Lifestyle Management Practice of 40 - 59 Years Cohort in Hong Kong

doi:10.4236/ape.2013.32009

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Advances in Physical Education

2013. Vol.3, No.2, 53-61

Published Online May 2013 in SciRes (http://www.scirp.org/journal/ape) http://dx.doi.org/10.4236/ape.2013.32009

Lifestyle Management Practice of 40 - 59 Years Cohort

in Hong Kong

Frank H. Fu1, An Nan2, Sandy C. Li3

1Department of Physical Education, Hong Kong Baptist University, Hong Kong, China

2China Institute of Sports Science, Beijing, China

3Department of Education Studies, Hong Kong Baptist University, Hong Kong, China

Email: [email protected]

Received February 1st, 2013; revised March 5th, 2013; accepted March 17th, 2013

tribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the

original work is properly cited.

The role of the parents in influencing children is very important, in terms of the value system, attitude and

behaviour. The importance and values of health are recognized by Hong Kong people, the development of

an active lifestyle and exercise habit is relatively unsatisfactory. In Hong Kong, the Sport for All move-

ment has been implemented by the SAR Government of Hong Kong for 40 years, but recent researches

showed that more than 60% of the population didn’t exercise adequately. This suggested that alternative

means to promote the sport for all were desirable. The health practices namely, exercise frequency, snack

habit, breakfast habit, regular meals, sleeping hours, drinking habit, smoking habit, medication taking,

exercise and medical expenditures of 919 randomly and systemically selected subjects aged 40 - 59 years

were assessed. For each health practice, gender differences were analyzed using Cramer’s V and Ward

Linkage method (cluster) was used to assess their cluster membership.

Keywords: Lifestyle; Health

Introduction

Lifestyle is one of the major factors associated with health.

According to WHO, life expectancy is determined 40% by

heredity and living condition and 60% by individual lifestyle

(WHO, 1996). Compared with years before, people are more

prone to suffer from diseases related to an unhealthy lifestyle.

In Hong Kong, the prevalence of cardiovascular disease (CHD)

increased from 38.6% in 1972 to 59.4% in 1992, especially

among the middle-aged population who are in their mid-career.

Khaw et al. (2008) examined the prospective relationship

between lifestyle and mortality of 20,244 men and women aged

45 - 79 years with no known cardiovascular disease or cancer in

the UK. They found the mortality risk was linked with four

health behaviors—smoking, physically inactive, moderate al-

cohol intake and diet (plasma vitamin C and vegetable intake).

Those with zero risk behavior were equivalent to be 14 years

younger than those with four risk behaviors. The four health

behaviors combined predicted a 4-fold difference in total mor-

tality in men and women. This was supported by Mitchell et al.

(2010) who conducted a study on the health profile (cardiovas-

cular fitness, self-reported physical activity, smoking status,

alcohol consumption and body mass index) of 38,110 men and

women in the US. They found that acquiring a minimum of two

of five positive health factors would reduce the risk of cardio-

vascular disease mortality significantly. Fu (2001) conducted a

study to investigate the CHD risk factors of 1432 Hong Kong

Chinese aged 18 - 60 years old. It was found that the percentages

of subjects with high risk factors were substantially lower than

those reported in other countries such as Australia. The preva-

lence of CHD risk factors increased with age and it was also

higher in the male subjects. There were more men with three or

more CHD risk factors than women (23.5% vs. 9.9%). Fu and

Fung (2004) conducted a study with 2196 (39.0 ± 10.7 years)

subjects living in three major metropolitan cities in China,

namely Beijing, Shanghai and Hong Kong, in order to better

understand the cardiovascular health and leisure-time physical

activity of residents there. Subjects were recruited during their

annual medical examination exercise at hospitals or research

laboratories. The eight CHD risk factors investigated were hy-

pertension, overweight, high serum cholesterol, and low level

of HDL, smoking, drinking, perceived stress and sedentary

lifestyle. It was found that over 80% of the subjects were sed-

entary and that Hong Kong has the lowest incidence of CHD

risk factors.

