Attitudes toward Nutrition and Dietary Habits and Effectiveness of Nutrition Education in Active Adolescents in a Private School Setting: A Pilot Study

General and sport-specific nutrition knowledge and behaviors of adolescent athletes

INTRODUCTION

Most youth do not meet national nutrition recommendations and overconsume high-calorie, low nutrient-dense foods. Adequate nutritional intake is crucial for growth and development. Nutrition practices play a key role in sports performance and recovery. Nutritional knowledge can affect eating patterns. However, there is limited research on general and sport-specific nutrition knowledge and behaviors of adolescent athletes.

PURPOSE

To examine general and sport-specific nutrition knowledge and behaviors of adolescent athletes.

METHODS

Adolescent athletes were assessed on nutrition knowledge and general and sport-specific nutrition behaviors, including food group consumption, hydration practices, and sport supplement use. Gender differences in general and sport-specific nutrition behaviors were compared using a Mann-Whitney U test. Odds ratios and logistic regression, controlling for age, ethnicity, and years in sport participation were used to determine differences in correct responses between genders. Significance was set at the p < 0.05 level.

RESULTS

One hundred and ninety-four athletes (n = 63 male, n = 132 female, mean age = 14.9 ± 1.63 years) were assessed. Differences in nutrition behaviors were found in fruit, dairy, and sugary beverage consumption between genders. Male athletes were more likely to monitor hydration and use sports supplements. Both males and females scored less than 50% on both general and sport-specific knowledge questions.

CONCLUSION

Adolescent athletes report lower than recommended food group consumption and lack knowledge of general and sport-specific nutrition information. Improvements in these areas can play a significant role in the health and performance of adolescent athletes.

Risky Behaviors for Non-Communicable Diseases: Italian Adolescents' Food Habits and Physical Activity

BACKGROUND

Driving adolescents to more correct food habits and physical activity is crucial to promoting health and avoiding the increase in morbidity and mortality in adulthood. Literature has focused on these behaviors in the adult population, while studies on adolescents are more limited. This study aims to explore the level of knowledge, attitudes, and behaviors regarding nutrition and physical activity to acquire insight into adolescents and identify the associated predictors.

METHODS

A cross-sectional study was conducted among adolescents aged 10 to 19 years from public middle and high schools randomly selected in the Campania Region, Southern Italy. A self-administered questionnaire, including closed and open-ended questions, assessed socio-demographic and health-related characteristics, dietary habits, physical activity, and sources of health information.

RESULTS

Regarding socio-demographic and health-related characteristics, among 1433 adolescents who completed the survey, the mean age was 15.2 years, 50.5% were boys, 16.8% reported having a non-communicable disease, and 18% were overweight or obese. Multivariate analysis showed that older age, male gender, daily breakfast with at least one parent, higher self-rated knowledge on nutrition, awareness of fruit and vegetables consumption recommendations, correct dietary attitudes (daily breakfast, consumption of fruit and vegetables at least once a day, of legumes at least twice a week, and of carbonated sugary drinks less than once a day), the need for additional dietary information, meeting WHO physical activity recommendations, and less than two hours of daily screen time are determinants of a high quality diet score. Conversely, living with a single family member and current smoking were negatively associated with high quality diet. Older age, male gender, risk of alcohol abuse, higher quality diet, and lower mobile phone use are associated with meeting WHO physical activity recommendations. Since we investigated risky behaviors, potential limitations of this study could include social desirability and recall bias.

CONCLUSIONS

Many adolescents lead unhealthy lifestyles, but younger adolescents and girls appear to be at higher risk of unhealthy behaviors. Targeted initiatives promoting regular physical activity and balanced diets in schools, involving parents and teachers in a collaborative plan, are essential to improving adolescents' health and well-being.

