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Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (3): 421-428. doi: 10.19723/j.issn.1671-167X.2023.03.006

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Association of outdoor artificial light at night exposure with overweight and obesity among children and adolescents aged 9 to 18 years in China

Jia-jia DANG,Shan CAI,Pan-liang ZHONG,Ya-qi WANG,Yun-fei LIU,Di SHI,Zi-yue CHEN,Yi-hang ZHANG,Pei-jin HU,Jing LI,Jun MA,Yi SONG*()   

  1. Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
  • Received:2023-02-12 Online:2023-06-18 Published:2023-06-12
  • Contact: Yi SONG E-mail:songyi@bjmu.edu.cn
  • Supported by:
    the National Natural Science Foundation of China(82273654);the Natural Science Foundation of Beijing(7222247)

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Abstract:

Objective: To analyze the association between outdoor artificial light-at-night (ALAN) exposure and overweight and obesity among children and adolescents aged 9 to 18 years in China. Methods: Using follow-up data of 5 540 children and adolescents aged 9 to 18 years conducted from November 2019 to November 2020 in eight provinces of China, latitude and longitude were determined based on school addresses, and the mean monthly average nighttime irradiance at the location of 116 schools was extracted by the nearest neighbor method to obtain the mean outdoor ALAN exposure [unit: nW/(cm2·sr)] for each school. Four indicators of overweight and obesity outcomes were included: Baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. Mixed effects Logistic regression was used to explore the association between ALAN exposure levels (divided into quintiles Q1-Q5) and baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. In addition, a natural cubic spline function was used to explore the exposure response association between ALAN exposure (a continuous variable) and the outcomes. Results: The prevalence of baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence among the children and adolescents in this study were 21.6%, 16.3%, 2.9% and 12.8%, respectively. The OR value for the association between ALAN exposure and baseline overweight and obesity was statistically significant when ALAN exposure levels reached Q4 or Q5, 1.90 (95%CI: 1.26-2.86) and 1.77 (95%CI: 1.11-2.83), respectively, compared with the children and adolescents in the Q1 group of ALAN exposure. Similar to the results for baseline overweight and obesity, the OR values for the association with persistent overweight and obesity were 1.89 (95%CI: 1.20-2.99) and 1.82 (95%CI: 1.08-3.06) when ALAN exposure levels reached Q4 or Q5, respectively, but none of the OR values for the association between ALAN and overweight and obesity progression and overweight and obesity incidence were statistically significant. Fitting a natural cubic spline function showed a non-linear trend between ALAN exposure and persistent overweight and obesity. Conclusion: There is a positive association between ALAN exposure and overweight and obesity in children and adolescents, and the promotion of overweight obesity in children and adolescents by ALAN tends to have a cumulative effect rather than an immediate effect. In the future, while focusing on the common risk factors for overweight and obesity in children and adolescents, there is a need to improve the overweight and obesity-causing nighttime light exposure environment.

Key words: Artificial light-at-night, Overweight, Obesity, Children, Adolescents

CLC Number: 

  • R179

Table 1

Baseline characteristics of children and adolescents aged 9-18 years in the follow-up survey from November 2019 to November 2020"

