To increase teenagers’ nutrition knowledge is an important target and has the potential to improve their dietary habits and lifestyle while reducing incidences of obesity-related non-communicable diseases throughout the whole lifespan. This study protocol presents the general approach and details of an assessment of nutritional knowledge, attitudes toward nutrition, diet quality, lifestyle and body composition that have been used to comprehensively evaluate the cross-behavioral patterns covering dietary and lifestyle behaviors in Polish teenagers. The study was designed in two paths as: a cross-sectional study (covering 1569 students) and an education-based intervention study (464 students) with a 9-month follow-up. We describe a short form of the food frequency questionnaire (SF-FFQ4PolishChildren) used to collect data and details of diet-related and lifestyle-related education program, which was developed and implemented by academic researchers involved in the study. We also describe details of the data development and statistical analysis, including multidimensional methods of clustering variables to identify cross-behavioral patterns covering diet and lifestyle. The results of the study will provide evidence-based support for preventive health care to promote normal growth and development of young population and reduce the risk of diet-related diseases in adulthood, by early shaping of adequate dietary and lifestyle behaviors. In the future, well-tailored education programs addressed to teenagers can be created as an important public health action, based on our results.

The aim of the study was to evaluate the reproducibility of the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN) in Polish adolescents and adults, including the assessment of indexes developed based on the questionnaire. In total, the study involved 954 subjects aged 15–65 (53.9% females). Interviews using the interviewer-administered questionnaire (IA-Q) in healthy subjects (n 299) and the self-administered questionnaire (SA-Q) in healthy subjects (n 517) and outpatients (n 138) were conducted and repeated after two weeks. Considering the consumption frequency of 33 food items, the cross-classification (test-retest) agreement of classification into the same category obtained for IA-Q in healthy subjects ranged from 72.2% (fruit juices) to 91.6% (energy drinks); the kappa statistic was >0.60 for all food items. For SA-Q conducted in healthy subjects the cross-classification agreement ranged from 63.8% (vegetable oils, margarines, mixes of butter and margarines) to 84.7% (lard); the kappa statistic was >0.50 for all food items. For SA-Q in outpatients, the cross-classification agreement ranged from 42.0% (both fruit juices and white rice, white pasta, fine-ground groats) to 92.0% (energy drinks); the kappa statistic was ≥0.40 for 20/33 food items. The kappa statistic for lifestyle items ranged 0.42–0.96, and for the nutrition knowledge level it ranged 0.46–0.73. The questionnaire showed moderate to very good reproducibility and can be recommended to assess dietary habits, lifestyle and nutrition knowledge of healthy adolescents and adults and those suffering from chronic diseases, after validation and/or calibration study is carried out. The reproducibility of the interviewer-administered questionnaire was better than its self-administered version. The reproducibility of the self-administered questionnaire was better in healthy subjects than in outpatients.

The food frequency questionnaire (FFQ) and the food record (FR) are among the most common methods used in dietary research. It is important to know that is it possible to use both methods simultaneously in dietary assessment and prepare a single, comprehensive interpretation. The aim of this study was to compare the energy and nutritional value of diets, determined by the FFQ and by the three-day food records of young women. The study involved 84 female students aged 21–26 years (mean of 22.2 ± 0.8 years). Completing the FFQ was preceded by obtaining unweighted food records covering three consecutive days. Energy and nutritional value of diets was assessed for both methods (FFQ-crude, FR-crude). Data obtained for FFQ-crude were adjusted with beta-coefficient equaling 0.5915 (FFQ-adjusted) and regression analysis (FFQ-regressive). The FFQ-adjusted was calculated as FR-crude/FFQ-crude ratio of mean daily energy intake. FFQ-regressive was calculated for energy and each nutrient separately using regression equation, including FFQ-crude and FR-crude as covariates. For FR-crude and FFQ-crude the energy value of diets was standardized to 2000 kcal (FR-standardized, FFQ-standardized). Methods of statistical comparison included a dependent samples t-test, a chi-square test, and the Bland-Altman method. The mean energy intake in FFQ-crude was significantly higher than FR-crude (2740.5 kcal vs. 1621.0 kcal, respectively). For FR-standardized and FFQ-standardized, significance differences were found in the mean intake of 18 out of 31 nutrients, for FR-crude and FFQ-adjusted in 13 out of 31 nutrients and FR-crude and FFQ-regressive in 11 out of 31 nutrients. The Bland-Altman method showed an overestimation of energy and nutrient intake by FFQ-crude in comparison to FR-crude, e.g., total protein was overestimated by 34.7 g/day (95% Confidence Interval, CI: −29.6, 99.0 g/day) and fat by 48.6 g/day (95% CI: −36.4, 133.6 g/day). After regressive transformation of FFQ, the absolute difference between FFQ-regressive and FR-crude equaled 0.0 g/day and 95% CI were much better (e.g., for total protein 95% CI: −32.7, 32.7 g/day, for fat 95% CI: −49.6, 49.6 g/day). In conclusion, differences in nutritional value of diets resulted from overestimating energy intake by the FFQ in comparison to the three-day unweighted food records. Adjustment of energy and nutrient intake applied for the FFQ using various methods, particularly regression equations, significantly improved the agreement between results obtained by both methods and dietary assessment. To obtain the most accurate results in future studies using this FFQ, energy and nutrient intake should be adjusted by the regression equations presented in this paper.

