Adherence to the "10 steps to a healthy diet for children" and associated factors in schoolchildren

Objective To assess the frequency of adherence to the "10 Steps to Healthy Eating for Children" and associated factors in schoolchildren. Methods The present study had a cross-sectional design and was conducted on 813 first grade students from elementary public schools in Sao Leopoldo (RS). Data were obtained using a questionnaire completed by mothers/guardians. It consisted of questions about food, physical activity, screen time, and socio-demographic characteristics. The criterion of adherence to every step was defined by the researchers. Pearson's chi-square and linear trends were used to evaluate the factors associated with the frequency of adherence to each step of the recommendations investigated. Results The average number of steps of the "Healthy Eating for Children" recommendations actually followed was 4.9, and none of the students followed all of the steps. Step 4 (consumption of the beans and rice at least five times/week) showed higher compliance (99.8%), and those involving restrictive measures, such as avoiding fatty foods and fried foods (Step 6) and sweets, soft drinks, and sugar-sweetened beverages (Step 7), showed the least compliance, respectively, 2.1 and 0.0%. Step 10 (be active and have screen time <= 2 hours/day) also showed low compliance (14.5%). Respondents' (mothers/guardians) higher level of education and higher economic level were positively associated with Step 5 (daily consumption of milk and meat groups). The opposite was observed for Step 2 (daily consumption of cereals, stem tubers, tuberous roots) and for Step 10 (mentioned above). Conclusion This study revealed an unfavorable scenario for the population investigated, which indicates the need for actions by different actors (government, school, family, and fruit, nut, cereal, grain, and vegetable growers), in order to increase the frequency of adherence to the 10 Steps by young students.