5A's Behavior Change Model Improves Nutrition Knowledge and Intake Among Adolescent Athletes

This study compared the effects of 12 weeks of intensive nutrition education (IE) using the 5A's behavioral change model and basic nutrition education (BE) on nutritional knowledge and nutrient intake among Korean adolescent athletes. This study included elite adolescent athletes (IE group: n = 65, BE group: n = 65) at a physical education high school in Seoul. In this prospective, randomized, controlled trial, the athletes' body composition, nutritional knowledge, nutrient intake, and self-management practices were evaluated at the beginning and end of the intervention. Both groups had increased levels of nutrition knowledge between pre- and post-test, but the change in total score for nutrition knowledge was significantly higher in the IE group than in the BE group (p < 0.001). Energy intake post-test increased significantly in the IE group (from 2,185 to 2,651 kcal/day, p < 0.001) but not in the BE group. The intake of carbohydrates, protein, and fat also increased significantly in the IE group (carbohydrates: from 298 to 352 g/day, protein: from 86 to 106 g/day, fat: from 71 to 88 g/day, all p < 0.001), but the change in the BE group was not significant. Additionally, the IE group showed a significant overall increase in vitamins and minerals compared to the BE group at post-test. Adolescent athletes in the IE group showed improved nutritional knowledge and intake compared to those in the BE group 12 weeks after the intervention.

Effect of nutrition education on dietary diversity and academic achievement among adolescent school girls in North Shoa Zone, Oromia, Ethiopia

OBJECTIVES

Globally, adolescent students, particularly girls, are severely affected by malnutrition, in part because of their specific biological needs, and that they have not been considered a health and nutrition priority. Hence, this study was designed to evaluate the effect of a health belief model-based nutrition education on the dietary diversity and grades of adolescent school girls in the north Shewa zone, Oromia, Ethiopia.

METHODS

A quasi-experimental study was done in the north Shewa zone, Oromia, Ethiopia. Adolescent school girls ages 10 to 19 y old were selected from the zone districts from February 1 to May 30, 2023. The main outcome variables included grades and dietary diversity, which were collected on the baseline and end line from the intervention and control groups.

RESULTS

This study revealed that there were statistically significant differences in good nutritional knowledge, 88.1% versus 69.2% (χ2 = 16.835, P < 0.001), good dietary diversity; 77.4% versus 45.9% (χ2 = 33.247, P < 0.001) and grades above average, 90.6% versus 65.4% (χ2 = 29, P < 0.001) among school adolescent girls between the intervention and control groups, respectively. Regarding positive attitude, 84.3% versus 85.5% (χ2 = 0.098, P = 0.876), there was no statistically significant difference between the intervention and control groups.

CONCLUSIONS

In this study, the dietary diversity scores and grades of adolescent school girls in the intervention group were higher than those in the control group. Therefore, health belief model-based strategies should be recommended as effective communication channels to improve adolescent school girls' dietary diversity and academic performance.

Understanding the Knowledge, Attitudes, and Practices of Healthy Eating among Adolescents in Chongqing, China: An Empirical Study Utilizing Structural Equation Modeling

Healthy eating is crucial for optimal growth, development, and the prevention of chronic diseases in adolescents. Our study aimed to develop a comprehensive structural equation model (SEM) to analyze the relationships between knowledge, attitudes, practices (KAP), and healthy eating among adolescents in Chongqing. An online questionnaire was administered to middle school students in 39 districts and counties of Chongqing, China from 2 December to 15 December 2021 to collect sociodemographic and KAP information. SEM models were constructed to examine the relationships between educational environment and healthy eating knowledge, attitudes, and practices. The Monte Carlo test was employed to assess the significance of the mediating effect of relevant variables. The study included 139,832 adolescents aged 14.8 ± 0.7 years, with a 14% rate of overweight and obesity. Health and nutrition knowledge averaged a score of 3.60 ± 1.50 (correct rate: 60%). Participants had positive attitudes (average score: 13.61 ± 2.29) and engaged in healthy eating practices (average score: 12.06 ± 3.08). The results of the SEM revealed a significant influence of the educational environment on adolescents' knowledge (β = 0.235, p < 0.001) and attitude towards healthy eating (β = 0.143, p < 0.001). Knowledge exhibited positive effects on both attitude (β = 0.225, p < 0.001) and practice (β = 0.054, p < 0.001), while attitude exhibited positive effects on practice behavior (β = 0.565, p < 0.001). The indirect effect of knowledge on practices through attitude was more substantial than the direct effect (ratio 2.361). Our study highlights the mediating role of attitude between healthy eating knowledge and practices. A significant association exists between a favorable educational environment and improved knowledge and positive attitudes toward healthy eating among adolescents. In the future, nutrition and health education should prioritize exploring effective ways to translate knowledge into practices.

