title: A study of the dietary intake of Cypriot children and adolescents aged 6-18 years and the association of mother's educational status and children's weight status on adherence to nutritional recommendations.
abstract: BACKGROUND
  A balanced diet is fundamental for healthy growth and development of children. The aim of this study was to document and evaluate the dietary intake of Cypriot children aged 6-18 years (y) against recommendations, and to determine whether maternal education and children's weight status are associated with adherence to recommendations.
  
  
  METHODS
  The dietary intake of a random sample of 1414 Cypriot children was assessed using a 3-day food diary. Adherence to recommendations was estimated and the association of their mother's education and their own weight status on adherence were explored.
  
  
  RESULTS
  A large percentage of children consumed less than the minimum of 45% energy (en) of carbohydrate (18.4%-66.5% in different age groups) and exceeded the recommended intakes of total fat (42.4%-83.8%), saturated fatty acids (90.4%-97.1%) and protein (65.2%-82.7%), while almost all (94.7%-100%) failed to meet the recommended fibre intake. Additionally, a large proportion of children (27.0%-59.0%) consumed >300 mg/day cholesterol and exceeded the upper limit of sodium (47.5%-78.5%). In children aged 9.0-13.9y, there was a high prevalence of inadequacy for magnesium (85.0%-89.9%), in girls aged 14.0-18.9y, of Vitamin A (25.3%), Vitamin B6 (21.0%) and iron (25.3%) and in boys of the same group, of Vitamin A (35.8%). Children whose mother was more educated were more likely to consume >15%en from protein, Odds Ratio (OR) 1.85 (95% CI:1.13-3.03) for mothers with tertiary education and exceed the consumption of 300 mg/day cholesterol (OR 2.13 (95% CI:1.29-3.50) and OR 1.84 (95% CI:1.09-3.09) for mothers with secondary and tertiary education respectively). Children whose mothers were more educated, were less likely to have Vitamin B1 (p<0.05) and Vitamin B6 intakes below the EAR (p < 0.05 for secondary school and p < 0.001 for College/University) and iron intake below the AI (p < 0.001). Overweight/obese children were more likely to consume >15%en protein (OR 1.85 (95% CI:1.26-2.71) and have a < Adequate Intake of calcium (OR 1.85 (95% CI:1.11-3.06)).
  
  
  CONCLUSIONS
  Cypriot children consume a low quality diet. Maternal education and children's own weight status are associated with children's adherence to recommendations. Public health policies need to be evaluated to improve dietary quality and reduce disease burden.
authors.affiliation: Research and Education Institute of Child Health, 138 Limassol Ave, 2015 Strovolos, Cyprus. tor.michael@cytanet.com.cy.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Tornaritis
authors.forename: Elena
authors.initials: E
authors.lastname: Philippou
authors.forename: Charalambos
authors.initials: C
authors.lastname: Hadjigeorgiou
authors.forename: Yiannis A
authors.initials: YA
authors.lastname: Kourides
authors.forename: Adamos
authors.initials: A
authors.lastname: Panayi
authors.forename: Savvas C
authors.initials: SC
authors.lastname: Savva
mesh_terms: D000293:Adolescent; D001835:Body Weight; D002648:Child; D003535:Cyprus; D004032:Diet; D015930:Diet Records; D004522:Educational Status; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D009035:Mothers; D064167:Recommended Dietary Allowances