DIETARY PATTERNS AND IMPACT OF A NUTRITION EDUCATION INTERVENTION ON DIETARY BEHAVIORS OF MIDDLE SCHOOL STUDENTS FROM MILAN AND ITS PROVINCE: THE 'PROJECT ALIMENTAZIONE'

Childhood obesity prevalence has been rising worldwide in the last few decades generating concerns about future public health in most developed countries. Latest children and adolescents dietary patterns changes in Southern European countries show that healthy Mediterranean lifestyles are being abandoned, especially by young adolescents. The purpose of the study was two-fold: (1) to investigate the dietary patterns of first and second year middle school students within Milan and its province, (2) to evaluate the impact of the "Project AlimentAzione" nutrition education intervention on dietary behaviors in the intervention group compared to the control group. The “Project AlimentAzione” nutrition education intervention was a large study involving 5 middle schools and 5 to 7 classes in each school, resulting in 29 classes and 644 students. Daily student food and drink frequency was assessed through a 7- Day Food Record (7-DFR). To investigate the dietary patterns at baseline in the whole sample, intake frequencies by day and by meal episode were analyzed. The intervention consisted of three 2-hour workshops at school that addressed the following: (1) Bread and grains; (2) Fruit and vegetables; (3) Balancing energy intake and energy expenditure through a healthy diet. To study the impact of the nutrition education intervention, daily student food and drink frequency was assessed in the intervention group compared to the control group at school at three time points: Baseline (November 2008), Post-Intervention Assessment (March 2009) and Follow-up (November 2009). Foods and drinks intake frequency by day at baseline showed that the intake of Grains, grain products and substitutes, Fruit and vegetables, Fish, Legumes, Wholegrain and Water were lower than the recommended intakes for this age population and that the intake of Meat (especially Red meat and Preserved meat products), Sweets products and substitutes (especially Other packaged snacks) and Other beverages (especially Soft drink) were higher than maximum recommended amounts for this age population. The “Project AlimentAzione” nutrition intervention increased children’s intakes of the categories of Fruit and vegetables, and Grains, grain products and tubers; and the individual items of Fish and Water. At follow-up, the results were less definitive: the individual items of Sandwiches, White meat, and Chocolate. This study investigated the dietary patterns of middle school students highlighting the different importance of meal and snacking patterns in middle school students and addressing future intervention strategies. Furthermore, the evaluation of the impact of the “Project AlimentAzione” nutrition education intervention showed its effectiveness in the promotion of healthier dietary behaviors among middle school students from Milan and its province. Future interventions among this age population can take advantage from these findings in the design and the implementation of this complex preventive strategy.