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Article(id=1321170599364383194, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170520196895605, articleNumber=null, orderNo=null, doi=10.11847/zgggws1145665, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1723392000000, receivedDateStr=2024-08-12, revisedDate=1730304000000, revisedDateStr=2024-10-31, acceptedDate=1731945600000, acceptedDateStr=2024-11-19, onlineDate=1792921217050, onlineDateStr=2026-10-25, pubDate=1741536000000, pubDateStr=2025-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921217050, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921217050, creator=13701087609, updateTime=1792921217050, updator=13701087609, issue=Issue{id=1321170520196895605, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='3', pageStart='257', pageEnd='384', issueExtLink='null', onlineDate='null', pubDate='1741536000000', pubDateStr='2025-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921198175, creator='13701087609', updateTime=1792921198175, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=366, endPage=371, ext={EN=ArticleExt(id=1321170599565709787, articleId=1321170599364383194, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Adherence to four healthy lifestyle factors and their influencing factors among residents aged 35–75 years in Gansu province, columnId=1320427686514770171, journalTitle=Chinese Journal of Public Health, columnName=Survey and Report, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the adherence to four healthy lifestyle factors–nonsmoking, no or moderate alcohol consumption, adequate physical activity, and a healthy diet–among residents aged 35–75 years in Gansu province and to identify the influencing factors, providing a reference for promoting healthy lifestyles among residents.

Methods

Data were collected from December 2015 to December 2022 as part of the Early Screening and Comprehensive Intervention Program for High-Risk Cardiovascular Disease Populations. The study included 27 436 residents aged 35–75 years from 10 project sites in Gansu province: Baiyin district of Baiyin city, Anding district and Tongwei county of Dingxi city, Huating city of Pingliang city, Qingcheng county of Qingyang city, Qingshui county of Tianshui city, Gaotai county and Shandan county of Zhangye city, Liangzhou district of Wuwei city, and Yongjing county of Linxia Hui autonomous prefecture. The dataset included demographic information, adherence to the four healthy lifestyle factors (nonsmoking, no or moderate alcohol consumption, adequate physical activity, and healthy diet), and was complete with no history of CVD or cancer. Adherence to the four healthy lifestyle factors was analyzed, and a multifactorial unconditional logistic regression model was used to analyze the influencing factors.

Results

Among the 27 436 residents aged 35–75 years included in the analysis, 20 777 (75.7%), 27 183 (99.1%), 5 838 (21.3%), and 3 917 (14.3%) adhered to nonsmoking, no or moderate alcohol consumption, adequate physical activity, and a healthy diet, respectively. Only 713 residents (2.6%) adhered to all four healthy lifestyle factors. Multifactorial unconditional logistic regression analysis showed that being female, aged 65–75 years, and having a college degree or higher were positively associated with nonsmoking. Being aged 45–54 years, having a junior high school education, and having a history of hypertension or diabetes were negatively associated with nonsmoking. Being female, aged 55–75 years, and having a history of myocardial infarction or stroke were positively associated with no or moderate alcohol consumption, while having a junior high school education or higher was negatively associated. Being female, aged 45–75 years, having a junior high school education or higher, and having a history of hypertension, diabetes, myocardial infarction, or stroke were positively associated with adequate physical activity. Being female, having a junior high school education or higher, and having a history of hypertension, diabetes, myocardial infarction, or stroke were positively associated with a healthy diet, while living in rural areas was negatively associated. Being female, aged 55–75 years, having a junior high school education or higher, and having a history of hypertension or diabetes were positively associated with adherence to all four healthy lifestyle factors.

Conclusions

The adherence rate to all four healthy lifestyle factors was low among residents aged 35–75 years in Gansu province. Sex and education level were common influencing factors for adherence to the four healthy lifestyle factors.

, authors=Yixuan LI, Peiyuan GAO, Jing ZHANG, Bin WANG, Chouji ZHANG, authorsList=Yixuan LI, Peiyuan GAO, Jing ZHANG, Bin WANG, Chouji ZHANG, authorCompany=null, correspAuthors=Chouji ZHANG, authorNote=null, correspAuthorsNote=
ZHANG Chouji, E-mail:
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., 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=1321170600173883870, articleId=1321170599364383194, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=甘肃省35～75岁居民4种健康生活方式遵循情况及其影响因素分析, columnId=1320427686770622717, journalTitle=中国公共卫生, columnName=调查报告与分析, runingTitle=null, highlight=null, articleAbstract=
目的

了解甘肃省35～75岁居民不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食4种健康生活方式的遵循情况及其影响因素，为促进居民健康生活方式提供参考依据。

方法

收集2015年12月—2022年12月心血管病高危人群早期筛查与综合干预项目中甘肃省白银市白银区、定西市安定区、定西市通渭县、平凉市华亭市、庆阳市庆城县、天水市清水县、张掖市高台县、张掖市山丹县、武威市凉州区和临夏回族自治州永靖县10个项目点人口学信息以及不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食4种健康生活方式信息完整且无心血管疾病和癌症病史的27 436名35～75岁居民的相关数据，分析其4种健康生活方式的遵循情况，并应用多因素非条件logistic回归模型分析4种健康生活方式遵循情况的相关影响因素。

