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Article(id=1324077506915082544, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202509248, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1757779200000, receivedDateStr=2025-09-14, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614277818, onlineDateStr=2026-11-02, pubDate=1775750400000, pubDateStr=2026-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614277818, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614277818, creator=13701087609, updateTime=1793614277818, updator=13701087609, issue=Issue{id=1324077443828560770, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='7', pageStart='1153', pageEnd='1344', issueExtLink='null', onlineDate='null', pubDate='1775750400000', pubDateStr='2026-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614262778, creator='13701087609', updateTime=1793614352085, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324077818509918661, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324077818509918662, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1264, endPage=1269, ext={EN=ArticleExt(id=1324077507162546481, articleId=1324077506915082544, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Mediating effect of healthy lifestyles in the association between personality traits and obesity in primary school students in grades 4-6, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the mediating effect of healthy lifestyle between personality traits and obesity among primary school students in grades 4-6, so as to provide evidence for targeted obesity interventions.

Methods

A cross-sectional survey and physical examinations were conducted among 3 519 primary school students in grades 4-6 from 14 schools in Changzhou in 2024 by stratified cluster random sampling method. The personality traits were measured by the Big Five Inventory-10. The healthy lifestyle was assessed across four dimensions: healthy diet, moderate exercise, adequate sleep and reasonable screen time. A structural equation model was constructed to analyze the association between personality traits and obesity in primary school students and the mediating effect of the healthy lifestyle.

Results

The detection rate of obesity among primary school students in grades 4-6 was 20.60%, significantly higher in boys (25.16%) than girls (15.49%) (χ2=50.127, P<0.001). The detection rate of obesity decreased significantly with the increase of education level of father and mother (all P<0.05). The total score of healthy lifestyle and the score of conscientiousness were negatively correlated with obesity (rs=-0.066, P<0.001; rs=-0.058, P<0.001). After controlling for gender and parental education, the model results showed that the indirect effect of conscientiousness on obesity through healthy lifestyle was -0.010 (95% CI: -0.018~-0.002), and the mediating effect accounted for 18.87% of the total effect.

Conclusion

Conscientiousness can directly or indirectly affect obesity among primary school students in grades 4-6 in Changzhou through healthy lifestyle. Personalized intervention programs for childhood obesity should be designed in combination with personality traits to promote healthy lifestyle.

, authors=Chang-qian WU, Hui-bin DONG, Ye-xiang ZHANG, Xiao-qiang LI, authorsList=Chang-qian WU, Hui-bin DONG, Ye-xiang ZHANG, Xiao-qiang LI, authorCompany=null, correspAuthors=Hui-bin DONG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077509540716854, articleId=1324077506915082544, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=健康生活方式在人格特质与4~6年级小学生肥胖关联间的中介效应, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

探究健康生活方式在人格特质与4~6年级小学生肥胖间的中介效应，为制定针对性肥胖干预措施提供科学依据。

方法

采用分层整群随机抽样法，于2024年对常州市14所学校的3 519名4~6年级小学生开展横断面调查和体格检查。通过大五人格量表简表测量人格特质，通过健康饮食、适度运动、充足睡眠和合理视屏四个维度评估健康生活方式，构建结构方程模型分析小学生人格特质与其肥胖的关联及健康生活方式的中介效应。

结果

4~6年级小学生肥胖检出率为20.60%，男生（25.16%）高于女生（15.49%）（χ2=50.127，P<0.001）。肥胖检出率随父亲和母亲文化程度升高而降低（P值均<0.05）。健康生活方式总分和尽责性评分均与肥胖呈负相关（rs=-0.066，P<0.001; rs=-0.058，P<0.001）。控制性别和父母文化程度后，模型结果显示，尽责性通过健康生活方式对肥胖产生的间接效应为-0.010（95%CI：-0.018~-0.002），中介效应占总效应的18.87%。

结论

尽责性可直接或间接通过健康生活方式影响常州市4~6年级小学生肥胖。应结合人格特质设计儿童肥胖个性化干预方案，促进健康生活方式。

, authors=武常倩, 董惠斌, 张叶香, 李小强, authorsList=武常倩, 董惠斌, 张叶香, 李小强, authorCompany=null, correspAuthors=董惠斌, authorNote=