The rapidly growing epidemic of non-communicable dis-

eases (NCDs), already responsible for some 60% of world

deaths, is clearly related to changes in global dietary patterns

and increased consumption of industrially processed fatty, salty

and sweet foods (WHO, 2002). Hong Kong is a fast-paced

economical and trade centre in Asia and its workforce has to

remain productive to be competitive. Lifestyle management in

Hong Kong should be regarded as one of the most important

factors in attaining good health and quality of life, especially

for the middle age population.

The aim of this study is to assess the current status of life-

style among 40 - 59 years old people in Hong Kong and try to

find the relationships between lifestyles with a view to propose

suggestions to acquire a more active lifestyle and quality of life.

F. H. FU ET AL.

Methods

A total of 919 subjects aged from 40 to 59 years old (with

approximately equal numbers of male and female and among

the 4 age cohorts of 40 - 44, 45 - 49, 50 - 54 and 55 - 59 years)

were recruited by random sampling in Hong Kong and partici-

pated in this project on lifestyle management. The process of

data collection and analyses observes the laws and regulations

on protection on confidentiality. Data collections were through

telephone interview. Household telephone numbers were ran-

domly selected from the telephone directory published in 2010,

with fixed numbers (0, ±1 and ±2) added to the last digit. The

following variables were included in the questionnaire:

1) Morphological data (Body height, body weight, shoulder

width, waist, calculated BMI (Body Mass Index, weight/

height2) and WI (Waist Index, waist/height));

2) 10 items of lifestyles (Exercise frequency, snacks habit,

breakfast habit, regular meals, sleeping hours, drinking, smok-

ing, usage of medication, exercise expenditure and medical

expenditure). For each item there were 5 selections (see Ap-

pendix).

Statistical analyses were conducted with SPSS 16.0. The

numeric data were presented as Means ± SDs and categorical

data as Crosstab frequencies. T-Test (for morphological data)

and Chi-square tests associated with Phi and Cramer’ V coeffi-

cient (for lifestyle data) were used to compare the differences

among gender and occupation groups. Hierarchical cluster

method (Ward’s method) was used to classify the health related

lifesty les. The general demographic and occupational charac-

teristics of the subjects are presented in Table 1.

Results and Discussion

Profile of Morphological Investigation

Data on the physique are presented in Table 2. The mean

BMI of 40 - 59 years old people in Hong Kong is 24.02 in male

and 22.29 in female and is significantly different between gen-

ders (p < .01). The mean WI of both genders is normal but

near .50, especially in male. The percentage distributions are

presented in Table 3 and Table 4. The percentage of over-

weight (BMI > 24) is 32.4% in male, which is much higher

than that of female subjects (17.2%). Moreover, the percentage

of obesity (BMI > 30) is 5.2% in male, also higher than that of

female subjects (2.0% only). Similar findings with WI are ob-

tained. The ratio of WI > .5 is more than 25% in male subjects,

only around 16% in female. These results suggested that over-

weight and obesity as well as abdominal obesity were more

popular in middle-aged male than female in Hong Kong. Ko et

al. (2010) found similar results—the age-standardized rate of

obesity was stable in men (31.6% in 1996 vs 31.0% in 2005)

but declined in women (22.4% in 1996 vs 18.8% in 2005). Pos-

sible reasons for this difference might be female would attach

more importance to keep fit and drinking and smoking were

more popular in male than female. The latter was reported to

have relationship with obesity (Yeomans, 2010).

Ko et al. (2010) found that despite stable or declining BMI,

age-standardized abdominal obesity failed to decline in Hong

Kong women and continued to increase in men over a 10-year

period. As for the effects of obesity and abdominal obesity on

health, Thomas et al. (2006) conducted a study on cardiovascu-

lar risk factors in Hong Kong and found that the waist and ab-

dominal obesity were associated with increased risk in female

Table 1.