结果

甘肃省最终纳入分析的27 436名35～75岁居民中，遵循不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食健康生活方式的居民分别为20 777、27 183、5 838和3 917人，遵循率分别为75.7%、99.1%、21.3%和14.3%；遵循全部4种健康生活方式居民713人，遵循率仅为2.6%。多因素非条件logistic回归分析结果显示，女性、年龄65～75岁和大专及以上文化程度的居民更易遵循不吸烟的健康生活方式，年龄45～54岁、初中文化程度和有高血压或糖尿病病史的居民不易遵循不吸烟的健康生活方式；女性、年龄55～75岁和有心肌梗塞或中风病史的居民更易遵循不饮酒或适量饮酒的健康生活方式，初中及以上文化程度的居民不易遵循不饮酒或适量饮酒的健康生活方式；女性、年龄45～75岁、初中及以上文化程度、有高血压或糖尿病病史和有心肌梗塞或中风病史的居民更易遵循充足身体活动的健康生活方式；女性、初中及以上文化程度、有高血压或糖尿病病史和有心肌梗塞或中风病史的居民更易遵循健康饮食的健康生活方式，居住在农村的居民不易遵循健康饮食的健康生活方式；女性、年龄55～75岁、初中及以上文化程度和有高血压或糖尿病病史的居民更易遵循全部4种健康生活方式。

结论

甘肃省35～75岁居民对全部4种健康生活方式的遵循率较低，性别和文化程度是4种健康生活方式遵循情况的共同影响因素。

, authors=李艺璇, 高佩媛, 张静, 王斌, 张丑吉*, *, authorsList=李艺璇, 高佩媛, 张静, 王斌, 张丑吉, authorCompany=null, correspAuthors=张丑吉, authorNote=

李艺璇（1994—），医师，硕士，研究方向：慢性病、儿童青少年健康与伤害预防控制

, correspAuthorsNote=
张丑吉，E-mail：
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李艺璇（1994—），医师，硕士，研究方向：慢性病、儿童青少年健康与伤害预防控制

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Comparison of adherence to four healthy lifestyle factors among residents aged 35-75 years with different characteristics by gender,age,education, marital status, urban/rural,occupation, annual household income, social medical insurance, history of high blood pressure or diabetes, history of myocardial infarction or stroke in Gansu province

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特征分类调查人数不吸烟不饮酒或适度饮酒充足身体活动健康饮食全部4种健康生活方式
遵循人数遵循率/%遵循人数遵循率/%遵循人数遵循率/%遵循人数遵循率/%遵循人数遵循率/%
性别男性12 140558046.011 92198.22 48820.51 72014.21901.6
女性15 29615 19799.4 d15 26299.8 d3 35021.9 c2 19714.45233.4 d
年龄/岁35～4440833 20815.4403314.867611.659615.29413.2
45～549561719434.6944934.81 73529.71 32333.820628.9
55～647718572827.6766228.21 83531.41 16629.822231.1
65～756074464722.4 d603922.2 d1 59227.3 d83221.2 d19126.8 d
文化程度a小学及以下14 03611 36154.713 97151.42 14536.71 37235.021229.7
初中6827474922.9674424.81 50225.71 30033.219226.9
高中37882 62512.6373413.71 26121.673018.619126.8
大专及以上2 7422 0049.6 d2 6919.9 d92515.8 d50813.0 d11616.3 d
婚姻状况a非在婚1 7001 3506.51 6866.24267.32155.5578.0
在婚25 69419 40093.4 d25 45593.6540492.6 d369694.4 b65291.4 c
居住地城市10 530809076.810 45399.32 62224.92 31422.04224.0
农村16 90612 68775.0 d16 73099.0 c3 21619.0 d1 6039.5 d2911.7 d
职业a非农民11 628891942.911 49642.3396167.82 36260.356679.4
农民15 60811 70056.3 d15 49057.0 d1 83531.4 d1 52338.9 d14219.9 d
家庭年均收入（元）a<10 0005445424220.4541319.984914.568117.411816.5
10 000～50 00018 00413 49765.017 85165.7374664.22 67868.444562.4
>50 0003 1172 33911.3 d3 05611.2 c1 08418.6 d46311.8 d12717.8 a
社会医疗保险a无52400.2520.2230.4110.310.1
有27 30920 67699.527 05699.5579299.2 d390099.671099.6
高血压或糖尿病病史无20 1361 85627.96927.3500623.2613626.1702326.3
有7300544426.2 c723126.22 29439.3 d1 16429.7 d27738.8 d
心肌梗塞或中风病史无26 4023315.052.06322.98173.51 0073.8
有1 0347003.4 d1 0293.84026.9 d2175.5 d273.8
), ArticleFig(id=1321170918408311490, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170599364383194, language=CN, label=表1, caption=