武常倩（1994—），女，医学硕士，主管医师，研究方向：学校卫生

, correspAuthorsNote=
董惠斌，E-mail：
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(In Chinese), articleTitle=Thirty-year study on development and cultivation of Chinese children and adolescents' personality, refAbstract=null), Reference(id=1324077520567542160, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, doi=null, pmid=null, pmcid=null, year=2024, volume=32, issue=7, pageStart=704, pageEnd=708, url=null, language=null, rfNumber=[33], rfOrder=43, authorNames=丁艳华, 费知行, journalName=中国儿童保健杂志, refType=null, unstructuredReference=丁艳华, 费知行. 儿童早期社会性和人格发展与家庭教养[J]. 中国儿童保健杂志, 2024, 32(7): 704-708., articleTitle=儿童早期社会性和人格发展与家庭教养, refAbstract=null), Reference(id=1324077520647233937, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, doi=null, pmid=null, pmcid=null, year=2024, volume=32, issue=7, pageStart=704, pageEnd=708, url=null, language=null, rfNumber=[33], rfOrder=44, authorNames=Ding YH, Fei ZH, journalName=Chinese Journal of Child Health Care, refType=null, unstructuredReference=Ding YH, Fei ZH. Children's social and personality development and the influence of family upbringing[J]. Chinese Journal of Child Health Care, 2024, 32(7): 704-708. (In Chinese), articleTitle=Children's social and personality development and the influence of family upbringing, refAbstract=null)], funds=[Fund(id=1324077514557104482, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, awardId=QY202408, language=CN, fundingSource=常州市卫健委科技项目(QY202408), fundOrder=null, country=null), Fund(id=1324077514628407651, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, awardId=CJ20220223, language=CN, fundingSource=常州市科学技术局应用基础研究计划(CJ20220223), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324077509834318135, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, xref=null, ext=[AuthorCompanyExt(id=1324077509842706744, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, companyId=1324077509834318135, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu 213022, China), AuthorCompanyExt(id=1324077509851095353, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, companyId=1324077509834318135, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=常州市疾病预防控制中心，江苏　常州　213022)])], figs=[ArticleFig(id=1324077511625285974, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=EN, label=Figure 1, caption=Results of mediation path analysis of the effect of personality traits on obesity (model 1), figureFileSmall=7QRWGT6mHeYKbPuSxP2clA==, figureFileBig=+yPAiPumpuCSdoXsksL0FA==, tableContent=null), ArticleFig(id=1324077511700783447, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=CN, label=图1, caption=人格特质对肥胖影响的中介路径分析结果（模型1）

注：*表示P<0.05，**表示P<0.001。

, figureFileSmall=7QRWGT6mHeYKbPuSxP2clA==, figureFileBig=+yPAiPumpuCSdoXsksL0FA==, tableContent=null), ArticleFig(id=1324077511914692952, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=EN, label=Figure 2, caption=Results of mediation path analysis of the effect of personality traits on obesity (model 2), figureFileSmall=si9O9m7PIQHARk5sDYwtkA==, figureFileBig=LAkBkEItbQjwFYuhVPGi5Q==, tableContent=null), ArticleFig(id=1324077512011161945, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=CN, label=图2, caption=人格特质对肥胖影响的中介路径分析结果（模型2）

注：*表示P<0.05；**表示P<0.001。

, figureFileSmall=si9O9m7PIQHARk5sDYwtkA==, figureFileBig=LAkBkEItbQjwFYuhVPGi5Q==, tableContent=null), ArticleFig(id=1324077512157962586, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=EN, label=Table 1, caption=

Basic characteristics of the subjects [n (%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
组别选项合计肥胖非肥胖χ2值P值
性别男1 860468（25.16）1 392（74.84）50.127<0.001
女1 659257（15.49）1 402（84.51）
年龄（岁）91 026226（22.03）800（77.97）2.7190.437
101 197243（20.30）954（79.70）
111 143230（20.12）913（79.88）
1215326（16.99）127（83.01）
健康饮食：过去7 d内不喝含糖饮料是836161（19.26）675（80.74）1.2110.271
否2 683564（21.02）2 119（78.98）
过去7 d内不吃油炸食品是1 005191（19.00）814（81.00）2.1950.139
否2 514534（21.24）1 980（78.76）
每天吃新鲜水果是2 861577（20.17）2 284（79.83）1.7670.184
否658148（22.49）510（77.51）
每天吃蔬菜是3 092629（20.34）2 463（79.66）1.0500.306
否42796（22.48）331（77.52）
每天吃早餐是3 162628（19.86）2 534（80.14）10.4790.001
否35797（27.17）260（72.83）
适度运动：每天中高强度运动时间≥1 h是728126（17.31）602（82.69）6.0910.014
否2 791599（21.46）2 192（78.54）
充足睡眠：每天睡眠时间≥10 h是1 301245（18.83）1 056（81.17）3.9570.047
否2 218480（21.64）1 738（78.36）
合理视屏：每天视屏时间≤2 h是3 237649（20.05）2 588（79.95）7.5520.006
否28276（26.95）206（73.05）
父亲文化程度小学及以下19750（25.38）147（74.62）10.1900.017
初中/中专/高中1 825402（22.03）1 423（77.97）
大学1 254230（18.34）1 024（81.66）
硕士及以上24343（17.70）200（82.30）
母亲文化程度小学及以下22959（25.76）170（74.24）14.0330.003
初中/中专/高中1 806402（22.26）1 404（77.74）
大学1 255225（17.93）1 030（82.07）
硕士及以上22939（17.03）190（82.97）
), ArticleFig(id=1324077512275403099, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=CN, label=表1, caption=

