Nutrition knowledge and other determinants of food intake and lifestyle habits in children and young adolescents living in a rural area of Sicily, South Italy

Objective: The study aimed to test the reliability of a nutrition questionnaire and to assess potential associations between nutrition knowledge, food consumption and lifestyle behaviours, controlling for sociodemographic factors. Design: Cross-sectional survey. Setting: Comprehensive school in the municipality of Butera, a rural area of Sicily, South Italy. Subjects: The survey was conducted between March and May 2010 on 445 students (4-16 years). Results: All constructs of the questionnaire had statistically significant Cronbach's alpha and Pearson's correlation coefficients, showing good internal consistency and temporal stability. After controlling for covariates, nutrition knowledge was positively associated with pasta/rice, fish, vegetable and fruit intakes, and negatively with sweets, snacks, fried foods and sugary drinks consumption. Moreover, students whose parents were in the highest educational and occupational categories reported eating significantly more fruits and vegetables and less meat, sweets, snacks, fried foods and sugary drinks. Students with higher nutrition knowledge scores were less likely to have two or more snacks daily and to spend more than 3 h in sedentary activities daily (OR = 0.89, 95% CI 0.83, 0.97 and OR = 0.92, 95% CI 0.86, 0.99, respectively). High parental education was associated with less frequent snacking and more frequent weekly physical activity, compared with lower categories, whereas high parental occupational category was associated with daily breakfast. Conclusions: Improving nutrition knowledge in children and young adolescents may translate into educating them in good dietary habits. Moreover, nutrition intervention programmes should also involve parents to improve dietary quality and nutritional habits of the entire family.