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Background  The purpose of this study is to determine whether the lifestyle and body stature are significantly associated with the axial length (AL) of the eyes of Japanese third grade students.    Methods  A prospective, cross sectional, observational study was performed on 122 third grade students consisting of 61 boys and 61 girls ages 8 to 9 years. The AL, body height, body weight, and body mass index (BMI) were measured. The lifestyle was determined by activities such as the daily duration of indoor studying, television viewing, use of computers and smart phones, outdoor activity time, bed time, Japanese or Western dietary habits, and parental myopia were investigated by a questionnaire with three or five grade levels. The relationship between AL and the questionnaire variables were analyzed by Spearman’s correlation analyses.    Results  Westernized dietary habits ( r  = −0.24,  P  = 0.01), duration of computer and smart phone use ( r  = 0.24,  P  = 0.008), parental myopia ( r  = 0.39,  P  < 0.001), body weight ( r  = 0.26,  P  = 0.005), and BMI ( r  = 0.23,  P  = 0.011) were significantly correlated with the AL. Multiple logistic regression analyses showed that the sex [ r  = −0.48; 95% confidence interval (CI) -0.80 to −0.17,  P  = 0.003], body weight ( r  = 0.04; 95% CI 0.02 to 0.07,  P  = 0.038), westernized dietary habits ( r  = −0.30; 95% CI -0.55 to −0.05,  P  = 0.021), and parental myopia ( r  = 0.40; 95% CI 0.20 to 0.61,  P  < 0.001) were significantly and independently correlated with the AL.    Conclusions  The body weight and parental myopia and westernized dietary habits are factors significantly associated with myopia. Changing from Japanese food style to westernized food style might increase the risk of progression of school myopia.

Association of lifestyle and body structure to ocular axial length in Japanese elementary school children