研究对象的一般情况[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
组别选项合计肥胖非肥胖χ2值P值
性别男1 860468（25.16）1 392（74.84）50.127<0.001
女1 659257（15.49）1 402（84.51）
年龄（岁）91 026226（22.03）800（77.97）2.7190.437
101 197243（20.30）954（79.70）
111 143230（20.12）913（79.88）
1215326（16.99）127（83.01）
健康饮食：过去7 d内不喝含糖饮料是836161（19.26）675（80.74）1.2110.271
否2 683564（21.02）2 119（78.98）
过去7 d内不吃油炸食品是1 005191（19.00）814（81.00）2.1950.139
否2 514534（21.24）1 980（78.76）
每天吃新鲜水果是2 861577（20.17）2 284（79.83）1.7670.184
否658148（22.49）510（77.51）
每天吃蔬菜是3 092629（20.34）2 463（79.66）1.0500.306
否42796（22.48）331（77.52）
每天吃早餐是3 162628（19.86）2 534（80.14）10.4790.001
否35797（27.17）260（72.83）
适度运动：每天中高强度运动时间≥1 h是728126（17.31）602（82.69）6.0910.014
否2 791599（21.46）2 192（78.54）
充足睡眠：每天睡眠时间≥10 h是1 301245（18.83）1 056（81.17）3.9570.047
否2 218480（21.64）1 738（78.36）
合理视屏：每天视屏时间≤2 h是3 237649（20.05）2 588（79.95）7.5520.006
否28276（26.95）206（73.05）
父亲文化程度小学及以下19750（25.38）147（74.62）10.1900.017
初中/中专/高中1 825402（22.03）1 423（77.97）
大学1 254230（18.34）1 024（81.66）
硕士及以上24343（17.70）200（82.30）
母亲文化程度小学及以下22959（25.76）170（74.24）14.0330.003
初中/中专/高中1 806402（22.26）1 404（77.74）
大学1 255225（17.93）1 030（82.07）
硕士及以上22939（17.03）190（82.97）
), ArticleFig(id=1324077513957319004, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=EN, label=Table 2, caption=

Scores of healthy lifestyle and personality traits of the subjects [M (P25, P75)]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类合计肥胖非肥胖Z值P值
健康生活方式总分2（1，2）2（1，2）2（1，2）-3.895<0.001
人格特质评分外向性7（6，9）7（6，9）7（6，9）-0.3890.697
宜人性6（6，8）6（6，8）6（6，8）-0.6200.535
尽责性7（6，9）6（6，8）7（6，9）-3.425<0.001
神经质6（3，6）6（3，6）6（3，6）2.2460.025
开放性7（6，9）7（6，9）7（6，10）-2.6980.007
), ArticleFig(id=1324077514074759517, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=CN, label=表2, caption=

研究对象的健康生活方式及人格特质评分[M（P25，P75）]

, figureFileSmall=null, figureFileBig=null, tableContent=
变量分类合计肥胖非肥胖Z值P值
健康生活方式总分2（1，2）2（1，2）2（1，2）-3.895<0.001
人格特质评分外向性7（6，9）7（6，9）7（6，9）-0.3890.697
宜人性6（6，8）6（6，8）6（6，8）-0.6200.535
尽责性7（6，9）6（6，8）7（6，9）-3.425<0.001
神经质6（3，6）6（3，6）6（3，6）2.2460.025
开放性7（6，9）7（6，9）7（6，10）-2.6980.007
), ArticleFig(id=1324077514183811422, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=EN, label=Table 3, caption=