Demographic characteristics of 40 - 59 years old cohort from Hong

Kong (n = 919, Hong Kong, 2010).

Male Female Total

Sedentary 172 161 333

Labor 194 107 301

Housewife 0 170 170

Students 1 3 4

Unemployed 14 42 56

Retired 24 31 55

Total 405 514 919

Table 2.

Physique of 40 - 59 years old cohort from Hong Kong (male: n = 405,

female: n = 514, Hong Kong, 2010).

Male Female

Height (cm) 168.96 ± 6.55 158.17 ± 5.40**

Weight (kg) 68.53 ± 11.30 55.73 ± 9.00**

BMI (weight/height2) 24.02 ± 4.00 22.29 ± 3.50**

Shoulder width (cm) 42.16 ± 1.50 33.56 ± 1.21**

Waist (cm) 81.83 ± 7.25 72.62 ± 6.66**

WI (waist/height) .48 ± .04 .46 ± .04**

Note: Between gender: *p < .05, **p < .01.

Table 3.

Percentage on BMI of 40 - 59 age cohort from Hong Kong (n = 919).

<18.518.5 - 2424 - 30 30 - 35 >35 Total

Male 16 258 110 15 6 405

4.0%63.7% 27.2% 3.7% 1.5%100.0%

Female46 380 78 7 3 514

8.9%73.9% 15.2% 1.4% .6% 100.0%

Total 62 638 188 22 9 919

6.7%69.4% 20.5% 2.4% 1.0%100.0%

Note: Between gender: Cramer’s V = .194, p < .01.

Table 4.

Percentage of WI of 40 - 59 age cohort from Hong Kong (n = 919,

Hong Kong, 2010).

≤.5 >.5 Total

Male 288 117 405

71.1% 28.9% 100.0%

Female 436 78 514

84.8% 15.2% 100.0%

Total 724 195 919

78.8% 21.2% 100.0%

Note: Between gender: Cramer’s V = .167, p < .01.

F. H. FU ET AL.

only, but not in male. Auyeung et al. (2010) monitored BMI

and waist-hip ratio (WHR) as well as the mortality after 5 years

and found that older men were resistant to hazards of over-

weight and adiposity, while mild overweight, obesity, and even

abdominal obesity might be protective. The long-term effects of

overweight and abdominal obesity as well as the differences

between male and female need further study.

Profile of Li f estyle Inve stigation

The status of lifestyle among 40 - 59 age people in Hong

Kong is presented in Tables 5-14. Results showed that male

exercised more than female (p < .01). The percentage of sub-

jects who exercise everyday is 9.4% in male compared with

8.8% in female, while the percentage of those who do not exer-

cise is 41.5% in male, and 52.5% in female. It is rather dis-

couraging to note that nearly half of the middle-aged subjects

never exercise at all. Exercise can affect health directly and

exert a long-term effect on it. According to the suggestion of

ACSM and previous researches, the recommended exercise

frequency should be at least 2 - 3 times per week (American

College of Sports Medicine Guidelines, 2009). It is accepted

that aerobic exercise can help develop and maintain the func-

tions of respiratory and cardiovascular system, while the proper

dose of strength exercise can be a good measure to prevent cal-

cium loss and related fracture in middle life (Lau et al., 1988).

Dietary habit is another major factor which can affect health.

In our study, we focused on snack taking, breakfast skipping

and irregular meals. Results showed that female take more

snacks than male. The percentage of taking snacks of more than

2 times per week is 43.4% in female and 36.3% in male, while

38.3% of male and 28.2% of female do not eat snacks (p < .01)

Table 5.

Percentage on exercise frequency of 40 - 59 age cohort from Hong

Kong (n = 919, Hong Kong, 2010).

