[Dietary recommendation-related knowledge level of Chinese school-aged children in 2023 to 2024]

To analyze the knowledge level and influencing factors related to dietary recommendations for Chinese school-aged children in 2023 to 2024.

A multi-stage cluster random sampling was used to select 195 survey sites across the country, there were 126 802 children surveyed, with 90 240 children in upper elementary, middle and high school included in the analysis. The "Nutrition and Health Knowledge Questionnaire for School-Aged Children in China" comprises five dimension, scored out of 100 points; dietary recommendation-related knowledge was scored out of 28 points, and a score of 21 points or above was judged as acquiring relevant knowledge. Univariate and multi-variate Logistic regression models were used to analyze the factors influencing relevant knowledge level.

The average score of dietary recommendation-related knowledge was 16.7±5.1, and the knowledge awareness rate was 22.5%. In elementary, middle and high schools, the correct rates of food groups in each level of the Dietary Pagoda(upper elementary grades: 38.0%-69.1%; middle school: 33.3%-63.7%; high school: 28.3%-59.9%) and nutritional breakfast combinations(upper elementary grades: 14.6%; middle school: 40.7%; high school: 43.7%) were low; in middle and high schools, the recommended daily intake of oil(middle school: 22.9%; high school: 20.8%), salt(middle school: 33.8%; high school: 34.1%) and sugar(middle school: 35.1%; high school: 39.7%) per person was also low. Multivariate analysis revealed that the knowledge of dietary recommendations was lower among children in rural(OR_(upper elementary)=0.683, OR_(middle school)=0.923, OR_(high school)=0.830), central(OR_(upper elementary)=0.645, OR_(middle school)=0.573, OR_(high school)=0.487) and western(OR_(upper elementary)=0.586, OR_(middle school)=0.480, OR_(high school)=0.444) areas compared to the counterparts; female(OR_(upper elementary)=1.226, OR_(middle school)=1.197, OR_(high school)=1.123) had a higher awareness rate compared to male. The awareness rate is higher among day students compared to boarders in elementary and middle schools(OR_(upper elementary)=1.485, OR_(middle school)=1.081); while the rate was lower among day students in high schools(OR=0.932). The awareness rate of children increased with mother's literacy, and the trend was statistically significant(P<0.001).

The level of knowledge related to the dietary recommendations for Chinese school-aged children in 2023-2024 was low, especially in terms of the foods at each level of the Dietary Pagoda, breakfast combinations, and the recommended intake of oil, salt, and sugar, and the knowledge level of children in rural, central and western areas, and those whose mothers are less literate is even lower.