Correlation between healthy lifestyle, personality traits and obesity among primary school students

, figureFileSmall=null, figureFileBig=null, tableContent=
变量健康生活方式健康饮食适度运动充足睡眠合理视屏人格特质
外向性宜人性尽责性神经质开放性
肥胖-0.066**-0.035*-0.042*-0.034*-0.046*-0.007-0.010-0.058**0.038*-0.045*
健康生活方式0.628**0.535**0.656**0.385**0.169**0.038*0.231**-0.212**0.184**
健康饮食0.129**0.109**0.123**0.140**0.0290.173**-0.162**0.160**
适度运动0.125**0.037*0.073**<-0.0010.129**-0.092**0.098**
充足睡眠0.083**0.103**0.038*0.116**-0.148**0.086**
合理视屏0.053*0.0030.135**-0.084**0.077**
宜人性0.241**-0.166**0.145**
尽责性-0.503**0.375**
神经质-0.407**
), ArticleFig(id=1324077514267697503, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=CN, label=表3, caption=

小学生健康生活方式、人格特质与肥胖的相关性

, figureFileSmall=null, figureFileBig=null, tableContent=
变量健康生活方式健康饮食适度运动充足睡眠合理视屏人格特质
外向性宜人性尽责性神经质开放性
肥胖-0.066**-0.035*-0.042*-0.034*-0.046*-0.007-0.010-0.058**0.038*-0.045*
健康生活方式0.628**0.535**0.656**0.385**0.169**0.038*0.231**-0.212**0.184**
健康饮食0.129**0.109**0.123**0.140**0.0290.173**-0.162**0.160**
适度运动0.125**0.037*0.073**<-0.0010.129**-0.092**0.098**
充足睡眠0.083**0.103**0.038*0.116**-0.148**0.086**
合理视屏0.053*0.0030.135**-0.084**0.077**
宜人性0.241**-0.166**0.145**
尽责性-0.503**0.375**
神经质-0.407**
), ArticleFig(id=1324077514372555104, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=EN, label=Table 4, caption=

Standardized effects estimated by ADF method and bootstrap method (model 1)

, figureFileSmall=null, figureFileBig=null, tableContent=
模型路径直接效应通过健康生活方式的间接效应总效应
β95%CIP值β95%CIP值β95%CIP值
外向性→肥胖0.029-0.008~0.0670.124-0.002-0.006~0.0000.0070.027-0.011~0.0640.164
宜人性→肥胖0.009-0.025~0.0400.6370.000-0.001~0.0020.4050.009-0.025~0.0410.632
尽责性→肥胖-0.043-0.084~-0.0030.036-0.007-0.012~-0.0020.007-0.049-0.090~-0.0090.016
神经质→肥胖0.030-0.013~0.0730.1620.0040.001~0.0090.0040.034-0.009~0.0770.116
开放性→肥胖0.010-0.028~0.0480.578-0.003-0.006~-0.0010.0050.007-0.030~0.0450.682
), ArticleFig(id=1324077514443858273, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077506915082544, language=CN, label=表4, caption=

采用ADF法和bootstrap法估计的标准化效应（模型1）

, figureFileSmall=null, figureFileBig=null, tableContent=
模型路径直接效应通过健康生活方式的间接效应总效应
β95%CIP值β95%CIP值β95%CIP值
外向性→肥胖0.029-0.008~0.0670.124-0.002-0.006~0.0000.0070.027-0.011~0.0640.164
宜人性→肥胖0.009-0.025~0.0400.6370.000-0.001~0.0020.4050.009-0.025~0.0410.632
尽责性→肥胖-0.043-0.084~-0.0030.036-0.007-0.012~-0.0020.007-0.049-0.090~-0.0090.016
神经质→肥胖0.030-0.013~0.0730.1620.0040.001~0.0090.0040.034-0.009~0.0770.116
开放性→肥胖0.010-0.028~0.0480.578-0.003-0.006~-0.0010.0050.007-0.030~0.0450.682
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健康生活方式在人格特质与4~6年级小学生肥胖关联间的中介效应
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武常倩 , 董惠斌 , 张叶香 , 李小强
现代预防医学 | 儿少卫生与妇幼保健 2026,53(7): 1264-1269
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (7) : 1264 -1269
健康生活方式在人格特质与4~6年级小学生肥胖关联间的中介效应
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武常倩, 董惠斌 , 张叶香, 李小强
作者信息
  • 常州市疾病预防控制中心，江苏　常州　213022
通讯作者:
董惠斌，E-mail：
作者简介:

武常倩（1994—），女，医学硕士，主管医师，研究方向：学校卫生

Mediating effect of healthy lifestyles in the association between personality traits and obesity in primary school students in grades 4-6
Chang-qian WU, Hui-bin DONG , Ye-xiang ZHANG, Xiao-qiang LI
Affiliations
  • Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu 213022, China
出版时间: 2026-04-10 doi: 10.20043/j.cnki.MPM.202509248
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摘要
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目的

探究健康生活方式在人格特质与4~6年级小学生肥胖间的中介效应，为制定针对性肥胖干预措施提供科学依据。

方法

采用分层整群随机抽样法，于2024年对常州市14所学校的3 519名4~6年级小学生开展横断面调查和体格检查。通过大五人格量表简表测量人格特质，通过健康饮食、适度运动、充足睡眠和合理视屏四个维度评估健康生活方式，构建结构方程模型分析小学生人格特质与其肥胖的关联及健康生活方式的中介效应。

结果

4~6年级小学生肥胖检出率为20.60%，男生（25.16%）高于女生（15.49%）（χ2=50.127，P<0.001）。肥胖检出率随父亲和母亲文化程度升高而降低（P值均<0.05）。健康生活方式总分和尽责性评分均与肥胖呈负相关（rs=-0.066，P<0.001; rs=-0.058，P<0.001）。控制性别和父母文化程度后，模型结果显示，尽责性通过健康生活方式对肥胖产生的间接效应为-0.010（95%CI：-0.018~-0.002），中介效应占总效应的18.87%。

结论

尽责性可直接或间接通过健康生活方式影响常州市4~6年级小学生肥胖。应结合人格特质设计儿童肥胖个性化干预方案，促进健康生活方式。

肥胖  /  生活方式  /  人格特质  /  中介效应
Objective

To investigate the mediating effect of healthy lifestyle between personality traits and obesity among primary school students in grades 4-6, so as to provide evidence for targeted obesity interventions.

Methods

A cross-sectional survey and physical examinations were conducted among 3 519 primary school students in grades 4-6 from 14 schools in Changzhou in 2024 by stratified cluster random sampling method. The personality traits were measured by the Big Five Inventory-10. The healthy lifestyle was assessed across four dimensions: healthy diet, moderate exercise, adequate sleep and reasonable screen time. A structural equation model was constructed to analyze the association between personality traits and obesity in primary school students and the mediating effect of the healthy lifestyle.

Results

The detection rate of obesity among primary school students in grades 4-6 was 20.60%, significantly higher in boys (25.16%) than girls (15.49%) (χ2=50.127, P<0.001). The detection rate of obesity decreased significantly with the increase of education level of father and mother (all P<0.05). The total score of healthy lifestyle and the score of conscientiousness were negatively correlated with obesity (rs=-0.066, P<0.001; rs=-0.058, P<0.001). After controlling for gender and parental education, the model results showed that the indirect effect of conscientiousness on obesity through healthy lifestyle was -0.010 (95% CI: -0.018~-0.002), and the mediating effect accounted for 18.87% of the total effect.

Conclusion

Conscientiousness can directly or indirectly affect obesity among primary school students in grades 4-6 in Changzhou through healthy lifestyle. Personalized intervention programs for childhood obesity should be designed in combination with personality traits to promote healthy lifestyle.

