[Geographical distribution characteristics of nutrition knowledge among Chinese school-aged children in 2023 to 2024]

To analyze the geographical distribution characteristics of the nutrition knowledge(NK) level among school-aged children in China.

Data were from the China Nutrition Knowledge Survey among school-aged children from 2023 to 2024. The survey was conducted using a multi-stage stratified cluster random sampling method at 195 survey points, covering all grades from primary to senior high school, with data from 90 240 students in senior primary, junior and senior high school grades ultimately analyzed. After applying complex weighting to the sample, the population's NK level and its geographical disparities were described. The NK scores were described using mean±standard error, and the NK awareness rate was described using rates and 95%CI. Differences in scores across regions were tested using a complex sampling design-based one-way linear regression model, and comparisons of the awareness rates were performed using a design-based Rao-Scott χ~2 test.

Urban children had higher scores(70.4±0.5) and NK awareness rates(n=31 750, 44.0%) than rural children(score: 66.5±0.9, awareness rate 32.4%(n=5667)). The eastern region(71.5±0.8, 47.3%(n=16 823)) also outperformed the central(67.4±0.8, 36.2%(n=10 200)) and western(67.7±0.8, 34.0%(n=10 404)) regions. Among all areas, North China recorded the highest NK level(72.3±0.7, 49.8%(n=5882)), while Northwest region had the lowest(65.1±0.8, 27.0%(n=2784)). All these reigonal differences were statistically significant(P<0.01). Regarding specific knowledge points, the correct rate for identifying a balanced breakfast was the lowest among primary school students across all regions(urban 14.6%, rural 14.5%; eastern 14.6%, central 11.8%, western 17.2%). For junior high school students, knowledge about the expiration date and food safety had the lowest correct rate(urban 18.0%, rural 18.9%; eastern 17.6%, central 17.0%, western 21.0%). For senior high school students, knowledge about the recommended intake of cooking oil had the lowest correct rate in the western region(19.4%), while in other regions, knowledge about expiration date and food safety remained the weakest.

Significant geographical disparities were observed in the NK levels of Chinese school-aged children. Urban children, as well as those from the eastern and northern regions, demonstrated significantly higher NK levels than their rural, central/western, and northwestern counterparts.