F., Chou, R., Ekelund, U., Firth, J., … Tremblay, M. S. (2020). 2020 WHO guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 1451–1462. https://pmc.ncbi.nlm.nih.gov/articles/PMC7691077/
6. Deng, X., Ma, J., Yuan, Y., Zhang, Z., Niu, W., & Zhang, C. (2021). Sleep duration and obesity in children and adolescents: A systematic review and meta-analysis. Sleep Medicine, 84, 92–103. https://www.sciencedirect.com/science/article/abs/pii/S1389945720305773
7. Fang, K., Mu, M., Liu, K., & He, Y. (2019). Screen time and childhood overweight/obesity: A systematic review and meta-analysis. Child: Care, Health and Development, 45(5), 744– 753. https://pubmed.ncbi.nlm.nih.gov/31270831/
8. Florence, M. D., Asbridge, M., & Veugelers, P. J. (2008). Diet quality and academic performance. Journal of School Health, 78(4), 209–215.
https://pubmed.ncbi.nlm.nih.gov/18336680/
9. Ghasemirad, M., Rastgoo, S., & Kelishadi, R. (2023). The association between screen use and central obesity in children and adolescents: A systematic review and meta-analysis. Journal of Health, Population and Nutrition, 42(1), 54.
https://jhpn.biomedcentral.com/articles/10.1186/s41043-023-00391-5
10. Haghjoo, P., Keshavarz, S. A., Ejtahed, H.-S., & Qorbani, M. (2022). Screen time increases overweight and obesity risk among adolescents: A systematic review and meta-analysis. BMC Primary Care, 23, 165. https://pmc.ncbi.nlm.nih.gov/articles/PMC9238177/
11. Han, S. H., Ha, J., & Song, J. (2022). Impact of short sleep duration on the incidence of obesity among children: A systematic review and meta-analysis. Medicina, 58(8), 1037. https://www.mdpi.com/1648-9144/58/8/1037
12. James, J., Nelson, J., & Yaqubi, S. (2023). The effects of physical activity on academic performance in school-aged children. International Journal of Environmental Research and Public Health, 20(12), 6040. https://pubmed.ncbi.nlm.nih.gov/37371251/
13. Latino, F., Cataldi, S., Fischetti, F., & Mazzilli, M. (2023). Physical activity and academic performance in school-age children: The role of physiological, emotional, social, and cognitive factors. Sustainability, 15(8), 6616. https://www.mdpi.com/2071- 1050/15/8/6616
14. Miller, M. A., Kruisbrink, M., Wallace, J., Ji, C., & Cappuccio, F. P. (2018). Sleep duration and incidence of obesity in infants, children, and adolescents: A systematic review and meta-analysis of prospective studies. Sleep, 41(4), zsy018.
https://academic.oup.com/sleep/article/41/4/zsy018/4833233
15. Musshafen, L. A., Johnson, D. A., & Marino, M. (2021). Associations between sleep and academic performance in US secondary students: A systematic review and meta-analysis. Sleep Health, 7(4), 431–446. https://pubmed.ncbi.nlm.nih.gov/33991893/
16. Nagata, J. M., Pettee Gabriel, K., Ganson, K. T., et al. (2023). Association of physical activity and screen time with body mass index among adolescents. JAMA Network Open, 6(2), e2254612. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801192
17. Paruthi, S., Brooks, L. J., D’Ambrosio, C., et al. (2016). Recommended amount of sleep for pediatric populations: A consensus statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine, 12(6), 785–786.
https://aasm.org/resources/pdf/pediatricsleepdurationconsensus.pdf
18. Rajan, A., & Nandini, A. (2024). Relation of dietary practices and academic achievement among school children: A cross-sectional study. Journal of Education and Health Promotion, 13, 291. https://pmc.ncbi.nlm.nih.gov/articles/PMC11611424/
19. Rasberry, C. N., Lee, S. M., Robin, L., et al. (2011). The association between school-based physical activity and academic performance: A systematic review. Preventive Medicine, 52(Suppl 1), S10–S20.