Obesity  /  Lifestyle  /  Personality traits  /  Mediating effect
武常倩, 董惠斌, 张叶香, 李小强. 健康生活方式在人格特质与4~6年级小学生肥胖关联间的中介效应. 现代预防医学, 2026 , 53 (7) : 1264 -1269 . DOI: 10.20043/j.cnki.MPM.202509248
Chang-qian WU, Hui-bin DONG, Ye-xiang ZHANG, Xiao-qiang LI. Mediating effect of healthy lifestyles in the association between personality traits and obesity in primary school students in grades 4-6[J]. Modern Preventive Medicine, 2026 , 53 (7) : 1264 -1269 . DOI: 10.20043/j.cnki.MPM.202509248
正文
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世界卫生组织将肥胖定义为“对健康构成风险的异常或过多的脂肪堆积”[1]。其病理生理基础涉及下丘脑-脑干中枢能量平衡系统及大脑高级中枢认知-情绪系统调节通路的紊乱，导致能量摄入或消耗失衡[2]。《中国居民营养与慢性病状况报告（2020）》数据显示，我国6~17岁儿童青少年肥胖率达7.9%[3]，预计2030年将增至15.1%[4]。儿童青少年肥胖可能会延续至成年，并增加2型糖尿病、高血压、冠心病、脂肪肝、哮喘及心理健康问题的风险[5]。肥胖发生受多种因素影响，包括生命早期宫内环境、遗传、生活方式（视屏行为、睡眠、身体活动、饮食）、社会环境等[5]。
五因素模型的人格特质（外向性、宜人性、尽责性、神经质和开放性）能反映个体在情绪、人际、认知和动机等方面的稳定特征[6]。人格特质可通过影响健康行为、社会环境因素和生理机制作用于健康[7]。行为遗传学和纵向建模研究提示人格特质与儿童肥胖存在因果关联，且肥胖与饮食行为存在双向影响[8]。但人格特质影响儿童肥胖的相关机制尚不明确。本研究旨在探讨健康生活方式在人格特质与小学生肥胖间的中介效应，从而为制定干预措施提供依据。
1　对象与方法
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1.1　对象
基于江苏省学生常见病和健康影响因素监测项目，采用分层整群随机抽样法，2024年从常州市7个县区各抽取2所小学，每所学校按年级分层后，随机抽取各年级2个班至少80名学生参与调查，并对四年级及以上学生进行问卷调查。本研究共纳入4~6年级小学生3 544人，剔除年龄异常：<9岁或>12岁（n=2）及问卷填写数值异常者（n=23），最终有效样本3 519人。研究通过常州市疾控中心医学伦理委员会批准（批号：常疾控伦审[2024]04号）。
1.2　方法
1.2.1　体格检查
身高体重测量遵循《学生健康检查技术规范》（GB/T 26343—2010）[9]，并严格执行“三点靠立柱”“两点呈水平”等要求。
1.2.2　问卷调查
由学生在学校机房集中自填电子问卷，内容涵盖一般人口学特征、健康行为、大五人格量表简表等。
1.2.3　判定标准
（1）肥胖：依据《学龄儿童青少年超重与肥胖筛查》（WS/T 586—2018）[10]，计算身体质量指数（body mass index，BMI），BMI=体重（kg）/身高的二次方（m2），按照性别年龄别BMI值判定肥胖。
（2）健康生活方式：借鉴北京大学儿童青少年卫生研究所提出的近视与肥胖综合干预策略“22510SS”中健康生活方式的内涵[11]，及澳大利亚青少年电子健康校园干预计划“Health4Life”中干预的健康风险行为[12]，从四个维度评估：（1）健康饮食，包括过去7 d内不喝含糖饮料、不吃油炸食品、每天吃新鲜水果、每天吃蔬菜、每天吃早餐；（2）适度运动，每天中高强度运动时间≥1 h；（3）充足睡眠，每天睡眠时间≥10 h；（4）合理视屏，每天视屏时间≤2 h。每条健康行为达标赋分1分，未达标则为0分，其中健康饮食方面达标4条及以上则赋1分。累积所有条目得分即为健康生活方式总分，范围为0~4分。
（3）人格特质：采用Rammstedt和John[13]改编的大五人格量表简表（big five inventory-10，BFI-10）评估人格特质，共包括外向性、宜人性、尽责性、神经质、开放性5个维度，每个维度含2个条目，每个条目得分范围为1~5分，得分越高表示该特质越突出。本研究中该量表的Cronbach α系数为0.80，内部一致性较好。
1.3　统计学方法