甘肃省不同特征35～75岁居民4种健康生活方式遵循情况比较

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特征分类调查人数不吸烟不饮酒或适度饮酒充足身体活动健康饮食全部4种健康生活方式
遵循人数遵循率/%遵循人数遵循率/%遵循人数遵循率/%遵循人数遵循率/%遵循人数遵循率/%
性别男性12 140558046.011 92198.22 48820.51 72014.21901.6
女性15 29615 19799.4 d15 26299.8 d3 35021.9 c2 19714.45233.4 d
年龄/岁35～4440833 20815.4403314.867611.659615.29413.2
45～549561719434.6944934.81 73529.71 32333.820628.9
55～647718572827.6766228.21 83531.41 16629.822231.1
65～756074464722.4 d603922.2 d1 59227.3 d83221.2 d19126.8 d
文化程度a小学及以下14 03611 36154.713 97151.42 14536.71 37235.021229.7
初中6827474922.9674424.81 50225.71 30033.219226.9
高中37882 62512.6373413.71 26121.673018.619126.8
大专及以上2 7422 0049.6 d2 6919.9 d92515.8 d50813.0 d11616.3 d
婚姻状况a非在婚1 7001 3506.51 6866.24267.32155.5578.0
在婚25 69419 40093.4 d25 45593.6540492.6 d369694.4 b65291.4 c
居住地城市10 530809076.810 45399.32 62224.92 31422.04224.0
农村16 90612 68775.0 d16 73099.0 c3 21619.0 d1 6039.5 d2911.7 d
职业a非农民11 628891942.911 49642.3396167.82 36260.356679.4
农民15 60811 70056.3 d15 49057.0 d1 83531.4 d1 52338.9 d14219.9 d
家庭年均收入（元）a<10 0005445424220.4541319.984914.568117.411816.5
10 000～50 00018 00413 49765.017 85165.7374664.22 67868.444562.4
>50 0003 1172 33911.3 d3 05611.2 c1 08418.6 d46311.8 d12717.8 a
社会医疗保险a无52400.2520.2230.4110.310.1
有27 30920 67699.527 05699.5579299.2 d390099.671099.6
高血压或糖尿病病史无20 1361 85627.96927.3500623.2613626.1702326.3
有7300544426.2 c723126.22 29439.3 d1 16429.7 d27738.8 d
心肌梗塞或中风病史无26 4023315.052.06322.98173.51 0073.8
有1 0347003.4 d1 0293.84026.9 d2175.5 d273.8
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Multivariable unconditional logistic regression analysis of influencing factors of adherence to four healthy lifestyles among residents aged 35-75 years in Gansu province

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项目因素比较组参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
不吸烟性别女性男性5.280.112 449.04<0.001196.286159.250～241.937
年龄/岁45～5435～44–0.140.065.550.0260.8640.766～0.976
55～64–0.030.060.170.6830.9740.857～1.106
65～750.290.0717.14<0.0011.3351.164～1.530
文化程度初中小学及以下–0.130.057.070.0130.8760.795～0.966
高中0.080.061.870.1831.0850.965～1.220
大专及以上0.340.0724.38<0.0011.4051.228～1.608
高血压或糖尿病病史有无–0.090.044.540.0060.9100.834～0.992
不饮酒或适量饮酒性别女性男性1.600.2158.72<0.0014.9473.286～7.446
年龄/岁45～5435～440.010.170.010.9891.0020.716～1.404
55～640.510.206.300.0181.6641.118～2.477
65～750.680.248.050.0081.9671.233～3.138
文化程度初中小学及以下–0.380.174.880.0360.6820.485～0.958
高中–0.430.204.690.0390.6480.438～0.960
大专及以上–0.490.215.370.0280.6100.402～0.926
心肌梗塞或中风病史有无0.920.444.400.0062.5241.062～5.998
充足身体活动性别女性男性0.330.0461.02<0.0011.3911.280～1.511
年龄/岁45～5435～440.440.0564.31<0.0011.5481.391～1.723
55～640.740.06166.17<0.0012.0971.873～2.346
65～751.040.06285.21<0.0012.8462.521～3.213
文化程度初中小学及以下0.450.04107.77<0.0011.5671.439～1.705
高中0.910.05329.18<0.0012.4852.253～2.742
大专及以上1.210.06437.88<0.0013.3633.002～3.767
高血压或糖尿病病史有无0.600.03287.34<0.0011.8281.705～1.960
心肌梗塞或中风病史有无0.430.0735.140.0011.5381.334～1.773
健康饮食性别女性男性0.140.058.570.0171.1491.047～1.261
文化程度初中小学及以下0.580.05150.24<0.0011.7781.622～1.950
高中0.430.0655.98<0.0011.5371.373～1.720
大专及以上0.500.0755.65<0.0011.6451.443～1.875
居住地农村城市–1.320.526.500.0340.2670.097～0.737
高血压或糖尿病病史有无0.210.0424.730.0011.2351.136～1.341
心肌梗塞或中风病史有无0.400.0823.060.0011.4981.270～1.767
全部4种健康生活方式性别女性男性1.070.09155.18<0.0012.9012.453～3.430
年龄/岁45～5435～440.190.120.010.1461.2050.944～1.540
55～640.500.130.050.0011.6431.273～2.121
65～750.770.140.23<0.0012.1611.644～2.841
文化程度初中小学及以下0.600.100.15<0.0011.8181.484～2.227
高中1.070.110.71<0.0012.9142.345～3.621
大专及以上1.200.130.87<0.0013.3202.570～4.290
高血压或糖尿病病史有无0.570.080.15<0.0011.7741.513～2.079
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甘肃省35～75岁居民4种健康生活方式遵循情况影响因素多因素非条件logistic回归分析