Never ≤1/week 2 - 3/week4 - 6/week EverydayTotal

Male 168 93 81 25 38 405

41.5% 23.0% 20.0% 6.2% 9.4% 100.0%

Female 270 80 81 38 45 514

52.5% 15.6% 15.8% 7.4% 8.8% 100.0%

Total 438 173 162 63 83 919

47.7% 18.8% 17.6% 6.9% 9.0% 100.0%

Note: Between gender: Cramer’s V = .129, p < .01.

Table 6.

Percentage on snack taking of 40 - 59 age cohort from Hong Kong (n =

919, Hong Kong, 2010).

Never ≤1/week 2 - 3/week4 - 6/week ≥7/week

(everyday) Total

Male 155 103 73 28 46 405

38.3% 25.4% 18.0% 6.9% 11.4% 100.0%

Female 145 146 110 24 89 514

28.2% 28.4% 21.4% 4.7% 17.3% 100.0%

Total 300 249 183 52 135 919

32.6% 27.1% 19.9% 5.7% 14.7% 100.0%

Note: Between gender: Cramer’s V = .134, p < .01.

Table 7.

Percentage on breakfast taking of 40 - 59 age cohort from Hong Kong

(n = 919, Hong Kong, 2010).

Never≤1/week2 - 3/week 4 - 6/week ≥7/week

(everyday)

Male30 6 12 17 340 405

7.4%1.5% 3.0% 4.2% 84.0% 100.0%

Female33 5 23 15 438 514

6.4%1.0% 4.5% 2.9% 85.2% 100.0%

Total63 11 35 32 778 919

6.9%1.2% 3.8% 3.5% 84.7% 100.0%

Note: Between gender: Cramer’s V = .060, p > .05.

Table 8.

Percentage on regular meals of 40 - 59 age cohort from Hong Kong (n

= 919, Hong Kong, 2010).

Never≤1/week2 - 3/week 4 - 6/week ≥7/week

(everyday)

Male36 11 20 35 303 405

8.9%2.7% 4.9% 8.6% 74.8% 100.0%

Female52 16 37 44 365 514

10.1%3.1% 7.2% 8.6% 71.0% 100.0%

Total88 27 57 79 668 919

9.6%2.9% 6.2% 8.6% 72.7% 100.0%

Note: Between gender: Cramer’s V = .055, p > .05.

Table 9.

Percentage on sleeping hours of 40 - 59 age cohort from Hong Kong (n

= 919, Hong Kong, 2010).

≤4

hours

4 to 5

hours

6 to 7

hours

8 to 9

hours

≥10

hours Total

Male 2 29 241 127 6 405

.5% 7.2%59.5% 31.4% 1.5% 100.0%

Female 10 41 290 161 12 514

1.9%8.0%56.4% 31.3% 2.3% 100.0%

Total 12 70 531 288 18 919

1.3%7.6%57.8% 31.3% 2.0% 100.0%

Note: Between gender: Cramer’s V = .074, p > .05.

Table 10.

Percentage on drinking of 40 - 59 age cohort from Hong Kong (n = 919,

Hong Kong, 2010).

Never≤1/week2 - 3/week 4 - 6/week EverydayTotal

Male30544 19 12 25 405

75.3%10.9%4.7% 3.0% 6.2% 100.0%

Female46531 11 2 5 514

90.5%6.0% 2.1% .4% 1.0% 100.0%

Total77075 30 14 30 919

83.8%8.2% 3.3% 1.5% 3.3% 100.0%

Note: Between gender: Cramer’s V = .223, p < .01.

F. H. FU ET AL.

Table 11.

Percentage on smoking of 40 - 59 age cohort from Hong Kong (n = 919,

Hong Kong, 2010).

Never ≤1/week 2 - 3/week4 - 6/week EverydayTotal

Male 323 3 2 2 75 405

79.8% .7% .5% .5% 18.5% 100.0%

Female 504 2 0 0 8 514

98.1% .4% .0% .0% 1.6% 100.0%

Total 827 5 2 2 83 919

90.0% .5% .2% .2% 9.0% 100.0%

Note: Between gender: Cramer’s V = .306, p < .01.

