Association between lifestyle factors and suboptimal health status among Chinese college freshmen: a cross-sectional study

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.