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项目因素比较组参照组β $ S_{\overline{x}} $Wald χ2值P值OR值95%CI
不吸烟性别女性男性5.280.112 449.04<0.001196.286159.250～241.937
年龄/岁45～5435～44–0.140.065.550.0260.8640.766～0.976
55～64–0.030.060.170.6830.9740.857～1.106
65～750.290.0717.14<0.0011.3351.164～1.530
文化程度初中小学及以下–0.130.057.070.0130.8760.795～0.966
高中0.080.061.870.1831.0850.965～1.220
大专及以上0.340.0724.38<0.0011.4051.228～1.608
高血压或糖尿病病史有无–0.090.044.540.0060.9100.834～0.992
不饮酒或适量饮酒性别女性男性1.600.2158.72<0.0014.9473.286～7.446
年龄/岁45～5435～440.010.170.010.9891.0020.716～1.404
55～640.510.206.300.0181.6641.118～2.477
65～750.680.248.050.0081.9671.233～3.138
文化程度初中小学及以下–0.380.174.880.0360.6820.485～0.958
高中–0.430.204.690.0390.6480.438～0.960
大专及以上–0.490.215.370.0280.6100.402～0.926
心肌梗塞或中风病史有无0.920.444.400.0062.5241.062～5.998
充足身体活动性别女性男性0.330.0461.02<0.0011.3911.280～1.511
年龄/岁45～5435～440.440.0564.31<0.0011.5481.391～1.723
55～640.740.06166.17<0.0012.0971.873～2.346
65～751.040.06285.21<0.0012.8462.521～3.213
文化程度初中小学及以下0.450.04107.77<0.0011.5671.439～1.705
高中0.910.05329.18<0.0012.4852.253～2.742
大专及以上1.210.06437.88<0.0013.3633.002～3.767
高血压或糖尿病病史有无0.600.03287.34<0.0011.8281.705～1.960
心肌梗塞或中风病史有无0.430.0735.140.0011.5381.334～1.773
健康饮食性别女性男性0.140.058.570.0171.1491.047～1.261
文化程度初中小学及以下0.580.05150.24<0.0011.7781.622～1.950
高中0.430.0655.98<0.0011.5371.373～1.720
大专及以上0.500.0755.65<0.0011.6451.443～1.875
居住地农村城市–1.320.526.500.0340.2670.097～0.737
高血压或糖尿病病史有无0.210.0424.730.0011.2351.136～1.341
心肌梗塞或中风病史有无0.400.0823.060.0011.4981.270～1.767
全部4种健康生活方式性别女性男性1.070.09155.18<0.0012.9012.453～3.430
年龄/岁45～5435～440.190.120.010.1461.2050.944～1.540
55～640.500.130.050.0011.6431.273～2.121
65～750.770.140.23<0.0012.1611.644～2.841
文化程度初中小学及以下0.600.100.15<0.0011.8181.484～2.227
高中1.070.110.71<0.0012.9142.345～3.621
大专及以上1.200.130.87<0.0013.3202.570～4.290
高血压或糖尿病病史有无0.570.080.15<0.0011.7741.513～2.079
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甘肃省35～75岁居民4种健康生活方式遵循情况及其影响因素分析
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李艺璇 , 高佩媛 , 张静 , 王斌 , 张丑吉 *, *
中国公共卫生 | 调查报告与分析 2025,41(3): 366-371
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中国公共卫生 |调查报告与分析 2025 , 41 (3) : 366 -371
甘肃省35～75岁居民4种健康生活方式遵循情况及其影响因素分析
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李艺璇（1994—），医师，硕士，研究方向：慢性病、儿童青少年健康与伤害预防控制

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李艺璇（1994—），医师，硕士，研究方向：慢性病、儿童青少年健康与伤害预防控制

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李艺璇, 高佩媛, 张静, 王斌, 张丑吉*, *
作者信息
  • 甘肃省疾病预防控制中心社区卫生与慢性非传染性疾病防制科，兰州 730020
通讯作者:
张丑吉，E-mail：
作者简介:

李艺璇（1994—），医师，硕士，研究方向：慢性病、儿童青少年健康与伤害预防控制

Adherence to four healthy lifestyle factors and their influencing factors among residents aged 35–75 years in Gansu province
Yixuan LI, Peiyuan GAO, Jing ZHANG, Bin WANG, Chouji ZHANG
Affiliations
  • Community Health and Chronic Non-communicable Disease Control Department, Gansu Province Center for Disease Control and Prevention, Lanzhou 730020, China
    • Corresponding Author:
    ZHANG Chouji, E-mail:
出版时间: 2025-03-10 doi: 10.11847/zgggws1145665
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摘要
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目的

了解甘肃省35～75岁居民不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食4种健康生活方式的遵循情况及其影响因素，为促进居民健康生活方式提供参考依据。

方法

收集2015年12月—2022年12月心血管病高危人群早期筛查与综合干预项目中甘肃省白银市白银区、定西市安定区、定西市通渭县、平凉市华亭市、庆阳市庆城县、天水市清水县、张掖市高台县、张掖市山丹县、武威市凉州区和临夏回族自治州永靖县10个项目点人口学信息以及不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食4种健康生活方式信息完整且无心血管疾病和癌症病史的27 436名35～75岁居民的相关数据，分析其4种健康生活方式的遵循情况，并应用多因素非条件logistic回归模型分析4种健康生活方式遵循情况的相关影响因素。

结果

甘肃省最终纳入分析的27 436名35～75岁居民中，遵循不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食健康生活方式的居民分别为20 777、27 183、5 838和3 917人，遵循率分别为75.7%、99.1%、21.3%和14.3%；遵循全部4种健康生活方式居民713人，遵循率仅为2.6%。多因素非条件logistic回归分析结果显示，女性、年龄65～75岁和大专及以上文化程度的居民更易遵循不吸烟的健康生活方式，年龄45～54岁、初中文化程度和有高血压或糖尿病病史的居民不易遵循不吸烟的健康生活方式；女性、年龄55～75岁和有心肌梗塞或中风病史的居民更易遵循不饮酒或适量饮酒的健康生活方式，初中及以上文化程度的居民不易遵循不饮酒或适量饮酒的健康生活方式；女性、年龄45～75岁、初中及以上文化程度、有高血压或糖尿病病史和有心肌梗塞或中风病史的居民更易遵循充足身体活动的健康生活方式；女性、初中及以上文化程度、有高血压或糖尿病病史和有心肌梗塞或中风病史的居民更易遵循健康饮食的健康生活方式，居住在农村的居民不易遵循健康饮食的健康生活方式；女性、年龄55～75岁、初中及以上文化程度和有高血压或糖尿病病史的居民更易遵循全部4种健康生活方式。

结论

甘肃省35～75岁居民对全部4种健康生活方式的遵循率较低，性别和文化程度是4种健康生活方式遵循情况的共同影响因素。

健康生活方式  /  不吸烟  /  不饮酒或适量饮酒  /  充足身体活动  /  健康饮食  /  遵循情况  /  影响因素  /  甘肃省
Objective

To investigate the adherence to four healthy lifestyle factors–nonsmoking, no or moderate alcohol consumption, adequate physical activity, and a healthy diet–among residents aged 35–75 years in Gansu province and to identify the influencing factors, providing a reference for promoting healthy lifestyles among residents.

Methods

Data were collected from December 2015 to December 2022 as part of the Early Screening and Comprehensive Intervention Program for High-Risk Cardiovascular Disease Populations. The study included 27 436 residents aged 35–75 years from 10 project sites in Gansu province: Baiyin district of Baiyin city, Anding district and Tongwei county of Dingxi city, Huating city of Pingliang city, Qingcheng county of Qingyang city, Qingshui county of Tianshui city, Gaotai county and Shandan county of Zhangye city, Liangzhou district of Wuwei city, and Yongjing county of Linxia Hui autonomous prefecture. The dataset included demographic information, adherence to the four healthy lifestyle factors (nonsmoking, no or moderate alcohol consumption, adequate physical activity, and healthy diet), and was complete with no history of CVD or cancer. Adherence to the four healthy lifestyle factors was analyzed, and a multifactorial unconditional logistic regression model was used to analyze the influencing factors.

Results

Among the 27 436 residents aged 35–75 years included in the analysis, 20 777 (75.7%), 27 183 (99.1%), 5 838 (21.3%), and 3 917 (14.3%) adhered to nonsmoking, no or moderate alcohol consumption, adequate physical activity, and a healthy diet, respectively. Only 713 residents (2.6%) adhered to all four healthy lifestyle factors. Multifactorial unconditional logistic regression analysis showed that being female, aged 65–75 years, and having a college degree or higher were positively associated with nonsmoking. Being aged 45–54 years, having a junior high school education, and having a history of hypertension or diabetes were negatively associated with nonsmoking. Being female, aged 55–75 years, and having a history of myocardial infarction or stroke were positively associated with no or moderate alcohol consumption, while having a junior high school education or higher was negatively associated. Being female, aged 45–75 years, having a junior high school education or higher, and having a history of hypertension, diabetes, myocardial infarction, or stroke were positively associated with adequate physical activity. Being female, having a junior high school education or higher, and having a history of hypertension, diabetes, myocardial infarction, or stroke were positively associated with a healthy diet, while living in rural areas was negatively associated. Being female, aged 55–75 years, having a junior high school education or higher, and having a history of hypertension or diabetes were positively associated with adherence to all four healthy lifestyle factors.