Effect of an action-research nutrition intervention on the Global Diet Quality Score of Colombian adolescents

Strategies to address the nutritional needs of adolescent girls and young women often focus on supplementation. In this study, an action-research approach involving a nutrition education and entrepreneurship intervention was carried out among adolescent girls and young women in poor neighborhoods of Medellín, Colombia. The intervention group significantly increased its intake of several nutrients, including energy, protein, total fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, dietary fiber, calcium, zinc, and vitamins A, B2, B3, B9, and C. A significant increase was observed in the intake of the Global Diet Quality Score (GDQS) healthy food groups (other fruits, other vegetables, legumes, high-fat dairy products), accompanied by a decrease in the consumption of some unhealthy food groups (sweets and ice creams). A multivariate regression controlling for age, socioeconomic status, occupation, Household Hunger Scale, mean probability of adequacy, physical activity, and body self-perception showed that the nutrition intervention improved the total GDQS by 33% in the intervention group-a substantial improvement notwithstanding the study group's precarious social and economic conditions. We conclude that nutrition education and entrepreneurship models based on this approach may improve the dietary profile of this population and reduce future pressures from nutrition-related chronic diseases.

Developing a knowledge, attitude, and practice questionnaire on nutrition, physical activity, and body image for 13-14-year-old female adolescents

Objectives

The objective of this study was to develop and validate a Knowledge, Attitude, and Practice Questionnaire (KAPQ) on nutrition, physical activity, and body image for 13-14-year-old female adolescents.

Method

The KAPQ initially consisted of 73 items, covering knowledge (30), attitude (22), and practice (21) related to nutrition, physical activity (PA), and body image (BI). The content and face validity were tested to identify the relevance of the questionnaire items to the content and their relevance to nutrition, PA, and BI. Construct validity was assessed using an exploratory factor analysis (EFA). Internal consistency was determined by Cronbach's α value, and stability was determined based on test-retest reliability.

Results

Based on the EFA, each scale had several dimensions. The Cronbach's α ranged between 0.977 and 0.888 for knowledge, 0.902 and 0.977 for attitude, and 0.949 and 0.950 for practice. The test-retest reliability revealed that the kappa of knowledge was 0.773-1.000, while the intraclass correlation (ICC) values for attitude and practice were 0.682-1.000 and 0.778-1.000, respectively.

Conclusion

The final KAPQ, which included 72 items, was valid and reliable for assessing the KAP levels for nutrition, PA, and BI of 13-14-year-old female students in KSA.

Nutrition knowledge, attitudes, and dietary practices among parents of children and adolescents in Weifang, China: A cross-sectional study

Parent's nutrition knowledge, attitudes, and dietary practices (KAP) play imperative roles in preventing malnutrition for themselves and their children. Our study aimed to determine the status and contributing factors of nutrition KAP among parents of children and adolescents. A total of 1746 parents (mean age 39.67 ± 5.38 years, females accounting for 69.82%) of primary and junior high school students in Weifang, China, completed a self-reported KAP questionnaire in August 2021. An analysis of Pearson product-moment correlation was conducted to determine the relationship between knowledge, attitudes, and practices. Chi-square test, followed by a multivariable robust Poisson regression analysis, was performed to identify the contributing factors to parents' KAP. A 65.94% awareness rate of nutritional knowledge was observed. The correlations between nutrition knowledge and attitudes (r = 0.03, P = 0.23), knowledge and practices (r = 0.02, P = 0.34), and attitudes and practices (r = 0.16, P < 0.01) were relatively weak. After adjusting for other contributing factors, females [prevalence ratio (PR) = 1.28, 95% confidence interval (CI) = 1.13-1.45], participants with secondary education (PR = 4.64, 95% CI = 1.60-13.50), junior college education (PR = 5.87, 95% CI = 2.01-17.13) and college degree or above education (PR = 6.58, 95% CI = 2.25-19.23) acquired higher nutrition knowledge scores. Moreover, healthy diet behaviors were more commonly implemented by females than males (PR = 1.42, 95% CI = 1.14-1.76), and which needed to be improved in those with abnormal body mass indexes (BMIs) [overweight (PR = 0.86, 95% CI = 0.74-0.99) and obese (PR = 0.76, 95% CI = 0.56-0.99)]. It was necessary for nutrition KAP promotion to be emphasized in nutritional knowledge and dietary practices, as well as health behavior guidance, especially for parents with low education and elevated BMIs.