CharacteristicsTotal
(n = 5 540)		Boys
(n = 2 760)		Girls
(n = 2 780)		Z/χ2P
Age/years, M (IQR)13.00 (5.00)13.00 (5.00)13.00 (5.00)-0.472a0.637
Residence, n (%)8.9850.003
  Urban2 998 (54.1)1 438 (52.1)1 560 (56.1)
  Rural2 542 (45.9)1 322 (47.9)1 220 (43.9)
Only-child status, n (%)35.028< 0.001
  Only-child1 982 (35.8)1 093 (39.6)889 (32.0)
  Non-only-child3 558 (64.2)1 667 (60.4)1 891 (68.0)
Paternal education background, n (%)0.5050.447
  Lower secondary or below2 654 (47.9)1 309 (47.4)1 345 (48.4)
  Upper secondary or above2 886 (52.1)1 451 (52.6)1 435 (51.6)
Maternal education background, n (%)0.4670.494
  Lower secondary or below2 883 (52.0)1 449 (52.5)1 434 (51.6)
  Upper secondary or above2 657 (48.0)1 311 (47.5)1 346 (48.4)
Height/cm, M (IQR)155.00 (20.20)158.30 (25.90)153.70 (15.40)-14.053a< 0.001
Weight/kg, M (IQR)46.00 (19.15)47.95 (22.65)45.00 (16.50)-9.391a< 0.001
BMI/(kg/m2), M (IQR)18.82 (4.58)18.89 (4.73)18.75 (4.44)-2.120a0.034
Baseline overweight and obesity, n (%)1 194 (21.6)696 (25.2)498 (17.9)43.698< 0.001
Persistent overweight and obesity, n (%)905 (16.3)563 (20.4)342 (12.3)66.428< 0.001
Overweight and obesity progression, n (%)162 (2.9)107 (3.9)55 (2.0)17.583< 0.001
Overweight and obesity incidence, n (%)506 (12.8)264 (14.5)242 (11.4)8.5470.003
ALAN/[nW/(cm2·sr)], n (%)6.1540.188
  Q11 148 (20.7)596 (21.6)552 (19.9)
  Q21 081 (19.5)511 (18.5)570 (20.5)
  Q31 019 (18.4)497 (18.0)522 (18.8)
  Q41 212 (21.9)620 (22.5)592 (21.3)
  Q51 080 (19.5)536 (19.4)544 (19.6)

Table 2

The prevalence of overweight and obesity in children and adolescents aged 9-18 years in the follow-up survey from November 2019 to November 2020"

SubgroupsOverweight and obesity in 2019Overweight and obesity in 2020Persistent overweight and obesityOverweight and obesity progressionOverweight and obesity incidence
Total, n (%)1 194 (21.6)1 447 (26.1)905 (16.3)162 (2.9)506 (12.8)
Residence, n (%)
  Urban688 (22.9)813 (27.1)510 (17.0)94 (3.1)284 (13.4)
  Rural506 (19.9)634 (24.9)395 (15.5)68 (2.7)222 (12.2)
  χ27.5343.3792.1821.0271.320
  P0.0060.0660.1400.3110.251
Gender, n (%)
  Boys696 (25.2)854 (30.9)563 (20.4)107 (3.9)264 (14.5)
  Girls498 (17.9)593 (21.3)342 (12.3)55 (2.0)242 (11.4)
  χ243.69866.29866.42817.5838.547
  P< 0.001< 0.001< 0.001< 0.0010.003
Age group, n (%)
  9-12 years640 (24.3)803 (30.5)511 (19.4)106 (4.0)268 (15.0)
  13-15 years353 (20.4)412 (23.8)257 (14.8)36 (2.1)145 (11.5)
  16-18 years201 (17.1)232 (19.7)137 (11.7)20 (1.7)93 (10.4)
  χ227.07655.04439.61319.40013.066
  P< 0.001< 0.001< 0.001< 0.001< 0.001
Area, n (%)
  Shanghai104 (29.0)105 (29.2)83 (23.1)6 (1.7)21 (8.9)
  Fujian222 (25.1)269 (30.5)199 (22.5)33 (3.7)68 (11.5)
  Shanxi150 (22.2)282 (41.7)112 (16.5)23 (3.4)153 (31.0)
  Henan72 (23.9)88 (29.2)54 (17.9)11 (3.7)29 (14.1)
  Hunan42 (12.7)60 (18.1)31 (9.3)5 (1.5)24 (9.2)
  Gansu193 (24.4)165 (20.9)100 (12.6)19 (2.4)64 (11.5)
  Chongqing216 (22.2)248 (25.5)176 (18.1)39 (4.0)72 (10.3)
  Guangxi195 (15.9)230 (18.8)150 (12.3)26 (2.1)75 (8.3)

Figure 1

Association between ALAN exposure and overweight and obesity in children and adolescents aged 9-18 years from November 2019 to November 2020 Model 1, crude model; Model 2, adjusted for urban and rural areas, gender, age, GDP, and population density; Model 3, Model 2 + adjusted for one-child status, parental education level, sugar-sweetened beverage intake, moderate-to-vigorous physical activity time, screen time, and sleep duration. ALAN, artificial light-at-night; Ref, reference."

Figure 2

Exposure response association between ALAN and overweight and obesity in children and adolescents aged 9-18 years from November 2019 to November 2020 ALAN, artificial light-at-night."

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