Conclusions

The adherence rate to all four healthy lifestyle factors was low among residents aged 35–75 years in Gansu province. Sex and education level were common influencing factors for adherence to the four healthy lifestyle factors.

healthy lifestyle  /  nonsmoking  /  no or moderate alcohol consumption  /  adequate physical activity  /  healthy diet  /  adherence  /  influencing factors  /  Gansu province
李艺璇, 高佩媛, 张静, 王斌, 张丑吉. 甘肃省35～75岁居民4种健康生活方式遵循情况及其影响因素分析. 中国公共卫生, 2025 , 41 (3) : 366 -371 . DOI: 10.11847/zgggws1145665
Yixuan LI, Peiyuan GAO, Jing ZHANG, Bin WANG, Chouji ZHANG. Adherence to four healthy lifestyle factors and their influencing factors among residents aged 35–75 years in Gansu province[J]. Chinese Journal of Public Health, 2025 , 41 (3) : 366 -371 . DOI: 10.11847/zgggws1145665
正文
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健康的生活方式被认为是减少疾病发生的重要手段[1–2]。据报道，保持健康的饮食习惯，包括多吃水果、蔬菜、谷物、豆类和鱼类以及少吃盐、糖、脂肪和红肉，将有助于减少全球每年约1 100万人的死亡；而不吸烟、不饮酒或适量饮酒和充足身体活动可以分别减少全球每年约700万、300万和100万人的死亡[3]；同时坚持这几种健康生活方式则会产生更大的健康效益，防止>60%的过早死亡[4]，并使心血管疾病、癌症和2型糖尿病的预期寿命延长7～10年[5]。近年来，已有多项研究分析了居民对健康生活方式行为的遵循情况[6–7]，但由于方法的不同，如调查对象的纳入标准和健康生活方式定义等的差异，导致了研究结果的不同。有研究结果表明，中国居民心血管疾病危险因素（包括吸烟、饮酒、健康饮食和体力活动等）均存在明显的地域差异[8]，因此有必要深入分析不同地域居民的健康生活方式遵循情况及其影响因素。甘肃省位于中国西北地区，地广人稀，自然资源丰富，地貌复杂多样，气候类型多、四季分明，具有丰富和独特的饮食和风俗习惯。为了解甘肃省35～75岁居民不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食4种健康生活方式的遵循情况及其影响因素，为促进居民健康生活方式提供参考依据，本研究收集2015年12月—2022年12月心血管病高危人群早期筛查与综合干预项目中甘肃省白银市白银区、定西市安定区、定西市通渭县、平凉市华亭市、庆阳市庆城县、天水市清水县、张掖市高台县、张掖市山丹县、武威市凉州区和临夏回族自治州永靖县10个项目点人口学信息以及不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食4种健康生活方式信息完整且无心血管疾病和癌症病史的27 436名35～75岁居民的相关数据分析其4种健康生活方式的遵循情况，并应用多因素非条件logistic回归模型分析4种健康生活方式遵循情况的相关影响因素。
1　资料与方法
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1.1　资料来源
收集2015年12月—2022年12月心血管病高危人群早期筛查与综合干预项目中甘肃省白银市白银区、定西市安定区、定西市通渭县、平凉市华亭市、庆阳市庆城县、天水市清水县、张掖市高台县、张掖市山丹县、武威市凉州区和临夏回族自治州永靖县10个项目点人口学信息以及不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食4种健康生活方式信息完整且无心血管疾病和癌症病史的27 436名35～75岁居民的相关数据，内容包括性别、年龄、文化程度、婚姻状况、居住地、职业、家庭年均收入、有无社会医疗保险、有无高血压或糖尿病病史、有无心肌梗塞或中风病史以及不吸烟、不饮酒或适量饮酒、充足的身体活动、健康饮食4种健康生活方式的遵循情况等。其中，有高血压、糖尿病、心肌梗死和中风病史者均为调查对象自报曾在乡镇卫生院或社区卫生服务中心及以上医疗机构确诊者；不吸烟指从不吸烟或曾经吸烟但现在已不吸烟[9]；不饮酒或适量饮酒指从不饮酒或男性平均饮酒量<25 g/d、女性平均饮酒量<15 g/d[10]；充足身体活动指进行球类运动、散步、体操、民间舞蹈、太极拳和气功等中等强度有氧活动≥150分/周或进行游泳和跑步等高强度有氧活动≥75分/周[11]；健康饮食指符合每天摄入新鲜水果、每天摄入新鲜蔬菜、每天摄入全谷物、每周吃鱼和其他海产品≥1 d、每周吃豆类和豆类食品≥4 d和每周吃红肉<7 d等6种健康饮食中的≥4种[10]。本研究经中国医学科学院阜外医院中心伦理委员会审查批准（批号：2014-574），且所有研究对象均签署了知情同意书。