Table 12.

Percentage on medication usage of 40 - 59 age cohort from Hong Kong

(n = 919, Hong Kong, 2010).

Never ≤1/week 2 - 3/week4 - 6/week EverydayTotal

Male 321 7 3 0 74 405

79.3% 1.7% .7% .0% 18.3% 100.0%

Female 393 14 4 1 102 514

76.5% 2.7% .8% .2% 19.8% 100.0%

Total 714 21 7 1 176 919

77.7% 2.3% .8% .1% 19.2% 100.0%

Note: Between gender: Cramer’s V = .050, p > .05.

Table 13.

Percentage on exercise expense of 40 - 59 age cohort from Hong Kong

(n = 919, Hong Kong, 2010).

≤1000 1001 to

4999

5000 to

9999

10,000 to

19,999 ≤20,000Total

Male 320 61 16 5 3 405

79.0% 15.1% 4.0% 1.2% .7% 100.0%

Female 442 50 13 7 2 514

86.0% 9.7% 2.5% 1.4% .4% 100.0%

Total 762 111 29 12 5 919

82.9% 12.1% 3.2% 1.3% .5% 100.0%

Note: Between gender: Cramer’s V = .097, p > .05.

Table 14.

Percentage on medical expense of 40 - 59 age cohort from Hong Kong

(n = 919, Hong Kong, 2010).

≤1000 1001 to

4999

5000 to

9999

10,000 to

19,999 ≤20,000Total

Male 269 102 18 11 5 405

66.4% 25.2% 4.4% 2.7% 1.2% 100.0%

Female 293 168 30 19 4 514

57.0% 32.7% 5.8% 3.7% .8% 100.0%

Total 562 270 48 30 9 919

61.2% 29.4% 5.2% 3.3% 1.0% 100.0%

Note: Between gender: Cramer’s V = .102, p < .05.

(See Table 6). At the same time, the average percentage of

subjects who eat breakfast and take regular meals everyday are

84.7% and 72.7% respectively with no difference between male

and female (p > .05) (See Tables 7 and 8). These figures sug-

gest that most 40 - 59 years old subjects acquired a relative

healthy dietary habit except too much of snacks taking. Dietary

habit is affected mainly by the individual awareness of health.

During the past 30 years, Hong Kong people were better edu-

cated and more affluent, which might be initially associated

with a less healthy diet in relation to cardiovascular health,

obesity, and other risk factors (Woo et al., 1999). The habit of

taking snacks seems to be related to the dietary culture and

tradition in Hong Kong. Fu and Hao (2002) conducted a similar

survey among 404 Hong Kong students and found that 68.08%

of them ate snacks and the majority of them preferred the

snacks high in cholesterol. Middle-aged people should reduce if

not cut out eating snacks which might make them prone to get

NCDs.

Previous studies suggested that sleeping less than 6 hours/

day might speed up the process of decrepitude (Knutson, 2010).

According to our investigation, the percentage of 40 - 59 years

subjects who sleep less than 6 hours/day is only 8.9%, while the

percentage of subjects sleeping more than 8 hours/day is 33.3%,

with no significant differences between male and female (p

> .05) (See Table 9). It was indicated that there was a cross-

sectional association between short sleep duration (generally <7

hour/day) and increased BMI or obesity (Patel et al., 2006),

prevalent diabetes (Meisinger et al., 2005) and hypertension

(Nagai et al., 2010). James et al. (2008) suggested that inade-

quate sleep (less than 7 hours/day) reduced life expectancy.