使用SAS 9.4软件描述与分析。计量资料根据正态检验结果以（均值±标准差）或中位数（第一四分位数，第三四分位数）[M（P25，P75）]描述。计数资料以例数（百分比）描述。组间比较采用χ2检验、Cochran-Armitage趋势检验或Wilcoxon秩和检验。变量间相关性通过Spearman相关分析。应用SPSS AMOS 25软件构建结构方程模型（structural equation model，SEM），探究小学生健康生活方式在人格特质与肥胖间的中介效应。采用Harman单因素检验测量共同偏差程度（第一个因子解释了方差的21.582%<40%，无共同方法偏差）[14]。鉴于模型的多变量非正态性（多变量峰度系数为7.384，临界比=14.137>1.96），故采用渐进分布自由法（asymptotically distribution-free，ADF）和bootstrap法进行路径分析和中介效应检验，将学生性别、父母文化程度作为模型内的控制变量，计算标准化路径系数和95%置信区间。模型适配度指标P值>0.05、GFI>0.900、AGFI>0.900、RMSEA<0.080表示模型拟合较好[15]。检验水准α=0.05，双侧检验。
2　结果
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2.1　调查对象基本情况
共纳入3 519名4~6年级小学生，其中男生1 860人（52.86%），女生1 659人（47.14%），肥胖检出率20.60%。女生、每天吃早餐、每天中高强度运动时间≥1 h、每天睡眠时间≥10 h、每天视屏时间≤2 h的小学生肥胖检出率较低（P值均<0.05）。小学生肥胖检出率在父亲不同文化程度组间及母亲不同文化程度组间的差异均有统计学意义（χ2=10.190，P=0.017；χ2=14.033，P=0.003），且肥胖检出率均随父亲和母亲文化程度升高而降低（Z=3.070，P=0.002；Z=3.624，P<0.001）。见表1。
2.2　健康生活方式及人格特质得分
肥胖小学生的健康生活方式总分较非肥胖组低（Z=-3.895，P<0.001），尽责性和开放性得分较非肥胖组低，神经质得分较非肥胖组高（P值均<0.05）。见表2。
2.3　健康生活方式、人格特质与肥胖的相关性
健康生活方式总分及四类健康行为得分与肥胖均呈显著负相关（P值均<0.05）。人格特质中尽责性和开放性与肥胖呈显著负相关（rs=-0.058，P<0.001；rs=-0.045，P<0.05），神经质与肥胖呈显著正相关（rs=0.038，P<0.05）。健康生活方式与外向性、宜人性、尽责性和开放性均呈显著正相关（P值均<0.05），与神经质呈显著负相关（rs=-0.212，P<0.001）。见表3。
2.4　健康生活方式在人格特质与小学生肥胖间的中介效应分析
构建健康生活方式在人格特质与小学生肥胖间中介效应的初始模型1，见图1。模型1拟合良好（χ2=6.873，P=0.442>0.05；RMSEA=0.000<0.050，GFI=1.000>0.900，AGFI=1.000>0.900）。
模型1的分析结果显示，外向性（β=0.049，P=0.008）、开放性（β=0.057，P=0.005）、神经质（β=-0.091，P<0.001）和尽责性（β=0.146，P<0.001）对健康生活方式有显著影响。健康生活方式对肥胖有直接负向影响（β=-0.045，P=0.008）。尽责性对肥胖有显著影响（β=-0.043，P=0.036）。
表4结果显示，除尽责性外，其余人格特质对肥胖的直接效应和总效应均无统计学意义（均P值>0.05）。
删除模型1中的非显著路径后得到模型2，见图2。模型2拟合良好（χ2=4.745，P=0.191>0.05；RMSEA=0.013<0.050，GFI=1.000>0.900，AGFI=1.000>0.900）。模型2的分析结果显示，尽责性对肥胖和健康生活方式的直接效应分别为-0.043（95%CI：-0.076~-0.008，P=0.021）、0.224（95%CI：0.189~0.254，P<0.001），健康生活方式对肥胖的直接效应为-0.045（95%CI：-0.079~-0.010，P=0.008），尽责性通过健康生活方式对肥胖的间接效应为-0.010（95%CI：-0.018~-0.002，P=0.007），尽责性对肥胖的总效应为-0.053（95%CI：-0.086~-0.019，P=0.002），中介效应占总效应的18.87%。
3　讨论
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本研究中常州市4~6年级小学生肥胖检出率为20.60%，男生高于女生。这一性别差异可能与父母对子女喂养习惯不同、两性在体成分及激素水平上的生物学差异，以及对自身理想形象认知的性别差异等有关[16]。肥胖检出率随父亲和母亲文化程度升高而降低，这可能与受教育程度更高的父母对体重健康管理的认知水平较高有关[17]。本研究中，肥胖小学生的健康生活方式总分较低，与其它研究结论一致[18]，说明综合健康干预对肥胖防控具有重要意义。