1.2　统计分析
采用SAS 9.4和R 3.6.2软件进行统计分析。不同特征居民4种健康生活遵循率的比较采用χ2检验；应用多因素非条件logistic回归模型分析4种健康生活方式遵循情况的主要影响因素，对于每种被评估的健康生活方式，本研究在模型中同时调整了其他3种健康生活方式。检验水准为双侧检验α=0.05。
2　结　果
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2.1　一般情况
甘肃省纳入的27 436名35～75岁居民中，男性12 140人（44.2%），女性15 296人（55.8%）；年龄35～44岁4 083人（14.9%），45～54岁9 561人（34.8%），55～64岁7 718人（28.1%），65～75岁6 074人（22.1%）；文化程度小学及以下14 036人（51.2%），初中6 827人（24.9%），高中3 788人（13.8%），大专及以上2 742人（10.0%），不详43人（0.2%）；婚姻状况非在婚1 700人（6.2%），在婚25 694人（93.7%），不详42人（0.2%）；居住在城市10 530人（38.4%），农村16 906人（61.6%）；职业为非农民11 628人（42.4%），农民15 608人（56.9%），不详200人（0.7%）；家庭年均收入<10 000元5 445人（19.8%），10 000～50 000元18 004人（65.6%），>50 000元3 117人（11.4%），不详870人（3.2%）；无社会医疗保险52人（0.2%），有社会医疗保险27 309人（99.5%），不详75人（0.3%）；无高血压或糖尿病史20 136人（73.4%），有高血压或糖尿病病史7 300例（26.6%）；无心肌梗塞或中风病史26 402人（96.2%），有无心肌梗塞或中风病史1 034例（3.8%）。
2.2　甘肃省35～75岁居民4种健康生活方式遵循情况（表1）
甘肃省最终纳入分析的27 436名35～75岁居民中，遵循不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食健康生活方式的居民分别为20 777、27 183、5 838和3 917人，遵循率分别为75.7%、99.1%、21.3%和14.3%；遵循全部4种健康生活方式居民713人，遵循率仅为2.6%。甘肃省不同特征35～75岁居民比较，不同性别、年龄、文化程度、婚姻状况、居住地、职业、家庭年均收入以及有无高血压或糖尿病病史、心肌梗塞或中风病史居民不吸烟健康生活方式遵循率不同，不同性别、年龄、文化程度、居住地、职业和家庭年均收入居民不饮酒或适量饮酒健康生活方式遵循率不同，不同性别、年龄、文化程度、婚姻状况、居住地、职业、家庭年均收入及有无社会医疗保险、高血压或糖尿病病史、心肌梗塞或中风病史居民充足身体活动健康生活方式遵循率不同，不同年龄、文化程度、婚姻状况、居住地、职业、家庭年均收入及有无高血压或糖尿病病史、心肌梗塞或中风病史居民健康饮食健康生活方式遵循率不同，不同性别、年龄、文化程度、婚姻状况、居住地、职业、家庭年均收入和有无高血压或糖尿病病史居民全部4种健康生活方式遵循率不同，差异均有统计学意义（均P<0.05）。
2.3　甘肃省35～75岁居民4种健康生活方式遵循情况影响因素多因素非条件logistic回归分析（表2）
分别以甘肃省35～75岁居民是否遵循不吸烟（0=否，1=是）、不饮酒或适度饮酒（0=否，1=是）、充足身体活动（0=否，1=是）、健康饮食（0=否，1=是）和全部4种健康生活方式（0=否，1=是）为因变量，以性别、年龄、文化程度、婚姻状况、居住地、职业、家庭年均收入、有无社会医疗保险、有无高血压或糖尿病病史和有无心肌梗塞或中风病史共10个因素为自变量进行多因素非条件logistic回归分析。结果显示，女性、年龄65～75岁和大专及以上文化程度的居民更易遵循不吸烟的健康生活方式，年龄45～54岁、初中文化程度和有高血压或糖尿病病史的居民不易遵循不吸烟的健康生活方式；女性、年龄55～75岁和有心肌梗塞或中风病史的居民更易遵循不饮酒或适量饮酒的健康生活方式，初中及以上文化程度的居民不易遵循不饮酒或适量饮酒的健康生活方式；女性、年龄45～75岁、初中及以上文化程度、有高血压或糖尿病病史和有心肌梗塞或中风病史的居民更易遵循充足身体活动的健康生活方式；女性、初中及以上文化程度、有高血压或糖尿病病史和有心肌梗塞或中风病史的居民更易遵循健康饮食的健康生活方式，居住在农村的居民不易遵循健康饮食的健康生活方式；女性、年龄55～75岁、初中及以上文化程度和有高血压或糖尿病病史的居民更易遵循全部4种健康生活方式。