However, Knutson (2010) suggested that too much sleeping

(more than 8 hours/day) could also do harm to health—there

might be a link between sleeping long hours and increase of

cardio-metabolic risk. Ko et al. (2007) reported that the mean

daily sleeping time was 7.06 ± 1.03 h (women/men: 7.14 ± 1.08

h/6.98 ± .96 h, p < .001), and obesity was associated with re-

duced sleeping hours only in men. Our results showed that

around 60% of middle-aged people in Hong Kong sleep 6 to 8

hours/day which seems to be satisfactory. The effects as well as

the optimal duration of sleeping for this age need further study.

Our results showed that 40 - 59 years subjects seldom

smoked or drank. The percentages of never drinking and smok-

ing are 83.8% and 90.0% in male and higher in female (90.5%

and 98.1%) (p < .01) (See Tables 10 and 11). Fu & Fung (2004)

found that Hong Kong people have better cardiovascular health

compared with the residents of Beijing and Shanghai. Other

studies reported the adverse effects of drinking and cigarette

smoking, with emphases on the correlations with coronary heart

disease (CHD) (Fu & Fung, 2004), hypertension (Xue et al.,

1994) and blood cholesterol (Wang et al., 1996). Drinking 50 g

or more ethanol/day or smoking 40 cigarettes or more per day

are confirmed CHD risk factors (Fu & Fung, 2004). Drinking is

also suggested as a factor in obesity. In both genders, smoking

was significantly associated with the likelihood of drinking

(Kim et al., 2008). Higher intake of alcohol in the absence of

alcohol dependence may increase the risk of obesity (Yeomans,

2010). Non-smoking and non-drinking habit may have contrib-

uted to the longevity of Hong Kong people—achieving the 2nd

place in the world with an average life expectancy of 79.4 yeas

in male and 85.1 years in female during (United Nations, 2006).

The prevalence of using medication everyday among mid-

dle-aged people in Hong Kong is 19.2% with no differences

F. H. FU ET AL.

between male and female (p > .05) (See Table 12). The per-

centages of medical expense more than HK$1000/month are

33.6% in male and 43% in female (p < .05) (See Table 14).

Comparing to the expense on exercise, the percentages of ≥ HK

$1000 decreased to 21% in male and 14% in female (p > .05)

(See Table 13). These results suggested that middle-aged peo-

ple in Hong Kong are prone to rely on medicine than exercise

to maintain their health.

Lifestyles Comparison between Sedentary

and Labor Groups

The nature of occupation can affect health. The comparisons

on prevalence of lifestyles between sedentary (white collar) and

labor (blue collar) groups in the 40 - 59 years old cohort are

presented in Figure 1. Results show that there are significant

differences between the sedentary and labor groups in WI > .5

(16.8% vs. 27.9%), exercise frequency ≤1/week (66.6% vs.

70.1%), drinking ≥3/week (3/6% vs. 7.7%), smoking (7.2% vs.

15.9) and exercise expense ≤HK$1000 (77.5% vs. 86.4%).

Sedentary lifestyle is a known risk factor in CHD, hypertension

and diabetes etc. (Tremblay et al., 2010). Our investigation

suggested that among 40 - 59 years old cohort, sedentary work-

ers led a healthier lifestyle than labor workers (they have less

WI, less drinking and smoking, and more exercise). It also

suggested that excessive drinking and smoking may have posi-

tive relationship with abdominal obesity in this age cohort.

Cluster of Lifestyles of 40 - 59 Age Cohort in

Hong Kong

Recent findings suggested that the lifestyle risk factors were

not randomly distributed but were clustering within individuals

in the general population (Ma et al., 2000). For better under-

standing of the relationships among health related lifestyles in

the 40 - 59 years cohort, the 10 items as well as BMI and WI

were classified by hierarchical cluster analysis (Ward’s me-

thod). The results and dendrogram of cluster analysis are pre-

sented in Table 15 and Figure 2. Four clusters of lifestyles are

identified as follows:

Figure 1.