School Feeding and Nutritional Status of Students in Dubti District, Afar, Northeast Ethiopia: Comparative Cross-Sectional Study

Background

Providing food to the school children is an important means of compacting malnutrition especially in high food insecure areas. Our study was conducted to evaluate the association between school feeding and nutritional status among students in primary schools of Dubti district in Afar region.

Methods

A comparative cross-sectional study was employed on 936 primary school students from March 15-31/2021. For data collection, structured questionnaire was administered by the interviewer. Descriptive statistics as well as logistic regression was conducted. WHO Anthro-plus software was used to compute anthropometric data. Adjusted odds ratio with 95% CI was calculated to identify the level of association. Variables with p-value <0.05 were taken as statistical level of significance.

Results

A total of 936 primary school students, with 100% response rate, were included in the current study. The prevalence of stunting in school fed and non-school fed students was 13.7% 95% CI (11, 17) and 21.6% 95% CI (18, 25), respectively. The prevalence of thinness in school fed and non-school fed students was 4.9% 95% CI (3, 7) and 13.9% 95% CI (11, 17), respectively. Even though no record of overweight and obesity were found in non-school fed students, 5.4% 95% CI (3, 7) among school fed students was overweight/obese. Grade level, diet information source, media source availability, maternal age, the critical time for hand washing, and nutrition education were found to be predictors of malnutrition in both groups of students.

Conclusion

The magnitude of stunting and thinness in school fed students is found to be lower, but overnutrition is higher than non-school fed. Grade level of students and diet selection information were determinants that affected the nutritional status of students. Coordinated education regarding good feeding practice, and personal as well as environmental hygiene should be given to the students and their families.

Early adolescents’ physical activity and nutrition beliefs and behaviours

Obesity in early adolescents is a public health concern and presents a risk for poor health outcomes later in life. Early adolescents’ beliefs and behaviours of physical activity and healthy eating are not well understood. The purpose of this ethnographic inquiry was to explore the physical activity and healthy eating beliefs and behaviours of early adolescents (n = 15) who attended a community organization in an urban cluster in the Southeastern USA. Data from semi-structured interviews, participant observations and artefact collection were analysed using constant comparative analysis. We learned that five main influences on the early adolescents’ healthy eating and physical activity included recognizing benefits of physical activity and healthy eating, family influences, connecting with the community, peer influences, and developing a sense of self. Findings highlight community influences on early adolescents’ physical activity and healthy eating beliefs and behaviours that should be taken into account when developing health promotion strategies.

The Impact of Physical Activity at School on Eating Behaviour and Leisure Time of Early Adolescents

(1) Background: Diet and physical activity (PA) significantly impact health. The aim of this study was to evaluate the impact of long-term increase in organized PA level at school on the eating behaviour and leisure time of early adolescences in the period from the age of 10 to 12. (2) Methods: Children born in 2007 (n = 278) in groups with a standard (control group) and increased level of organized PA at school (4 and 10 h a week) were subjected to an anonymous follow-up survey. The questionnaire included 22 questions related to the eating behaviour and ways and frequency of leisure time PA. The study was conducted in the same groups in three assessment sessions in September 2017, 2018 and 2019. (3) Results: During the course of the study, it was shown improvement of eating behaviour in the increased PA group whereas decline in the standard PA one. The share of children with good and very good scores of eating behaviour decreased in the standard PA group from 56.89% to 54.54% and increased in the increased PA from 58.06% to 60.29%. In the increased PA group children more frequently than standard PA ate vegetables, fruits, fish, poultry meat, wholemeal bakery products, milk, dairy products and drinking tea without sugar, as well as ate breakfast. The standard PA children more frequently than increased PA ate high sugar and/or fat content food as sweets, savoury snacks and drank fizzy drinks as well as fast foods. The frequency of often undertaken leisure time PA increased in the increased PA group from 67% to 74%, while decreased in the standard PA from 58% to 52%. (4) Conclusions: Increase in organized PA at school beneficially influenced early adolescents' eating behaviour and frequency of leisure time PA during 2 years observation. It also increased early adolescents' awareness of healthy diet. Increased PA at school helps shaping healthy lifestyle among early adolescents.