人格特质方面，肥胖小学生表现出更低的尽责性和开放性，及更高的神经质。尽责性通常与良好自控力及规范遵从性相关。一项综合多国各年龄群体队列数据的荟萃分析发现，尽责性较高则肥胖风险较低[19]。另一项针对儿童肥胖与人格特质的荟萃分析结果也显示，高尽责性与儿童BMI及肥胖风险存在负向关联[20]。而有研究发现尽责性与青少年饮食行为异常呈正相关，可能是尽责性人格倾向于饮食节制，在某些情况下反而增加不良饮食行为的风险[21]。开放性反映好奇心、兴趣广泛性及思想开放性。印度尼西亚的一项研究发现开放性与食用健康和非健康食物的饮食习惯均呈正相关，并与身体活动呈正相关，但未发现其与肥胖间的显著关联[22]。神经质体现为情绪稳定性低、对负面情绪敏感及易焦虑倾向。一项meta分析表明，BMI与神经质呈弱正相关，可能与神经质伴随的冲动性进食和情绪化饮食有关[23]。但韩国的一项研究发现神经质是五年级小学生超重肥胖的保护因素[24]。这些不一致的研究结果提示神经质与体重可能存在曲线关联，神经质较高的人群可能存在消瘦或肥胖两种极端体重问题[25]。
本研究中，健康生活方式总分及四类健康行为得分与尽责性均呈显著正相关。中介路径分析结果显示，尽责性可直接或间接通过健康生活方式影响常州市4~6年级小学生肥胖。既往研究也认为尽责性能促进健康行为，从而降低肥胖风险。如健康饮食方面：刘峥等[26]发现小学生尽责性能通过控制情绪性过食行为进而降低肥胖风险、闵鹤葳等[27]报告尽责性能促进12~17岁青少年健康进食行为。尽责性高的个体可能通过自我调节和冲动控制以延迟不健康饮食的即时满足，并坚持健康饮食习惯。适度运动方面：印度尼西亚的研究发现青少年的尽责性与身体活动呈正相关[22]。高尽责性反映较好的自控能力，可能使其更易坚持体育锻炼，从而减少久坐时间并增加身体活动。充足睡眠方面：一项系统综述结果表明高尽责性与良好的睡眠质量有关，且倾向于早睡早起的“清晨型”个体在尽责性上的评分更高[28]。这表明高尽责性的人更可能维持规律的睡眠习惯和良好的睡眠卫生。合理视屏方面：西班牙青少年的队列研究发现，尽责性较高者过度使用屏幕和社交网络的风险较低，且生活方式健康的青少年尽责性评分更高[29]。这提示高尽责性带来的自控力优势，可能有助于个体更好地约束视屏行为，并保持健康生活方式。
相关纵向研究也支持尽责性人格特质与健康行为间的动态关联。例如，12~21岁美国青年的尽责性随年龄增长而呈线性增加[30]，健康行为（包括身体活动水平）的增加与澳大利亚成年人群的尽责性提高有关[31]。这些发现提示，早期培养尽责性和保持健康生活方式，可能为个体在生命后期保持较高水平的尽责性提供正反馈。因此，实施儿童肥胖干预措施应注重多种健康行为的综合干预策略，并着力教育学生树牢“每个人是自己健康第一责任人”的理念，以增强其内在动机和自我管理能力，从而帮助其从小养成自律的生活方式。
在控制性别和父母文化程度后，模型结果显示，除尽责性外，其它人格特质对小学生肥胖的直接效应及总效应均无统计学意义。一方面，这可能与儿童期人格仍处在发展中，其行为模式尚未完全定型有关。如杨丽珠[32]等的研究发现，小学阶段的儿童人格中认真自控维度呈显著上升趋势，其余维度均呈现先上升，而后发展速度放缓，最后下降的动态变化趋势。另一方面，人格发展的理论研究表明，儿童人格的发展受遗传天性和环境教养长期复杂交互作用的共同影响[33]。儿童人格特质的行为表达可能还受社会文化及家庭、学校等环境因素的调节，这可能导致本研究未发现其它特质与儿童肥胖间的显著关联。
本研究的局限性在于：（1）横断面研究无法确定变量间的因果关联；（2）样本仅来源于常州地区，研究结论的外推性可能受限；（3）以BMI作为判定肥胖的唯一标准，虽简便易行，但未能结合体成分分析进行更精准的体重状况评估，可能遗漏“隐性肥胖”个体；（4）问卷调查通过学生自填完成，可能存在报告偏倚；（5）仅检验健康生活方式的中介效应，未纳入其它潜在中介变量。
基金
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  • 常州市卫健委科技项目(QY202408)
  • 常州市科学技术局应用基础研究计划(CJ20220223)
文献
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2026年第53卷第7期
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doi: 10.20043/j.cnki.MPM.202509248
  • 接收时间：2025-09-14
  • 首发时间：2026-11-02
  • 出版时间：2026-04-10
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  • 收稿日期：2025-09-14
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常州市卫健委科技项目(QY202408)
常州市科学技术局应用基础研究计划(CJ20220223)
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    常州市疾病预防控制中心，江苏　常州　213022

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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