20. https://www.sciencedirect.com/science/article/abs/pii/S0091743511000557
21. Sivakumar, C. T., Venkatasamy, V., & Thilagavathy, G. (2022). Effect of sleep habits on academic performance in school children. Journal of Family Medicine and Primary Care, 11(1), 345–349. https://pmc.ncbi.nlm.nih.gov/articles/PMC8807888/
22. World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. https://www.who.int/publications/i/item/9789240015128
23. Adelantado-Renau, M., Diez-Fernández, A., Beltran-Valls, M. R., Soriano-Maldonado, A., & Moliner-Urdiales, D. (2019). Independent and combined influence of healthy lifestyle behaviors on academic performance in adolescents: DADOS study. Pediatric Research, 85(4), 455–462. https://doi.org/10.1038/s41390-018-0261-4
24. American Academy of Pediatrics. (2016a). Media and young minds. Pediatrics, 138(5), e20162591. https://doi.org/10.1542/peds.2016-2591
25. American Academy of Pediatrics. (2016b). Media use in school-aged children and adolescents. Pediatrics, 138(5), e20162592. https://doi.org/10.1542/peds.2016-2592
26. Chaput, J.-P., Willumsen, J., Bull, F., Chou, R., Ekelund, U., Firth, J., & Tremblay, M. S. (2020). 2020 WHO guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 1451–1462. https://doi.org/10.1136/bjsports-2020-102955
27. Deng, X., Ma, J., Yuan, Y., Zhang, Z., Niu, W., & Zhang, C. (2021). Sleep duration and obesity in children and adolescents: A systematic review and meta-analysis. Sleep Medicine, 84, 92–103. https://doi.org/10.1016/j.sleep.2021.05.011
28. Fang, K., Mu, M., Liu, K., & He, Y. (2019). Screen time and childhood overweight/obesity: A systematic review and meta-analysis. Child: Care, Health and Development, 45(5), 744– 753. https://doi.org/10.1111/cch.12791
29. Florence, M. D., Asbridge, M., & Veugelers, P. J. (2008). Diet quality and academic performance. Journal of School Health, 78(4), 209–215. https://doi.org/10.1111/j.1746- 1561.2008.00288.x
30. Gupta, N., Goel, K., Shah, P., & Misra, A. (2022). Childhood obesity in developing countries: Epidemiology, determinants, and prevention. Endocrine Reviews, 43(4), 439–
31. 458. https://doi.org/10.1210/endrev/bnac003
32. Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F. C. (2020). Global trends in insufficient physical activity among adolescents: A pooled analysis of 298 population-based surveys with 1.6 million participants. The Lancet Child & Adolescent Health, 4(1), 23–35. https://doi.org/10.1016/S2352-4642(19)30323-2
33. Han, S. H., Ha, J., & Song, J. (2022). Impact of short sleep duration on the incidence of obesity among children: A systematic review and meta-analysis. Medicina, 58(8), 1037. https://doi.org/10.3390/medicina58081037
34. Haghjoo, P., Keshavarz, S. A., Ejtahed, H.-S., & Qorbani, M. (2022). Screen time increases overweight and obesity risk among adolescents: A systematic review and meta-analysis. BMC Primary Care, 23, 165. https://doi.org/10.1186/s12875-022-01833-z
35. James, J., Nelson, J., & Yaqubi, S. (2023). The effects of physical activity on academic performance in school-aged children: A systematic review. International Journal of Environmental Research and Public Health, 20(12), 6040.
https://doi.org/10.3390/ijerph20126040
36. Latino, F., Cataldi, S., Fischetti, F., & Mazzilli, M. (2023). Physical activity and academic performance in school-age children: The role of physiological, emotional, social, and cognitive factors. Sustainability, 15(8), 6616. https://doi.org/10.3390/su15086616
37. Lobstein, T., Jackson-Leach, R., Moodie, M. L., et al. (2015). Child and adolescent obesity: Part of a bigger picture. The Lancet, 385(9986), 2510–2520. https://doi.org/10.1016/S0140-6736(14)61746-3
38. Ministry of Health and Family Welfare (MoHFW). (2021). National Family Health Survey (NFHS-5), 2019–2021: India Fact Sheet. Government of India. https://main.mohfw.gov.in/
39. Miller, M. A., Kruisbrink, M., Wallace, J., Ji, C., & Cappuccio, F. P. (2018). Sleep duration and incidence of obesity in infants, children, and adolescents: A systematic review and meta-analysis. Sleep, 41(4), zsy018. https://doi.org/10.1093/sleep/zsy018
40. Ng, M., Fleming, T., Robinson, M., et al. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis. The Lancet, 384(9945), 766–781. https://doi.org/10.1016/S0140-6736(14)60460-8
41. Paruthi, S., Brooks, L. J., D’Ambrosio, C., et al. (2016). Recommended amount of sleep for pediatric populations: A consensus statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine, 12(6), 785–786. https://doi.org/10.5664/jcsm.5866
42. Rajan, A., & Nandini, A. (2024). Relation of dietary practices and academic achievement among school children: A cross-sectional study. Journal of Education and Health Promotion, 13, 291. https://doi.org/10.4103/jehp.jehp_1868_23
43. Ranjani, H., Mehreen, T. S., Pradeepa, R., et al. (2016). Epidemiology of childhood overweight and obesity in India: A systematic review. Indian Journal of Medical Research, 143(2), 160–174. https://doi.org/10.4103/0971-5916.180203
44. Rasberry, C. N., Lee, S. M., Robin, L., et al. (2011). The association between school-based physical activity, including physical education, and academic performance: A systematic review. Preventive Medicine, 52(Suppl 1), S10–S20.
https://doi.org/10.1016/j.ypmed.2011.01.027
45. Reilly, J. J., & Kelly, J. (2011). Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality: Systematic review. International Journal of Obesity, 35(7), 891–898. https://doi.org/10.1038/ijo.2010.222
46. Sahoo, K., Sahoo, B., Choudhury, A. K., Sofi, N. Y., Kumar, R., & Bhadoria, A. S. (2015). Childhood obesity: Causes and consequences. Journal of Family Medicine and Primary Care, 4(2), 187–192. https://doi.org/10.4103/2249-4863.154628
47. World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. https://www.who.int/publications/i/item/9789240015128
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Parvaize Ahmad Yarbash
Department of Physical education, University of kashmir
Dr. Surjeet Singh
Department of Physical education, University of kashmir