OBJECTIVE: Prioritizing a healthy lifestyle can help young individuals quickly boost their immunity and reduce the prevalence of cardiovascular diseases. Adopting better sleep and diet during the COVID-19 pandemic could play a crucial role in achieving better epidemic outcomes and protecting communities. The study aimed to investigate the association between sleep quality and dietary habits, physical activity, and screen time among high school students during regular epidemic prevention and control in Shanghai.

METHODS:  A self-reported online questionnaire was used to collecting data on Pittsburgh sleep quality scale, physical activity, food consumption, mobile phone use, and social demographical information (e.g., parents’ educational level, etc.) from senior high school students in Shanghai, China, in October 2021. The data were analyzed by correlation and hierarchical analysis using IBM SPSS Statistics v. 26.0.

RESULTS: 1099 students (mean age = 16.1 ± 0.9 years) responded to the online survey. A small number of respondents (14.1%, n = 156) exhibited inadequate sleep quality. Nearly half of the students were not physically active (49.2%, n = 544). The average daily sedentary time exceeded eight hours. There was a significant positive association between sleep quality and physical condition (r=0.08, p<0.01), and sleep quality had a significant negative association with sedentary time (weekdays: r=0.68, p<0.01; weekends: r=0.09, p<0.01). Hierarchical regression analysis showed that the parents` educational level and physical condition had a positive predictive effect on sleep quality (F=29.42, Δr2=0.07, p<0.001); after controlling the factors of parents` educational level and physical condition, the intake frequency of food (F=14.75, Δr²=0.1, p<0.001), the weekly walking time and physical activity intensity (F=31.37, Δr²=0.32, p<0.001) had a positive predictive effect on sleep quality. The duration of mobile phone use was negatively predictive of sleep quality (F=35.77, Δr²=0.31, p<0.001).

CONCLUSION: This study provides evidence on the health status and behaviors of high school students after reopening in the context of COVID-19, which can help schools and policy makers to promote physical activity and healthy diet to reduce the risk of various diseases due to public health events.