Implementation and Evaluation of a School-Based Educational Program Targeting Healthy Diet and Exercise (DIEX) for Greek High School Students

The present study examined the effectiveness of a school-based health education program promoting healthy diet and exercise, named DIEX, implemented on adolescents. The program is based on the Theory of Planned Behavior (TPB) and is supported by life skills training. The recipients of the program were high school students (n = 367; 168 boys and 199 girls) from 14 schools in Greece who attended 10 1 h sessions implemented by their schoolteachers. Data were collected before and after the program implementation through online questionnaires for: a. attitude, intention, subjective norms, and PBC toward healthy eating; b. knowledge about healthy eating; c. exercise behavior and attitude toward the DIEX program; and d. satisfaction with the DIEX program (only post-program). The results showed that there were significant differences among the pre- and post-measures of students' knowledge and behavior about healthy diet, as well as attitudes and satisfaction toward the program's application. The results show that the DIEX program may have improved nutrition behavior variables. Conclusively, a theory-based behavioral intervention with skills training may result in positive behavioral changes for young students during health education in school settings with the assistance of new technologies.

Diet Quality, Dieting, Attitudes and Nutrition Knowledge: Their Relationship in Polish Young Adults-A Cross-Sectional Study

The purpose of this study was to examine the relationships between diet quality, dieting, nutrition knowledge and attitudes in a group of Polish young adults. A cross-sectional survey was conducted in 2018 amongst 638 students of food and nutrition-related majors. Based on the frequency of consumption of 24 food groups, the “Pro-Healthy Diet Index” (pHDI) and “Non-Healthy Diet Index” (nHDI) were calculated. To assess the nutrition knowledge, the “GAROTA” test was used. The k-means clustering method was used to identify clusters-attitudes towards food and nutrition. The relationships between pHDI and nHDI indices, dieting, nutrition knowledge (NK), and attitudes towards food and nutrition were verified, using multiple linear regression analysis. The results confirmed some relationships between the variables. Higher nHDI characterized males (p < 0.0001) and people with more unfavorable attitudes towards food and nutrition (p < 0.0001), and those not using a diet (p < 0.0001). Higher nutrition knowledge (p < 0.0001) and higher BMI (p = 0.0370) were correlated with lower nHDI. Higher pHDI characterized people with more favorable attitudes (p < 0.0001) and those using a diet (p = 0.0002). Nutrition knowledge showed an adverse association with nHDI (r = −0.172, p < 0.05) and no association with pHDI. Thus, declarative nutrition knowledge does not seem to be a good indicator of healthy dietary behavior. Nutrition education programs that concentrate only on knowledge of facts, and neglect the development of favorable attitudes towards food and nutrition, may not be efficient enough to develop adequate dietary behavior of students.

The Effect of Family Approach Model Education and Zinc Supplementation on Pregnant Women with Chronic Energy Lack from Poor Family

BACKGROUND: Pregnant women’s health and nutritional status must be maintained because they are indicators of perinatal growth and neonatal welfare; efforts to prevent fetal growth disorders must begin with pregnant women, one of which is through increased knowledge and nutritional supplementation. AIM: This study aimed to examine the effect of family-based education and zinc supplementation on knowledge, weight, upper arm circumference, nutritional intake, serum zinc levels, insulin-like growth factor-1 (IGF-1), hemoglobin, infant anthropometry, and placenta in stunted pregnant women. MATERIALS AND METHODS: Quasi-experiment with a pre-post-test control design was carried out from September 2020 to June 1, 2021, in four areas of the Mamuju Regency City Health Center. The subject population is pregnant women aged 20–26 weeks gestation, experiencing chronic energy deficiency. RESULTS: The mean knowledge increased in the intervention group with a rate of change of 133.57%, while the control group did not experience a significant increase. Unpaired t-test showed a significant difference in the mean serum zinc, IGF-1, and hemoglobin levels with p < 0.001. CONCLUSION: Zinc supplementation is very beneficial for pregnant women, especially teenage pregnant women who have chronic energy deficiency, but the results of zinc supplementation are better accompanied by providing education based on a family approach, as a form of community support system for mothers, because family diet has a strong impact on pregnant women diet.