Profile of prevalence of lifestyles between Sedentary and Labor groups

in Hong Kong (n = 919, Hong Kong, 2010). (Between groups: BMI >

25, WI > .5 (p < .01), Q1-exercise frequency ≤1/week (p < .01), Q2—

snacks taking ≥ 4 - 6/week, Q3—breakfast taking ≤ 3/week, Q4—

regular meals ≤ 3/week, Q5—sleeping hours ≤ 6h/day, Q6—drinking ≥

3/week (p < .05), Q7—smoking ≥ 3/week (p < .01), Q8—medication

taking ≥ 3/week, Q9—exercise expenditure ≤ 1000 HKD (p < .05),

Q10—medical expenditure ≥ 1000 HK$).

Table 15.

Cluster membership of lifestyle of 40 - 59 age cohorts in Hong Kong

(Ward’s method, Hong Kong, 2010).

Case 4 Clusters 3 Clusters

BMI 1 1

WI 2 2

Q1—exercise 1 1

Q2—snacks 1 1

Q3—breakfast 3 3

Q4—meals 3 3

Q5—sleeping 1 1

Q6—drinking 2 2

Q7—smoking 2 2

Q8—medication 4 2

Q9—exercise expense 2 2

Q10—medication expense 2 2

Dendrogram using Ward Method

C A S E

0 5 10 15 20 25

Rescaled Distance Cluster Combine

Labe 1

BMI

Figure 2.

Cluster Membership of lifestyle of 40 - 59 age cohorts in HK (Ward’s

method, Hong Kong, 2010).

1) BMI, exercise, snacks, sleeping;

2) WI, drinking, smoking, exercise and medical expense;

3) Regular meals; and

4) Usage of medication.

The results suggest that proper exercise, adequate sleeping

duration and reducing additional energy intake can help to con-

trol the body-weight, while drinking and smoking seem to have

more close relationship with abdominal obesity. Regular meal

and reduction in usage of medication may have special implica-

tions for maintaining health at middle-age. Similar to our find-

ings, a previous study also identified drinking and smoking as

one cluster which was related to CHD (Fu & Fung, 2004).

Smoking and lack of physical activities will increase the preva-

lence of obesity (Yeomans, 2010). Some studies have focused

on the different cluster of lifestyles regarding genders. A study

on elderly people analyzed the four lifestyle risk factors in-

volving smoking, drinking, lack of exercise and low intake of

vegetables and fruits. It found that the prevalence of multiple

risk factors was much greater among older male than older

female (Chou, 2008). Another study found that BMI was inde-

F. H. FU ET AL.

pendently associated with age in female, whereas waist was

associated with age and smoking. In male, sleeping hours and

working hours were independently associated with BMI,

whereas waist was independently associated with age, smoking,

sleeping hours and working hours (Ko et al., 2007). The effects

and implications of different lifestyle on the health of mid-

dle-aged people still need more investigations.

Summary

While Hong Kong has made tremendous stride in economical

development, its workforce is also becoming old. Middle-aged

people are experiencing health crisis after years of hard work

and competitions in life. The rapid growth and epidemic of

non-communicable diseases, which is already responsible for

some 60% of world deaths, is clearly related to changes in

global dietary patterns and increased consumption of industri-

ally processed fatty, salty and sweet foods (WHO, 2002). It is

commonly accepted that lifestyle is one of the most important

factors associated with health. Although heredity might play an

important role in determining life expectancy and health, the

individual’s lifestyle is, along with the environment, one of the

most modifiable factors. Health promotion aims to encourage

habits and lifestyles conducive to attaining old age and quality

of life should be organized. This notion has been encapsulated

by the term “healthy ageing”, and is a concept actively pro-

moted by WHO and other agencies (WHO, 1998). Lifestyle

management thus plays an important role in the daily life of

middle-aged people.

Our study on lifestyle management of 40 - 59 years cohort in

Hong Kong found that: 1) Male are more prone to become

over-weight and obese (abdominal) than female (32.4% vs.