3　讨　论
收起
本研究结果显示，甘肃省35～75岁居民不饮酒或适度饮酒健康生活方式的遵循率最高（99.1%），其次为不吸烟健康生活方式的遵循率（75.7%），充足运动和健康饮食健康生活方式的遵循率相对较低（21.3%和14.3%）；此外，甘肃省35～75岁居民对全部4种健康生活方式的遵循率则更低，仅为2.6%，低于2015—2019年中国成年人4种健康生活方式遵循率的2.8%[8]，2015—2021年华北地区（北京市、天津市、河北省、山西省和内蒙古自治区）成人4种健康生活方式和遵循率和4.7%[12]和2017年北京市成年人数据4种健康生活方式遵循率的2.8%[6]。这可能与甘肃省的社会经济水平相对较低有关，居民在风险认知、长寿收益、效能与能动性和辅助健康行为等方面处于劣势地位将导致其对健康生活方式的理解有一定偏差[13]。与此同时，随着生活压力的增加和年龄的增长，其生活能力和身体功能均有所降低，因此坚持遵循全部4种健康生活方式有一定难度。然而，《基层心血管病综合管理实践指南（2020）》[14]中提出，长期坚持多种健康生活方式是心血管疾病预防和治疗不可或缺的部分。由此可见，培养和坚持健康的生活方式对促进健康和提高生活质量至关重要。此外，本研究结果还显示，甘肃省35～75岁居民不饮酒或适度饮酒和不吸烟的遵循率最高，与王椿淇等[9]和Zhang X Y等[12]研究结果一致，提示近年来戒烟戒酒或戒烟限酒已成为很多人生活中不可或缺的一部分。
本研究多因素非条件logistic回归分析结果显示，女性居民较男性居民更易遵循不吸烟、不饮酒或适量饮酒、充足身体活动和健康饮食的健康生活方式，这可能是因为相对于男性居民而言，女性居民更注重自身的健康管理，更愿意获得社会支持和卫生保健服务，坚持健康生活方式的意识更强，而男性居民则因工作压力和社会需要容易频繁地接触烟酒和不健康的饮食[13, 15]。本研究还发现，年龄增长也是居民对健康生活方式高遵循率的保护因素，与李婷婷等[16]的研究结果一致，这可能是因为随着年龄的增长，居民更愿意拥有健康的身体状况，更易做到不吸烟、不饮酒或适度饮酒，也会参与身体活动，保持充足的运动，利于促进健康的生活方式[16]。此外，文化程度较高的居民更加注重自己的生活习惯，具有较强的自我保健意识，在健康知识获取和医疗资源的可及性及服务质量等方面更具优势，而优越的工作和生活环境还可降低健康损害的风险[17–18]，从而更有可能遵循全部4种健康生活方式。研究表明，有高血压或糖尿病病史和有心肌梗塞或中风病史会增加个体患心脑血管疾病的风险[19]，因此有高血压或糖尿病病史和有心肌梗塞或中风病史的人群需要更多的生活方式干预来降低疾病风险，医护人员也会指导其戒烟戒酒、均衡饮食和参加体育锻炼等，从而使得此类人群对健康生活方式的遵循率较高。本研究结果还显示，居住在农村的居民不易遵循健康饮食的健康生活方式，这可能与生活在农村地区的居民健康素养较低，不易接触和获得新的健康知识有关[20]。
综上所述，本研究的发现对甘肃省慢性病预防和控制具有一定的政策意义。首先，在开展面向普通民众的健康促进项目时需要特别关注男性、文化程度较低和居住在农村的居民；其次，健康促进战略应该适合不同地区条件和不同人群，重点解决我省重大卫生问题更有意义；再次，许多居民对充足身体活动和健康饮食的遵循率不高，因此综合干预如合理膳食、适当运动、戒烟限酒、劳逸结合和降低体重等可能是一种更实际的方式，能够最大限度地发挥健康促进对改善普通民众遵守健康生活方式的影响。但本研究仍存在一定的局限性：第一，由于生活方式因素为自我报告的，可能存在回忆偏倚；第二，本研究未对身体活动和饮食问卷进行检验，且饮食信息收集仅考虑摄入频率并未考虑整体能量摄入情况；第三，本研究仅纳入了4种健康生活方式，对其他生活方式，如久坐行为或睡眠时长等，需要在未来的研究中进行深入探索。

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doi: 10.11847/zgggws1145665
  • 接收时间：2024-08-12
  • 首发时间：2026-10-25
  • 出版时间：2025-03-10
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  • 收稿日期：2024-08-12
  • 修回日期：2024-10-31
  • 录用日期：2024-11-19
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    甘肃省疾病预防控制中心社区卫生与慢性非传染性疾病防制科，兰州 730020

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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