Sports nutrition knowledge and perceptions among professional basketball athletes and coaches in Lebanon-a cross-sectional study

BACKGROUND

Basketball is the most popular sport in Lebanon. Adequate nutrition has been established to be a key component of optimal athletic performance, recovery from exercise and exercise-induced injury and documented to be associated with adequate nutrition knowledge (NK). In Lebanon, nutrition education is not incorporated into the basketball player training program and there is no established position for sports nutritionists in basketball clubs. To our knowledge, the present study is the first to evaluate the NK status of Division I Basketball (D1B) players /coaches in Lebanon. The objectives of this study are to assess the prevalence of inadequate NK; identify the gaps in NK, main sources of nutrition information, perceptions on sports nutrition and independent predictors of inadequate NK among D1B players and coaches in Lebanon.

METHODS

All D1B players (n = 184) and coaches (n = 16) in Lebanon were invited to participate in the study. Study participants were asked to complete a questionnaire that included questions on NK, resources and perceptions. A percentage of ≥60% of NK questions answered correctly was used as indicative of having adequate NK. Descriptive statistics were used to summarize the sample characteristics. The T-test and chi square test were used for comparisons of means and proportions, respectively. Logistic regression was used to explore the predictors of inadequate NK in D1B players.

RESULTS

The sample consisted of 178 D1B players (nM = 126; nF = 52) and 11 male coaches, resulting in survey response rates of 97 and 69%, respectively. Inadequate NK was found among about 80 and 54% of D1B players and coaches, respectively. Inadequate NK was found to be independently associated with lack of nutrition education in D1B players.

CONCLUSIONS

Despite widespread lack of adequate NK among D1B players and coaches in Lebanon, our sports clubs do not have dietitians. Basketball sports clubs in Lebanon should start to budget for hiring a dietitian or carrying out nutrition education campaigns that are based on analyses of incorrect responses of our study participants. Findings of this study are of tremendous significance to D1B players in Lebanon in terms of improving the athletes' physical health and performance.

Effectiveness of Diet Habits and Active Life in Vocational Training for Higher Technician in Dietetics: Contrast between the Traditional Method and the Digital Resources

Vocational training of students in diet habits and active lifestyle habits has recently become an important issue, given the health problems caused as a result of a poor diet. The objective of this study is to analyze the effectiveness of different training actions (traditional method and digital resources) carried out in a program of dietary habits and active lifestyle at the vocational training stage. A quasi-experimental design of the pre-post type was developed. A sample of 177 participants was chosen. The instrument to collect the data was the validated ECHAES questionnaire. The results show that all study groups demonstrated similar averages across all dimensions, except in the digital resource post-test design, where the averages were higher than the rest. There was a significant relationship between the traditional teaching method and the post-test digital resources design in all dimensions. There was also a significant relationship between the pre-test and post-test of the traditional teaching method and the digital resource group in the dimensions. It can be concluded that both the traditional and the innovative method lead to learning in the vocational training student, although the values achieved by the group where the innovative method was adopted were much higher than in the traditional group.

Education and Diet in the Scientific Literature: A Study of the Productive, Structural, and Dynamic Development in Web of Science

Nutrition-related education is necessary to protect and improve the health status of schoolchildren and to minimize the risk of future diseases. The objective of this research was to analyze the trajectory and transcendence of the concepts “education” and “diet” in the Web of Science literature. The methodology focused on bibliometry, analyzing both the performance and the structural and dynamic development of the concepts through a co-word analysis. A total of 1247 documents were analyzed, and the results show that scientific production experienced a turning point in 2009, in comparison to the level of production reported in previous years. The medium of papers and the language of English were the most common. In relation to the research topic, before 2014, scientific production focused on medical and disease-related aspects; however, since 2014, it has focused on disease prevention and feeding. It was therefore concluded that the theme “diet and education” has been researched for more than 20 years, although it is only in the last decade that it has become more relevant—particularly studies focusing on disease prevention and the type of food, specifically fruit, which is presented as the most outstanding issue for researchers in this field of knowledge.