Objective To investigate the dietary behavior and impact factors among students in primary and secondary schools in Minhang District of Shanghai in order to develop nutritional interventions and improve students' nutritional status.
Methods A cluster random sampling approach was performed to identify 5 581 students from grades 3 to 12 and 5 581 parents. Information on the students' eating behaviors(including breakfast, lunch, snacks, fast food, and monophagia)and their parents' characteristics(including educational level, nutritional awareness, and family income)were collected by a set of self-designed questionnaires. Unconditional logistic regression was used to analyze the main factors affecting the students' dietary behaviors.
Results The primary and secondary school students who reported eating breakfast everyday accounted for 79.0%, and 79.4% of the breakfast were at a low nutritional quality level. Up to 51.9% students did not like school lunches because the meals were not tasty. Most students reported frequent consumptions of snacks(97.6%)and beverages(95.4%), respectively. Only 45.9% of students reported drinking milk every day; 62.7% students consumed Western style fast food in the past month and 45.5% ate Chinese style fast food in the past week. The rate of monophagia in selected students was 33.2%. The results of multivariate analysis showed maternal education level and parents' nutritional awareness were associated with their children's behaviors of eating breakfast every day, high nutritional quality of breakfast, and drinking milk every day(P<0.01 or P<0.05); family income was associated with drinking milk everyday and eating Western style fast food(P<0.01); school age was associated with eating breakfast every day, drinking milk every day, monophagia, and eating Western style fast food(P<0.01). Gender was related to drinking milk every day, eating Western style fast food and Chinese style fast food(P<0.01 or P<0.05).
Conclusion The current students' breakfast consumption rate and breakfast nutritional quality are far from satisfaction, school lunches are at a low nutritional quality level, and unhealthy dietary behaviors are more than common. Thus, schools, families, and the whole society should pay attention to these problems. Family income is an important impact factor of various students' dietary behaviors.
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