BackgroundSimilar to other countries, trends of decreasing levels of physical activity (PA) and an increasing prevalence of unhealthy dietary patterns are observed among girls in Poland. Better understanding of potentially inter-related behaviours within this population can help to design tailored interventions. The purpose of this study was to determine associations between PA patterns and dietary patterns in a representative sample of Polish girls.MethodsGirls aged 13-21 years (n = 1107) were randomly selected for the study. PA was assessed using International Physical Activity Questionnaire – Long (IPAQ-L). Dietary data were collected with food frequency questionnaires. PA patterns and dietary patterns were drawn separately by Principal Component Analysis (PCA). Logistic regression was used to find the associations between PA patterns and dietary patterns.ResultsFour major PA patterns (‘School/work activity’, ‘Active recreation’, ‘Yard activity’ and ‘Walking and domestic activity’) and four dietary patterns (‘Traditional Polish’, ‘Fruit & vegetables’, ‘Fast food & sweets’ and ‘Dairy & fats’) were identified. Level of PA was the highest in the upper tertile of ‘School/work activity’ pattern (mean 1372.2 MET-minutes/week, 95 % Confidence Intervals [CI]: 1285.9–1458.5). Girls in upper tertiles of ‘Yard activity’, ‘Active recreation’ and ‘School/work activity’ patterns had significantly higher chances of being in the upper tertile of the ‘Fruit and vegetables’ dietary pattern (odds ratio [OR] 2.17, 95 % CI: 1.50–3.14, p < 0.0001; OR 2.02, 95 % CI: 1.41–2.91; p < 0.001 and OR 1.76, 95 % CI: 1.24–2.51, p < 0.01 respectively; all adjusted for confounders) in comparison to bottom tertiles. Weak, but significant inverse associations were found between upper tertiles of ‘Active recreation’ and ‘Yard activity’ patterns and unhealthy dietary patterns.ConclusionsWe found associations between PA patterns and dietary patterns in the population of Polish girls. Girls with the highest adherence to the ‘School/work activity’ pattern had the highest levels of PA and presented pro-healthy dietary behaviours. School should be recognised as potentially efficient and important setting to maximise girls' PA potential. The after-school time is the area that should also be targeted to increase daily PA or to at least sustain the level of PA after completing education.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3367-4) contains supplementary material, which is available to authorized users.

A holistic approach to understanding the relationship between diet, lifestyle and obesity is a better approach than studying single factors. This study presents the clustering of dietary and lifestyle behaviours to determine the association of these dietary-lifestyle patterns (DLPs) with adiposity, nutrition knowledge, gender and sociodemographic factors in teenagers. The research was designed as a cross-sectional study with convenience sampling. The sample consisted of 1549 Polish students aged 11–13 years. DLPs were identified with cluster analysis. Logistic regression modelling with adjustment for confounders was applied. Three dietary-lifestyle patterns were identified: Prudent-Active (29.3% of the sample), Fast-food-Sedentary (13.8%) and notPrudent-notFast-food-lowActive (56.9%). Adherence to Prudent-Active pattern (reference: notPrudent-notFast-food-lowActive) was 29% or 49% lower in 12-year-old or 13-year-old teenagers than in 11-year-old teenagers, respectively, and higher by 57% or 2.4 times in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score. To the contrary, adherence to Fast-food-Sedentary (reference: notPrudent-notFast-food-lowActive) was lower by 41% or 58% in the middle or the upper tertile than the bottom tertile of the nutrition knowledge score, respectively. In Prudent-Active, the chance of central obesity (waist-to-height ratio ≥0.5) was lower by 47% and overweight/obesity was lower by 38% or 33% (depending on which standard was used: International Obesity Task Force, 2012: BMI (body mass index)-for-age ≥ 25 kg/m2 or Polish standards, 2010: BMI-for-age ≥ 85th percentile) when compared with the notPrudent-notFast-food-lowActive pattern. In Fast-food-Sedentary, the chance of central obesity was 2.22 times higher than the Prudent-Active pattern. The study identified a set of characteristics that decreased the risk of general and central adiposity in teenagers, which includes health-promoting behaviours related to food, meal consumption and lifestyle. Avoiding high-energy dense foods is insufficient to prevent obesity, if physical activity and the consumption frequency of health-promoting foods are low and breakfast and a school meal are frequently skipped. The results highlight the importance of the nutrition knowledge of teenagers in shaping their health-promoting dietary habits and active lifestyle to decrease adiposity risk and negative aspects of lower family affluence which promotes unhealthy behaviours, both related to diet and lifestyle.