17.2%, 5.2% vs. 2.0%). 2) 41.5% of male and 52.5% of female

at this age never exercise at all. 3) Most of the people (72.7%,

84.7%) have regular meals and breakfast. Female eats more

snacks than male. 4) 57.8% of the people at this age have 6 to 8

hours of sleeping per day. 5) Drinking and smoking are not

popular (16.2%, 10.0%). 6) 22.3% of the people seeks the help

of medication to stay healthy. The annual expense of medicine

is higher than physical exercise. 7) Sedentary workers have

more healthy lifestyles and less abdominal obesity than labor

worker for they exercise more and drink and smoke less. 8)

Cluster analysis showed that proper exercise, adequate sleeping

and eating less snacks can help to control body-weight, drink-

ing and smoking, the latter may have close relationship with

abdominal obesity. Regular meals and usage of medication may

have special implications on health.

We strongly suggest that middle-aged people in Hong Kong

should exercise more, reduce their medication usage, maintain

proper dietary pattern and sleep adequately. Furthermore, fe-

male should cut down on their snacks taking and blue collar

workers should change their drinking and smoking habit.

Acknowledgements

The authors wish to acknowledge the contribution of Prof.

Chung PK, Prof. Lena Fung, Prof. Leung Meelee, and Ms.

Mavis Pang in the design of the research project. Also to the

Centre for the Advancement of Social Sciences , HKBU for her

support in conducting the survey and data analyses and the Dr.

Stephen Research Centre of Physical Recreation and Wellness,

HKBU for funding.

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Appendix

Questionnaire

Name: _________________________ Age: ______________ Gender: ______________

Height: ________________ (in cm) Weight: _________________ (in kg)

Body Type: Upper body frame/size (Large, Medium and Small)

Waist: ________________ (in cm)

Please tick (√ ) the most appropriate answer.

1. How often do you participate in physical activity weekly?

A. Never

B. 1 - 2 times

C. 3 - 4 times

D. 5 - 6 times

E. Every day

2. How about do you eat snack?

A. Never

B. Less than once/week

C. 2 - 3 times/week

D. Regularly—More than 3 times per week

E. Every Day

3. Do you eat breakfast?

A. Never

B. Less than once/week

C. 2 - 3 times/week

D. Regularly—More than 3 times per week

E. Every Day

4. Do you eat 3 meals at regular times each day?

A. Never

B. Less than once/week

C. 2 - 3 times/week

D. Regularly—More than 3 times per week

E. Every Day

5. How many hours do you normally sleep a day?

A. 4 hours or less per day

B. 4 - 5 hours per day

C. 6 - 7 hours per day

D. 8 - 9 hours per day

E. 10 hours or more per day

6. Do you drink (alcohol)?

A. Never

B. Less than once/week

C. 2 - 3 times/week

D. Regularly—More than 3 times per week

E. Every Day

7. Do you smoke (cigarette)?

A. Never

B. Less than once/week

F. H. FU ET AL.

C. 2 - 3 times/week

D. Regularly—More than 3 times per week

E. Every Day

8. Do you take prescribed medication (not including vitamins and health drinks) ?

A. Never

B. Less than once/week

C. 2 - 3 times/week

D. Regularly—More than 3 times per week

E. Every Day

9. What is your annual expenditure on participating in sports activities (in Hong Kong) ?

A. Below HK$1000 per year

B. Between HK$1000 - 4999 per year

C. Between HK$5000 - 9900 per year

D. Between HK$10,000 - 19,990 per year

E. More than HK$20,000 per year

10. What is your annual expenditure on medical bills (in Hong Kong)?

A. Below HK$1000 per year

B. Between HK$1000 - 4999 per year

C. Between HK$5000 - 9900 per year

D. Between HK$10,000 - 19,990 per year

E. More than HK$20,000 per year

11. What kind of you job do you have?

A. Office work

B. Labour work

C. Household work

D. In School

E. Others

Note: For school children/students, information will be provided by their parents on Questions 9 and 10