title: Nutritional surveillance in Tuscany: eating habits at breakfast, mid-morning and afternoon snacks among 8-9 y-old children.
abstract: BACKGROUND
  The prevalence of overweight and obesity in children is rapidly increasing in many countries. For that it has been interesting to investigate the eating habits of 8-9 y-old Tuscany children by paying attention to their meals frequency per day and their food choices in total and in relation to children's Body Mass Index (BMI) classes. In addition we considered some environment factors that could affect the children eating behaviours, such as mother's BMI and their education level.
  
  
  METHODS
  A statistical sample of 3076 (1583 males, 1493 females), 8-9 year-old school-children was collected; weight and height were measured using standardized personnel and instruments. BMI classes were calculated using Cole et al.'s cutoff for children and adolescents. In order to evaluate the consumption frequency of individual meals and various foods, a Food Frequency Questionnaire (FFQ) was used, which was completed by the children themselves at school. A self-administered questionnaire revealed the weight and height of parents and their educational levels. Three educational levels were established: high, medium and low.
  
  
  RESULTS
  The results showed that 92.3% of children ate breakfast from 4-7 times a week, the vast majority at home, while only 3% declared consuming breakfast never or almost never The most preferred breakfast consisted of milk and biscuits for all children's BMI classes. 95.9% of children reported having midmorning snack at school; fruit juice and tea are the most frequently consumed liquid foods, and pizza, salami sandwiches and pre-packaged snacks are the most frequently consumed solid foods in all BMI classes. 93.6% ate afternoon snack for the most part at home, even if 12% of children reported consuming it elsewhere; fruit juice and tea with pizza, sandwiches and pre-packaged snacks are still the most highly consumed foods by all children's BMI classes. The consumption frequency of breakfast (P < 0.001), mid-morning (P < 0.05) and afternoon snack (P < 0.05) of 8-9 y-old Tuscany children decrease with increase the children's BMI classes. The same tendency may be noted for the consumption frequency of breakfast in relation to mother's BMI (P < 0.05) and their education level (P < 0.05). This data strengthens the thesis that some home environments can affect the children's eating behaviours.
  
  
  CONCLUSIONS
  No substantial differences in food choices at the meals analyzed were determined among normal weight, overweight and obese children. Children of normal weight had a greater tendency to consume meals more regularly. Mother's BMI and their education level can have influence on children's eating behaviours.
authors.affiliation: Center of Research for Health Education and Promotion, University of Siena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Lazzeri
authors.forename: D
authors.initials: D
authors.lastname: Giallombardo
authors.forename: C
authors.initials: C
authors.lastname: Guidoni
authors.forename: A
authors.initials: A
authors.lastname: Zani
authors.forename: A
authors.initials: A
authors.lastname: Casorelli
authors.forename: A
authors.initials: A
authors.lastname: Grasso
authors.forename: T
authors.initials: T
authors.lastname: Pozzi
authors.forename: S
authors.initials: S
authors.lastname: Rossi
authors.forename: M
authors.initials: M
authors.lastname: Giacchi
mesh_terms: D015992:Body Mass Index; D002648:Child; D004034:Diet Surveys; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009035:Mothers / Q000193:education; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight; D015995:Prevalence; D011795:Surveys and Questionnaires; D013851:Thinness; D013997:Time Factors