The aim of this study was to evaluate the test–retest reproducibility of a non-quantitative food frequency questionnaire (acronym: 62-item FFQ-6) and the possibility of identifying dietary patterns (DPs) in 13–21-year-old females. The study involved 97 females within three age groups: 13–15, 16–18, and 19–21 years, including 31, 38, and 28 subjects, respectively. The questionnaire was completed twice with a two-week interval (test and retest). For the total sample, using a principal component analysis (PCA), two similar PCA-driven DPs (DP1 and DP2) were identified separately from test data and retest data, considering two sets of input variables. 60-item-DP1 and 60-item-DP2 were identified after excluding two items—vegetables and fruits in general—due to including single items of various kinds of vegetables and fruits. After an aggregation of some items of the questionnaire, 25-item-DP1 and 25-item-DP2 were identified. The kappa statistic (test vs. retest) in the total sample averaged at 0.52 (0.32–0.72 for food items), while within age groups, it averaged at 0.41, 0.53, and 0.65, respectively. The percentage of subjects classified into the same food frequency category (test vs. retest) in the total sample averaged at 68% (51%–89% for food items), while within age groups, it averaged at 60%, 68%, and 77%, respectively. The Spearman correlations between dietary pattern scores (test vs. retest) in the total sample were: 0.84 (within age groups 0.83, 0.81, and 0.78, respectively) for 60-item-DP1, 0.68 (within age groups 0.24, 0.79, and 0.76, respectively) for 60-item-DP2, 0.76 (within age groups 0.56, 0.82, and 0.89, respectively) for 25-item-DP1, and 0.48 (within age groups 0.40, 0.57, and 0.53, respectively) for 25-item-DP2 (p < 0.05 for all). In conclusion, the test–retest reproducibility of the 62-item FFQ-6 was good or very good for most food items, with a tendency to be higher in older age groups of females under study. Due to the acceptable-to-good reproducibility of dietary pattern identification, the use of a 62-item FFQ-6 to describe the overall diet of young Polish females can be recommended.

The sustainability of education focused on improving the dietary and lifestyle behaviours of teenagers has not been extensively studied. The aim of this study was to determine the sustainability of diet-related and lifestyle-related school-based education on sedentary and active lifestyle, diet quality and body composition of Polish pre-teenagers in a medium-term follow-up study. An education-based intervention study was carried out on 464 students aged 11–12 years (educated/control group: 319/145). Anthropometric measurements were taken and body mass index (BMI) and waist-to-height ratios (WHtR) were calculated, both at the baseline and after nine months. Dietary data from a short-form food frequency questionnaire (SF-FFQ4PolishChildren) were collected. Two measures of lifestyle (screen time, physical activity) and two diet quality scores (pro-healthy, pHDI, and non-healthy, nHDI) were established. After nine months, in the educated group (vs. control) a significantly higher increase was found in nutrition knowledge score (mean difference of the change: 1.8 points) with a significantly higher decrease in physical activity (mean difference of the change: −0.20 points), nHDI (−2.3% points), the z-WHtR (−0.18 SD), and the z-waist circumference (−0.13 SD). Logistic regression modelling with an adjustment for confounders revealed that after nine months in the educated group (referent: control), the chance of adherence to a nutrition knowledge score of at least the median was over 2 times higher, and that of the nHDI category of at least the median was significantly lower (by 35%). In conclusion, diet-related and lifestyle-related school-based education from an almost one-year perspective can reduce central adiposity in pre-teenagers, despite a decrease in physical activity and the tendency to increase screen time. Central adiposity reduction can be attributed to the improvement of nutrition knowledge in pre-teenagers subjected to the provided education and to stopping the increase in unhealthy dietary habits.

Purpose The purpose of this paper is to assess the reliability of a Portuguese version of the cooking skills scale (CSS) and to evaluate the association between cooking skills and socio-demographic, psychological and other cooking-related variables. Design/methodology/approach The study was conducted as an online survey among 730 Portuguese university students. Translation and back-translation of the CSS were performed. Data were assessed in two stages (test and retest) and the psychometric properties of the CSS were analyzed. The effect of socio-demographic variables was assessed by binary logistic regression analysis. The odds ratios for upper tertile of the CSS score were calculated using the lower tertile as reference. Findings Cronbach’s α for the CSS was 0.90. In the analysis of test-retest reliability, Spearman’s rank correlation coefficient was 0.79 and Cohen’s κ (for tertiles) was 0.49. Cooking skills were higher in respondents cooking more often, feeling more confident, enjoying more and indicating the personal interest as the main motivation to learn how to cook. Cooking skills were significantly better in females, older students and those with more independent place of residence. Originality/value Very good psychometric properties of the Portuguese version of the CSS were found among university students, providing a proper and simple tool to measure cooking skills in future studies with similar populations. The interventions encouraging to acquire and improve cooking skills as part of promoting healthy eating should be targeted especially toward men and young adults.